Blog Posts

Concerning Sudden Cardiac Arrest

October 23rd, 2018

They’re sometimes referred to as “massive heart attacks,” but that moniker is not quite accurate. It’s true sudden cardiac arrests, or SCAs, affect the heart, but they’re not true heart attacks. A heart attack occurs when blood flow to a part of the heart is stopped or slowed, generally due to a blockage, causing the death of heart muscle tissue.

Generally, there are signs and symptoms signaling a heart attack, and in most cases, those hearts continue beating. But with SCA, people just collapse, discontinue breathing and their hearts simply stop beating. A very serious heart attack can lead to SCA, but most SCAs are caused by problems in the rhythm of the heartbeats.

According to the National Heart, Lung and Blood Institute, part of the National Institutes of Health, between 250,000 and 450,000 Americans suffer SCA annually. It occurs most often in people in their mid-30s to mid-40s and affects men twice as often as women. SCA is rare in children, affecting one to two per 100,000 each year.

Most of the body’s electrical activity is handled by nerves, but the heart has its own unique electrical system. In the heart, electricity is generated in special pacemaker cells in the atrium, or upper chamber, and is then carried through designated pathways to the heart muscle cells. The cells then all contract at once to produce a heartbeat.

If there is an interruption anywhere along that pathway, the heartbeat can become faster, slower or erratic. The most common cause of SCA is ventricular fibrillation, a very fast or chaotic heart rhythm, or arrhythmia. While ventricular fibrillation is most common, any arrhythmia can cause the heart the stop beating.

Most people at risk for SCA have coronary artery disease (CAD), although some don’t even know it. There are other heart-related risk factors for SCA including having an enlarged heart or cardiomyopathy, valvular heart disease and a congenital heart condition, a condition present since birth.

Some other factors that put you at risk for SCA include the risk factors for CAD. These include being a smoker, having diabetes, high blood pressure, high cholesterol and/or being overweight or obese, as well as living a sedentary lifestyle. Drinking more than two drink a day is another CAD risk factor, as is having a family history of the disease.

Other risk factors for SCA include having had a previous SCA or having a family history of SCA. If you’ve had a heart attack or have a family history of heart disease, your risk for SCA increases. The risk for SCA goes up with getting older, being male, using recreational drugs like cocaine and amphetamines, and having low levels of potassium or magnesium in your system.

Blunt force trauma, like what can occur in a car accident or after taking a direct blow to the chest, can also result in SCA. This is called commotio cordis. Strenuous physical activity can trigger SCA, but in most cases, there is an underlying heart problem that the people doing the activity may or may not be aware of. This is often the case when athletes in top physical condition experience SCA.

Most people who have SCA, about 95 percent, die from it, often within minutes. Rapid treatment of someone suffering SCA is critical not only for that person’s survival, but also to minimize damage to the brain from being without oxygenated blood for too long. Because when the heart stops beating, blood flow to the rest of the body also ceases.

The chances of a positive outcome increase dramatically if the person’s receives CPR and treatment with a defibrillator within minutes. Automated external defibrillators (AEDs) are available in more and more public places, including shopping malls, busses, parks and schools. You can even get an AED for your home, but talk to your doctor before you buy.

AEDs are devices that analyze the heart and if they detect a problem deliver an electrical shock to restore the heart’s normal rhythm. They are designed for use by laypeople and provide visual and voice prompts. They will only shock the heart when shocks are needed to restore normal rhythm.

If you witness someone in SCA, call, 911 immediately, then check to see if the person is breathing. If they’re not, begin chest compressions. If an AED happens to be available, use it on the unconscious, unbreathing person. Follow the instructions and prompts provided with the AED. Use the AED once, then continue chest compressions until emergency personnel arrive.

SCAs happen without notice, so they can’t be diagnosed until after they occur. There are, however, tests to diagnose contributory disorders and steps to reduce the impact of some risk factors. Having routine appointments and physicals with your doctor and getting appropriate screenings when required can help alert you to potential risk factors for SCA.

If you survive SCA or are at very high risk for SCA, your doctor may choose to place an implantable cardioverter defibrillator (ICD). An ICD is placed under the skin in your chest wall, with wires that attach to the heart. The ICD works like a pacemaker. When it detects a dangerous arrhythmia, it sends a shock to the heart to restore the natural rhythm.

