Is a pulse oximeter always reliable?
No, there are times when a Pulse Oximetry is not accurate in the following situations:
1.Individuals in shock who are vasoconstricted and have no
pulse generally cannot be monitored by pulse Oximetry. Other
conditions where the pulse may be absent or very faint include
severe dehydration, heart failure, excessive hemorrhage, peripheral
vascular disease, many collagen vascular disorders and other heart
disorders
2.Occasionally bright white lights in hospital rooms can interfere
with accuracy of the oximeter. The numbers may be amplified.
3.The oximeter is sometimes affected by the use of electrocautery
in the operating room. Other medical equipment that can interfere
with the pulse oximeter includes laser beams, ultrasonic devices
and certain types of electronic hardware.
4.Individuals who are shivering or have a persistent tremor often
give unreliable oximeter reading
5.Nail varnish/polish can also cause erroneously low readings.
What are normal pulse oximeter readings?
In general, pulse oxygen saturation in healthy individuals should be above 95% and above. In patients with lung or heart disease, the oxygen saturation may be lower. When the pulse oximeter reads less than 88%, the individual will definitely show difficulty with breathing and may appear out of breaths.
Are pulse oximeters reliable?
Pulse Oximeters available today are very sensitive and reliable. The degree of accuracy has led to their widespread use not only in the hospital setting, but also for use in emergency rooms, out patients medical centers, ambulatory care medicine, outpatient or walk in clinics and even at home.
What is cost of a pulse oximeter?
Advances in Oximetry have now led to the development of devices which can also measure the levels of carbon dioxide at the skin level. The pulse oximeter had been of a tremendous advance in medicine and serves as a vital tool for monitoring the oxygen status of an individual. The cost of pulse Oximetry device is variable depending on the type one wants. The price ranges from $170-$950
For more on pulse Oximeters, visit www.medexsupply.com
Tuesday, October 20, 2009
Pulse Oximeters : Part 1
What is Oximetry?
Oximetry is a simple non invasive medical procedure used to measure the concentration of oxygen in the blood. Oximetry is widely used in the hospital care setting to assess patients who have a variety of lung and heart disorders. The measurement of oxygen is done by an oximeter which is a photoelectric device. The majority of Oximeters are small, portable and reusable. Many home devices can be run on batteries.
Where is a pulse oximeter placed on the body?
The oximeter can be placed on the finger tip, ear lobe or toes. Pulse Oximeters are so called because they react only to pulsations of the blood vessels. If there is no pulse, Oximeters will not pick up the pulsations and oxygen concentration cannot be obtained.
Pulse Oximeters are used in all intensive care units, the neonatal unit, coronary care unit, emergency room and during anesthesia. Portable Oximeters are now widely used on the regular medical floors in hospitals across America. The majority of patients who have emphysema, COPD or congestive heart failure are monitored by pulse Oximetry in the hospital.
How does a pulse oximeter work?
The pulse Oximeters work by transmitting a beam of red and infrared light though a pulsating blood vessel. The ratio of red to infra red blood light transmitted provides a measure of the oxygen saturation of the blood. The oximeter identifies the pulse and then deducts the intensity of color perceived when the pulse is absent. The residual intensity of color corresponds to only the oxygenated red blood. This is shown on the electronic screen as a percentage of oxygen saturation in the blood.
Oximetry is a simple non invasive medical procedure used to measure the concentration of oxygen in the blood. Oximetry is widely used in the hospital care setting to assess patients who have a variety of lung and heart disorders. The measurement of oxygen is done by an oximeter which is a photoelectric device. The majority of Oximeters are small, portable and reusable. Many home devices can be run on batteries.
Where is a pulse oximeter placed on the body?
The oximeter can be placed on the finger tip, ear lobe or toes. Pulse Oximeters are so called because they react only to pulsations of the blood vessels. If there is no pulse, Oximeters will not pick up the pulsations and oxygen concentration cannot be obtained.
Pulse Oximeters are used in all intensive care units, the neonatal unit, coronary care unit, emergency room and during anesthesia. Portable Oximeters are now widely used on the regular medical floors in hospitals across America. The majority of patients who have emphysema, COPD or congestive heart failure are monitored by pulse Oximetry in the hospital.
How does a pulse oximeter work?
The pulse Oximeters work by transmitting a beam of red and infrared light though a pulsating blood vessel. The ratio of red to infra red blood light transmitted provides a measure of the oxygen saturation of the blood. The oximeter identifies the pulse and then deducts the intensity of color perceived when the pulse is absent. The residual intensity of color corresponds to only the oxygenated red blood. This is shown on the electronic screen as a percentage of oxygen saturation in the blood.
Friday, October 16, 2009
Urine strips for making Diagnosis: Part 3
Urobilinogen test does provide a clue in patient with hemolytic disorders, live failure, poisoning, resolving hematoma or hepatitis. Sometimes low values may occur when there is failure to produce bile or there is an obstruction for passage of bile. A negative result does not mean there is absence of Urobilinogen. High concentrations of ascorbic acid or sulphonamides can also obscure the color and lead to a false negative test.
The nitrite test pad gives an indirect indication of presence of bacteria. When the pad goes pink it signifies a positive reaction. Abnormal nitrite values may indicate presence of a UTI (usually from gram negative bacteria). While the test is accurate in most cases, false negatives may result if there is ascorbic acid present. To confirm present of a urinary tract infection, send a specimen for bacterial culture. Excessive urination or use of diuretic drugs can often create a false negative test due to dilution. The urine test for nitrite is most accurate when antibiotics have been discontinued for at least 3 days prior to the test
Ketones in urine can readily be identified on a urine strip. Ketones are produced in the body when fat is broken down to generate energy. Ketones are generally seen in
- Diabetic ketoacidosis
- Insulin over dose
- Starvation
- Persistent nausea and vomiting
- Strict dieting
- Stress
- Infections.
When Ketones are detected in urine, the next step is to measure urine glucose. If glucose levels are low, one should immediately seek medical attention.
The urine strip is the most inexpensive method to detect white cells in the urine. While a few cells are always present in urine, more than 20 WBC/ul is considered pathological. WBC in the urine may occur from
- Urinary tract infection
- Kidney abscess
- Bladder infection
- Infected kidney stone
The intensity of the color formed is generally proportional to the number of WBC. Results of the test can be obscured by presence of oxalic acid or oxidizing agents. Other factors that affect the test include high sugar, high protein and presence of certain antibiotics like tetracyclines and cephalosporins.
The urine strip allows at least ten quick clinical measurements in an inexpensive way. The results can then be used to treat or counsel patients for further treatment. To view our urine test kit and prices, please visit www.medexsupply.com
The nitrite test pad gives an indirect indication of presence of bacteria. When the pad goes pink it signifies a positive reaction. Abnormal nitrite values may indicate presence of a UTI (usually from gram negative bacteria). While the test is accurate in most cases, false negatives may result if there is ascorbic acid present. To confirm present of a urinary tract infection, send a specimen for bacterial culture. Excessive urination or use of diuretic drugs can often create a false negative test due to dilution. The urine test for nitrite is most accurate when antibiotics have been discontinued for at least 3 days prior to the test
Ketones in urine can readily be identified on a urine strip. Ketones are produced in the body when fat is broken down to generate energy. Ketones are generally seen in
- Diabetic ketoacidosis
- Insulin over dose
- Starvation
- Persistent nausea and vomiting
- Strict dieting
- Stress
- Infections.
When Ketones are detected in urine, the next step is to measure urine glucose. If glucose levels are low, one should immediately seek medical attention.
The urine strip is the most inexpensive method to detect white cells in the urine. While a few cells are always present in urine, more than 20 WBC/ul is considered pathological. WBC in the urine may occur from
- Urinary tract infection
- Kidney abscess
- Bladder infection
- Infected kidney stone
The intensity of the color formed is generally proportional to the number of WBC. Results of the test can be obscured by presence of oxalic acid or oxidizing agents. Other factors that affect the test include high sugar, high protein and presence of certain antibiotics like tetracyclines and cephalosporins.
The urine strip allows at least ten quick clinical measurements in an inexpensive way. The results can then be used to treat or counsel patients for further treatment. To view our urine test kit and prices, please visit www.medexsupply.com
Urine strips for making Diagnosis: Part 2
Urine glucose is the most frequent diagnosis sought out on a urine strip. Urine strips readily identify glucose in the urine; however, for the result to be reliable one has to ensure that the strip has not expired. If the enzymatic action of enzymes is altered on the pad, then the results may be spurious.
Urine strips are quite sensitive to glucose in the urine and this is one of the fastest and inexpensive ways to check for glucose. Abnormal glucose may be seen in diabetes, pregnancy or after a heavy diet. The sensitivity of urine strip to glucose is decreased when the urine has high specific gravity or ascorbic acid concentration is high
Bilirubin levels on a urine strip are often unreliable. The best way to use urinary bilirubin level is to correlate them with clinical findings and laboratories values.
The occult blood test on a urine strip may detect red blood cells, free hemoglobin or myoglobin. The test is very sensitive and quite useful. Blood may be seen in the urine due to a kidney stone, urinary tract infection, break down of muscle, or red blood cells. When urine has high specific gravity it reduces sensitivity of the strip, while ascorbic acid may cause a falsely negative test.
The protein test pad only gives a rough estimate of protein in the urine. However, false positives may occur if the urine pH is very alkaline. Protein may occur in urine from a variety of conditions including:
- Position
- Strenuous exercise
- Extremes of temperature (too hot or too cold)
- Pregnancy
- Low blood pressure
- Liver cirrhoses
- Renal failure
- Upper respiratory tract infection
- Immune complex disorders
- Sepsis
The urine strip reagent is highly sensitive to albumin and less to globulin
Urine strips are quite sensitive to glucose in the urine and this is one of the fastest and inexpensive ways to check for glucose. Abnormal glucose may be seen in diabetes, pregnancy or after a heavy diet. The sensitivity of urine strip to glucose is decreased when the urine has high specific gravity or ascorbic acid concentration is high
Bilirubin levels on a urine strip are often unreliable. The best way to use urinary bilirubin level is to correlate them with clinical findings and laboratories values.
The occult blood test on a urine strip may detect red blood cells, free hemoglobin or myoglobin. The test is very sensitive and quite useful. Blood may be seen in the urine due to a kidney stone, urinary tract infection, break down of muscle, or red blood cells. When urine has high specific gravity it reduces sensitivity of the strip, while ascorbic acid may cause a falsely negative test.
The protein test pad only gives a rough estimate of protein in the urine. However, false positives may occur if the urine pH is very alkaline. Protein may occur in urine from a variety of conditions including:
- Position
- Strenuous exercise
- Extremes of temperature (too hot or too cold)
- Pregnancy
- Low blood pressure
- Liver cirrhoses
- Renal failure
- Upper respiratory tract infection
- Immune complex disorders
- Sepsis
The urine strip reagent is highly sensitive to albumin and less to globulin
Urine strips for making Diagnosis: Part 1
Urine strips are widely used in medicine to make a quick diagnosis of numerous medical disorders. The majority of these diagnostic reagent strips are designed only for human use and provide immediate useful information about health. Urine strips are frequently used by physicians and health care professionals in emergency room, outpatient clinics, nursing homes, doctor’s office and mobile ambulatory centers. The majority of urine strips are multipurpose and readily show color changes when an abnormality is identified. Most strips have gradations of color which allows one to judge the severity of the problem. For those who are not familiar with urine strips, the following information is readily available from urine strips:
Specific Gravity: Urine specific gravity is readily obtained from a strip but it only provides a clue to change in urine density. For more accurate testing, one needs to use a calibrated refractometer.
Urine pH is the most widely used property on a urine strip. The test strips are designed to measure pH change values to within 0.5 units. For the most part, urine pH values are okay for emergency use. Abnormal pH levels may be seen in the following conditions:
Alkaline urine
- Urinary tract infection
- Consuming a vegetarian diet
- Systemic alkalosis
- Bowel obstruction- pyloric stenosis
- Excessive vomiting
- Use of alkaline drugs
Acid urine
- Gout
- Fever
- Use of drugs like phenacetin
- Uric acid stones
The test strips are most accurate for pH in the range from 5-9. However, one has to remember that false negatives can occur because the solution may run over from the highly acidic protein test pad to the urine pH pad. Thus, it is important to hold the strip horizontally when evaluating urine for pH. Whenever there is doubt about urine pH, a pH meter can be used to verify your results.
Specific Gravity: Urine specific gravity is readily obtained from a strip but it only provides a clue to change in urine density. For more accurate testing, one needs to use a calibrated refractometer.
Urine pH is the most widely used property on a urine strip. The test strips are designed to measure pH change values to within 0.5 units. For the most part, urine pH values are okay for emergency use. Abnormal pH levels may be seen in the following conditions:
Alkaline urine
- Urinary tract infection
- Consuming a vegetarian diet
- Systemic alkalosis
- Bowel obstruction- pyloric stenosis
- Excessive vomiting
- Use of alkaline drugs
Acid urine
- Gout
- Fever
- Use of drugs like phenacetin
- Uric acid stones
The test strips are most accurate for pH in the range from 5-9. However, one has to remember that false negatives can occur because the solution may run over from the highly acidic protein test pad to the urine pH pad. Thus, it is important to hold the strip horizontally when evaluating urine for pH. Whenever there is doubt about urine pH, a pH meter can be used to verify your results.
Friday, October 2, 2009
Shoe Covers: Part 2
Almost all shoes covers available today for health professionals are made from poly lactic acid which is an environmentally friendly fabric that is easy to dispose. It biodegrades into water and carbon dioxide. All shoe covers for hospital use are made in accordance with guidelines from OSHA.
The shoe cover fabric is generally 0.1-0.5 mm in thickness and comes in white or blue colors. Shoe covers are ideal for people who not only work in the health care industry but also for those who process food, do house work, work in hair salons, cook foods or work into pharmaceutical manufacturing industry. Shoe covers available today are very light weight, convenient and easy to use. Most have an elastic band along the edges which helps the cover from falling off.
For individual who have latex allergy, there are even shoe covers which are latex free. Disposable shoe covers are considered to be an investment for hospitals because they limit the spread of diseases. One wears them to protect the environment.
Like disposable gloves shoe covers also are available in mass quantities. The majority of shoe covers available are fire resistant, splash proof and non slippery. Most are non allergenic and are easy to dispose.
For more on shoe covers, please visit www.medexsupply.com
The shoe cover fabric is generally 0.1-0.5 mm in thickness and comes in white or blue colors. Shoe covers are ideal for people who not only work in the health care industry but also for those who process food, do house work, work in hair salons, cook foods or work into pharmaceutical manufacturing industry. Shoe covers available today are very light weight, convenient and easy to use. Most have an elastic band along the edges which helps the cover from falling off.
For individual who have latex allergy, there are even shoe covers which are latex free. Disposable shoe covers are considered to be an investment for hospitals because they limit the spread of diseases. One wears them to protect the environment.
Like disposable gloves shoe covers also are available in mass quantities. The majority of shoe covers available are fire resistant, splash proof and non slippery. Most are non allergenic and are easy to dispose.
For more on shoe covers, please visit www.medexsupply.com
Shoe Covers: Part 1
Every hospital has difficulty controlling and preventing infections. There is a lot of evidence that a number of infections acquired in hospitals are passed on to patients from other people (both health care professionals and non health professionals). Despite all advances in science, infections still remain a major cause of death. With recent epidemic of swine flu and bird flu, the importance of hand washing has again been re-emphasized. Another aspect of prevention or transmission of infection is wearing of shoe covers. Shoe covers are vital for health care professionals who work in the operating rooms or in areas of the hospital where complete anti sepsis is required.
All of us wear shoes and walk into environments which are dirty and unsanitary. Show covers help materials from shoes from falling inside clean environments.
Besides preventing transmission of dirt and junk from the outside, show covers also prevent contamination of personal clothing like socks and shoes. There are many types of shoe covers but most health care facilities prefer the disposal shoe covers which come in one size fits all.
Shoe covers are made from light paper cloth, which has a stretchable fabric so that the fit is perfect around any type of shoe. Once the shoe cover is worn it stays firm and does not easily slip off irrespective of the circumstances. Most shoe cover fabrics are sturdy and prevent transmission of fluid into the shoe or socks.
