INDEX Top
• -- Basics : A slow reproducing mycobacteria.
• - History : Pre-historic origin disfiguring infection.
• Symptoms: Loss of nerve sensations; skin abnormalities.
• - Pharmas: multidrug therapy (MDT); individual treatments.
• - Holistics: Herbs & Aromatherapy.
• Contagion: Delayed activation, reduced temperature enhancement.
• Diagnosis: Tests & Procedures.
• -Recovery: Leprosy Elimination.
• Variations: Different immune responses.
• - Personal: Lifestyle Changes for Adaptation.

• Medical: Clofazimine, Lamprene, G 30320, B-663, Riminophenazine.
• Medical: Dapsone, diaminodiphenyl sulfone (DDS).
• Medical: Minocycline (Minocin), (minocycline hydrochloride).
• Medical: Ofloxacin (Floxin, Ocuflox).
• Medical: Prednisone, Deltasone -- Glucocorticoid, adrenocortical steroids.
• Medical: Rifampicin; rifampin - antibacterial and antiviral antibiotic.

• Research: Plaque Psoriasis.
• - Report : Leprosy associated with psoriasis.
• Summary: Differences between Plaque Psoriasis & Leprosy.

  Product Possibilities, NOT Recommendations.

  Product: Frankincense Oil, Aromapathic Labs

  Product: Frankincense Oil, NOW

  Product: Neem Leaves, Nature's Way.

  Product: Neem Cream (Original Vanilla), Theraneem.

  Product: Neem Oil (PURE), Theraneem.

  Product: Sarsaparilla Root 425 mg., Natures Way.

  Product: Sarsaparilla, 560 mg, 60 Tablets, HealthAid.

  Product: Sarsaparilla Root, 450 mg, Solaray.

  -Device : The SOTA Magnetic Pulser.

• Insight: Drug resistance can develop more easily with single drug use.
• Insight: ADT® (Alternate Day Therapy) can be safer as a treatment option.
• Insight: Nephrotic syndrome from kidney damage may challenge protein balance.
• Insight: Circulation weakening contributors can release/activate leprosy.

• Glossary: Definitions of relevant scientific - medical terms.

• -Focus-: Monographs on Toxins and Enhancers.

Basics: A slow reproducing mycobacteria. INDEX
https://www.medicinenet.com/leprosy/article.htm
Medical Author: Charles Patrick Davis, MD, PhD
Medical Editor: Melissa Conrad Stöppler, MD
Medically Reviewed on 9/8/2017

LINK 2: https://www.cdc.gov/leprosy/
LINK 3: https://en.wikipedia.org/wiki/Leprosy
last edited on 25 May 2018

Leprosy is caused mainly by Mycobacterium leprae, a rod-shaped bacillus that is an obligate intracellular (only grows inside of certain human and animal cells) bacterium. M. leprae is termed an "acid fast" bacterium because of its chemical characteristics. When special stains are used for microscopic analysis, it stains red on a blue background due to mycolic acid content in its cell walls. The Ziehl-Neelsen stain is an example of the special staining techniques used to view the acid-fast organisms under the microscope.

Currently (2017), the organisms cannot be cultured on artificial media.
The bacteria take an extremely long time to reproduce inside of cells (about 12-14 days as compared to minutes to hours for most bacteria). The bacteria grow best at 80.9 F-86 F, so cooler areas of the body tend to develop the infection. The bacteria grow very well in the body's macrophages (a type of immune system cell) and Schwann cells (cells that cover and protect nerve axons). M. leprae is genetically related to M. tuberculosis (the type of bacteria that cause tuberculosis) and other mycobacteria that infect humans. As with malaria, patients with leprosy produce anti-endothelial antibodies (antibodies against the lining tissues of blood vessels), but the role of these antibodies in these diseases is still under investigation.

In 2009, investigators discovered a new Mycobacterium species, M. lepromatosis, which causes diffuse disease (lepromatous leprosy). This new species (determined by genetic analysis) was found in patients located in Mexico and the Caribbean islands.

Leprosy has affected humanity for thousands of years.
The disease takes its name from the Greek word (lépra), from (lepís; "scale"), while the term "Hansen's disease" is named after the Norwegian physician Gerhard Armauer Hansen.

There is evidence that many of the genes that were present in the genome of the common ancestor of M. leprae and M. tuberculosis have been lost in the M. leprae genome. 1500 genes are still common to both M. leprae and M. tuberculosis.

History: Pre-historic origin disfiguring infection. INDEX
https://www.medicinenet.com/leprosy/article.htm
Medical Author: Charles Patrick Davis, MD, PhD
Medical Editor: Melissa Conrad Stöppler, MD
Medically Reviewed on 9/8/2017

LINK 2: https://en.wikipedia.org/wiki/Leprosy
last edited on 25 May 2018

Unfortunately, the history of leprosy and its interaction with man is one of suffering and misunderstanding.
The newest health research suggests that at least as early as 4000 B.C. individuals had been infected with M. leprae, while the first known written reference to the disease was found on Egyptian papyrus in about 1550 B.C. The disease was well recognized in ancient China, Egypt, and India, and there are several references to the disease in the Bible. Because the disease was poorly understood, very disfiguring, slow to show symptoms, and had no known treatment, many cultures thought the disease was a curse or punishment from the gods. Consequently, leprosy was left to be "treated" by priests or holy men, not physicians.

Norway was the location of a progressive stance on leprosy tracking and treatment and played an influential role in European understanding of the disease. In 1832, Dr. JJ Hjort conducted the first leprosy survey, thus establishing a basis for epidemiological surveys. Subsequent surveys resulted in the establishment of a national leprosy registry to study the causes of leprosy and for tracking of the rate of infection.

Early leprosy research throughout Europe was conducted by Norwegian scientists Daniel Cornelius Danielssen and Carl Wilhelm Boeck. Their work resulted in the establishment of the National Leprosy Research and Treatment Center. Danielssen and Boeck believed the cause of leprosy transmission was hereditary. This stance was influential in advocating for the isolation of those infected by gender to prevent reproduction

Symptoms: Loss of nerve sensations; skin abnormalities. INDEX
https://www.medicinenet.com/leprosy/article.htm
Medical Author: Charles Patrick Davis, MD, PhD
Medical Editor: Melissa Conrad Stöppler, MD
Medically Reviewed on 9/8/2017

Unfortunately, the early signs and symptoms of leprosy are very subtle and occur slowly (usually over years).
The symptoms are similar to those that may occur with syphilis, tetanus, and leptospirosis.
The following are the major signs and symptoms of leprosy:

Numbness (among the first symptoms)
Loss of temperature sensation (among the first symptoms)
Touch sensation reduced (among the first symptoms)
Pins and needles sensations (among the first symptoms)
Pain (joints)
Deep pressure sensations are decreased or lost
Nerve injury
Weight loss
Blisters and/or rashes
Ulcers, relatively painless
Skin lesions of hypopigmented macules (flat, pale areas of skin that lost color) 
Eye damage (dryness, reduced blinking)
Large ulcerations (later symptoms and signs)
Hair loss (for example, loss of eyebrows)
Loss of digits (later symptoms and signs)
Facial disfigurement (for example, loss of nose) (later symptoms and signs)

This long-term developing sequence of events begins and continues on the cooler areas of the body (for example, hands, feet, face, and knees).

Pharmas: multidrug therapy (MDT); individual treatments. https://www.medicinenet.com/leprosy/article.htm
Medical Author: Charles Patrick Davis, MD, PhD
Medical Editor: Melissa Conrad Stöppler, MD
Medically Reviewed on 9/8/2017

LINK 2: https://www.webmd.com/skin-problems-and-treatments/
guide/leprosy-symptoms-treatments-history#1
2017 WebMD, LLC
LINK 3: https://en.wikipedia.org/wiki/Leprosy
last edited on 25 May 2018

Long-term treatment with two or more antibiotics is recommended, usually from six months to a year.
People with severe leprosy may need to take antibiotics longer. Antibiotics cannot treat the nerve damage.

Anti-inflammatory drugs are used to control nerve pain and damage related to leprosy.
This may include steroids, such as prednisone.

Patients with leprosy may also be given thalidomide, a potent medication that suppresses the body's immune system.
It helps treat leprosy skin nodules. Thalidomide is known to cause severe, life-threatening birth defects and should never be taken by women who are pregnant or women who may become pregnant.

The majority of cases (mainly clinically diagnosed) are treated with antibiotics.
The recommended antibiotics, their dosages, and length of time of administration are based on the form or classification of the disease and whether or not the patient is supervised by a medical professional. In general, paucibacillary leprosy is treated with two antibiotics, dapsone and rifampicin, while multibacillary leprosy is treated with the same two plus a third antibiotic, clofazimine. Usually, the antibiotics are given for at least 6 to 12 months or more to cure the disease.

Antibiotics can treat paucibacillary leprosy with little or no residual effects on the patient.
Multibacillary leprosy can be kept from advancing, and living M. leprae can be essentially eliminated from the person by antibiotics, but the damage done before antibiotics are administered is usually not reversible. Recently, the WHO suggested that single-dose treatment of patients with only one skin lesion with rifampicin, minocycline (Minocin), or ofloxacin (Floxin) is effective. Studies of other antibiotics are ongoing. Each patient, depending on the above criteria, has a schedule for their individual treatment, so treatment schedules should be planned by a clinician knowledgeable about that patient's initial diagnostic classification.

Steroid medications have been used to minimize pain and acute inflammation with leprosy; however, controlled trials showed no significant long-term effects on nerve damage.

The role for surgery in the treatment of leprosy occurs after medical treatment (antibiotics) has been completed with negative skin smears (no detectable acid-fast bacilli) and is often only needed in advanced cases. Surgery is individualized for each patient with the goal to attempt cosmetic improvements and, if possible, to restore limb function and some neural functions that were lost to the disease.

Some people in the United States may be treated in special clinics run by the National Hansen's Disease Program.

Multidrug therapy (MDT) with three antibiotics (dapsone, rifampicin, and clofazimine) is used for multibacillary leprosy,
while a modified MDT with two antibiotics (dapsone and rifampicin) is recommended for paucibacillary leprosy and composes most current treatments today (see treatment section below).

Paucibacillary leprosy usually includes indeterminate, tuberculoid, and borderline tuberculoid leprosy from the Ridley-Jopling classification, while multibacillary leprosy usually includes the double (mid-) borderline, borderline lepromatous, and lepromatous leprosy.

Treatment cost :
Between 1995 and 1999, the WHO, with the aid of the Nippon Foundation, supplied all endemic countries with free MDT in blister packs, channeled through ministries of health. This free provision was extended in 2000 and again in 2005, 2010 and 2015 with donations by the MDT manufacturer Novartis through the WHO.

In the latest agreement signed between the company and the WHO in October 2015, the provision of free MDT by the WHO to all endemic countries will run until the end of 2020. At the national level, nongovernment organizations affiliated with the national program will continue to be provided with an appropriate free supply of this WHO-supplied MDT by the government.

Holistics: Herbs & Aromatherapy. INDEX
https://www.medicinenet.com/leprosy/article.htm
Medical Author: Charles Patrick Davis, MD, PhD
Medical Editor: Melissa Conrad Stöppler, MD
Medically Reviewed on 9/8/2017

LINK 2: http://www.naturalhealth-supplements.com/remedies/leprosy.htm
LINK 3: https://www.home-remedies-for-you.com/leprosy/home-remedies.html
LINK 4: http://www.natural-homeremedies.com/blog/leprosy-treatment-with-herbal-remedies/
LINK 5: https://top20remedies.com/leprosy-cure/ --- (2017-02-01)
LINK 6: http://www.ayurvedic-medicines.com/leprosy.html

As is the case with many diseases, home remedies can be found in the lay literature.
For example, a paste made from the neem plant, Hydrocotyle, also known as Cantella asiatica, and even aromatherapy with frankincense have been suggested.

Helpful herbs are reported to include red clover blossoms, burdock seeds, yellow dock root, lobelia, red root, poke root, goldenseal, myrrh, bittersweet, sassafras, poplar bark, black cherry bark, and comfrey.

1. Rhizome juice - The paste of rhizome can be applied on the skin to prevent bacterial infection.
Rhizome has an antifungal property and is used as an antidote. The extract of the dried rhizome is given to the patient in epilepsy and leprosy either internally or externally, depending on how it is made. Rhizome has a bitter and hot taste and has a heady smell. The raw rhizome should be consumed to treat leprosy and venereal illness.

2. Chalmoogra Oil - Indians have been using the oil to cure intestinal worms and skin diseases from a longtime and it is also effective in treating the inflammation and infections caused by leprosy bacteria. Chaulmoogra oil is obtained from the seeds of Taraktogenos kurzii, a tree that is native in Burma. This tree bears fruits the size of an orange and has many irregular brown seeds that are rich in oil. This oil has a popular medicinal reputation and is used in the treating of leprosy by applying it externally as well as taking it internally. Begin by swallowing 10 drops a day, gradually increasing to 30 if the person can tolerate it. Chaulmoogra Oil, also known as Tuvrak and Kushtavairi in Ayurveda, was one of the first effective traditional medications for treating leprosy and its adverse effects. It has been in use in Ayurvedic healing for more than 4,000 years in the treatment of rheumatism, eczema, leucoderma, scrofula, wounds, sprains, sores, congestion and bruises.

Chaulmoogra Essential Oil is useful in the treatment of skin diseases, scrofula, rheumatism, eczema, as a counter-irritant for bruises, sprains, etc. sometimes applied to open wounds and sores. The essential oil contains chaulmoogric acid and palmitic acid, and the fatty oil has been found to yield glycerol, a very small quantity of phytosterol and a mixture of fatty acids. The ripe and fresh seeds yield essential oil reputed to be a specific remedy against leprosy when the disease has just started to develop. Chaulmoogra has been used as traditional medicine in India since ancient times to treat Leprosy, chronic skin diseases, wounds, and ulcers. chaulmoogra oil may be included as an active ingredient in several lotions, creams, balms, ointment, massage oil, lip balm as well as balm formulations for wound care. The bark of the chaulmoogra tree encloses tannins that are useful for reducing fever.

Chalmoogra Oil, which is a liniment mixed with lime Juice, is used in a paste format to aid in elimination various inflammations of the skin, and ulcers throughout the body.

3. Vibhitaki fruit is considered effective in treating the disease.
The rind of the Vibhitaki fruit, which is part of the triphala group, is used for the composition of Triphaladi curnam, Triphaladi oil, Dasamularishtam, Parantyadi tailam and Triphaladi ghrtam. Some of these medications are helpful in combating a variety of diseases, including leprosy.

4. Babchi seeds can be used to make an extract and it can be applied on the skin.
Psoralia or Babchi ... is considered as the most effective herb in treating leprosy.
The part of the plant that is used is the seed and the seed is made into powder that is used to treat leprosy internally.
External application is also possible if the herb is converted into a paste and used as an ointment.

Another one of the treatments for leprosy comes from a plant, of which the common name is Babchi (a.k.a. Bakuchi, Someraji). It comes from the family Papilionaceae. The English name of this plant is Psoralea. The part that is used is the seed, which is prepared into an extract, powder, tincture, or oil. These can be applied to various parts of the body, usually externally.

5. Hydrocotyle asiatica also known as Gota Kola, can be used to heal skin infections.
There are certain side effects of using gota kola such as liver problem and stomach upset.
It is an herbal medicines, which can be taken in diet to reduce inflammation and a tea of gota kola can be taken two to three times in a day.

Hydrocotyle is also known as called Cantella Asiatica.
You may use hydrocotyle extract for topical application and cover it with a bandage.
It may also be consumed as tea. It is also available as an ointment and in powder form.
The herb helps relieve skin inflammation and pigmentation problems, soothing the affliction.
The remedy is best known to alleviate the skin condition, leading to visible results in skin texture.

Gota Kola is a small creeper that is widely used to promote longevity and combat skin diseases like leprosy and psoriasis.
Today, this herb is used for curing wounds, inflammation and other skin diseases too.
This herb is also used for treating diseases like headaches, diuretic, fever, varicose veins, inflammation, rheumatism and wounds.
One must take 3/4^th handful of fresh pegagan.
Then it should be cleaned and boiled until the water is reduced to 3/4^th.
Then the mixture is to be strained and drink 3/4^th glass of the mixture thrice daily.

Gota Kola can be applied to the body by way of a bandage dipped into the liquid form of the herb.
Other forms that it comes in are a powder and ointment, which can both be used externally in a variety of ways.
It can be used for the treatment of leprous wounds and inflammations. It also comes in a herbal form that is eaten with rice.

Mandukaparni, a medicine created with the herb Gota Kola known also by the Latin name, Cantella Asiatica, also aids in the treatment of leprosy, as an indigenous drug. It is rich in vitamin B and C, and an extract contains necessary forms of glucose is taken from the leaves.

6. Vibhitaki is effective in curing skin related problem.
It is also found in the triphala powder and it can be taken in the form of tea or in powdered form with milk.
The peel of Vibhitaki is used for the cure.

7. Babhachi seeds can be used to make an extract and tincture oil, which can be used externally.

8. The gum of the tree neem (Azadirachta indica) is also effective in fighting infections of bacteria and it can be taken with water everyday.
The neem tree oil is also effective in reduction of body pain caused by the problem.

(Neem) is an excellent antiseptic agent, helping to get rid of bacteria - the causal organism of leprosy.
It also soothes the patches on skin and enhances the skin texture.
You may crush the leaves and make a paste, mix it with oil and apply on the skin at least twice a day to cure the skin lesions.
You may also mix the paste with some pepper powder for better and faster results. A neem bath also helps.

Contagion: Delayed activation, reduced temperature enhancement. INDEX
https://www.medicinenet.com/leprosy/article.htm
Medical Author: Charles Patrick Davis, MD, PhD
Medical Editor: Melissa Conrad Stöppler, MD
Medically Reviewed on 9/8/2017

LINK 2: https://www.webmd.com/skin-problems-and-treatments/
guide/leprosy-symptoms-treatments-history#1
2017 WebMD, LLC
LINK 3: https://en.wikipedia.org/wiki/Leprosy
last edited on 25 May 2018

Researchers suggest that M. leprae are spread person to person by nasal secretions or droplets.
However, the disease is not highly contagious like the flu. They speculate that infected droplets reach other peoples' nasal passages and begin the infection there. Some investigators suggest the infected droplets can infect others by entering breaks in the skin. M. leprae apparently cannot infect intact skin.

Occurrence in animals makes it difficult to eradicate leprosy from endemic sources.
Routes of transmission are still being researched for leprosy. Recent genetic studies have demonstrated that several genes (about seven) are associated with an increased susceptibility to leprosy. Some researchers now conclude that susceptibility to leprosy may be partially inheritable.

It usually takes about 3 to 5 years for symptoms to appear after coming into contact with the leprosy-causing bacteria.
Some people do not develop symptoms until 20 years later. The time between contact with the bacteria and the appearance of symptoms is called the incubation period. Leprosy's long incubation period makes it very difficult for doctors to determine when and where a person with leprosy got infected.

Several genes have been associated with a susceptibility to leprosy.
Often, the immune system is able to eliminate leprosy during the early infection stage before severe symptoms develop.
A defect in cell-mediated immunity may cause susceptibility to leprosy. The region of DNA responsible for this variability is also involved in Parkinson's disease, giving rise to current speculation that the two disorders may be linked in some way at the biochemical level. Some evidence indicates not all people who are infected with M. leprae develop leprosy, and genetic factors have long been thought to play a role, due to the observation of clustering of leprosy around certain families, and the failure to understand why certain individuals develop lepromatous leprosy while others develop other types of leprosy

Wild 9-banded armadillos (Dayspus novemcinctus) in south central United States often carry Mycobacterium leprae.
This is believed to be because armadillos have such a low body temperature. Leprosy lesions appear mainly in cooler body regions such as the skin and mucous membranes of the upper respiratory tract. Because of armadillos' armor, skin lesions are hard to see. Abrasions around the eyes, nose and feet are the most common signs. Infected armadillos make up a large reservoir of M. leprae and may be a source of infection for some humans in the United States or other locations in the armadillos' home range. In armadillo leprosy, lesions did not persist at the site of entry in animals, M. leprae multiplied in macrophages at the site of inoculation and lymph nodes.