Your doctor may also prescribe medication, especially if you’ve had a heart attack or if you have heart failure or an arrhythmia. Types of medications include ACE inhibitors, beta blockers, calcium channel blockers and other anti-arrhythmia drugs. If you’ve got high cholesterol and CAD, your doctor may also prescribe a statin medication for lowering your cholesterol levels.

If you’re aware of a heart condition or other risk factors for SCA, you can help yourself by making some lifestyle changes to reduce your risk of CAD and subsequently SCA. Lifestyle behaviors to put into practice in your life include quitting smoking, maintaining a healthy weight, exercising regularly, eating a low-fat diet and managing diabetes, high blood pressure and other chronic conditions.

For the best outcome in the case of SCA, treatment must be started within minutes of the event. If someone you love is at high risk for SCA, do them a favor and learn the proper techniques for CPR. The American Heart Association and many hospitals and health organizations routinely offer classes you can sign up for.

Think about learning CPR. You can save someone’s life.

MBC Miseries

October 16th, 2018

It’s pretty common knowledge that when someone is diagnosed with cancer, the cancer is typically assigned a “stage,” which is based on where the cancer cells have been detected. Generally, it goes from stage 0, meaning the cells are found only within the organ’s tissues, to stage IV, meaning the cancer cells have spread beyond the original organ.

The same is true with breast cancer. Stage IV breast cancer, which is also known as metastatic breast cancer, or MBC, is when breast cancer cells have traveled through the bloodstream or lymphatic system to other areas of the body. The most common places for MBC are the bones, lungs, liver and brain.

According to the Susan G. Komen Breast Cancer Foundation, there are an estimated 154,000 people in the United States with MBC.1 In some cases, women have MBC when they’re initially diagnosed with breast cancer. This is called de novo MBC, and it’s uncommon. It only occurs in about 6 percent of cases.

The rest of the time, MBC is diagnosed months or years after the initial breast cancer treatment has been completed. This is generally referred to as a distant recurrence. In either case, the disease starts in the cells of the breast, and they’re breast cancer cells that cause the problems elsewhere, not bone, lung, liver or brain cells.

Symptoms of MBC vary tremendously and depend on which area of the body is involved. When the bones are affected, the most common symptoms are pain and bone fractures. Lung symptoms include shortness of breath, difficulty breathing, prolonged coughing and fatigue.

Liver MBC symptoms tend to be subtle and are not obvious until much of the liver is compromised. They include nausea, extreme fatigue, increased abdominal size, swelling of the feet and hands, and yellowing of the skin. Brain symptoms may include headaches, confusion, memory loss, blurred or double vision, and speech or movement difficulties.

The reality is that, unlike breast cancer confined to the breast, MBC cannot be cured. It can, however, be treated, and treatment is guided by several factors. These include the characteristics or biology of the cancer cells themselves, the location of the metastasis, the current symptoms and past treatments used on the breast cancer.

The major goals of MBC treatment are to shrink tumors and weaken the cancer, manage your symptoms and side effects, and prevent the cancer from spreading further. The guiding hope is to control the cancer for as long as possible, while providing the highest possible quality of life. There are many approaches to treatment for MBC to help achieve this.

Chemotherapy, which is a systemic treatment, is often used to treat MBC; but in many cases, it is supplemented by another approach such as hormonal, or biologic or targeted therapies. Hormonal therapies target cancers that grow in the presence of certain hormones like estrogen or progesterone. Biologics target specific genes that make proteins that stimulate cell growth. They work if the MBC tumor overexpresses these proteins.

Other medications are sometimes used in the treatment of women with MBC. These include CDK4/6 inhibitors, which are a class of drugs designed to inhibit the CDK4 and CDK6 enzymes that are important in cell division. The CDK4/6 inhibitors interrupt the growth of cancer cells.

Research into new and improved treatment options for MBC is ongoing. One way to access these advanced approaches is by participating in a clinical trial. Clinical trials are research studies on the safety and effectiveness of new medications and treatment protocols. To find a clinical trial on MBC near you, ask your oncologist or visit www.clinicaltrials.gov.

Receiving treatment as soon as possible and updating it when appropriate are good strategies for helping to increase your longevity and your quality of life with MBC. Building good lifestyle habits can also help improve your quality of life as you cope with the strain of treating and living with MBC.

Eating a balanced diet low in saturated fat but high in plant-based foods is your best nutritional bet for fighting cancer. Exercise is important for your overall physical and mental health. It can help you increase your strength, reduce your stress, improve your mood and reduce side effects from cancer treatment.

