Tuesday, September 27, 2011

[sehat] Digest Number 16125

Milis SEHAT Group

Messages In This Digest (25 Messages)

1a.
Re: KB utk pria From: astrid_proborini@yahoo.com
1b.
Re: KB utk pria From: handa yani
1c.
Re: KB utk pria From: Ade Novita Juliano
2a.
Help! Bingung anak sakit apa? From: gracelynevalenvya@yahoo.com
2b.
Re: Help! Bingung anak sakit apa? From: Endah
2c.
Re: Help! Bingung anak sakit apa? From: Hilda
3.1.
Re: [NEWS] Ketika Caesar Jadi Pilihan From: yovers@yahoo.com
3.2.
Re: [NEWS] Ketika Caesar Jadi Pilihan From: Qiqie Mama Nayla
4a.
Re: Sakit mata umur 5 tahun From: yuli1307@yahoo.com
5a.
Re: (TANYA): BB&PB bayi cenderung menurun?? From: majid.zikra@gmail.com
6a.
Re: please really need advice - tanya dokter RUM di solo/jogja??? From: navi_yarsiska
7.
(no subject) From: Nova Rini
8a.
(Sehat) (Tanya) konstipasi, dikasih apa ya ? From: Nova Rini
8b.
Re: (Sehat) (Tanya) konstipasi, dikasih apa ya ? From: Hilda
8c.
Re: (Sehat) (Tanya) konstipasi, dikasih apa ya ? From: F.B.Monika
8d.
Re: (Sehat) (Tanya) konstipasi, dikasih apa ya ? From: Ade Novita Juliano
8e.
Re: (Sehat) (Tanya) konstipasi, dikasih apa ya ? From: Nova Rini
9a.
Mohon saran, anakku demam From: Levina - Feiv's Mom
9b.
Mohon saran, anakku demam From: Levina - Feiv's Mom
9c.
Re: Mohon saran, anakku demam From: F.B.Monika
9d.
Re: Mohon saran, anakku demam From: Ade Novita Juliano
9e.
Re: Mohon saran, anakku demam From: 'Ita' Elisabeth Dianita
10.
Fwd: When Your Therapist Is Only a Click Away From: Billy N.
11a.
Re: REPOST: Fw: tanya polynel From: F.B.Monika
12.
(Tanya) lanjutan - guyur air langsung ke kepala bisa bikin stroke?? From: lilis nurindah sari

Messages

1a.

Re: KB utk pria

Posted by: "astrid_proborini@yahoo.com" astrid_proborini@yahoo.com   astrid_proborini

Mon Sep 26, 2011 8:50 am (PDT)



@dr.anto
Wah,bgtu ya dok.
Brati msh lama dong ya :(

~ Astrid ~
mamanya Icha (5y6m) & Gavin (1d to 1year).

1b.

Re: KB utk pria

Posted by: "handa yani" handayani97@yahoo.com

Mon Sep 26, 2011 2:32 pm (PDT)



dear all

info terbaru yang saya dapatkan dari dosen di Universitas Indonesia
gandarusa (penelitian mulai tahun 1979 oleh Unair) sudah masuk tahap klinis fase 2
semoga ada database penelitian sehingga mempercepat proses saintifikasi jamu
*Indonesia mempunyai lebih dari 30.000 tanaman dan 7000 diantaranya mempunyai efek dan jamu menjadi tuan di negeri sendiri
semoga ........

salam,
Hani

[Non-text portions of this message have been removed]

1c.

Re: KB utk pria

Posted by: "Ade Novita Juliano" ade.novita.juliano@gmail.com   novita_ade

Mon Sep 26, 2011 3:53 pm (PDT)



Dear All

Metode KB beragam ya.. silahkan pilih yang disepakati suami dan isteri

mengenai pengaruhnya kepada ASI, untuk kandungan tidak ada pengaruh

untuk kuantitas atau jumlah atau volume yang dihasilkan tetap tidak pengaruh
atau bisa disiasati

karena harus diingat, ASI dihasilkan oleh 2 aktor penting yaitu Ibu yang
hatinya damai, tidak dalam tekanan, tidak dikejar target, meyakini dirinya
mampu
serta bayi yang menghisap dengan optimal dalam artian caranya tepat, latch
on nya tepat

dan susui lebih sering, makin sering ASI disusui atau diperah makin banyak
ASI yang dihasilkan

salam,
@Ade_Novita

[Non-text portions of this message have been removed]

2a.

