Tramadol

Generic Name: tramadol (TRAM a dol)
Brand names: ConZip, Rybix ODT, Ryzolt, Ultram, Ultram ER

What is Tramadol?

Tramadol is a narcotic-like pain reliever.

Tramadol is used to treat moderate to severe pain. Tramadol extended-release is used to treat moderate to severe chronic pain when treatment is needed around the clock.

Tramadol may also be used for other purposes not listed in this medication guide.

Important information about tramadol

You should not take this medication if you are allergic to tramadol, if you have ever been addicted to drugs or alcohol, or if you have ever attempted suicide. Do not take tramadol while you are intoxicated (drunk) or taking any of the following: alcohol or street drugs, narcotic pain medicine, sedatives or tranquilizers, or medicine for depression, anxiety, or mental illness.

Seizures (convulsions) have occurred in some people taking this medicine. Tramadol may be more likely to cause a seizure if you have a history of seizures or head injury, a metabolic disorder, or if you are taking certain medicines such as antidepressants, muscle relaxers, narcotic, or medicine for nausea and vomiting.

Seek emergency medical attention if you think you have used too much of this medicine. A tramadol overdose can be fatal.

Tramadol may be habit-forming and should be used only by the person it was prescribed for. Keep the medication in a secure place where others cannot get to it.

Do not crush the tramadol tablet. This medicine is for oral (by mouth) use only. Powder from a crushed tablet should not be inhaled or diluted with liquid and injected into the body. Using this medicine by inhalation or injection can cause life-threatening side effects, overdose, or death.

Before taking tramadol

You should not take this medication if you are allergic to tramadol, if you have ever been addicted to drugs or alcohol, or if you have ever attempted suicide.

Do not take tramadol while you are intoxicated (drunk) or taking any of the following:

• alcohol or street drugs;

• narcotic pain medicine;

• sedatives or tranquilizers (such as Valium);

• medicine for depression or anxiety; or

• medicine for mental illness (such as bipolar disorder, schizophrenia).

Seizures have occurred in some people taking tramadol. Talk with your doctor about your seizure risk, which may be higher if you have:

• a history of drug or alcohol addiction;

• a history of epilepsy or other seizure disorder;

• a history of head injury;

• a metabolic disorder; or

• if you are also taking an antidepressant, muscle relaxer, narcotic, antipsychotic, or medicine for nausea and vomiting.

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

• kidney disease (or if you are on dialysis);

• cirrhosis or other liver disease;

• a stomach disorder; or

• a history of depression, mental illness, or thoughts of suicide.

Tramadol may be habit forming and should be used only by the person it was prescribed for. Never share tramadol with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it.

FDA pregnancy category C. It is not known whether tramadol will harm an unborn baby. Tramadol may cause serious or fatal side effects in a newborn if the mother uses this medication during pregnancy or labor. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. Tramadol can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are taking tramadol. Do not give this medication to anyone younger than 16 years old without the advice of a doctor.

How should I take tramadol?

Take tramadol exactly as prescribed. Never take tramadol in larger amounts, or for longer than recommended by your doctor. Follow the directions on your prescription label. Tell your doctor if the medicine seems to stop working as well in relieving your pain.

Tramadol can be taken with or without food, but take it the same way each time.

Do not crush, chew, or break a tramadol tablet. Swallow it whole. Breaking the pill may cause too much of the drug to be released at one time. This medicine is for oral (by mouth) use only. Powder from a crushed tablet should not be inhaled or diluted with liquid and injected into the body. Using this medicine by inhalation or injection can cause life-threatening side effects, overdose, or death.

To take tramadol orally disintegrating tablets (Rybix ODT):

• Keep the tablet in its blister pack until you are ready to take it.

• Using dry hands, remove the tablet and place it in your mouth. It will begin to dissolve right away.

• Do not swallow the tablet whole. Allow it to dissolve in your mouth without chewing.

• Swallow several times as the tablet dissolves. If desired, you may drink liquid to help swallow the dissolved tablet.

If you use the tramadol extended-release tablet, the tablet shell may pass into your stools (bowel movements). This is normal and does not mean that you are not receiving enough of the medicine.

Do not stop using tramadol suddenly, or you could have unpleasant withdrawal symptoms. Talk to your doctor about how to avoid withdrawal symptoms when stopping the medication.

Store tramadol at room temperature away from moisture and heat. Keep track of the amount of medicine used from each new bottle. Tramadol is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.