The Susan G. Komen Foundation reports that of American women with MBC today, an estimated 34 percent have lived at least five years after diagnosis. And as treatments continue to improve, some may live ten years or more after diagnosis.

Life expectancy after an MBC diagnosis can be influenced by many factors. These include your age, your overall health, the types of tissues affected by the MBC and your general attitude and outlook. The fact is many women with breast cancer now live longer than they used to.

This is good news for women with MBC as well. Ongoing research is finding ever new and improved ways to treat this disease. Improved screening, and early diagnosis and treatment are prolonging the lives of women with MBC, as well as improving the quality of those lives.

Say “Yes” to Yoga

October 10th, 2018

Do you practice yoga or have you ever thought about trying it? I think about it quite a bit, but the problem is I just THINK about it. However, after reading about all of yoga’s benefits, I might actually DO something about it. Like any activity, you can get injured doing yoga, but most doctors agree that the benefits greatly outweigh the risks.

Yoga has an interesting backstory. For starters, it’s a 5,000-year-old practice with origins in ancient Indian philosophy. There are many different styles, or schools, of yoga that typically combine various physical poses (asanas) and breathing techniques to stimulate the body with meditation to relax the mind. In the West, it’s become a popular form of exercise to improve mind-body control and enhance well-being.

The word “yoga” comes from the Sanskrit word “yuj,” which means “to yoke or join together.” Most people believe that refers to the union of the mind and body that occurs with yoga practice. Because there are many styles of yoga with various degrees of complexity, people of all fitness levels can find a style that suites them.

The practice of yoga focuses on your body’s natural tendency to gravitate toward health as well as its ability to self-heal. It works to create strength, awareness and harmony in mind and body. It can help you develop skills for coping and a more positive outlook on life. It also helps you get in tune with both your physical body and your inner self.

As I mentioned earlier, practicing yoga has many health benefits. Research has shown that yoga can help prevent disease and helps recover from it. I’ve read articles with long lists of benefits, but I’ve chose just a few to highlight here.

One of the biggest benefits of yoga is that it reduces stress, and high stress – which is bad enough on its own – is also a risk factor for a bunch of disorders Multiple research studies have shown that yoga can decrease the release of cortisol, which is the main stress hormone. Lower cortisol and lower the stress. Lowering stress helps fight many conditions, including anxiety, depression, high blood pressure and cardiovascular disease.

There’s a growing body of research that shows yoga can help reduce chronic pain, a problem that affects millions of Americans. It has been shown to be especially effective in reducing pain due to carpal tunnel syndrome and osteoarthritis. Several studies suggest that yoga may be effective for chronic low-back pain as well.

Yoga improves flexibility and builds muscle strength. After several yoga classes, you’ll likely notice a gradual loosening of your muscles, and you’ll be able to get into poses you couldn’t get into before. You’ll strengthen your muscles as well, and when you build strength through yoga, you balance it with flexibility.

Another benefit of yoga is it gives your immune system a boost. The poses and breathing exercises probably play a part in this, but believe it or not, most of the research supports the role of meditation. Apparently, it gives the immune system a boost at times its called for duty, as in response to an invading organism, but mitigates its function when a reaction is inappropriate, such as with an autoimmune disease like psoriasis.

Yoga has many physical health benefits, but it also has mental health benefits. In addition to fighting depression and anxiety, yoga also helps raise self-esteem. People with low self-esteem often handle their feelings negatively. They might take drugs, drink, overeat, work too hard or sleep around, but yoga is a positive way to direct their energy.

Yoga teaches that its practitioners are manifestations of the Divine. If you practice yoga regularly, you’ll get in tune with your inner self, and you’ll discover that you’re worthwhile. You’ll also experience feelings of gratitude, empathy and forgiveness. Suddenly, you get a sense that you’re part of something bigger, and it gives you a whole new perspective on yourself. Who can’t use a little self-confidence enhancement!

It’s pretty clear that adding yoga a few times a week to your routine can give you a physical and mental boost. It’s worth giving it a try. Say “yes” to yoga. Say “yes” to better physical and mental health.

Breast Cancer Breakthroughs

October 9th, 2018

If you read the recent posting, you learned the basics of breast cancer. You know it’s a nasty disease. In fact, death rates from breast cancer are higher than those of any other cancer except lung cancer for American women. Knowing that may help you appreciate these remarkable breakthroughs recently announced by breast cancer researchers.

The results of one study were released in February and published in the journal Nature. The investigators in the study reported their findings that a certain protein found in many foods may reduce a dangerous type of breast cancer’s tendency to spread. This suggests that your diet may be a factor in treating this form of breast cancer.

