maybe, so watch, and we will be vigorous and healthy, we are starting. today the program is about the most important thing, chronic pain in the elderly, what most often provokes it, why painkillers do not help and how to reduce this pain? the reason went away, the pain remained, the older the age, the more dangerous the painkillers. how are you?

culture, at some period of time this bacterium takes out the hatchet, it also produces poison, my back hurts, i can’t move, my knees ache, i can’t walk, every bone hurts, many elderly people constantly complain of pain, but their loved ones and even doctors shrug their shoulders, what to do, such is their age, but it turns out that this constant pain is often caused by a condition from... how to distinguish these conditions, what examinations need to be done to understand the true cause of chronic pain in the elderly and what to do to get rid of it, the local doctor will tell you about it, it sounds great, yes, we’ll find the cause, cure it, everything will pass. if so, how

to get rid of it? answer: no way, we jumped, right? a person is coming to you to get rid of pain, you begin to treat him, realizing that it is impossible to cure him, so first, you must agree with him, what will you and i have at the end? i don’t take into account undiagnosed diseases, by the way, there are issues here called polymyolgia, right? i ’ll turn it all here now, fields of myalgia can often occur in the elderly, stiff shoulders, you can’t raise your arms, this is often considered together with the inflammatory disease arteritis, the temple hurts, you need to give hormones there, this is a special disease, i won’t let me list it now, the reason is this chronic pain in the elderly, it is very diverse, it... there is no one reason,

even in a patient with polymyalgia, when it would seem that hormones are always a mixture of objective factors, polymyolgia, diabetes, sodoobjective hernia, mental factors, that he had a hernia yesterday, diabetes started yesterday, he’s had it for years, he’s already used to this pain, he’s used to being disabled, he’s already depressed, necessarily the psychological, social aspect, why social, and no one needs him, he ’s tired of his pain, he’s tired doctor, tired of relatives, tired of pharmacists, he already understands himself as an outcast, that is, this is a complex reason and this is the only way to approach it, so when a patient comes to you, what do you give to the patient, what do you give to the elderly, well, okay, i think it’s good if hormones, so we take 99% of the rest painkillers, well listen, the older you are, the more dangerous the painkillers, you can only, so to speak, relieve his pain for a while, he will then die from stomach

bleeding or a heart attack or liver failure, we generally say , what non-steroidal anti-inflammatory drugs cannot be given to people over 65 years of age, who are we all over 65 years of age, everything that we don’t drink, then in general we shouldn’t give you, that is, we don’t have an effective medicine for you, an effective drug, so with medicines it’s unclear, so first we have to agree, at best we can... you have back 30% more pain, this is a study where pain was measured on a scale from one to 10, but in the end, as a result of all all the measures we came up to approximately this figure, we are saying that you know what, here we are in pain we won’t get rid of it, it is now your constant companion, the question is that you learn to coexist with it, so that we remove the most unpleasant sensations for you. and so that you

understand that when pain is just your boring companion, when it is still a signal about something new, first you agree on a goal, then we begin to say,

the joint is a pain, you have inflammation, and you need these are anti-inflammatory drugs, which you can’t do if you have neuralgia, and as a rule, chronic pain is precisely neuralgia, people had pain due to something, there was a hernia, osteoarthritis, the reason for it went away, the pain remained, that is, a kind of looped pain, namely neurological... completely different drugs, there are first-generation antidepressants, but how do you give them to an elderly patient? the pain will go away, and he will begin to fall, why are we now saying that the elderly need to take medications on time, in particular antidepressants, anticonvulsants, which i wanted to say, antihalinergic drugs, they lead, an old person

falls, breaks his femoral neck and leads it simply leads to disability, then to death, an extra pill, i read the work on thousands of people, did an analysis that if you stop taking all the pills in time, we reduce the mortality rate of older people by 30%, by 30%. do you also understand that, let’s say we give you some kind of medicine, and these patients, look at their faces, they are suffering, they are depressed, and why am i saying this, this is how it checks whether they will respond to the medicine or not, there is such a thing as a placebo, you know well, a placebo is when i give you a dummy, you feel better, a new medicine, good, effective, dress.

