Tuesday, November 24, 2015

Health Care and Thanksgiving in 2015

It’s that time of year that families gather together to celebrate and give thanks for all their blessings, and look forward to spending time around a table laden with bountiful food and drink. Thanksgiving is a uniquely American holiday, and it has been celebrated in one form or fashion since the Pilgrims made nice with the Native American Indians in the 1620’s. About 400 years of  togetherness sometimes has its benefits, and sometimes not.

According to the History Channel, in November 1621, after the Pilgrims’ first corn harvest proved successful, Governor William Bradford organized a celebratory feast and invited a group of the fledgling colony’s Native American allies, including the Wampanoag chief Massasoit. Now remembered as American’s “first Thanksgiving”—although the Pilgrims themselves may not have used the term at the time—the festival lasted for three days.

While no record exists of the historic banquet’s exact menu, the Pilgrim chronicler Edward Winslow wrote in his journal that Governor Bradford sent four men on a “fowling” mission in preparation for the event, and that the Wampanoag guests arrived bearing five deer. Historians have suggested that many of the dishes were likely prepared using traditional Native American spices and cooking methods.

Because the Pilgrims had no oven and the Mayflower’s sugar supply had dwindled by the fall of 1621, the meal did not feature pies, cakes or other desserts, which have become a hallmark of contemporary celebrations. For a lot of detail about the history of this holiday, go to this site: http://www.history.com/topics/thanksgiving/history-of-thanksgiving .

One major component that is part of Thanksgiving is the food. People get in a festive mood and begin preparing days in advance for the main feast of the holiday, and other meals leading up to it as well as afterwards—it is a major event. The Food Network has some incredible ways to you to make your guests feel as though they’ve dined and experienced Nirvana. Here is your path to gourmet victory: http://www.foodnetwork.com/thanksgiving.html .

Additionally, as if that’s not enough, the New York Times has a significant Thanksgiving food “How To” cooking guide that shows every neophyte baker or aspiring gourmand the best way to prepare about any dish you wish: http://cooking.nytimes.com/thanksgiving . And Southern Living Magazine displays every possible Thanksgiving side dish you could want: http://www.southernliving.com/food/holidays-occasions/thanksgiving-dinner-side-dishes .

As well, there are parades and football games to watch on the big screen television or on your electronic devices. Thanksgiving Day parades are held in some cities and towns on or around Thanksgiving Day. Some parades or festivities also mark the opening of the Christmas shopping season. Some people have a four-day weekend so it is a popular time for trips and to visit family and friends.

Most government offices, businesses, schools and other organizations are closed on Thanksgiving Day. Many offices and businesses allow staff to have a four-day weekend so these offices and businesses are also closed on the Friday after Thanksgiving Day. Public transit systems do not usually operate on their regular timetables. Thanksgiving Day it is one of the busiest periods for travel in the USA. This can cause congestion and overcrowding. Seasonal parades and busy football games can cause disruption to local traffic. More information about what goes on in America is found at this website: http://www.timeanddate.com/holidays/us/thanksgiving-day .

Thanksgiving is one of the busiest travel seasons of the year, with tens of millions of people flying, driving and headed out of town. For some the journey is short, and for others it’s a major travel event. The American Red Cross provides very helpful advice if you’re bustling the family off to Grandma’s house for the holiday: http://www.redcross.org/news/article/Travel-Safety-Tips-for-Thanksgiving-Travelers .

And, you’ll especially want to be careful about fire safety during this holiday, whether in the kitchen when preparing meals or in the home when having a fire in the family den fireplace. ABC News has some great advice: http://abcnews.go.com/blogs/lifestyle/2014/11/5-fire-safety-tips-to-keep-in-mind-this-thanksgiving/ .

Even though Thanksgiving is celebrated as a wonderful day and season of giving thanks for all your blessings, there are some safety precautions you should take to ensure that your celebration doesn’t get derailed.

Turkey safety— the turkey is the biggest star. Make sure he evokes a round of applause—not a round of visits to the bathroom or, worse, the hospital.

Buy carefully.
·         Avoid fresh, stuffed turkeys; buy your turkey at least 1-2 days before you cook it, and keep it in the fridge; keep it in the freezer if you’ve bought it earlier.

Defrost properly.
·         Thaw in the refrigerator (every 4-5 lbs. needs one day to thaw).
·         Submerge the turkey (wrapped in leak-proof packaging) in cold water (every 1 lb. needs 30 minutes to thaw) that should be changed every half hour.
·         Microwave in a microwave-safe pan, removing any packaging and following the manufacturer’s instructions.

Cook immediately after thawing.
·         Avoid slow cooking or partially cooking the turkey.
·         At 165 degrees F at least.
·         Opt to cook the stuffing separately.