The type of cancer is called triple-negative breast cancer because its cells lack receptors   for estrogen and progesterone and don’t make very much of a protein known as HER2. It is often deadly because it tends to travel to distant sites in the body.

In this multicenter study, which used laboratory mice, investigators found that by limiting an amino acid called asparagine, they could dramatically reduce the cancer’s ability to spread to the farther reaches of the body. That’s great news!

One of the drawbacks of this good news is that many foods contain a lot of asparagine. These include beef, poultry, fish, seafood, dairy products, eggs, potatoes, nuts, seeds, soy, whole grains and, surprise, surprise, asparagus. Most fruits and vegetables are low in the amino acid.

Unless you’re vegan, your diet will change dramatically. But it’s worth it if it stops the spread of this deadly cancer. The next step for researchers is to begin an early phase clinical trial using healthy subjects. The subjects would eat a low-asparagine diet, and the investigators would test for drops in asparagine levels.

After that, investigators will move on the next phase clinical trial and test their diet treatment on cancer patients. In that case, diet changes would be made in combination with the patients’ chemotherapy or other traditional treatments.

The results of another study were made public in September but are not due to be officially presented until the 2018 American Society of Clinical Oncology Annual Meeting in June. This study was a federally funded phase III clinical trial of women with an early-stage breast cancer that had certain characteristics.

The early stage breast cancer studied must be hormone receptor-positive, HER2-negative and axillary node-negative. It must also score in the mid-range on a specialized test called a 21-tunor gene expression assay. The study investigators have some welcome news for women with this type of cancer.

Here’s something you’ll want to hear. The clinical trial showed that women with this breast cancer do not need to have chemotherapy after surgery. That’s awesome because you avoid all those horrible side effects. Apparently, there wasn’t any improvement in disease-free survival when chemotherapy was added to other treatments after surgery.

This is especially good news when you consider that half of all breast cancers are hormone receptor-positive, HER2-negative and axillary node-negative. That means a lot of women are affected by this study’s outcome. Read what the study’s lead author, Joseph A. Sparano, MD, has to say about it:

“Our study shows that chemotherapy may be avoided in about seventy percent of these women when its use is guided by the test (21-tumor gene expression assay), thus limiting chemotherapy to the thirty percent who we can predict will benefit from it.”

These are the results of just two recently completed studies on breast cancer. These are many more that have been completed or are in progress. Because breast cancer is so deadly, research on it is ongoing. If you want to get involved in a clinical trial of a new drug or treatment, ask your doctor about one close to you or visit clinicaltrials.gov.

Between the last posting and this one, we’ve increased our awareness of breast cancer two-fold. Don’t keep your knowledge to yourself. Share a fact about breast cancer with someone else. Keep the awareness alive in others.

The Bottom Line on Breast Cancer

September 25th, 2018

It’s October. Everybody knows it’s Breast Cancer Awareness Month. Look around. You see pink everywhere. The color is a reminder to get the facts about breast cancer and then get screened. Don’t think this doesn’t apply to you, men. You can get breast cancer, too, even though it’s much more common in women.

Consider these statistics. About one in eight American women will develop invasive breast cancer over the course of her lifetime. This year, an estimated 266,120 new cases of invasive breast cancer are expected to be diagnosed in women in the US, as well as 63,960 new cases of non-invasive breast cancer.

Sadly, an estimated 40,920 American women are expected to die in 2018 from breast cancer.

Listen up, men. An estimated 2.550 new cases of invasive breast cancer are expected to be diagnosed in American men in 2018. You have a one in 1,000 chance of developing breast cancer over your lifetime. It’s much lower than the risk in women, but it’s still a risk.

Let’s start at the beginning. Breast cancer happens when cells in the breast start growing  uncontrollably. Most of the time, but not always, these extra cells collect and form tumors. These are the lumps that can be detected in the breasts on your self-exams or mammograms.

Feeling a lump in your breast is one warning sign of breast cancer, but there are others as well. You might notice thickening, swelling or dimpling of an area of your breast. Look for red or flaky skin, or other changes near the nipple, as well as any secretion from the nipple other than breast milk. Pain in the breast could also be a sign of breast cancer.

If you have any of these symptoms, see your doctor for a proper diagnosis.