Help! Bingung anak sakit apa?

Posted by: "gracelynevalenvya@yahoo.com" gracelynevalenvya@yahoo.com   gracelynevalenvya

Mon Sep 26, 2011 9:11 am (PDT)



Dear Docs and SPs,

3 minggu yg lalu Gavriel batuk batuk berdahak, tidak nafsu makan, waktu itu juga tumbuh gigi. Seminggu yg lalu kita liburan, selama liburan gavriel rewel, ga nafsu makan,nafas dan mulutnya bau dan nangis tiap kali mandi. Pernah suatu kali sedang minum susu, ada cairan seperti darah keruh disekitar mulut, kita ga terlalu mikirin waktu itu, jumat malam saya sempat melihat ada bercak darah di telinga sebelah kiri, saya pikir kena garuk, lecet, sabtu pagi, telinganya penuh dengan darah kering, langsung saya bawa ke THT, kata dokternya kok sudah parah baru kesini, kena gendangnya lo katanya, saya tanya bahaya tidak, dia bilang mesti di evaluasi. Dan di resepkan Ryzen, Kenacort, Epexol, Equal, H2O2 3%, Otopain Ear Drops, Abbotic . Diagnosanya Otitis Media. Nah kita pikir uda sembuh, barusan jam 9 malam td, waktu sedang minum susu, keluar darah lagi disekitar mulut. Mohon pencerahannya. Ada yg tau ga ya apa yg terjadi. Terimakasih



Salam,

Sansan yg sedang kebingungan
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2b.

Re: Help! Bingung anak sakit apa?

Posted by: "Endah" endahgunawan@ymail.com

Mon Sep 26, 2011 4:37 pm (PDT)



Otitis media akut, tdk butuh kenacort, ryzen, epexol, apalagi sampai dipuyer begitu. Kalaupun OMA, cuma butuh antibiotik, itu pun amoksisilin saja cukup, tdk perlu yg mahal spt abbotic. Silakan digoogling kandungan masing2 obat tadi dan cari indikasi serta kontraindikasi. Anaknya mengeluh sakit telinga kah?

Darah sekitar mulut, ada mimisan kah? Ada gusinya yg bengkak dan berdarah?

Endah

2c.

Re: Help! Bingung anak sakit apa?

Posted by: "Hilda" hilda.iriany@gmail.com   h_iriany

Mon Sep 26, 2011 4:43 pm (PDT)




Hilda

-----Original Message-----
From: "Endah" <endahgunawan@ymail.com>
Sender: sehat@yahoogroups.com
Date: Mon, 26 Sep 2011 23:37:24
To: <sehat@yahoogroups.com>
Reply-To: sehat@yahoogroups.com
Subject: Re: [sehat] Help! Bingung anak sakit apa?

Otitis media akut, tdk butuh kenacort, ryzen, epexol, apalagi sampai dipuyer begitu. Kalaupun OMA, cuma butuh antibiotik, itu pun amoksisilin saja cukup, tdk perlu yg mahal spt abbotic. Silakan digoogling kandungan masing2 obat tadi dan cari indikasi serta kontraindikasi. Anaknya mengeluh sakit telinga kah?

Darah sekitar mulut, ada mimisan kah? Ada gusinya yg bengkak dan berdarah?

Endah

[Non-text portions of this message have been removed]

3.1.

Re: [NEWS] Ketika Caesar Jadi Pilihan

Posted by: "yovers@yahoo.com" yovers@yahoo.com   yovers

Mon Sep 26, 2011 9:14 am (PDT)



Betul mba elona,aq setuju.
Pgn sharing sdkt ah.....aq ngelahirin Nabila 2thn lalu,krn ketubanqu berkurang(aq ga rembes di cd n bbqu turun 2kg,kt dsogqu bs lewat bak).
Akhnya,aq diinduksi hbs jum'atan via 1/4tablet sampai jam 7mlm baru aq mules2/kontraksi yg sgt aduhai rasanya :) udh pembukaan 2,dikasih 1/4 tablet lg.akhnya Nabila alhamdulillah lahir jam 23.20 via waterbirth n bs IMD.


Salam asi,
Sofie ibunya Nabila ( 25bln )
Sent from my BlackBerry® smartphone from Sinyal Bagus XL, Nyambung Teruuusss...!
3.2.

Re: [NEWS] Ketika Caesar Jadi Pilihan

Posted by: "Qiqie Mama Nayla" deswita.nashwa@gmail.com   rizkie3

Mon Sep 26, 2011 11:39 am (PDT)



Ikutan sharing ya..