Diagnosis: Tests & Procedures. INDEX
https://www.medicinenet.com/leprosy/article.htm
Medical Author: Charles Patrick Davis, MD, PhD
Medical Editor: Melissa Conrad Stöppler, MD
Medically Reviewed on 9/8/2017

LINK 2: https://www.webmd.com/skin-problems-and-treatments/
guide/leprosy-symptoms-treatments-history#1
2017 WebMD, LLC
LINK 3: https://en.wikipedia.org/wiki/Leprosy
last edited on 25 May 2018

If you have a suspicious skin sore, your doctor will remove a small sample of the abnormal skin and send it to a lab to be examined.
This is called a skin biopsy. A skin smear test may also be done. With paucibacillary leprosy, no bacteria will be detected. In contrast, bacteria are expected to be found on a skin smear test from a person with multibacillary leprosy.

The majority of cases of leprosy are diagnosed by clinical findings, especially since most current cases are diagnosed in areas that have limited or no laboratory equipment available. Hypopigmented patches of skin or reddish skin patches with loss of sensation, thickened peripheral nerves, or both clinical findings together often comprise the clinical diagnosis.

Skin smears or biopsy material that show acid-fast bacilli with the Ziehl-Neelsen stain or the Fite stain (biopsy) can diagnose multibacillary leprosy, or if bacteria are absent, diagnose paucibacillary leprosy.

Other tests can be done, but most of these are done by specialized labs and may help a clinician to place the patient in the more detailed Ridley-Jopling classification and are not routinely done (lepromin test, phenolic glycolipid-1 test, PCR, lymphocyte migration inhibition test or LMIT).

Other tests such as CBC test, liver function tests, creatinine test, or a nerve biopsy may be done to help determine if other organ systems have been affected.

Due to extensive loss of genes necessary for independent growth, M. leprae and M. lepromatosis are obligate intracellular pathogens, and unculturable in the laboratory, a factor that leads to difficulty in definitively identifying the organism under a strict interpretation of Koch's postulates. The use of nonculture-based techniques such as molecular genetics has allowed for alternative establishment of causation.

While the causative organisms have to date been impossible to culture in vitro, it has been possible to grow them in animals such as mice and armadillos.

Naturally occurring infection also has been reported in nonhuman primates, including the African chimpanzee, sooty mangabey, and cynomolgus macaque, as well as in armadillos and red squirrels.

Red squirrels (Sciurus vulgaris) - a threatened species - in England were found to have leprosy in November 2016.
However, no squirrel cases have spread to a human for hundreds of years

Recovery: Leprosy Elimination. INDEX
http://www.who.int/lep/mdt/en/
World Health Organization
LINK 2: http://www.naturalhealth-supplements.com/remedies/leprosy.htm

Precaution and treatment -
The patient who suffers from leprosy can be treated if the illness is detected in an early stage.
If the disease is diagnosed early, the patient can be treated to be non infectious to others and he or she can lead a normal lifestyle. The patient should be given proper care to prevent related health issues. There was no cure for the diseases before 1940, but later the MDT drug was discovered, which is effective against the disease. The vaccination BCG is given against leprosy infection and it is partially helpful in protecting against the infection.

Variations: Different immune responses. INDEX
https://www.medicinenet.com/leprosy/article.htm
Medical Author: Charles Patrick Davis, MD, PhD
Medical Editor: Melissa Conrad Stöppler, MD
Medically Reviewed on 9/8/2017

There are multiple forms of leprosy described in the literature.
The forms of leprosy are based on the person's immune response to M. leprae.

A good immune response can produce the so-called tuberculoid form of the disease, with limited skin lesions and some asymmetric nerve involvement.

A poor immune response can result in the lepromatous form, characterized by extensive skin and symmetric nerve involvement. Some patients may have aspects of both forms.

Currently, two classification systems exist in the medical literature: the WHO system and the Ridley-Jopling system.
The Ridley-Jopling system is composed of six forms or classifications, listed below according to increasing severity of symptoms:

Indeterminate leprosy: a few hypopigmented macules; can heal spontaneously, this form persists or advances to other forms

Tuberculoid leprosy: a few hypopigmented macules, some are large and some become anesthetic (lose pain sensation); some neural involvement in which nerves become enlarged; spontaneous resolution in a few years, persists or advances to other forms

Borderline tuberculoid leprosy: lesions like tuberculoid leprosy but smaller and more numerous with less nerve enlargement. This form may persist, revert to tuberculoid leprosy, or advance to other forms

Mid-borderline leprosy: many reddish plaques that are asymmetrically distributed, moderately anesthetic, with regional adenopathy (swollen lymph nodes). The form may persist, regress to another form, or progress

Borderline lepromatous leprosy: many skin lesions with macules (flat lesions) papules (raised bumps), plaques, and nodules, sometimes with or without anesthesia; the form may persist, regress or progress to lepromatous leprosy

Lepromatous leprosy: Early lesions are pale macules (flat areas) that are diffuse and symmetric.

Later many M. leprae organisms can be found in them. Alopecia (hair loss) occurs. Often patients have no eyebrows or eyelashes.
As the disease progresses, nerve involvement leads to anesthetic areas and limb weakness. Progression leads to aseptic necrosis (tissue death from lack of blood to area), lepromas (skin nodules), and disfigurement of many areas, including the face. The lepromatous form does not regress to the other less severe forms. Histoid leprosy is a clinical variant of lepromatous leprosy that presents with clusters of histiocytes (a type of cell involved in the inflammatory response) and a grenz zone (an area of collagen separating the lesion from normal tissue) seen in microscopic tissue sections.

Personal: Lifestyle Changes for Adaptation. INDEX

Quick INDEX to Personal INDEX

• Personal: Baseline Practices.
• Personal: The Possibilities and the Reality.
• Personal: Avoidance is better than a tenacious infection.
• Personal: Bandages, for protection or enhanced recovery?
• Personal: Times of significant weakness will open doors.
• Personal: Inhibiting accelerated symptom expression.
• Personal: Possible Leprosy weakening choices may include
• Personal: Exposure will intensify symptoms.
• Personal: Cremes can be destructive, useful, or, irrelevant.
• Personal: Discernment between Scaly vs Flaking Skin.
• Personal: Awareness, Belief, and Skills will make or break.

In writing tips and cautions about a potentially complex practice, it is easy to overlook those preparations and actions which one may carry out in a somewhat automatic fashion as longer-term skills and preferences which can contribute greatly to the success of protocols adopted later, as in this case, to enable coping with and recovery from ill health conditions or diseases. That is why THIS part was added to this section last, yet is, in my experience, even more fundamental than what follows.

Quick INDEX to Baseline INDEX

1. Baseline: Self-Respecting Belief.
2. Baseline: Reverence for a Divine Source or God.
3. Baseline: Sanitary Environment.
4. Baseline: Reduced Stimulation Lifestyle.
5. Baseline: Resource Restraint.
6. Baseline: Independent Qualified Research.

1. Self-Respecting Belief. Baseline-INDEX
This is a self-directed, self-assertive, confident acceptance of oneself.
In my experience, if you must look to others to encourage you, tell you what and when to take action or rest, acquire and prepare your food, pay your bills, provide you with transportation, act as a companion, keep your belongings organized, and, ensure that your utensils and clothing are regularly cleaned ... you are unlikely to survive as what follows will be beyond your abilities, and, it is unfair to impose on others and expect them to be a slave to you. I fortunately grew up on a mixed use farm which held me distant from continuous contact with persons beyond my immediate family. I was expected to learn skills and accept responsibilities as a given from a likely age of 6 or earlier. My father carried out his chores without complaint and as per a seasonally flexible routine. It was a norm; an imprinted value; a reality. I was rewarded with confidence by choosing to learn about and practice skills that brought me opportunity and a sense of achievement.

I was also fortunate, that at least within my family setting, my parents and sisters were never physically or emotionally violent towards me and never abused me with threats, manipulation, deceptions, or gossip. I was born with a high number of energy blocks, inherited through the histories of my parents' lineages, and, I was born premature and thus began life with a poor expectation of survival. I did survive, and my parents exhibited to me an openmindedness to seek and utilize non-medical approaches to health when medical approaches failed or had nothing to offer. I was also fortunate to have a Basic Personality of given traits which included an interest in the Spiritual .. first expressed through a great respect for and curiosity about religion. Without searching for an internal spiritual appreciation, information came to me that provide me with an opportunity for self-instruction in Yoga practices which enhanced my physical abilities and unexpectedly introduced me to what others might reference as "mystical" experiences. These "fortunes" both brought me a level of unquestioned confidence in some areas, and, a separation from most other people who depended upon human authorities to engineer, permit, and define how they would live their lives.

In my experience, without a sincere belief in a Divine Intelligence and our capability to reverence that Source and a willingness to interact to determine what choices could present the best outcomes from what was available, I would never have survived Leprosy, recovered from it, or, have survived many challenges which began before I reached my teens. This Self-Respecting belief is not one of immature pride and selfishness. Rather, it is an extension of Reverence, Humility, and a "I can do it" attitude in which I view myself as a part of the Whole of Life. I treat myself as I seek to treat others and I respect and wish the best for others in the same way that I have experienced the Divine caring for and ALWAYS ready to work with me.

Many persons, men in particular, in many so-called civilized cultures ... inherit energy blocks that encourage, and, are taught and imprinted with the belief that they are Guilty of something and that it is best that they serve leaders and human authorities. Their worship of human stand-ins for a God is both satanic (disrespectful of God), and often a source of traumas and imprinting that are derived from many forms of abuse. As in so many parts of this section, if you do not have the attitudes, beliefs, and habits I have found of great benefit, you may find other options which suit you better. Or, you may choose to develop them and encourage them, provided you have the health and resources remaining to afford such. Or, you may be best to accept that survival or recovery with what you have and what is available to you is impossible and choose to live the remainder of your life in ways you find rewarding and in ways you may wish to be remembered for.

2. Reverence for a Divine Source or God. Baseline-INDEX
The study and use of Sentics has demonstrated consistently that North Americans have a High Capability for experiencing the emotion of Reverence, yet most adults have NOT developed the ABILITY. That is like a person being given wealth which they stash away and forget about. Opportunities, choices, experiences ... arise when the use of some of that wealth could provide a maintained stability, bring a calm and joy where panic and fear are presenting, transmute conflict into harmony, and enable accelerated growth to provide a surplus which can be shared, and/or, invested for even added future benefits. Yet the person who has stashed away and forgotten about their wealth suffers ALL the destructive losses which both individually and together throw one ever deeper into an abyss of separation, pain, and guilt. Reverence is NOT a worship of something or someone as in a lust for a magical gift or privilege. Rather, it is an identification and awareness of the presence of something or someone who has knowledge, skill, or other abilities which could be accessed to enable benefits for us. and, which is offered to us (never imposed), openly and without debt, subjugation, or cost out of a sincere desire for us to have and experience what is best for us. The message of many religions, as could be best expressed by the founder in the language of their era, is that one or more gods OFFER this dynamic to us, as individuals. God is always with us and available to assist us in discoveries and choices and actions which will bring us the best of what we as humans have made available and neither contaminated, discarded, or destroyed.

My early self-direction in exploring many spiritual writings and in choosing to experience unprepared for, and thus unlimited, spiritual realities ... opened my awareness and appreciation for what could be for myself and others. Building on this, I founded a form of Balancing Therapy both by working with God to discern the answers to hundreds of questions which could assist individual clients in very personal ways, and, which by its very use would continually enhance my discernment of what I could request from the Divine in the form of questions, and, how to discern and confirm the accuracy and relevancy of the answer. The outcome of these dynamics is that I saw and experiences great positive changes arising out of very destructive health conditions and lifestyle patterns, and, others shared with me at some point during or after the sessions how the dynamics of their life and relationships were markedly improving. My ABILITY to experience Reverence and benefit from the dynamic has been continually reinforced by my helping myself to recover from "terminal" conditions, and then by my using those skills and awareness to assist other who wanted and were ready to have their life enhanced. Without this SKILL of Reverence I would not have been able to ASK, LISTEN, and FIND the information, relevant resources, and make the choices which have enabled me to both understand what the source of the illness factors affecting me were, how those factors were encouraged and discouraged, when and how much of which foods and supplements and application of which devices and therapies at what times and to what degree ... would enable me to cope, remain productive to some degree, and recover .. from what has often proven to be "terminal" to others.

3. Sanitary Environment. Baseline-INDEX
The amount of health contaminating influences we immerse ourselves into does influence the degree to which our immune system can effectively protect us, and, the degree to which our organs, glands, and biosphere keep us physically, emotionally, and spiritually healthy. Since we, as a species, chose to be transformed from the Balanced state that our God created us in, and, irreverently abandon our God to our Pride of acting as gods ... we have lost the benefits of any Eden. We have continually imposed on our surroundings and each other with increasing dominance, distraction, disrespect, destruction, concentration (toxicity), and, pollution. As a species, we have made for ourselves a history that mirrors this satanic direction. We have created cultures that reward and encourage most often the actions and behaviors of the immature and selfish, the dependent and the insecure. By a lack of self esteem, self respect, and self-restraint we encourage the contamination of our homes, workplaces, and wider environments. These behaviors encourage the presence of microbes and pests in numbers that challenge our health.

In a desperation to provide the resources for and the food for an unrestrained population growth paired with political insecurities which amplify conflicts and allow for our deception and manipulation into the murder and economic enslavement of others ... we tend to adopt practices which encourage manufactured disorder ... a threat to and in opposition to the presence of variety and ENOUGH in the natural environment before humanity interfered with it. The intensity and expanse of floods, drought, desertification, and pest infestations directly follow from the influence of humanity decreasing the protective nature of our atmosphere, the construction of housing on flood plains, the removal of much of the natural forestation of the Earth (as it was 3000 years ago), the changing and restriction of riverways, and, the extensive concentration of elements into solvents, gases, chemicals, and, genetically modified organisms which threaten the health balance of most Earth lifeforms, including ourselves.

Urinating from a standing position into a toilet is a behavior which most North American males have been culturally encouraged to do and are likely to continue lifelong. It came clearly to my awareness when I was attending university after working in commerce and services for a decade. I shared a 2-bedroom campus apartment with another male and we elected to take turns cleaning the bathroom. My roommate had seemingly not had this arrangement earlier. When I went to clean the tiled floor around the base of the toilet, i was surprised and astounded by the thick, greasy layer of urine deposit that covered the floor. This required some serious cleaning with strong cleaners, rubber gloves, sponge, and a fair degree of effort. With only a little consideration, it became obvious that if the floor was this dirty, standing on the floor nearby likely meant that one's shoes would pick up and track this source of bacteria and other pathogens throughout the apartment. Subsequent weeks confirmed that a lot of time or a large number of urinations were not required to deposit a new layer of grime. That was in the late 1970's.

In 2018, Urine splash from a toilet was researched and a scientific finding was finally made available on a CBC radio program. This built on urine splash back findings regarding urinal use published on November 7, 2013 by Bob Yirka, Phys.org. The Plateau-Rayleigh instability principle, where a pee stream breaks up into drops before striking something else, explains why the further the stream travels before hitting a firm object, like a toilet bowl, the more each drop creates splash-back, and, the further those drops may travel. Essentially, gravity contributed energy to the falling drops making those which fall further having greater power to transfer to how hard they strike the porcelain, and, how far they travel away from the porcelain, and, potentially how far out of the bowl. Thus, the greater the distance between a male penis and the surface it strikes, the larger the floor area around the toilet bowl which will receive some of the spray. This dynamic will be modified by just how voluminous the stream is leaving the male and at what speed it is leaving. These later factors depend largely upon the urinary-prostate health of the person, the fullness of the bladder, and the amount of effort being added by the male to expelling the fluid.
LINK: https://phys.org/news/2013-11-university-physicists-urine-splash-back-tactics.html

An extensive article was published on the subject on Aug 9, 2016 by Alex Mayyasi, at LINK: https://priceonomics.com/why-cant-we-build-a-splash-proof-toilet/ As noted,

If you share a bathroom with someone who stands when he pees, a fine layer of pee covers your bathroom floor.

If you’ve used a urinal at the same time as someone standing next to you, his pee has splashed on you.

Of course, this same dynamic results in pee being splashed on the fellow's trousers, which may result in a stain, does result in fabric thinning, often acts to deposit bacteria, and, increases the immune irritating ability of the clothing.

So, why is this important as a factor in one's coping with and recovery from a significant, or, a chronic illness, or multiple illness reality? In the case of Hansen's Disease, and with the co-present intestinal problems resulting from metal toxicity and GMO induced cell changes ... it was necessary for me to spend between 2 and 4 hours daily in a small washroom. Part of this time was in the service of flushing my intestines to prevent auto-toxicity from waste being reabsorbed into my blood and making coma more possible, and, part of the time was necessary for the removal of the bandages over the Hansen's Disease skin presentations on my feet, followed by bathing, application of oils and creams, adding new bandaging, and, careful cleaning of both the bathtub, sink, and toilet. The benefit of these procedures could be lessened and even made hazardous if the floor and appliances were not frequently and adequately cleaned. In my experience and understanding, if you are not going to devote the time and effort to assisting yourself in a medically SAFE manner, just accept that you are not going to recover and live your life as best as you enjoy and wish to be remembered for. It isn't that difficult to get into a habit of SITTING down when using a toilet when one is aware of the dangers, added effort, and longer periods of illness of being lazy.

4. Reduced Stimulation Lifestyle. Baseline-INDEX
We have created and imposed on ourselves and our children a high stimulus environment.
There are several health weaknesses presented by an environment which is constantly challenging our immunity.
Health and immunity generally benefit from an environment which has a lot of constants and some gentle variations.
That was the reality we were created for and largely populated for more than a million years before we were made too rebellious, proud, and aggressive to remain in our Edens. What are a very few of those ...

sources of hyper-stimulation?
• Urban life: many strangers, many signals, many services, many sounds.
• Electronics: computers, cellphones, social media, radio, television, movies.
• Chemicals: scents, air fresheners, stale air, combustion gases, pesticides, fungicides.
• Electricity: EMF radiation, motors, artificial lighting, automated utilities, security.
• Urgencies: schedules, appointments, traffic movement, accidents, conflicts.

And how are we weakened by these:
• Distraction: less discernment, more projection, more demand for dissociation.
• Priorities: more attention is given to devices than to humans; less acknowledgement of us.
• Anxiety: more effort is expended on possibilities & losses than on reality and interaction.
• Immune dysfunction: every year the prevalence of multiple chronic disease expression is increased.
• Politics: deception, manipulation, dependency, fear .. are intensified by lies, gossip, injustices.

I found, for me, that if I am going to cope with the symptom impositions of heavy metals and other toxic overburdens, and continue to be focused on finding the relevant information and making the best choices ... I will benefit from the clearest and most available degree of focus. That means eliminating or reducing stimulations to a level of ENOUGH rather than fall into the depressive desperation mode encouraged by many commercial-media cultures of persistent Ecstasy. A Balanced person has the self-esteem and maturity to accept and take pleasure from much of their surroundings and not feel driven by the lack of physical and sensual contact offered by nature and positive interpersonal relationships which human industrially constructed and dependent environments and virtual electronic realities reduce one's presence to.

5. Resource Restraint. Baseline-INDEX
Most people only have a finite amount of income and savings.
There is often also a range within which these variables can be increased or decreased.
Pushing beyond these limits involves degrees of RISK ... which many commercialized cultures preach as a means of Freedom from Reality. With the USA government promotion of the book, "Think and Grow Rich" with free copies offered to all returning military service personnel at the end of WWII, and with the cult classic of "Atlas Shrugged", an infusion of self-centered lust for personal physical riches and power became a atheist religion founded in the USA. Particularly promoted to the poor within, and, those immigrating to North America, it was preached as the key to the American Dream. Preaching often proposes fantasies and dreams as realities. With all fantasies and dreams held by large numbers of people, there will be a small number of attainers and a large number of failures. The accepted dynamic is for those doing the preaching to focus on and promote the attainers as examples of a dream majority. Seeking an imbalance as a Norm has never resulted in Equality, Fairness, or, Justice.

