Monthly care
Water filter cartridges must be cleaned using the cleaners and water balance to be checked.
Periodic care
Your tub will need complete draining and refilling as there is always a build up of total dissolved. One may do this, as a thumb rule, once every 45 days.
Hot tub covers
A hot tub cover is a very useful and handy invention and support accessory for any homeowner who would like to receive the best and most long lasting service from his home spa system. To make hot tubs energy efficient and to keep energy use to a minimum, it is important that heat does not escape it and the covers help to do this by insulating the hot tub efficiently.
Materials used in tub covers
There is a lot of variety in the market today for the types and materials of hot tub covers and some companies even provide these free of cost when you purchase a tub. Some can be customized for you and there are still others waiting to indulge your need for something different by providing hand made covers, which you can design, and they can implement for you.
A high quality vinyl spa cover will usually be treated with UV, mildew and cold crack inhibitors, which are used to attract sunlight and deter mold from building up on your cover. The advantage to a vinyl cover is that it is available in many colors and can add to the aesthetic appeal of your tub as well.
These can be one to three pounds in weight or even larger ones for harsh weather conditions and prove to be very effective as vinyl is the strongest and most durable type of hot tub cover in today's market.
Purpose and application
The advantage of a hot tub cover is that it protects your tub from both indoor and outdoor pollutants, depending on its location. Covers are available in many forms and features in order to ensure the most effective protection possible; each component well thought out for maximum contribution to the overall performance of your tub.
A model that has locking mechanisms provides child and pet safety, as it is well known that every year thousands of children are killed or injured from accidental drowning. An easy access model is a good choice as the zipper has handles for convenience when entering and exiting the tub.
As people spend a considerable amount of money on hot tubs so spending a few extra dollars to ensure its quality is a minor expense in comparison, especially when it affords them added quality for the hot tub and longevity too.
Effective Treatment for Fever Syndrome Caused by Cold Exposure
Remember when Grandma used to say 'don't go out in the cold; you'll get sick"? It turns out that she was right for a small number of people who have a condition called familial cold autoinflammatory syndrome (FCAS), in which individuals are afflicted by rash, fever, joint pain and flu-like symptoms after exposure to cold conditions as mild as an air-conditioned room or fall breeze.
The disorder became a hot protocol for research labs in 2001 after investigators at the University of California, San Diego (UCSD) School of Medicine discovered the mutated gene that caused FCAS*. Now, the same UCSD team reports in the November 13, 2004 issue of the journal Lancet, that they've found an effective treatment - one that inhibits an abnormal immune response that leads to symptoms in FCAS-affected patients.
"We witnessed a truly remarkable response and a life-changing therapy for these patients," said Hal M. Hoffman, M.D., a UCSD assistant professor of medicine and pediatrics, and the lead author of the study in Lancet. "On a scientific level, the investigation of uncommon disorders such as FCAS can provide important insights into the mechanisms of more common diseases. For example, inflammation has been shown in recent years to be important in many disorders from arteriosclerosis to Alzheimer's disease."
Because cold triggers fever in FCAS patients, in 2001 the UCSD team named the disease-causing protein they discovered "cryopyrin," which means icy fire. In their new studies with seven individuals, four afflicted with FCAS and three normal subjects, the investigators determined that cryopyrin regulates the release of interleukin-1 (IL-1), an important mediator of fever and systemic inflammation during the body's initial immune response. After finding increased levels of IL-1 in the skin of the FCAS patients following an experimental cold challenge, the researchers administered a recombinant IL-1 receptor antagonist, a drug called anakinra, which inhibits the action of IL-1 and thus prevents acute inflammation, fever and flu-like symptoms. The treatment prior to cold exposure prevented the clinical and laboratory manifestations of the disease in the FCAS patients. Anakinra is currently approved by the Food and Drug Administration for treatment of rheumatoid arthritis.
FCAS is a hereditary disorder thought to affect nearly 300 Americans, with 90 percent of them tracing their ancestry to a man from Northern Europe who migrated to the U.S. in the 1600s. FCAS is one of a family of seven distinct, single-gene defects that are considered to be hereditary periodic fever disorders**, characterized by recurrent bouts of systemic inflammation involving several tissues, including joints and skin.
Over the past seven years, Hoffman has studied FCAS by drawing blood samples at different family reunions held throughout the United States, from Georgia, Ohio, Illinois and Missouri, to Utah and California. Frequently, the individuals with FCAS didn't know they had distant relatives in other states with the same condition. Interviewing hundreds of patients in divergent regions of the country, Hoffman said he found a similar story that had been passed along through the years.