then it is unknown what will come of this, respectively, the matter of saving drowning people, the work of the drowning people themselves, you must understand that along with what i am doing now, i am now doing from the tv screen what doctors are prescribed to do for the treatment of pain with

each of their patient, the first thing he should do is to have such a conversation with each patient, i just do it now on such a scale, but this is on purpose. specially trained, how to speak, what tasks to set, how to set up, teach, what because of this pain it’s worth something, how dangerous it is, how not dangerous it is, divide it into gradations, say that you can live from this pain, this is the background, nothing will happen anymore, this, this, you must do this, that is , in the treatment of this pain , emphasis is placed on communication between the doctor and the patient, because otherwise he will not go to the pool, do yoga, do tai chi, and this is all... by the way, official recommendations, international doctors, anesthesiologists for patients with chronic pain, they not only have pain, they have a thickening jelly effect, if there is no move, then he wakes up, in addition to the pain , they all have stiffness, they can’t, if they don’t warm up, and they will, and the more

constrained you are, it will be the effect of thickening jelly, the more you will tighten, the more in the end there will be pain ; sit and you can speed it up, yes sometimes she. look through, no big deal, sometimes a pill, now i always have a painkiller with me, sometimes it happens that i am, but it’s dark in my eyes, you take a pill, well, it happens rarely, well, i also have gout, you can and should live with this, but you have to don’t fall into this depression, just like you just fell into depression and want to go to the doctor, help me, well, with a mask of suffering on your face you won’t overcome pain, believe me, so people, we... we are soviet people, so everything will be fine with us, further, how varicose

veins affect the development of a heart attack, and what to do to suspect osteoporosis at an early stage? questions from the doctor, alexander myasnyakov asks, you answer, you wrote the answer there, not yet, and now i feel professional... i’m getting married, i’m very happy for you, premiere, i want to terminate the contract, it’s up to you to decide, there won’t be a child , i just want you to think carefully, stop putting pressure on me, you’re about to lose sasha and you can’t come to terms with it, now there’s a great opportunity, grandson, we can reunite, light in the window, today on rtr.

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body shape and size, supports your posture in all positions while sleeping good ventilation throughout the night. you 'll sleep better than ever. and most importantly, the dremalina swan pillow is ideal for those who sleep on their side, back, and also those who sleep on their stomach. the dremalina swan pillow provides optimal sleep for everyone. this is what makes her so unique. experience the best and most comfortable sleep of your life. call and order a unique drimalina cvon pillow for your best sleep for an incredible 5995. but wait, if you call right now, it will be especially for you we will reduce the price, the dremaliina swan pillow will be yours for an incredible 3995, and you will immediately save 20 euros. hurry up, the offer is strictly limited and only valid for a short period of time. can you explain to me

why we are leaving st. petersburg and dragging ourselves to this sample. i have problems in business. do you remember tanka, vasil, and she was in love with you, she was still in love. oh, she's not married. it would seem that we have been living together all our lives, we know everything about each other. however, not everyone, well, you liked me at school 20 years ago, are you really still obsessed with this stupid children's love, this is stupid, girls love their dreams to come true, olya, your husband, your husband is cheating on you, olya, olya, let's go there together, pasha, stop it, this has never happened before, you don't see me, you you don’t even look in my direction, but i’m a woman, where we are not, on friday on rtr. 5 years ago

, a story from the chelyabinsk region shocked the whole country. ginazizova kept her children locked up for 11 years. they did not go to school, did not receive medical care and never left the threshold of their own home. mother i dressed the girls like dolls every day and posted online videos about their happy lives. but in fact, the children were starving, and their mother severely beat them for any righteousness. when the children escaped from their home prison, the mother set the house on fire and committed suicide. captives of a doll's house for 5 years. let malakhov on rtr today. time for the section questions from the doctor. i ask questions. based on previous programs, i’m calling mainly people who seem to be familiar with physical education, because if you can’t answer, they’ll start lifting weights, well, i’m scared, who’s ready? here you go come here, what's your name? arina, arina,

