Individualized drug counseling does more than focus on reducing or stopping illicit drug or alcohol use. Drug counseling also addresses related areas of impaired functioning such as employment status, illegal activity and family or social. By emphasizing short term behavioral goals, individualized counseling helps the patient develop coping strategies and tools to abstain from drug use and maintain abstinence. The addiction counselor encourages 12-step participation at least one or two times per week and refer the patient to experts who can provide supplemental medical, psychiatric, employment and other services.

Institute on Alcohol Abuse and Alcoholism

National Institute on Alcohol Abuse and Alcoholism provides leadership in a national effort to reduce problems related to alcohol. The National Institute on Alcohol Abuse and Alcoholism conducts research in a range of scientific areas, including genetics, neuroscience, epidemiology, and studies the health risks and benefits of alcohol consumption, prevention and treatment. The National Institute on Alcohol Abuse and Alcoholism coordinates and collaborates with other research institutes and Federal programs on issues related to alcohol. The National Institute on Alcohol Abuse and Alcoholism collaborates with international, national, state and local institutions, organizations, agencies and programs to translate and disseminate research findings to health care providers, researchers, policymakers and the public.

Nail Bed

The nail bed is the skin beneath the nail plate. Like all skin, it has two types of tissues: the deeper dermis, the living tissue fixed to the bone, which contains capillaries and glands; and the superficial epidermis, the layer just beneath the nail plate, which moves forward with the plate. The epidermis attaches to the dermis by tiny longitudinal grooves as the matrix crests or crests of nail matrix. As we age, the plate grows thinner and these ridges become evident in the plate itself. A nail is a horn-like envelope covering the dorsal aspect of the terminal phalanges of fingers and toes. The nail is made of a hard protein called keratin. Nails can dry out, just like skin. They can also peel, break, and become infected. The nail protects the ends of the fingers and toes from trauma and helps pick up small objects. Care of the fingernails and toenails is important. Poor nail care causes problems. Recommendations for maintaining nail health include: keeping nails clean and dry in order to keep bacteria and other infectious organisms from collecting under the nails; cutting nails straight across with only slight rounding at the tip; using a fine-textured file to keep nails shaped and free of snags; and avoiding nail-biting. Nail changes, swelling and pain can signal serious problems that may require a physician and medical nail care.

Lap Band

A lap band is an inflatable silicone device that a surgeon places around the top portion of the stomach, via laparoscopic surgery, in order to treat obesity. Lap band surgery is an example of bariatric surgery designed for obese patients with a body mass index (BMI) of 40 or greater, or between 35 to 40 in cases of patients with certain co-morbidities that are known to improve with weight loss, such as sleep apnea, diabetes, osteoarthritis, high blood pressure or metabolic syndrome, among others. Lap banding is the least invasive surgery of all bariatric surgeries. Lap banding using laparoscopic surgery usually results in a shorter hospital stay, faster recovery, smaller scars, and less pain than open surgical procedures. The patient can continue to absorb nutrients from food normally. Lap bands are made entirely of biocompatible materials, so they can stay in the body without causing harm. However, not all patients are eligible for laparoscopy. Patients who are extremely obese, who have had previous abdominal surgery or have complicating medical problems may require a more open surgery approach. The surgeon creates a small incision near the belly button and pumps carbon dioxide into the abdomen to create a workspace. Then the surgeon inserts a small laparoscopic camera through the incision into the abdomen. The camera sends a picture of the stomach and abdominal cavity to a video monitor. It gives the surgeon a good view of the key structures in the abdominal cavity. The surgeon makes more small incisions in the abdomen. The surgeon watches the video monitor and works through these small incisions using instruments with long handles to complete the procedure. The surgeon creates a small, circular tunnel behind the stomach, inserts the lap band through the tunnel and locks the band around the stomach. Clinical studies of lap band surgery patients found that they felt better, spent more time doing recreational and physical activities, benefited from enhanced productivity and economic opportunities and had more self-confidence than they did before surgery. The placement of the band creates a small pouch, or stoma, at the top of the stomach. This pouch holds approximately one half cup of food. A typical stomach holds about six cups of food. The pouch fills with food quickly, and the band slows the passage of food from the pouch to the lower part of the stomach, causing the sensation of being full. As the upper part of the stomach registers as full, the message to the brain is that the entire stomach is full, and this sensation helps a person to be hungry less often, feel full more quickly and for a longer period, eat smaller portions, and lose weight over time. As patients lose weight, their bands will need adjustments, or "fills," to ensure comfort and effectiveness. The surgeon can adjust the lap band by introducing a saline solution into a small access port just under the skin. There are many port designs and a surgeon may place them in varying positions, but they always connect to the muscle wall in and around the diaphragm via sutures or staples.