Health Care and Pace Makers

Pacemakers for the heart are a tremendous health asset for individuals who suffer from certain irregular heart beats. A pacemaker is a small device that's placed in the chest or abdomen to help control abnormal heart rhythms. This device uses electrical pulses to prompt the heart to beat at a normal rate. Pacemakers are used to treat arrhythmias, according to the National Heart Lung and Blood Institute. Arrhythmias are problems with the rate or rhythm of the heartbeat. During an arrhythmia, the heart can beat too fast, too slow, or with an irregular rhythm.

A heartbeat that's too fast is called tachycardia. A heartbeat that's too slow is called bradycardia. During an arrhythmia, the heart may not be able to pump enough blood to the body. This may cause symptoms such as fatigue (tiredness), shortness of breath, or fainting. Severe arrhythmias can damage the body's vital organs and may even cause loss of consciousness or death. A pacemaker can relieve some arrhythmia symptoms, such as fatigue and fainting. A pacemaker also can help a person who has abnormal heart rhythms resume a more active lifestyle.

According to the Mayo Clinic, normal aging of the heart may disrupt your heart rate, making it beat too slowly. Heart muscle damage resulting from a heart attack is another common cause of disruptions of your heartbeat. Some medications can affect your heart rate as well. For some, genetic conditions cause an abnormal heart rate. Regardless of the underlying cause of an abnormal heart rate, a pacemaker may fix it. A pacemaker can often be implanted in your chest with a minor surgery. You may need to take some precautions in your daily life after your pacemaker is installed.

Your heart has its own internal electrical system that controls the rate and rhythm of your heartbeat. With each heartbeat, an electrical signal spreads from the top of your heart to the bottom. As the signal travels, it causes the heart to contract and pump blood, according to the NHLBI. Faulty electrical signaling in the heart causes arrhythmias. A pacemaker uses low-energy electrical pulses to overcome this faulty electrical signaling. Pacemakers can:

--Speed up a slow heart rhythm.
--Help control an abnormal or fast heart rhythm.
--Make sure the ventricles contract normally if the atria are quivering instead of beating with a normal rhythm (a condition called atrial fibrillation).
--Coordinate the electrical signaling between the upper and lower chambers of the heart.
--Coordinate the electrical signaling between the ventricles. Pacemakers that do this are called cardiac resynchronization therapy (CRT) devices. CRT devices are used to treat heart failure.
--Prevent dangerous arrhythmias caused by a disorder called long QT syndrome.

According to the American Heart Association (AHA), some are permanent (internal) and some are temporary (external). They can replace a defective natural pacemaker or blocked pathway. A pacemaker uses batteries to send electrical impulses to the heart to help it pump properly. An electrode is placed next to the heart wall and small electrical charges travel through the wire to the heart. Most pacemakers are demand pacemakers. They have a sensing device. It turns the signal off when the heartbeat is above a certain level. It turns the signal back on when the heartbeat is too slow. If you have an artificial pacemaker, be aware of your surroundings and the devices that may interfere with pulse generators--cell phones, medical equipment, and home appliances to name a few. More info is available at this site: http://www.americanheart.org/presenter.jhtml?identifier=4676.

Although life-threatening complications of pacemaker implantation are rare, there are certain risks when having a pacemaker implanted. Complications from having surgery to implant your pacemaker are uncommon, but could include:

--Infection where the pacemaker was implanted.
--Allergic reaction to the dye or anesthesia used during your procedure.
--Swelling, bruising or bleeding at the generator site, especially if you are taking blood thinners.
--Damage to your blood vessels or nerves near the pacemaker.
--Collapsed lung.
--Puncture of your heart muscle, which can lead to bleeding into the lining (pericardium) of your heart and may require emergency medical care.

The Mayo Clinic has valuable information on what to expect about having a pacemaker available at this site: http://www.mayoclinic.com/health/pacemaker/MY00276/DSECTION=what-you-can-expect. Once your pacemaker is implanted, it should last five to 10 years, which is the average battery life. When a pacemaker's battery wears out, the entire pacemaker's pulse generator is replaced, and you'll need another procedure to fix your device. The leads of your pacemaker can be left in place, and the procedure to change your pacemaker's battery is often quicker and requires less recovery time than the procedure to first implant your pacemaker. Pacemakers are a standard treatment for many conditions affecting your heart's electrical system. By preventing a slow heart rate, pacemakers can treat symptoms, such as fatigue, lightheadedness and fainting. Because most of today's pacemakers automatically adjust your heart rate to match your level of physical activity, they can allow you to resume a more active lifestyle.

If you have a pacemaker and become terminally ill with a condition unrelated to your heart, such as cancer, it's possible that your pacemaker could prolong the process of dying. Doctors and researchers have varied opinions on turning off a pacemaker in end-of-life situations, according to the Mayo Clinic. If you have a pacemaker implanted and are concerned about turning off your pacemaker, talk to your doctor. You may also want to talk to family members or another person designated to make medical decisions for you about what you'd like to do in end-of-life care situations.
 
Key points about pace makers can be found on the NHLBI's site: http://www.nhlbi.nih.gov/health/dci/Diseases/pace/pace_keypoints.html. This website has a very good overview as well as great details concerning pace makers.
 
