Tendonitis in detail….

What is a Tendon??

Tendons are nothing but the tissue that attaches muscles to the bones… It is a tough however flexible band of fibrous tissues.

What is Tendonitis?

The tendons sometimes become inflated for a number of reasons, and your muscles get irritated and pulled up. This affects the normal smooth gliding motion of your tendon because of which they become inflamed and movement of these tendons causes severe pain. This is called Tendonitis, and literally means inflammation of the tendon.

There are many types of Tendonitis:

There are many types of Tendonitis;

• Foot Tendinitis
• Extensor Tendinitis
• Finger Tendinitis
• Elbow Tendinitis or Tennis Elbow
• Dequervains Tendinitis
• Calcific Tendinitis
• Bicep Tendinitis
• Ankle Tendinitis
• Achilles Tendinitis
• Adductor Tendinitis

How do I know I have it??

Symptoms of Tendonitis are really good and clearly felt; that they alert us of worse things. Pain that is caused is directly proportional to that of the damage that tissue had suffered. Damaged tendon tissues will feel tight and as if ropey cords which contact all the time. Sharp pain in some cases include aching and some discomfort while moving elbow or wrist.

Symptoms of Tendonitis

Tendonitis has distinctive symptoms that are always bothering you until you take proper care for it.

• Tenderness directly over the tendon
• Pain with movement of muscles and tendons
• Swelling of the tendon

The normal risk factors

Repetitive movements, trauma, thermal injuries, and use some antibiotics such as levofloxacin and ciprofloxacin, smoking tobacco are some of the most common risk factors that one usually has before the symptoms worsen for the condition, Tendonitis. People with certain diseases such as obesity, rheumatoid arthritis and diabetes are also prone to develop conditions such as Tendonitis.

How Chinese medicine and Acupuncture helps here??

Acupuncture is one of the world’s oldest treatments. It enriches blood tissues and cures you naturally. One more added advantage is both Chinese medicine and Acupuncture are not just effective but also, they have no side effects. Sustain Health is one of the finest choices for you to treat your condition in Australia, do visit us directly, we are located in South Melbourne!

Call us Now on 1300 432 639 or Fill the online Appointment form for appointments!

]]> http://www.sustainhealth.com.au/2011/08/01/treat-tendonitis-effectively-with-acupuncture-and-chinese-medicines/feed/ 0 http://www.sustainhealth.com.au/2011/07/18/treat-sciatica-traditionally/ http://www.sustainhealth.com.au/2011/07/18/treat-sciatica-traditionally/#comments Mon, 18 Jul 2011 09:58:55 +0000 Dr Scott Ling http://www.sustainhealth.com.au/?p=1082 Sciatica is low back pain that comes along with a pain through the buttock and down one leg. Anything to relieve pain can be treated using Acupuncture and Traditional Chinese Medicines. Traditional treating methods prove highly effective as they are the ones that exist from ages ago. In this post, let us see about the medical condition called Sciatica, its causes, symptoms and methods it could be treated!

What is Sciatica?

• Sciatica is pain in the lower extremity that occurs as a result of the irritation of the Sciatic nerve .
• Sciatica is characterized by pain that can be felt along the path of the sciatic nerve
• The pain of Sciatica is characteristically felt from the lower back to behind the thighs and it continues down below the knee. Each leg has its own sciatic nerve
• The sciatic nerve is the largest nerve in the body; it is the longest as well!

Causes of Sciatica

There are a few definite causes of developing Sciatica;

• Sciatica is commonly a result of a lumbar disc herniation.
• Any cause of irritation or inflammation of the sciatic nerve results in an abnormal intervertebral disc called Radiculopathy
• Irritation of the nerve from adjacent bone
• Tumors
• Internal bleeding of Muscles
• Infections
• Injury and other causes
• Sometimes Sciatica occurs because of irritation of the sciatic nerve during pregnancy
• Lifting heavy objects and sudden movement causes pain
• It can be caused due to ageing

Symptoms of Sciatica

• Causes severe pain
• A burning sensation
• Numbness or tingling that is felt from the lower back and upper buttock down the leg
• Leg pain
• Sometimes the pain radiates around the hip causing severe hip pain
• Sciatica is often connected with lower back pain (Lumbago)
• There can be difficulty in walking (at severe stages)

Look for Medical Care if;

• The pain seems to be getting worse
• If you presently have cancer or a history of cancer
• If you have lost a large amount of weight recently
• Fever with back pain
• If you are HIV positive
• When you notice that your body is getting weak over a period of time
• If there is pain at the back of your chest

CLICK here to read a post on Sciatica..