Breast cancer is the result of a mutation or abnormal change in the genes that regulate the growth and reproduction of breast cells. Only about five to ten percent of breast cancers are caused by mutations passed on from your parents. The rest are caused by abnormal changes that occur as a result of aging and life in general.

That makes getting older a risk factor for breast cancer, one you can’t do anything about. Other risk factors out of your control include inheriting a genetic mutation, getting your period before age 12 and menopause after 55, having dense breasts, having a personal or family history of breast cancer and having been treated with radiation therapy.

There are also risk factors for breast cancer that you can do something about, things like being physically inactive, being overweight, drinking a lot of alcohol and taking hormones. In addition, having your first baby after age 30, not breastfeeding and never having a full-term pregnancy can also increase the risk of breast cancer.

You can’t change your age or your genes, but there are steps you can take to reduce your risk of developing breast cancer. A few of these suggestions are no-brainers. We already know that we should maintain a healthy weight, exercise regularly and limit our alcohol consumption to no more than one drink a day.

These suggestions you may not have heard. For one, think hard and have a heart-to-heart discussion with your doctor about the risks of taking the Pill or hormone replacement therapy (HRT). They may not be right for you. If you have a baby, consider breastfeeding, if you’re able. If you have a family history or a genetic mutation, talk to your doctor about things you can do to lessen your risk.

With breast cancer, as with most cancers, detecting it early is critical to treatment success. It’s best to find it before the cancer cells have had a chance to invade the nearby lymph nodes and spread to other areas of the body from there. Maintaining a routine screening schedule can assist with early detection.

The first part of the screening process is regular breast self-exams. You know the look and feel of your breasts, so you’re likely to notice changes such as lumps, pain, or differences in size or shape. You should also get regular clinical breast exams by a doctor or nurse, who use their hands to feel your breasts for lumps.

 

The next step is to get a mammogram. The current recommendations are that women ages 50 to 74 at average risk should get a mammogram every two years. Women 40 to 49 should talk to their doctors about when to start and how often to get the test. If lumps are detected, your doctor may perform a biopsy to determine if their cells are cancerous.

If cancer is detected, there are many approaches to treating it. Doctors often use more than one approach on each patient.

Chemotherapy is a common approach. It uses drugs to kill cancer cells and shrink tumors. Surgery, called mastectomy, is often used to remove the breasts and the tumors. Radiation therapy uses high-energy rays directed at the spot of the cancer to kill cancer cells. Unfortunately, chemotherapy and radiation have uncomfortable side effects.

Doctors use additional treatment approaches including hormonal therapy. Hormonal therapy doesn’t allow the cancer cells to get the hormones they need to survive. Another approach is biological therapy, which works with the immune system, your body’s natural defense against disease. Biological therapy helps the immune system fight the cancer. It also helps control the side effects of other cancer treatments.

Breast cancer is the subject of a lot of research, and if you’re interested, you can participate in a clinical trial to test the safety and effectiveness of new drugs and treatments. To find a clinical trial near you, ask your doctor or go to clinicaltrials.gov.

Now, you’ve got the facts on breast cancer. Put on something pink and share what you’ve learned!

Skyrocketing STDs

September 24th, 2018

With all of the breakthroughs science has made on complicated diseases like cancer, you’d think we’d have the simple stuff figured out. But that’s not the case with sexually transmitted diseases, or STDs. For a while there, doctors seemed to have a handle on these infections, but over the past four years, their rates have skyrocketed. 

According to a Centers for Disease Control and Prevention report, last year was no different. It posted the highest rates of chlamydia, gonorrhea and syphilis in history, with nearly 2.3 million cases diagnosed. That turns out to be 200,000 more cases than in 2016, which was the previous record-breaking year.

Chlamydia, as usual, was the most common of the STDs. In 2017, there were more than 1.7 million cases of chlamydia diagnosed. However, the CDC was especially concerned about the dramatic rise in syphilis cases, which increased by 76 percent since 2013. Gonorrhea diagnoses grew by 67 percent since 2013.

The reality of these numbers is made worse by the fact that gonorrhea might soon become resistant to the last-ditch antibiotic we have to treat it. Over time and through genetic mutations, gonorrhea has built up resistance to nearly every class of antibiotics we have except one, ceftriaxone.

Now, the CDC is worried that the bug’s immunity to antibiotics could spread to ceftriaxone and become untreatable by anything currently available. And unfortunately, development of new, stronger antibiotics has not been a priority for researchers. As a result, gonorrhea is on course to becoming one of the world’s treatment-resistant “super bugs.”