All of us wear shoes and walk into environments which are dirty and unsanitary. Show covers help materials from shoes from falling inside clean environments.
Besides preventing transmission of dirt and junk from the outside, show covers also prevent contamination of personal clothing like socks and shoes. There are many types of shoe covers but most health care facilities prefer the disposal shoe covers which come in one size fits all.
Shoe covers are made from light paper cloth, which has a stretchable fabric so that the fit is perfect around any type of shoe. Once the shoe cover is worn it stays firm and does not easily slip off irrespective of the circumstances. Most shoe cover fabrics are sturdy and prevent transmission of fluid into the shoe or socks.
Thursday, September 10, 2009
Surgical Masks
Surgical masks have always played an important role in preventive medicine. With the advent of Swine and Bird flu, surgical masks have gained even more significance in the world of medicine. Surgical masks were once only worn in hospitals by health care professional and patients. Surgical masks help protect health care workers from bodily fluids, blood, various lung secretions and reduce spread of microorganisms from patients to health care worker and vice versa.
Since the advent of influenza virus, two other airborne viruses have been discovered that have the potential to cause many deaths. Large-scale pandemics of bird and swine flu viral infections have led to use of surgical masks outside health care facilities. The availability of relatively cheap surgical masks has led to high usage among populations in South East Asia. In many Oriental countries, use of surgical masks is a frequent public site to help avoid spread of the common cold virus.
Since the Bird flu scare several years ago, surgical masks have become popular among the public in many parts of America, including Canada and Mexico. There is abundant clinical evidence indicating that surgical masks play an important role in protecting health care workers from contaminated body fluids and aerosol particles. Surgical masks are primarily worn in hospital to prevent inhalation of aerosolized particles including microorganisms.
Awareness of serious viral and bacterial infections has led to development of guidelines regarding use of surgical masks in many health care facilities. Today, surgical masks are advocated for health care professional by the following institutions:
- American National Standards Institute Practice for
Occupational and Educational Eye and Face Protection
- Association of Perioperative Registered Nurses
- Joint Council on Accreditation of Healthcare Organizations
- National Committee for Quality Assurance
- National Institute for Occupational Safety and Health
- Occupational Safety and Health Administration
- The Food and Drug Administration
For more on surgical masks, please visit www.medexsupply.com
Since the advent of influenza virus, two other airborne viruses have been discovered that have the potential to cause many deaths. Large-scale pandemics of bird and swine flu viral infections have led to use of surgical masks outside health care facilities. The availability of relatively cheap surgical masks has led to high usage among populations in South East Asia. In many Oriental countries, use of surgical masks is a frequent public site to help avoid spread of the common cold virus.
Since the Bird flu scare several years ago, surgical masks have become popular among the public in many parts of America, including Canada and Mexico. There is abundant clinical evidence indicating that surgical masks play an important role in protecting health care workers from contaminated body fluids and aerosol particles. Surgical masks are primarily worn in hospital to prevent inhalation of aerosolized particles including microorganisms.
Awareness of serious viral and bacterial infections has led to development of guidelines regarding use of surgical masks in many health care facilities. Today, surgical masks are advocated for health care professional by the following institutions:
- American National Standards Institute Practice for
Occupational and Educational Eye and Face Protection
- Association of Perioperative Registered Nurses
- Joint Council on Accreditation of Healthcare Organizations
- National Committee for Quality Assurance
- National Institute for Occupational Safety and Health
- Occupational Safety and Health Administration
- The Food and Drug Administration
For more on surgical masks, please visit www.medexsupply.com
Eye Protection in health care facilities: Part 2
What types of safety eye wear is available for hospital workers?
The presently available safety eyewear include:
- non prescription eye glasses
- prescription safety glasses
- goggles
- Face shields that are combined with a surgical mask
Eye goggles are easy to use and do provide an important protective function. Before buying a pair of eye goggles one should look for the following features:
- are the goggles lightweight
- are the goggles easy to wear and comfortable
- Do the goggles protect against fluid splatter
- Do the goggles easily fog up?
- Are the lenses strong?
- Are the goggles resistant to chemicals and fluids?
- Are the goggles scratchproof?
It is highly recommended that one wear eye protection if there is any potential for eye injury. Today, OSHA standards require that all health care facilities make available to their staff appropriate eye protection. To be useful, the eyewear must be of the correct type for the risk encountered and correctly fitted.
Eye protection devices must be maintained if one wants them to last. The lenses should be regularly cleaned – dented, scratched or and soiled lenses can diminish vision and may be a factor in causing injury
For more on eye protection devices, please visit www.medexsupply.com
The presently available safety eyewear include:
- non prescription eye glasses
- prescription safety glasses
- goggles
- Face shields that are combined with a surgical mask
Eye goggles are easy to use and do provide an important protective function. Before buying a pair of eye goggles one should look for the following features:
- are the goggles lightweight
- are the goggles easy to wear and comfortable
- Do the goggles protect against fluid splatter
- Do the goggles easily fog up?
- Are the lenses strong?
- Are the goggles resistant to chemicals and fluids?
- Are the goggles scratchproof?
It is highly recommended that one wear eye protection if there is any potential for eye injury. Today, OSHA standards require that all health care facilities make available to their staff appropriate eye protection. To be useful, the eyewear must be of the correct type for the risk encountered and correctly fitted.
Eye protection devices must be maintained if one wants them to last. The lenses should be regularly cleaned – dented, scratched or and soiled lenses can diminish vision and may be a factor in causing injury
For more on eye protection devices, please visit www.medexsupply.com
Eye Protection in health care facilities: Part 1
Protection of the eye is very important in health care facilities. Each year thousands of health care workers are exposed to sick patients, contaminated aerosolized environments, infected body fluids, and blood. Surgeons especially are always at risk from flying fragments and body fluids during surgery. Despite protection from prescription glasses, a number of health care workers develop various types of eye injuries. Moreover, besides direct injury to the eye, there is always a potential for coming into contact with infectious organisms or blood.
When the eye is injured or infected, one has to miss work. This adds to loss of manpower and adds more stress on the already overworked workman’s compensation program. There is no dollar figure that can entirely replicate the personal toll these injuries take on injured health professionals.
Eye experts indicate that proper eye protection can significantly reduce incidence of eye injuries in hospitals and related facilities.
What are common causes of eye injuries in a hospital setting?
- Flying objects especially during surgery (blood particles,
bone chips, metal particles)
- Chemicals
- Aerosolized particles
- Fumes
- Laser beams
How can one prevent eye injury at work?
Eye injuries can be very serious and thus a preventive approach is ideal. All individuals who work in a hospital environment should know the following:
- location of nearest emergency eye wash basin
- be aware of all potential causes of eye injuries in
the working environment
- wear proper eye protection
- be familiar with use of eye goggles
If there is any chance that the eye may be injured at work, one should wear eye goggles. There are many types of protective eyewear available today and most work well. The choice of eye goggles is strictly personal.
When the eye is injured or infected, one has to miss work. This adds to loss of manpower and adds more stress on the already overworked workman’s compensation program. There is no dollar figure that can entirely replicate the personal toll these injuries take on injured health professionals.
Eye experts indicate that proper eye protection can significantly reduce incidence of eye injuries in hospitals and related facilities.
What are common causes of eye injuries in a hospital setting?
- Flying objects especially during surgery (blood particles,
bone chips, metal particles)
- Chemicals
- Aerosolized particles
- Fumes
- Laser beams
How can one prevent eye injury at work?
Eye injuries can be very serious and thus a preventive approach is ideal. All individuals who work in a hospital environment should know the following:
- location of nearest emergency eye wash basin
- be aware of all potential causes of eye injuries in
the working environment
- wear proper eye protection
- be familiar with use of eye goggles
If there is any chance that the eye may be injured at work, one should wear eye goggles. There are many types of protective eyewear available today and most work well. The choice of eye goggles is strictly personal.
Thursday, June 11, 2009
HPV vaccine: Part 3
Finally the cost of HPV vaccine
Medicine is foremost a business and nothing is free. A single dose of Gardasil costs $120-$140. Each individual requires three doses over a 6-month period. Further, many physicians are also charging for a consultation fee, cost of syringe and office time. Thus, the average cost for the entire series of HPV vaccine amounts to about $500-$600 plus.
Not all health insurance plans cover Gardasil. Moreover, some insurance plans only cover the vaccine for females in-between the ages of 9-26, the age where the vaccine has been FDA approved. At present, there is no legislation mandating that insurance plans cover the cost of the vaccine.
The pharmaceutical giant, Merck now has released data that the vaccine is also useful in women up to the age of 45. If there is FDA approval for the vaccine for this older group of individuals, perhaps some insurance companies may cover the cost.
At the moment, Gardasil is covered under a federal program for those who have no insurance and to Medicaid eligible children under the age of 18. For those individuals who lack medical insurance, one can check with the physician or the local health clinic to determine if there is program to get the vaccine free.
Medicine is foremost a business and nothing is free. A single dose of Gardasil costs $120-$140. Each individual requires three doses over a 6-month period. Further, many physicians are also charging for a consultation fee, cost of syringe and office time. Thus, the average cost for the entire series of HPV vaccine amounts to about $500-$600 plus.
Not all health insurance plans cover Gardasil. Moreover, some insurance plans only cover the vaccine for females in-between the ages of 9-26, the age where the vaccine has been FDA approved. At present, there is no legislation mandating that insurance plans cover the cost of the vaccine.
The pharmaceutical giant, Merck now has released data that the vaccine is also useful in women up to the age of 45. If there is FDA approval for the vaccine for this older group of individuals, perhaps some insurance companies may cover the cost.
At the moment, Gardasil is covered under a federal program for those who have no insurance and to Medicaid eligible children under the age of 18. For those individuals who lack medical insurance, one can check with the physician or the local health clinic to determine if there is program to get the vaccine free.
HPV vaccine: Part 2
The one reason why Gardasil is not recommended for women over the age of 25 is that by this time it appears many women have already been exposed to HPV. However, there are studies that have documented safety of this vaccine in the older age group. At present, Gardasil is believed to be effective for at least 5 years after injection. Current research is trying to determine if a booster shot at the end of 5 years will extent protection from the vaccine.
All consumers should understand that getting the HPV vaccine does not eliminate the need for future doctor visits. Pap smears are highly recommended in all females when they become sexually active.
As far as side effects are concerned, both vaccines have proven to be quite safe. From the recent clinical trials, the most common side effects observed were redness and pain at the injection site. These transient side effects last for a few days.
Neither Gardasil nor Cervarix is recommended for pregnant women. Once injected with the HPV vaccine, more than 95-98 percent of women are protected from developing cervical cancer
All consumers should understand that getting the HPV vaccine does not eliminate the need for future doctor visits. Pap smears are highly recommended in all females when they become sexually active.
As far as side effects are concerned, both vaccines have proven to be quite safe. From the recent clinical trials, the most common side effects observed were redness and pain at the injection site. These transient side effects last for a few days.
Neither Gardasil nor Cervarix is recommended for pregnant women. Once injected with the HPV vaccine, more than 95-98 percent of women are protected from developing cervical cancer
What is all the fuss about the human papillomavirus (HPV) vaccine?
Cervical cancer is quite common all over the world. The tragedy of cervical cancer is that it affects young females. Current estimates indicate that in America, approximately 11,000 women develop cervical cancer and there are about 3,000 deaths each year. Over the years, a strong link between the human papilloma virus (HPV) and cervical cancer has been established. Furthermore, HPV has also been linked to cancers of the mouth, vulva, anus, and penis. With more people engaging in sexual activities at an earlier age, a vaccine would be a great way to prevent these cancers associated with HPV.
At present two vaccines have been developed to prevent infection from HPV. Both vaccines are administered by an injection in three divided doses. The current injection guidelines recommend that the first injection be followed by the 2nd and 3rd dose, two and six months, apart.
So far, only one vaccine is currently available in North America. Gardasil is currently available and recommended for all girls and young women between the ages of 9 and 26. In different countries, the age of vaccination is slightly variable. For example in Australia, cervarix is recommended for all females between the ages of 10-45 and for boys in-between the ages of 9-15. Cervarix is currently in the clinical trials stage in North America but data indicate that it is just as effective and safe as Gardasil.
The most important factor with both vaccines is that one gets vaccinated prior to becoming sexually active. Current data indicate that if the vaccine is injected in sexually active individuals, it does not get rid of HPV infection and thus protection against cervical cancer is not a guarantee.
At present two vaccines have been developed to prevent infection from HPV. Both vaccines are administered by an injection in three divided doses. The current injection guidelines recommend that the first injection be followed by the 2nd and 3rd dose, two and six months, apart.
So far, only one vaccine is currently available in North America. Gardasil is currently available and recommended for all girls and young women between the ages of 9 and 26. In different countries, the age of vaccination is slightly variable. For example in Australia, cervarix is recommended for all females between the ages of 10-45 and for boys in-between the ages of 9-15. Cervarix is currently in the clinical trials stage in North America but data indicate that it is just as effective and safe as Gardasil.
The most important factor with both vaccines is that one gets vaccinated prior to becoming sexually active. Current data indicate that if the vaccine is injected in sexually active individuals, it does not get rid of HPV infection and thus protection against cervical cancer is not a guarantee.
Monday, June 8, 2009
Blood in urine: Part 4
Treatment
When hematuria occurs, the doctor has to treat the underling cause.
Urinary tract infections are treated with antibiotics and within a few days both the symptoms and hematuria will disappear. In rare cases, one may need long-term treatment with antibiotics
Kidney stones generally pass spontaneously through the ureter when one drinks a lot of water and remains active. If this method fails, then there are several other options to reveal kidney stones. One is non-invasive use of ultrasonic shock waves to break up the stone. Other more invasive methods include Cystoscopy or surgery.
Enlarged prostate does require treatment when the patient has symptoms. There is no ideal treatment for enlarged prostate. Every treatment has some negatives. In general, one is treated with medications and these do work well, but they also have side effects. When medications fail, the other options are use of heat, laser, or ultrasonic waves to shrink the prostate.
Immunological kidney disease does require treatment. The treatment depends on the type of kidney disease.
Cancers of kidney and bladder are generally treated with surgery. These tumors generally do not respond well to radiation or chemotherapy. In most cases, surgery is combined with an assorted variety of chemotherapeutic drugs.
Inherited disorders of the kidney which cause hematuria, do not always require treatment. Some disorders may cause extensive kidney damage and dialysis may be the only alternative.
Prevention of blood in urine
Unfortunately, one cannot not prevent hematuria. Even then, one should lead a healthy life style. Drinking adequate water and urinating right after intercourse does help prevent some urinary tract infections
To decrease the risk of kidney stones drink lots of water, limit salt, excess protein, and foods such as spinach.
To decrease risk of cancer, stop smoking, avoid exposure to heavy metals or chemicals and get regular exams from a physician.
When hematuria occurs, the doctor has to treat the underling cause.
Urinary tract infections are treated with antibiotics and within a few days both the symptoms and hematuria will disappear. In rare cases, one may need long-term treatment with antibiotics
Kidney stones generally pass spontaneously through the ureter when one drinks a lot of water and remains active. If this method fails, then there are several other options to reveal kidney stones. One is non-invasive use of ultrasonic shock waves to break up the stone. Other more invasive methods include Cystoscopy or surgery.
Enlarged prostate does require treatment when the patient has symptoms. There is no ideal treatment for enlarged prostate. Every treatment has some negatives. In general, one is treated with medications and these do work well, but they also have side effects. When medications fail, the other options are use of heat, laser, or ultrasonic waves to shrink the prostate.
Immunological kidney disease does require treatment. The treatment depends on the type of kidney disease.
Cancers of kidney and bladder are generally treated with surgery. These tumors generally do not respond well to radiation or chemotherapy. In most cases, surgery is combined with an assorted variety of chemotherapeutic drugs.
Inherited disorders of the kidney which cause hematuria, do not always require treatment. Some disorders may cause extensive kidney damage and dialysis may be the only alternative.
Prevention of blood in urine
Unfortunately, one cannot not prevent hematuria. Even then, one should lead a healthy life style. Drinking adequate water and urinating right after intercourse does help prevent some urinary tract infections
To decrease the risk of kidney stones drink lots of water, limit salt, excess protein, and foods such as spinach.
To decrease risk of cancer, stop smoking, avoid exposure to heavy metals or chemicals and get regular exams from a physician.