Your doctor can provide more information about pacemakers and refer you to a cardiologist for more tests. If your heart is suffering from an irregular heartbeat, a pacemaker can make a huge difference in your health and your quality of life. Visit your primary care physician for an initial diagnosis if you feel that you may be experiencing this medical issue. You only have one heart. Keep it safe.
 
Until next time.

Health Care and Twins

According to the American Congress of Obstetricians and Gynecologists (ACOG) twins are born once in about every 41 births. Having twins can bring great joy and rewards to a family. Sometimes, however, it also can pose a risk to the mother and her babies. Complications can occur that require special care. Have you ever seen a mother with a stroller that looks like it was made by a limo company--extra seats? When having twins, your likelihood of having healthy births becomes riskier. So, that scene with a twofer is extra special, because both babies are a miracle of birth.

When a sperm meets an egg in the fallopian tube, fertilization—union of egg and sperm—can occur. If this happens, the fertilized egg moves down the fallopian tube to the uterus where it attaches and grows into a fetus, according to ACOG. During this process, twins can form. Twins can be either fraternal or identical. Most are fraternal twins—each develops from a separate egg and sperm. Fraternal twins each have their own placenta and amniotic sac. Because each twin develops from the union of a different egg and a different sperm, these twins may not look alike. The twins can be boys, girls, or one of each.

Identical twins are more rare. They occur when a fertilized egg splits early in pregnancy and develops into two fetuses. Identical twins may share a placenta, but each baby usually has its own amniotic sac. Identical twins are the same sex and have the same blood type, hair color, and eye color, and they look very much alike, according to ACOG. Some families are more likely than others to have fraternal twins. Women who take fertility drugs or have in vitro fertilization also have a greater chance of having twins.

According to BabyCenter.com, These days, about one in 32 births are twin births. This rate has gone up 65 percent since 1980, and it's more than double the rate among women who conceive without medical assistance — one in 89. The rise in triplets and quadruplets is even more dramatic. Between 1980 and 1998, the rate of triplets and higher-order multiple births shot up by more than 400 percent, but it's crept back down over the past few years as fertility treatments have become more refined. In 2003, one in 535 births resulted in triplets, quadruplets, or more. Meanwhile, the likelihood of having identical twins (when one fertilized egg divides in half) is about one in 250. This rate hasn't changed over the decades and is remarkably constant all over the world. While identical twins generally happen by sheer chance, there are several factors that influence your chances of having fraternal twins:

• Heredity: If you're a twin or if twins run in your family, you're slightly more likely to have a set yourself. Women who are fraternal twins have a one in 60 chance of bearing twins.

• Race: Twins are more common than average in African Americans and less common in Hispanics and Asians.

• Age: The older you are, the higher your chances of having fraternal twins or higher-order multiples. A 2006 study found that women over 35 produce more follicle stimulating hormone (FSH) than younger women. Ironically, increasing levels of this hormone are a sign of failing ovaries and declining fertility. But FSH is also the hormone that causes an egg to ripen in preparation for ovulation each month, and women with extra FSH may release more than one egg in a single cycle. So while older women are statistically less likely to get pregnant, if they do get pregnant, they're more likely to have twins.

• Number of pregnancies: The more pregnancies you've had, the greater your chances of having twins.

• History of twins: Once you have a set of fraternal twins, you're twice as likely to have another set in future pregnancies.

• Body type: Twins are more common in large and tall women than in small women.

Don't let anyone tell you differently -- having two babies at once is very different than having just one. And no, it's not twice as hard! Here is a site that gives you 17 things to know about having twins: http://www.ivillage.com/what-know-when-youre-having-twins/6-b-311544 . Lots of extra details on this site will help you when it comes to twins. Also, another site with significant info on twins is here:
http://www.having-twins.com/.

Most twins are diagnosed before delivery, according to ACOG. Your doctor may suspect that you are carrying twins if your uterus grows more quickly or is larger than expected. However, twins usually are diagnosed by using an ultrasound exam. Ultrasound also may be able to tell if the twins are identical or fraternal. You will need special prenatal care with twins if you are the expectant mother. You should see your doctor more often and you may need special tests. Plan to take childbirth classes during your 4th to 6th month of pregnancy. Ask your doctor about classes for parents expecting twins.

An important factor of twin pregnancies is the greater risk of premature delivery--on average, twins are born at 36 1/2 weeks instead of 40 to 41 weeks for singletons, according to PregnancyToday.com. If you find you're having twins, prepare to be on bed rest for the end of your pregnancy. That is a possibility for most twin births.

Also, one of the biggest concerns for couples having twins is the double hit to the pocketbook. The costs are definitely doubled, especially when it comes to things such as diapers and food. But there are also some advantages that can balance out the costs. Additionally, if twins bring double the happiness, they also double the stress; establishing a schedule eased a lot of the pressure. A routine is important. While the challenge of meeting the needs of two personalities seems daunting to many expecting parents, the rewards of parenting are increased exponentially. Twins can be daunting, particularly when budgets are tight. However, having multiple children at one time is unique, and can be rewarding as a parent.

Until next time.