Use a thermometer on the innermost part of the thigh and wing, as well as the thickest portion of the breast, to ensure that the turkey is well cooked.
·         Don’t carve at once; give the juices time (20 min.) to settle.
·         Keep Clean!
·         Wash your hands with soap and water before and after handling food.
·         Keep all surfaces and utensils clean.
·         Never handle cooked and raw food together, in order to avoid cross-contamination.
·         Keep raw meat away from vegetables or other uncooked food.

The Thanksgiving dinner should be fun and festive, not fearful and dangerous. A significant amount of safety information about all things Thanksgiving is found at this website: http://www.atlantictraining.com/safety-tips/thanksgiving-safety-tips.php . As well, the CDC has some safety tips for you to follow about food prep: http://www.cdc.gov/features/turkeytime/ .

Also, according to the ASPCA, Thanksgiving is a time for friends, family and holiday feasts—but also a time for possible distress for our animal companions. Pets won’t be so thankful if they munch on undercooked turkey or a pet-unfriendly floral arrangement, or if they stumble upon an unattended alcoholic drink. Check out the following tips for a fulfilling Thanksgiving that your pets can enjoy, too, at this website: https://www.aspca.org/pet-care/general-pet-care/thanksgiving-safety-tips .

Overall, Thanksgiving is a time to celebrate your blessings and be thankful for all you have. Take time to remember what and who are important, and say a simple prayer to Him for that which provides the real reason you can give thanks.

Until next time.

Monday, November 9, 2015

Health Care and Legionnaires Disease

Several years ago a strange illness was diagnosed after many attendees of a conference in 1976 became very sick. American Legionnaires returning from a state convention in Philadelphia began to fall ill with mysterious symptoms including pneumonia and fevers up to 107 degrees. Several of the conference attendees died, and no laboratory tests could determine the cause of their illness, which quickly became known as Legionnaires’ disease. Over 30 people died. Many more were hospitalized for several weeks.

It took researchers six months to determine that the illness had been caused by a bacterium, Legionella pneumophilia. Doctors now know this illness usually succumbs to the timely prescription of proper antibiotics, according to the New York Times. The bacterium, which in this case was apparently spread from the hotel’s air-conditioning system, is a cause of pneumonia and other illnesses worldwide. A more detailed background story of this illness is available at this site: http://www.nytimes.com/2006/08/01/health/01docs.html?pagewanted=all&_r=0 .

CDC researchers named the species of bacteria Legionella pneumophila because the second word means "lung-loving" in Latin. This bacteria is actually very common in the natural world and only causes trouble when it gets into people's respiratory systems. It finds your lungs to be an especially comfortable place because they have conditions the bacteria prefer—they are warm and moist, according to ScienceClarified.com.

Legionella are found to exist naturally in stagnant water, and in the Philadelphia case, the CDC traced the outbreak source to the hotel's air conditioning system whose condenser was vented very close to its air intake system. This meant that the large air conditioning system, which had not been cleaned for some time, had the common Legionella germ growing in it, which people then inhaled after the organism had gotten into the air intake pipes. Read more at this site: http://www.scienceclarified.com/Io-Ma/Legionnaires-Disease.html

However, while the disease can be treated with antibiotics, many times it is misdiagnosed and it is estimated that only 5-10% of cases are ultimately reported. The fatality rate of Legionnaires’ disease has ranged from 5% to 30% during various outbreaks and can approach 50% when treatment with antibiotics is delayed. More information about the history of Legionnaires’ Disease is available at this website: http://www.thelegionnaireslawyer.com/history-legionnaires-disease/ .

According to the Centers for Disease Control (CDC), Illness caused by Legionella continues to be detected, now more than ever. Each year, it is estimated that between 8,000 and 18,000 people in the United States need care in a hospital due to Legionnaires' disease. More illness is usually found in the summer and early fall, but it can happen any time of year.

Legionella is a type of bacterium found naturally in fresh water. When people are exposed to the bacterium, it can cause illness (Legionnaires’ disease and Pontiac fever). This bacterium grows best in warm water, like the kind found in:
·         Hot tubs
·         Cooling towers (air-conditioning units for large buildings)
·         Hot water tanks
·         Large plumbing systems
·         Decorative fountains

Cooling towers use water to remove heat from a process or building. They are often part of the air conditioning systems of large buildings. In contrast, home and car air conditioning units do not use water to cool, so they do not aerosolize water (spread small droplets of water in the air) and are not a risk for Legionella growth. More info is located online at this site: http://www.cdc.gov/legionella/about/history.html .

Patients with Legionnaires' disease have pneumonia and in addition may have clinical findings suggestive of a systemic disease, according to this website: Open-Access-Biology.com .The symptoms and signs of the disease are often quite variable. The majority of patients have fever, which is usually one of the earliest signs of the illness. Accompanying the fever may be anorexia, myalgia, rigors, and headache.

Clinical diagnosis also may indicate chest pain, shortness of breath and cough may or may not be prominent findings. The cough may or may not be productive, and when it is productive the sputum can be bloody, purulent, or scant and mucoid. In some patients the absence of purulent sputum production, chest pain and cough may fool clinicians into discarding pneumonia as a possibility. When chest pain and haemoptysis are prominent the patient may be suspected of having a pulmonary infarction.