what are you doing? i teach, what? primary grades? i see, how are you doing with lifting weights? in general, i bring it up from time to time, well , listen, if you are a teacher, then i think many of the questions will be familiar to you, but i haven’t had a teacher for a long time, come on, now i remember everything, and i remember my fane izrailina, math teacher, from which i cried, she made me understand these numbers, osteoparosis, what osteoporosis is, well, it’s a disease of the joints. yes, this is a vacuum bones, it can be suspected at an early stage, it’s written, stop, don’t answer, clinically it can be suspected at an early stage, i think yes, just think about it, teacher, if a student comes out to you, you ask, is there, say, him , who discovered america, here he stretches his hand, pulls, pulls, pulls, says, you are columbus, what is

the teacher doing, she says, well done, she asks when, yeah, because i would have done it right away too.

porovos, as you rightly said, cannot be suspected at an early stage clinically, but we understand that any woman is under a threat in monopause, we should do 60 plus studies for the presence of ostaoporosis, just for everyone, ugh, so that they figure it out soon, so varicose veins of the lower leg increases the risk of developing a heart attack or not, it’s this on... the legs are like that, i understand, and why? well, a heart attack is something related to cardiac and activity, but here it’s more where the heart is, where the legs are, well , it’s clear, it’s just that the pathology is different from the very beginning, if we say heart attacks of the heart muscle - this is the formation of blood clots, the deposition of cholesterol plaques, narrowing the process of blood vessels, there it is an artery, varicose

veins are veins, that’s how it is written, dilatation of veins, yeah, well, there’s a different mechanism. this is mainly obesity, congestion, valves and insufficiency of these veins. yes, blood clots can form there, but if the superficial ones are in the deep ones, even if we take this option, then there is thrombosis of the deep veins of the legs, it can be dangerous, it could be thromboembolism in the lungs up to death, but this does not apply to the heart, so no , this is not a risk factor for a heart attack, here is a typical woman’s question, anti-cellulite body cream. yes, helps get rid of cellulite? no, oh, write, why did you answer that way, because if he helped, yes, everyone would go, well, that’s right, well, teachers, you and i have three a’s, yes, three a’s, come

here. so i really give the teachers grades, but no, we’re not in a hurry, let’s do it, well, of course i’ll choose a book like yours, that’s right, it’s a good book, let’s do it. here you go irina, thank you, thank you very much, please sit down, if you want to review it again, this is the platform we are watching.

this is what it looks like when examined microscopic, whoever heard of this, raise your hands, you’re raising your hand, i just heard this word everyone, who’s hand? hello, hello, well, i know, it happens in the nose, it settles, well, yes, and what does it do there, well, some of its properties are so bad, logical, who else raised their hand, i just know that if it is found in operating room, then the operating room is closed and completely processed, yes, well, in principle, as is clear, a golden-looking bacterium. in microscopic examination, very dangerous, on the one hand, due to the fact that it has two types of endotoxin, that is, it not only

itself, it also produces a poison that causes so-called toxic shock in patients with a drop in pressure, a rash , even death, and with all that, the young man said correctly, lives in the nose, in 30% of healthy people (1, 2,3), one or two out of... well , every third person lives in the nose for the time being, well, mingococci and pneumococci also live there, and for the time being they do not bother, everything was b nothing, because until the fifties he was perfectly treated with penicillin, then certain mutations occurred and he suddenly ceased to be sensitive to penicillin, then he was mostly in recovery in the hospital. intensive care units in nursing homes, just like that, it was dangerous only for patients of these hospitals, but in the nineties it

mutated again and brought with it two epidemics, one epidemic was a direct epidemic of skin diseases, the second, this is when it begins to circulate in the blood and in in particular causes such... a deadly disease like infective endocarditis, this outbreak of infective endocarditis, and very strongly then drew attention to stephylococcus aureus. those 30% of the population who carry stephylococcus in the nasopharynx, on their skin, feel great, at some period of time this bacterium takes out the ax of war, apparently, the state of immunity drops.

