and. basically the safety of the us to the top of the nation full of. israeli peace it's sad to go somewhere every day and see more and more time it seems gives me everything the way the wind have to give something back it's like still apply to a certain. point waves surfers fighting against a unseen illusion the sea started in january seventh on g.w. . and welcome to in good shape coming up pediatric heart transplants a new lease on life. under pressure

how to stop grinding your teeth. and kicking the habit for a smokeless future and here's your host dr carsten i could talk to. hi welcome to my practice great that you're here. i've just been reading the fender and there's a maid from google shimon from australia and she's been smoking for sixty years and she really wants to quit and she says that she tried numerous times but so far she has been able to overcome her addiction now she wrote does without the help of in good shape she'll never be able to quit what a stroke of luck that i know the perfect expert for this is dr thomas healing he supposed the knowledge is in the next part in smoking cessation.

quitting to smoke it's worthwhile at any time at any age and it will be easier when you think me when i tell my patients to quit smoking i feel a lot of fear fear that the coffee will taste as good anymore fear that i will miss nice conversations with my friends and fear that i don't know what to do was too healthy hence. but is it really so difficult to stop smoking me. many of the twenty million smokers in germany know all too well how hard it is to quit. i started when i was thirteen and fourteen now and i'm addicted. so if some of i've tried to quit i've managed two months at the most. of life and smoking since i was twenty one that's twenty seven years at least a pack

a day so about twenty to thirty every day. just to give a talk does he think he could give it up. your i'm going to give it a try here's my pack of cigarettes my lighter let's see how it goes but. it won't be easy because nicotine is physically and psychologically addictive as. explained. nicotine floods the brain and alters the brain metabolism and what it does it stimulate the reward pathway so without nicotine smokers feel bad they need nicotine to feel normal. sebastian paschal is thirty four and has been a smoker for nearly twenty years he smoked about fifteen cigarettes a day tried to give up now and then the last time was two years ago but i never managed more than two or three weeks'. time to try again. the body processes

quickly. doesn't take long after eight to twelve hours the nicotine will be gone and the body stress system is no longer being activated nor driveline and adrenaline levels drop and as a result blood pressure and pulse will start to normalize. but that doesn't mean you won't relapse. i had a relapse i realize that you have to quit every day and you as it were. it feels like the. sickle and psychological addiction get stronger. if you relapse than have a cigarette the nicotine needs to leave your system all over again quitting is hard but it's worth us. one thing i've noticed is that my sense of smell and taste regenerated. i have the feeling i can smell much more than i used to. that's

not all circulation also improves the bronc tubes and the long start to regenerate although this can take some time but it's not the next step is that the time needs to be washed out the toxins that are responsible for the damaging effect of smoking that's a process that takes months or even a year if you've been smoking for twenty years and then stop you can reduce by fifty percent your risk of lung cancer in the next ten to fifteen years. before quitting sebastien experience shortness of breath and cough to last when jogging so has this started to improve now that he's not smoking. so far over the past four weeks i haven't noticed that i'm breathing more easily but i hope it'll start to get better. and if he confident he can place. i haven't smoked for a month and i feel pretty proud of myself even so i know this is just the beginning

it's a good start but i've got to stick to it. sebastian hasn't had a cigarette for a month now he's almost there. now all the benefits of giving up will start to make themselves felt he'll become fitter his concentration will improve he'll feel more focused and ultimately his risk of developing smoking related conditions will be significantly reduced. the. time to give back to figure out is weak. understated if you hours ago. yes in fact the first two hours were no problem but then every now and then i'd feel like a smoker it. could be considered quitting. it made me think about having another go at quitting. smoking supposable quitting smoking requires island discipline but it really is where. we just spoke to us

about him and he admitted that he started smoking again and this is what i'm going to talk about now with dr thomas healing here in berlin you're pulmonologist and you're an expert in smoking cessation thanks for having me today why is it so hard to quit smoking almost most of the small coasts are addicted to smoking and the addiction is works in two ways to elements that draw the smoker to. smoke again one element is the nicotine addiction the other mechanism of smoking dependence is. the fact the get used to combine certain situations in life with smoking and the.