Abdominal pain, diarrhea, nausea and vomiting may occur as well, symptoms that have led to consideration of intra-abdominal infections and inflammatory conditions such as appendicitis, peritonitis, abscesses, inflammatory bowel disease and diverticulitis.

Elderly and immune-compromised patients may not have fever or findings that localize to the lung. Confusion and memory loss are common presenting findings. Much less common are frank encephalopathy, focal neurological findings, seizures and meningitis. A deep dive into the clinical analysis of all aspects of Legionnaires’ Disease can be found at that same site: http://www.open-access-biology.com/legionella/edelstein.html.

According to OSHA, some people have lower resistance to disease and are more likely to develop Legionnaires' disease. Some of the factors that can increase the risk of getting the disease include:
·         Organ transplants (kidney, heart, etc.)
·         Age (older persons are more likely to get disease)
·         Heavy smoking
·         Weakened immune system (cancer patients, HIV-infected individuals)
·         Underlying medical problem (respiratory disease, diabetes, cancer, renal dialysis, etc.)
·         Certain drug therapies (corticosteroids)
·         Heavy consumption of alcoholic beverages

Early treatment reduces the severity and improves chances for recovery. The drugs of choice belong to a class of antibiotics called macrolides. They include azithromycin, erythromycin, and clarithromycin. In many instances physicians may prescribe antibiotics before determining that the illness is Legionnaires' disease because macrolides are effective in treating a number of types of pneumonia, according to OSHA.

Avoiding water conditions that allow the organism to grow to high levels is the best means of prevention, according to OSHA. Specific preventive steps include:
·         Regularly maintain and clean cooling towers and evaporative condensers to prevent growth of Legionella. This should include twice-yearly cleaning and periodic use of chlorine or other effective biocide.
·         Maintain domestic water heaters at 60°C (140°F). The temperature of the water should be 50°C (122°F) or higher at the faucet.
·         Avoid conditions that allow water to stagnate. Large water-storage tanks exposed to sunlight can produce warm conditions favorable to high levels of Legionella. Frequent flushing of unused water lines will help alleviate stagnation.

If you have people living with you who are at high risk of contracting the disease, then operating the water heater at a minimum temperature of 60°C (140°F) is probably a good idea. Consider installing a scald-prevention device. More detailed information is located at this website: https://www.osha.gov/dts/osta/otm/legionnaires/faq.html .

Legionnaires’s Disease can be deadly if not properly diagnosed. Any incident you experience of flu-like symptoms, especially if you’ve been traveling, should be reported to your doctor or a health care professional. Don’t take chances that it may be something minor like a cold or other type of nominal illness. Not many individuals contract this disease, but those who do should take immediate action to get prompt medical attention.

Until next time. 

Wednesday, November 4, 2015

Health Care and Dizziness

Being dizzy is symptomatic of several medical or underlying health issues. Dizziness can be caused by different reasons and should never really be taken lightly, especially if you are experiencing it on a regular or sustained basis.

According to HealthLine, dizziness is the feeling of being lightheaded, woozy, or unbalanced. It affects the sensory organs, specifically eyes and ears. It can cause fainting. Dizziness is not a disease but a symptom of other disorders.

Vertigo and disequilibrium may cause a feeling of dizziness, but those two terms describe different symptoms. Vertigo is characterized by a feeling of spinning. Disequilibrium is a loss of balance or equilibrium. True dizziness is the feeling of lightheadedness or nearly fainting.

Dizziness is common. The underlying cause of dizziness is usually not serious. Occasional dizziness is nothing to worry about. However, frequent or sustained dizziness is another problem.

Seek medical attention if you have recurring bouts of dizziness with no apparent cause. Also seek immediate help if you experience sudden dizziness along with a head injury, a headache, neck ache, blurred vision, hearing loss, a loss of motor ability, a loss of consciousness, or chest pain. These could indicate serious issues. More detailed info can be found at this website: http://www.healthline.com/symptom/dizziness .

According to the Mayo Clinic, dizziness has many possible causes, including inner ear disturbance, motion sickness and medication effects. Sometimes it's caused by an underlying health condition, such as poor circulation, infection or injury. The way dizziness makes you feel and your triggers provide clues for possible causes. How long the dizziness lasts and any other symptoms you have also help pinpoint the cause. Factors that may increase your risk of getting dizzy include:

Age: Older adults are more likely to have medical conditions that cause dizziness, especially a sense of imbalance. They're also more likely to take medications that can cause dizziness.

A past episode of dizziness: If you've experienced dizziness before, you're more likely to get dizzy in the future.

Dizziness can increase your risk of falling and injuring yourself. Experiencing dizziness while driving a car or operating heavy machinery can increase the likelihood of an accident. You may also experience long-term consequences if an existing health condition that may be causing your dizziness goes untreated. Much more detailed material is located at this website: http://www.mayoclinic.org/diseases-conditions/dizziness/basics/definition/con-20023004.

