Even excellent tools can be mis-used. Here are seven sins of medical testing:

1. Ordering the wrong test for the right condition.

If I had a nickel for every time a doctor ordered a carotid artery test in a patient with a fainting spell, I could fund my retirement several times over. And this is despite the fact that problems with the carotid arteries (the pulsating blood-vessels in the front of the neck) are incapable of generating fainting spells! Narrowed or blocked carotid arteries are capable of generating many other symptoms -- including paralysis on one side of the body or loss of speech -- but not unconsciousness. Yet this test is frequently ordered in a knee-jerk fashion for people with fainting spells. Moreover, when the artery is found to be narrowed, it sometimes triggers a needless and risky operation on the affected artery. All because of a test that shouldn't have been ordered in the first place!

2. Treating the test instead of the patient.

There are situations in which a tool gets confused with a goal. One example of this is in the treatment of people with epileptic seizures. Most people with seizures do well with the help of seizure-suppressing medications. The amount, or level, of some of these medications can be measured in the bloodstream and there are circumstances in which it is useful to do so. A drug level can be a useful tool. But it's only a tool, and nothing more.

The goals of seizure treatment are simple -- no seizures and no side-effects. What could be more straightforward? However, some physicians appear to believe that the goal of treatment is to produce a certain drug level on a lab report. When this occurs, trouble can ensue. For example, a patient might be doing great on a certain dose of a medication that stops his or her seizures without causing side effects. (How can one improve on that?) But then a doctor, ordering a drug level because it seems like the right thing to do, feels compelled by the number appearing on the lab slip to lower the dose of medication. When this occurs, a seizure sometimes results. This is a seizure that didn't need to happen.

3. Using a test as a substitute for interacting with the patient.

I have great respect for emergency physicians. Having done emergency work myself, I know it's not an easy job. Emergency physicians work in a fish bowl, subject to criticism and second-guessing for decisions made in crisis situations and under pressure of time. That said, one gains the impression that sometimes they order thousands of dollars worth of tests based on a 30-second interview and a cursory exam. Yet there are cases in which, if a few more questions had been asked of the patient or family, the diagnostic possibilities and choice of tests would have changed.

4. Ordering irrelevant tests.

There are certain tests -- like a chloride level in spinal fluid or blood-levels of some of the newer seizure-preventing drugs -- that are not known to be useful for anything. But they get ordered anyway.

5. Forgetting that tests are imperfect.

All tests -- from high-tech scans to lowly blood measurements -- have false-positives (overcalls) and false-negatives (undercalls). But sometimes test-results are handled as if they're perfect and never wrong. As an example, sometimes patients have attacks for which the descriptions are compelling for a diagnosis of seizures, but then have normal electroencephalograms (brain-wave tests). Electoencephalograms can be very helpful, but it's possible for a patient who really does have seizures to have a normal tracing. Yet it's not unusual to encounter cases where patients' normal brain-wave tests kept them from receiving the treatments they needed.

6. Forgetting that there aren't tests for every medical condition.

When patients report hard-to-diagnose symptoms to their doctors, medical tests are often ordered. Sometimes all the test-results are normal. Does this mean there is nothing wrong with the patient? Not necessarily. There are many conditions -- like migraine, Parkinson's disease, fibromyalgia and restless legs syndrome -- for which conventional tests show no abnormality. We just don't have tests for everything. So it can happen that the tests are normal, but the patient isn't.

7. Failing to order tests that could affect treatment.

One axiom of medical management is that a test should only be done if its different outcomes would lead to different plans of action. If the plan of action is the same no matter how the test turns out, then why do the test? There's a flip side to this axiom. If a test's different outcomes would indeed lead to different plans of action, then the test really should be done, or at least be strongly considered. So, when it comes to ordering a test, there can be sins of omission as well as sins of commission.

It is tragic when a patient develops progressive memory loss and confusion. But it's even more tragic when it is assumed that the cause is Alzheimer's disease (for which there is no good treatment) when it's really due to something else for which good treatment is available. A risk-free head scan and a small assortment of blood tests can check for a number of curable conditions, but sometimes these tests are omitted.