When a person is PROMISED a reality which is NOT delivered in return for the sacrifices demanded of the individual, the individual frequently feels an injustice. In commercialized and intellectualized cultures, it is a short step from injustice to a seeking of justice by way of small injustices. It becomes easily rationalized by the failures that having done their part towards receiving the promised riches, they must have fallen short because others are unfairly succeeding. The excuses border on the reality and include privilege, resources, education, heredity, race, street smarts, aggressiveness (willingness to deny and accept risk), persistence (ability to lose and try, try, again) and, timing. Some of these often contributing factors can, with more effort and more investment, be personally acquired; others cannot. For the highly motivated (desperate, lustful, addicted) breaking the law or morality (a little) suggests a rationale of equalling the scales of opportunity and enabling success for those who feel downtrodden. Unfortunately, sustaining and growing a success that is based upon moral abdication and legal pragmatism morphs automatically into a policy of moral twisting and legal manipulation.

If you have been pressured, attracted, or persuaded into an attitude of entitlement then you will likely have a difficult or impossible outcome to coping with and recovering from any chronic illness. Such an attitude conditions persons in a human authority structured culture to expect that others, who have been sanctioned with resources and powers that seem appropriate, will Rescue one from one's "unfair" loss of health or other "Right". The Reality is that most people, statistically, who look for such a rescue, either live on through torturous experiences, or die. Blindly assuming that "experts" have all the answers is convenient in a political infrastructure or bureaucracy. Therein, the practice is to promote the few successes, and deny, ignore, unacknowledged, or, hide the failures. In healthcare, a requirement to sign a form releasing the practitioners involved from all responsibility for any errors protects such practitioners from disastrous financial loss, dismissal from their profession, publicity about their incompetence, and, any encouragement to either maintain or improve their level of practice.

Errors come and go, but, patients live on in pain, despair, or, disappear in death. Persons who owe their income to an employer, maintain any sense of stability and security of that income by following the accepted and employer rewarding principles and practices. Spending the least, using the cheapest, and investing minimal time contribute to an intellectualized fantasy of economy. The result is often that tests are inadequate, drugs are misprescribed by projected and superstitious associations, surgeries are incomplete and create more and new problems, and, people needlessly die. Yet, no one is responsible, the public are maintained in a state of false storybook expectation, professionals learn to become technicians, the media fear revealing the truth under threat of losing necessary advertising income and gaining political manipulation, and, patients thankfully remain reclusive in their misery, or silent in their death.

If you have such a complex and generally misunderstood and often mistreated illness such as Hansen's Disease, is there hope. Resources are a critical answer to solutions. Resources of time, knowledge, experience, finances, relevant and confident choices. YOUR Resources. If you have neither acquired resources (skills, attitudes, beliefs) nor have the opportunity to expand those resources ... your only hope is in choosing to live the life you have left in as positive a way as possible. Politically sanctioned technicians (doctors, surgeons, therapists, ... ) will seldom elect to go beyond their employer imposed boundaries of time, effort, and risk ... even if you offer to privately pay them separately and richly. Their terms of employment will often define such institution defying actions as fraudulent, unacceptable, and even rebellious. Such independent actions, if successful, could publicly reveal, by comparison, the weaknesses, incompetency, irrelevancy, and wastefulness of the institutional system ... to the horror of their political purse holders, the administration bureaucrats, and the self-demoted medical staff. Your options include those medical practitioners who live an work in alternate political realities, those healthcare participants who work in the legally grey areas, those who patently provide illegal services, and, yourself.

If YOU are going to pull yourself forward and out of your health challenge, you will require a degree of financial access. I can only speak from my personal experience and its highly defining specifics. You may be able to dry some possibilities for yourself. What you are unable to do yourself, you may be able to find someone else with the skills, experience, or other motivation to assist you. Without being retired and receiving a minimum pension, I would have become unemployable, destitute, homeless. An early death would have been the best option. Without my long exposure and experience to the medical system as practiced in 3 of Canada's provinces, I would have been encouraged to feel that the medical system was either prejudiced against me, or, that specific doctors were holding be captive in illness by their ignorance and insensitivity. Such frustration encourages violence. My beliefs, experience, skills, and awareness supported my choices and actions towards recovery. My lack of addictions (drugs, gambling, alcohol, smoking, chemicals, food, sex, acceptance) preserved what income I had for constructive deployment in acquiring supplements, detox agents, relevant tests, access to research information, bandages, and the purchase of significant health enhancing devices. Resource restraint meant using what I had towards the best enhancement of my health, when options were available, and, when I could afford the energy, clarity of mind, or balance of finances.

6. Independent Qualified Research. Baseline-INDEX
From my perspective, NEVER assume that ANY article, monograph, research paper or advocated practice is complete, accurate, relevant for you, or, black-and-white worthy of total confidence. I note that my own monographs are best to be approached by concerned individuals as a STARTING POINT in one's search for information and options which are relevant for them. There are ALWAYS degrees of relevancy ranging from totally to partially, to minimally. As mentioned elsewhere, the MAJORITY of so-called scientific research and the findings and conclusions promoted by the funding sources for the research, the medical fraternity, and the commercial participants ... is poorly constructed, poorly delivered, poorly assessed, and often irrelevant. Few persons will recognize this reality because few persons have taken in-depth courses in the elements of Sociological Research, Psychological Research, and, the contrasting elements of truth, significance, and taboo between different cultures and peer groups. A complete awareness of the contents of the book, "How to Lie with Statistics" is fundamental.

How do inaccuracies and irrelevancies happen?
It may be helpful in one's discernment to know that thesis supervisor professors at universities often enough TELL their students HOW their thesis will be structured, WHAT will be tested for and assumed, WHEN these observations and activities will be ended, and, WHO the results will be phrased to support or confirm. If the student disagrees with any of these fundamentals, they can either Fail, or, quit their thesis course. North American journals are frequently significantly funded by singular or dominant manufacturers or service providers who market to the field in which the thesis argument falls. In addition, with such an intense need within the North American health professions to establish one's presence and expertise through peer referenced publications, the researcher is rewarded, easily, for presenting results which confirm a building dominance of former research results. It is now recognized (in 2017) that the founders of critical principles accepted, promoted, and status quo verified since the 1950s, by their own admission, distorted the true results of their experiments, lied to their peers, and were REWARDED by receiving continuing praise and recognition plus high paying positions, for MANY decades. Automatic belief in such findings will waste your resources, maintain you degrading health, and ultimately advance the timing of your death. The fact that your doctor, therapist, surgeon, or other health professional mirrors these results like the gods they are taught to believe of themselves and their professions... in service to patient peons, will endanger you.

So, how and where does one find such Quality research?
The best source is yourself, IF, you have both research experience, and, critical research evaluation skills.
Most people do not have these, so, second best is to find someone who does have them. There will be a cost, perhaps relative to the skill and experience of the person and the amount of time you want them to spend on finding relevant data and answers/options. Then, there are a number of online doctors and scientists who make it their focus to offer insights into both health difficulties and their possible causes and treatment, and, a criticism and promotion of (new) products (which they often promote) and therapies, treatments and tests which have attracted their attention. The cautions here include:

1. Many writers will confidently promote a solution based upon a disease name or significant symptom.
   --- The reality is that diagnoses are often inadequate and in error and the same symptom can be shared by many illnesses.

2. EVERY researcher has their blind spots, areas of denial, absences in their training or experiences, and reactive conclusions. If they do not note them as a reflection on their findings, and, if you cannot discern them from your analysis of multiple articles or statements from them, any conclusions and suggestions offered are best considered with great skepticism.

3. EVERY researcher has one or more knowledge areas where they have optimal understanding and treatment successes. Many tend to focus on those areas as indicative of all knowledge and exclude, deny, and miss the many other possibilities ... of which one or more is most constructive for you.

4. IF you have one or more illnesses which appear to afford a low rate of recovery, whether the literature suggests a complete awareness and understanding of it or a vague rationalization of what may be the cause ... be open to finding a new, and sometimes previously abandoned perspective that might afford better results.

5. A global perspective which considers multiple influences and potentially multiple contributors to an abatement of, improvement in health, or recovery from an illness, tends to be complex and lengthy and tends to be avoided by editors and publishers, and, not considered by drama and authority seeking persons with much study and little experience. A black-or-white rationale may bring you quickly to health improvement, or, shield you from a workable combination.

6. It is easy, almost automatic, and constantly rewarded for a satanic, self-centered, denial of the spiritual and a reverence for the Divine to be expressed. Well, we see where that has driven humanity. Health realities are continually being made more complex by our history of irresponsibility and abuse of the environment, ourselves, and others. Perhaps human authorities and experts will provide a secular remedy or solutions for you. In almost 72 years of personal experience, they NEVER have for me and those I personally know.

7. In a misuse of and misunderstanding of the Occam's Razor Principle, the simplest and most rational solution to a problem is possible, yet highly unlikely and largely irrelevant in most successful outcomes.

8. Leprosy is spread ONLY by lung expelled damaged bacteria.
   Many more people carry it in a dormant state than is politically and medically acknowledged to the public.

9. If one ATTACKS Hansen's Disease, they are likely to gain autoimmune additional health problems which will insulate the leprosy bacteria even more such that it is effectively encouraged by an increasingly distracted immune system.

10. Intimate behavior involving the sharing of lung exhalations, such as in kissing and hugging, have an optimal opportunity for the transfer of the damaged bacteria from a contaminated person to a prospect.

11. What worked for me may not work for you, yet, it is a safe beginning, IF, used early enough.

12. The resulting outward appearance of Hansen's Disease is NOT so much an extension of its symptoms as it is an extension of the infection complications and nerve signal insulating functions. Fear and ignorance encourage abandonment by others and by oneself (despair) and both of these encourage the dominance of attitudes and beliefs which depress our immune system and delay, or prevent, recovery.

13. Leprosy was poorly understood, minimally researched, subject to many superstitions and spurious associations, and largely left untreated because of a combination of pride/revulsion, authority/ignorance, and, a lack of personalization and skills ... for 5000 YEARS!

It is quite likely that 99% of North Americans are unaware of the information in this monograph or of any research results gleaned in the past 20 years. That includes doctors, specialists, surgeons, healthcare professional and therapists, nursing and support staff. That has been my lifelong experience. I am a Canadian, having lived in the provinces of Ontario and British Columbia, and now in Alberta, and having experienced the healthcare systems in these regions. I am now over age 70.

If you doubt the info and suggestions herein, that is your right and your choice, here and before medical staff.
Check the information by way of the LINKS to the original articles and research. Find your own also.
Recognize that in diseases of this nature of complexity, each person can demonstrate their own selection of symptoms and may have differences in what works best for them to restrain those symptoms and to effect a recovery. My experience can open your mind to the basic options and questions that are likely best for you to find answers to, as a constructive starting point.

For a point of interest, I had researched leprosy 30 years ago by the only available paper resources of encyclopedias and journals. I had again reviewed what was available about 20 years ago after the movie Papillion became available. As an extension of those forays into the literature the conclusions i was left with were:

• North Americans were not susceptible to leprosy;
• two forms of leprosy were the contagious and the non-contagious;
• infected persons quickly became disfigured and lost fingers & toes;
• there were no known treatments that were widely known and accepted;
• leprosy victims were excluded from society into confinement locations.

It is now more accurate to consider that:
• ALL humans on the Earth are susceptible, including North Americans;
• there are numerous forms of leprosy with varying degrees of contagion;
• leprosy may begin to develop any time from infection to decades later;
• infected persons may be present throughout the community, undiagnosed;
• there are a few recognized treatment protocols and some home remedies;
• leprosy is now know to be spread mostly by way of respiratory water droplets;
• leprosy is an illness resulting from a badly damaged, slow & weak, bacteria;
• cooler skin areas of the body are more susceptible to leprosy development.

I have made a dramatic improvement in recovery from my symptoms (2018-07) with a good likelihood that I could recover fully.

The word "infection" is used herein as the most applicable term to which most readers will hopefully share a similar understanding. It is an infection in that it will impact the strength of one's immune system, it will spread from cell to cell, it will influence one's lifestyle capabilities more to less, and, short-term to longer-term, and, it will challenge one's emotional, social, political, intimate, and physical survival. It is unlike what many of us have experienced as an infection in that it will interact with our cells and physical systems in usually VERY slow and persistent ways. It will not, of itself, stimulate the production by our immune system of pus (collections of dead cells). There may be adjacent areas of skin which erratically express symptoms (i.e. pain) which have no outward physical presentation (i.e. color and/or texture changes).

My personal experience demonstrated that other immune distractions and EXTERNALLY sourced infections could build from unprotected cracks and fissures in the skin being exposed to contaminated water or air, or, to contact with unclean surfaces and raw soils. For this reason it was imperative to become or remain consciously aware of the external integrity of INTERNALLY infected skin areas, clean and treat these Daily, and keep them bandaged to reduce greatly the aggravating influence of air exposure. After cleaning the affected areas of the skin, I found, consistently, that an intensification of symptoms would develop, consistently, with free exposure to the air. This could become obvious in seconds; always would develop within minutes.

As a weakened and highly damaged lifeform, this bacteria may have features that are more similar to a virus than to a bacteria.

It is
• temperature sensitive;
• will depress the immune system;
• can support the appearance of other diseases;
• can have symptom irregularities from the addition of those of other diseases;
• will respond to some known anti-viral herbals when they are used consistently;
• can be made more dramatic in symptoms by NOT respecting its characteristics;
• pharmaceuticals tend to be more symptom hiding than constructive;
• symptom appearance and diminishing can occur in dramatic stages.

It is likely that the beginning of a leprosy outbreak may be the result of some trigger experience or exposure, of one or more kinds.

With cool body areas being more susceptible to leprosy symptom expression, one would be best to AVOID nutrients and activities which REDUCE circulation to the extremities:

• reduced Salt use,
• highly refined sugar intake,
• heavy or high starch foods,
• smoking of cigarettes or other tobacco,
• insufficient clothing in cold weather,
• air conditioning, especially if excessive,
• swimming, especially in cool or cold water,
• pain reducing pharmaceuticals,
• sensations & expressions of Fear,
• longer sleep periods,
• diabetes,
• anesthesia,
• severe fatigue,
• Low blood pressure,
• wet or sweaty clothing,
• longer periods without food,
• longer periods without activity,
• inadequate hydration,
• confusion, anxiety; hypertension,
• inhibitors of prostaglandin E2 **,
• wearing light colored socks and gloves,
• use of dilating drugs and herbs++,
• pregnancy,
• viral outbreaks,
• parasitic attacks,
• intensive detoxing.

++ Dilating drugs and herbs (promote heat loss) include:
yarrow, lithium, sedatives, pomegranate, poppy seeds, sesame, melons, cucumber, citrus.

Applying bandages over scaly and thickened skin can help keep such areas warm and sheltered from air conditioned and breeze cooled air, and cool surfaces.

Bandage adhesives can present aggravating, neutral, or beneficial interactions with one's skin.
Skin areas can differ in their pH level, their degree of texture, their degree of cleanliness, and, their illness symptom intensity.
Bandage adhesives can vary greatly in their hold and releasing characteristics, and, their ability to interact with tissue.
There are reports of specific lots, brands, and origins of bandages which interact with skin similar to a superglue compound.
That is, I and others have had bandages which seemed to fuse, to a degree with the skin they were applied to.
Removal became troublesome such that uncomfortable, painful, and sometimes dangerous results presented by one making an effort to remove them. This can be considerably annoying if the size and type of the bandage that is best to protect your damaged skin is only available locally with this adhesive characteristic. As this may be a short-term LOT characteristic, or may persist for some time with a BRAND, usage practice may benefit from some defined non-normal actions.

I found it best, often, for the continued treatment and protection of affected skin areas, that spanned distances beyond what could be covered with a single bandage, to visualize how the bandages would be applied, and then pre-application, remove some or most of the adhesive strip along those edges which would be self-terminating. For greater lengths or widths of coverage, bandages will be applied side-to-side, or length-to-length. The adhesive edge of the extending bandage will overlap the initial bandage, Reducing the adhesive strip along this connecting edge on the initially applied bandage will increase skin coverage and reduce adhesive contact. I found that the bottom and outer edge of both my feet were the first, prominent, and most affected skin areas. To reduce skin contact with bandage adhesives yet maintain coverage integrity (continuity) and limit contact with unclean surfaces, I applied sockets (thin, snug socks that cover the foot but have no ankle height) over the bandages. They ensured that the bandages would not be dislodged, folded, lifted, or directly contaminated by the surface i walked on, or, by the footwear I used. They acted as a secondary adhesive for the bandage and as an additional layer of protection to insulate my regular sox and footwear from treatment oil and cream spreading.

Cleanliness of bandaging is also important.
Most infections which have skin manifestations elicit immune responses which result in puss formation.
These are collections of dead cells that collect at the skin surface in the form of pimples, boils, and weeping draining breaks in the skin. This illness is driven by a weak, persistent, and damaged bacteria which our immune system mostly fails to detect or have the capability to defend against. To survive, one must determine what the real characteristics of the disease organism are and then, with acknowledgement and respect, take actions to restrain it, and, ultimately, to diminish it into obscurity. Trying to FORCE it out will only aid it by robbing energies from many bodily systems to result in greater and more widespread weaknesses ... which encourage the presence and spread of the bacterial invasion. From the beginning to the end of my exposure, I never had one area which presented any evidence, puss formation, of an immune response.

Different forms, sizes, brands, and adhesive materials for bandages were required for my best treatment.
Sometimes, the use of a particular bandage would change dramatically due to availability, skin response, intensity of symptoms for a particular infected area, or size of area, and, the combination of treatments being applied. While someone else may find the characteristics of the bandages which are best for them to be different from my own, a list of the main bandaging components I used will suggest the span of possibilities which can be considered as a starting point. At the time I lived in the city of Lethbridge in southern Alberta, a Canadian province. Most of the bandages I used, I could only find easy access to at the local and huge Real Canadian Superstore (RCSS). Most of the pharmacies around the town had only a limited supply of bandages that would be suitable, in size and style, for my requirements. Most had none. One distant pharmacy was the only source of 2 larger bandages, and those I was best to have shipped in as a special order, by the box of 20.

Examples:

• Large Gauze Pads, 4 in x 4 in -- 10.1 cm x 10.1 cm. --- 10 per box; use up to 2 per day. Bandaid
• Large Adhesive Pad, 7.6 cm x 10.1 cm -- 4-sided adhesive, latex free -- 10 per box; use up to 7 per day. Exact
• Extra Large, Flexible Fabric bandage, 4.4 cm x 10.1 cm -- stretchable, won't stick to the wound - 10 per box. Bandaid
• Clear Waterproof bandage, assorted sizes, latex free, blends with the skin -- 30 per box. Brand: Exact.
• Bandage, Primapore, non-woven wound dressing, 4-sided adhesive, 25 cm x 10 cm. -- 10 in x 4 in, 20 per box
• Bandage, Primapore, non-woven wound dressing, 4-sided adhesive, 15 cm. x 8 cm. -- 6 in x 3.8 in, 20 per box
• Tape, Nexcare for Sensitive Skin, clean removal, 1in x 144 in -- 25.4 mm x 3.65 m. -- light blue, Brand: 3M
• Tape, Plastic w/dispenser, latex free, flexible, breathable, tears easily, 2.5 cm x 9.1 m. -- Brand: Exact.
• Tape, Cloth, latex free, durable, strong adhesion -- good for wrapping gauze pads -- 2.5 cm x 9.1 m., Brand: Exact.

I am retired on a small pension and use public transit; while ill, I travel as little as possible.
It often seemed as if I was going to the grocery megastore, RCSS, more often for bandages than for food.
My interest was in RECOVERY. My prayers rarely Guided me to purchase more than 4 boxes of bandages per visit.
Unless one expects NOT to recover, has surplus funds, or is lazy ... there may be no financial or emotional benefit in purchasing large stocks of bandages. Also, the coverage area of the symptoms may and likely will change, and may require a different form of bandage.