Blood in urine: Part 3
What are risk factors?
Anyone can develop blood in the urine.
Age: Many men in the 5th decade of life develop and enlarged prostate and have blood in urine
Females generally tend to have hematuria in urine from a UTI
Family history may predispose one to kidney stones which may lead to blood in urine.
Medications like aspirin and penicillin can cause blood in the urine.
Athletes who are long distance runners or joggers often develop hematuria.
Diagnosis
After a complete history and physical examination, hematuria work up depends on the suspected cause.
Urine analysis can determine if there is blood, infection, or a stone. Urine analyses is not specific for diagnosis and some type of radiological study is usually required.
Imaging with CT scan, MRI, or ultrasound can help look at the urinary tract.
Sometimes a long flexible camera (cystoscope) is passed from the penis or vagina into the urethra and up the ureter. The camera can help visualize structures and biopsy can be obtained.
In a few cases the diagnosis of hematuria may not be evident. This may occur if one has had a prior exposure to a drug or an environmental toxin.
In elderly individuals, the cause of hematuria is almost always investigated to rule out a cancer.
Anyone can develop blood in the urine.
Age: Many men in the 5th decade of life develop and enlarged prostate and have blood in urine
Females generally tend to have hematuria in urine from a UTI
Family history may predispose one to kidney stones which may lead to blood in urine.
Medications like aspirin and penicillin can cause blood in the urine.
Athletes who are long distance runners or joggers often develop hematuria.
Diagnosis
After a complete history and physical examination, hematuria work up depends on the suspected cause.
Urine analysis can determine if there is blood, infection, or a stone. Urine analyses is not specific for diagnosis and some type of radiological study is usually required.
Imaging with CT scan, MRI, or ultrasound can help look at the urinary tract.
Sometimes a long flexible camera (cystoscope) is passed from the penis or vagina into the urethra and up the ureter. The camera can help visualize structures and biopsy can be obtained.
In a few cases the diagnosis of hematuria may not be evident. This may occur if one has had a prior exposure to a drug or an environmental toxin.
In elderly individuals, the cause of hematuria is almost always investigated to rule out a cancer.
Blood in urine: Part 2
Causes of hematuria
There are a number of structures that make up the urinary tract. Starting with kidney, there are the ureters, bladder and urethra. The kidneys remove waste products and make urine. The urine is then carried by the ureter to the bladder where it is stored. When the bladder is full, the urethra opens and one urinates. blood can originate from any one of these structures.
Urinary tract infections (UTI) are common in women then men. Often some women develop microscopic hematuria during a UTI. This usually clears up once the UTI is treated with an antibiotic. No investigations are needed.
Infections of the kidney is known as pyleonephritis and can also result as microscopic hematuria. The condition is associated with significant flank pain, fever, and difficulty passing urine. The condition is typically treated with antibiotics.
Stones are a common cause of blood in urine. Urinary stones are excruciatingly painful and often cause both gross and microscopic hematuria. Identification of stones is easy with a dye study. When the stone has passed, hematuria usually clears up.
Enlarged prostate is a leading cause of hematuria in man over the age of 50. The prostate is located at the base of the bladder. As men age, the prostate gets bigger and compresses the urethra; often this leads to difficulty in urination. Often the condition is associated with both gross and microscopic hematuria. The condition is easily diagnosed with a rectal exam or an ultrasound.
Kidney disorders; There are many kidney disorders that can cause microscopic hematuria. Most of these disorders are either infections or immune mediated. These disorders also have other organ involvement and need to be worked up. Most of these immunological kidney disorders present much early in life.
Cancer: Gross hematuria is often the first sign of cancer of bladder, kidney or prostate. Unfortunately, when gross hematuria occurs the cancer is generally more advanced.
Trauma is a common cause of hematuria. Individuals into contact sports may see blood in urine after trauma.
Medications like aspirin and blood thinners can also cause blood in urine.
Strenuous exercise can cause gross hematuria. This is most probably related to dehydration, trauma to the bladder or breakdown of red cells. The condition usually improves within a few days.
There are a number of structures that make up the urinary tract. Starting with kidney, there are the ureters, bladder and urethra. The kidneys remove waste products and make urine. The urine is then carried by the ureter to the bladder where it is stored. When the bladder is full, the urethra opens and one urinates. blood can originate from any one of these structures.
Urinary tract infections (UTI) are common in women then men. Often some women develop microscopic hematuria during a UTI. This usually clears up once the UTI is treated with an antibiotic. No investigations are needed.
Infections of the kidney is known as pyleonephritis and can also result as microscopic hematuria. The condition is associated with significant flank pain, fever, and difficulty passing urine. The condition is typically treated with antibiotics.
Stones are a common cause of blood in urine. Urinary stones are excruciatingly painful and often cause both gross and microscopic hematuria. Identification of stones is easy with a dye study. When the stone has passed, hematuria usually clears up.
Enlarged prostate is a leading cause of hematuria in man over the age of 50. The prostate is located at the base of the bladder. As men age, the prostate gets bigger and compresses the urethra; often this leads to difficulty in urination. Often the condition is associated with both gross and microscopic hematuria. The condition is easily diagnosed with a rectal exam or an ultrasound.
Kidney disorders; There are many kidney disorders that can cause microscopic hematuria. Most of these disorders are either infections or immune mediated. These disorders also have other organ involvement and need to be worked up. Most of these immunological kidney disorders present much early in life.
Cancer: Gross hematuria is often the first sign of cancer of bladder, kidney or prostate. Unfortunately, when gross hematuria occurs the cancer is generally more advanced.
Trauma is a common cause of hematuria. Individuals into contact sports may see blood in urine after trauma.
Medications like aspirin and blood thinners can also cause blood in urine.
Strenuous exercise can cause gross hematuria. This is most probably related to dehydration, trauma to the bladder or breakdown of red cells. The condition usually improves within a few days.
Why do I have blood in my urine?
Having blood in urine is not normal. Seeing blood in urine can be a frightening experience for most people. When blood occurs in the urine, the condition is medically known as hematuria. In most cases, having blood in urine is not a cause for alarm. Sometimes participating in strenuous sports can cause blood to appear in urine. Some footballers often see traces of blood in urine after being knocked down on the sports field. Other common causes of blood in urine include kidney stones and drugs. However, in the elderly individual blood in urine may signal the appearance of a cancer.
Blood in the urine is classified as gross or microscopic. When the urine is only slightly red and red blood cells are only seen under a microscope, this is known as microscopic hematuria. When there is frank blood in urine, this is known as gross hematuria.
When gross hematuria occurs, one must always rule out a cancer. When there is microscopic hematuria, the cause may be an infection or a stone.
Hematuria that is caused with exercise or sports trauma usually disappears within a few days and does not require any extensive work up
Symptoms
In many individuals, microscopic hematuria may present as red or pink colored urine. It takes only a few red blood cells to make the urine look red. In most cases, there is no pain associated with blood in urine.
Blood in the urine is classified as gross or microscopic. When the urine is only slightly red and red blood cells are only seen under a microscope, this is known as microscopic hematuria. When there is frank blood in urine, this is known as gross hematuria.
When gross hematuria occurs, one must always rule out a cancer. When there is microscopic hematuria, the cause may be an infection or a stone.
Hematuria that is caused with exercise or sports trauma usually disappears within a few days and does not require any extensive work up
Symptoms
In many individuals, microscopic hematuria may present as red or pink colored urine. It takes only a few red blood cells to make the urine look red. In most cases, there is no pain associated with blood in urine.
Sunday, June 7, 2009
Blood clots:Part 6
How can I prevent blood clots?
The best methods of preventing blood clots include:
- Being active, walking on a daily basis
- If flying or driving a long distance, walk around
every few hours
- Wear compression stockings
- Lose weight
- Avoid prolonged standing
- If possible, avoid the birth control pill
Are there any home treatments to treat blood clots in the legs?
Yes, once you have been started on a blood thinner, you can do a number of things at home to relieve symptoms:
- Frequently elevate the leg, this will decrease
swelling and pain
- Avoid standing for long periods
- Wear compression stockings
- If it feels warm at the back of the leg where the
blood clot has been identified, apply a warm compress
Final advice
All individuals who are being treated with blood thinning medications should wear a medical bracelet to alert health care workers of their medical problem.
The best methods of preventing blood clots include:
- Being active, walking on a daily basis
- If flying or driving a long distance, walk around
every few hours
- Wear compression stockings
- Lose weight
- Avoid prolonged standing
- If possible, avoid the birth control pill
Are there any home treatments to treat blood clots in the legs?
Yes, once you have been started on a blood thinner, you can do a number of things at home to relieve symptoms:
- Frequently elevate the leg, this will decrease
swelling and pain
- Avoid standing for long periods
- Wear compression stockings
- If it feels warm at the back of the leg where the
blood clot has been identified, apply a warm compress
Final advice
All individuals who are being treated with blood thinning medications should wear a medical bracelet to alert health care workers of their medical problem.
Blood clots: part 5
Is there a risk from taking these medications?
Yes, all blood thinning medication can cause bleeding. Thus one should avoid activities that can lead to trauma to the body, otherwise severe bleeding can occur.
Can blood clots be dissolved instantly?
Yes, there are medications (thrombolytics) which can rapidly dissolve blood clots. However, there are specific indications for use of these medications and they all carry a higher risk of complications. Their use is only limited to hospital patients.
Is surgery ever used to treat blood clots from the legs?
Yes, in very rare cases surgery (thrombectomy/embolectomy) is sometimes used in the treatment of blood clots. However, this is done for life or limb threatening cases only. There is no role for surgery in the routine treatment of blood clots in the legs. The surgery is hazardous and fraught with complications. However, it is life saving.
What happens if I am unable to tolerate a blood thinning medication?
Today, there are several devices (filters) which can be placed in the vein to prevent blood clots from migrating to lungs. The filter has to be placed before the blood clot has broken off. The filter acts like an umbrella and is quite effective in preventing the blood clot from moving to lung. These devices have an umbrella like appearance and do not dissolve the clot but prevent it from going to lungs. Filters are more commonly used in individuals who can not take blood thinners. There are both permanent and temporary filters available today but they do cost a fortune. Some of the temporary filters cost more than $15, 000.
Yes, all blood thinning medication can cause bleeding. Thus one should avoid activities that can lead to trauma to the body, otherwise severe bleeding can occur.
Can blood clots be dissolved instantly?
Yes, there are medications (thrombolytics) which can rapidly dissolve blood clots. However, there are specific indications for use of these medications and they all carry a higher risk of complications. Their use is only limited to hospital patients.
Is surgery ever used to treat blood clots from the legs?
Yes, in very rare cases surgery (thrombectomy/embolectomy) is sometimes used in the treatment of blood clots. However, this is done for life or limb threatening cases only. There is no role for surgery in the routine treatment of blood clots in the legs. The surgery is hazardous and fraught with complications. However, it is life saving.
What happens if I am unable to tolerate a blood thinning medication?
Today, there are several devices (filters) which can be placed in the vein to prevent blood clots from migrating to lungs. The filter has to be placed before the blood clot has broken off. The filter acts like an umbrella and is quite effective in preventing the blood clot from moving to lung. These devices have an umbrella like appearance and do not dissolve the clot but prevent it from going to lungs. Filters are more commonly used in individuals who can not take blood thinners. There are both permanent and temporary filters available today but they do cost a fortune. Some of the temporary filters cost more than $15, 000.
Blood clots:Part 4
What is treatment of a blood clot?
If a blood clot is found in the deep veins, you will require admission to hospital for at least 4-7 days. Following some blood work, you will be started on heparin.
What is heparin?
Heparin is a blood thinner that is given intravenously. It does not dissolve the clot but helps to stabilize the clot so that it does not move. After a few days, you will be started on an oral medication called warfarin and then discharged home. Anyone who receives warfarin needs his or her blood assessed on a weekly to monthly basis to ensure that blood thinning is adequate.
How long do I need to take a blood thinner?
For a first time blood clot, you will need to take warfarin for at least 6-9 months. Those with recurrent blood clots will require warfarin for an indefinite time.
Are there any other medications one can take for blood clots?
Yes, the newer medications are called low molecular weight heparins (LMWH). These medications do not require monitoring and can be taken at home. Unfortunately they need to be injected daily and are more expensive.
If a blood clot is found in the deep veins, you will require admission to hospital for at least 4-7 days. Following some blood work, you will be started on heparin.
What is heparin?
Heparin is a blood thinner that is given intravenously. It does not dissolve the clot but helps to stabilize the clot so that it does not move. After a few days, you will be started on an oral medication called warfarin and then discharged home. Anyone who receives warfarin needs his or her blood assessed on a weekly to monthly basis to ensure that blood thinning is adequate.
How long do I need to take a blood thinner?
For a first time blood clot, you will need to take warfarin for at least 6-9 months. Those with recurrent blood clots will require warfarin for an indefinite time.
Are there any other medications one can take for blood clots?
Yes, the newer medications are called low molecular weight heparins (LMWH). These medications do not require monitoring and can be taken at home. Unfortunately they need to be injected daily and are more expensive.
Blood Clots: part 3
What causes blood clots in the veins?
There are many reasons why blood clots can form in veins. These include
- Prolonged immobility (after surgery)
- Long airplane ride
- Taking the birth control pill
- Trauma or fractures of leg(s)
- Injury to veins
- Cancer
- Stroke- which has caused one to become bed ridden
- After any surgery- especially hip and knee
- Obesity
- Congestive heart failure
- Pregnancy or just after delivery
- Inherited blood disorders
- Prior blood clot –there is increased chance of a
second clot if one has had a previous blood clot
Are blood clots dangerous?
Most definitely. Any time you have one of the above symptoms; one should go and see a doctor. Blood clots in veins have a high tendency to break off and migrate to the lungs where they can cause serious problem’s including death.
How can blood clots in veins be detected?
Your physician will first examine you and order the most appropriate tests. The first test to detect blood clots in all cases is an ultrasound.
Doppler ultrasound is a painless test that takes a few minutes and can easily detect the presence of blood clots in arm and leg veins. However, if blood clots are located in the chest, abdomen or pelvis, Ultrasound is not good enough.
MRI: This non invasive test is also excellent for evaluating presence of blood clots. The test does not use radiation but is slightly more expensive. It is useful for detection of blood clots almost anywhere in the body, but is not the first test of choice.
Venogram: In the old days Venogram was used to look for blood clots. However this test is rarely used to day because of availability of US and MRI. Venogram requires use of a dye and radiation.
CT scan: The newer CT scans can easily identify presence of clots in the lungs. However, CT scans are not routinely used to detect blood clots as the initial test. CT scan requires exposure to radiation and use of an iodinated dye.
There are many reasons why blood clots can form in veins. These include
- Prolonged immobility (after surgery)
- Long airplane ride
- Taking the birth control pill
- Trauma or fractures of leg(s)
- Injury to veins
- Cancer
- Stroke- which has caused one to become bed ridden
- After any surgery- especially hip and knee
- Obesity
- Congestive heart failure
- Pregnancy or just after delivery
- Inherited blood disorders
- Prior blood clot –there is increased chance of a
second clot if one has had a previous blood clot
Are blood clots dangerous?
Most definitely. Any time you have one of the above symptoms; one should go and see a doctor. Blood clots in veins have a high tendency to break off and migrate to the lungs where they can cause serious problem’s including death.
How can blood clots in veins be detected?
Your physician will first examine you and order the most appropriate tests. The first test to detect blood clots in all cases is an ultrasound.
Doppler ultrasound is a painless test that takes a few minutes and can easily detect the presence of blood clots in arm and leg veins. However, if blood clots are located in the chest, abdomen or pelvis, Ultrasound is not good enough.
MRI: This non invasive test is also excellent for evaluating presence of blood clots. The test does not use radiation but is slightly more expensive. It is useful for detection of blood clots almost anywhere in the body, but is not the first test of choice.
Venogram: In the old days Venogram was used to look for blood clots. However this test is rarely used to day because of availability of US and MRI. Venogram requires use of a dye and radiation.
CT scan: The newer CT scans can easily identify presence of clots in the lungs. However, CT scans are not routinely used to detect blood clots as the initial test. CT scan requires exposure to radiation and use of an iodinated dye.
Friday, June 5, 2009
blood clots: part 2
What are veins?