Ways to Eliminate Stress

Ways to Eliminate Stress

You often see articles on ways to unwind and relax after a stressful day, which I always find useful, but for me the most important advice would be to get to the source of the problem, and cut stress out before it even happens.

By careful editing of your life, and changing certain habits, you can eliminate most (not all) sources of stress in your life.

I don’t believe that a stress-free life is possible. Stress is a response to challenges in life, and a life without challenges is too boring to contemplate. However, I do believe that most of the stress in our lives is unnecessary, and that it can be eliminated by taking some simple (and some not-so-simple) steps. It can’t be accomplished overnight — I’ve been eliminating stressors in my life for awhile now, and I’m still not done. But I think it’s a worthwhile goal.

Let’s first take a look at an example — it’s a little extreme, but it exemplifies the typical stressors in people’s lives. Let’s say Fred gets up in the morning, waking up late, and now has to rush to get ready. He’s so rushed that he spills his coffee on his shirt and has to change, a nicks himself shaving. He heads out the door and then has to go back in the house because he forgot his wallet. He gets in the car and realizes he forgot his keys.
Now he’s on the way in to work and is in the middle of rush-hour traffic — and his temper starts to flare after someone cuts him off. He’s honking at people, cursing, and arrives to work late and in a bad mood. He snaps at someone and is surly all morning. His desk is covered in piles of paper, and he can’t find that report he needs to work on. His inbox is overflowing and his email notification is going off, and he sees he has 36 messages to respond to. He knows he’s late on two projects and his boss isn’t happy. He’s got to finish 5 tasks before the 11 a.m. meeting, and he’s got meetings all afternoon.
You get the idea. His day does not go well, and he hits rush-hour traffic on the way home. He gets home late, exhausted, completely stressed, his mind still on his late and as-yet uncompleted projects, his still-full inbox and email inbox, and all the stuff piling up that he has to work on tomorrow. The house is a mess and he snaps at his family. His kids have not put things away exactly where he told them to put them away, so he begins to yell at them. He has a quick, greasy dinner in front of the TV and zones out before falling asleep late.
Again, this is a bit extreme, but you can see through this illustration some of the things that stress people out. There are many more, of course, and I won’t cover all of them here.
But these sources of stress can be eliminated with a little thought. Here’s how:

1. Identify stressors. This is the most important step of all, as identifying the things that stress you out in your life is the first step towards eliminating them. Take 10 minutes to think about what stresses you out during the day. What weekly occurrences stress you out? What people, activities, things cause stress in your life? Make a Top 10 list, and see which of them can be eliminated, and start to weed them out. For those that can’t, find ways to make them less stressful.
2. Eliminate unnecessary commitments. I did a post on editing your commitments before … apply those concepts here. We all have many commitments in our life, starting with work but also including commitments related to kids, our spouses, things to do at home, other family, civic, side work, religious, hobbies, online activities and more. Consider each of them, the amount of stress they provide, and the value you get out of them. Edit brutally, and take steps today to remove the ones that stress you out the most.
3. Procrastination. We all do this, of course. But allowing stuff to pile up will stress us out. Find ways to take care of stuff now (form a Do It Now habit) and keep your inbox and desk clear. See 20 Procrastination Hacks for more ideas.
4. Disorganization. We’re all disorganized to some extent. Even if we’ve organized something, and created a great system for keeping it that way, things tend to move towards chaos over time. But disorganization stresses us out, in terms of visual clutter, and in making it difficult to find stuff we need. Take time to get things in your life organized, starting with your desk and the papers in your home, and moving on to other areas.
5. Late. Being late always stresses us out. We have to rush to get ready, rush to get there, and stress out the whole time about looking bad and being late. Learn the habit of being early, and this stress disappears. Make a conscious effort to start getting ready earlier, and to leave earlier. This also makes driving less stressful. Time yourself to see how long it actually takes to get ready, and how long it actually takes to get somewhere. You’ve probably been underestimating these times. Once you know these times, you can plan backwards so that you show up 10 minutes early each time. It’s a good feeling.
6. Controlling. We are not the Master of this Universe. I know we sometimes wish we were, but acting as if we are is a sure way to get stressed out. Trying to control situations and people cannot work, and only serves to increase our anxiety when it doesn’t work. Learn to let go, and accept the way that other people do things, and accept what happens in different situations. The only thing you can control is yourself — work on that before you consider trying to control the world. Also learn to separate yourself from tasks and to delegate them. Learning to let go of our need to control others and the situations around us is a major step towards eliminating stress.
7. Multitasking. Having multiple tasks going on at the same time might seem productive, but in actuality it slows us down from actually focusing on a task and completing it — and it stresses us out in the meantime. Learn to single-task.
8. Eliminate energy drains. If you’ve analyzed your life (in Step 1) and found things that stress you out, you might have also noticed things that drain your energy. Certain things in our life just cause us to be more exhausted than others, with less value. Identify them, and cut them out. You’ll have much more energy and much less stress. Happiness ensues.
9. Avoid difficult people. You know who they are. If you take a minute to think about it, you can identify all the people in your life — bosses, coworkers, customers, friends, family, etc. — who make your life more difficult. Now, you could confront them and do battle with them, but that will most certainly be difficult. Just cut them out of your life.
10. Simplify life. Simplifying, of course, is a major theme of Zen Habits. Simplify your routines, your commitments, your information intake, your cluttered rooms, the mass of stuff going on in your life … and have less stress as a result. Start with Edit Your Life and then look through the other simplicity articles.
11. Unschedule. Create more open periods of time in your life. It’s not necessary to schedule every minute of our lives. Learn to avoid meetings, keep wide open blocks of time where we either work on our important tasks or batch process the smaller ones. When someone asks to schedule a meeting, first try to get it done through email or phone … if that doesn’t work, avoid having it scheduled. Ask them to call you and see if you’re free at that time. You will love having an open schedule.
12. Slow down. Instead of rushing through life, learn to take things slow. Enjoy your food, enjoy the people around you, enjoy nature. This step alone can save tons of stress.
13. Help others. It may sound contradictory to add more tasks to your life by trying to help other people (you’ve got enough to do), but if you were to add anything to your life, this should be it. Helping others, whether volunteering for a charity organization or just making an effort to be compassionate towards people you meet, not only gives you a very good feeling, it somehow lowers your stress level. Of course, this doesn’t work if you try to control others, or help others in a very rushed and frenetic way — learn to take it easy, enjoy yourself, and let things happen, as you work to make the lives of others better.
14. Relax throughout the day. It’s important to take mini-breaks during your work day. Stop what you’re doing, massage your shoulders and neck and head and hands and arms, get up and stretch, walk around, drink some water. Go outside and appreciate the fresh air and the beautiful sky. Talk to someone you like. Life doesn’t have to be all about productivity. You should also avoid using online activity too much as your de-stressing activity — get away from the computer to relax.
15. Quit work. This one’s drastic, and probably too drastic for most. But in most likelihood, your work is your absolute biggest stressor. Getting out of your 9-to-5, automating your income, and finding something you truly love to do, that you’re passionate about, will create a positive life and much less stressful one at that. Give it a little thought before dismissing it — there might be possibilities here you haven’t considered.
16. Simplify your to-do list. I’ve written about this before, but attempting to do everything on your long to-do list will definitely stress you out. Learn to simplify your to-do list down to the few essential tasks, and you will enjoy the process much more.
17. Exercise. This is common advice for stress relief, and that’s because it works … but it’s also a stress prevention method. Exercising helps relieve the stress buildup, it gives you some quiet time to contemplate and relax, and just as importantly, it makes you more fit. A fitter person is better equipped to handle stress. Another important factor: being unhealthy can be a major stressor (especially once you have to go to the hospital), and exercise can help prevent that.
    
18. Eat healthy. This goes hand-in-hand with exercise as a stress prevention method, of course. Become healthier and a major source of stress will disappear. Also, I’ve found that greasy food, for me, puts me in a worse mood and can contribute to stress levels immediately.
19. Be grateful. This might not be as obvious as some of the others, but developing an attitude of gratitude (I sound like a preacher with that rhyme!) is a way of thinking positive, eliminating negative thinking from your life, and thereby reducing stress. Learn to be grateful for what you have, for the people in your life, and see it as a gift. With this sort of outlook on life, stress will go down and happiness will go up. That’s a winning formula.
20. Zen-like environment. Take time to declutter your desk (as mentioned above) and even once you do that, continually edit your desk and working space, and the things in your home, until you’ve created a simple, peaceful, Zen-like environment. It will be much less stressful to work in an environment like that than a more cluttered and distracting one.