because it was there that an environment favorable for the development of stophylococcus aureus developed, it released its poison, these infections flared up, the temperature was 40, the woman was unconscious , the pressure was almost zero, covered with a rash , menstruation ended 2 days ago, the diagnosis was clear even at the entrance, and not only by the way menstrual tampons, i had a story , the head of a doctor from one of the hospitals came to me for... and says: i’m a good ent doctor, you know him, the old-school doctor, he comes here often, i want to fix my septum, i ’ll go, i say : go, he says, but you’re not

going yet, i say, i’m afraid, i say, i’m also afraid, but i can’t breathe, i say, well, go, go, you know, that was one number of years ago, now we have such special plastic clamps are all, then we just put tampons in the nose, well, can you imagine? when the doctor comes to me, he says, and he says his temperature is 40, his blood pressure is zero, i understand that this is toxic shock syndrome, his chance of dying is very high, a person came to the septum, i know that it happens one in a thousand, but no, well, thank god, we pulled him out, but i’m just saying that this happens, it also happens that those who are more likely to be carriers get sick, but this is undoubtedly, as you said , hospital visitors, that’s it you come to the hospital, they tell you, put on a robe, you... put on a robe in the hospital is not so as not to bring some kind of dirt to the hospital, you cannot bring anything there, if you throw out a ton of manure, come to the hospital, it’s

nothing, for the hospital it’s nothing, because there are more bacteria there. than in this manure, you are protecting yourself from this, you touched something in the hospital, that’s it, it’s in your hands, what happens next, i was amazed by the work, they collected the stethoscopes of doctors in several hospitals , took a sample from them from this, 80 % infected, 80%, so going to the hospital is 100%, nothing you can’t touch, you can’t touch, and in general, even if you’re with relatives, someone has ulcers, boils, and so on, acne, that’s all, you just unwittingly become infected with it. by the way, this is how a student fights, you know, like someone who just came in for a late shift and left something else to do, or a woman, let me touch up your pussy there, i forgot my lipstick, these are typical ways, by the way, one of the factors is sports, being athlete, why? well, because we are always rubbing, always fighting, sparring, the same exercise machines, some haven’t wiped them down, some haven’t cleaned them, some

not before that. and so on, this is also a risk factor, well, accordingly, patients on dialysis especially, well, with patients - this is a different story. further, which antibiotics are effective against stephylococcus aureus and which are not? and what to do to protect yourself from it? don’t touch anything, just like that , it requires surgery to remove the pus, plus taking antibiotics for many weeks. bor, i don’t believe that you betrayed me, but i must know the truth. i understand you, in order not to lose love, you need to lose

your memory. retrograde amnesia, such it happens that she won’t forgive me, but you remembered something, it seems to me that it’s easy to fall in love with you, if only you could, i want to forget everything, but get out of this slush, let spring into your heart, belated spring, premiere in saturday on rtr. you 've been tossing and turning sleeplessly all night with your old pillows and waking up completely stressed out, now that's over, introducing the dremaliina svon pillow, a comfortable lounging pillow that hugs your entire body to optimally align it so you experience the best sleep of your life. the unique shape of the dremalina swan pillow offers seven comfort zones that

support your back and shoulders. head and neck, arms, hips, knees, ankles, feet. you remain in the most comfortable sleeping position without tossing and turning. unlike conventional pillows, dremalinost keeps the spine in an ideal position and the neck at an optimal height. your shoulders and arms will be relaxed. in addition, the dremalina one pillow prevents your knees from touching each other, providing soothing relief to your lower back, legs and feet. pillow dremalina. made from breathable , hypoallergenic lyocell fabric, it adapts perfectly to any body shape and size, supports your posture in all sleeping positions and ensures good ventilation throughout the night. you'll sleep better than ever. and most importantly , the dremalina swan pillow is ideal for those who sleep on their side, back, and those who sleep on their stomach. the dremalina swan pillow provides optimal sleep for everyone. this is

what. what makes it so unique? experience the best and most comfortable sleep in of your life! call and order a unique dremalina svon pillow for your best sleep for an incredible 5995. but wait, if you call right now, we will reduce the price especially for you, the dremaliina svon pillow will be yours for an incredible 3995 and you will immediately save 20 euros. but hurry up. strictly on time, you don’t need to make an appointment with him, it’s a joke, it’s limited and only for a short period of time , he’ll come to your house himself, we’ll start, he’ll always help, we’ll train on how to walk on ice correctly.