(C) 2006 by Gary Cordingley

Gary Cordingley, MD, PhD, is a clinical neurologist, teacher and researcher who works in Athens, Ohio. For more health-related articles see his websites at: http://www.cordingleyneurology.com and http://www.neurologyarticles.com.

Restless Legs.

Typical symptoms include an unpleasant, creepy crawley itching or tugging sensations in your legs with an irresistable urge to keep moving them around. It tends to get worse in the evening and movement is the only thing that brings relief.

Restless leg syndrome often runs in families and is more common in over 65s and pregnant women, although the condition usually disappears after giving birth. There is no known cause in most cases although it is sometimes linked to an iron deficiency. Other possible culprits are low levels of calcium and magnesium and poor circulation.

Self help measures to try are:

• Try taking a mineral supplement containing calcium, magnesium and potassium and zinc.
• Limit tea and coffee. Have a cup of herbal tea instead.
• If your legs want to move, indulge them. Get out of bed and take a quick stroll around the house.
• Even though sleep experts advise giving exercise a miss immediately before bed, gentle exercise such as stretching just before bed can be helpful.
• Have a warm bath with a cup of Epsom salts in it.
• Put 30 drops of Valerian tincture in some water and drink - this helps relax the muscles.
• Massage your legs with some almond oil containing a few drops of Roman Chamomile essential oil.

If you just can't sleep after all that, I suppose you'll just have to put on your dancing shoes and go dancing!

Nimsy is the webmaster for Sleep Tips which is about all matters to do with sleep and curing insomnia and sleeplessness with natural remedies.

Permanent Hair Removal with Lasers? Can You Really Kiss the Razor Bye Bye?

Permanent hair removal via new laser technology is quickly becoming the method of choice for thousands of women to permanently banish those long leg and underarm shaving sessions, and to leave them soft and smooth without wasting precious minutes every day. So, what is the cost of laser hair removal, and what does the process entail? Well, I will tell you?

First of all, not everyone is eligible for laser hair removal, so you should definitely consult with a specialist or specialist organization before you even consider this route for permanent hair removal.

While laser hair removal is much less expensive than the (somewhat painful) method of removing hair called electrolysis, some individuals may only be eligible for electrolysis due to physical and hair characteristics which make laser hair removal very difficult or impossible.

First of all, any person who is exceptionally dark in skin pigmentation would not be a good candidate for this procedure, and may want to look into alternatives to lasers to remove unwanted body or facial hair. Additionally, people with tanned skin and light hair, or people with generally very light hair would not be good candidates.

Cost of Laser Hair Removal?

The cost can vary considerably, depending on whether you choose to do a large area of your body, like your legs (which will cost considerably more), or just a small area, like facial hair above the lip and so on. Generally each session costs roughly $500 for smaller or medium size areas, and depending on the surface area covered will cost more per session, and require return sessions to get all of the hair removed.

How Does Laser Hair Removal Work?

Well, I?ve got good and bad news here. You will require return treatments to keep the hair gone, and to get all of it, and contrary to what most people believe, you will not be able to hang up the razor forever, because you will still have a few stray hairs here and there. Trust me, it would be nearly impossible to get every single hair, maybe some day, but this technology has not come this far yet today. I will say this, you will be considerably smoother and have to worry about shaving way less though, so it?s still worth it.

And get this, while they know that laser hair removal makes your hair fall out, they still are not exactly sure why. In other words, there is conjecture that the laser action and heat below the surface of the skin breaks the hair follicle apart and destroys that hair permanently, but they don?t have 100% conclusive evidence of that theory yet. What happens after a laser treatment is that over the course of the next few weeks or months after treatment, the hair on the treated area just falls out. For whatever reason, laser hair removal tends to work best for people with a fair complexion and darker hair.

Interesting huh? So, if you were considering having your hair removed by a laser professionally, whether it be for your legs, or facial hairs or any other unwanted bodily hair, hopefully now you can go into it a little more educated!

Visit Laser Hair Removal Finder for more information where to find laser hair removal in your specific area, and what to expect. Danna Schneider is also the founder of Herbal Therapeutics Herbal Remedies and Supplements: Hair Removal Product.