Kalau saya sejak hamil anak pertama sudah "divonis" hipertiroid, yang
mana baru ketahuan saat usia kandungan 7bulan.. 2 bulan rutin ke
internis dan minum obat tapi ternyata menjelang HPL cek darah masih
tinggi T3 dan T4nya dan saya harus SC.. Selang 4,5 tahun tiroidnya
masih tinggi walau sudah tidak setinggi waktu hamil sebelumnya tapi
teteeeep harus SC lagi..

Sekarang hamil ke-3 T3 dan T4nya masih diatas normal walaupun dari
gejala klinis dinyatakan hipertiroid saya tidak bermasalah jika harus
normal, plus sharing salah satu SP yang bisa VBAC setelah 2x SC..
walaupun sempet senang (mengingat biaya SC yang lumayan ;p dan ga
ditanggung kantor ataupun asuransi) ternyata DSOG bilang ga bisa
normal, karena alasan lainnya jarak lahir sebelumnya belum 2 tahun..
itupun tetap harus dipantau ke internis terus.. sempet kecewa juga
tapi toh normal ataupun SC sama saja.. sama2 9bulan ada di rahim
saya.. bedanya cost yang dikeluarkan lebih besar, hehe..

dari SC2 sebelumnya ga pernah tuh 2 jam setelah operasi bisa jalan2..
malah 6jam harus observasi terus.. bisa jalan atau dipaksa jalan yaa
setelah lepas kateter atau 24 jam kemudian.. lagian saya tipe yang ga
bisa sehari aja ga BAB ;p penyembuhannya beda antara SC pertama dan
ke-2.. ada yang sakitnya masih di RS ada yang sakitnya waktu udah
pulang ke rumah.. tapi 2-2 setelah 1tahun SC saya sudah bisa naik
gunung ataupun climbing ;p

salam,
qiqie
*34w pregnancy.. masih belum memutuskan pilih tanggal berapa

4a.

Re: Sakit mata umur 5 tahun

Posted by: "yuli1307@yahoo.com" yuli1307@yahoo.com

Mon Sep 26, 2011 9:57 am (PDT)



Terimakasih mba chitra mba dita..
Saya akan lakukan besok pagi HT nya..

Nanya lagi.. Untuk sementara apakah harus dipisahkan dng adik2nya? Takut aja menular

Link nya nanti kubaca dulu yaa

-̶̶•-̶̶•̸Ϟ•̸Thank You•̸Ϟ•̸-̶̶•-̶ ™
♡̬̩̃ Yuli bunda Davina Devaney Diva ♡̬̩̃

Mon, Sep 26, 2011 | 23:35:40
I'm Strong in my Weakness. I'm Happy in my Pain
Powered by DakotaBerry®
5a.

Re: (TANYA): BB&PB bayi cenderung menurun??

Posted by: "majid.zikra@gmail.com" majid.zikra@gmail.com   deedee_ntu

Mon Sep 26, 2011 10:30 am (PDT)



Mba cy,

Makasi ya utk sharingnya, Fayda (7bln) dah sebulan ini bb nya malah ga naik. Bener ya faktor makanan ibu mmg pengaruh bgt...pas puasa aku ckp disiplin mkn bnyk dgn nutrisi bgs (bnyk protein hewani, bnyk sayur buah, kurma) pas sahur & buka, tgh2 bln puasa aku nimbang Fayda kenaikan bb ttp bagus (400gr dlm 3mg utk baby umur 6bln lmyn kan ya?).
Setelah bln puasa makan malah ngasal walau ttp 3x sehari. Selain itu Fayda jg smpt cc & mmg geraknya tbh bnyk bgt. Jd bb ga naik slm 1bln an ini:(

Yg pgn kutanyain..gpp ya tiap hari makan telur 2btr?heheeh kalau ndak salah pernah bc dimana ya..konsumsi maks telur 4btr per minggu?
Trus pengganti pepaya & turunannya apa ya mba? Di tempatku ga ada..sayurnya standar aja wortel, kentang, labu gitu.


-dianti-





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6a.

Re: please really need advice - tanya dokter RUM di solo/jogja???