"One older family member told me that the disease started with his great-great-great-great grandfather who was working on a farm during a hot day, and he fell into cold water," Hoffman said. "Then, at another reunion, someone else would tell me that the problem started with a man who got shipwrecked and was in cold water for a long period of time. The common thread was always cold water."
In actuality, the common thread was exposure to cold. When individuals with FCAS get cold, within an hour or so they develop fever, chills, joint pain, red eyes, achy muscles and rash. In severe cases, patients develop kidney failure related to the disorder.
A typical FCAS patient is 77-year-old Arlene Fowler of Menifee in Southern California California. "I've had this all my life," she said. "My Mom, who had it, told me that some long-distant cousin caused the problem by daring our relative to jump in ice water."
"I couldn't live back east; it's far too cold," Fowler noted. "Even a slight change of temperature causes a rash, swollen joints, chills, a headache and painful red eyes. It's hard for me to breathe when I get out in the cold air. I feel miserable, but I've learned to live with it. Having a hot tub to warm up helps!"
Fowler and her two daughters with FCAS were among the individuals who participated in Hoffman's study at UCSD. With the other study participants, they spent 45 minutes in a cold-storage room. Hoffman accompanied them, telling jokes and keeping the conversation going, to keep their minds off the 36 degree temperature.
One of Hoffman's FCAS patients who has greatly benefited from his new findings is 63-year-old Peggy Furst of Vacaville, in northern California. She suffered from the severe form of FCAS that had caused kidney failure in several generations of her family. Since she began injections of anakinra every other day, her symptoms have disappeared, her kidneys are working normally, and Furst says she's never felt better.
"My quality of life has had such dramatic improvement that I feel like shouting from the rooftops," she said. "I've gone snowmobiling, walked on the beach in the cold and fog, enjoyed the San Francisco chilly dampness, and, best of all, no longer make my husband suffer by keeping the house constantly at 80 degrees."
While anakinra eliminates symptoms of FCAS, it has a couple of disadvantages, according to Hoffman. "Frequent injections are required, and they sting a bit. In addition, it's very expensive�about $30 a shot," he said.
The cost is what keeps many of Hoffman's FCAS patients from benefiting from the new therapy.
"When my daughters and I got the injections during the clinical trial, our symptoms went away," Fowler said. "But, I can't afford the high cost and my insurance company won't pay for it. I really wish my daughters and my granddaughter in college could use the drug, but right now, none of us can afford it."
The Hoffman team plans further clinical trials with anakinra to determine optimal dosing and they hope to get FDA approval for anakinra treatment of FCAS. "This would help with insurance coverage," he said.
The senior author of the Lancet article was Gary Firestein, M.D., chief of the UCSD Division of Rheumatology, Allergy and Immunology and director of the UCSD Clinical Investigation Institute. Additional UCSD authors from the Division of Rheumatology, Allergy and Immunology were Sanna Rosengren, Ph.D.; David L. Boyle, B.S; Jae Y. Cho, M.D.; and Jyothi Nayar, B.S. Participating from the UCSD Department of Pediatrics were James L. Mueller, B.S. and Justin P. Anderson, B.S. Hoffman and ueller are also members of the Ludwig Institute of Cancer Research.
The study was funded by the National Institute of Allergy and Infectious Diseases, the Ludwig Institute for Cancer Research, the UCSD Rheumatic Diseases Core Center, and the UCSD General Clinical Research Center.
* Fire and ice: An altered protein brings fever, chills
http://health.ucsd.edu/news/2001/10_23_Hoffman.html
** In addition to FCAS, additional hereditary periodic fever disorders are:
Familial Mediterranean fever (FMF)
TNF receptor-associataed periodic syndrome (TRAPS)
Hyperimmunoglobulinemia D with periodic fever syndrome (HIDS)
Blau syndrome
Muckle-Wells syndrome (MWS)
Neonatal-onset multisystem inflammatory disease (NOMID)
University of California, San Diego
University Communications, 0938 9500 Gilman Dr. LaJolla, CA 92093 United States
Phone 858-534-3120
Fax 858-534-0905
http://ucsdnews.ucsd.edu
Warning To Spa Pool Owners And Users About Risks Of Infections
In new guidance issued today the Health Protection Agency (UK) is warning both commercial and domestic owners of spa pools about the risks of infections if they do not follow guidance on how to maintain them properly.