Occasional dizziness is very common in adults, but it may surprise you to learn that vertigo — a related but more serious condition that makes you feel like the room is spinning as you stand still — affects nearly 40 percent of people over 40 at least once, according to the University of San Francisco Medical Center.

While dizziness can make you feel momentarily unbalanced, and ranges in severity from merely annoying to seriously debilitating, vertigo may be a major symptom of a balance disorder. It can also cause nausea and vomiting.  Additional facts about dizziness are available at this site: http://www.everydayhealth.com/news/10-surprising-facts-about-dizziness-vertigo/ .

According to the Vestibular Disorders Association, the body maintains balance with sensory information from three systems: vision,  proprioception (touch sensors in the feet, trunk, and spine), and vestibular system (inner ear). Sensory input from these three systems is integrated and processed by the brainstem. In response, feedback messages are sent to the eyes to help maintain steady vision and to the muscles to help maintain posture and balance.

A healthy vestibular system supplies the most reliable information about spatial orientation. Mixed signals from vision or proprioception can usually be tolerated. When sitting in a car at a railroad crossing, seeing a passing train may cause the sensation of drifting or moving, and feeling a soft, thick carpet underfoot as opposed to a solid wood floor can produce a floating sensation.

However, compensating for vestibular system abnormalities is more problematic. Just as a courtroom judge must rule between two sides presenting competing evidence, the vestibular system serves as the tie-breaker between conflicting forms of sensory information. When the vestibular system malfunctions, it can no longer help resolve moments of sensory conflict, resulting in symptoms such as dizziness, vertigo, and disequilibrium. Dizziness can also be linked to a wide array of problems and is commonly linked to blood-flow irregularities from cardiovascular problems. A lot of detailed material on this subject is available at this website: http://vestibular.org/node/2 .

Dizziness accounts for about 5% to 6% of doctor visits, according to the Merck Manuals. Dizziness may be temporary or chronic. Dizziness is considered chronic if it lasts more than a month. Chronic dizziness is more common among older people. People who have warning signs, those whose symptoms are severe or have been continuous for over an hour, and those with vomiting should go to a hospital right away. Other people may see their doctor within several days. People who had a single, brief (less than 1 minute), mild episode with no other symptoms may choose to wait and see whether they have another episode.

Doctors first ask questions about the person's symptoms and medical history. Doctors then do a physical examination. What they find during the history and physical examination often suggests a cause of the dizziness or vertigo and the tests that may need to be done. In addition to warning signs, important features that doctors ask about include severity of the symptoms (has the person fallen or missed work), presence of vomiting and/or ringing in the ears, whether symptoms come and go or have been continuous, and possible triggers of the symptoms (for example, changing position of the head or taking a new drug).

Doctors then do a physical examination. The ear, eye, and neurologic examinations are particularly important. Hearing is tested, and the ears are examined for abnormalities of the ear canal and eardrum. The eyes are checked for abnormal movements. Additional details are available at this site: http://www.merckmanuals.com/home/ear-nose-and-throat-disorders/symptoms-of-ear-disorders/dizziness-and-vertigo .

Pregnant women also experience dizziness. It's not uncommon to feel lightheaded or dizzy occasionally. When you're pregnant, your cardiovascular system undergoes dramatic changes. Your heart rate goes up, your heart pumps more blood per minute, and the amount of blood in your body increases by 40 to 45 percent, according to BabyCenter.com.

What's more, during a normal pregnancy, your blood vessels dilate and your blood pressure gradually decreases, reaching its lowest point in mid-pregnancy. It then begins to go back up, returning to its regular level by the end of pregnancy. Most of the time, your cardiovascular and nervous systems are able to adjust to these changes, and there's adequate blood flow to your brain. But occasionally they don't adapt quickly enough, which can leave you feeling lightheaded or dizzy or cause you to faint.

The first thing to do is lie down so you won't fall and hurt yourself if you do faint. If you're in a place where it's impossible to lie down, sit down and try to put your head between your knees. And naturally, if you're doing anything that might put you or others at risk for injury, such as driving, pull over and stop right away. Lying on your side maximizes blood flow to your body and brain. It may keep you from fainting, and could relieve lightheadedness altogether. Lots of helpful information on pregnancy and dizziness is located at this site: http://www.babycenter.com/0_dizziness-and-fainting-during-pregnancy_228.bc .

Dizziness is typically not harmful, unless there is a more severe underlying cause. It’s definitely inconvenient and can be stressful. However, if you feel that symptoms are more severe than usual for any reason, see your doctor, or go to the nearest medical facility to get checked out. It may be nothing to worry about, or it might be a health situation that needs definite medical attention and diagnosis by a healthcare professional. Be careful.

Until next time. 