If anything, that highlights how important it is for us to shift our priorities, provide the necessary funding and work to develop new antibiotics and novel treatments such as vaccines. We don’t want 2018 to be another record-breaking year.

There are several factors contributing to the recent rise in STD rates in the US. One of the biggest is insufficient funding for STD education and prevention programs. For example, the budget for the STD awareness and prevention program at the CDC has remained stagnant for the past two decades.

Without adequate funding, STD prevention workers have limited resources for outreach, education and awareness programs. These programs are important because many STDs have no early symptoms, so infected people end up passing the infections to their partners without realizing it. The partners pass it on and so forth.

The lack of funding has also forced the closing of many publicly-funded STD clinics across the country. Because of this, many infected people are unable to get appropriate care and are going to emergency rooms or urgent care centers. Unfortunately, these facilities don’t have the expertise with STDs to properly test and treat infected individuals.

STDs have a higher prevalence in certain community and socioeconomic groups, so the closures of  local STD clinics have a larger impact on these groups. In addition, other public health issues can compound the problem of soaring STD rates, issues such as substance abuse and domestic violence.

Without the benefit of outreach programs, there are no programs in place to educate people about STDs and encourage safe sex practices and screening for infections. One thing is sure, more comprehensive community education and outreach is necessary, along with better screening and treatment practices by doctors.

If we want to lower the skyrocketing STD rates, we all have a lot of work to do.

Raising Sepsis Awareness

September 18th, 2018

Every month of the year celebrates awareness of a health disorder or healthy behavior, and September is the national month for a ton of things. One of the September celebrations is Sepsis Awareness Month. I thought we could all use a little more awareness about this potentially fatal condition.

For example, did you know that sepsis is the third leading cause of death in the United States, and the leading cause of death in US hospitals. There are more than one million Americans diagnosed with sepsis every year. And more than 250,000 people die from sepsis every year in the US.

Sepsis is a serious medical condition that occurs when the body’s immune system has an overwhelming response to an infection. In the case of any infection – bacterial, viral, fungal or parasitic – the immune system releases chemicals to fight the invading germ. The result is inflammation at the site of the infection. Inflammation is the damage caused by the fight between your immune system and the infection.

With sepsis, the germ-fighting chemicals cause inflammation throughout the body, which impairs blood flow. This undermines blood getting to the body’s organs and tissues, depriving them of oxygen and nutrients, and leading to organ damage. This whole-body reaction to infection spread through the bloodstream is sepsis.

Anybody can end up with sepsis, but some people are at greater risk for developing it. These include very young babies, seniors, people with chronic illnesses such as diabetes and AIDS, people with compromised immune systems such as those receiving treatment for cancer or following organ transplantation, and people in hospitals at risk for infections from IV lines, catheters, surgical wounds or bedsores.

There are three stages of sepsis: sepsis, severe sepsis and septic shock. Symptoms of sepsis include a body temperature above 101 degrees F or below 96.8 degrees F, a heart rate higher than 90 beats per minute, a breathing rate higher than 20 breaths per minute, and a probable or confirmed infection.

When your organs begin to fail, you’re headed for severe sepsis. Common symptoms of severe sepsis include decreased urination, changes in mental ability, chills, weakness, problems breathing, abnormal heart function, low blood platelet count and unconsciousness.

Add very low blood pressure to the symptoms of severe sepsis and you’ve got septic shock. That’s when there’s not enough blood pressure to keep your organs and tissues infused with blood and they fail. The organs most likely to fail include the lungs, the heart and blood vessels, the kidneys, and the brain and nerves.

Sepsis should be treated as a medical emergency as quickly and efficiently as possible as soon as it has been diagnosed. The first lines of treatment are IV antibiotics and IV fluids. The antibiotics given initially are broad-spectrum that kill a variety of bacteria. When the specific germ is identified, the medication can be adjusted to target the specific germ.

IV fluids are given to help keep the blood pressure from dropping dangerously low and throwing you into septic shock. The fluids also help the organs and tissues do their work, and they may help reduce organ damage from sepsis.

There are other treatments that may be used to support your functioning during your hospitalization. These might include kidney dialysis to help filter waste from your blood and mechanical ventilation to help you breathe if you’ve gone into septic shock. You may also be given corticosteroids to help reduce inflammation or vasopressors to tighten blood vessels and force the blood pressure to increase.

The outlook for people with sepsis depends on their age, health history, overall health status, how quickly the sepsis was diagnosed and the type of germ that caused the infection. Most people recover from mild cases of sepsis, but septic shock has a mortality rate of nearly 50 percent.