Build Muscle and Lose Fat

Build Muscle and Lose Fat

Build Muscle. The fastest way to build muscle is to get stronger. The stronger you are, the stronger you’ll look. Get into strength training. Do barbell exercises that hit several muscles at the same time: Squats, Deadlifts, Overhead Press, etc.

Start with an empty barbell. Learn the exercise technique. Increase the weight gradually. If you don’t know where to start, check out the Beginner Strength Training Program: it takes 3 times 30 minutes a week.
Nutrition. You need solid nutrition to get stronger and build muscle. Keep the nutrition healthy and you’ll lose fat. Some tips:

• Protein. 1g/lbs daily. Meat, poultry, fish, eggs, etc.
• Fat. Balance omega 3, 6 & 9 intake: fish oil, saturated fat & olive oil.
• Veggies. All kinds, especially green fibrous veggies.
• Fruit. Also all kinds. Eat veggies and/or fruits with every meal.
• Water. 1 liter per 1000 calories you expend.
• Whole grain food. Oats, rice, pasta, breads, …

Eat foods that come in their natural state. Avoid anything that comes out of a box. Avoid trans-fats. Limit junk food consumption to once a week. Quit drinking soda. These simple tips will make a big difference in a very short time.

Lose Fat. Strength training will build muscle while decreasing your body fat. Eating healthy will further decrease your body fat. If you need to lose a lot of fat or if you’re impatient, these tips are for you:

• Cardio. Do 30 minutes of cardio after your strength training. Three times a week at moderate intensity will do. The goal of cardio is to burn fat, not to exhaust yourself. You should breathe heavier than when at rest, but not gasping.
• Cut calories. Track your food intake using Fitday. Start eating 18x your current body-weight in lbs. One week later: cut 500kcal. Check the balance one week later again. Did you lose weight? If you did, keep eating the same amount of calories. If not: cut another 500kcal.

Whatever you do: don’t starve yourself. Fat is emergency storage for your body. If you don’t eat your body will hold the fat and burn muscles. That’s the opposite of what you’re after. Only cut calories if you don’t progress.
Women. Building muscle, losing fat and strength training for women is same as for men. The only difference is women have other hormonal profiles than men. Meaning women will always have less muscle mass and more body fat than men.
But the approach is the same. Follow these tips and you’ll get results. You won’t get bulky if you don’t overeat and stay away from steroids.
Vegan & Vegetarian. Leo is a vegan, and other readers of Zen Habits are also vegans or vegetarians. You’ll find plenty of examples of vegans and vegetarians who built muscle. It can be done. But you might have less results than meat-eaters.
Red meat contains saturated fat and cholesterol which raises your testosterone levels. Testosterone is needed for muscle. Ask your doctor for a blood-test. Eat red meat for 2 months. Do another blood-test. Compare testosterone levels.
Eat lots of dairy products: milk, eggs and cheese if you’re vegetarian. Don’t let the fact that you’re vegan or vegetarian serve as excuse. You can build muscle.
Motivation. The best way to keep yourself motivated is to set goals & track your progress. The classic scale is not your best tool. Here are better ways.

• Fat measurements. Measure your body fat weekly using a fat caliper.
• Pictures. Take pictures every 4 weeks.
• Blood test. Check health improvements.
• Strength stats. Keep a training journal. More strength is more muscles.
• Weigh scale. Only use it once a week. Each Friday for example.

6 Secrets to Gorgeous Skin

Some people have complexions that are radiant. What can we learn from their daily skin care habits?

More than a great wardrobe or a skilled hand with make-up, healthy glowing skin is the key to turning heads.

Just ask Kelly Campbell, a Los Angeles public relations consultant and mom. She regularly gets stopped by strangers complimenting her on her seemingly poreless, lit-from-within complexion.

The key to that gorgeous skin? She was born with it.

“Honestly, I’ve always been lucky to have good skin," Campbell says. “Except when I was pregnant and I broke out from all the hormones, I’ve never had trouble with my skin.”

Yes, some people win the hereditary lottery when it comes to good skin, just as others are blessed with the kind of metabolism that lets them eat vast amounts of pizza, chocolate, and Chunky Monkey without gaining an ounce.

“Not all skin is created equally,” says Paula Bourelly, MD, a dermatology professor at Georgetown University. “You can’t underestimate the value of genetics.”

But genes are just the starting point. Beautiful skin is also about good skin care habits, practiced day in and day out.

Here are, from top dermatologists and Campbell herself, the secrets to stunning skin.

Read more »

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