Tuesday, October 20, 2015

Health Care and Pseudobulbar Affect

Have you seen those TV commercials lately with actor Danny Glover talking about a neurological disorder that causes people to break out into uncontrollable laughter or crying? This health care issue is known as pseudobulbar affect or PBA, and its debilitating characteristics effects tens of thousands of newly diagnosed cases per year.

Pseudobulbar affect (PBA), emotional lability, labile affect, or emotional incontinence refers to a neurologic disorder characterized by involuntary crying or uncontrollable episodes of crying and/or laughing, or other emotional displays. PBA occurs secondary to a neurologic disease or brain injury. 

Patients may find themselves crying uncontrollably at something that is only moderately sad, being unable to stop themselves for several minutes. Episodes may also be mood-incongruent: a patient might laugh uncontrollably when angry or frustrated, for example.

PBA episodes can be described in two key ways, according to PBAinfo.com:
·         PBA outbursts can be inappropriate: The crying or laughing episodes are inappropriate to the situation in which they occur. Sometimes these are spontaneous crying or laughing eruptions that don’t reflect the way a person is actually feeling.

·         PBA outbursts can be exaggerated: Another characteristic of PBA episodes is that though the crying or laughing may be appropriate for a given situation, they’re exaggerated – they’re more intense or last longer than the situation calls for.

One of the jobs of the brain is to figure out how we feel in the moment. That information is then sent down to the brainstem, also known as the “bulb.” The brainstem then sends signals to the face and other parts of the body that show emotion.

PBA is believed to be the result of a disruption of these signals. When people have certain neurologic conditions or brain injuries, it can cause damage in the brain tissue that creates a disconnection between the parts of the brain that express emotion and those that control emotion.

The result is the frequent outbursts of involuntary crying or laughing known as pseudobulbar affect. If you break the term down literally, “pseudo” means false, “bulbar” refers to the brainstem and “affect,” describes how the body shows mood or emotion. More details can be found at this website: http://www.pbainfo.org/science .

The side-effects for PBA sufferers include feelings of emotional exhaustion and, frequently, social isolation, according to Psychology Today. Without realizing that they have a medical problem, people with PBA often adapt their lives to avoid things that trigger the response, including interacting with others unless they absolutely have to. With social isolation comes more negative emotion that can over time manifest as depression.  

While all of this may sound like new knowledge about a recently discovered disease, PBA has actually been well-documented in the medical literature for more than 100 years, though it has been labeled at least ten different things during that time. More detailed material is found at this site: https://www.psychologytoday.com/blog/neuronarrative/201110/not-all-crying-is-depression-understanding-pseudobulbar-affect .

According to the National Institutes of Health, although it is most commonly misidentified as a mood disorder, particularly depression or a bipolar disorder, there are characteristic features that can be recognized clinically or assessed by validated scales, resulting in accurate identification of PBA, and thus permitting proper management and treatment. Mechanistically, PBA is a disinhibition syndrome in which pathways involving serotonin and glutamate are disrupted.

This knowledge has permitted effective treatment for many years with antidepressants, particularly tricyclic antidepressants and selective serotonin reuptake inhibitors. A recent therapeutic breakthrough occurred with the approval by the Food and Drug Administration of a dextromethorphan/quinidine combination as being safe and effective for treatment of PBA.

Side effect profiles and contraindications differ for the various treatment options, and the clinician must be familiar with these when choosing the best therapy for an individual, particularly elderly patients and those with multiple comorbidities and concomitant medications. A much more detailed clinical explanation and overview is available at this site: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3849173/ .

To distinguish PBA from depression or other causes, doctors may administer a questionnaire rating episode frequency, duration, voluntary control and appropriateness to context and inner feelings. Additional details can be found at this website: http://alsn.mda.org/article/pba-symptoms-no-laughing-matter .

According to the American Stroke Association, in January 2011, the FDA approved a new drug called Nuedexta™ (dextromethorphan quinidine) specifically for PBA. In clinical trials, it proved effective against placebo, but it has not been compared directly to antidepressants. Analyzing data across studies, it appears to be faster acting than the anti-depressants with few side effects. Nuedexta™ is not recommended for patients with certain arrhythmias: prolonged Q-T interval, complete heart block, history of torsades de point (a type of ventricular tachycardia) or heart failure.

As with any new drug, there is a considerable cost difference when compared to older, off-patent medications. Nuedexta™ is manufactured by Avanir Pharmaceuticals and costs $200–300 for a month’s supply. The SSRIs mentioned in the article are $10–$12/month. Though off-patent antidepressants are often used in treating PBA, Nuedexta™ is the only prescription drug currently indicated specifically for PBA by the FDA. Avanir, like many pharmaceutical companies, does have a Patient Assistance Program. More detail on this medication and PBA is available at this website: http://www.strokeassociation.org/STROKEORG/LifeAfterStroke/RegainingIndependence/EmotionalBehavioralChallenges/Pseudobulbar-Affect-PBA_UCM_467457_Article.jsp

One of the best ways to deal with PBA is to tell your friends, co-workers, and family that you have it. Explain what PBA is and what causes it. Let the people around you know that you may have uncontrolled emotional outbursts. That way, when you suddenly burst into tears or start laughing they won’t be surprised or shocked. And you won’t have to always worry about losing control at the wrong moments, according to HealthLine.com.