Posted by: "navi_yarsiska" mom_akeela@yahoo.com   navi_yarsiska

Mon Sep 26, 2011 11:02 am (PDT)




terimakasiih banyak bunda nia,wulan,erika dan bunda dian.. sy dr awal dah sangsi dgn obat2 ini..tapi ayahnya akeela percaya sm dokter ini.. dah 2x sy berobat ke beliau dan selalu banyak terapi obat.. beliau padahal DSA senior di RS terkemuka di Solo, bahkan beliau aktif di WHO..hmmm bener2 butuh info dokter pro RUM di Solo/Jogja.. please tlg bantu klo ada yg tau..

Pak Pria Ardhana.. DSA yg saya sebutkan itu salah satu DSA senior di salah satu RS yg telah disebutkan.. nah.. bisa tolong bantu.. dimana ya dokter pro RUM di Solo???

makasiiiih

--- In sehat@yahoogroups.com, pria ardhana <priaardhana@...> wrote:
>
> Coba ke RS-RS besar di Solo, Bu. Moewardi, Yarsis, PKU, Oen.
>
> Salam,
> Ardhana
>
> On Sun, 25 Sep 2011 03:20 ICT Navi Yarsiska wrote:
>
> >dear sp's n docs.. akeela (11m) py bakat alergi yg cukup tinggi..sampe skrng perjalanan alerginya udah pernah DA,rhinitis sampe asma bronkiale.. udah 2x batuk sampe dinebu karena lendir masuk ke bronkus.. ini batuk yg ke 2 pita suaranya kena..jadi sempet serak keilangan suara.. diberi resep AB dari amox 3hr sekarang tambah streptomisin 3hr plus obat puyer.. pleaseeeee really need advice.. bisa ga bayi dgn bakat alergi ttp sehat tanpa obat2 yg banyak?? saya tanya sm DSAnya.. mnrt beliau bayi dg potensi alergi bagaimanapun harus terapi dg steroid..atau klo dibiarkan bisa sampai kena jamur nanti..huhuhuhu.. adakah solusi lain selain obat?? atau ada yg tau dokter RUM di Solo?? really need advice.. makasiiih
> >
> >
> >regard,
> >Navi, akeela's mom
> >
> >--(maaf kalau yang mau japri silahkan kirim ke naviatullaily@... biar ga nyempil  )--
> >
> >[Non-text portions of this message have been removed]
> >
>

7.

(no subject)

Posted by: "Nova Rini" no_pha@yahoo.com   no_pha

Mon Sep 26, 2011 11:17 am (PDT)




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8a.

(Sehat) (Tanya) konstipasi, dikasih apa ya ?

Posted by: "Nova Rini" no_pha@yahoo.com   no_pha

Mon Sep 26, 2011 11:22 am (PDT)



Moms,

Saya Nova Mommy dr Matteo (3w5d), member baru nih...

Mau nanya, baby saya setiap kali mau pup seperti mengejan kesakitan, sampai mukanya merah dan kadang menangis..
Pup dalam sehari bisa lebih dari lima kali karena setiap habis disusuin selalu pup (selama ini hanya diberi ASI, dan InsyaAllah eksklusif)


Apakah baby saya mengalami konstipasi ? Lalu apa solusinya ya Moms ? Kasihan soalnya kalau sudah lihat baby mengejan...

Trimakasih buat jawabannya...

Maaf klau emailnya masih berantakan, maaf pendatang baru...


Nova - Matteo's Mommy
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8b.

Re: (Sehat) (Tanya) konstipasi, dikasih apa ya ?

Posted by: "Hilda" hilda.iriany@gmail.com   h_iriany

Mon Sep 26, 2011 2:23 pm (PDT)



Mbak nova, masak bayi 3minggu konstipasi?
Yakin itu bukan ngulet2?
Seingat saya, anak saya waktu umur segitu emang lg 'rajin' ngulet. Emang biasanya endingnya menangis...

Hilda

8c.

Re: (Sehat) (Tanya) konstipasi, dikasih apa ya ?

Posted by: "F.B.Monika" f_monika_b@yahoo.com   f_monika_b

Mon Sep 26, 2011 3:35 pm (PDT)



Dear Mba Nova,

Bisa diperhatikan saran dari Mba Hilda apakah sekedar 'ngulet' / tidak. Soalnya kalau dari cerita Mba frekuensi pup nya normal ya, bagaimana Mba konsistensinya, normal juga kah?

Sementara baby nya dibuat nyaman saja dengan pijatan lembut terutama Pijat ILU n kayuh/gowes sepeda sambil berbaring terlentang.
F.B.Monika

8d.