situations compellingly bound to to having a cigarette so those two mechanisms. in combination. resulted in the addiction when i speak to my patients in day advice them to quit smoking many of them tell me will they smoke for years no i'm quite old think there is no use in quitting smoking at my age so what do you say to them in fact in most cases there is a huge benefit for any patient to quit smoking but depends for him. on who's specific situation what diseases he has and we as physicians may advise specifically for a cardio patient we will advise differently from a pulmonologist patient for example the risk to have cardiac. myocardial infarction decreases within hours and

days after quitting smoking and is half after one year and is diminished to almost the risk of a never smoker after three years this is the best benefit smoker can achieve with cutting smoking is really where to go for it and we got this letter with a cry for help from our as trillian viewer gudrid sheen them and she desperately wants to stop smoking she is not perfect if she would come into your practice what would you offer the main smoking cessation measure is behavior therapy which takes some time and we have kind of a. three element program where in three sessions in groups we offer the preparation and then in a second session the stop smoking session where all the participants really

smoke their last cigarette and then stabilization session and who support the behavioral therapy intervention with medical support there are a kind of medication through substances. that we can give to support and to step allies to. the effect of their behavior. what are your results how many people do you really stop smoking for yourself after such an intervention of the c. between thirty five and fifty percent. are continuous x. no because after twelve twelve months people don't only smoke cigarettes they change into these cigarettes so. they. mean. cigarettes aren't as popular as they used to be but there are still plenty of die hard smokers. it's a pleasure but it's also an addiction and

a costly one seven million people die of smoking related illness every year. a growing number of people are looking for alternatives such as an electronic cigarettes and vaporizing. i've been dating for three years but i haven't had a single cigarette since. i used to be really heavy smoker but it just became too expensive. to rush after no packs a day i was a heavy smoker i've been facing for about eighteen months now. does baking help smokers quit there still aren't any long term studies on the effects of aping push for heavy smokers trying to break their tobacco habit a cigarettes are definitely an option to be a supporter is an expert on addiction just switching to the cigarettes is better than smoking you can't argue with the science but it raises the question does vaporing also have harmful effects the actual vapor contains chemicals also found

in dry ice antifreeze anstey icing agents these are the vapor contains the substance probably. that's a respiratory irritant it also contains flavorings which are harmless if you eat them but we don't really know what they do when you inhale them and as i know i meant to spice mine for. what we do know is that they ping is a booming business and with the cigarette market shrinking the tobacco companies are looking to cash in on the vaporing trend. there snapping up taping companies we don't know what their strategy is right now used but it's a very big market last year alone a cigarette sales in germany reached four hundred million euros three and a half million people in the country are vaporing and more are joining their ranks all the time. me so what's your take on the cigarettes the

government of u.k. has published estimation that the risk from the cigarettes is about five percent the risk of a tobacco cigarette so it may be a risk so the best is the zero consumption. what we have cases may be another exists patients will see a pretty well we desperately need. to help the patient quitting smoking. so no not the least smoke should enter the bronco system and in those cases. the road may be a tolerable alternative as in that you cigarette the patient inhaled by her smoke one important thing in smoking cessation you said earlier the previous talk

is behavioral therapy so that one of all of us right now wants to stop smoking altogether and they don't want to go to behavioral therapist can they do some tweaks in their lives that they can put some kind of behavioral therapy in their lives. it's a matter of good preparation actually. they may advise their smoking situations by having kind of a diary before quitting a diary in which situations they usually smoke and. much worse at the urge to smoke and they may take down notes and analyze the most dangerous trigger situations that may change those situations for example if they have breakfast with coffee in the kitchen in the morning and i understand this is a strong trigger situation for them they might change and have their breakfast in another place of their float and maybe change to to.

decreasing the trigger and so may be successful and avoided it. what do you think about smoking cessation with the help of patches and you get to patches you know this is. important support. it is a support the main thing is the change of behavior but using nicotine patches for example or. gums or there is a spray in the market now which. is a very important support to decrease withdrawal symptoms i love you there you are tommy ellen from the grotesque he quit smoking two years ago but since then he's been addicted to nicotine gum so what can he do. well actually. should be proud that he quit smoking. the main goal is obviously he

reached that the nicotine by itself is not a real dangerous substance. so actually i think he should try to get rid of the nicotine gum. after time but it's not a real concern so he'll be fine and so what are commonly key smoked for over twenty years and he had three needles piece through his ear lobes and china could punch a treatment and he never puffed again so how successful is this complimentary medicine like a compact a treatment and so while it's very good for walter he succeeded. the general the darter pose on. smoking cessation measure is disappointing so actually we wouldn't recommended in a general way. the effects may depend very much on the attitude of the patient

to the method to go and if the attitude and the expectation is very strong he should try and if he's successful very well thanks so much for having me today and if you still smoke it's worth it to stop but don't stop writing me emails. on one of our upcoming shows we'll be looking at chronobiology how does the day night rhythm affect our body clock why does medication affect us differently at different times of the day if you have a question about that right to in good shape at d w dot com with the subject line chronobiology we look forward to hearing from you. whether it is a kidney liver or heart worldwide people are waiting for donor organs even children like little ilesha me. at least to celebrate her birthday twice on the day she was