Veins are thin walled vessels which play a role in removing all deoxygenated blood from the tissues and take it back to the lungs for oxygenation. They are numerous veins all over the body; the largest vein is called the inferior vena cava.
Can blood clots occur in veins?
Most definitely, blood clots are far more common in veins than arteries. When clots occur in veins they have a tendency to break off and move to the lungs where they can compromise breathing. Clots can occur in both the arm and leg veins.
Which veins are more prone to blood clots?
The majority of blood clots occur in veins of the leg but they can occur in any vein in the body.
Which blood clots are of importance?
Blood clots can occur in both superficial and deep veins. Only blood clots in deep veins are of concern. Blood clots in superficial veins do not need any treatment except for an aspirin.
What happens when blood clots migrate to lungs?
The lungs are important for gas exchange. When blood clots move into the lungs, they can block blood vessels and impair oxygen transport. If the clots are large, one can have severe difficulty breathing and death is not uncommon.
Are blood clots in veins common?
In the United States, about 2 million people per year develop blood clots. Most of them are aged 40 years or older. Statistics reveal that at least 200,000 patients die each year from blood clots in their lung.
How do I know if I have blood clots?
It depends where the blood clot has formed. In most cases blood clots form in the legs, especially the calf area. You may have some of the following symptoms:
a. heaviness of leg
b. tenderness in calf area
c. swelling in calf area
d. warmth near the calf
e. at least 30% will not have any symptoms
Veins are thin walled vessels which play a role in removing all deoxygenated blood from the tissues and take it back to the lungs for oxygenation. They are numerous veins all over the body; the largest vein is called the inferior vena cava.
Can blood clots occur in veins?
Most definitely, blood clots are far more common in veins than arteries. When clots occur in veins they have a tendency to break off and move to the lungs where they can compromise breathing. Clots can occur in both the arm and leg veins.
Which veins are more prone to blood clots?
The majority of blood clots occur in veins of the leg but they can occur in any vein in the body.
Which blood clots are of importance?
Blood clots can occur in both superficial and deep veins. Only blood clots in deep veins are of concern. Blood clots in superficial veins do not need any treatment except for an aspirin.
What happens when blood clots migrate to lungs?
The lungs are important for gas exchange. When blood clots move into the lungs, they can block blood vessels and impair oxygen transport. If the clots are large, one can have severe difficulty breathing and death is not uncommon.
Are blood clots in veins common?
In the United States, about 2 million people per year develop blood clots. Most of them are aged 40 years or older. Statistics reveal that at least 200,000 patients die each year from blood clots in their lung.
How do I know if I have blood clots?
It depends where the blood clot has formed. In most cases blood clots form in the legs, especially the calf area. You may have some of the following symptoms:
a. heaviness of leg
b. tenderness in calf area
c. swelling in calf area
d. warmth near the calf
e. at least 30% will not have any symptoms
Blood clots 101
In a healthy human there is a delicate balance between factors that cause blood clots to form and factors that dissolve blood clots. Blood clots form all the time in blood vessels, but the body immediately responds by breaking them up. However, sometimes, the body’s defense mechanisms fail and blood clots form. Blood clots when they initially form look like red jelly. Blood clots are useful because they can help stop bleeding. However, in some cases, blood clots continue to form and can break off can create problems
Where do blood clots generally occur?
Blood clots can occur in arteries and veins of any size. Veins usually take blood back to the heart. Thus, when a blood clot occurs in a vein blood starts to pool and collect in the vessel. The most obvious sign of a blood clot in the leg vein is swelling, pain, and discoloration. Blood clots in small veins like in the feet or hands are not important. However, when blood clots occur in large veins, they are important. These blood clots can break off, go to the lung, and make breathing difficult.
What are arteries?
Arteries are muscular blood vessels which take blood from the heart and supply oxygen to the body. When a blood clot forms in an artery, the body part does not get oxygen. Hence the leg goes blue, feels cold and is painful. Blood clots commonly block off arteries in the leg vessels near the groin.
Can clots occur in arteries?
Yes, blood clots can and do occur in arteries. Since arteries supply oxygen to the body, blood clots formation is usually more serious. Blood clots can deprive the hand or leg of oxygenated blood. This is what happens in a stroke or a heart attack. Blood clots generally tend to occur in arteries that supply the brain, heart, legs, or kidneys. Blood clots formed in leg arteries generally require urgent surgery
Where do blood clots generally occur?
Blood clots can occur in arteries and veins of any size. Veins usually take blood back to the heart. Thus, when a blood clot occurs in a vein blood starts to pool and collect in the vessel. The most obvious sign of a blood clot in the leg vein is swelling, pain, and discoloration. Blood clots in small veins like in the feet or hands are not important. However, when blood clots occur in large veins, they are important. These blood clots can break off, go to the lung, and make breathing difficult.
What are arteries?
Arteries are muscular blood vessels which take blood from the heart and supply oxygen to the body. When a blood clot forms in an artery, the body part does not get oxygen. Hence the leg goes blue, feels cold and is painful. Blood clots commonly block off arteries in the leg vessels near the groin.
Can clots occur in arteries?
Yes, blood clots can and do occur in arteries. Since arteries supply oxygen to the body, blood clots formation is usually more serious. Blood clots can deprive the hand or leg of oxygenated blood. This is what happens in a stroke or a heart attack. Blood clots generally tend to occur in arteries that supply the brain, heart, legs, or kidneys. Blood clots formed in leg arteries generally require urgent surgery
Wednesday, May 6, 2009
Irritable bowel syndrome 101 part 10
Alternative therapy
The failure of conventional medicine to help individuals with IBS has led many people to seek alternative care. Acupuncture is widely used as a treatment for IBS. While some claim that it works, clinical evidence is scant and limited trials show that is does very little. There are hundreds of people who have tried acupuncture and found to be junk therapy. Acupuncture is a therapy still looking for a medical disorder it can cure.
Other therapies tried out in IBS include use of peppermint to relax the intestine and Probiotics. The data on both these therapies are mixed. Some say it works and others say it does not. As far as clinical evidence is concerned, there is only one study that shows mild benefit of peppermint. Most of the time the effectiveness of these therapies is only in the minds of people who sell these products.
The failure of conventional medicine to help individuals with IBS has led many people to seek alternative care. Acupuncture is widely used as a treatment for IBS. While some claim that it works, clinical evidence is scant and limited trials show that is does very little. There are hundreds of people who have tried acupuncture and found to be junk therapy. Acupuncture is a therapy still looking for a medical disorder it can cure.
Other therapies tried out in IBS include use of peppermint to relax the intestine and Probiotics. The data on both these therapies are mixed. Some say it works and others say it does not. As far as clinical evidence is concerned, there is only one study that shows mild benefit of peppermint. Most of the time the effectiveness of these therapies is only in the minds of people who sell these products.
Irritable bowel syndrome 101 part 9
Can IBS be prevented?
One of the ways to avoid symptoms of IBS is to decrease the triggers. To avoid trigger factors and lessen their effects, one may need to undergo some type of counseling, biofeedback, or alternative therapy.
Coping
The best way to cope with IBS is to find a treatment that works for you. Every individual has his or her own remedy and often this regimen does not work for all individuals. The goal is not to find a temporary solution but a long-term solution that is effective
Fiber. Even though fiber is good for patient with IBS, fiber can also be a real hassle. Fiber can help decrease constipation but it can also produce a lot of gas and cause abdominal cramps. Fiber should be gradually introduced in the diet over a period of weeks and not days. Foods, which contain decent amount of fiber, include whole grains, fruits, vegetables, and beans. Most individuals do not need to consult a dietician for a fiber consult. There is enough free literature on cyberspace that can tell you what to eat and how much fiber to eat. When eating a fiber supplement like Metamucil or Citrucel, introduce these supplements slowly and drink lots of water. This will minimize bloating and gas. If a fiber works for you, stick to that brand and use it on a regular basis.
Avoid “problem” foods. Keep a dairy and make a note of foods that make your symptoms worse. Culprit foods that often worsen IBS include:
- Alcohol
- Chocolate
- Caffeinated beverages (coffee and sodas)
- Medications that contain caffeine
- Dairy products
- Sugar-free sweeteners (sorbitol or mannitol)
Other foods that produce gas and make symptoms worse include beans, cabbage, cauliflower, and broccoli. Fatty or oily foods can also be problematic for others.
Individuals who chew gum, drink through a straw and talk while they are eating can swallow more air and this can also lead to more gas
Eat at regular times
To synchronize your bowel movements, eat at regular times. Do not skip meals and do not eat large meals all the time. Many individuals with diarrhea find that eating several small meals can help reduce symptoms. If you are constipated all the time, add fiber to your diet
Dairy products: Individuals who have problems with lactose should avoid dairy products or eat lactose free products. One can even use an enzyme product called lactaid that can break down lactulose. For some individuals, milk or dairy products may have to be completely eliminated from diet to relieve symptoms. In these individual it is essential to eat other food containing calcium and vitamin B
Drink liquids: Drink lots of fluids. While there are hundreds of beverages, there is nothing better than water. Avoid alcohol or caffeine containing beverages as it can make diarrhea worse.
Exercise regularly: Regular exercise will help you maintain a decent weight, relieve stress, and stimulate your bowels to work better. One does not have to join an exercise club, spend a fortune joining a gym- start with walking, or jog regularly. Nothing beats daily walking.
Avoid excessive use of anti-diarrheal medications and laxatives: Individual who have diarrhea should try and avoid use of excessive anti diarrheal medications. Imodium and kaopectate do work, but one should start with the lowest dose. These medications can rapidly resolve diarrhea but can also worsen constipation.
One of the ways to avoid symptoms of IBS is to decrease the triggers. To avoid trigger factors and lessen their effects, one may need to undergo some type of counseling, biofeedback, or alternative therapy.
Coping
The best way to cope with IBS is to find a treatment that works for you. Every individual has his or her own remedy and often this regimen does not work for all individuals. The goal is not to find a temporary solution but a long-term solution that is effective
Fiber. Even though fiber is good for patient with IBS, fiber can also be a real hassle. Fiber can help decrease constipation but it can also produce a lot of gas and cause abdominal cramps. Fiber should be gradually introduced in the diet over a period of weeks and not days. Foods, which contain decent amount of fiber, include whole grains, fruits, vegetables, and beans. Most individuals do not need to consult a dietician for a fiber consult. There is enough free literature on cyberspace that can tell you what to eat and how much fiber to eat. When eating a fiber supplement like Metamucil or Citrucel, introduce these supplements slowly and drink lots of water. This will minimize bloating and gas. If a fiber works for you, stick to that brand and use it on a regular basis.
Avoid “problem” foods. Keep a dairy and make a note of foods that make your symptoms worse. Culprit foods that often worsen IBS include:
- Alcohol
- Chocolate
- Caffeinated beverages (coffee and sodas)
- Medications that contain caffeine
- Dairy products
- Sugar-free sweeteners (sorbitol or mannitol)
Other foods that produce gas and make symptoms worse include beans, cabbage, cauliflower, and broccoli. Fatty or oily foods can also be problematic for others.
Individuals who chew gum, drink through a straw and talk while they are eating can swallow more air and this can also lead to more gas
Eat at regular times
To synchronize your bowel movements, eat at regular times. Do not skip meals and do not eat large meals all the time. Many individuals with diarrhea find that eating several small meals can help reduce symptoms. If you are constipated all the time, add fiber to your diet
Dairy products: Individuals who have problems with lactose should avoid dairy products or eat lactose free products. One can even use an enzyme product called lactaid that can break down lactulose. For some individuals, milk or dairy products may have to be completely eliminated from diet to relieve symptoms. In these individual it is essential to eat other food containing calcium and vitamin B
Drink liquids: Drink lots of fluids. While there are hundreds of beverages, there is nothing better than water. Avoid alcohol or caffeine containing beverages as it can make diarrhea worse.
Exercise regularly: Regular exercise will help you maintain a decent weight, relieve stress, and stimulate your bowels to work better. One does not have to join an exercise club, spend a fortune joining a gym- start with walking, or jog regularly. Nothing beats daily walking.
Avoid excessive use of anti-diarrheal medications and laxatives: Individual who have diarrhea should try and avoid use of excessive anti diarrheal medications. Imodium and kaopectate do work, but one should start with the lowest dose. These medications can rapidly resolve diarrhea but can also worsen constipation.
Irritable bowel syndrome 101 part 8
The treatment for each patient is individualized and based on type and severity of symptoms.
Constipation-predominant IBS with mild symptoms may benefit from
- Increased fluid intake
- Guar gum
- Exercise
- Fiber
For constipation-predominant IBS with moderate symptoms,
- An antispasmodic (Bentyl)
- Peppermint oil
- Osmotic laxative
In severe cases, the above therapies may be supplemented with
- Tricyclic antidepressants
- Psychotherapy
- Consideration of drug like Paxil/lotronex
For diarrhea-predominant IBS, begin with
- Dietary changes
- Use an antispasmodic (Bentyl)
- Alternatively, peppermint oil if symptoms are moderate.
In severe diarrhea-predominant IBS,
- Consider tricyclic antidepressants
- Add a serotonin 5-HT3 antagonist (lotronex if patient is female).
In pain-predominant IBS
- Use an antispasmodic (Bentyl)
- Tricyclic antidepressant
If severe with diarrhea
- Consider a serotonin 5-HT3 agonist (lotronex).
Constipation-predominant IBS with mild symptoms may benefit from
- Increased fluid intake
- Guar gum
- Exercise
- Fiber
For constipation-predominant IBS with moderate symptoms,
- An antispasmodic (Bentyl)
- Peppermint oil
- Osmotic laxative
In severe cases, the above therapies may be supplemented with
- Tricyclic antidepressants
- Psychotherapy
- Consideration of drug like Paxil/lotronex
For diarrhea-predominant IBS, begin with
- Dietary changes
- Use an antispasmodic (Bentyl)
- Alternatively, peppermint oil if symptoms are moderate.
In severe diarrhea-predominant IBS,
- Consider tricyclic antidepressants
- Add a serotonin 5-HT3 antagonist (lotronex if patient is female).
In pain-predominant IBS
- Use an antispasmodic (Bentyl)
- Tricyclic antidepressant
If severe with diarrhea
- Consider a serotonin 5-HT3 agonist (lotronex).
Irritable bowel syndrome 101 part 7
Other treatments
Clonidine, which is an anti hypertensive drug, has been shown to relieve symptoms of IBS in a few patients. So far, studies are few and benefits are not seen in all individual with IBS.
Complementary therapies
Because of lack of satisfaction with conventional medicine, many individuals with IBS now seek treatment from alternative care. The complementary treatments for IBS include peppermint that can reduce muscle spasms and improves digestive function. Individuals who take peppermint claim that the supplement does wonders, cures cramps, and improves life style. Recent trials indicate that peppermint does work in about 10-30 percent of individuals with IBS. It decreases stool frequency and also helps ease up on gas and bloating.
Other supplements that may be beneficial in individuals with IBS is ginger, fennel seeds and Aloe Vera. Anecdotal reports by individuals with IBS claim that these herbs can help relieve bloating. Unlike peppermint, there are no clinical studies that actually prove efficacy of these herbs. There are also lots of testimonials that these herbs do not work in IBS. Less than 5% of individuals with IBS show improvement with herbal therapy
Approach to the Patient
There is a tremendous variation in response of IBS patients to treatment. There is no one treatment that works for everyone. The treatment is generally focused on methods to improve dysfunction of bowels. However, it is vital that the individual understand and know about the disorder. Education is a vital part of treatment. Other aspects of treatment include reassurance that nothing life threatening will occur, methods to ease stress and learn how to relax
Clonidine, which is an anti hypertensive drug, has been shown to relieve symptoms of IBS in a few patients. So far, studies are few and benefits are not seen in all individual with IBS.
Complementary therapies
Because of lack of satisfaction with conventional medicine, many individuals with IBS now seek treatment from alternative care. The complementary treatments for IBS include peppermint that can reduce muscle spasms and improves digestive function. Individuals who take peppermint claim that the supplement does wonders, cures cramps, and improves life style. Recent trials indicate that peppermint does work in about 10-30 percent of individuals with IBS. It decreases stool frequency and also helps ease up on gas and bloating.