As we discussed earlier, Traditional treating methods such as Acupuncture and Chinese Medicines can help great deal in reducing the pain and intensity of the symptom of any clinical condition in an effective and easy way! All you have to do is to contact the best Acupuncture and Chinese medicine clinic in you city! Why do you need to think when you have Sustain Health?! Visit us directly; we are located in South Melbourne.

Contact Us right away for making online appointments!

Neck Pain in general!!

• Neck is generally an intricate, interlocking structure which consists of bones, joints, nerves, muscles, tendons and ligaments
• The main function of the neck is to support the weight of your head!
• In addition to giving support, the functions of neck are many and are all equally important!!
• The head should be able to move from side to side and up and down
• Neck acts as a channel for the spinal cord to carry blood to and from the head
• Neck also has passageways for air and food, and now you know why neck pain is to be seriously considered

Structure of the Neck

• The physical structure of the neck is well described as seven interlocking vertebrae.
• They are called the cervical vertebrae and are numbered C1 to C7
• C1 is otherwise known as the Atlas and is the closest one to your head
• It is followed by C2, which is known as the Axis
• Each vertebra is linked to the next by facet joints
• In between the vertebrae are Rubbery cushion like intervertebral discs which are made of cartilage that act as shock absorbers

Causes of Neck pain

These are some of the most common causes of neck pain.

• Whiplash - It is the pain that is caused when your neck muscles get strained due to car accidents in which you head would get hurt first!
• Muscle strain – Over use of neck muscles causes neck pain
• Poor neck position while performing daily routines, (computer work) can trigger neck muscle strain, causing chronic neck pain and stiffness
• Degenerative disc disease will cause neck pain as the shock absorbing discs which would contain soft gelatinous substance in it will get dried off
• Herniated disc; It happens when outer layer of cervical discs tear and the gelatinous substance inside bulges out
• Cervical Spondylosis – Neck pain due to ageing and over use of the neck muscle
• Cervical spinal stenosis; this is nothing but the narrowing down of the canal in which the spinal cord is present
• Occasionally, you would feel an electric shock down the body when the neck is bent forward, this is called as Lhermitte’s sign

Symptoms of Neck pain

Symptoms of neck pain are many; here are a few…

• Muscle spasm – A spasm is an unexpected, powerful, spontaneous contraction of muscles; If you have neck muscle spasms, you may not be able to move your neck
• Muscle ache – The neck muscles are painful and may have hard knots that are extremely sensitive!
• Stiffness – The neck muscles become tight if you keep your neck in one position for a long time!
• Nerve pain – Pain from the neck can spread or run down the arms, and sometimes even the legs. You may feel a sensation of tingling in your arms, along with numbness, burning or weakness. This pain is usually worse at night
• Headaches – Headaches are common in combination with neck problems
• Loss of range of motion – It means you will not be able to move your head left or right towards each shoulder and if you try doing so, or try tilting your head backwards, will get severe pain! It means you have reduced range of motion
• Dizziness - It accompanies neck pain and can be due to some injuries

You need to get immediate medical attention for neck pain if;

If you experience severe neck pain, especially after a neck injury

If you experience symptoms such as;

• loss of bladder control
• shooting pains
• numbness
• tingling
• weakness in the arms or legs

If you experience any of the above symptoms, suddenly and also if it’s unbearable; then make sure you get medication at once!! As I always say, Traditional Acupuncture and Chinese Medicines help you big time in relieving pain. Sustain Health is one of the finest Acupuncture and Chinese Medicine clinic located in South Melbourne!

Do visit us directly or Contact Us for booking appointments, right away!

What is Knee pain??

Knee pain is considered as one of the most common and wide spread musculoskeletal complaint that’s prevalent among many people worldwide… Knee pain has a variety of specific causes and treatments. Let us first try to understand the anatomy of the knee!