It quickly became an early requirement for the areas to be washed daily, and new bandages be applied.
Any longer and the infected area and the bandages began to smell of rotting skin ... even though there was no dead skin, discolored skin, or flaking skin present. It was NOT the typical odour of perspiration, nor of a fungus, nor of a bacteria. Even though this bacteria does not really spread by touch or external skin contact, changing the bandages ensured that no EXTERNAL contamination was introduced to the area. It was also an easy addition to a medical protocol which had been necessary for me to do on a daily basis for the previous 2-12 years in coping with complex symptoms arising from GMO cellular modification of my intestines and the presence of very HIGH amounts of heavy metals and other toxic metal levels. Initially, for at least 2 months after the symptoms suddenly appeared, and since I had been doing high intensity detoxing, I considered it to be an odd detoxing symptom. Later, I came to the new awareness of what Hansen's Disease was, and that I had it.

Triggers are likely to include exposure to virus carrying parasites, viral outbreaks, intense detoxing.
If one is following a detoxing protocol which is more than incidental when one has a HIGH toxicity burden, one will acquire pathogen outbreaks more easily than previously, and, will find them more difficult and lengthy to cope with than had one NOT been detoxing. The security guard of the immune system capabilities can not do an effective job if it is the sole officer on duty, is posted at the front door, with a back door opened by the detoxing agents, and the windows smashed open by the mineral toxins ... while it is making every effort to check and confirm the identity of the hoards streaming in at the front entrance.

Spiritual Awareness and Strength is highly beneficial and significant in this reality of being attacked by both significant BIG brutes and seemingly insignificant dwarf robbers while one's house is on fire. If you have not devoted a part of your life efforts to increasing your skill and awareness level in the spiritual realm, and, have NOT developed a close participative relationship with God and those who choose to work WITH God ... these physical challenges are likely to stimulate fears, doubts, confusion, anger, and child-like acting out ... ALL of which highlight the irreverent ... and will plunge you ever deeper into errors of choice and increased intensity of symptoms until the end of mortality seems a welcome gift to the rising presence of depression and despair. With the Faith of a life of spiritual presence and experience, "miracles" will have been observed previously, and Hope and Confidence will support a continued attitude of working with God to allay these hardships. Ultimately, Reverence, Respect, and Confidence will enable survival, if survival is possible, from challenges which will destroy many others.

Self-Responsibility becomes an extension of spiritual awareness and an acceptance of a difficult reality.
When I had been Guided spiritually through Prayer to take on a volunteer (self-funded) position as an international diplomat working for peace, some years previously, and with it involving a constant average of 80 hours participation per week, it was obvious that such activity and concerns left no time or space for an intimate relationship. This was further indicated by my not having a like skilled and called partner with whom I might share any information about my involvements and newly arising global political conflicts. To impose them on another who had no previous interest, knowledge, or skills in such an endeavour would be the equal of emotional and spiritual abuse. If I truly loved my wife, it was necessary for both her safety and mine that we separate. As my activities did not have an endframe, it would also be selfish and thievery to rob her of a more normal relationship with another partner. As Guided, I divorced her. We remain close friends in frequent contact with each other to this day.

Self-Responsibility also means taking actions to benefit one's survival and health integrity.
When other who are institutionally sanctioned to provide such services (doctors, therapists, scientists, politicians, etc.) fail to sincerely involve themselves beyond their minimum of duties, it is for us to take the actions they delay, discount, or refuse to take responsibility for. Politically, we have created a society in which most of these government sanctioned employees are rewarded with pay, power, and privilege for doing the least within their professions in support of the least expenditures and the easiest and most secure lifestyle in service of the symbolic identities of public and private corporations. They can quickly learn to mirror their peers, or, be fired for secular incompetence, or, disobedience of human authority. Spiritually, one recognizes the patterns, with humility, and chooses to move on, as best as one can with the skills and knowledge one has in the partnership with the Divine. My life experiences, basic personality motivations, and planning and problem solving skills thus fit me for doing the research and finding the affordable constructive options by which I could maintain and improve my health as best as possible and continue to help others.

The outcome would be up to me and only rest upon myself and my willingness to continue to work with God, regardless of the challenges, the patience, the seemingly unending urgencies for new answers and directions gained, often, with the full expenditures of my energies and finances. I asked doctors for assistance. They assisted as far as their employers would allow. I then went further with personally funded medical tests, huge amounts of researching and discerning, selective choosing and acquisition of dozens of herbal and nutritional supplements and innovative devices ... particular to my personal health realities. That attitude and those skills were well in use when this and other more recent health defining challenges presented. Each, I have improved on, more than any other. And so, within 24 hours of obtaining Neem Oil and Cream and beginning its use, 95% of my symptoms of Hansen's Disease would disappear. The remainder would take more innovations, more patience, more expenditures of time and finances ... yet, they could be possible.

Experiencing viral symptoms often includes getting a FEVER which creates high core temperature and reduced extremity temperatures. The more intense the viral symptoms, the more likely the immune system has been significantly distracted and weakened, at least temporarily. Intensive detoxing can also challenge the immune system with distraction and weakening. With leprosy, one must be careful to keep extremities warm, for the pathogen is stimulated by cold tissues and reduced circulation. It can also be stimulated, indirectly, by increased temperatures in these areas for such increases the chances of experiencing a "cold" chill is other bodily regions ... and we have again, an open door to both viruses and this bacterial pathogen. The enemy is NOT the pathogens. It is weakness. The constructive Response is one of Faith, Confidence, and mediated Action.

** Inhibitors of Prostaglandin E2 include these:
• Curcumin (turmeric),
• anti-histamines,
• anti-inflammatories,
• pain medications,
• gout and arthritis medications,
• osteoarthritis & rheumatoid arthritis drugs,
• Sulforaphane (SFN): a dietary cancer preventive

Dinoprostone (Prostaglandin E 2) stimulates the smooth muscle of the gastrointestinal tract.
It may also cause bronchodilation or bronchoconstriction and vasodilation. Dinoprostone can elevate body temperature due to its effect on hypothalamic thermoregulation. It has been used as an abortant. Like other prostaglandins, E2 contributes to both sustaining homeostatic functions and mediating pathogenic mechanisms, including the inflammatory response. As a drug, it is also used in cancer and cholera treatment and in transplants.

Common side effects include vomiting, fever, diarrhea, and excessive uterine contraction.
In babies there may be decreased breathing and low blood pressure. Care should be taken in people with asthma or glaucoma and it is not recommended in those who have had a prior C-section. Prostaglandin E2 is in the oxytocics family of medications. It works by binding and activating the prostaglandin E2 receptor which results in the opening and softening of the cervix and dilation of blood vessels. It is a direct vasodilator, relaxing smooth muscles, and it inhibits the release of noradrenaline from sympathetic nerve terminals.

They may also influence sleep regulation and lower blood pressure.

Personal: Possible Leprosy weakening choices may include Personal-INDEX

• Increase your Salt intake,
• Wear bandages and dark socks,
• Eat ice milk rather than ice cream,
• Avoid starches and refined foods and sugars,
• Use coconut oil as your dominant food source of fat,
• Don't smoke and minimize your exposure to second hand smoke.

I was fortunate in that I had made many of the above choices and integrated them into my lifestyle at the time of infection. From my awareness of energy transfer and the influence of color frequencies, known for decades through my physics studies, the socks variation was perfectly understandable. Avoiding starches and refined foods became easily acknowledged when a consistency presented that using any of these almost immediately led to strengthened symptoms in the short-term. The different impact degree from the ice milk to the full milk ice cream also became highly experienced and on further inspection likely correlated with the later having much more refined and modified foods as ingredients, and, the later being made with coconut oil. That became somewhat redundant a month after the discovery when I acquired Bartonella (see associated monograph) from a minor exposure to bed bug ticks which had become endemic throughout the building my apartment was in. As any dairy product triggers the symptoms of the Bartonella bacteria, one quickly makes adjustments to their diet, or, chooses to suffer greatly.

Other changes of activity which proved beneficial to restricting the spread and reducing the intensity of the leprosy bacteria included the daily washing of the affected areas, bandaging to cover and protect those areas, and, later, the DAILY application of Neem oil and cream. Later still, the direct application of Frankincense Oil, followed by Neem Oil, followed by Neem cream proved most helpful. As I had been intensively detoxing at the beginning of the leprosy symptoms, once I knew that they were NOT the result of the detoxing and once I became aware of the true nature of the leprosy bacteria ... it also became both a necessity, and, a benefit to discontinue detoxing for the short-term. Detoxing, even light duty detoxing, does require bodily energy and the participation of many organ and tissue systems. This both distracts and weakens the immune system and leaves it even more ineffective against ALL pathogens than it would otherwise be. Fundamentally, if I had not already detoxed my toxic element load by 70% from its worst, I would have faced an immune system collapse, not just a weakened immune system.

Air Exposure was an early definitive leprosy stimulant that came to my attention.
The replacement of and application of daily clean bandages over the irritated areas was a considerable aid.
This containment of the skin, I found best to wash with soap daily and to remove dead and over-thick skin at the time.
Leaving the sensitized area open to the air quickly, within minutes, resulted in the drying and hardening of the skin-scales resulting in their presenting sharp edges and producing cracks, within hours, which opened up to the raw flesh below. These presented significant pain when pressure was applied, as in walking, and endangered general health with an increased likelihood of contamination and other forms of more active infections. It was the transmuted form of the skin with all of its layers banding together and with it seeming to dry out faster which heightened the danger of air exposure. These forms of cracks would also open the physical system to easier invasions by local parasites.

It required considerable self-control NOT to remove too much of the thick crusty uneven layered skin which rebuilt a new thick layer every day. There became decreased sensitivity of the skin in the affected area. This required awareness and care to avoid exposing the area to water which was too hot, and, to avoid sanding or filing the dry, hard, broken, scaly skin too deeply. I found it best NOT to use such items. If one did use them, it would be prudent to either discard the used portion after a use, or, to wash with an effective cleaner and rinse and dry thoroughly.

Skin Cremes:
I tested a number of skin and dermal lotions, oils and creams.
NONE of them were helpful; a few seemed to be counterproductive.
This approach would be an expected suggestion from any of many healthcare advisors if they were unaware of the reality of leprosy, or, were unaware of the more recent findings about leprosy.

TheraNeem Neem Cream was the only cream which I did find that was a benefit.
In fact, in the first 24 hours of my use, my symptoms DECREASED by 80%.
To this, I quickly added the use of Theraneem Neem Oil, applied first over the cleaned major areas.
This improvement remained constant with my continued use of the cream and oil.
Over the following 3 weeks, there was a very slow yet continued improvement, gradually increasing to 96%.

I was using Aromapathic Frankincense Oil (Boswellia Serrata) in a diffuser during this time to assist in reducing the symptoms of Bartonella. It is likely that the use of it also assisted in the reduction of Leprosy symptoms.

Scaly vs Flaking Skin.
It is possible that some readers, perhaps many, will confuse the Reality of the leprosy "Scaly" with their experience of "flaking" skin. Most people have experienced "flaking" skin at some point in their lives. It could be a case of dandruff, dry skin, dead skin, wound healing, or some similar dynamic. For me, and perhaps most others in the initial stage of experiencing leprosy symptoms, "scaly" is entirely different. It is a changing of the skin texture and appearance into one of scales, suggestive of what one might expect to find on a reptile like a snake or crocodile. The skin becomes thicker than usual and harder than usual. The tick areas do NOT form a uniform surface. It becomes variable in thickness, almost bumpy.

Within a few more hours, if allowed to dry out further, it can begin to crack.
Unlike flaking skin which releases a layer at a time and can be removed, at times, like an even layer ... these "scales" tend to crack deep like a ravine slashing through all layers of the skin to the raw flesh below. When that happens, there is no bleeding. Pain quickly attends any movement of or pressure on this area. It is as if one has received a huge paper cut. And, if one attempts to remove some of the raised patches of thickness, my fingernails would only ever raise a piece of the "scale" as if detaching a section of skin, not a layer at a time, but multiple layers at a time. Once one small section of thick skin was removed, adjacent areas projected their dominance as irregular thick patches demanding to me picked and raised and pulled away in an effort to smooth the skin area. This unconscious, for me, urging to re-smooth the wider skin area may be an idiosyncratic response of Basic Personality strengths which I and some other people share.

Importantly, when these scale-like patches thicken and dry to an optimum content, they will crack.
When they crack, an open wound will become available to invite infection from the less than pristine clean surroundings.
These infections with dirt, bacteria, fungi, parasites ... will produce inflammation, pus boils and pockets ... and skin disfiguration will occur. This appearance degradation will not be a direct influence of the leprosy bacteria. Rather, it will be an extension of an inability to protect the influenced skin scales from thickening, drying, cracking, and becoming septic. Efforts to reduce and minimize this dynamic are thus most important ... both in how far they are taken, when they are taken, and with what devices (bandages), and, ameliorating (creams, nutrition, herbs) actions, and, curative products (antibiotics, herbs, supplements) are brought into constant involvement.

The following are my personal beliefs and skills which I know have been significant to my survival, health coping and improvement, and, the finding of relevant answers to support constructive choices and actions. They may NOT, in total, be either appropriate or desirable for others, yet, they will provide a framework from which you can define your own. If you are not consciously aware of your own, they will not assist you in times of challenge. Without that assistance, you will react when you could respond, fear when you could be confident, be irreverent and self-centered when you could have a divine partner. In that mode, you will make mistakes which will not only worsen your health, they will endanger others, and they will eventually end your life. God gave us Choice. This is YOUR Choice.

INDEX to Beliefs and Awareness Personal INDEX

• Awareness: Spirituality.
• Awareness: Problem-Solving Skills.
• Awareness: A Patient Centered Perspective.
• Awareness: Experience with persons and institutions.

Spirituality. Awareness INDEX
I am fortunate in that I was born with a Basic Personality that has as one of its strength, Spirituality.
From an early age, I read all of the Bible, and then again several times later. During my teens and twenties I intensively studied specific books of the Bible, read Commentaries, and explored the text of original text languages. I added to this major spiritual works from other cultures and eras including many Chinese and Greek philosophers, Tibetan Buddhist, Hindu, Arab (The Koran), and other writings. By way of an intensive use of Breath Yoga in my early teens, I unexpectedly had several mystical experiences. When I became terminally ill with both life threatening and chronic hypersensitivities in my late 30's, an opportunity for me to risk spiritual innovation loomed when a former priest mentioned the possibility of learning by self-directed practice how to Pray in such a manner as to communicate with the Divine directly. A therapy team introduced me to the reality of using Bach Flower Remedies (homeopathics) in specific ways to release energy Block (addictive, trauma induced, reactive behaviors and attitudes). The possibility of combining these 2 Principles seemed rationally impossible. The reward would be health and life.

I developed a Balancing Therapy approach to assisting myself to Recovery, and then, assisting others who truly wanted recovery from their health challenges or repetitive life experience failures. I went on to both improve my skills and understanding of this dynamic by helping many hundreds of others. Fundamentally, I released ALL of my own energy blocks (most humans are born with inherited blocks to which they add more from their own life experiences) and, with the Spiritual Guidance I requested and received, I recovered from a number of other health difficulties described by the medical community variously as "permanent", "untreatable", or "Terminal". I was repeatedly successful as I am over age 71 and was not expected to either survive birth, or the more than 14 "END" diagnoses offered to me since. Bottom line: I believe that EACH of us can have a close relationship with the Divine and that Source can assist us in coping with and recovering from ANYTHING that it is possible to recover from ... even if we consciously do not believe that anything we can personally do will benefit. If one does not have Faith and Confidence in a Spiritual Force beyond oneself, they will not survive any or many of the number and intensity of the health challenges I have had.

Problem-Solving Skills. Awareness INDEX
I grew up on a large enough mixed use farm.
That meant that you either developed a mechanical awareness to operate and repair machinery, or you were useless.
It also meant that one developed a respect for and an understanding for animals, or, their health would suffer and you would be held responsible for that. In addition, if you chose not to be sincerely caring and encouraging of such animals, accidents would happen which would endanger one's own health. In a rural environment, distant from other-than most human contact, one could also make friends of specific animals, or, be lonely and depressed. I chose friendship and service over imposition, force, pride, separation, and frustration. This closeness, and a long-term case of severe allergy encouraged me to leave rural life.

In a city environment, I took work and training positions in management, administrative support, technical support, and, customer service. Over many years and beyond many experiences, I gained awareness and communication skills which enabled me to excel in task areas within banking, mass media, sales, computers, and finally, health enhancement. ALL of these involvements required a great familiarity with the protocols, principles, technical options, and individual client capabilities that could lead to successful conclusions, or, one would fail, be demoted, fired, or transferred to more routine tasks. Balancing Therapy was all about finding answers to hundreds of questions with possible thousands of possibilities, in seconds each. Development of it required finding the best questions to include in a protocol, while leaving an open door to the addition of new questions and answers as relevant for the client. Recovering from Myalgic Encephalomyelitis (aka Chronic Fatigue Syndrome) required finding answers to questions that had not been previously asked by researchers ... especially when my wife had acquired a similar form of CFS with significant differences. We both recovered. Recovering from ANY chronic illness will often require the Patient to become aware of their own expressed idiosyncrasies and determining how they can best be addressed. No politically funded medical system or institutionally funded research group is going to encourage such an innovative, time consuming, and potentially open ended approach to building relevant INDIVIDUAL protocols. If I didn't do it for myself, no one else was going to. No answers = no solutions = no Life.

A Patient Centered Perspective. Awareness INDEX
If I had developed this and other dramatic, typically unrecoverable, often fatal health diseases, and, had an attitude of taking such challenges PERSONALLY, I would have become susceptible to any of many destructive feelings, beliefs, and attitudes ... which would have driven rational projections (superstitions, pride, fear, anxiety, guesswork, spurious associations, cognitive irrelevancy, ... ) which would have led to reactive actions. Such actions lead to not only time wasting and resource loss energy expenditures but also to errors which result in accidents, health degradation, and irreverence. Feeling guilty, blaming others, and hateful expressions devoted to the Divine .. for decisions WE have made without the Humility to ASK for what would be best, is both emotionally immature, rationally imbecilic, and spiritually abusive. Anyone can FORCE an action. Doing so will most often produce destructive results ... which if we survive, we conveniently forget. It takes a strong, mature, aware, and respectful person to acknowledge their failures and LEARN from them. Sadly, our 21st century cultures do NOT encourage or reward this integrative process.

With only a few seconds difference when I was most severely toxic, I approach my own health and the diagnosing and treatment that is relevant from the perspective of interacting with my "health file" as if I am the health assistant, AND, the patient. This intellectual and emotional separation enables me to avoid all of the fears and acting out, and anxieties of taking my diminished health as a Personal victimization. This "I am helping you/me" context also limits any interference by the Ego and SuperEgo Identity Factors of myself with the Spiritual Guidance available from our God-Source. In an optimal time, I ask questions, explore research, receive answers, confirm answers, and discern as to what I can best do to cope with the present reality. Over decades of practice and continual improvement this skill leads me to what I can best do with the resources I have and the options that are available. It also, frequently, provides me with the detail required for me to understand the Why and How and Where that supports the answers and the best action to take. The RESULT has ALWAYS been constructive ... often beyond what could be rationally projected. I have coped with and recovered from, with the assistance of the God-Source from dozens of challenges which have cost others their lives. Anyone can gain such benefits if they put in the time, humility, sincerity, commitment, and effort to developing the skill.

Experience with persons and institutions. Awareness INDEX
I could not be as patient, compassionate, calm, and understanding about the limitations of others who are politically sanctioned and financially supported to provide healthcare support, yet, in complex and demanding diagnostic and treatment situations such as mine at this time ... only have the resources, skill, and interest to provide a very small part of the solution, or even, no part at all. Indeed, many are career rewarded by their institutional support and restrictions to provide fast, guesswork projections and spurious associations which often provide delay and NO benefit, or even destructive health disasters. i will not list the many consistent negative medical realities which I have experienced and observed over my 70 plus years of life in Canada (across 3 provinces) beyond the general summary statement that my personal health has been endangered or significantly diminished by more than 14 medical interventions. It was improved by 2. I have seen hospital patients, and heard of others who lived nearby me, of patients who were denied or delayed, or exposed to medical procedures which could have saved their lives, or, exposed to contaminants which resulted in their fatality ... at least 22 instances. Yet the employees who work for an institution whose services are controlled and limited by political insufficiency cannot be held fully responsible for what they could do that would risk the end of their career. It is important to ASK of others only what they can, and are willing to provide. Anything more is an imposition, a demonstration of one's ignorance of the institutional and political realities, and, an invitation to receive hasty answers and services which WORSEN the outcome.