You can gain some control over your symptoms with a few simple tricks. When you start feeling the urge to laugh or cry, try to distract yourself. Think about something different. If you’re crying, try to focus on something upbeat or funny. For example, you could think about a funny movie you saw recently. Take slow, deep breaths. And relax the muscles that start to tense up whenever you have an episode. More info is located at this site: http://www.healthline.com/health/multiple-sclerosis/pseudobulbar-affect#Medicines8 .

PBA can have an enormous impact on a person's social life. Emotional episodes caused by the disease can be embarrassing and can damage interpersonal relationships. The Brain Injury Association of America study indicates that 60% of people with brain injuries feel that PBA and its accompanying outbursts make it hard for them to initiate and maintain friendships. The disease was also the cited culprit in being housebound for 40% of people in the survey.

For caregivers of people with PBA, it can be difficult trying to deal with a person who feels isolated and alone because of their disease.  PBAinfo.org offers a few tips for caregivers to help them interact positively with emotionally explosive loved ones:

·         Let them know that you support them and they are not alone. Reassure them that many people suffer from the symptoms of PBA.
·         Remind them that their outbursts are caused by a physical disease, not a mental condition.
·         Indicate your willingness to listen to their frustrations and concerns.
·         Keep an "episode diary." By recording PBA episodes, you can ensure better communication with your doctor and help him or her make an accurate diagnosis.

According to the American Stroke Association, these episodes can strike a person up to 100 times a day. They can be a few seconds to a few minutes long. More information about this topic for seniors and others is available at this website: https://www.agingcare.com/Articles/crying-is-not-always-depression-148580.htm .

Psuedobulbar Affect has been identified in several million patients, both men and women. It is a disease that can be managed, but not readily identified unless the doctor knows what to look for and how to treat it. More people suffer every day from PBA. The good news is that there are therapies to help overcome PBA and its impact on the lives of those who have it. If you think you may be symptomatic, or know someone whom you may suspect exhibits the symptoms, see your healthcare provider to get a proper diagnosis.

Until next time.

Wednesday, October 14, 2015

Health Care and Hypertension

Hypertension, or high blood pressure as it is commonly called, is a dangerous health care issue, and can be a killer. Tens of millions of men and women, as well as some children, suffer from this malady on a daily basis; and for some, hypertension is a lifelong struggle.

Hypertension (HTN or HT), also known as high blood pressure or arterial hypertension, is a chronic medical condition in which the blood pressure in the arteries is persistently elevated. Blood pressure is expressed by two measurements, the systolic and diastolic pressures, which are the maximum and minimum pressures, respectively, in the arterial system.

The systolic pressure occurs when the left ventricle is most contracted; the diastolic pressure occurs when the left ventricle is most relaxed prior to the next contraction, according to JAMA, the Journal of the American Medical Association. The publication has a lot of info about this medical topic, and you can locate it at this site: http://jama.jamanetwork.com/journal.aspx .

According to the American Society of Hypertension, hypertension--the most prevalent cause of stroke and kidney failure--is part of a bigger disease conglomerate almost always accompanied by obesity, diabetes, kidney disease or many other co-existing problems involving lifestyle and/or genetics. More details are located at this site: http://www.ash-us.org/About-Hypertension/Hypertension-Information.aspx

Here are some statistics provided by the Centers for Disease Control at this site http://www.cdc.gov/nchs/fastats/hypertension.htm :

·         Percent of adults ages 20 and over with hypertension (measured high blood pressure and/or taking antihypertensive medication): 32.5% (2011-2012).
·         Number of visits to physician offices with essential hypertension as primary diagnosis: 38.9 million.
·         Number of visits to hospital outpatient departments with essential hypertension as primary diagnosis: 3.7 million.
·         Number of deaths from essential hypertension and hypertensive renal disease: 30,770.
·         Deaths per 100,000 population from essential hypertension and hypertensive renal disease: 9.7.

One in three Americans are at risk for hypertension, according to the American Heart Association. Science has identified several factors that can increase your risk of developing hypertension, or high blood pressure. One big contributor is that it may be in your genes. Family history has a lot to do with your risk of hypertension. Height, hair and eye color runs in families --- so can high blood pressure. If your parents or close blood relatives have had hypertension, you are more likely to develop it, too.

You might also pass that risk factor on to your children. That's why it's important for children as well as adults to have regular blood pressure checks. You can't control heredity, but you can take steps to live a healthy life and lower your other risk factors. Lifestyle choices have allowed many people with a strong family history of HBP (hypertension/high blood pressure) to avoid it themselves.  Much more detail can be found at this site: http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/UnderstandYourRiskforHighBloodPressure/Understand-Your-Risk-for-High-Blood-Pressure_UCM_002052_Article.jsp .