The main function of the knee joint is to bend, straighten, twist and rotate. To perform all such actions and to give firm support to the entire body while doing so, the knee relies on different parts or structures which include;

• Bones
• Ligaments
• Tendons
• Cartilage

Bones

• The knee joint is made up of three bones; Femur, Tibia and Patella
• The Femur is nothing but the thighbone; it covers the entire top portion of the joint
• Tibia is found in the bottom portion of the joint (lower leg)
• Patella is the kneecap that is found in front of the Femur
• Fibula is the remaining part of the bone. It is close to the outer portion of the knee joint

Ligaments

• Ligaments are fibrous (tough) bands that connects bones to other bones
• The knee is made up of four important ligaments
• All four of them are connected to the thighbone and also to Tibia
• The Anterior Cruciate ligament (ACL) & Posterior cruciate ligament (PCL) are the first two ligaments that provides front and back rotational stability to the knee
• The Medial Collateral Ligament (MCL) & Lateral Collateral Ligament (LCL) are the other two ligaments that are located along the inner and outer sides of the knee to provide all rounded stability

Tendons

• Tendons are fibrous, tough bands that are similar to that of the ligaments
• Unlike ligaments that connect bones to other bones; tendons connect muscles to bones.
• There are two important tendons in the knee
• One; the Quadriceps tendon  - It connects the quadriceps muscle, which lies on the front of the thigh, to the patella
• Two; the Patellar tendon – It connects the patella to the tibia
• The Quadriceps, Patellar tendons and the Patella together facilitate leg extension

Cartilage

• Cartilaginous structures are called Menisci… It forms a lining on the top of the tibia and lie between the tibia and the two knuckles at the bottom of the femur
• It is called as the Femoral Condyles
• Menisci provide space and cushion for the knee joint

Bursae

Bursae are sacs that are filled with fluid and it actually helps to cushion the knee. The knee contains three important groups of bursae.

• The Prepatellar bursae – It lies in front of the patella
• The Anserine bursae – It is located on the inner side of the knee
• The Infrapatellar bursae – are located underneath the patella

Causes of Knee pain

There are various causes of Knee pain. Since you the anatomy of the knee joint, now you can clearly understand how you get knee pain and what the symptoms that indicate it are!!

• Sports injury
• Wear & tear
• Ageing
• Faulty foot biomechanics
• Accident
• Constant grinding of the knee cartilage due to continuous movement of the knee joint causes pain and swelling that finally leads to partial or complete erosion
• Another factor that brings severe pain to the knee is muscle imbalance
• Arthritis
• Bone tumors
• Ligament injury
• Meniscus tears
• Tendinitis
• Fractures

Symptoms of Knee pain

• Swelling of the knee joint
• Rigorous pain
• Infections such as fever
• Warmth of the joint
• Sudden chilling of the body, specially the knee joint

Knee pain is definitely a serious condition to be considered because it is something that can be as severe as affecting the mobility of a person and also could cause erosion. The most important reason why it will bother you is because; it causes severe pain that is unbearable! Traditional treating methods such as Acupuncture and Chinese Medicines can bring a huge relief as it helps in reducing pain. Sustain Health is the place you need to drop in right away and get your condition treated!!

Call us for booking appointments, or visit us directly, we are located in Melbourne!

What is Osteo Arthritis??

Osteo Arthritis is not considered as a single disease but the result of various disorders leading to the structural or functional failure your joints. Osteo Arthritis involves not just the joint but also the nearby muscles, underlying bones, ligaments, the joint cover etc. Osteoarthritis also involves an advancing loss of cartilage. Here the cartilage tries to repair itself, the bones get remodeled, harden and bone cyst gets formed. Osteo Arthritis is an advancing condition and proper care needs to be taken to avoid serious complications.

Osteo Arthritis & its Causes

The causes of Osteo Arthritis are diverse

• The cause of Osteo Arthritis is actually unclear. But however a few of them can be found to be one of the reasons of developing OA
• People with diabetes are prone to develop Osteo Arthritis
• Hypothyroidism,  hyperthyroidism, and Obesity
• Traumatic causes contribute to the development of Osteo Arthritis. It can be either Macro trauma or Micro trauma. Macro traumas are injuries such as broken bones, misalignment, loss of stability, damaged cartilage etc. Micro trauma occurs over a period of time. Over use of joint bones causes this condition. It includes problems such as infected joints, chronic Gouty Arthritis, and Rheumatoid related diseases
• Metabolism related troubles may cause Osteo Arthritis
• Abnormal body anatomy, like unequal leg length might be because Osteo Arthritis
• A genetic or hereditary defects may also be a reason
• Nutritional problems can develop Osteo Arthritis
• Conditions such as Hemophilia and Sickle cell also contribute in developing OA