Recognizing the ABILITIES of other individuals is equally if not more important then being aware of the controlled environment in which and from which they must provide their services. I have been fortunate, or challenged, to work with, supervise, and interact with persons from and representing personal histories and realities which differed from my own in the contexts of occupation, schooling, personal interests, religion, race, finances, health degree and complexity, exposure to trauma, imprinting by mass media, and, degree and type of technical experience. In the often most successful roles of workmate, customer service, sales professional, marketing designer, health and lifestyle counselor, building contractor and designer, SCUBA diver, and scientist ... the necessity to hear and feel the concerns, fears, and hopes of the other person, and, the ability to communicate positive options which could add to, complete, or resolve anxieties, conflicts, and doubts has been crucial. Success in these task areas, in my experience, has required that I be able to see persons as both individuals apart from their tasks and employment, and, participants working within or at odds with those who exert financial or other forms of control over their choices and decisions ... which impacts their action outcomes. While stereotypes can be a quick-look relevant benefit in emergencies, they are often inaccurate and irrelevant, even destructive, when applied to individuals with whom we must, or chose to interact on a personal basis. Failure to recognize these variances can result in a loss of opportunities and resources, which in this and similar situations could become fatal.

Medical: Clofazimine, Lamprene, G 30320, B-663, Riminophenazine. INDEX
https://pubchem.ncbi.nlm.nih.gov/compound/clofazimine
Modify Date: 2018-05-27; Create Date: 2005-03-25
LINK 2: https://reference.medscape.com/drug/clofazimine-342661#4

Clofazimine is is a phenazine dye with anti-mycobacterial and anti-inflammatory activities.
Clofazimine is a fat soluble, brick red dye that is used in combination with other agents in the therapy of leprosy.
The exact mechanism through which clofazimine exerts its effect is unknown.
Clofazimine is a fat-soluble riminophenazine dye used for the treatment of leprosy.
It has been used investigationally in combination with other antimycobacterial drugs to treat Mycobacterium avium infections in AIDS patients. Clofazimine also has a marked anti-inflammatory effect and is given to control the leprosy reaction, erythema nodosum leprosum.

Clofazimine binds preferentially to mycobacterial DNA, thereby inhibiting DNA replication and cell growth.
Clofazimine has a slow bactericidal effect on Mycobacterium leprae and is active against various other Mycobacteria.
Although bacterial killing may begin shortly after starting the drug, it cannot be measured in biopsy tissues taken from patients ... until approximately 50 days after the start of therapy.

Drug Indication.
For the treatment of lepromatous leprosy, including dapsone-resistant lepromatous leprosy and lepromatous leprosy complicated by erythema nodosum leprosum.

Availability:
No longer commercially available in the United States; only available by obtaining an investigational new drug (IND).

Adverse Effects:
Causes orange-pink to brownish-black discoloration of skin, as well as discoloration of conjunctivae, tears, sweat, sputum, urine and feces in 75-100% of patients; advise patients that skin discoloration is likely to occur and may take several months or years to reverse after conclusion of therapy; other skin reactions associated with therapy include ichthyosis, dry skin and pruritus.

Severe abdominal symptoms have necessitated exploratory laparotomies; rare reports have included splenic infarction, bowel obstruction, and GI bleeding; deaths reported with severe abdominal symptoms.

May accumulate in various organs as crystals, including mesenteric lymph nodes and histiocytes at lamina propria of intestinal mucosa, spleen and liver; deposition in intestinal mucosa may lead to intestinal obstruction that may necessitate exploratory laparotomy; splenic infarction, gastrointestinal bleeding, and death reported; ; doses > 100 mg daily should be given for as short period as possible < 3 months) and only under close medical supervision.

If patient complains of pain in abdomen, nausea, vomiting, or diarrhea, initiate appropriate medical assessment and reduce daily dose, increase dosing interval, or discontinue therapy.

Nervous: Dizziness, drowsiness, fatigue, headache, giddiness, neuralgia, taste disorder.

Medical: Dapsone, diaminodiphenyl sulfone (DDS). INDEX
https://www.drugs.com/cdi/dapsone-systemic.html
Medically reviewed on May 2, 2018

LINK 2: https://www.sciencedirect.com/topics/
biochemistry-genetics-and-molecular-biology/dapsone
From: Side Effects of Drugs Annual, 2017

LINK 3: https://en.wikipedia.org/wiki/Dapsone

Dapsone was first studied as an antibiotic in 1937. Its use for leprosy began in 1945.
It is a second-line medication for the treatment and prevention of pneumocystis pneumonia and for the prevention of toxoplasmosis in those who have poor immune function. Additionally, it has been used for acne, dermatitis herpetiformis, and various other skin conditions.

As an anti-inflammatory, dapsone inhibits the enzyme myeloperoxidase.
As part of the respiratory burst that neutrophils use to kill bacteria, myeloperoxidase converts hydrogen peroxide (H2O2) into hypochlorous acid (HOCl). HOCl is the most potent oxidant generated by neutrophils, and can cause significant tissue damage during inflammation. Dapsone arrests myeloperoxidase in an inactive intermediate form, reversibly inhibiting the enzyme. This prevents accumulation of hypochlorous acid, and reduces tissue damage during inflammation. Myeloperoxidase inhibition has also been suggested as a neuron-sparing mechanism for reducing inflammation in neurodegenerative diseases such as Alzheimer's disease and stroke.

Contraindications and precautions
People with porphyria, anemia, cardiac disease, lung disease, HIV infection, G6PD deficiency, and liver impairment are at higher risks of adverse effects when using dapsone.

Adverse effects
The dapsone hypersensitivity syndrome develops in 0.5–3.6% of persons treated with the medication, and is associated with a mortality of 10%. It is a form of severe cutaneous adverse reactions (SCARs) in which a SCARs disorder, primarily the DRESS syndrome or a DRESS syndrome-like reaction occurs.

Dapsone syndrome
Hypersensitivity reactions occur in some patients. This reaction may be more frequent in patients receiving multiple-drug therapy.

The reaction always involves a rash, may also include fever, jaundice, and eosinophilia, and is likely to be one manifestation of the SCARs reaction viz., the DRESS syndrome. In general, these symptoms will occur within the first six weeks of therapy or not at all, and may be ameliorated by corticosteroid therapy.

Significant Side Effects:
• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.

• Signs of infection like fever, chills, very bad sore throat, ear or sinus pain, cough, more sputum or change in color of sputum, pain with passing urine, mouth sores, or wound that will not heal.

• Signs of liver problems like dark urine, feeling tired, not hungry, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes.

• Signs of a pancreas problem (pancreatitis) like very bad stomach pain, very bad back pain, or very bad upset stomach or throwing up.

• Signs of lupus like a rash on the cheeks or other body parts, sunburn easy, muscle or joint pain, chest pain or shortness of breath, or swelling in the arms or legs.

• Pale skin.
• Purple spots or redness of the skin.
• Any unexplained bruising or bleeding.
• Feeling very tired or weak.
• A burning, numbness, or tingling feeling that is not normal.
• Muscle weakness.
• Trouble moving around.
• Blurred eyesight.
• Ringing in ears.
• Mood changes.
• Not able to pass urine or a change in how much urine is passed.
• A fast heartbeat.
• A very bad skin reaction (toxic epidermal necrolysis) may happen.
  It can cause very bad health problems that may not go away, and sometimes death.
  Get medical help right away if you have signs like red, swollen, blistered, or peeling skin (with or without fever); red or irritated eyes; or sores in your mouth, throat, nose, or eyes.

More frequent Side Effects:
• Upset stomach or throwing up.
• Headache.
• Belly pain.
• Not able to sleep.

Dapsone is inexpensive and major adverse effects are uncommon.
Dapsone hypersensitivity syndrome is characterized by an exfoliative dermatitis, fever and hepatitis which may be life-threatening. Dapsone hypersensitivity typically develops after 4–6 weeks of treatment and patients must be warned to stop the drug and seek urgent medical attention if symptoms develop. Mild haemolytic anaemia is common following dapsone treatment and rarely warrants change of therapy, but severe haemolysis occurs in patients with glucose-6-phosphate dehydrogenase deficiency (G6PD) and dapsone should be avoided in these patients.

Complete blood counts should be performed every 2 weeks for the first 3 months and then every 2 months thereafter.
Dapsone should be started at a dose of 25 mg twice daily and eventually raised to 100 mg daily.
Dapsone also interacts with all oxidant drugs, such as phenacetin and macrodantin.
Concurrent administration of 800 U of vitamin E daily may decrease the degree of dapsone-induced hemolysis.

Medical: Minocycline (Minocin), (minocycline hydrochloride). INDEX
Brand Names: Dynacin, Minocin, Minocin PAC, Myrac, Solodyn
https://www.sciencedirect.com/topics/neuroscience/minocycline

LINK 2: http://antibiotics.emedtv.com/minocycline/minocycline-side-effects.html
LINK 3: https://www.rxlist.com/minocin-capsules-drug.htm

A semisynthetic derivative of tetracycline

Minocycline is used to treat many different bacterial infections, such as urinary tract infections, respiratory infections, skin infections, severe acne, gonorrhea, tick fever, chlamydia, and others.

Get emergency medical help if you have any of these signs of an allergic reaction:
hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

A few common side effects of minocycline include fever, diarrhea, or a skin reaction to sunlight.
Some side effects, such as blurred vision or stomach cramps, may indicate a serious problem.

Call your doctor at once if you have a serious side effect such as:

• stomach cramps, diarrhea that is watery or bloody;
• flu symptoms, sores in your mouth and throat;
• pale or yellowed skin, weakness, dark colored urine, unusual bleeding
  --- (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;

• fever, skin rash, bruising, severe tingling or numbness, muscle weakness,
• upper stomach pain, loss of appetite, jaundice (yellowing of the skin or eyes);
• chest pain, irregular heart rhythm, cough, wheezing, feeling short of breath;
• confusion, vomiting, swelling, weight gain, urinating less than usual or not at all;
• headache or pain behind your eyes, ringing in your ears, vision problems;

• joint pain or swelling with fever, swollen glands, muscle aches, general ill feeling,
  unusual thoughts or behavior, and/or seizure (convulsions); or

• severe skin reaction
  -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain,
  followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Less serious side effects may include:
• dizziness, tired feeling, spinning sensation;
• joint or muscle pain;
• discoloration of you skin or nails;
• mild nausea, mild diarrhea, upset stomach;
• mild skin rash or itching;
• swollen tongue, discoloration of your gums; or
• vaginal itching or discharge.

Other important cautions:

Do not use this medicine if you are pregnant. It could harm the unborn baby or cause permanent tooth discoloration later in life.

Minocycline can make birth control pills less effective.
Ask your doctor about using a non hormone method of birth control (such as a condom, diaphragm, spermicide) to prevent pregnancy while using minocycline.

Minocycline passes into breast milk and may affect bone and tooth development in a nursing baby.
Do not take this medication without telling your doctor if you are breast-feeding a baby.

Children should not take minocycline.
Minocycline can cause permanent yellowing or graying of the teeth in children younger than 8 years old.

Avoid exposure to sunlight or tanning beds.
Minocycline can make you sunburn more easily.
Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

Do not take iron supplements, multivitamins, calcium supplements, antacids, or laxatives within 2 hours before or after taking minocycline. These products can make minocycline less effective.

Take this medication for the full prescribed length of time.
Your symptoms may improve before the infection is completely cleared.
Skipping doses may also increase your risk of further infection that is resistant to antibiotics.

Throw away any unused medicine after the expiration date on the label has passed.
Using expired minocycline can cause damage to your kidneys.

Tell your doctor about all other medicines you use, especially:

• other antibiotics;

• acetaminophen (Tylenol);

• isotretinoin (Accutane, Amnesteem, Claravis, Sotret);

• methotrexate (Rheumatrex, Trexall);

• antifungal medicine such as itraconazole (Sporanox), ketoconazole
  (Extina, Ketozole, Nizoral, Xolegal), miconazole (Oravig), or voriconazole (Vfend);

• a blood thinner such as warfarin (Coumadin, Jantoven);

• cholesterol medications such as niacin (Advicor, Niaspan, Niacor, Simcor, Slo Niacin, and others),
  atorvastatin (Lipitor, Caduet), fluvastatin (Lescol), lovastatin (Mevacor, Altoprev, Advicor),
  pravastatin (Pravachol), rosuvastatin (Crestor), or simvastatin (Zocor, Simcor, Vytorin);

• heart or blood pressure medicine such as
  benazepril (Lotensin), enalapril (Vasotec), lisinopril (Prinivil, Zestril),
  quinapril (Accupril), ramipril (Altace), and others;

• migraine headache medicine such as ergotamine
  (Ergomar, Cafergot, Migergot), dihydroergotamine (D.H.E. 45, Migranal), or methylergonovine (Methergine); or

• an NSAID (non-steroidal anti-inflammatory drug) such as
  ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn, Naprelan, Treximet), celecoxib (Celebrex),
  diclofenac (Cataflam, Voltaren), indomethacin (Indocin), meloxicam (Mobic), and others.

Medical: Ofloxacin (Floxin, Ocuflox) INDEX
https://www.emedicinehealth.com/drug-ofloxacin/article_em.htm

LINK 2: https://www.sciencedirect.com/topics/neuroscience/ofloxacin
LINK 3: https://www.dokteronline.com/en/ofloxacin#what-is-ofloxacin

Ofloxacin is in a group of antibiotics called fluoroquinolones (flor-o-KWIN-o-lones). Ofloxacin fights bacteria in the body.
Ofloxacin is a fluoroquinolone carboxylic acid antibacterial showing bactericidal effects by inhibition of DNA gyrase.

Ofloxacin is absorbed into the bloodstream and deposited in the infected tissue and urine to provide short-term relief from symptoms.

Ofloxacin is metabolized in liver at the piperazinyl moiety following oral doses.
Unlike other fluoroquinolones, ofloxacin structure contains an oxazine ring linking the nitrogen at position 1 and carbon at position 8 of the quinolone nucleus. This fused ring results in low metabolism of the drug in vivo. Nearly 90% of the administered dose is excreted unchanged in the urine within 48 h following single oral of ofloxacin doses and less than 10% of the compound is excreted as metabolites.

Ofloxacin is used to treat bacterial infections that cause
bronchitis, pneumonia, chlamydia, gonorrhea, skin infections, urinary tract infections, and infections of the prostate.

Ofloxacin is effective against a large number of bacteria and is used to treat many different types of infections, including:

• Infections of the airways (pneumonia, bronchitis);
• Bladder infection and other infections of the urinary tract;
• Gastrointestinal infections;
• STDs such as gonorrhoea;
• Inflammation of the cervix.

Ofloxacin tablets should be swallowed whole with a glass of water.
Do not take this medicine in combination with dairy products or antacids: these products could make Ofloxacin less effective.

Side Effects:
Get medical help right away if you have signs like red, swollen, blistered, or peeling skin (with or without fever); red or irritated eyes; or sores in your mouth, throat, nose, or eyes.

• Burning.
• Dizziness or drowsiness;
• Eye irritation.
• Gastrointestinal symptoms (nausea, vomiting, diarrhoea);
• Headache;
• Insomnia;
• Joint pain or swelling.
• Pins and needles or numb sensations in limbs;
• an allergic reaction:
  ---- hives; difficult breathing; swelling of your face, lips, tongue, throat; rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.

• Change in eyesight, eye pain, or very bad eye irritation.
• A very bad skin reaction (Stevens-Johnson syndrome/toxic epidermal necrolysis) may happen.
  It can cause very bad health problems that may not go away, and sometimes death.

  
  Stop using ofloxacin and call your doctor at once if you have a serious side effect such as:

• confusion, hallucinations, anxiety, feeling resltess, tremors, insomnia,
  --- nightmares, unusual thoughts or behavior, feeling light-headed;
• diarrhea that is watery or bloody;
• easy bruising or bleeding;
• fever, swollen glands, general ill feeling;
• numbness, burning pain, or tingly feeling in your hands or feet;
• seizure (convulsions);
• severe dizziness, fainting, fast or pounding heartbeat;
• sudden pain, snapping or popping sound, bruising, swelling,
  --- tenderness, stiffness, or loss of movement in any of your joints;
• urinating less than usual or not at all;

  
  Skin abnormalities:

  the first sign of any skin rash, no matter how mild; or

  Increased sensitivity of the skin to UV light: avoid exposure to direct sunlight and sunbeds.

  pale skin, dark colored urine, fever, weakness, jaundice (yellowing of the skin or eyes);;

  severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

  
  Less serious side effects may include:

  • nausea, vomiting, mild diarrhea;
  • headache, dizziness;
  • changes in your sense of taste;
  • vaginal itching or discharge; or
  • mild skin itching.

What is the most important information I should know about ofloxacin (Floxin)?

1. You should not use this medication if you have a history of myasthenia gravis, or if you are allergic to ofloxacin or similar antibiotics such as ciprofloxacin (Cipro), gemifloxacin (Factive), levofloxacin (Levaquin), moxifloxacin (Avelox), norfloxacin (Noroxin), and others.

2. Before taking ofloxacin, tell your doctor if you have kidney or liver disease, joint problems, myasthenia gravis, seizures or epilepsy, diabetes, low levels of potassium in your blood (hypokalemia), or a personal or family history of Long QT syndrome.

3. Ofloxacin may impair your thinking or reactions.
   Be careful if you drive or do anything that requires you to be alert.

4. Avoid exposure to sunlight or tanning beds.
   Ofloxacin can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors. Call your doctor if you have severe burning, redness, itching, rash, or swelling after being in the sun.

5. Antibiotic medicines can cause diarrhea, which may be a sign of a new infection.
   If you have diarrhea that is watery or bloody, stop taking ofloxacin and call your doctor.
   Do not use anti-diarrhea medicine unless your doctor tells you to.

6. Avoid taking antacids, vitamin or mineral supplements, sucralfate (Carafate), or didanosine (Videx) powder or chewable tablets within 2 hours before or after you take ofloxacin. These other medicines can make ofloxacin much less effective when taken at the same time.

7. Ofloxacin may cause swelling or tearing of a tendon (the fiber that connects bones to muscles in the body), especially in the Achilles' tendon of the heel. These effects may be more likely to occur if you are over 60, if you take steroid medication, or if you have had a kidney, heart, or lung transplant. Stop taking ofloxacin and call your doctor at once if you have sudden pain, swelling, tenderness, stiffness, or movement problems in any of your joints. Rest the joint until you receive medical care or instructions.

8. Ofloxacin can pass into breast milk and may harm a nursing baby.
   You should not breast-feed while you are using ofloxacin.

9. FDA pregnancy category C.
   It is not known whether ofloxacin will harm an unborn baby.
   Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

To make sure you can safely take ofloxacin, tell your doctor if you have any of these other conditions:

• heart rhythm disorder, especially if you take
  • quinidine (Quin-G),
  • disopyramide (Norpace),
  • bretylium (Bretylol),
  • procainamide (Pronestyl,
  • Procan SR),
  • amiodarone (Cordarone, Pacerone), or
  • sotalol (Betapace);

• a history of allergic reaction to an antibiotic;
• muscle weakness or trouble breathing;
• joint problems;
• kidney or liver disease;
• epilepsy or a history of seizures;
• diabetes;
• low levels of potassium in your blood (hypokalemia); or
• a personal or family history of Long QT syndrome.

What should I avoid while taking ofloxacin (Floxin)?
You may be taking certain other medicines that should not be taken at the same time as ofloxacin.
Avoid taking the following medicines within 2 hours before or after you take ofloxacin.
These other medicines can make ofloxacin much less effective when taken at the same time:

• antacids that contain calcium, magnesium or aluminum (such as Tums, Mylanta, or Rolaids);
• the ulcer medicine sucralfate (Carafate);
• didanosine (Videx) powder or chewable tablets; or
• vitamin or mineral supplements that contain calcium, iron, or zinc.