You'll likely have your blood pressure taken as part of a routine doctor's appointment. Ask your doctor for a blood pressure reading at least every two years starting at age 18, according to the Mayo Clinic. Blood pressure generally should be checked in both arms to determine if there is a difference. Your doctor will likely recommend more frequent readings if you've already been diagnosed with high blood pressure or other risk factors for cardiovascular disease. Children age 3 and older will usually have blood pressure measured as a part of their yearly checkups.

If you don't regularly see your doctor, you may be able to get a free blood pressure screening at a health resource fair or other locations in your community. You can also find machines in some stores that will measure your blood pressure for free. Public blood pressure machines, such as those found in pharmacies, may provide helpful information about your blood pressure, but they may have some limitations.

The accuracy of these machines depends on several factors, such as a correct cuff size and proper use of the machines. More information about hypertension can be found at this website: http://www.mayoclinic.org/diseases-conditions/high-blood-pressure/basics/definition/con-20019580 .

According to the Cleveland Clinic, approximately 1% of Americans with hypertension are estimated to be affected by hypertensive crises. Hypertensive crisis broadly covers both hypertensive urgency and emergency. Hypertensive emergencies are more common in patients with essential hypertension (20%-30% in Caucasians and 80% in African Americans). Factors such as renal failure, heart failure, cerebrovascular accidents, and nonadherence to antihypertensive therapy are associated with hypertensive crisis. Illicit drug use is an important cause for hypertensive crisis.

One in 3 Americans over the age of 18 years suffers from hypertension. The prevalence is higher among older individuals, women and non-Hispanic blacks. The prevalence of hypertension increases progressively with age. Significant clinical data is available for review at this site: http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/nephrology/arterial-hypertension/

About 72 million Americans are estimated to have high blood pressure. High blood pressure occurs more often in blacks—in 41% of black adults compared with 28% of whites and 28% of Mexican Americans. It also occurs with high frequency in people whose ancestors are from China, Japan, and other East Asian or Pacific areas (such as Koreans, Thais, Polynesians, Micronesians, Filipinos, and Maori), according to Merck.

The consequences of high blood pressure are worse for blacks. High blood pressure occurs more often in older people—in about two thirds of people aged 65 or older, compared with only about one fourth of people aged 20 to 74. People who have normal blood pressure at age 55 have a 90% risk of developing high blood pressure at some point in their life. High blood pressure is twice as common among people who are obese as among those who are not. 

In the United States, only an estimated 81% of people with high blood pressure have been diagnosed. Of people with a diagnosis of high blood pressure, about 73% receive treatment, and of the people receiving treatment, about 51% have adequately controlled blood pressure. Although many have a solution, a significant number still do not.

To many people, the word hypertension suggests excessive tension, nervousness, or stress. In medical terms, hypertension refers to high blood pressure, regardless of the cause. This site has a substantial amount of info about hypertension: http://www.merckmanuals.com/home/heart-and-blood-vessel-disorders/high-blood-pressure/high-blood-pressure.  Because it usually does not cause symptoms for many years—until a vital organ is damaged—hypertension has been called "the silent killer." Here is the high level overview of hypertension as a summary:

·         Often no cause for high blood pressure can be identified, but sometimes it occurs as a result of an underlying disorder of the kidneys or a hormonal disorder.
·         Obesity, a sedentary lifestyle, stress, smoking, and excessive amounts of alcohol or salt in the diet all can play a role in the development of high blood pressure in people who have an inherited tendency to develop it.
·         In most people, high blood pressure causes no symptoms.
·         Doctors make the diagnosis after measuring blood pressure on two or more occasions.
·         People are advised to lose weight, stop smoking, and decrease the amounts of salt and fats in their diets.
·         Antihypertensive drugs are given.

Hypertension, or high blood pressure, should not be ignored. If you feel that you may be suffering from symptoms, then see your doctor. If you have hypertension, follow your physician’s directions on how to treat it or how you can get rid of it if possible. Each person needs to have a diagnosis specific to him/her, but hypertension can kill you if you’re not careful. Don’t be another statistic.

Until next time. 

Monday, September 21, 2015

Health Care and Spices

One essential element of most cooking is spice, and they are as varied as there are types. A spice is a dried seed, fruit, root, bark, or vegetable substance primarily used for flavoring, coloring or preserving food. Spices are distinguished from herbs, which are parts of leafy green plants used for flavoring or as a garnish. Many spices have antimicrobial properties.

Spices are more commonly used in warmer climates and why the use of spices is prominent in meat, which is particularly susceptible to spoiling. A spice may have other uses, including medicinal, religious ritual, cosmetics or perfume production.  