Other supplements that may be beneficial in individuals with IBS is ginger, fennel seeds and Aloe Vera. Anecdotal reports by individuals with IBS claim that these herbs can help relieve bloating. Unlike peppermint, there are no clinical studies that actually prove efficacy of these herbs. There are also lots of testimonials that these herbs do not work in IBS. Less than 5% of individuals with IBS show improvement with herbal therapy
Approach to the Patient
There is a tremendous variation in response of IBS patients to treatment. There is no one treatment that works for everyone. The treatment is generally focused on methods to improve dysfunction of bowels. However, it is vital that the individual understand and know about the disorder. Education is a vital part of treatment. Other aspects of treatment include reassurance that nothing life threatening will occur, methods to ease stress and learn how to relax
Irritable bowel syndrome 101 part 6
Psychotherapy
Many individuals with IBS tend to be under stress and undue tension. This often aggravates the condition and symptoms. To relieve tension, a variety of psychotherapy techniques have been utilized to reduce stress; this includes cognitive behavior therapy, hypnosis, stress management, yoga, acupuncture and relaxation. Psychotherapy does benefit some patients. The problem with these techniques is that it requires a long-term commitment and results are not immediate. In addition, these treatments are quite expensive and not usually covered by medical insurance plans. When treatments are stopped, relapses are common. Overall, about 10-20 percent of patients with mild IBS show benefit with psychotherapy.
Serotonin Receptor antagonists
A new class of drugs like Alosetron (lotronex) has been approved for use in decreasing symptoms of IBS. Lotronex has been shown to increase colonic compliance, and decreases gastrocolonic reflexes. So far, a few studies indicate that this drug can lead to modest benefit over a sugar pill, reduce bloating, and pain. When the drug was first released, it was linked to a few deaths. However, it is now again available with strict prescribing regulations. Alosetron is currently indicated only for women with severe diarrhea-predominant symptoms in whom conventional treatment has failed. Constipation is a common complaint with use of this drug.
Another drug released for IBS is Tegaserod (zelnorm). It has been found to be of mild benefit in individuals with constipation-predominant IBS. Tegaserod is approved for up to 12 weeks for treatment of constipation-predominant IBS in women. At present there is still some concern regarding long-term safety of the drug. Individuals with generalized symptoms of IBS do improve but the benefits are mild. More studies are needed before the drug can be used in all patients with IBS.
Probiotics & Antibiotics
The role of antibiotics in IBS is not common. Antibiotics are only used when an infection is suspected. Prolonged use of antibiotics can lead to severe diarrhea due to overgrowth of bowel bacteria.
The health food industry is heavily marketing Probiotics for treatment of IBS. Probiotics consist of mixtures of live organisms that are presumed to restore normal bowel flora. To date, most reports of efficiency of Probiotics are made by vendors of these products. Scientific studies are lacking. In addition, not everyone sees benefits from Probiotics
Many individuals with IBS tend to be under stress and undue tension. This often aggravates the condition and symptoms. To relieve tension, a variety of psychotherapy techniques have been utilized to reduce stress; this includes cognitive behavior therapy, hypnosis, stress management, yoga, acupuncture and relaxation. Psychotherapy does benefit some patients. The problem with these techniques is that it requires a long-term commitment and results are not immediate. In addition, these treatments are quite expensive and not usually covered by medical insurance plans. When treatments are stopped, relapses are common. Overall, about 10-20 percent of patients with mild IBS show benefit with psychotherapy.
Serotonin Receptor antagonists
A new class of drugs like Alosetron (lotronex) has been approved for use in decreasing symptoms of IBS. Lotronex has been shown to increase colonic compliance, and decreases gastrocolonic reflexes. So far, a few studies indicate that this drug can lead to modest benefit over a sugar pill, reduce bloating, and pain. When the drug was first released, it was linked to a few deaths. However, it is now again available with strict prescribing regulations. Alosetron is currently indicated only for women with severe diarrhea-predominant symptoms in whom conventional treatment has failed. Constipation is a common complaint with use of this drug.
Another drug released for IBS is Tegaserod (zelnorm). It has been found to be of mild benefit in individuals with constipation-predominant IBS. Tegaserod is approved for up to 12 weeks for treatment of constipation-predominant IBS in women. At present there is still some concern regarding long-term safety of the drug. Individuals with generalized symptoms of IBS do improve but the benefits are mild. More studies are needed before the drug can be used in all patients with IBS.
Probiotics & Antibiotics
The role of antibiotics in IBS is not common. Antibiotics are only used when an infection is suspected. Prolonged use of antibiotics can lead to severe diarrhea due to overgrowth of bowel bacteria.
The health food industry is heavily marketing Probiotics for treatment of IBS. Probiotics consist of mixtures of live organisms that are presumed to restore normal bowel flora. To date, most reports of efficiency of Probiotics are made by vendors of these products. Scientific studies are lacking. In addition, not everyone sees benefits from Probiotics
Irritable bowel syndrome 101 part 5
Antispasmodic agents
There are many patients with IBS who get frequent abdominal cramps. These individuals may benefit from anti spasmodic agents. These drugs can help relax the intestine and reduce intensity of contractions. Some of the common anti spasmodic used to treat IBS include dicyclomine (Bentyl) and hyoscyamine (levsin). A number of studies have shown that these agents are significantly better than sugar pills at reducing abdominal distension and cramps but do not alter constipation. To date, these agents have only been evaluated for short-term efficacy and long-term results remain unknown.
Antidiarrheal agents
Both Imodium and pepto bismol can decrease diarrhea and do work well in individuals with diarrhea type IBS. However, both these drugs have side effects and can immediately turn the diarrheal IBS type into the constipation variety. Use of these drugs should be used with caution and one should start at very low doses.
Antidepressant and antianxiety medications
Of all the medications for IBS, anti depressants have had great success. Many anti depressants have been shown to relieve pain with very low doses. How anti depressants relieve pain is not well understood but is believed to be to due to an action in the brain. These drugs also help reduce diarrhea and improve mental status. Many studies have been conducted on antidepressants and their role in IBS. Overall about 30% of patients show improvement. Among patients who do respond, many stop using the drug because of side effects.
Among the anti depressant shown to be beneficial include amitriptyline, clomipramine (Anafranil), desipramine (Norpramin), doxepin (Sinequan), and trimipramine (Surmontil).
Paxil has also been demonstrated to work well in some patients with IBS. However, experience with these drugs is limited and is not recommended as first line therapy. Other drugs that have shown to be beneficial in some patients with IBS include the benzodiazepines. However, these drugs are expensive, have side effects including dependence, and can interact with alcohol. Currently these drugs are only recommended for short-term use in acute situations
There are many patients with IBS who get frequent abdominal cramps. These individuals may benefit from anti spasmodic agents. These drugs can help relax the intestine and reduce intensity of contractions. Some of the common anti spasmodic used to treat IBS include dicyclomine (Bentyl) and hyoscyamine (levsin). A number of studies have shown that these agents are significantly better than sugar pills at reducing abdominal distension and cramps but do not alter constipation. To date, these agents have only been evaluated for short-term efficacy and long-term results remain unknown.
Antidiarrheal agents
Both Imodium and pepto bismol can decrease diarrhea and do work well in individuals with diarrhea type IBS. However, both these drugs have side effects and can immediately turn the diarrheal IBS type into the constipation variety. Use of these drugs should be used with caution and one should start at very low doses.
Antidepressant and antianxiety medications
Of all the medications for IBS, anti depressants have had great success. Many anti depressants have been shown to relieve pain with very low doses. How anti depressants relieve pain is not well understood but is believed to be to due to an action in the brain. These drugs also help reduce diarrhea and improve mental status. Many studies have been conducted on antidepressants and their role in IBS. Overall about 30% of patients show improvement. Among patients who do respond, many stop using the drug because of side effects.
Among the anti depressant shown to be beneficial include amitriptyline, clomipramine (Anafranil), desipramine (Norpramin), doxepin (Sinequan), and trimipramine (Surmontil).
Paxil has also been demonstrated to work well in some patients with IBS. However, experience with these drugs is limited and is not recommended as first line therapy. Other drugs that have shown to be beneficial in some patients with IBS include the benzodiazepines. However, these drugs are expensive, have side effects including dependence, and can interact with alcohol. Currently these drugs are only recommended for short-term use in acute situations
Irritable bowel syndrome 101 part 4
Treatment
The treatment of IBS is difficult and no one treatment is adequate for all patients. The major emphasis of therapy focuses on changes in diet, drugs, behavior, and alternative therapies
Dietary therapy
It has been known that certain foods can trigger IBS symptoms. These foods include caffeine, citrus, corn, dairy lactose, wheat, and wheat gluten. The two most common foods that can worsen IBS include Lactose and caffeine. It is highly recommended that individuals who have IBS keep a diary to identify and avoid trigger foods. Based on elimination of certain foods, at least 50 percent of individuals can have a dramatic reduction in their condition.
The role of Probiotics and other dietary changes have not been effective in treatment of IBS. However, some patients develop symptoms that occur with all types of foods. These individuals are the most difficult to treat.
There are some experts who recommend dietary fiber for treating IBS. It is believe that fiber can hold more water, increases lubrication, and bulk of stools. The evidence for dietary fiber in treating IBS is not very strong. Some studies do show improvement, whereas others show no difference in symptoms.
However, individuals with IBS who have constipation should try out dietary fiber. Dietary fiber is cheap, readily available and very safe. Synthetic fibers can improve symptoms but produce more gas. Other fiber containing foods include psyllium and linseed, both of which are natural and provide good lubrication to stools. Wheat bran is good but should not be consumed by individuals who have gluten sensitivity.
Those individuals with IBS with slow transit time may show improvement with use of osmotic laxatives like magnesium salts, phosphate salts and polyethylene glycol. Other fiber substances that have been used include hydrolyzed guar gum. A number of studies have shown that guar gum is especially useful for individuals who cannot tolerate other fibers.
The treatment of IBS is difficult and no one treatment is adequate for all patients. The major emphasis of therapy focuses on changes in diet, drugs, behavior, and alternative therapies
Dietary therapy
It has been known that certain foods can trigger IBS symptoms. These foods include caffeine, citrus, corn, dairy lactose, wheat, and wheat gluten. The two most common foods that can worsen IBS include Lactose and caffeine. It is highly recommended that individuals who have IBS keep a diary to identify and avoid trigger foods. Based on elimination of certain foods, at least 50 percent of individuals can have a dramatic reduction in their condition.
The role of Probiotics and other dietary changes have not been effective in treatment of IBS. However, some patients develop symptoms that occur with all types of foods. These individuals are the most difficult to treat.
There are some experts who recommend dietary fiber for treating IBS. It is believe that fiber can hold more water, increases lubrication, and bulk of stools. The evidence for dietary fiber in treating IBS is not very strong. Some studies do show improvement, whereas others show no difference in symptoms.
However, individuals with IBS who have constipation should try out dietary fiber. Dietary fiber is cheap, readily available and very safe. Synthetic fibers can improve symptoms but produce more gas. Other fiber containing foods include psyllium and linseed, both of which are natural and provide good lubrication to stools. Wheat bran is good but should not be consumed by individuals who have gluten sensitivity.
Those individuals with IBS with slow transit time may show improvement with use of osmotic laxatives like magnesium salts, phosphate salts and polyethylene glycol. Other fiber substances that have been used include hydrolyzed guar gum. A number of studies have shown that guar gum is especially useful for individuals who cannot tolerate other fibers.
Irritable bowel syndrome 101 part 3
Tests for IBS
Common tests which are performed in patients suspected of IBS include:
Sigmoidoscopy- a test which uses a flexible scope passed through the rectum and examines lower colon
Colonoscopy uses a flexible scope with a camera but can examine the entire colon.
CT scan is used to examine the entire abdomen and pelvis. It does use radiation and a dye
Because symptoms of IBS are often similar to lactose intolerance, many individuals undergo a breath test to rule out it out.
The other disorder that is very similar in presentation to IBS is celiac disease. Thus, one may need to undergo some types of blood tests to determine presence of celiac disease
Affect on lifestyle
IBS is not life threatening but can interfere with personal life, relationships and friends. One becomes preoccupied with food and develops certain degree of paranoia. This often leads to a disturbed personality, anger, and isolation. One can even develop malnourishment if proper nutrients are not consumed.
Most patients seek help when symptoms affect quality of life. Because of the vague symptoms, the diagnosis of IBS is always delayed. However, even when the diagnosis is made, treatment is not always effective.
Pathophysiology
Why IBS occurs is a mystery. There are countless theories and speculations but the real reason for IBS is not known. The most likely factors that lead to development of IBS include disordered gut motility, increase sensitivity of intestines to food or chemicals, and increased contractions of gut. When these factors are combined, they can lead to constipation, diarrhea, abdominal bloating, nausea, and abnormal gas expulsion. Most individuals who have IBS are very sensitive to wheat and dairy products leading to rapid diarrhea, abdominal cramps, and gas production.
In each and every case, the symptoms can be very confusing and doctors generally try to rule out the most common abdominal disorders with radiological tests.
In all cases, IBS is a diagnosis of exclusion and often it takes several months to a year to make the diagnosis
Common tests which are performed in patients suspected of IBS include:
Sigmoidoscopy- a test which uses a flexible scope passed through the rectum and examines lower colon
Colonoscopy uses a flexible scope with a camera but can examine the entire colon.
CT scan is used to examine the entire abdomen and pelvis. It does use radiation and a dye
Because symptoms of IBS are often similar to lactose intolerance, many individuals undergo a breath test to rule out it out.
The other disorder that is very similar in presentation to IBS is celiac disease. Thus, one may need to undergo some types of blood tests to determine presence of celiac disease
Affect on lifestyle
IBS is not life threatening but can interfere with personal life, relationships and friends. One becomes preoccupied with food and develops certain degree of paranoia. This often leads to a disturbed personality, anger, and isolation. One can even develop malnourishment if proper nutrients are not consumed.
Most patients seek help when symptoms affect quality of life. Because of the vague symptoms, the diagnosis of IBS is always delayed. However, even when the diagnosis is made, treatment is not always effective.
Pathophysiology
Why IBS occurs is a mystery. There are countless theories and speculations but the real reason for IBS is not known. The most likely factors that lead to development of IBS include disordered gut motility, increase sensitivity of intestines to food or chemicals, and increased contractions of gut. When these factors are combined, they can lead to constipation, diarrhea, abdominal bloating, nausea, and abnormal gas expulsion. Most individuals who have IBS are very sensitive to wheat and dairy products leading to rapid diarrhea, abdominal cramps, and gas production.
In each and every case, the symptoms can be very confusing and doctors generally try to rule out the most common abdominal disorders with radiological tests.
In all cases, IBS is a diagnosis of exclusion and often it takes several months to a year to make the diagnosis
Wednesday, April 29, 2009
Do I need a Heart Scan? part 4
What happens if the calcium score is high?
Well, in theory it means that you have a risk of a heart attack. So one should start changing lifestyle, eat healthy, quit smoking, and reduce cholesterol. One should start to walk.
Can the machine be wrong?
Sure, like any machine, heart scan can create errors in interpretation. Sometimes the heart scan indicates you have calcium when there is in fact none. This is a false positive test and happens quite frequently. When a false positive test occurs, more studies are needed to confirm the results. This may involve undergoing a coronary angiography, more exposure to radiation, contrast dye and thus more expense.
On opposite side of the coin, if there is no calcium, then you just move on with your life as before without having to worry about a heart attack. However, one should be aware that coronary arteries can be very narrow or clogged up and yet not have calcium. In such a case, the heart scan may show there is no calcium but you may have serious blockage in your coronary vessels. This means the test is falsely negative. It shows you have no disease when you actually have disease.
Heart scan technology is still in infancy but is continuing to improve. Scientists are learning more about the role of calcium in heart disease and devising better machines.
In the meantime, one should not overlook the traditional risk factors that can increase your chance of developing heart disease. Moreover, remember that if you do have a heart scan, it is useful only if you actually follow up with your doctor and make lifestyle changes that can prevent worsening of heart disease
Final point
One of the reasons why medicine has become expensive is because of unscrupulous doctors offering unnecessary tests. There are hundreds of walk-in clinics and private health centers that offer quick scans which are nothing more than scams. These clinics falsely scare the public leading to unnecessary worries. These walk-in facilities rarely need any referrals. You just walk in, pay close to 1400 dollars, and you get your scan. The heart scans are not covered by medical insurance
As a consumer before you join the queue to get a heart scan, talk to your physician. Read about the procedure, get to understand your risk factors and ask yourself if the heart scan can make a difference in treatment. If you still decide to get a heart scan, make sure you go to a reputable center and get a copy of results sent to your physician.