What other drugs will affect ofloxacin (Floxin)?
Tell your doctor about all other medicines you use, especially:
• a blood thinner such as warfarin (Coumadin, Jantoven);
• cimetidine (Tagamet);
• cyclosporine (Neoral, Sandimmune, Gengraf);
• insulin or oral diabetes medication such as glyburide (Micronase, Diabeta, Glynase);
• probenecid (Benemid);
• theophylline (Elixophyllin, Theo-24, Theochron, Uniphyl);
• an NSAID (non-steroidal anti-inflammatory drug) such as
  ---- ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn, Naprelan, Treximet),
  ---- celecoxib (Celebrex),
  ---- diclofenac (Arthrotec, Cambia, Cataflam, Voltaren, Flector Patch, Pennsaid, Solareze),
  ---- indomethacin (Indocin),
  ---- meloxicam (Mobic),
  ----------- and others; or
• steroid medication (prednisone and others).

Ofloxacin induced cutaneous reactions:
Three case reports describe children developing ofloxacin induced cutaneous reactions.

The first case describes a 5-year-old female given ofloxacin hydrochloride syrup 5 ml twice daily with paracetamol syrup 5 ml three times daily. The patient developed red colored papules all over the body with severe itching after 3 days. When the ofloxacin was withdrawn, the reactions subsided.

The second case describes a 4-year-old boy who developed multiple itchy annular erythematous lesions all over the body 2 days after starting ofloxacin 7.5 ml twice daily and paracetamol 5 mg twice daily for enteric fever. After stopping the ofloxacin and substituting it with azithromycin, 48 hours later the patient's symptoms resolved.

The third case is a 6-year-old female who developed erythema of eyelids with conjunctival congestion, buccal mucosal ulcerations, and painful red to black colored erythematous maculopapular blisters rapidly appeared all over the body 48 hours after taking ofloxacin. The ofloxacin was stopped, and the patient was given IV dexamethasone, chlorohexidine mouthwash, levocetrizine and calamine lotion. Ten days later, the patient's reaction resolved.

Medical: Prednisone, Deltasone -- Glucocorticoid, adrenocortical steroids. INDEX
(Often packaged with Corn Starch, Lactose, Sorbic Acid and Sucrose.)
https://www.peoplespharmacy.com/2012/04/08/prednisone-side-effects-deal-with-the-devil/

LINK 2: https://www.drugs.com/sfx/prednisone-side-effects.html Medically reviewed on April 30, 2018

LINK 3: https://www.kidney.org/content/what-you-need-know-about-prednisone

LINK 4: https://www.sharecare.com/health/
prednisone/what-impact-prednisone-diabetes-control

Prednisone is a glucocorticoid.
Glucocorticoids are adrenocortical steroids, both naturally occurring and synthetic, which are readily absorbed from the gastrointestinal tract. Prednisone is a white to practically white, odorless, crystalline powder. It is very slightly soluble in water; slightly soluble in alcohol, in chloroform, in dioxane, and in methanol.

Naturally occurring glucocorticoids (hydrocortisone and cortisone), which also have salt-retaining properties, are used as replacement therapy in adrenocortical deficiency states. Their synthetic analogs are primarily used for their potent anti-inflammatory effects in disorders of many organ systems.

Glucocorticoids cause profound and varied metabolic effects.
In addition, they modify the body's immune responses to diverse stimuli.
Persons who are on immunosuppressant doses of corticosteroids should be warned to avoid exposure to chicken pox or measles.

Steroid drugs, such as prednisone, work by lowering the activity of the immune system.
The immune system is your body’s defense system. Steroids work by slowing your body’s response to disease or injury.
Prednisone can help lower certain immune-related symptoms, including inflammation and swelling.

Applications:

Endocrine Disorders
• Primary or secondary adrenocortical insufficiency
• (hydrocortisone or cortisone is the first choice; synthetic analogs may be used in conjunction with mineralocorticoids where applicable; in infancy mineralocorticoid supplementation is of particular importance)
• Congenital adrenal hyperplasia
• Hypercalcernia associated with cancer
• Nonsuppurative thyroiditis
  Rheumatic Disorders
  --- As adjunctive therapy for short-term administration
  --- (to tide the patient over an acute episode or exacerbation) in:
  • Psoriatic arthritis
  • Rheumatoid arthritis, including juvenile rheumatoid arthritis
    (selected cases may require low-dose maintenance therapy)
  • Ankylosing spondylitis
  • Acute and subacute bursitis
  • Acute nonspecific tenosynovitis
  • Acute gouty arthritis
  • Post-traumatic osteoarthritis
  • Synovitis of osteoarthritis
  • Epicondylitis
Collagen Diseases During an exacerbation or as maintenance therapy in selected cases of:
• Systemic lupus erythematosus
• Systemic-dermatomyositis (polymyositis)
• Acute rheumatic carditis
  Dermatologic Diseases
  • Pemphigus
  • Bullous dermatitis herpetiformis
  • Severe erythema multiforme
    ---- (Stevens-Johnson syndrome)
  • Exfoliative dermatitis
  • Mycosis fungoides
  • Severe psoriasis
  • Severe seborrheic dermatitis
Allergic States Control of severe or incapacitating allergic conditions intractable
---- to adequate trials of conventional treatment:
• Seasonal or perennial allergic rhinitis
• Bronchial asthma
• Contact dermatitis
• Atopic dermatitis
• Serum sickness
• Drug hypersensitivity reactions
  Ophthalmic Diseases Severe acute and chronic allergic and inflammatory processes
  ---- involving the eye and its adnexa such as:
  • Allergic cornea marginal ulcers
  • Herpes zoster ophthalmicus
  • Anterior segment inflammation
  • Diffuse posterior uveitis and choroiditis
  • Sympathetic ophthalmia
  • Allergic conjunctivitis
  • Keratitis
  • Chorioretinitis
  • Optic neuritis
  • Iritis and iridocyclitis
Respiratory Diseases
• Symptomatic sarcoidosis
• Loeffler's syndrome not manageable by other means
• Berylliosis
• Fulminating or disseminated pulmonary tuberculosis
  ---- when used concurrently with appropriate antituberculous chemotherapy
• Aspiration pneumonitis
• Hematologic Disorders
• Idiopathic thrombocytopenic purpura in adults
• Secondary thrombocytopenia in adults
• Acquired (autoimmune) hemolytic anemia
• Erythroblastopenia (RBC anemia)
• Congenital (erythroid) hypoplastic anemia
  Neoplastic Diseases For palliative management of:
  • Leukemias and lymphomas in adults
  • Acute leukemia of childhood
  • Edematous States
    ---- To induce a diuresis or remission of proteinuria in the nephrotic syndrome,
    ---- without uremia, of the idiopathic type or that due to lupus erythematosus
Gastrointestinal Diseases To tide the patient over a critical period of the disease in:
• Ulcerative colitis
• Regional enteritis
• Nervous System
• Acute exacerbations of multiple sclerosis
  Miscellaneous
  • Tuberculous meningitis with subarachnoid block or impending block
    when used concurrently with appropriate antituberculous chemotherapy
  • Trichinosis with neurologic or myocardial involvement



Side Effects that occur while taking prednisone:

More common
• Aggression
• agitation
• blurred vision
• decrease in the amount of urine
• dizziness
• fast, slow, pounding, or irregular heartbeat or pulse
• headache
• Increased appetite
• irritability
• mood changes
• noisy, rattling breathing
• numbness or tingling in the arms or legs
• pounding in the ears
• shortness of breath
• swelling of the fingers, hands, feet, or lower legs
• trouble thinking, speaking, or walking
• troubled breathing at rest
• weight gain

Incidence not known
• Abdominal or stomach cramping or burning (severe)
• Abnormal fat deposits on the face, neck, and trunk
• abdominal or stomach pain
• acne
• backache
• bloody, black, or tarry stools
• cough or hoarseness
• darkening of the skin
• decrease in height
• decreased vision
• diarrhea
• dry mouth
• dry scalp
• eye pain
• eye tearing
• facial hair growth in females
• fainting
• fever or chills
• flushed, dry skin
• fractures
• fruit-like breath odor
• full or round face, neck, or trunk
• heartburn or indigestion (severe and continuous)
• increased hunger
• increased thirst
• increased urination
• lightening of normal skin color
• loss of appetite
• loss of sexual desire or ability
• lower back or side pain
• menstrual irregularities
• muscle pain or tenderness
• muscle wasting or weakness
• nausea
• pain in the back, ribs, arms, or legs
• painful or difficult urination
• red face
• reddish purple lines on the arms, face, legs, trunk, or groin
• skin rash
• sweating
• swelling of the stomach area
• thinning of the scalp hair
• trouble healing
• trouble sleeping
• unexplained weight loss
• unusual tiredness or weakness
• vision changes
• vomiting
• vomiting of material that looks like coffee grounds

SIDE EFFECTS by Category

Fluid and Electrolyte Disturbances
• Sodium retention
• Fluid retention
• Congestive heart failure in susceptible patients
• Potassium loss
• Hypokalemic alkalosis
• Hypertension

Musculoskeletal
• Muscle weakness
• Steroid myopathy
• Loss of muscle mass
• Osteoporosis
• Tendon rupture, particularly of the Achilles tendon
• Vertebral compression fractures
• Aseptic necrosis of femoral and humeral heads
• Pathologic fracture of long bones

Gastrointestinal
• Peptic ulcer with possible perforation and hemorrhage
• Pancreatitis
• Abdominal distention
• Ulcerative esophagitis
• Increases in alanine transaminase (ALT, SGPT), aspartate transaminase (AST, SGOT)
  --- and alkaline phosphatase have been observed following corticosteroid treatment.
  --- These changes are usually small, not associated with any clinical syndrome and
  --- are reversible upon discontinuation.

Dermatologic
• Impaired wound healing
• Thin fragile skin
• Petechiae and ecchymoses
• Facial erythema
• Increased sweating
• May suppress reactions to skin tests

Metabolic
• Negative nitrogen balance due to protein catabolism

Neurological
• Increased intracranial pressure with papilledema
  --- (pseudo-tumor cerebri) usually after treatment
• Convulsions
• Vertigo
• Headache

Endocrine
• Menstrual irregularities
• Development of Cushingoid state
• Secondary adrenocortical and pituitary unresponsiveness,
  --- particularly in times of stress, as in trauma, surgery or illness
• Suppression of growth in children
• Decreased carbohydrate tolerance
• Manifestations of latent diabetes mellitus
• Increased requirements for insulin or oral hypoglycemic agents in diabetics

Ophthalmic
• Posterior subcapsular cataracts
• Increased intraocular pressure
• Glaucoma
• Exophthalmos

Additional Reactions
• Urticaria and other allergic, anaphylactic or hypersensitivity reactions

Symptoms by Category.

General
The most commonly reported adverse effects ... associated with corticosteroid use include fluid retention, alteration in glucose tolerance, high blood pressure, behavior and mood changes, increased appetite and weight gain. Occurrence is often associated with dose and duration of therapy; long-term effects include HPA suppression, Cushingoid appearance, cataracts and increased intraocular pressure/glaucoma, osteoporosis and vertebral compression fractures.

Metabolic
Frequency not reported:
Decreased carbohydrate and glucose tolerance, increased requirements for insulin or oral hypoglycemic agents in diabetics, lipid abnormal, negative nitrogen balance caused by protein catabolism, hypokalemia, hypokalemic alkalosis, metabolic alkalosis, potassium loss, sodium retention with resulting edema, increased appetite and weight gain, anorexia and weight loss, hypertriglyceridemia, hypercholesterolemia

Cardiovascular
Frequency not reported:
Bradycardia, cardiac arrest, cardiac arrhythmias, cardiac enlargement, circulatory collapse, congestive heart failure, ECG changes caused by potassium deficiency, edema, fat embolism, hypotension, hypertension or aggravation of hypertension, hypertrophic cardiomyopathy in premature infants, myocardial rupture following recent myocardial infarction, necrotizing angiitis, syncope, tachycardia, thromboembolism, thrombophlebitis, vasculitis

Endocrine
Frequency not reported:
Adrenal insufficiency associated symptoms including arthralgias, buffalo hump, amenorrhea, postmenopausal bleeding or menstrual irregularities, development of cushingoid state, hyperthyroidism, hypothyroidism, moon face, secondary adrenocortical and pituitary unresponsiveness (particularly in times of stress as in trauma, surgery, or illness), increased or decreased motility and number of spermatozoa

Ocular
Frequency not reported:
Blurred vision, cataracts (including posterior subcapsular cataracts) central serous chorioretinopathy, secondary bacterial, fungal, and viral infections, exophthalmos, glaucoma, increased intraocular pressure

Gastrointestinal
Frequency not reported:
Abdominal distention, abdominal pain, constipation, diarrhea, gastric irritation, nausea, oropharyngeal candidiasis, pancreatitis, peptic ulcer with possible perforation and hemorrhage, perforation of the small and large intestine (particularly in patients with inflammatory bowel disease), ulcerative esophagitis, vomiting

Immunologic
Frequency not reported:
Immunosuppression, aggravation/masking of infections, decreased resistance to infection

Musculoskeletal
Frequency not reported:
Arthralgia, aseptic necrosis of femoral and humeral heads, increased risk of fracture, loss of muscle mass, muscle weakness, myalgias, osteopenia, osteoporosis, pathologic fracture of long bones, steroid myopathy, tendon rupture (particularly of the Achilles tendon), vertebral compression fractures, suppression of growth in pediatric patients

Hypersensitivity
Frequency not reported:
Anaphylaxis, angioedema, allergic reactions

Nervous system
Frequency not reported:
Arachnoiditis, benign intracranial hypertension, convulsions, dementia, dizziness, EEG abnormalities, impaired cognition, increased intracranial pressure with papilledema, increased motor activity, ischemic neuropathy, severe tiredness or weakness, meningitis, neuritis, neuropathy, paraparesis/paraplegia, sensory disturbances

Psychiatric
Frequency not reported:
Amnesia, anxiety, delirium, depression, emotional instability and irritability, euphoria, hallucinations, severe psychiatric symptoms, insomnia, long-term memory loss, mania, mood swings, neuritis, neuropathy, paresthesia, personality changes, psychiatric disorders including steroid psychoses or aggravation of preexisting psychiatric conditions, restlessness, schizophrenia, verbal memory loss, withdrawn behavior

Hematologic
Frequency not reported:
Anemia, neutropenia, febrile neutropenia, moderate leukocytosis, lymphopenia, eosinopenia, polycythemia

Dermatologic
Frequency not reported:
Acne, acneiform eruptions, allergic dermatitis, alopecia, angioedema, angioneurotic edema, atrophy and thinning of skin, dry scaly skin, ecchymosis and petechiae (bruising), erythema, facial edema, hirsutism, impaired wound healing, increased sweating, lupus erythematosus-like lesions, perineal irritation, purpura, rash, striae, subcutaneous fat atrophy, suppression of reactions to skin tests, telangiectasis, thin fragile skin, thinning scalp hair, urticaria, hypertrichosis[Ref]

Hepatic
Frequency not reported:
ALT, AST and alkaline phosphatase elevations (usually reversible upon discontinuation), hepatomegaly[Ref]

Respiratory
Frequency not reported:
Hiccups, pulmonary edema

General Precautions

1. Drug-induced secondary adrenocortical insufficiency may be minimized by gradual reduction of dosage.
   This type of relative insufficiency may persist for months after discontinuation of therapy; therefore, in any situation of stress occurring during that period, hormone therapy should be reinstituted. Since mineralocorticoid secretion may be impaired, salt and/or a mineralocorticoid should, be administered concurrently.

2. There is an enhanced effect of corticosteroids on patients with hypothyroidism and in those with cirrhosis.

3. Corticosteroids should be used cautiously in patients with ocular herpes simplex because of possible corneal perforation.
   
   

4. The lowest possible dose of corticosteroid should be used to control the condition under treatment, and when reduction in dosage is possible, the reduction should be gradual.

5. Psychic derangements may appear when corticosteroids are used, ranging from euphoria, insomnia, mood swings, personality changes, and severe depression, to frank psychotic manifestations. Also, existing emotional instability or psychotic tendencies may be aggravated by corticosteroids.
   
   

6. Steroids should be used with caution in nonspecific ulcerative colitis, if there is a probability of impending perforation, abscess or other pyogenic infection; diverticulitis; fresh intestinal anastomoses; active or latent peptic ulcer; renal insufficiency; hypertension; osteoporosis; and myasthenia gravis.

7. Growth and development of infants and children on prolonged corticosteroid therapy should be carefully observed.
   
   

8. Kaposi's sarcoma has been reported to occur in patients receiving corticosteroid therapy.
   Discontinuation of corticosteroids may result in clinical remission.

9. Although controlled clinical trials have shown corticosteroids to be effective in speeding the resolution of acute exacerbations of multiple sclerosis, they do not show that corticosteroids affect the ultimate outcome or natural history of the disease. The studies do show that relatively high doses of corticosteroids are necessary to demonstrate a significant effect.
   
   

10. Since complications of treatment with glucocorticoids are dependent on the size of the dose and the duration of treatment, a risk/benefit decision must be made in each individual case as to dose and duration of treatment and as to whether daily or intermittent therapy should be used.

11. Convulsions have been reported with concurrent use of methylprednisolone and cyclosporin.
    Since concurrent use of these agents results in a mutual inhibition of metabolism, it is possible that adverse events associated with the individual use of either drug may be more apt to occur.

WARNINGS

• In patients on corticosteroid therapy subjected to unusual stress, increased dosage of rapidly acting corticosteroids before, during, and after the stressful situation is indicated.

• Corticosteroids may mask some signs of infection, and new infections may appear during their use.
  Infections with any pathogen including viral, bacterial, fungal, protozoan or helminthic infections, in any location of the body, may be associated with the use of corticosteroids alone or in combination With other immunosuppressive agents that affect cellular immunity, humoral immunity, or neutrophil function.

  These infections may be mild, but can be severe and at times fatal.
  With increasing doses of corticosteroids, the rate of occurrence of infectious complications increases.
  There may be decreased resistance and inability to localize infection when corticosteroids are used.
  Prolonged use of corticosteroids may produce posterior subcapsular cataracts, glaucoma with possible damage to the optic nerves, and may enhance the establishment of secondary ocular infections due to fungi or viruses.
  
  

• Usage in pregnancy:
  Since adequate human reproduction studies have not been done with corticosteroids, the use of these drugs in pregnancy, nursing mothers or women of childbearing potential requires that the possible benefits of the drug be weighed against the potential hazards to the mother and embryo or fetus. Infants born of mothers who have received substantial doses of corticosteroids during pregnancy, should be carefully observed for signs of hypoadrenalism.

• Average and large doses of hydrocortisone or cortisone can cause elevation of blood pressure, salt and water retention, and increased excretion of potassium. These effects are less likely to occur with the synthetic derivatives except when used in, large doses. Dietary salt restriction and potassium supplementation may be necessary. All corticosteroids Increase calcium excretion.

• Administration of live or live, attenuated vaccines is contraindicated in patients receiving immunosuppressive doses of corticosteroids. Killed or inactivated vaccines may be administered to patients receiving immunosuppressive doses of corticosteroids; however, the response to such vaccines may be diminished. Indicated immunization procedures may be undertaken in patients receiving nonimmunosuppressive doses of corticosteroids.
  
  

• The use of DELTASONE (prednisone) Tablets in active tuberculosis should be restricted to those cases of fulminating or disseminated tuberculosis in which the corticosteroid is used for the management of the disease in conjunction with an appropriate anti-tuberculous regimen.

• If corticosteroids are indicated in patients with latent tuberculosis or tuberculin reactivity, close observation is necessary as reactivation of the disease may occur. During prolonged corticosteroid therapy, these patients should receive chemoprophylaxis.
  
  

• Persons who are on drugs which suppress the immune system are more susceptible to infections than healthy individuals.
  Chicken pox and measles, for example, can have a more serious or even fatal course in non-immune children or adults on corticosteroids. In such children or adults who have not had these diseases, particular care should be taken to avoid exposure. How the dose, route and duration of corticosteroid administration affects the risk of developing a disseminated infection is not known. The contribution of the underlying disease and/or prior corticosteroid treatment to the risk is also not known.