Your best bet is to seek treatment as soon as you start noticing symptoms so your doctors can begin treatment right away. Early and aggressive medical attention can help prevent sepsis from progressing to severe sepsis and then septic shock, and give you the best opportunity for a positive outcome.

Glioblastoma: A Ghastly Cancer

September 11th, 2018

On Saturday, Aug 25, Arizona Senator John McCain succumbed to an especially heinous brain cancer called glioblastoma. Glioblastoma, the most common of all of the malignant primary brain tumors, is the same illness that killed Sen. Ted Kennedy and Beau Biden, the son of former Vice President Joe Biden.

John Sidney McCain III (August 29, 1936 – August 25, 2018)

In the United States, there are approximately 18,000 people diagnosed with glioblastoma every year, and an estimated 13,000 die from it annually. As you can see, glioblastoma is a very deadly disease. It is a primary tumor because it starts in the cells of the central nervous system, the brain and spinal cord, and quickly spreads to other cells in the brain.

Glioblastoma is more common in men than in women, and the chances of getting it increase with age. Glioblastoma tumors tend to occur in adults between 45 and 70 years old. A study conducted between 2005 and 2009 found that the median age group for death from brain and other central nervous system cancers was 64.

There are two main types of cells in the brain: neurons, which transmit messages from cell to cell, and glial cells, which provide support to neurons and help regulate the transmission of those messages. Glioblastomas start in the star-shaped glial cells called astrocytes. The tumors generally begin in the cerebrum, the largest part of the brain.

A glioblastoma tumor is highly malignant, or able to spread, because it can rapidly invade nearby healthy brain tissue. As the tumor grows, it puts increasing pressure on the brain, which leads to various symptoms. These include headaches, blurred or double vision, difficulty thinking or remembering, changes in mood or personality, seizures, vomiting and trouble speaking.

In most cases, the exact cause of glioblastoma is not known. In rare cases, it can occur in people with certain genetic syndromes. In these cases, the affected people typically also have additional symptoms characteristic of those syndromes. Those syndromes are generally caused by mutations to a specific gene.

Diagnosing glioblastoma begins with a history of symptoms and a full physical exam. Your doctor will likely order an imaging test, most commonly an MRI. The MRI can show the size and location of the tumor. Your doctor may also perform a biopsy, the removal of a sample of  tumor tissue to study under a microscope.

If you are healthy enough to have a procedure, treatment for glioblastoma will begin with surgery to remove the tumor. Due to the location of the tumor and how far it has invaded into healthy brain cells, doctors are often unable to remove the entire tumor. However, removing as much as possible, or debulking it, can release some of the pressure on the brain and help reduce symptoms.

Following surgery, you will be given radiation therapy and chemotherapy. Radiation therapy uses high-energy beams, such as x-rays or protons, to kill cancer cells remaining after surgery. Chemotherapy uses drugs to kill cancer cells. For people who are unable to undergo surgery, radiation therapy and chemotherapy are the primary treatments for glioblastoma.

Newer treatments that have been showing promise are biological therapies. These therapies target the specific biological functions that are essential for the tumor to grow. They are also designed to be less toxic to healthy cells than radiation therapy and chemotherapy.

Often, glioblastoma tumors return after treatment. If this happens, you can repeat the cycle of surgery, radiation and chemotherapy. You may also want to consider a clinical trial of a new treatment still in the testing phase. Ask your doctor about available clinical trials in your area or visit www.clinicaltrials.gov.

Your doctor may also recommend palliative care. This is a specialized type of medical care that aims to provide relief from your pain and other symptoms. The palliative care doctors work with you, your family and your cancer specialists to provide care that complements any other treatment you may be receiving.

Unfortunately, because glioblastoma is such a malignant and aggressive cancer, the outlook for those affected by it is not promising. There is currently no cure for the disease, and many people who get it live less than a year after their initial diagnosis. Currently, the median survival for adults with aggressive glioblastoma is approximately 14.6 months. The two-year survival is 30 percent. Thank God this is a relatively rare cancer.

Don’t be a Tech Neck

September 4th, 2018

A YouTube video showing people walking into everything from doors and walls to cars and fountains while looking down at their cell phones has drawn hundreds of thousands of online views and at least that many laughs.

The potential for injury stemming from staring at your cell phone is no laughing matter, however, and the dangers extend beyond the possibility of stumbling or falling as a result of simply not paying attention to what you’re doing while on your phone.