Re: (Sehat) (Tanya) konstipasi, dikasih apa ya ?

Posted by: "Ade Novita Juliano" ade.novita.juliano@gmail.com   novita_ade

Mon Sep 26, 2011 3:42 pm (PDT)



Dear Mba Mateo

Bayi ASI Ekslusif (asi dan hanya asi tanpa tambahan asupan makanan dan
minuman apapun sedikitpun juga) biasanya jarang yg konstipasi

ibu menyusui juga diharapkan memastikan nutrisi yang dikonsumsi ibu
mengandung vitamin dan serat serta cukup air

mengenai bayi tampak mengejan, coba perhatikan apakah keadaan ini sejak awal
kelahiran, atau baru di usia ini saja

kalau baru di usia ini saja bisa jadi karena bayi mulai tambah kebisaan
mengekspresikan apa yng dirasakan

jadi lebih ke psikologis merasa bertanya-tanya, khawatir, merasakan sesuatu
diperutnya atau di sistem digestivenya

coba mba elus dan katakan dengan lembut, bahwa BAB iti proses normal setiap
manusia, bunda juga BAB ayah juga, lakukan eye contact sambil juga elus
perut dan punggungnya

bisa juga bantu dengan menghangatkan perut bayi dengan handuk hangat dan
pukpuk tulang ekor bawah dgn lembut

salam,
@Ade_Novita

[Non-text portions of this message have been removed]

8e.

Re: (Sehat) (Tanya) konstipasi, dikasih apa ya ?

Posted by: "Nova Rini" no_pha@yahoo.com   no_pha

Mon Sep 26, 2011 3:42 pm (PDT)



Dear Mbak Monika 'n Mba Hilda,

Trimakasih respon-nya...

Mudah2an memang cuman lagi seneng ngulet ya baby-nya...

Hehehe...

Seneng gabung di milis ini, banyak dapet pencerahan..

Salam

Nova -Matteo's Mommy :)
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9a.

Mohon saran, anakku demam

Posted by: "Levina - Feiv's Mom" bree_wellington@yahoo.com   bree_wellington

Mon Sep 26, 2011 11:58 am (PDT)



Dear Docs & Sps,
Feivel (14,5m) demam sejak hari minggu siang, selama ini cuma HT + minum parcet. Skrg suhunya 39,2, apa yg hrs saya lakukan ya? Tetap berikan parcet saja & tunggu sampai 72 jam? Atau saya hrs ke UGD terdekat minta parcet dari anus? ♥τнą♌k Y☺ΰ º°˚°º♥♡

Levina Mommy Feivel

Loving every second with Feivel

Sent from my WhiteBerry®
9b.

Mohon saran, anakku demam

Posted by: "Levina - Feiv's Mom" bree_wellington@yahoo.com   bree_wellington

Mon Sep 26, 2011 12:07 pm (PDT)



Dear Docs & Sps,
Feivel (14,5m) demam sejak hari minggu siang, selama ini cuma HT + minum parcet. Skrg suhunya 39,2, apa yg hrs saya lakukan ya? Tetap berikan parcet saja & tunggu sampai 72 jam? Atau saya hrs ke UGD terdekat minta parcet dari anus? ♥τнą♌k Y☺ΰ º°˚°º♥♡

Levina Mommy Feivel

Loving every second with Feivel

Sent from my WhiteBerry®
9c.

Re: Mohon saran, anakku demam

Posted by: "F.B.Monika" f_monika_b@yahoo.com   f_monika_b

Mon Sep 26, 2011 3:30 pm (PDT)



Dear Mba Levina,

Tenang ya Mba..Tingginya suhu saat demam tidak berbanding lurus dengan keparahan penyakit.
Kenapa Mba harus ke UGD dan dimasukkan parset lewat anus?
Kita berpatokan pada kondisi klinis anak saja dan ada tidaknya tanda2 kegawatdaruratan. Anaknya masih bisa minum? Tidak lemas sekali? Tidak dehidrasi?
Observasi saja dulu, semoga cepat ketauan penyakitnya.
F.B.Monika

9d.