  If exposed to chicken pox, prophylaxis with varicella zoster immune globulin (VZIG) may be indicated.
  If chicken pox develops, treatment with antiviral agents may be considered.

  If exposed to measles, prophylaxis with pooled intramuscular immunoglobulin (IG) may be indicated.
  
  

  ... corticosteroids. should be used with great care in patients with known or suspected Strongyloides (threadworm) infestation. In such patients, corticosteroid-induced immunosuppression may lead to Strongyloides hyperinfection and dissemination with widespread larval migration, often accompanied by severe enterocolitis and potentially fatal gram-negative septicemia.

DRUG INTERACTIONS ... Drugs that induce hepatic enzymes such as phenobarbital, phenytoin and rifampin may increase the clearance of corticosteroids and may require increases in corticosteroid dose to achieve the desired response.

Drugs such as troleandomycin and ketoconazole may inhibit the metabolism of corticosteroids and thus decrease their clearance. Therefore, the dose of corticosteroid should be titrated to avoid steroid toxicity.

Corticosteroids may increase the clearance of chronic high dose aspirin.
This could lead to decreased salicylate serum levels or increase the risk of salicylate toxicity when corticosteroid is withdrawn.
Aspirin should be used cautiously in conjunction with corticosteroids in patients suffering from hypoprothrombinemia.

The effect of corticosteroids on oral anticoagulants is variable.
There are reports of enhanced as well as diminished effects of anticoagulants when given concurrently with corticosteroids.

How does taking prednisone affect my diabetes?

Stacy Wiegman, PharmD
Pharmacy
Prednisone may complicate your diabetes treatment by raising your blood glucose levels.
You may have to adjust your diabetes treatment plan if you start taking prednisone, which is a corticosteroid medication used to treat inflammatory conditions in the body. When you stop prednisone therapy, your blood glucose levels should drop to where they were previously. If you need to take prednisone, be sure to talk to your doctor about the best ways to keep your diabetes under control while you're on the medication.

Amy Campbell
Endocrinology Diabetes & Metabolism
Prednisone and other steroid medications tend to increase blood glucose levels.
Most people find that they need more medication or insulin when taking prednisone (or a similar type of medication).
It's important to be aware of this and have a game plan from your healthcare provider as to how to manage higher blood glucose. Your provider may ask you to call him or her for a medication adjustment, for example. Some people may even temporarily need to start taking insulin while they are on prednisone. Also, it may take several days to a week or so after stopping the prednisone before blood glucose levels go back to "normal."

American Diabetes Association
Administration
Prednisone is used for a variety of conditions such as asthma and other lung problems.
It acts like a hormone that your body makes called "cortisol." Cortisol and prednisone both cause the body to make glucose when you're not eating (like during the night). They can worsen diabetes control. Cortisol is called a "stress hormone" because the body releases it to deal with stresses like accidents, infections, or burns. That's part of the reason why it takes more insulin to keep blood glucose near normal during an infection. If you have had prednisone prescribed for any reason and you have diabetes, you will need to take more diabetes medication. Prednisone's effect on your blood glucose will go away a day or two after you stop taking it. Your health care team can help you alter your diabetes treatment until you can stop taking the prednisone.

Medical: Rifampicin; rifampin - antibacterial and antiviral antibiotic. INDEX
https://www.sciencedirect.com/topics/medicine-and-dentistry/rifampicin

LINK 2: https://www.rxlist.com/rifadin-drug/patient-images-side-effects.htm
Last reviewed on RxList: 1/17/2018

An antibacterial and antiviral antibiotic;
action depends upon its preferential inhibition of bacterial ribonucleic acid polymerase over animal-cell RNA polymerase.

Used to Treat:
or prevent tuberculosis (TB); may also be used to eliminate a bacteria from your nose and throat that may cause meningitis or other infections, even if you do not have an infection. Rifampin prevents you from spreading this bacteria to other people, but the medication will not treat an infection caused by the bacteria.

Possible side effects of rifampin (Rifadin).

• fever, chills, body aches, flu symptoms;
• joint pain or swelling;
• easy bruising or bleeding, weakness;
• urinating less than usual or not at all; or
• nausea, stomach pain, loss of appetite, itching, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).
  Less serious side effects may include:
  • tired feeling; or
  • red or orange colored urine, stools, tears, sweat, or saliva.

Important information I should know:

Before taking rifampin, tell your doctor if you are allergic to any drugs, or if you have liver disease or porphyria (a genetic enzyme disorder that causes symptoms affecting the skin or nervous system).

Take this medication for the full prescribed length of time.
Your symptoms may improve before the infection is completely cleared.
Rifampin will not treat a viral infection such as the common cold or flu.

Take the rifampin capsule on an empty stomach 1 hour before or 2 hours after a meal.

Rifampin can make birth control pills less effective.
Ask your doctor about using a non-hormone method of birth control (such as a condom, diaphragm, spermicide) to prevent pregnancy while taking rifampin.

Do not wear contact lenses while you are taking rifampin.
This medicine may discolor your tears, which could permanently stain soft contact lenses.

Rifampin passes into breast milk and may harm a nursing baby.
Do not use this medication without telling your doctor if you are breast-feeding a baby.

What other drugs will affect rifampin (Rifadin)?

• acetaminophen (Tylenol);
• a blood thinner such as warfarin (Coumadin);
• a barbiturate such as phenobarbital (Solfoton);
• diazepam (Valium) or similar medicines such as alprazolam (Xanax),
  --- chlordiazepoxide (Librium), midazolam (Versed), temazepam (Restoril), triazolam (Halcion), and others;

• a beta-blocker such as atenolol (Tenormin), bisoprolol (Zebeta, Ziac),
  --- labetalol (Normodyne, Trandate), metoprolol (Lopressor, Toprol),
  --- propranolol (Inderal, InnoPran), timolol (Blocadren), and others;

• clofibrate (Atromid-S);
• steroids such as prednisone, fluticasone (Advair),
  --- mometasone (Asmanex, Nasonex), dexamethasone (Decadron, Hexadrol) and others;
• birth control pills or estrogen hormone replacement;
• heart medicines such as digoxin (Lanoxin), disopyramide (Norpace), quinidine (Quinaglute,
  --- Quinidex), mexiletine (Mexitil), tocainide (Tonocard), verapamil (Calan, Verelan, Isoptin), or enalapril (Vasotec);

• HIV medicines such as delavirdine (Rescriptor), saquinavir (Invirase, Fortovase), ritonavir (Norvir), nelfinavir (Viracept), and others;
• ketoconazole (Nizoral), itraconazole (Sporanox), or fluconazole (Diflucan);
• methadone (Dolophine);
• phenytoin (Dilantin), ethotoin (Peganone), and mephenytoin (Mesantoin);
• sulfa drugs (Bactrim, Gantanol, Septra, and others);
• diabetes medication you take by mouth;
• cyclosporine (Sandimmune, Neoral); or
• theophylline (Elixophyllin, TheoCap, Theochron, Uniphyl).
• others.

from ... The Three Cardinal Signs of Leprosy
Stephen L. Walker, ... Diana N.J. Lockwood,
in Manson's Tropical Infectious Diseases (Twenty-third Edition), 2014

Rifampicin is the key bactericidal component of all leprosy chemotherapy regimens.
A single dose of rifampicin can reduce the number of viable bacilli to undetectable levels within a few days, with killing rates measured in excess of 99.9% after 1 month. Standardized WHO regimens employ a monthly dose of rifampicin.

Rates of resistance in reported series and in clinical practice remain low.
Rifampicin resistance in leprosy is rare. Mutations in the rpoB gene, which encodes the ß-subunit of RNA polymerase, lead to high-level resistance to rifampicin in M. leprae.32 Leprosy treatment depends heavily on rifampicin and so contraindication to the drug requires significant modification of treatment. At least one bactericidal drug such as ofloxacin should be added to the treatment regimen.

Occasional cases of renal failure, thrombocytopenia, influenza-like syndrome and hepatitis are reported due to rifampicin. Rifampicin characteristically produces a reddish-brown colour in urine, sputum and sweat. The effect of oral corticosteroids given to treat reactions does not appear to be diminished by monthly rifampicin.




Tuberculosis should always be excluded before monthly rifampin is started.



Etiologic Agents of Infectious Diseases
Jeffrey R. Starke, in Principles and Practice of Pediatric Infectious Diseases (Fourth Edition), 2012

Although approximately 75% of drug is protein-bound, rifampin penetrates well into most tissues and fluids.
Rifampin penetrates meninges only in the presence of inflammation. Gastrointestinal upset is the most common side effect. Other reactions are skin eruptions, hepatitis, and occasional thrombocytopenia or cholestatic jaundice. Rifampin is excreted in urine, tears, sweat, and other body fluids. In 80% of recipients, body fluids and contact lenses are discolored orange during consumption of rifampin. ... Rifampin can lower the effectiveness of oral contraceptive drugs and accelerate excretion of other drugs that undergo hepatic metabolism.




Laboratory Diagnosis and Therapy of Infectious Diseases
Melissa B. Miller, Peter H. Gilligan, in
Principles and Practice of Pediatric Infectious Diseases (Fourth Edition), 2012

Rifampin targets the ß-subunit of bacterial DNA-dependent RNA polymerase encoded by the gene rpoB.
Point mutations in rpoB can result in amino acid substitutions, decreased binding and resistance.
Mutations in rpoB have been detected in a variety of bacteria, notably in S. aureus, N. meningitidis, and M. tuberculosis.
Because point mutations can result in high-level resistance, rifampin is rarely used alone in order to prevent emergence of resistance. Rifampin resistance does not always persist, suggesting that resistance mutations may adversely affect bacterial fitness.

Other mechanisms of resistance to rifampin including rifampin modifying enzymes and efflux pumps are found in environmental GPOs such as Nocardia and Mycobacterium and GNBs such as S. maltophilia and B. cenocepacia. Clinical significance of these mechanisms compared with rpoB mutations is minor.

Research: Plaque Psoriasis. INDEX
https://plaquepsoriasis.com/what-is-psoriasis/
Written by: Anna Nicholson | Last reviewed: July 2016.

Psoriasis is an autoimmune condition that causes symptoms to develop on the skin.
There are several different types of psoriasis, but the most common form is called plaque psoriasis, which affects between 80% and 90% of people with the condition. Plaques are patches of skin that are raised, red, dry, and often covered with a layer of silvery scales.

Psoriasis is a chronic, life-long condition.
It cannot be cured, but most people will cycle through periods of flare-ups and remissions.
Flare-ups are periods of time when symptoms get worse. Remissions are periods of time when the symptoms get better or even go away completely for a time. People who have psoriasis can learn to identify and avoid their own psoriasis triggers, which are things in the environment that can cause psoriasis symptoms to flare up.

What are plaques and why do they form?
Plaques are patches of skin that are raised, red, inflamed, and often covered with a layer of silvery scales.
Plaques develop because people with psoriasis have an immune system that is overactive, causing inflammation when it is not needed. This inflammation triggers the production of new skin cells more quickly than older skin cells can die off and be shed from the skin naturally. The new skin cells push the older cells up to the surface of the skin, where they build up in the form of plaques.

What are the symptoms of plaque psoriasis?
Plaques can develop anywhere on a person’s body, but may often form on the scalp, elbows, knees, lower back, hands, feet, nails, genitals, and skin folds. A person with psoriasis may have plaques just in one area of the body, or they may develop in multiple locations.

Most people with psoriasis (around 80%) have a mild form of the condition, with symptoms that affect less than 3% of a person’s total body surface area. Moderate psoriasis affects between 3% and 10% of the body surface, while severe psoriasis affects 10% or more of the body surface.

Plaques are the most common symptom of psoriasis, and they can cause itchiness and burning.
They can occasionally crack and bleed, particularly if they are very dry or located on an area of the body that bends or moves frequently (like a knee or elbow).

How is psoriasis treated?
Even though psoriasis cannot be cured, there are different types of treatments available that work effectively to reduce and relieve symptoms for many people. People with psoriasis that is will usually try treatment first with over-the-counter or prescription topical medications, which are applied directly to the affected skin. People with moderate to severe symptoms may need to combine topical treatments with systemic medications. These are taken by mouth or through an injection and work by affecting the way the person’s immune system functions in order to reduce inflammation and prevent as many new skin cells from being produced.

Light therapy (Phototherapy) is another treatment option for people with psoriasis.
Light therapy involves exposing the affected skin to ultraviolet light rays for a limited period of time to help reduce symptoms.

Many people also find that certain types of lifestyle changes can help them to control their psoriasis symptoms, such as dietary changes, regular exercise, stress management techniques, and home remedies. Others find that complementary and alternative therapies such as acupuncture, herbal remedies, and dietary supplements may be helpful.

Is psoriasis related to other health conditions?
Inflammation in the body is the cause of psoriasis symptoms on the skin.
Inflammation is also linked to other types of health conditions, which tend to affect people with psoriasis at higher rates than people without psoriasis. These include:

• Heart disease and other cardiovascular conditions
• Metabolic syndrome
• Type 2 diabetes
• Obesity
• Inflammatory bowel diseases
• Depression
• Certain types of cancers

Healthcare providers regularly monitor people with psoriasis for sign and symptoms of these other conditions, most of which can be controlled and treated effectively if they are caught early enough.

- Report: Leprosy associated with psoriasis. INDEX
https://www.lepra.org.uk/platforms/lepra/files/lr/Dec15/15-0005.pdf
Theisla Kely Azevedo Raiol, Solange Emanuelle Volpato, Jaci Maria Santana,
Isabelle Sousa Medeiros Torres Ferreira, and, Daniela Mayumi Takano
Hospital Otavio de Freitas, Recife, Pernambuco, Brazil
Lepr Rev (2015) 86, 368 – 373 --- Accepted for publication 21 July 2015

... The relation between psoriasis and leprosy has not been well elucidated, but has been controversial since ancient times, when psoriasis was considered a form of leprosy.

A report published in the second half of the twentieth century, about a large number of leprosy patients followed for approximately 40 years, pointed to a very low incidence of psoriasis among them. This observation stimulated the attention of researchers in the exploration of hypotheses that leprosy and psoriasis rarely develop in the same patient. Bassukas et al. published an article that defended the hypothesis that psoriasis (may) protects the clinical progression of leprosy; and that leprosy has been contained because of the increased prevalence of psoriasis.

This could be explained by the fact that patients with psoriasis (may) have an innate immunity and reinforced cell, which would protect against lepromatous leprosy and also against other bacterial infections.

Also reported in the literature was an increased prevalence of psoriasis in areas where there were leprosy epidemics, as in Mediterranean Europe and the Middle East. A high rate of psoriasis has been observed in individuals of European ancestry, so that the occurrence of resistance to leprosy was observed most commonly in Europe. In this way, psoriasis would have expanded due to the pressure exerted by leprosy, in the genotype of individuals, leading to natural selection.

Our patient did not have European ancestry and had never manifested psoriatic lesions; this is the opposite of the hypothesis above. Other theories suggest a protection against psoriasis in patients affected by leprosy. In the pathogenesis of psoriasis, psoriatic lesions have a significantly larger number of nerves with increased content of neuropeptides.

The Neuropathy caused by Mycobacterium leprae infection, results in structural and functional alterations in the cutaneous sensory nerves, and the consequent absence of neuropeptides in the leprous skin. This process of neurogenic inflammation, which seems to be an integral part of the psoriatic disease process, is inhibited.

The patient in question first reported the development of lesions suggestive of leprosy and afterwards of psoriatic lesions, contradicting the protection theory of psoriasis in patients with leprosy. There are few reports in the literature about the coexistence of psoriasis and leprosy in the same patient. Kumar et al. conducted a research using a questionnaire, which was filled out by medical treatment centres for leprosy in different parts of the world. Out of this research of 145,661 cases of leprosy, only 20 people had psoriasis.

Sugathan et al. (1990) and Nigam et al. (1991) also reported cases of association of both diseases in patients in India.

Initially the patient was oriented towards only hydrating the skin with urea lotion 10% which gave a slight improvement.
The relevant factor noticed in our clinical case, was the clinical improvement of psoriasis after the introduction of thalidomide (100 mg / day) for the treatment of ENL (erythema nodosum leprosy). This may have happened because Type 2 leprosy reaction (erythema nodosum) and psoriasis has high levels of TNF alpha. And thalidomide decreases TNF alpha levels by immunomodulatory action, which can justify the improvement of the ENL and psoriatic lesions, too.

The literature reinforces evidence of a negative association between psoriasis and leprosy. ...

Summary: Differences between Plaque Psoriasis & Leprosy. INDEX
http://www.bestonlinemd.com/difference-between-leprosy-and-psoriasis/
2017-04 --- Filament Group, Inc.

Leprosy is a contagious, chronic disease caused by Mycobacterium leprae, a rod-shaped bacterium.
The disease is also called Hansen’s disease, after a Norwegian doctor, Armauer Hansen. Hansen was the first to discover the bacterium that causes leprosy and published a paper on it in 1873, according to an article in the Indian Journal of Dermatology.

Leprosy affects not just the skin, but also the peripheral nerves, mucosa of the upper respiratory tract and the eyes.
If left untreated, the disease can be debilitating and cause muscle weakness, disfigurement, permanent nerve damage in the arms and legs and loss of sensation in the body.

Psoriasis is a noncontagious, chronic skin condition that produces plaques of thickened, scaling skin.
The dry flakes of skin scales result from the excessively rapid proliferation of skin cells. The proliferation of skin cells is triggered by inflammatory chemicals produced by specialized white blood cells called lymphocytes. Psoriasis commonly affects the skin of the elbows, knees, and scalp.

The spectrum of disease ranges from mild with limited involvement of small areas of skin to large, thick plaques to red inflamed skin affecting the entire body surface.

Psoriasis is considered an incurable, long-term (chronic) inflammatory skin condition.
It has a variable course, periodically improving and worsening. It is not unusual for psoriasis to spontaneously clear for years and stay in remission. Many people note a worsening of their symptoms in the colder winter months.

When you have psoriasis, the genes that control your immune system signals get mixed up.
Instead of protecting your body from invaders as it’s designed to do, it promotes inflammation and turns skin cells on overdrive.

Scientists have found about 25 genes that are different in people with psoriasis.
They think it takes more than one to cause the disease, and they’re looking for the main ones.

Psoriasis signs and symptoms can vary from person to person but may include one or more of the following:
• Red patches of skin covered with silvery scales
• Small scaling spots (commonly seen in children)
• Dry, cracked skin that may bleed
• Itching, burning or soreness
• Thickened, pitted or ridged nails
• Swollen and stiff joints

Psoriasis patches can range from a few spots of dandruff-like scaling to major eruptions that cover large areas

Leprosy is caused by Mycobacterium leprae, a slow-growing bacterium that cannot live outside its host.
It’s difficult to study because it can only be grown in animals and the symptoms take years to develop.

Psoriasis, on the other hand, is an autoimmune disorder.
It causes skin cells to grow rapidly, leading to skin lesions and plaques. Psoriasis isn’t contagious.
A combination of genetics and environmental triggers is thought to cause psoriasis.

Product: Frankincense Oil, Aromapathic Labs - 30 ml + Bonus. INDEX
http://www.nationalnutrition.ca/detail.aspx?ID=9212
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Enjoy the Sweet, Woody, Balsamic and Earthy aroma of Aromapathic Labs 100% Pure Frankincense Oil.
For centuries Frankincense Oil has been closely associated with religious traditions on top of being praised by aroma therapists.
Feel your stresses melt away when you diffuse this rich and musky scent in your home.
Frankincense Oil mixes great with other oils like Lavender, Orange, Clary Sage, Ylang Ylang and Basil.

For aromatherapy use. For all other uses, carefully dilute with a carrier oil such as jojoba, grapeseed, olive or almond oil prior to use. Please consult an essential oil book or other professional reference source for suggested dilution ratios.