Finally, if you do not have chest pain, shortness of breath and have no risks factors for heart disease, a heart scan is not recommended for you. If a physician still recommends a heart scan, you need a new doctor. The American College of Cardiology only recommends heart scans for individuals who have symptoms.
Well, in theory it means that you have a risk of a heart attack. So one should start changing lifestyle, eat healthy, quit smoking, and reduce cholesterol. One should start to walk.
Can the machine be wrong?
Sure, like any machine, heart scan can create errors in interpretation. Sometimes the heart scan indicates you have calcium when there is in fact none. This is a false positive test and happens quite frequently. When a false positive test occurs, more studies are needed to confirm the results. This may involve undergoing a coronary angiography, more exposure to radiation, contrast dye and thus more expense.
On opposite side of the coin, if there is no calcium, then you just move on with your life as before without having to worry about a heart attack. However, one should be aware that coronary arteries can be very narrow or clogged up and yet not have calcium. In such a case, the heart scan may show there is no calcium but you may have serious blockage in your coronary vessels. This means the test is falsely negative. It shows you have no disease when you actually have disease.
Heart scan technology is still in infancy but is continuing to improve. Scientists are learning more about the role of calcium in heart disease and devising better machines.
In the meantime, one should not overlook the traditional risk factors that can increase your chance of developing heart disease. Moreover, remember that if you do have a heart scan, it is useful only if you actually follow up with your doctor and make lifestyle changes that can prevent worsening of heart disease
Final point
One of the reasons why medicine has become expensive is because of unscrupulous doctors offering unnecessary tests. There are hundreds of walk-in clinics and private health centers that offer quick scans which are nothing more than scams. These clinics falsely scare the public leading to unnecessary worries. These walk-in facilities rarely need any referrals. You just walk in, pay close to 1400 dollars, and you get your scan. The heart scans are not covered by medical insurance
As a consumer before you join the queue to get a heart scan, talk to your physician. Read about the procedure, get to understand your risk factors and ask yourself if the heart scan can make a difference in treatment. If you still decide to get a heart scan, make sure you go to a reputable center and get a copy of results sent to your physician.
Finally, if you do not have chest pain, shortness of breath and have no risks factors for heart disease, a heart scan is not recommended for you. If a physician still recommends a heart scan, you need a new doctor. The American College of Cardiology only recommends heart scans for individuals who have symptoms.
Do I need a Heart Scan? part 3
What are risks of a heart scan?
Heart scan machine uses electron beam computerized tomography to assess calcium in your blood vessels. These scans exposure you to a lot of radiation- the same amount that you would receive from 30 chest x rays. Repeated heart scans could expose you to a lot of radiation and increase your risk of cancer. Further, anyone who is pregnant should never have a heart scan.
Heart scan can also be performed using CT angiography. Here you are administered a dye that could cause an allergic reaction and you are also exposed to a lot of radiation. The dye can even cause kidney failure or worsen damage to your kidneys.
There are no special preparations required for a heart scan at many of these walk in centers. The majority of these walk in centers are more interested in your finances than your heart. Only a brief history is obtained, a superficial physical exam is performed and your risk factors assessed. Rest assured, the heart scan will be done irrespective of your risks or symptoms. To these physicians the only thing of concern is whether you can pay for the scan.
How does Heart Scan work?
A heart scan usually takes less than 5-10 minutes. You come in and lie down on a flat table. There are no intravenous fluids, no needles or anesthesia. The table enters a small tunnel and the machine takes pictures of your heart. You hold your breath for a few second while the machine takes the pictures. The computer quickly draws up images of your blood vessels and calculates the calcium score.
Heart scan machine uses electron beam computerized tomography to assess calcium in your blood vessels. These scans exposure you to a lot of radiation- the same amount that you would receive from 30 chest x rays. Repeated heart scans could expose you to a lot of radiation and increase your risk of cancer. Further, anyone who is pregnant should never have a heart scan.
Heart scan can also be performed using CT angiography. Here you are administered a dye that could cause an allergic reaction and you are also exposed to a lot of radiation. The dye can even cause kidney failure or worsen damage to your kidneys.
There are no special preparations required for a heart scan at many of these walk in centers. The majority of these walk in centers are more interested in your finances than your heart. Only a brief history is obtained, a superficial physical exam is performed and your risk factors assessed. Rest assured, the heart scan will be done irrespective of your risks or symptoms. To these physicians the only thing of concern is whether you can pay for the scan.
How does Heart Scan work?
A heart scan usually takes less than 5-10 minutes. You come in and lie down on a flat table. There are no intravenous fluids, no needles or anesthesia. The table enters a small tunnel and the machine takes pictures of your heart. You hold your breath for a few second while the machine takes the pictures. The computer quickly draws up images of your blood vessels and calculates the calcium score.
Do I need a Heart Scan? part 2
There is still a lot of controversy about heart scans. If you have no family history, or risk factors then your risk of having a heart attack is very low. The heart scan in this instance will tell you what you and your doctor already know. In this case, the best advice is to get a second opinion and keep away from the physician who owns the machine.
Because of the rampant abuse of heart scans by physicians to generate income, the American College of Cardiology has developed guidelines to determine if you need a heart scan.
Individuals who do not need a heart Scan:
You do not need a heart scan if you are younger than age 55, have normal cholesterol, well controlled blood pressure and you do not smoke. In such a scenario, you have a very low risk of a heart attack. Since you are already at low risk, a heart scan will not tell the doctor anything new or what it not already known. The only thing a heart scan does in such a case is increase the doctor’s income by another $1,500.
A heart scan is not needed in individuals who have high cholesterol, high blood pressure, smoke and are over 65. these individuals are at high risk of a heart attack. Since both you and your doctor know this, a heart scan is useless. Hopefully, you have a decent doctor who will try and help you bring the cholesterol down and control your blood pressure. If you are smoking, you better quit. But you definitely do not need a heart scan
Individuals who have already had a heart attack should not have a heart scan because it does not tell anything new.
Individuals who have already had a open heart bypass should not have a heart scan because the scan can not reveal anything new. Similarly, individuals who have had angioplasty or ballooning of their coronaries should not have a heart scan. In all these cases, it is known that you are already at a high risk for a heart attack or have had one. So a heart scan is useless.
So when does one need a heart scan?
There are some individuals who fall some where in the middle. These individuals are in between the age of 55-65, may have borderline cholesterol, high blood pressure or may be light smokers. In such cases, the risk for a heart attack is not known. Thus, a heart scan may help determine the risk if you have any chest pain, especially if the doctor does not know what is causing your chest pain.
Because of the rampant abuse of heart scans by physicians to generate income, the American College of Cardiology has developed guidelines to determine if you need a heart scan.
Individuals who do not need a heart Scan:
You do not need a heart scan if you are younger than age 55, have normal cholesterol, well controlled blood pressure and you do not smoke. In such a scenario, you have a very low risk of a heart attack. Since you are already at low risk, a heart scan will not tell the doctor anything new or what it not already known. The only thing a heart scan does in such a case is increase the doctor’s income by another $1,500.
A heart scan is not needed in individuals who have high cholesterol, high blood pressure, smoke and are over 65. these individuals are at high risk of a heart attack. Since both you and your doctor know this, a heart scan is useless. Hopefully, you have a decent doctor who will try and help you bring the cholesterol down and control your blood pressure. If you are smoking, you better quit. But you definitely do not need a heart scan
Individuals who have already had a heart attack should not have a heart scan because it does not tell anything new.
Individuals who have already had a open heart bypass should not have a heart scan because the scan can not reveal anything new. Similarly, individuals who have had angioplasty or ballooning of their coronaries should not have a heart scan. In all these cases, it is known that you are already at a high risk for a heart attack or have had one. So a heart scan is useless.
So when does one need a heart scan?
There are some individuals who fall some where in the middle. These individuals are in between the age of 55-65, may have borderline cholesterol, high blood pressure or may be light smokers. In such cases, the risk for a heart attack is not known. Thus, a heart scan may help determine the risk if you have any chest pain, especially if the doctor does not know what is causing your chest pain.
Do I need a Heart Scan?
Everywhere in America, doctors have set up machines to screen the body. There are machines to screen your breasts, others machines to screen your lungs, others for your brain, your bones, your rectum, etc and now we have a machine to screen the heart. The heart scan is the latest device on market. With marketing ploys that frighten consumers like “you will die”, “you will get a heart attack” , “cholesterol is bad” and so on, these hyped up ads have been designed to scare consumers into thinking that death can occur any second from a heart attack.
Come-on doctors, Enough with these ads- relax, take a pill, get an enema and chill out.
What is a heart scan?
The heart scan is a technique that takes pictures of your heart and measures levels of calcium in your coronary vessels. You lie on a table, which enters a Tunnel with a camera. The camera takes pictures and in 5 minutes, it is all over- just $1,500 for this great procedure that can look at anatomy of your heart.
Physician now use heart scans to determine amount of calcium in your coronary vessels. If you have more calcium in your blood vessels, then it is bad. The higher the calcium score, the worse it is for you- at least this is what is speculated by the doctors who use heart scans.
Rather than go into mundane details, it is known that when cholesterol deposits in your blood vessels. Calcium also accumulates at the same time. Since we have no good way of measuring cholesterol deposits in a live human, the next best thing is to measure calcium levels. If the levels of calcium are high in your blood vessels, then it is bad.
The ads claims that if you have lot of calcium in your coronary vessels, you have a high risk of heart attack even if you do not have any symptoms- Such claims are bull because many people have calcium in their blood vessels and live a long healthy life without getting a heart attack.
Today, heart scans have popped up everywhere; in supermarkets, shopping centers, in every health care facility and plazas. Almost all doctors have a heart machine in their office or know of someone who has it. There are some doctors who own mobile heart scans that can come to your home.
Come-on doctors, Enough with these ads- relax, take a pill, get an enema and chill out.
What is a heart scan?
The heart scan is a technique that takes pictures of your heart and measures levels of calcium in your coronary vessels. You lie on a table, which enters a Tunnel with a camera. The camera takes pictures and in 5 minutes, it is all over- just $1,500 for this great procedure that can look at anatomy of your heart.
Physician now use heart scans to determine amount of calcium in your coronary vessels. If you have more calcium in your blood vessels, then it is bad. The higher the calcium score, the worse it is for you- at least this is what is speculated by the doctors who use heart scans.
Rather than go into mundane details, it is known that when cholesterol deposits in your blood vessels. Calcium also accumulates at the same time. Since we have no good way of measuring cholesterol deposits in a live human, the next best thing is to measure calcium levels. If the levels of calcium are high in your blood vessels, then it is bad.
The ads claims that if you have lot of calcium in your coronary vessels, you have a high risk of heart attack even if you do not have any symptoms- Such claims are bull because many people have calcium in their blood vessels and live a long healthy life without getting a heart attack.
Today, heart scans have popped up everywhere; in supermarkets, shopping centers, in every health care facility and plazas. Almost all doctors have a heart machine in their office or know of someone who has it. There are some doctors who own mobile heart scans that can come to your home.
Monday, April 20, 2009
Overactive bladder and incontinence part 9
Surgery
There are several types of surgical procedures to help individuals with an overactive bladder. Surgery is usually the last resort after the individual has failed lifestyle changes and drug treatment. Surgery should never be the first choice as the results are not that good. In fact, most individuals remain dis-satisfied with results of surgery.
Surgery is essentially done to improve the bladder’s storing ability and relax the muscles.
Surgical interventions include:
Stimulation of pelvic nerves. The nerves running from the spinal cord to the bladder (sacral nerves) are the target. The activity of these nerves is altered with the use of an electrical device. A very thin wire is placed near your tailbone and connected to a small pacemaker placed underneath your skin. The device is programmed to deliver very low current that relaxes the bladder. Like any electrical device, there are a number of technical problems and it often fails to work.
Enlarging the bladder (Augmentation cystoplasty). Some surgeons can increase capacity of the bladder by using a piece of bowel. This is a major undertaking. Because bowel does not have strong muscles, one constantly retains urine and thus, life long use of a catheter is a must. Enlargement of the bladder is a surgical procedure with a lot of risks and complications; it is only done when everything else has failed. The decision to undergo such surgery should not be undertaken lightly. Incontinence can be a difficult disorder to live with, but some of the complications from augmentation cystoplasty can make things a lot worse.
Detrusor Myectomy: There is another procedure that can thin or remove part of the muscle surrounding the bladder. This helps to strengthen the bladder and also avoids recurrent muscle contractions. The procedure is still in its infancy and results are not guaranteed.
Laser has also been used to relax or destroy the muscles around the hyperactive bladder. Laser is not a a magic bullet for overflow incontinence and often fails to work. The treatment is painful and the results are only temporary. Laser is also expensive.
Final Note
For those who are affected with an overactive bladder, there are many national and local organizations that provide support to other members. These support organizations offer the latest advice, coping methods and help improve self-esteem. These local chapters can be found on the internet under "incontinence support."
The other problem with incontinence is that most of the lay public and even many health care professionals remain clueless about this devastating disorder. Educating these individuals can help improve understanding and alleviate embarrassment.
There are several types of surgical procedures to help individuals with an overactive bladder. Surgery is usually the last resort after the individual has failed lifestyle changes and drug treatment. Surgery should never be the first choice as the results are not that good. In fact, most individuals remain dis-satisfied with results of surgery.
Surgery is essentially done to improve the bladder’s storing ability and relax the muscles.
Surgical interventions include:
Stimulation of pelvic nerves. The nerves running from the spinal cord to the bladder (sacral nerves) are the target. The activity of these nerves is altered with the use of an electrical device. A very thin wire is placed near your tailbone and connected to a small pacemaker placed underneath your skin. The device is programmed to deliver very low current that relaxes the bladder. Like any electrical device, there are a number of technical problems and it often fails to work.
Enlarging the bladder (Augmentation cystoplasty). Some surgeons can increase capacity of the bladder by using a piece of bowel. This is a major undertaking. Because bowel does not have strong muscles, one constantly retains urine and thus, life long use of a catheter is a must. Enlargement of the bladder is a surgical procedure with a lot of risks and complications; it is only done when everything else has failed. The decision to undergo such surgery should not be undertaken lightly. Incontinence can be a difficult disorder to live with, but some of the complications from augmentation cystoplasty can make things a lot worse.
Detrusor Myectomy: There is another procedure that can thin or remove part of the muscle surrounding the bladder. This helps to strengthen the bladder and also avoids recurrent muscle contractions. The procedure is still in its infancy and results are not guaranteed.
Laser has also been used to relax or destroy the muscles around the hyperactive bladder. Laser is not a a magic bullet for overflow incontinence and often fails to work. The treatment is painful and the results are only temporary. Laser is also expensive.
Final Note
For those who are affected with an overactive bladder, there are many national and local organizations that provide support to other members. These support organizations offer the latest advice, coping methods and help improve self-esteem. These local chapters can be found on the internet under "incontinence support."
The other problem with incontinence is that most of the lay public and even many health care professionals remain clueless about this devastating disorder. Educating these individuals can help improve understanding and alleviate embarrassment.
Overactive bladder and incontinence part 8
Medications
Unlike may other bladder disorders, there are some decent medications that can treat overflow incontinence. These medications all work in the same manner. They relax the bladder muscles and reduce urge incontinence. The available drugs include
- tolterodine (Detrol)
- oxybutynin (Ditropan)
- oxybutynin skin patch (Oxytrol)
- trospium (Sanctura)
- solifenacin (Vesicare)
- darifenacin (Enablex).
For the best effects, it is highly recommended that these medications be combined with above mentioned lifestyle changes. There is a lot of clinical evidence showing that these drugs do work for hyperactive bladder but the problem is never cured. The treatment has to be continued for many months. Relapse is very common when drug treatment is stopped.