Re: Mohon saran, anakku demam

Posted by: "Ade Novita Juliano" ade.novita.juliano@gmail.com   novita_ade

Mon Sep 26, 2011 3:34 pm (PDT)



Dear Mba Levina

sama nih, lagi jaga malam karena anak sedang demam :)

Feivel masih ASI kah? kalau masih beri ASI lebih sering, lalu bisa lakukan
skin to skin contact, atau mba dan feivel gunakan baju tipis dan adem
1. bisa dengan menggendong bayi dalam pelukan (metode kangguru)
2. bisa dgn tiduran (seperti IMD) atau berdampingan

anak2 saya klo sakit, sampe sekarang masih minta skin to skin, selain nyaman
dipeluk bunda, mungkin mereka ngerasain nyaman saat resah kebingungan kenapa
sih aku sakit.

coba mba levina sempatkan baca2 lagi file demam

tingginya suhu tidak menandakan gawat tidaknya sakit anak

coba mba liat tanda2 lain, ada batuk pilek kah?
ada dewasa yang sakit kah
masih kuat menyusu kah
masih kuat minum kah
berapa kali Buang air kecilnya

saat ini memang tugas kita sebagai ibu untuk siaga, wait & see observation,
sambil memastikan bayi kita dapat asupan cairan cukup

mengenai ke UGD, belum perlu ya mba... kecuali nanti ada tanda2 menunjukkan
memang harus seegra ke dokter

coba mba liat dulu deh hal2 yg aku sebut diatas tadi

salam,
@Ade_Novita

2011/9/27 Levina - Feiv's Mom <bree_wellington@yahoo.com>

> **
>
>
> Dear Docs & Sps,
> Feivel (14,5m) demam sejak hari minggu siang, selama ini cuma HT + minum
> parcet. Skrg suhunya 39,2, apa yg hrs saya lakukan ya? Tetap berikan parcet
> saja & tunggu sampai 72 jam? Atau saya hrs ke UGD terdekat minta parcet dari
> anus? ♥τнą♌k Y☺ΰ º°˚°º♥♡
>
> Levina Mommy Feivel
>
> Loving every second with Feivel
>
> Sent from my WhiteBerry®
>
>

[Non-text portions of this message have been removed]

9e.

Re: Mohon saran, anakku demam

Posted by: "'Ita' Elisabeth Dianita" ita_sehat@yahoo.com   ita_sehat

Mon Sep 26, 2011 4:40 pm (PDT)



Mbak, sudah ada gejala lain yg menyertai belum? Batuk, pilek, ada ruam? Kalau tidak ada gejala yang menyertai, seperti saran mb Ade & mb Monik, tetep observasi ketat ya. Parcet diberikan jika anaknya benar2 rewel tidak nyaman. Selama klinis anak baik sih parcet jg tdk perlu diberikan, cukup skin to skin kontak, berendam air hangat, pakai baju yang tipis aja dan perbanyak asupan cairan ya.
Setelah 72 jam, silakan cek kemungkinan ISK, tp dengan catatan seperti diatas tadi ya yaitu tidak ada gejala lain yg menyertai.
Get well soon ya..


salam sehat,
ita (ibuke Saka & Ambar)
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10.

Fwd: When Your Therapist Is Only a Click Away

Posted by: "Billy N." billy@hukum-kesehatan.web.id   yahrapha

Mon Sep 26, 2011 3:59 pm (PDT)



http://www.nytimes.com/2011/09/25/fashion/therapists-are-seeing-patients-online.html?_r=1&ref=health
When Your Therapist Is Only a Click Away

