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COPING WITH ANGINA AND STRESSFUL EVENTS: MANAGING PREDICTABLE AND UNAVOIDABLE EVENTS
Imagine being told at work your boss has to lose half his staff and you are on the redundancy list.
Imagine your family doctor asks to see you about your partner’s health. She explains your partner is expected to live no more than 6 months.
Imagine the local council has decided to put a road through your garden and is offering you compensation.
Imagine your partner has inherited a large sum of money from a distant relative.
All of these events are sudden and at least partially unpredictable. Depending upon your circumstances, you might interpret redundancy as welcome or unwelcome, the death of your partner as a catastrophic shock for a shortened happy life or a relief from years of suffering. Similarly, forcible house purchase and inheritance can be burdens or blessings. While there are obvious practical actions that must be taken depending upon the exact circumstances, some general rules will apply to most predictable and unavoidable events:
Identify all aspects of the event which cause you to
feel threatened
E.g. the threat of redundancy:
Will it really happen, and when?
What alternatives do I have?
What costs will it bring to me personally?
Are there any benefits for me now, and in the longer term?
Should I feel a failure or are other circumstances beyond my control to blame?
In practice, most of the answers can be obtained by talking to people in charge of the situation, or others who have been in your position before. These are the practical actions most people will carry out when faced with a real-life predictable threat. However, they often overlook the personal, emotional and physical health impact of the event. Dealing with these feelings and bolstering your healthy coping reactions are especially important.
Identify the personal impact of the event
Do you feel responsible for the event?
Do you feel responsible for how the event affects you?
Do you feel in control of how you will respond?
How do you feel about other people’s reactions?
Do you anticipate success or failure?
3Identify what you can do to manage your feelings
about the event
Let feelings out, both on your own and with supportive people.
Think through the problem and what can be learned from it.
Talk with people who can support you through the problem, or take some of this and other burdens away.
Give yourself ‘time out’ at regular intervals from the problem so you have time for emotional repair.
Identify what you can do to bolster your health and
well-being during this stressful time
Make sure you stick to a healthy daily lifestyle of balanced food, exercise, relaxation, and avoid excessive alcohol and smoking.
Avoid taking on other heavy demands during this time.
Delegate or say no to additional daily hassles, keeping these to a minimum.
Allow yourself real breaks away from the problem. For example, try to mix with some friends who do not know about it or who can be trusted to let you leave the problem behind for a short time.
An example of how a person with angina dealt with the threat of major heart surgery is given by the case of Barbara:
At 49 years old, Barbara had had angina for two years. Her symptoms were steadily getting more severe until she was unable to walk up more than ten stairs without becoming breathless and having strong chest pains.
Her physician referred her to the heart surgeon who examined her coronary arteries during a cardiac catheterization procedure. She was found to have one artery more than 50 per cent blocked and one artery 80 per cent blocked. The surgeon advised her to have coronary bypass surgery, so she was put on a 6-month waiting list.
Barbara felt relieved that some treatment was available, but angry that she had to wait, and also very fearful about the pain and risk of the operation as well as the disruption to her work and family plans. However, she talked it over with her physician, and her husband and the chief coronary surgery nurse. She asked to talk to patients who had been through the operation and was introduced to the ‘Mended Hearts’ post-bypass support group run by the hospital social worker. She talked to her family doctor about ways of keeping healthy and he agreed to give her monthly check-ups if she attended the health promotion class run in his practice.
She coped well until an unrelated crisis occurred. Her husband’s small business crashed. She knew she had coped reasonably well when his business had been in trouble before, but this seemed to be too much to cope with on top of her own troubles. Her husband blamed some of his business failure on the worry and expense of his wife’s illness. She realized they would both suffer if she let her health problems become an excuse for their marital and financial problems. After discussion with her husband they both agreed to get financial advice, and if their marriage did not improve when the financial worries were under control, to seek marriage guidance counselling. In the meantime, they decided to take a short break with old friends of theirs to give themselves a little breathing space.
So, even inevitable, predictable and unavoidable crises can be met either as an overwhelming catastrophe, or as a series of problems which can be tackled individually and systematically. This approach emphasizes that successful outcomes may not be achievable even with the best efforts, but that during the time when the crisis is anticipated, attempting to identify what is achievable and working towards those goals can reintroduce a sense of personal control.
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