Symptoms of Osteo Arthritis

The symptoms of Osteo Arthritis vary from person to person. Some of the most common symptoms include;

• Stiffness (Tautness)
• Joint pain
• Muscle weakness

The most common parts of the body that gets affected by Osteo Arthritis include;

• Hands – usually the finger joints
• Spine – in the neck or lower back
• Hips & Knees

How you realize it’s time to go to hospital…

• Injuries from trauma
• Sports-related injuries
• Signs of infection
• Fever, redness, or swelling of joints
• Unexpected inability to walk

Here are a few Self-Care techniques you can follow at Home!!

Lifestyle changes may hold the seriousness of Osteo Arthritis symptoms and help great deal in reducing pain. Here are a few that you could follow to have a control over its pain.

• Weight management – Having a control over your weight is important for because Osteo Arthritis can affect the weight-bearing joints that can result in severe joint pain. Researchers have found out that weight loss may reduce the risk for Osteo Arthritis in the knee, predominantly in women and also in men

• Exercise & Diet: Regular exercise definitely helps to strengthen the muscles and would probably arouse the healthy growth of cartilage. Vitamin C and E are antioxidants that can help in giving some protection as they are recommended for having strong bones. The recommended daily dosage of Calcium is 1000-1200 mg.

Here are a few tips on what kind of exercises you can do to reduce the symptoms and pain related to Osteo Arthritis.. CLICK here to read more…

• Relaxation and Support: Muscle relaxation and meditation helps you manage pain and difficult emotions, like anxiety, which can be experienced by people with Osteo Arthritis. There are a few devices that can be used for assistance while moving the joints without pain. These devices support, line up, prevent, and correct deformities. Splints or braces help with joint alignment and also weight redistribution. Few other devices used for assistance includes walkers, crutches, orthopedic footwear etc.

Osteo Arthritis is one of the most common forms of Arthritis. Osteo Arthritis commonly develops from the age of 45, although it can occur even in younger people but many of us will develop its symptoms as we become old. Acupuncture and Traditional Chinese Medicines help you treat such complications in an effective way… Sustain Health is one of the finest choices you have for getting your medical complications treated! Visit us anytime; we are located in South Melbourne or Call Us immediately to fix up an appointment!!

What is a frozen shoulder?

• A frozen shoulder is medically referred to as Adhesive Capsulitis
• A frozen shoulder is a condition in which the shoulder joint will be seen with momentous loss of motion in all directions, just as its name indicates. It is accompanied with severe pain.

Causes for Frozen Shoulder

• Frozen Shoulder is the consequence of inflammation (swelling), scarring, thickening, and shrinkage of the capsule that surrounds the shoulder joint.
• Injuries to the shoulder can lead to frozen shoulder
• Tendinitis, Bursitis, and Rotator cuff injuries contribute as well
• Frozen shoulders occur more frequently in patients with Diabetes , Chronic Inflammatory Arthritis of the shoulder
• Occurs in people who have undergone chest or breast surgery
• Long-term immobility of the shoulder joint significantly develop Frozen Shoulder
  • A clear family history shoulder pain, surgery etc
  • Auto-immune diseases
  • Poor posture and ageing

Stages of a Frozen Shoulder

• Painful/Freezing Stage – Extremely painful and this stage lasts upto 12 weeks
• Frozen Stage – Pain eases but stiffness worsens and this stage lasts upto 6 months
• Thawing Stage – The improvement stage, its takes more than a year to see definite results

Symptoms of Frozen Shoulder

The symptoms related with Frozen Shoulder develops gradually over a long period of time

• Dull ache that may increase to a sharper pain while performing certain activities
• Pain in upper arm, upper back and neck
• Stiffness in arms, back and neck
  • Stress while lifting heavy things, pushing, pulling etc…
  • Patients with a frozen shoulder often experience pain at night or upon waking in the morning.
  • Considerably reduced sort of movement of the shoulder (like rotation, elevation etc)

It is very important for people with a Frozen Shoulder to avoid re-injuring the shoulder tissues during the treatment period. These persons should avoid sudden jerking motions and also lifting of heavy things with the affected shoulder.