The major problem with the above drugs is side effects. Most individuals develop some type of side effect over time. The longer the treatment continues, the more prominent side effects become. The typical side effects of anti cholinergic drugs include
- Dry eye sensation
- Dry mouth
- Excessive thirst
- Headaches
- Nausea
- Constipation
To limit or eliminate these side effects, there are now some extended release preparations that can be applied as a skin patch. If dry mouth or dry eye sensation persists, one should use sugar free candy, apply eye drops or use products like Biotene that can help moisten the mouth for long periods
Botox
There is some anecdotal evidence that Botox can help relieve overflow incontinence. Botox can paralyze bladder muscles and reduce the urge to pee. Research is still ongoing and Botox has not yet been approved for use in this disorder. Some reports indicate that Botox when injected into bladder muscles can provide relief for as long as 4-6 months. However, it has also been observed that Botox injections in older men can create another problem- retention of urine. One develops a feeling of a full bladder but is unable to void. Often the only way to resolve this problem is to use a catheter to empty the bladder.
Unlike may other bladder disorders, there are some decent medications that can treat overflow incontinence. These medications all work in the same manner. They relax the bladder muscles and reduce urge incontinence. The available drugs include
- tolterodine (Detrol)
- oxybutynin (Ditropan)
- oxybutynin skin patch (Oxytrol)
- trospium (Sanctura)
- solifenacin (Vesicare)
- darifenacin (Enablex).
For the best effects, it is highly recommended that these medications be combined with above mentioned lifestyle changes. There is a lot of clinical evidence showing that these drugs do work for hyperactive bladder but the problem is never cured. The treatment has to be continued for many months. Relapse is very common when drug treatment is stopped.
The major problem with the above drugs is side effects. Most individuals develop some type of side effect over time. The longer the treatment continues, the more prominent side effects become. The typical side effects of anti cholinergic drugs include
- Dry eye sensation
- Dry mouth
- Excessive thirst
- Headaches
- Nausea
- Constipation
To limit or eliminate these side effects, there are now some extended release preparations that can be applied as a skin patch. If dry mouth or dry eye sensation persists, one should use sugar free candy, apply eye drops or use products like Biotene that can help moisten the mouth for long periods
Botox
There is some anecdotal evidence that Botox can help relieve overflow incontinence. Botox can paralyze bladder muscles and reduce the urge to pee. Research is still ongoing and Botox has not yet been approved for use in this disorder. Some reports indicate that Botox when injected into bladder muscles can provide relief for as long as 4-6 months. However, it has also been observed that Botox injections in older men can create another problem- retention of urine. One develops a feeling of a full bladder but is unable to void. Often the only way to resolve this problem is to use a catheter to empty the bladder.
Overactive bladder and incontinence part 7
Mattress covers: If incontinence causes accidents at night, then one should use mattress covers. Today, a whole range of mattress covers are available. The fabrics include linen, cotton, reinforced cotton, plastic and even soft flexible sheet protectors. These covers are often reinforced with extra padding to make cleaning easier. Many of these products also are anti deodorants impregnated into the lining to prevent urine odor.
Absorbent briefs designed for both men, women and children are now available. These briefs also protect outer garments and bed linen. Many of these briefs can be reused and are made from nylon. The waist and leg bands lined with elastic provide a good seal and protection. These fabrics are washable and come in many sizes. Those who have soft,fair, fragile skin and are prone to irritation should use disposable briefs.
Skincare: All individuals with incontinence should take good care of their skin. There are many products on the market to keep skin clean. It is essential to get a product which is fragrance free, free of synthetic chemicals and not irritating to the skin. Besides creams, there are lotions, sprays, soaps and ointments to keep skin clean
Absorbent briefs designed for both men, women and children are now available. These briefs also protect outer garments and bed linen. Many of these briefs can be reused and are made from nylon. The waist and leg bands lined with elastic provide a good seal and protection. These fabrics are washable and come in many sizes. Those who have soft,fair, fragile skin and are prone to irritation should use disposable briefs.
Skincare: All individuals with incontinence should take good care of their skin. There are many products on the market to keep skin clean. It is essential to get a product which is fragrance free, free of synthetic chemicals and not irritating to the skin. Besides creams, there are lotions, sprays, soaps and ointments to keep skin clean
Overactive bladder and incontinence part 6
Void twice. In some individuals the need to urinate develops very rapidly after voiding. In this case, always void twice and see this may help reduce the urge to urinate. The second voiding may empty completely empty the bladder and decrease the urge episodes.
Schedule your bathroom visits. Some people only go to the bathroom when there is an urge to void. This can make lifestyle difficult especially when there is no bathroom around. So make a habit of going to the bathroom at scheduled times. This will significantly decrease urge episodes. Try going to void every 2-4 hours. While this does not cure the problem, at least you will not pee in your pants all the time
Learn kegel exercise. Kegel exercises can increase strength in the pelvis floor muscles in some women. In the majority of cases, kegel exercise do help women who are premenopausal. Women who are postmenopausal generally do not obtain the same benefit from kegel exercises. Kegel exercises are not a one shot deal. The exercises have to be regularly practiced for months to strengthen muscles. These important muscles of the pelvic floor may help reduce overflow incontinence. The average time before one notices any benefit from kegel exercises is about 8-12 weeks. These exercises can help one enjoy sexual intercourse, reduce lower pelvic pain and increase flexibility of the lower pelvis. Unfortunately, many women see no difference with kegel exercises. Kegel exercises have been hyped up to treat a variety of female disorders but often the benefits are mild to moderate. Kegel exercise can be learnt from a physical therapist or from your physician.
Intermittent catheterization is a technique used to empty the bladder in some people. The catheter is passed in through the urethra into the bladder. In most cases intermittent catheterization technique is useful in patients with Multiple sclerosis, stroke, or those who are recovering from a stroke. In otherwise healthy people, frequent intermittent catheterization can also lead to infections when the procedure is not done properly. Intermittent catheterization is not a technique that should be started spontaneously by the patient. One needs to talk to the physician to determine the number of times, when to do it and also how do it. When done sterilely, the technique does work quite well. However, one has to carry a catheter and supplies everywhere. This can be expensive in the long run.
Absorbent pads. Today, there are many types of incontinent pads that can make a big difference in a patient’s life. The latest undergarments are soft, absorb well, prevent odor and help avoid accidents.
Weight control is a very important aspect of incontinence care. Obesity always worsens incontinence. So cut down on your weight, exercise regularly and change your lifestyle.
Schedule your bathroom visits. Some people only go to the bathroom when there is an urge to void. This can make lifestyle difficult especially when there is no bathroom around. So make a habit of going to the bathroom at scheduled times. This will significantly decrease urge episodes. Try going to void every 2-4 hours. While this does not cure the problem, at least you will not pee in your pants all the time
Learn kegel exercise. Kegel exercises can increase strength in the pelvis floor muscles in some women. In the majority of cases, kegel exercise do help women who are premenopausal. Women who are postmenopausal generally do not obtain the same benefit from kegel exercises. Kegel exercises are not a one shot deal. The exercises have to be regularly practiced for months to strengthen muscles. These important muscles of the pelvic floor may help reduce overflow incontinence. The average time before one notices any benefit from kegel exercises is about 8-12 weeks. These exercises can help one enjoy sexual intercourse, reduce lower pelvic pain and increase flexibility of the lower pelvis. Unfortunately, many women see no difference with kegel exercises. Kegel exercises have been hyped up to treat a variety of female disorders but often the benefits are mild to moderate. Kegel exercise can be learnt from a physical therapist or from your physician.
Intermittent catheterization is a technique used to empty the bladder in some people. The catheter is passed in through the urethra into the bladder. In most cases intermittent catheterization technique is useful in patients with Multiple sclerosis, stroke, or those who are recovering from a stroke. In otherwise healthy people, frequent intermittent catheterization can also lead to infections when the procedure is not done properly. Intermittent catheterization is not a technique that should be started spontaneously by the patient. One needs to talk to the physician to determine the number of times, when to do it and also how do it. When done sterilely, the technique does work quite well. However, one has to carry a catheter and supplies everywhere. This can be expensive in the long run.
Absorbent pads. Today, there are many types of incontinent pads that can make a big difference in a patient’s life. The latest undergarments are soft, absorb well, prevent odor and help avoid accidents.
Weight control is a very important aspect of incontinence care. Obesity always worsens incontinence. So cut down on your weight, exercise regularly and change your lifestyle.
Overactive bladder and incontinence part 5
Lifestyle changes
Lifestyle or behavioral modifications are the first step in management of an overactive bladder. The consumer has to understand that changes in lifestyle are not a cure for overflow incontinence. In many cases, these simple lifestyle changes can have a dramatic reduction in incontinence episodes.
The few lifestyles changes for overflow incontinence include:
Drink less fluids. Once a diagnosis of overflow incontinence has been made, watch how much you drink. The more you drink, the greater is the urge to urinate. So minimize your fluids but do not dehydrate yourself or remain thirsty.
Drink appropriate fluids: Some fluids which make incontinence worse are beverages containing caffeine and alcohol. Both tea and coffee should only be consumed on a minimal basis. Alcohol is probably the worst drink for all individuals with overflow incontinence. The best advice is quit alcohol.
Watch your diet. Often overflow incontinence is associated with constipation. The bowels sit on top of the bladder and when impacted with stools can compress the bladder. To avoid constipation, eat lots of fiber.
Bladder training is a protocol where one learns to cope with the urge to urinate. Over time, bladder training relaxes the bladder. One can try delaying going to urinate a few minutes every time there is an urge to urinate. Try to gradually prolong this time period by a few minutes over a few weeks or even months. Some individuals can teach the bladder to relax with this method. However, for the majority this method really does not work.
Lifestyle or behavioral modifications are the first step in management of an overactive bladder. The consumer has to understand that changes in lifestyle are not a cure for overflow incontinence. In many cases, these simple lifestyle changes can have a dramatic reduction in incontinence episodes.
The few lifestyles changes for overflow incontinence include:
Drink less fluids. Once a diagnosis of overflow incontinence has been made, watch how much you drink. The more you drink, the greater is the urge to urinate. So minimize your fluids but do not dehydrate yourself or remain thirsty.
Drink appropriate fluids: Some fluids which make incontinence worse are beverages containing caffeine and alcohol. Both tea and coffee should only be consumed on a minimal basis. Alcohol is probably the worst drink for all individuals with overflow incontinence. The best advice is quit alcohol.
Watch your diet. Often overflow incontinence is associated with constipation. The bowels sit on top of the bladder and when impacted with stools can compress the bladder. To avoid constipation, eat lots of fiber.
Bladder training is a protocol where one learns to cope with the urge to urinate. Over time, bladder training relaxes the bladder. One can try delaying going to urinate a few minutes every time there is an urge to urinate. Try to gradually prolong this time period by a few minutes over a few weeks or even months. Some individuals can teach the bladder to relax with this method. However, for the majority this method really does not work.
Overactive bladder and incontinence part 4
Diagnosis
The diagnosis of an overactive bladder is generally made from the medical history. The physical exam may include evaluation of the prostate via a rectal exam. Urine is generally analyzed to ensure that there is no urinary tract infection. A neurological exam is done to identify any nerve defects.
There many tests which are used to assess overactive bladders. Some of the tests may include
Measurements of post void residual urine. In this test, one is asked to void and remaining urine in the bladder is measured. The test requires you have a small tube placed via the urethra (penis in male, and vagina in female) and into the bladder. Once you have voided, the tube is inserted and the residual urine volume is measured. The test is unpleasant because having a tube placed via the penis/vagina is absolutely not thrilling. Some health care workers now use ultrasound to measure the amount of urine remaining in the bladder
Uroflowmetry is a device that can measure volume and speed of voiding. This is then compared against other individuals and can be used to monitor progress of disease
Cystometry and pressure flow studies simply measure when the bladder will contract when it is filling with fluid. The bladder is filled with fluid and then another recording device measures activity of bladder muscles. The pressure which is developed to empty the bladder is measured.
Electromyography is a test to assess coordination of nerve impulses in bladder muscles and urethra. These sensors are placed on skin around the urethra and lower pelvis
Video urodynamics. This technique uses either x rays or ultrasound and combines one of the above studies to monitor active bladder filling and contraction. The fluid is a special dye that can be visualized on x ray
Cystoscopy involves inserting a small thin tube with a camera from vagina or penis into the urethra and in the bladder. This device is often used to check for anatomical defects, presence of stones or cancers
Once diagnosis of overactive bladder is made, there are several treatments available. The treatment usually starts with conservative care and lifestyle changes
The diagnosis of an overactive bladder is generally made from the medical history. The physical exam may include evaluation of the prostate via a rectal exam. Urine is generally analyzed to ensure that there is no urinary tract infection. A neurological exam is done to identify any nerve defects.
There many tests which are used to assess overactive bladders. Some of the tests may include
Measurements of post void residual urine. In this test, one is asked to void and remaining urine in the bladder is measured. The test requires you have a small tube placed via the urethra (penis in male, and vagina in female) and into the bladder. Once you have voided, the tube is inserted and the residual urine volume is measured. The test is unpleasant because having a tube placed via the penis/vagina is absolutely not thrilling. Some health care workers now use ultrasound to measure the amount of urine remaining in the bladder
Uroflowmetry is a device that can measure volume and speed of voiding. This is then compared against other individuals and can be used to monitor progress of disease
Cystometry and pressure flow studies simply measure when the bladder will contract when it is filling with fluid. The bladder is filled with fluid and then another recording device measures activity of bladder muscles. The pressure which is developed to empty the bladder is measured.
Electromyography is a test to assess coordination of nerve impulses in bladder muscles and urethra. These sensors are placed on skin around the urethra and lower pelvis
Video urodynamics. This technique uses either x rays or ultrasound and combines one of the above studies to monitor active bladder filling and contraction. The fluid is a special dye that can be visualized on x ray
Cystoscopy involves inserting a small thin tube with a camera from vagina or penis into the urethra and in the bladder. This device is often used to check for anatomical defects, presence of stones or cancers
Once diagnosis of overactive bladder is made, there are several treatments available. The treatment usually starts with conservative care and lifestyle changes
Overactive bladder and incontinence part 3
What causes overflow incontinence?
Most of us have no problems with urination. The bladder is about the size of I-1.5 liter muscular pocket. The muscles have a complex set of nerves, which sense filling of the bladder. There are also other nerves that relax the bladder when the bladder is filling with urine. When the bladder capacity has reached a certain limit, the nerves stimulate muscles and the bladder empties. The outflow of bladder known as the urethra also has complex network of nerves that prevent the urine from running out of the bladder continuously. When the bladder contracts the urethra relaxes and the urine flows out.
Why the bladder muscles start to contract prematurely is not known. In the majority of cases, no cause of an overactive bladder is ever identified. Some neurological disorders which cause an overactive bladder include multiple sclerosis. Parkinson’s, stroke or chronic diabetes
Factors that can aggravate an overactive bladder include:
- excess fluid intake
- poor kidney function
- diabetes
- urinary tract infection
- anatomical abnormalities of bladder/ureter
- bladder cancer
- bladder stones
- excess consumption of coffee beverages
- excess consumption of alcoholic beverages
- certain medications that increase urine production
like diuretics
Who is prone to developing an over active bladder?
The two most common disorders, which are associated with overactive bladder are diabetes and enlarged prostate in men
Most of us have no problems with urination. The bladder is about the size of I-1.5 liter muscular pocket. The muscles have a complex set of nerves, which sense filling of the bladder. There are also other nerves that relax the bladder when the bladder is filling with urine. When the bladder capacity has reached a certain limit, the nerves stimulate muscles and the bladder empties. The outflow of bladder known as the urethra also has complex network of nerves that prevent the urine from running out of the bladder continuously. When the bladder contracts the urethra relaxes and the urine flows out.
Why the bladder muscles start to contract prematurely is not known. In the majority of cases, no cause of an overactive bladder is ever identified. Some neurological disorders which cause an overactive bladder include multiple sclerosis. Parkinson’s, stroke or chronic diabetes
Factors that can aggravate an overactive bladder include:
- excess fluid intake
- poor kidney function
- diabetes
- urinary tract infection
- anatomical abnormalities of bladder/ureter
- bladder cancer
- bladder stones
- excess consumption of coffee beverages
- excess consumption of alcoholic beverages
- certain medications that increase urine production
like diuretics
Who is prone to developing an over active bladder?