The spice trade developed throughout South Asia and Middle East in around 2000 BC with cinnamon and pepper, and in East Asia with herbs and pepper. The Egyptians used herbs for embalming and their demand for exotic herbs helped stimulate world trade. The word spice comes from the Old French word espice, derived from Latin. By 1000 BC, medical systems based upon herbs could be found in China, Korea, and India. Early uses were connected with magic, medicine, religion, tradition, and preservation. Over thousands of years, spices have been used for many reasons.

In healthcare, certain spices are used to help treat various maladies, especially in holistic or naturopathic medicine. For example, spices that help treat inflammation are tumeric, ginger, cinnamon, garlic, cayenne, black pepper, and clove. As with the other supplements, you should talk to your healthcare clinician before adding large amounts of cinnamon or oregano to your diet. Your discussion will help you avoid medication interactions or complications with a pre-existing condition. More details about these spices and other info can be found at this website: http://ministryhealth.org/HC/Home/2015/Winter2015/Spices.nws .

Another site has similar information with a bit more detail on these spices. Spices and herbs can do a lot more than add pizzazz to your cooking -- they can also promote heart health, fight cancer, reduce inflammation, and more. Visit this website: https://www.caring.com/articles/spices-with-healing-powers .
Heart patients need to know more about spices in particular. Herbs and spices contain trace amounts of sodium, according to Emory Healthcare. Their website shows herb and spice recommendations to infuse into your current recipes in place of salt: http://www.emoryhealthcare.org/heart-failure/self-care-strategies/salt-substitutes.html .

Spices not only just excite your taste buds but are composed of an impressive list of phyto-nutrients, essential oils, antioxidants, minerals and vitamins that are essential for overall wellness. Spices have been integral part part of our food since centuries, and today, even become more relevant for us. Thanks to the Arab and European explorers, whose contributions in spreading them from their place of origin to the rest of the planet has immensely broaden their use and popularity all over the world, according to this website: http://www.nutrition-and-you.com/healthy_spices.html . Here are some reasons why they say you should include spices in your diet:

·         Spices contain an impressive list of plant-derived chemical compounds that are known to have disease preventing and health promoting properties. They have been in use since ancient times for their anti-inflammatory, carminative, anti-flatulent properties.

·         The components in the spices have been found to have anti-clotting action (prevent clogging of platelets in the blood vessels) and thus help easing blood flow, preventing stroke and coronary artery disease.

·         The active principles in the spices may help in smooth digestion through augmenting intestinal tract motility as well as increasing the digestion power by stimulating excessive secretion of gastro-intestinal enzymes inside the gut.

·         Throat gargling with tepid thyme water can help relieve sore throat and bronchitis symptoms. Thyme is also being used as an anti-septic mouthwash in the treatment of caries and gingivitis.

·         Decoction of certain healthy spices is taken by mouth for the treatment of colds, influenza, mild fevers, indigestion, stomach upset, and painful menstruation.

·         Spices are also known to have natural anti-helminthes (control worm infestation) function in traditional medicines.

·         The essential volatile oils in certain spices (cloves, peppers, etc.) may work as a rubefacient (soothes skin around the site of application and improves the local blood circulation), increasing the flow of blood to make the skin feel warmer. They are being applied as a popular home remedy for arthritis and sore muscles, and used either as poultice or in hot baths.

·         Spice's essential oils are being used in the aromatherapy as well as de-odorants in the perfume industry.

·         Spices contain a good amount of minerals like potassium, manganese, iron, and magnesium. Potassium is an important component of cell and body fluids that helps in controlling heart rate and blood pressure. Manganese is used by the body as a co-factor for the antioxidant enzyme, superoxide dismutase.

According to the Washington Post, spices last a while, but they lose their flavor over time, so buy them in usable quantities. The ground versions lose flavor faster than their whole counterparts. Seal tightly in glass containers, and store in the dark, away from the heat of the oven, for optimal freshness. 

Many plastic spice containers contain the harmful chemical BPA, so glass is best. Never buy a spice rack with spices in it! Chances are they are not fresh, and there might be ones you won’t use. Choose the spices you desire and look for expiration dates. More details are located at this site: https://www.washingtonpost.com/lifestyle/wellness/spices-and-their-health-benefits/2014/01/07/4f074f24-6f2d-11e3-aecc-85cb037b7236_story.html

Herbs and Spices have antibacterial and antiviral properties and many are high in B-vitamins and trace minerals, according to Wellness Mama. True sea salt, for instance, contains 93 trace minerals. Most herbs and spices also contain more disease-fighting antioxidants than fruits and vegetables. The problem in America is that the most potent and healthy herbs are rarely used, mainly from lack of knowledge about them, while the least potent (salt and pepper) are the most commonly used seasonings. More details are found at this website: http://wellnessmama.com/1092/health-benefits-of-herbs-spices/ .

Spices are good for you, and have certain benefits for your health. However, not everyone can use them. Check with your healthcare provider or personal physician before using spices for any reason, especially if you have certain food allergies, have a compromised immune system, or are taking any prescription medications. Better safe than sorry, even if you want to use spices to spice up your life.

Until next time.