Traditional treating methods such as Acupuncture and Chinese Medicines prove really effective in treating diseases and conditions such as Frozen Shoulder. All you have to do is to find the right place to get it treated. Wondering which is the right one for you?? Well, Sustain Health is the best choice you have!! We are located in South Melbourne and we will make sure you get treated in the best possible way!

Contact Us immediately for further details..

What is Carpal Tunnel Syndrome?

• Carpal Tunnel Syndrome, shortly called as CTS is a condition caused by increased pressure on the median nerve of the wrist.
• There is a space in the wrist which is called the carpal tunnel
• The median nerve and nine tendons pass from the forearm into the hand in this space
• Carpal tunnel syndrome occurs when pressure builds up from inflammation in this tunnel and puts stress on the nerve

Causes of Carpal Tunnel Syndrome

• Generally the cause is unknown
• Pressure on the nerve is the main reason for developing this condition. This can happen in several ways; maybe the reason is swelling of the lining of the flexor tendons (Tenosynovitis); joint dislocations, fractures, and arthritis can narrow down the tunnel
• Keeping the wrist bent for long periods of time.
• Thyroid conditions, Rheumatoid Arthritis, Diabetes etc also can be related with developing Carpal Tunnel Syndrome.

Signs & Symptoms of Carpal Tunnel Syndrome

Symptoms include

• Numbness (lack of feeling) in the thumb, index, middle, and ring fingers.
• Tingling (Itchy or scratchy)
• Pain in the arm, hand, and fingers
• The symptoms predominantly are felt during the nights
• You would sometimes notice a weaker grip, tendency to drop things
• Occasional clumsiness
• When the condition becomes severe, sensation may be permanently lost and the muscles at the base of the thumb slowly shrink. This condition is called as Thenar Atrophy.

Read this article written by Tim H. Tanaka to know more about CTS!!

Treatment of Carpal Tunnel Syndrome

There are few methods in which you can self treat this condition to reduce the intensity of the symptoms and the pain. Changing the patterns of using the hands, or keeping the wrist splinted in a straight position might help in reducing pressure on the nerve. Wearing wrist splints at night may relieve the symptoms and pain that interfere or disturb with sleep.

But still if you could not control the pain it causes, then you must definitely consult a doctor and get it treated. Traditional treating methods such as Acupuncture and Chinese Medicines prove highly effective in treating CTS. Sustain Health is one of the finest Acupuncture and Chinese Medicine clinic located in South Melbourne, Australia. This kind of treatment is extremely effective and has no side effects.

Contact Us immediately for further queries!

]]> http://www.sustainhealth.com.au/2011/07/06/carpal-tunnel-syndrome-can-be-treated-with-acupuncture-and-traditional-chinese-medicines/feed/ 0 http://www.sustainhealth.com.au/2011/07/06/treat-systemic-lupus-erythematosus-sle-traditionally/ http://www.sustainhealth.com.au/2011/07/06/treat-systemic-lupus-erythematosus-sle-traditionally/#comments Wed, 06 Jul 2011 10:39:23 +0000 Dr Scott Ling http://www.sustainhealth.com.au/?p=1044 Systemic Lupus Erythematosus, simply called as Lupus is an autoimmune disease that attacks various organs of the body. It is difficult to be diagnosed but traditional Acupuncture and Chinese Medicines proves effective for treating them! This post will guide you ways and means by which you can find out the causes, symptoms and treatment methods to fight against SLE!

What is Systemic Lupus Erythematosus?

Systemic lupus erythematosus (SLE), is an autoimmune disease which attacks a person’s immune system related to various organs or cells of the body, causing damage and mal functioning. Lupus is a multisystem disease since it can affect many different tissues and organs in the body. Lupus can be a mild disease that could be treated with just medications and sometimes can be life threatening condition!

Lupus is more commonly found in women than in men!

CLICK here to read an excellent post on Lupus and its details…

Causes of developing this condition

• The exact cause is still unknown
• But Genetic or Hereditary reasons can be considered
• Environmental factors
• It may be triggered by hormones, infections, sunlight or stress.

Symptoms & Signs of Lupus

There are many signs and symptoms through which you can find whether you got Lupus!