Spa pools in the home are becoming more commonplace with about 14 - 15,000 installed in homes each year in Great Britain . The new guidance sets out the practical measures that can be followed to prevent users contracting infections such as Legionnaires' disease and folliculitis (inflammation of the hair follicles) and to prevent other hazards to health such as slipping.
Dr John Lee, an expert on waterborne infections from the Health Protection Agency said," Spa pools provide the perfect conditions for certain bacteria to survive, and cause infection because the pools have a raised water temperature and conditions that create an aerosol of water. They can also have large numbers of bathers compared to water volume"
"If pools are correctly disinfected, fully drained once a week and use the correct filtration they will not normally contain these bacteria, however in poorly maintained pools the conditions will be perfect for the growth of bacteria and these have been identified as a cause of outbreaks of infection in the past."
The Guidance sets out the specific responsibilities of those who manage commercially run spa pools to ensure staff working with the pool and recreational users are protected. Users should also be informed of precautionary measures they may take to reduce health risks such as:
� Not exceeding 15 minutes in the spa pool at a time.
� Not immersing their heads underwater or swallowing the water
� Bathers should use the toilet and shower before entering the pool
� Bathers should not use the spa pool if they have had diarrhoea in the last 14 days and those suffering from heart diseases or skin conditions should take medical advice before entering the pool.
Speaking at the stakeholder launch for the guidance, Professor Andy Hall, An Agency Board Member said, "The Agency sees this work as an important contribution to helping people to enjoy the relaxation of spa pools whilst minimising the risks".
The guidance can be found on the HPA website at - http://www.hpa.org.uk/publications/2006/spa_pools
Although the guidance is aimed primarily at commercial operators of spa pools, it contains invaluable information for those who have spa pools in their homes. The HPA will shortly be producing a quick reference leaflet to highlight guidance for those with spa pools and whirlpool baths in their homes.
Between 2000 and 2005 there were 5 reported outbreaks of Legionnaires' disease associated with spa pools that led to 28 cases, including 3 deaths.
The principal route of Legionella infection is through the inhalation of the bacteria into the lungs. The risk of Legionnaires' disease rises with increasing numbers of bacteria inhaled. People are at risk of infection because water creates an aerosol that can be inhaled.
Smokers, men, people over 50 and the immunocompromised are at most at risk of Legionnaires' disease. For more information on Legionnaire's disease see: http://www.hpa.org.uk/infections/topics_az/legionella/gen_info.htm
This figure was provided by the British and Irish Spa and Hot Tub Association (BISHTA)
Causes of Back Pain. How to treat back pain.
Many people experience neck and back discomfort at sometime in their lives. Problems can occur suddenly after an accident or injury, or may occur as the result of a slow, gradual process due to lack of exercise or poor posture. Incorrect posture throws the head forward and puts a tremendous amount of stress on the muscles in the back of the neck and upper shoulders.
Muscles in this position maintain a constant state of contraction, resulting in injury and subsequent discomfort. Poor sleeping habits, poor work habits, and tension can all contribute to this problem. While tension is not often the primary cause of back and neck pain, it can certainly worsen pain and make you more prone to injury.
Also, as outlined in the exercise section of this brochure, failure to exercise opposing muscle groups can also result in neck and shoulder pain. The imbalance of muscle strength can cause chronic or sporadic tension and tightness in these areas.
Some other specific conditions that can lead to muscle deterioration and pain may include a sedentary lifestyle, obesity, and general lack of muscular tone.
A healthy, pain-free neck also depends on the condition of your upper back. Because the neck and upper back share the same muscles, the strength and flexibility of the shoulders and upper back muscles are important for keeping the neck balanced.
Pain is also generated when muscles go into spasm. While such a spasm may occur as a protective reflex, it intensifies discomfort by reducing circulation and setting up an inflammatory response.
Stress of any kind, physical or emotional, may cause spasms in underexercised muscles. Lastly, pressure or "pinching" of the nerves in the spine can cause severe pain that can radiate (travel) down the back and leg.
SERIOUS SYMPTOMS
While dull aches can be annoying and even ignored, severe pain or pain accompanied by other symptoms may indicate a serious underlying disease that requires medical attention. If you have any of the following symptoms associated with pain in your neck or back, you are urged to seek medical assistance:
-- Fever - May indicate an infection.
-- Frequent, painful or bloody urination - May indicate a kidney problem.
-- Leg pain traveling down to or below the knee - May indicate a possible disc problem.
-- Numbness, tingling, weakness or loss of bladder or bowel control - May indicate a nerve or disc problem.