Frankincense has ... Historically believed to have the ability to rid evil sprits from the sick and purify the body.
It was an important part of many religious rituals both in the East and West. ...
Frankincense is praised by aroma therapists for its unique calming and meditative properties.
Used in a diffuser, added to a bath or just inhaled on its own, Frankincense encourages a state of relaxation and tranquility.

Product: Frankincense Oil, NOW INDEX
https://www.vitamart.ca/now-frankincense-oil-aromatherapy.html
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100% Pure (Aromatherapy), 30ml

NOW Frankincense Oil Details
• Relaxing
• Focusing
• Centering

Mixes well with balsam fir needle oil, myrrh oil, orange oil and sandalwood oil blend.

This blend is already pre-diluted and ready for use.

Product: Neem Leaves, Nature's Way. INDEX
https://www.vitamart.ca/natures-way-neem.html
Retail Price: $12.99 -- Vitamart Price: $9.47 -- You Save $3.52 -- You Save 27%
100 VCaps --- 2018-05-29

Nature's Way Neem Details

• Premium Herbal
• Certified 475 mg
• Dietary Supplement

Neem (Azadirachta indica) is an Ayurvedic herbal from India traditionally used for purifying and cleansing. Its benefits are also similar to Echinacea and Goldenseal.

Product: Neem Cream (Original Vanilla), Theraneem, 60 ml INDEX
http://www.nationalnutrition.ca/detail.aspx?ID=28
Reg: $26.99 -- Sale: $18.99 --- (Savings: $8.00) --- 2018-05-30

Ingredients:

Aqueous Extract of Azadirachta Indica (Neem)* Leaf, 
Aloe Barbadensis Leaf Gel*, 
Helianthus Annuus (Sunflower) Seed Oil*, 
Emulsifying Wax NF, 
Azadirachta Indica (Neem) Seed Oil*, 
Stearic Acid, 
Butyrospermum Parkii (Shea Butter) Fruit,
Simmondsia Chinensis (Jojoba) Seed Oil*, 
Glycerin, 
Beeswax,
Phenoxyethanol and Caprylyl Glycol, 
Tocopherol (Vitamin E),
Fragrance (Vanilla from Natural Ingredients), 
Persea Gratissima (Avocado) Oil 

Highlights:
• Original formula, fresh new look
• Safe for all skin types
• Contains many moisturizing oils
• Supports healthy skin with antioxidants
• Protects, moisturizes and nourishes even the most sensitive skin
• Paraben Free, Sulfate Free & Gluten Free.

Product: Neem Oil (PURE), Theraneem - 30 ml INDEX
http://www.nationalnutrition.ca/detail.aspx?ID=151
Reg: $12.99 -- Sale: $10.99 -- (Savings: $2.00) --- 2018-05-30

Ingredients:
100% pure, cold-pressed, wild-crafted and/or Certified Organic Azadirachta indica (Neem) Seed Oil

Highlights:
• Rich in nourishing essential fatty acids and antioxidants for protection and prevention
• Gentle and soothing for sensitive scalps and skin
• Gentle, yet effective alternative to tea tree oil with similar therapeutic benefits
• 100% Pure and Organic

Neem oil solidifies at a cool room temperature.
This is because of the high concentration of essential fatty acids in the oil.

Apply pure organic Neem oil directly to the skin, or add a drop or two to your favorite shampoo or body care product for soothing relief.

Helpful hair and scalp tip:
Hair and scalp challenges as well as thinning hair are often caused by over-washing.
If you are trying to “kick” the shampoo every day habit, feeding the hair and scalp additional nourishing neem oil and olive oil will help to balance oil production for oily, dry, or sensitive scalps.

Product: Sarsaparilla Root 425 mg., Natures Way. INDEX
https://www.luckyvitamin.com/
p-5269-nature-s-way-sarsaparilla-root-425-mg-100-vegetarian-capsules
Sale Price: $10.78 (CAD) --- $16.38 (CAD) -- Save 34% -- June 27, 2018
Item #: 54342 -- 50 days at 2 caps/day.

Ingredients: per capsule

425 mg. of Sarsaparilla Root
plant-derived capsule (modified cellulose),
magnesium stearate.

Dosage: Take 2 capsules daily.

Product: Sarsaparilla, 560 mg, 60 Tablets, HealthAid. INDEX
https://www.amazon.ca/HealthAid-Sarsaparilla-560mg-Vegan-Tablets/....
LINK 2: https://www.healthaid.co.uk/sarsaparilla-560mg-tablets
Ca $ 13.45 --- FREE SHIPPING.

HealthAid House, Marlborough Hill
Harrow, Middlesex, HA1 1UD
Phone: +44 (0) 20 8426 3400

Ingredients per capsule

140 mg --- Sarsaparilla Extract, (equivalent to 560mg of Sarsaparilla powder) Other:
di-Calcium Phosphate, Sarsaparilla Extract (smilax spp),
Microcrystalline Cellulose, Croscarmellose Sodium, Veg. Stearic Acid,
Veg. Magnesium Stearate, Polyvinylpyrrolidone (PVP), Talc.

Product: Sarsaparilla Root, 450 mg, Solaray. INDEX
https://www.vitacost.com/solaray-sarsaparilla-root
Sarsaparilla Root, 450 mg, Solaray 100 Capsules.
Retail price: USA $12.29 --- Our price: $7.37 --- Save: 40% -- 2018-06-24

Sarsaparilla was used widely as an extract in root beer formulas.

Ingredients per 3 capsules (suggested dosage)
450 mg --- Sarsaparilla Root (smilax aristolochiaefolia)
Other Ingredients: Gelatin capsule, magnesium stearate and cellulose.

Device: The SOTA Magnetic Pulser. INDEX
https://www.sota.com/magnetic-pulser.html
USA $350.00 --- 2018-07-10

LINK 2: https://www.chrisbeatcancer.com/bobbeck/
LINK3: https://www.sota.com/files/pdf/sota_brochure_legal.pdf
LINK 4: https://www.sota.com/default.aspx?page=Silver-Pulser
LINK 5: User Guide, 8 pages, pdf

This is a device that creates a PEMF (Pulsed Electromagnetic Field).
This is a moving magnetic field which causes 50-100 micro-amperes to be generated deep within tissues to neutralize the parasites, viruses, and pathogens that are latent in tissues and not circulating in the blood. The magnetic pulser is designed for specifically targeting lymph nodes, organs, and tumor sites, and should be used in conjunction with the Silver Pulser blood electrification device.

The SOTA Magnetic Pulser offers the benefits of a pulsed magnetic field to help balance the body’s natural electricity for health.

• Automatic Timer
• Bio-North Pole identified
• Fast and Slow Modes
• Output greater than 6,000 Gauss
• Magnetic Field penetrates up to 9 inches
• Two-year limited Warranty

The Magnetic Pulser generates pulsed magnetic fields which are known to create microcurrents.
For most applications, it is best to use the Bio North (-) polarity side of the Hand Paddle — the polarity is clearly marked on the Hand Paddle. The Bio North (-) polarity of the Hand Paddle can be applied to any area of the body. The Magnetic Pulser can be applied over clothing as the magnetic field penetrates clothing. Keep the Hand Paddle on one area or move to different locations during a session.

Basic Wellness Program:

Begin slowly, 10 minutes per day, and then gradually increase the length of each session until you are applying at least 20 minutes per day.
Daily use varies from 20-30 minutes to two hours or more.
Continue use for 8 to 12 weeks minimum.

When used as part of a wellness program, consistent daily use for many weeks is more important for results than using occasionally.
Longer and more frequent sessions may be more beneficial.

Focused Wellness Program:
Increase the amount of time used daily by increasing the number of sessions.
Use beyond the 8 to 12 week minimum. When following a more intense program, it may be necessary to continue for many months or even years.

Glossary: Definitions of relevant scientific - medical terms. INDEX

ADT® (Alternate Day Therapy)
ADT is a corticosteroid dosing regimen in which twice the usual daily dose of corticoid is administered every other morning.
The purpose of this mode of therapy is to provide the patient requiring long-term pharmacologic dose treatment with the beneficial effects of corticoids while minimizing certain undesirable effects, including pituitary-adrenal suppression, the Cushingoid state, corticoid withdrawal symptoms, and growth suppression in children.

... Acting primarily through the hypothalamus a fall in free cortisol stimulates the pituitary gland to produce increasing amounts of corticotropin (ACTH) while a rise in free cortisol inhibits ACTH secretion. Normally the HPA system is characterized by diurnal (circadian) rhythm. Serum levels of ACTH rise from a low point about 10 pm to a peak level about 6 am. Increasing levels of ACTH stimulate adrenocortical activity resulting in a rise in plasma cortisol with maximal levels occurring between 2 am and 8 am. This rise in cortisol dampens ACTH production and in turn adrenocortical activity. There is a gradual fall in plasma corticoids during the day with lowest levels occurring about midnight.

The diurnal rhythm of the HPA axis is lost in Cushing's disease, a syndrome of adrenocortical hyperfunction characterized by

• obesity with centripetal fat distribution,
• thinning of the skin with easy bruisability,
• muscle wasting with weakness,
• hypertension,
• latent diabetes,
• osteoporosis,
• electrolyte imbalance,
• etc.

The same clinical findings of hyperadrenocorticism may be noted during long-term pharmacologic dose corticoid therapy administered in conventional daily-divided doses. It would appear, then, that a disturbance in the diurnal cycle with maintenance of elevated corticoid values during the night may play a significant role in the development of undesirable corticoid effects. Escape from these constantly elevated plasma levels for even short periods of time may be instrumental in protecting against undesirable pharmacologic effects.

During conventional pharmacologic dose corticosteroid therapy, ACTH production is inhibited with subsequent suppression of cortisol production by the adrenal cortex. Recovery time for normal HPA activity is variable depending upon the dose and duration of treatment. During this time the patient is vulnerable to any stressful situation. ... it has been shown that a single dose of certain corticosteroids will produce adrenocortical suppression for two or more days. Other corticoids, including rnethylprednisolone, hydrocortisone, pednisone and prednisolone, are considered to be short acting (producing adrenocortical suppression for 1 1/4 to 1 1/2 days following a single dose) and thus are recommended for alternate day therapy.

The following should be kept in mind when considering alternate day therapy:

1. Basic principles and indications for corticosteroid therapy should apply.
   The benefits of ADT should not encourage the indiscriminate use of steroids.

2. ADT is a therapeutic technique primarily designed for patients in whom long-term pharmacologic corticoid therapy is anticipated.

3. In less severe disease processes in which corticoid therapy is indicated, it may be possible to initiate treatment with ADT. More severe disease states usually will require daily divided high dose therapy for initial control of the disease process. The initial suppressive dose level should be continued until satisfactory clinical response is obtained, usually four to ten days in the case of many allergic and collagen diseases. It is important to keep the period of initial suppressive dose as brief as possible particularly when subsequent use of alternate day therapy is intended.
   
   

4. Once control has been established, two courses are available:
   (a) change to ADT and then gradually reduce the amount of corticoid given every other day or
   (b) following control of the disease process reduce the daily dose of corticoid to the lowest effective level as rapidly as possible and then change over to an alternate day schedule. Theoretically, course (a) may be preferable.

5. Because of the advantages of ADT, it may be desirable to try patients on this form of therapy who have been on daily corticoids for long periods of time (e.g., patients with rheumatoid arthritis). Since these patients may already have a suppressed HPA axis, establishing them on ADT may be difficult and not always successful. However, it is recommended that regular attempts be made to change them over. It may be helpful to triple or even quadruple the daily maintenance dose and administer this every other day rather than just doubling the daily dose if difficulty is encountered. Once the patient is again controlled, an attempt should be made to reduce this dose to a minimum.

6. As indicated above, certain corticosteroids, because of their prolonged suppressive effect on adrenal activity, are not recommended for alternate day therapy (e.g., dexamethasone and betamethasone).
   
   

7. The maximal activity of the adrenal cortex is between 2 am and 8 am, and it is minimal between 4 pm and midnight.
   Exogenous corticosteroids suppress adrenocortical activity the least, when given at the time of maximal activity (am).

8. In using ADT it is important, as in all therapeutic situations to individualize and tailor the therapy to each patient.
   Complete control of symptoms will not be possible in all patients. An explanation of the benefits of ADT will help the patient to understand and tolerate the possible flare-up in symptoms which may occur in the latter part of the off-steroid day. Other symptomatic therapy may be added or increased at this time if needed.

9. In the event of an acute flare-up of the disease process, it may be necessary to return to a full suppressive daily divided corticoid dose for control. Once control is again established alternate day therapy may be re- instituted.

10. Although many of the undesirable features of corticosteroid therapy can be minimized by ADT, as in any therapeutic situation, the physician must carefully weigh the benefit-risk ratio for each patient in whom corticoid therapy is being considered.

DRESS syndrome:
DRESS syndrome (Drug Rash with Eosinophilia and Systemic Symptoms) is a hypersensitivity reaction with an estimated mortality of up to 10% DRESS syndrome most commonly manifests 2 to 8 weeks after starting the offending medicine, with a mean onset of three weeks. Upon re-challenge with the associated medicine symptoms may recur within one day; however symptoms may also flare up 3 to 4 weeks after stopping the medicine, even after initial improvement.

Patients routinely develop fever early on in the disease process, followed by the development of rashes.
These may vary from a very mild exanthem to extensive blistering and skin loss, but is more often a pruritic, macular erythema which may contain papules, pustules or vesicles. Systemic involvement commonly manifests as lymphadenopathy, hepatitis, pericarditis, interstitial nephritis or pneumonitis. Auto-immunity may develop as a sequalae to DRESS.

If DRESS syndrome is suspected, prescribers are reminded to look beyond the skin as the severity and extent of skin involvement does not always correlate with the extent of internal organ involvement. Diagnosis can be difficult due to the variable presentation of the syndrome and is more often obtained by exclusion. Symptoms such as rash, fever, and organ involvement can be attributed to a wide range of other causes. In addition, the long latency period following initiation or after stopping the medicine creates difficulties in diagnosis.

Medicines most commonly associated with DRESS syndrome are anticonvulsants, antibiotics (particularly beta-lactams), and allopurinol. Other medications that are known to be associated with DRESS include non-steroidal anti-inflammatory drugs, captopril, mood stabilisers, and antiretrovirals.

The pathogenesis of DRESS syndrome is partially understood.
Different mechanisms have been implicated in its development, including detoxification defects leading to reactive metabolite formation and subsequent immunological reactions, slow acetylation, and reactivation of human herpes, including Epstein-Barr virus and human herpesvirus (HHV)-6 and -7. The detection of HHV-6 reactivation has even been recently (2011) proposed as a diagnostic marker for DRESS.

LINK: The DRESS Syndrome: A Literature Review.
The American Journal of Medicine (2011) 124, 588-597
http://medstaff.aahs.org/wp-content/uploads/DRESSsyndromeAJM2012.pdf

environmental GPOs:
Gram-positive bacilli belong to a class of rod-shaped bacteria that acquire a violet color when subjected to the Gram staining method. Aside from its characteristic shape, this class of bacteria has a thick peptidoglycan layer, which lends itself to better absorption of antibiotics. Many Gram-positive bacilli have caused numerous diseases around the world. Mycobacterium tuberculosis causes severe lung disorders and is transmitted through the air by sneezing or coughing. Listeria monocytogenes is a facultative bacteria species that causes listeriosis, one of the primary causes of meningitis and meningoencephalitis. Mycobacterium leprae infection in humans results in Hansen's disease, more commonly known as leprosy. Bacillus anthracis is the main agent of anthrax, the fatal disease considered a bioterrorism threat in 2001 when bacterial spores were delivered in regular mail.

In contrast, some Gram-positive bacilli are safe for humans and are even infused in food.
Bacillus subtilis is a spore-forming bacteria used in manufacture of the Japanese food natto and is also used in antibiotics to treat urinary tract infections.

erythema nodosum leprosum:
(ENL) is an immune-mediated complication of leprosy, characterized by the presence of multiple inflammatory cutaneous nodules and systemic symptoms such as fever, malaise, arthritis, iritis, neuritis and lymphadenitis. Histopathologic examination demonstrates an inflammatory infiltrate of neutrophils with vasculitis and/or panniculitis, deposition of immune complexes and complement associated with Mycobacterium leprae antigens. The course is prolonged with recurrent episodes occurring over a period of 12 to 24 months, or longer than 7 years in some cases. ... presence of multiple, bilateral, tender inflammatory nodules. (red spots)

LINK: https://www.dermatologyadvisor.com/.../erythema-nodosum-leprosum-leprosy/.../691834/

Nephrotic syndrome :
Nephrotic syndrome may occur when the filtering units of the kidney are damaged.
This damage allows protein normally kept in the plasma to leak into the urine in large amounts, which reduces the amount of protein in your blood. Since the protein in the blood helps keep fluid in the bloodstream, some of this fluid leaks out of the bloodstream into your tissues, causing swelling, called edema. The swelling may be most noticeable in your legs after you have been standing and around your eyes when you first get up in the morning. Eventually, the swelling in your legs may be there all the time, and it may also occur in other parts of your body. You may notice that your urine foams more than usual because of the amount of protein in it.

If your nephrotic syndrome is caused by a disease that has no specific treatment, help may still be available.
Controlling your blood pressure is important. Reducing salt in your diet can help to control blood pressure and swelling (edema). Your doctor may also prescribe diuretics (water pills), which are prescribed for high blood pressure and can also help with swelling. The doctor may also prescribe the use of other blood pressure medicines that can also help reduce the protein in your urine.

Although the syndrome is caused by the loss of protein into your urine, eating a high-protein diet does not help and may actually make matters worse. Nephrotic syndrome may also cause an increase in fat in your blood. If the level of fats in your blood is too high, your doctor may recommend treatments to lower the levels of fat in your blood.

LINK: https://www.kidney.org/atoz/content/nephrotic
2015 National Kidney Foundation.

GNBs: Gram Negative Bacilli.
Gram-negative bacteria cause infections including pneumonia, bloodstream infections, wound or surgical site infections, and meningitis in healthcare settings. Gram-negative bacteria are resistant to multiple drugs and are increasingly resistant to most available antibiotics. These bacteria have built-in abilities to find new ways to be resistant and can pass along genetic materials that allow other bacteria to become drug-resistant as well.

The percentage of gram-negatives that are resistant to drugs is increasing.
High-risk sources of bacteremia were defined as the lung, peritoneum, or an unknown source.
... inappropriate initial antimicrobial therapy is associated with adverse outcome in antibiotic-resistant gram-negative bacteremia, particularly in patients with a high-risk source of bacteremia.

Bloodstream infection is a major cause of morbidity and mortality despite the availability of potent antimicrobial therapy and advances in supportive care. Bacteremia due to gram-negative bacilli is a significant problem in both hospitalized and community-dwelling patients. These organisms pose serious therapeutic problems because of the increasing incidence of multidrug resistance. Gram-negative bacillary sepsis with shock has a mortality rate of 12 to 38 percent (in the USA); mortality varies depending, in part, on whether the patient receives timely and appropriate antibiotic therapy.

Serious infections with gram-negative pathogens continue to be associated with considerable mortality.
Increasing antibiotic resistance in organisms such as Pseudomonas aeruginosa, Acinetobacter baumannii, and Klebsiella pneumoniae is contributing to difficulties with choosing antibiotics to prescribe for these infections. Optimization of therapy against these organisms starts with the initial empirical antibiotic choice. Surveillance data and hospital or unit antibiograms may inform this decision, although individualization of the initial regimen on the basis of prior antibiotic use and prior isolation of resistant pathogens may be more important. Combinations of antibiotics are often required empirically, and “combination antibiograms” may need to be developed for this purpose. ...

When identification and susceptibility testing is complete, the antibiotic regimen for infections due to gram-negative pathogens can be “fine tuned.” On some occasions, this fine tuning necessitates the introduction of “salvage” antibiotics, such as colistin or tigecycline; on others, it necessitates de-escalation and early termination of therapy. ... The mechanisms of this resistance are often complex but include production of multiple ß-lactamase types, outer-membrane impermeability, up-regulated efflux pumps, and target-site mutation. ... The lack of new antibiotic options against gram-negative pathogens underscores the need for optimization of current therapies and prevention of the spread of these organisms.