• High fever
• Abnormal headache
• Chest pain
• Breathing difficulty
• Legs get swollen
• Blood in the urine
• Weakness of the face, arms, or legs
• Joint pain
• Severe abdominal pain
• Visual disturbances
• Inability to move swollen joints due to rigorous pain
• Lupus actually begins with a skin rash over the nose and cheeks that worsens due to overexposure to the sun light!
• Thrombophlebitis which is nothing but inflammation of veins after blood clots get formed
• Hair loss
• Painless mouth ulcers
• Headaches & Tiredness
• Anaemia
• Fits
• High blood pressure

There’s no known cure for lupus. But once you get to experience any of the above symptoms, make sure you immediately consult a doctor to avoid worsening situations. Acupuncture and Chinese Medicines can help you treat Lupus great deal. Sustain Health is the best choice you have to get it treated! Do visit us directly; we are located in South Melbourne or Contact Us for further clarifications and to make appointments!

What is Rheumatoid Arthritis?

Rheumatoid arthritis (RA) is an autoimmune disease that causes persistent swelling (inflammation) of the joints. Rheumatoid arthritis can also cause inflammation of the tissue nearby or surrounding the joints, and also in other organs of the body.

Know what is autoimmune disease?

• Autoimmune diseases are those that occur when one’s own tissues by mistake attacks its own immune system.
• The immune system of our body is an intricate and delicate organization of cells and antibodies designed to find and destroy the infections that attack the body!
• People with autoimmune diseases have antibodies in their blood that target their own body tissues
• This leads to swelling (inflammation)
• Since RA affects multiple organs of the body, it is referred to as a Systemic Illness

Rheumatoid Arthritis is considered as a chronic illness because it can last for years! Patients with RA sometimes never experience any symptoms due to this condition! However, Rheumatoid Arthritis is characteristically an illness that grows worse over a period of time and thus has the potential to cause joint destruction and total functional disability of the bod

Occurrence of RA

• Rheumatoid Arthritis is three times more common in women than in men.
• Rheumatoid Arthritis begins at any age
• Children affected by RA are said to have Juvenile Rheumatoid Arthritis
• But predominantly starts after 40 years of age and before 60 years.

Causes of Rheumatoid Arthritis

• The cause of Rheumatoid Arthritis is unknown
• Infectious agents such as viruses, bacteria, and fungi have been suspected but none has been proven as the actual cause
• Tendency to develop Rheumatoid Arthritis could be hereditary (genetically inherited)
• Environmental factors also play some role in causing Rheumatoid Arthritis. For instance; scientists have found that smoking tobacco increases the threat of developing Rheumatoid Arthritis

Symptoms of Rheumatoid Arthritis

The symptoms of Rheumatoid Arthritis and its severity depend on the measure of tissue inflammation. When the tissues are highly inflamed, the disease is active. On the other hand, when the swelling in the tissues subside; the condition becomes inactive.

When the disease becomes inactive, the symptoms disappear and come again once it becomes active! The return of disease activity and its corresponding symptoms is called a flare.

During Flare, the symptoms can include

• Fatigue
• Loss of energy
• Lack of appetite
• Low-grade fever
• Muscle and joint aches
• Stiffness
• Joints often become red, swollen, painful, and tender
• Joint deformity, destruction, and loss of function
• It can cause hoarseness of the voice; due to inflation of the joint that tightens our vocal cords to change our voice.
• Sjogren’s syndrome; inflammation of eyes and mouth joints
• Pleuritis is the inflammation of the lung lining. It causes chest pain with difficulty to breathe
• Pericarditis is the inflammation of the tissues surrounding the heart. It can cause chest pain and other heart related conditions
• RA can cause Anemia, (reduce the number of Red Blood Cells (RBC) in the blood
• RA causes Felty’s Syndrome (reduced number of white blood cells, causing infections)
• Vasculitis is a rare symptom of RA

Now that you know the seriousness of developing RA in you, always be cautious that if you undergo any of the above symptoms, immediately consult a doctor. Traditional methods of treating diseases are becoming famous these days. This is because they are natural, side-effective free and effective! Sustain health can help you treat your RA condition efficiently! At Sustain Health they use traditional Acupuncture and Chinese Medicines to help you lessen the risk factor and treat them. Visit our office directly; we are located in South Melbourne or Contact Us for any queries regarding appointments!