The event reminder on Melissa Weinblatt's iPhone buzzed: 15 minutes
till her shrink appointment.
She mixed herself a mojito, added a sprig of mint, put on her
sunglasses and headed outside to her friend's pool. Settling into a
lounge chair, she tapped the Skype app on her phone. Hundreds of miles
away, her face popped up on her therapist's computer monitor; he
smiled back on her phone's screen.
She took a sip of her cocktail. The session began.
Ms. Weinblatt, a 30-year-old high school teacher in Oregon, used to be
in treatment the conventional way — with face-to-face office
appointments. Now, with her new doctor, she said: "I can have a Skype
therapy session with my morning coffee or before a night on the town
with the girls. I can take a break from shopping for a session. I took
my doctor with me through three states this summer!"
And, she added, "I even e-mailed him that I was panicked about a first
date, and he wrote back and said we could do a 20-minute
mini-session."
Since telepsychiatry was introduced decades ago, video conferencing
has been an increasingly accepted way to reach patients in hospitals,
prisons, veterans' health care facilities and rural clinics — all
supervised sites.
But today Skype, and encrypted digital software through third-party
sites like CaliforniaLiveVisit.com, have made online private practice
accessible for a broader swath of patients, including those who shun
office treatment or who simply like the convenience of therapy on the
fly.
One third-party online therapy site, Breakthrough.com, said it has
signed up 900 psychiatrists, psychologists, counselors and coaches in
just two years. Another indication that online treatment is migrating
into mainstream sensibility: "Web Therapy," the Lisa Kudrow comedy
that started online and pokes fun at three-minute webcam therapy
sessions, moved to cable (Showtime) this summer.
"In three years, this will take off like a rocket," said Eric A.
Harris, a lawyer and psychologist who consults with the American
Psychological Association Insurance Trust. "Everyone will have
real-time audiovisual availability. There will be a group of true
believers who will think that being in a room with a client is special
and you can't replicate that by remote involvement. But a lot of
people, especially younger clinicians, will feel there is no basis for
thinking this. Still, appropriate professional standards will have to
be followed."
The pragmatic benefits are obvious. "No parking necessary!" touts one
online therapist. Some therapists charge less for sessions since they,
too, can do it from home, saving on gas and office rent. Blizzards,
broken legs and business trips no longer cancel appointments. The
anxiety of shrink-less August could be, dare one say ... curable?
Ms. Weinblatt came to the approach through geographical necessity.
When her therapist moved, she was apprehensive about transferring to
the other psychologist in her small town, who would certainly know her
prominent ex-boyfriend. So her therapist referred her to another
doctor, whose practice was a day's drive away. But he was willing to
use Skype with long-distance patients. She was game.
Now she prefers these sessions to the old-fashioned kind.
But does knowing that your therapist is just a phone tap or mouse
click away create a 21st-century version of shrink-neediness?
"There's that comfort of carrying your doctor around with you like a
security blanket," Ms. Weinblatt acknowledged. "But," she added,
"because he's more accessible, I feel like I need him less."
The technology does have its speed bumps. Online treatment upends a
basic element of therapeutic connection: eye contact.
Patient and therapist typically look at each other's faces on a
computer screen. But in many setups, the camera is perched atop a
monitor. Their gazes are then off-kilter.
"So patients can think you're not looking them in the eye," said Lynn
Bufka, a staff psychologist with the American Psychological
Association. "You need to acknowledge that upfront to the patient, or
the provider has to be trained to look at the camera instead of the
screen."
The quirkiness of Internet connections can also be an impediment. "You
have to prepare vulnerable people for the possibility that just when
they are saying something that's difficult, the screen can go blank,"
said DeeAnna Merz Nagel, a psychotherapist licensed in New Jersey and
New York. "So I always say, 'I will never disconnect from you online
on purpose.' You make arrangements ahead of time to call each other if
that happens."
Still, opportunities for exploitation, especially by those with
sketchy credentials, are rife. Solo providers who hang out virtual
shingles are a growing phenomenon. In the Wild Web West, one site
sponsored a contest asking readers to post why they would seek
therapy; the person with the most popular answer would receive six
months of free treatment. When the blogosphere erupted with outrage
from patients and professionals alike, the site quickly made the
applications private.
Other questions abound. How should insurance reimburse online therapy?
Is the therapist complying with licensing laws that govern practice in
different states? Are videoconferencing sessions recorded? Hack-proof?
Another draw and danger of online therapy: anonymity. Many people
avoid treatment for reasons of shame or privacy. Some online
therapists do not require patients to fully identify themselves. What
if those patients have breakdowns? How can the therapist get emergency
help to an anonymous patient? "A lot of patients start therapy and
feel worse before they feel better," noted Marlene M. Maheu, founder
of the TeleMental Health Institute, which trains providers and who has
served on task forces to address these questions. "It's more complex
than people imagine. A provider's Web site may say, 'I won't deal with
patients who are feeling suicidal.' But it's our job to assess
patients, not to ask them to self-diagnose." She practices online
therapy, but advocates consumer protections and rigorous training of
therapists.
Psychologists say certain conditions might be well-suited for
treatment online, including agoraphobia, anxiety, depression and
obsessive-compulsive disorder. Some doctors suggest that Internet
addiction or other addictive behaviors could be treated through
videoconferencing.
Others disagree. As one doctor said, "If I'm treating an alcoholic, I
can't smell his breath over Skype."
Cognitive behavioral therapy, which can require homework rather than
tunneling into the patient's past, seems another candidate. Tech-savvy
teenagers resistant to office visits might brighten at seeing a
therapist through a computer monitor in their bedroom. Home court
advantage.
Therapists who have tried online therapy range from evangelizing
standard-bearers, planting their stake in the new future, to those
who, after a few sessions, have backed away. Elaine Ducharme, a
psychologist in Glastonbury, Conn., uses Skype with patients from her
former Florida practice, but finds it disconcerting when a patient's
face becomes pixilated. Dr. Ducharme, who is licensed in both states,
will not videoconference with a patient she has not met in person. She
flies to Florida every three months for office visits with her Skype
patients.
"There is definitely something important about bearing witness," she
said. "There is so much that happens in a room that I can't see on
Skype."
Dr. Heath Canfield, a psychiatrist in Colorado Springs, also uses
Skype to continue therapy with some patients from his former West
Coast practice. He is licensed in both locations. "If you're doing
therapy, pauses are important and telling, and Skype isn't fast enough
to keep up in real time," Dr. Canfield said. He wears a headset. "I
want patients to know that their sound isn't going through walls but
into my ears. I speak into a microphone so they don't feel like I'm
shouting at the computer. It's not the same as being there, but it's
better than nothing. And I wouldn't treat people this way who are
severely mentally ill."
Indeed, the pitfalls of videoconferencing with the severely mentally
ill became apparent to Michael Terry, a psychiatric nurse
practitioner, when he did psychological evaluations for patients
throughout Alaska's Eastern Aleutian Islands. "Once I was wearing a
white jacket and the wall behind me was white," recalled Dr. Terry, an
associate clinical professor at the University of San Diego. "My face
looked very dark because of the contrast, and the patient thought he
was talking to the devil."
Another time, lighting caused a halo effect. "An adolescent thought he
was talking to the Holy Spirit, that he had God on the line. It fit
right into his delusions."
Johanna Herwitz, a Manhattan psychologist, tried Skype to augment
face-to-face therapy. "It creates this perverse lower version of
intimacy," she said. "Skype doesn't therapeutically disinhibit
patients so that they let down their guard and take emotional risks.
I've decided not to do it anymore."
Several studies have concluded that patient satisfaction with
face-to-face interaction and online therapy (often preceded by
in-person contact) was statistically similar. Lynn, a patient who
prefers not to reveal her full identity, had been seeing her therapist
for years. Their work deepened into psychoanalysis. Then her
psychotherapist retired, moving out of state.
Now, four times a week, Lynn carries her laptop to an analyst's
unoccupied office (her insurance requires that a local provider have
some oversight). She logs on to an encrypted program at
Breakthrough.com and clicks through until she reads an alert: "Talk
now!"
Hundreds of miles away, so does her analyst. Their faces loom, side by
side on each other's monitors. They say hello. Then Lynn puts her
laptop on a chair and lies down on the couch. Just the top of her head
is visible to her analyst.
Fifty minutes later the session ends. "The screen is asleep so I wake
it up and see her face," Lynn said. "I say goodbye and she says
goodbye. Then we lean in to press a button and exit."
As attenuated as this all may seem, Lynn said, "I'm just grateful we
can continue to do this."