born and on the day she received an organ transplant. actually i got a new heart. after i know. on the one hand we were happy because we knew our daughter you know had a chance of becoming healthy again. but there was also an incredibly sad side because we knew that there was another family somewhere who had just lost a child. at least she was born healthy in january two thousand and eleven but a few months later she got a cold. medication didn't help and she had trouble breathing chest x. rays showed severe enlargement of her heart the doctors diagnosed myocarditis an inflammation of the heart muscle caused by the cold. while alicia was being taken to a clinic specializing in pediatric cardiology her heart stopped beating. down humvee

so long they spent two alleys resuscitating her. become overdose and they would come back out and say her heart had started beating for a few seconds but then stopped then again for minutes before stopping again. it was the worst two hours of our lives sleeve. but the doctors didn't give up. their venture they got her heart beating again regularly. ten weeks later she was released from the clinic but just a week after that the alarm on her heart rate monitor went off. on the side peeps of us suddenly they've all these peeping sounds heart stopped beating us that's when we realized her heart wasn't going to recover by. an air ambulance flew aleesha straight to the clinic. her heart was irreversibly damaged. her only hope now was for an organ transplant. paul said so mr kinda ordered only

be done if the patient is in an otherwise healthy condition is highest any other serious organ disorder would make a transplant impossible. that might be a tumor or active cancer. but otherwise transplants can be performed with patients regardless of their weight or age including babies up them. but the availability of suitable hearts is extremely limited for babies and toddlers the donor organ has to be around the same size as the recipients so patients can face a long wait elisa was fortunate to get a new heart after just four weeks post transplant life was transformed for the whole family. in fact it was vital we never left home without it. and the mask over her mouth and nose was also very important. for almost an entire

year when we wanted to go outside for some fresh air she had to have the mask on first. after transplant as one is not a risk of the organ being rejected is especially high in the first month after transplant every week the risk decreases. but the risk will always be there. as that's also why patients have to remain on medication for the rest of their lives becoming tiny most. alicia is now six she takes immunosuppressants to prevent her body from rejecting the foreign organ she also goes to the clinic every three months for an ultrasound. the limbs that one is constantly and i transplanted organ doesn't have the same lifespan as a native or can come on for they age faster as it were i ten at question at. children with the best chance of living a long life for those whose transplant takes place in their first year of life like the leadership in the first few months the new heart adjusts to the recipient size

elisa now plays like other kids but she still has to be careful since the medication weakens her immune system. often it's important to keep your distance from obvious sources of infection stick to standards of hygiene and try to avoid salmonella tainted food. now you should avoid getting diarrhea or infections in the upper respiratory tract. or coughs and colds infected you have to protect yourself in daily life. many people in germany say they'd be willing to donate an organ but if you actually make the effort to get an organ donor card. it's not only the recipients who stand to benefit. a lot of donor family as we've been in contact with actually experience relief and it helps them accept the death of their relative back knowing

that a good deed has been done and. has been very lucky. her mother often thinks of the donor child's parents should always be grateful they gave her daughter the gift of life. when you wake up in the morning and her maybe you're grinding your teeth. me. i get muscle pain here in my jaw and up here in the joint too of course how it spreads down to my neck and shoulder muscles. and it can be very very painful. often that's why ilona often feels tense and unrested when she gets up the pain comes from brooks's i'm grinding her teeth in her sleep. dentist has made a mold of her teeth to demonstrate the damage caused by all the nighttime clenching

and gnashing. over this into the this is how your teeth move at night. in particular these grinding movements are what's causing the erosion of your teeth . especially the ones in front. of him talking. brock's ism exerts up to one ton of pressure on the jaw a night guard like this protects the teeth not only at night here and so that is. it's easy to insert and it's a perfect fit. it gives me a bit of a lisp which makes things awkward at work when you have to do a lot of talking. otherwise it doesn't bother me that there's a slight ache but other than that i barely notice it. ilona tested the mouthguard for two weeks she had to wear it as often as possible. that's the most good thing during the day it only bothers me when i'm talking and you get

used to wearing it at night very quickly sometimes i even forget that i'm wearing it. alone as jaw pain hasn't vanished completely so her dentist is doing another test measuring her jaw with a special device. it's aimed at examining the behavior of her lower jaw where there's mobility and where movement is constrained. can you open a bit wider. and back again slowly. if you put on the measurement indicates that there's a problem with it alone as temperamental buehler joint. the dentist recommends a special retainer which ilona hopes will provide long term relief. all my life. it would protect my teeth and the joint and ensure that i wake up more relaxed and. once the latest test results have been evaluated alone as

dentist will fitter with a new retainer. that's it for today your follow up appointment is next week so you're going by.

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first democratic transition of power in decades also come.