Thursday 23rd June 2016

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Love Is the Key

Ray Thomas and Nicky James

Somewhere the sun is always shining,
Somewhere the breeze blows in another brand new day,
So let us gather up our tears
We’ll save them for a rainy day.

Come on let’s fill our world with laughter,
Let’s put the sunshine into everybody’s heart,
Then peace will last for ever after
Oh what a lovely start.

It gives you hope for a brand new day,
Have faith in love it will show the way,
Happiness, who could ask for anything more,
So realise there’s no need to hide,
Show yourself to the world outside,
Don’t you know that the world is an open door,
Don’t you know that love’s the key to open any door.

It gives you hope for a brand new day,
Have faith in love it will show the way,
Happiness, who could ask for anything more,
So realise there’s no need to hide,
Show yourself to the world outside,
Don’t you know that the world is an open door,
Don’t you know that love’s the key to open any door.

The earth is good, why do we abuse it,
Our land, our seas, our skies, let’s try our wings and fly
Across green meadows hand in hand,
Let’s be the brotherhood of man,
Come on, let’s fill our world with laughter,
Let’s put the sunshine into everybody’s heart,
Then peace will last for ever after,
And that’s a lovely start.

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High Above My Head

Ray Thomas

High above my head, there’s a silver lining
In the sky, I tell you no lie.
I know that we can make it
I know that were gonna make it
Thats what I said
Cause weve got a silver lining above our heads.
High above the storm clouds
Theres a new horizon, feast your eyes
Come on and feast your eyes
The beauty will astound you
The love there will surround you, open your eyes
The lord put the silver lining into our skies
I want you to see things clearly
I hope you can feel the truth,
I know theres a hope for all mankind
Living under one roof.
I want you to see things clearly
I hope you can feel the truth,
I know theres a hope for all mankind
Living under one roof.
I look around in wonder
While the world is living under
A broken dream, or thats how it seems
But we werent sent to change it
To change or rearrange it
Still we can dream,
And dreams were meant for living
If you know what I mean.

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Nerve conduction study

A nerve conduction study is a test that measures how fast signals are transmitted through your nerves. During the test, electrodes are placed on your hand and wrist and a small electrical current is used to stimulate the nerves in the finger, wrist and, sometimes, elbow.
The results from the test indicate how much damage there is to your nerves.

Carpal tunnel syndrome 

Carpal tunnel syndrome (CTS) is a medical condition due to compression of the median nerve as it travels through the wrist at the carpal tunnel. The main symptoms are pain, numbness and tingling, in the thumb, index finger, middle finger, and the thumb side of the ring fingers.Symptoms typically start gradually and during the night. Pain may extend up the arm. Weak grip strength may occur and after a long period of time the muscles at the base of the thumb may waste away. In more than half of cases both sides are affected.

Risk factors include obesity, repetitive wrist work, pregnancy, and rheumatoid arthritis.There is tentative evidence that hypothyroidism increases the risk. It is unclear if diabetes plays a role. The use of birth control pills does not affect the risk. Types of work that are associated include computer work, work with vibrating tools, and work that requires a strong grip. Diagnosis is suspected based on signs, symptoms, and specific physical tests and may be confirmed with electrodiagnostic tests. If muscle wasting at the base of the thumb is present, the diagnosis is likely.

Being physically active can decrease the risk of developing CTS. Symptoms can be improved by wearing a wrist splint or with corticosteroid injections. Taking NSAIDs or gabapentin does not appear to be useful. Surgery to cut the transverse carpal ligament is effective with better results at a year compared to non surgical options. Further splinting after surgery is not needed. Evidence does not support magnet therapy.

About 5% of people in the United States have carpal tunnel syndrome. It usually begins in adulthood and women are more commonly affected than men. Up to 33% of people may improve without specific treatment over approximately a year.Carpal tunnel syndrome was first fully described after World War II.

The carpal tunnel is an anatomical compartment located at the base of the palm. Nine flexor tendons and the median nerve pass through the carpal tunnel that is surrounded on three sides by the carpal bones that form an arch. The median nerve provides feeling or sensation to the thumb, index finger, long finger, and half of the ring finger. At the level of the wrist, the median nerve supplies the muscles at the base of the thumb that allow it to abduct, move away from the other four fingers, as well as move out of the plane of the palm. The carpal tunnel is located at the middle third of the base of the palm, bounded by the bony prominence of the scaphoid tubercle and trapezium at the base of the thumb, and the hamate hook that can be palpated along the axis of the ring finger. From the anatomical position, the carpal tunnel is bordered on the anterior surface by the transverse carpal ligament, also known as the flexor retinaculum. The flexor retinaculum is a strong, fibrous band that attaches to the pisiform and the hamulus of the hamate. The proximal boundary is the distal wrist skin crease, and the distal boundary is approximated by a line known as Kaplan’s cardinal line. This line uses surface landmarks, and is drawn between the apex of the skin fold between the thumb and index finger to the palpated hamate hook. The median nerve can be compressed by a decrease in the size of the canal, an increase in the size of the contents (such as the swelling of lubrication tissue around the flexor tendons), or both. Since the carpal tunnel is bordered by carpal bones on one side and a ligament on the other, when the pressure builds up inside the tunnel, there is nowhere for it to escape and thus it ends up pressing up against and damaging the median nerve. Simply flexing the wrist to 90 degrees will decrease the size of the canal.

Compression of the median nerve as it runs deep to the transverse carpal ligament (TCL) causes atrophy of the thenar eminence, weakness of the flexor pollicis brevis, opponens pollicis, abductor pollicis brevis, as well as sensory loss in the digits supplied by the median nerve. The superficial sensory branch of the median nerve, which provides sensation to the base of the palm, branches proximal to the TCL and travels superficial to it. Thus, this branch spared in carpal tunnel syndrome, and there is no loss of palmar sensation.

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