11a.

Re: REPOST: Fw: tanya polynel

Posted by: "F.B.Monika" f_monika_b@yahoo.com   f_monika_b

Mon Sep 26, 2011 4:05 pm (PDT)



Dear Mba Evi,

Kandungan aktifnya apa saja?

F.B.Monika

12.

(Tanya) lanjutan - guyur air langsung ke kepala bisa bikin stroke??

Posted by: "lilis nurindah sari" nyonya.zaky@gmail.com   lilo_chantiq

Mon Sep 26, 2011 5:33 pm (PDT)



Dear docs n sps,

Lg di bis brangkat kntr smbl baca2 detik, trus nemu artikel ini, bener
ga sih? Kmren2 kan lg rame tuh pembahasan soal mengguyur air langsung
ke kepala bisa bikin stroke, sptnya ini penjelasan lanjutannya ya. Klo
baca artikel tsb, ada resiko jg ya utk org2 dgn penyakit2 tertentu. Jd
penasaran euy, soale tiap pagi sy + anak sy pasti mandi air dingin
(air bak klo udh smaleman kan dingin ya) dan langsung guyur ke kepala
tuh.

Any comment?

http://m.detik.com/read/2011/09/26/190454/1730890/766/guyur-air-langsung-ke-kepala-saat-mandi-berisiko-stroke?hlight

Maap ya klo jd dibahas lg.

Lilis
Mama Keisha 2y1m24d

--
Sent from my mobile device

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