The two most common disorders, which are associated with overactive bladder are diabetes and enlarged prostate in men
Overactive bladder and incontinence part 2
Symptoms of overactive bladder
In all individuals the classic symptoms include of an overactive bladder include:
A very strong urge to urinate. Any delay in going to the bathroom leads to leaking of urine. Once the urine stream starts, it is impossible to stop in the middle. Accidents are common. Because of the fear of accidents, many individuals adopt a lifestyle which is restrictive and confined to the home and work. Whenever the individual ventures out, he/she will first locate the bathrooms
Many individuals urinate anywhere from 8-12 times in 24 hours. Sometimes the urge only leads to a few drops of urine and the urge persists even after emptying of bladder
Most individuals wake up 2-4 times a night to urinate
The most troublesome feature of overactive bladder is that the urge to urinate makes daily living every difficult. One cannot make any plans such as travel, going to movies or attend social functions. When the urge comes, most people need to get to a bathroom right away. Thus, most individuals with this diagnosis always sit close to bathrooms and know locations of all bathrooms where they work.
One of the biggest problems with overflow incontinence is that most people are unwilling to seek medical help for fear of embarrassment. Many individuals today simply avoid proper treatment by wearing undergarments, over flow absorbent pads or wearing plastic diapers. It is important for individuals with this problem to seek help because the cause of overflow can be treated and in some cases it may be an early cancer which can be removed.
In all individuals the classic symptoms include of an overactive bladder include:
A very strong urge to urinate. Any delay in going to the bathroom leads to leaking of urine. Once the urine stream starts, it is impossible to stop in the middle. Accidents are common. Because of the fear of accidents, many individuals adopt a lifestyle which is restrictive and confined to the home and work. Whenever the individual ventures out, he/she will first locate the bathrooms
Many individuals urinate anywhere from 8-12 times in 24 hours. Sometimes the urge only leads to a few drops of urine and the urge persists even after emptying of bladder
Most individuals wake up 2-4 times a night to urinate
The most troublesome feature of overactive bladder is that the urge to urinate makes daily living every difficult. One cannot make any plans such as travel, going to movies or attend social functions. When the urge comes, most people need to get to a bathroom right away. Thus, most individuals with this diagnosis always sit close to bathrooms and know locations of all bathrooms where they work.
One of the biggest problems with overflow incontinence is that most people are unwilling to seek medical help for fear of embarrassment. Many individuals today simply avoid proper treatment by wearing undergarments, over flow absorbent pads or wearing plastic diapers. It is important for individuals with this problem to seek help because the cause of overflow can be treated and in some cases it may be an early cancer which can be removed.
Overactive bladder and incontinence
What is an overactive bladder?
There are many individuals who just can’t control the bladder. The urge to urinate becomes so great that one cannot not sit still. Many individuals develop such strong urges to pee that they cannot sit through a meeting, attend any type of social or academic function and need to go the bathroom many times a day. While in many cases, there is relief after emptying the bladder, the urge to urinate persists and is recurrent.
Overactive bladder is a disorder associated with a severe urge to urinate all the time. This urge generally is impossible to suppress. This often leads to involuntary loss of urine- this means you pee in your pants if there is any delay in finding a bathroom.
An overactive bladder can be a real hassle, it create social difficulties, isolation, depression and can limit development of friendships. However, unlike many other bladder problems, an overactive bladder is one disorder that can be successfully treated in many cases.
Tuesday, April 14, 2009
Physical therapy and back pain part 2
When does physical therapy start?
After the acute back pain has subsided with bed rest and use of pain medications, most individuals are encouraged to enter a physical therapy program. Because of ongoing pain, the initial physical therapy is limited to improving mobility and there is little weight training. The majority of physical therapy centers offer excellent therapists who understand the problem and know what is required to get the individual back on their feet.
Rest assured, you will not be immersed into intense physical therapy the first day you arrive. In all cases, the therapist will assess and physically examine you to ensure that you are fit for physical therapy. The therapist will assess your degree of pain threshold, mobility, flexibility, and limitations and then prescribe an exercise program to fit your condition.
There is a lot of evidence that shows physical therapy is better able to treat individuals with mild or moderate back pain. Evidence now indicates that when regularly performed, both passive and active therapy can relieve back pain. Passive physical therapy programs consist of application of heat or ice packs, use of TENS unit and application of ultrasound. Passive modalities of physical therapy treatment work well in the early phase of back pain. Also included in physical therapy are massages, heat, diathermy, and hydrotherapy.
Once the individual has a decrease in back pain, active physical therapy is undertaken. This involves muscle stretching, improving range of motion exercises, gradual muscle strengthening, pain relieving movements and aerobic conditioning. Over time, many cases of back pain can be significantly improved with strengthening of back muscles.
For residual back pain, one may also undergo various spinal decompression treatments including use of traction devices.
If the pain continues, one can wear a brace or corset, which can be worn both during exercises and at rest. These braces help support the back, improve posture and assist with mobility. Braces can be bought from any medical supply store.
Physical therapy for back pain gives different results for different patients. No two individuals obtain the same response. Because each individual has a distinct body shape, anatomy, build, and physique, the benefits also vary. After a program of 2-4 months, most individual with back pain should see some improvement. Following this, one can be taught to undertake physical therapy exercises at home. These exercises can help improve posture and prevent back pain from coming back.
The major problem with physical therapy is that most people seem to think it is a bunch of useless exercises. Sure, physical therapy is not a magic bullet, nor does it work in everyone- but it is perhaps the best treatment for back pain- bar none. No available treatment for back pain can match the outcomes of physical therapy
Physical therapy is not a one shot deal and needs motivation, patience, and dedication. One may start off once a week and progress from that point. Physical therapy is also not a quick fix to back pain and requires time- perhaps 3-6 months. Nevertheless, in the long run, this therapy is safer, cheaper, and more effective than surgery or any other decompression treatment.
Once back pain has resolved, it is vital to maintain a decent weight, continue with exercises, and remain active.
for back pain braces and traction devices, visit www.medexsupply.com
After the acute back pain has subsided with bed rest and use of pain medications, most individuals are encouraged to enter a physical therapy program. Because of ongoing pain, the initial physical therapy is limited to improving mobility and there is little weight training. The majority of physical therapy centers offer excellent therapists who understand the problem and know what is required to get the individual back on their feet.
Rest assured, you will not be immersed into intense physical therapy the first day you arrive. In all cases, the therapist will assess and physically examine you to ensure that you are fit for physical therapy. The therapist will assess your degree of pain threshold, mobility, flexibility, and limitations and then prescribe an exercise program to fit your condition.
There is a lot of evidence that shows physical therapy is better able to treat individuals with mild or moderate back pain. Evidence now indicates that when regularly performed, both passive and active therapy can relieve back pain. Passive physical therapy programs consist of application of heat or ice packs, use of TENS unit and application of ultrasound. Passive modalities of physical therapy treatment work well in the early phase of back pain. Also included in physical therapy are massages, heat, diathermy, and hydrotherapy.
Once the individual has a decrease in back pain, active physical therapy is undertaken. This involves muscle stretching, improving range of motion exercises, gradual muscle strengthening, pain relieving movements and aerobic conditioning. Over time, many cases of back pain can be significantly improved with strengthening of back muscles.
For residual back pain, one may also undergo various spinal decompression treatments including use of traction devices.
If the pain continues, one can wear a brace or corset, which can be worn both during exercises and at rest. These braces help support the back, improve posture and assist with mobility. Braces can be bought from any medical supply store.
Physical therapy for back pain gives different results for different patients. No two individuals obtain the same response. Because each individual has a distinct body shape, anatomy, build, and physique, the benefits also vary. After a program of 2-4 months, most individual with back pain should see some improvement. Following this, one can be taught to undertake physical therapy exercises at home. These exercises can help improve posture and prevent back pain from coming back.
The major problem with physical therapy is that most people seem to think it is a bunch of useless exercises. Sure, physical therapy is not a magic bullet, nor does it work in everyone- but it is perhaps the best treatment for back pain- bar none. No available treatment for back pain can match the outcomes of physical therapy
Physical therapy is not a one shot deal and needs motivation, patience, and dedication. One may start off once a week and progress from that point. Physical therapy is also not a quick fix to back pain and requires time- perhaps 3-6 months. Nevertheless, in the long run, this therapy is safer, cheaper, and more effective than surgery or any other decompression treatment.
Once back pain has resolved, it is vital to maintain a decent weight, continue with exercises, and remain active.
for back pain braces and traction devices, visit www.medexsupply.com
Physical therapy and back pain
There is no question that physical therapy is of enormous benefit to individuals with back pain. Some health care professionals highly recommend this treatment to patients with back pain. One of the problems with treatment for back pain is that the business has become lucrative. Some physicians only send patients for treatments which are exorbitantly expensive and where they make some money. For example, surgeons tend to recommend surgery or pain injections.
While medications can relieve back pain, they do not cure the problem. Even the pain relief with medications is temporary. While physical therapy was never strongly emphasized in the past, it is now appreciated that physical therapy alone is far superior than many other treatments available for back pain. Today, the trend is to push individuals with back pain to enter physical therapy programs because of the dismal failure of surgery and other spinal decompression modalities.
Over the past two decades, a lot of evidence has accumulated that reveals the benefits of physical therapy. When done properly, physical therapy can help the process of healing much faster, reduce pain more effectively and also prevent recurrent episodes of back pain. Unlike the past, physical therapy is much more refined. It is not simply lifting weights or jogging around on a track. The specialty is individually designed to help the individual build strength, improve posture, increase flexibility, and adjust his/her lifestyle.
Physical therapy today focuses more on prevention and promotion of healing. In each and every case, physical therapy aims to restore function and increase mobility in the individual.
While medications can relieve back pain, they do not cure the problem. Even the pain relief with medications is temporary. While physical therapy was never strongly emphasized in the past, it is now appreciated that physical therapy alone is far superior than many other treatments available for back pain. Today, the trend is to push individuals with back pain to enter physical therapy programs because of the dismal failure of surgery and other spinal decompression modalities.
Over the past two decades, a lot of evidence has accumulated that reveals the benefits of physical therapy. When done properly, physical therapy can help the process of healing much faster, reduce pain more effectively and also prevent recurrent episodes of back pain. Unlike the past, physical therapy is much more refined. It is not simply lifting weights or jogging around on a track. The specialty is individually designed to help the individual build strength, improve posture, increase flexibility, and adjust his/her lifestyle.
Physical therapy today focuses more on prevention and promotion of healing. In each and every case, physical therapy aims to restore function and increase mobility in the individual.
Monday, April 13, 2009
Can H pylori be transmitted sexually or by kissing?
H pylori is a spiral shaped bacterium which is most likely acquired during childhood. It is believed that poor sanitation, drinking contaminated water, and lack of sanitation facilities contribute to infection with this organism. However, 90% of individuals who do acquire H pylori never develop any symptoms. In some individuals, H pylori has been shown to cause peptic ulcer disease.
The acute infection may present with abdominal pain, bloating, belching, nausea, excess gas, or bad breath. Almost all patients who have had confirmed endoscopic evidence of peptic ulcer disease are known to be infected with H pylori. Further, there is now strong evidence linking H pylori to development of stomach cancers. Why only some individuals develop stomach cancer remains a mystery. In fact, this association is even more puzzling because the incidence of stomach cancer has gone down in the last 2 decades but infection with H pylori has gone up.
However, the question remains, can H pylori be passed on to your partner, family, or child either orally or sexually? No one seems to know as the problem has never been studied. One fact needs to be understood- H pylori is a not sexually transmitted organism but whether it can be transmitted via sex is unknown. There is always the possibility that simple kissing can transmit H pylori, but so far, no such reports exist. Because of routine practice of oral sex in most relationships, this may be another method of H pylori transfer to the partner. But again, there are no reports to confirm such a possibility.
In any case, even if H pylori is acquired, it can be easily treated. In most cases, a 10-14 day treatment with an antibiotic and an acid suppressive drug is all that is required.
The acute infection may present with abdominal pain, bloating, belching, nausea, excess gas, or bad breath. Almost all patients who have had confirmed endoscopic evidence of peptic ulcer disease are known to be infected with H pylori. Further, there is now strong evidence linking H pylori to development of stomach cancers. Why only some individuals develop stomach cancer remains a mystery. In fact, this association is even more puzzling because the incidence of stomach cancer has gone down in the last 2 decades but infection with H pylori has gone up.
However, the question remains, can H pylori be passed on to your partner, family, or child either orally or sexually? No one seems to know as the problem has never been studied. One fact needs to be understood- H pylori is a not sexually transmitted organism but whether it can be transmitted via sex is unknown. There is always the possibility that simple kissing can transmit H pylori, but so far, no such reports exist. Because of routine practice of oral sex in most relationships, this may be another method of H pylori transfer to the partner. But again, there are no reports to confirm such a possibility.
In any case, even if H pylori is acquired, it can be easily treated. In most cases, a 10-14 day treatment with an antibiotic and an acid suppressive drug is all that is required.
Thursday, April 2, 2009
VAX-D for back pain Part 5
When will I feel better after VAX -D?
The honest reply is NEVER. VAX- D does not produce results immediately. From the reports by the providers of VAX-D , it is felt that you will feel great after 6-8 sessions. Maximal benefit is obtained after 15-20 treatments. The pain relief may last up to 4years-but there is no guarantee.
IS VAX- D painful?
NO. you only lie down flat on your stomach and feel relaxed. You may feel some tugging and pulling sensation.
What if I cannot lie down on my stomach?
Do not worry, the treatment does not work anyway. They just want your money. On the serious side, if you cant lie down on the stomach you will be asked to lie down on your back (if this does this not sound like bogus, what will?). the treatment works in all positions.
What actually happens during the VAX-D sessions?
After you lie down, you will be fitted with a harness that goes around your lower back and groin. A couple of wires and a monitor will be attached to make it look like something fancy.
Is VAX-D effective for failed back syndrome?
Sure, if you pay money. Individuals who have failed back from prior surgery cannot be helped by such therapies. Despite the claims that 50 percent of individuals with failed back do great, this is simply unproven hype.
Does VAX D have any complications?
No, VAX-D has no major side effects or complications. The most common complain is people tire of lying down on the flat table for 60 minutes.
Does VAX- D work in everyone with back pain?
No. while the exact numbers who respond to VAX D are not known , these are a minority. Most testimonials are extremely negative about this therapy. the dealers suggest that one can only know if VAX D will work after 6 sessions. For those who are in limbo, they should register for at least 6 sessions. If you have not responded by the 6th session, than you got suckered into a bogus treatment
Does VAX D have an age limit?
Yes, anyone younger than 16-18 and older than 65, should not go for this therapy. elderly individuals with weak bones and poor gait should avoid such therapies.
The honest reply is NEVER. VAX- D does not produce results immediately. From the reports by the providers of VAX-D , it is felt that you will feel great after 6-8 sessions. Maximal benefit is obtained after 15-20 treatments. The pain relief may last up to 4years-but there is no guarantee.
IS VAX- D painful?
NO. you only lie down flat on your stomach and feel relaxed. You may feel some tugging and pulling sensation.
What if I cannot lie down on my stomach?
Do not worry, the treatment does not work anyway. They just want your money. On the serious side, if you cant lie down on the stomach you will be asked to lie down on your back (if this does this not sound like bogus, what will?). the treatment works in all positions.
What actually happens during the VAX-D sessions?
After you lie down, you will be fitted with a harness that goes around your lower back and groin. A couple of wires and a monitor will be attached to make it look like something fancy.
Is VAX-D effective for failed back syndrome?
Sure, if you pay money. Individuals who have failed back from prior surgery cannot be helped by such therapies. Despite the claims that 50 percent of individuals with failed back do great, this is simply unproven hype.
Does VAX D have any complications?
No, VAX-D has no major side effects or complications. The most common complain is people tire of lying down on the flat table for 60 minutes.
Does VAX- D work in everyone with back pain?
No. while the exact numbers who respond to VAX D are not known , these are a minority. Most testimonials are extremely negative about this therapy. the dealers suggest that one can only know if VAX D will work after 6 sessions. For those who are in limbo, they should register for at least 6 sessions. If you have not responded by the 6th session, than you got suckered into a bogus treatment
Does VAX D have an age limit?
Yes, anyone younger than 16-18 and older than 65, should not go for this therapy. elderly individuals with weak bones and poor gait should avoid such therapies.
Subscribe to:
Posts (Atom)
Posts