Staring down at your cell phone for extended periods of time can also lead to some painfully serious medical conditions, including a few that are tied exclusively to the simple way in which most of us typically look at our cell phones.

Tech Neck, Text Neck and the Smart Phone Slump are some of the names of these conditions, and they are all byproducts of the stresses that are placed on our head, neck and shoulders when we assume this seemingly standard posture.

For most, that posture includes simply looking down, but a study conducted by, Dr. Kenneth K Hansraj, the chief of spine surgery at New York Spine Surgery and Rehabilitation Medicine, found that the stress created by that posture is significant.

For example, when we stand upright and hold our head in the neutral or straight-up position, 10-12 pounds of force is placed on the neck and cervical spine. That force increases dramatically, however, with every degree with which we tilt the head forward.

By tilting the head forward just 15 degrees, the force on the neck muscles and cervical spine more than doubles to 27 pounds. At 30 degrees of tilt the force increases to 40 pounds and at 60 degrees, where the chin is nearest the chest, the force is 60 pounds.

Stay in that position long enough or assume it often enough as cell-phone users often do and the resulting damage to those areas of the body can include intermittent or constant neck, shoulder and back pain and headaches.

For some, these symptoms are so severe that a doctor’s care is required to correct them. Others may be able to correct them by doing a few simple home exercises such as placing your hands behind your head, opening your elbows wide and looking upward.

As is often the case, though, the best remedy is prevention. With that in mind here are five simple tips – courtesy of Spine-Health.com – to follow that can help you prevent Tech Neck, Text Neck, Smart Phone Slump and other related problems.

  1. Set time limits.Limit the amount of time and frequency that you use your device. If you have to use it for an extended period of time, take breaks. Develop a habit of taking a three-minute break for every 15-20 minutes you use your device. Change your posture and move around.
  2. Set automatic reminders.Utilize an automatic alarm with your smart device reminding you to take a time out. For those of you that have wearable devices these can be set to remind you to break, such as the iWatch which can tap you every 15-20 minutes.
  3. Use a tablet holder.Purchase a holder to elevate your device to significantly reduce the amount of neck flexion and forward positioning. Try to keep the device as close to eye-level as possible. This is a great tool to reduce Tech Neck.
  4. Sit in a chair with a headrest.Switch to a chair with a headrest and make sure to keep the back of your head in contact with the headrest while using your tablet, phone or laptop. Keeping the back of your head flush against the headrest will ensure that you’re not looking down with your neck flexed forward.
  5. Use pain as a warning.If you’re experiencing neck pain between the shoulder blades, numbness or tingling in the arms or frequent headaches there may be a more serious issue going on. Pay attention to these warning signs and act quickly to make changes to reduce or eliminate any head-forward posture that is straining your neck.

Bye-Bye Vertigo!

August 28th, 2018

Living in Florida can be brutal for an allergy sufferer. I know, because I’ve lived in Florida since I was three and can’t remember a time when I didn’t suffer from allergies and ear and nasal infections. I’m allergic to the world so I’m always having to make trips to the doctor for antibiotics and allergy treatments.Photo from iSockPhoto.com.

Recently, I started getting frequent dizzy spells as well. I assumed at first that they were the result of another infection and put off doing anything about it. But then the dizzy spells became more severe and quite random. They would occur almost anytime, anywhere.

At first, they lasted only for a few seconds. But then, about a month ago, I woke up one morning feeling very dizzy, and as I started to move around, the dizziness did not let up at all. In fact, it only got worse, to the point where I didn’t feel safe driving myself to work.

I struggled through that entire day, literally using the walls in the hallway to hold me up because my balance was terrible, and I didn’t trust myself not to fall. After another couple days of feeling like this, I ended up having to miss a day of work.

It was at that point that I finally gave in and went to see a doctor. I was feeling anxious before my appointment, not knowing exactly what was going on at this point or how it would be diagnosed or treated, but then, after the doctor did a few maneuvers on me, he said, You have vertigo.

He explained briefly what vertigo is and provided a video for me to watch. At first, I thought, A videoHow is a video going to help me? But he was right. The video was extremely informative and explained in detail what vertigo is while also providing a detailed demonstration of how to treat it.

I went home and started following the protocol from the video right away. By the next morning, I was feeling much better. The treatment helped rid me of the dizziness and changed my life. If it ever comes back again, I will know exactly what to do. I hope this video helps you as much as it did me.

 

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