-- Persistent pain that hasn't improved and can not be relieved - May indicate a serious back disorder or injury.
SEEKING HELP
If you have any of the symptoms listed above or have other concerns about your neck or back, you are encouraged to consult with a medical provider. Evaluation of your problem may include a discussion and review of your medical history, a physical examination and diagnostic tests.
To be a better health care consumer, you should prepare for your appointment in advance. You may want to make a written, chronological history of your problem with accurate descriptions of your symptoms. You may also want to prepare a list of questions in advance. By letting your provider know you have prepared these, it may help ensure that you have an exchange of communication and that all of your concerns and questions are addressed.
Your provider should let you know the advantages and disadvantages of all recommended tests, procedures and treatments and give you an idea (or prognosis) of outcomes, especially if extensive drug therapy, physical therapy or surgery may be required. If your provider refers you for tests or additional consultation, you should also be aware of the financial obligations you may incur. Talk with the provider's office or your insurance company, if you have coverage, about filing a claim or payment expectations.
SELF-CARE
Self-care and treatment can be responsibly done under the consultation of a medical provider. The following are some safe and effective methods, but remember, if your back still hurts after a week of self-treatment, seek medical advice.
Application of heat or ice
Apply heat and/or ice in a way that makes you most comfortable. To relieve initial pain, you may want to apply ice packs wrapped in towels for 10 minutes every two hours for the first one or two days. Then you may apply heat or ice. Always make sure you have a cloth of some type between your skin and the ice, to prevent freezing the skin and frostbite. It is not recommended that you lie on an ice pack. Since back sprains and strains don't usually cause much swelling, some people find moist heat, such as a hot shower, tub bath, wet towels, or hot water bottle, to be more effective than ice. Limit heat to 15-20 minutes every few hours. Too much heat can make you feel drained and tired, rather than relaxed.
Massage
Massage helps increase the blood flow to your muscles, improves muscle tone and helps your muscles to relax. Classes are often offered for massage training and there are resources such as books and handouts available to teach proper massage technique.
Medication
Pain relievers, such as acetaminophen, ibuprofen and aspirin can help reduce pain. Be aware that products such as these can cause stomach irritation for some people. Take all medications in the dosages and time schedules recommended on the label.
Rest
Try to lie comfortably in a well-supported bed. The best position for your back is on your side with the knees bent. A pillow between the knees may also help increase comfort. Another good resting position is on your back with a pillow underneath your knees. Lying on your stomach or flat on your back with your legs straight out are not recommended positions.
Exercise
Once your pain subsides, do the exercises outlined in this brochure. A bit of initial discomfort is normal, but if you avoid exercise for too long, your muscles will stiffen and weaken and may cause you more problems in the future. If you experience any significant pain, stop immediately and seek medical attention. Gradually increase the amount, intensity and frequency of exercise as tolerated. Do not perform any exercise with pain that is increasing or not improving.
Stress and Tension Management
Techniques, such as progressive muscular relaxation, exhalation breathing, meditation and guided imagery can help create a more relaxed body that is receptive to healing. You might want to seek out a class or book on one of these topics. Soothing music played on a stereo or radio and resting your body and mind may also be beneficial.
Recreational Activities
Some activities can be helpful in toning and stretching muscles while reducing the possibility of further injury. Swimming, walking, and water walking are recommended. Conversely, some activities can cause problems if done before symptoms are gone and strength, flexibility and conditioning are restored. Avoid tennis, golf, bowling, racquetball, diving, high-impact aerobics, and other activities that combine sudden bending and twisting.
SUMMARY
You are not alone if you suffer from back and neck pain and related problems. Restoring your body to optimal conditioning with proper exercise and prevention measures will help ensure an active life. Consultation with a medical provider may be necessary for some individuals.
REFERENCES:
American College Health Association. (1990). Oh, my aching back! Rockville, MD: Author.
Instructions for patients, 4th edition. H. Winter Griffith, M.D. W. B. Saunders Co. Philadelphia, PA: 1989.
Back pain prescription: Out of bed and into the gym. The Physician and Sports Medicine, Vol. 17, No. 9. September, 1989.
Posture perfect performance. The Physician and Sports Medicine, Vol. 14, No. 6. June, 1986.
Kennedy, C., and Legel, D. Anatomy of an exercise class: An educator's handbook. Sagamore Publishing. Champaign, IL: 1992.
Phillips, G., and Clippinger-Robertson, K. Has the bend been banned? Aerobics and fitness. January/February, 1987.
http://www.spineuniverse.com
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