Blog Posts

Discussing Diabetes

November 26th, 2022

November is American Diabetes Month, so let’s discuss this chronic metabolic disease that affects 37.3 million adults in the United States. The Centers for Disease Control and Prevention report that one of five aren’t even aware they have the disease. Yet, it’s the seventh leading cause of death in the country.

When you eat food — particularly carbohydrates such as bread, rice and pasta — your body breaks it down into a simple sugar called glucose, which enters your cells to be used as fuel. But glucose cannot enter your cells without help, which comes from a hormone made by your pancreas called insulin. Insulin serves as the “key” to help glucose get inside your cells.

With diabetes, your body doesn’t make enough or any insulin, or cannot use the insulin it makes efficiently, which is called insulin resistance. As a result, the level of glucose in your bloodstream increases. High blood glucose levels over time can lead to serious health complications, such as cardiovascular disease, nerve damage (neuropathy), kidney damage, eye damage (retinopathy) and even death.

There are three main types of diabetes: Type 1, Type 2 and gestational.

Type 1 diabetes, which accounts for approximately 5 percent of cases, is an autoimmune disorder. With this type, your body’s infection-fighting immune system mistakenly attacks the insulin-producing beta cells in your pancreas. Type 1 can occur at any time but is most often diagnosed in young children, teens and young adults.

Type 2 diabetes is the most common, affecting up to 95 percent of cases. With Type 2, your body becomes resistant to the effects of insulin and glucose builds up in the bloodstream. It typically develops over many years and is most often diagnosed in adults older than 35, although it’s being seen with greater frequency in young children, teens and younger adults.

Gestational diabetes develops in some pregnant women It typically goes away after the pregnancy, but patients are at a higher risk for developing Type 2 diabetes when they are older.

There also is is a condition called prediabetes if blood glucose levels are higher than normal but not enough to be formally diagnosed with Type 2 diabetes.

Symptoms of Type 1 and Type 2 diabetes are similar, but their onset is more rapid with Type 1. Symptoms appear slowly, over time, with Type 2. General symptoms include increased hunger, increased thirst, weight loss, frequent urination, blurry vision, fatigue and sores that are slow to heal.

Most women with gestational diabetes experience no symptoms. Pregnant women are routinely tested for diabetes between the 24th and 28th weeks of pregnancy, so getting regular prenatal care is important to detect and treat this condition before it causes damage to the mother and baby.

There are different causes for each type. Researchers don’t know what causes the immune system to attack beta cells in the pancreas that result in Type 1 diabetes but suspect that genetics plays a role. They also surmise a virus may activate the immune system to attack beta cells.

Type 2 is associated with a combination of genetics and lifestyle factors. The condition runs in families. It is more common in people who are overweight, eat an unhealthy diet and have a sedentary lifestyle. Having high blood pressure, high cholesterol, high triglycerides or prediabetes also puts someone at a higher risk for developing Type 2 diabetes.

Gestational diabetes is caused by hormonal changes during pregnancy. The placenta produces hormones that make cells less sensitive to the effects of insulin, causing high levels of blood glucose in the bloodstream. If a woman is overweight while pregnant or has a family history of Type 2 diabetes, she is at a greater risk for developing gestational diabetes.

Those with Type 1 diabetes must take insulin every day to survive. In many cases, Type 2 diabetes can be managed with a healthy lifestyle, which includes eating a healthy diet, getting regular physical activity, not smoking and maintaining a healthy weight. If that’s not enough, patients must to take oral medication and/or receive insulin injections.

Treatment for gestational diabetes includes special meal plans and scheduled physical activity. In some cases, medication or insulin injections may become necessary to keep blood glucose levels at a healthy level.

Type 1 diabetes cannot be prevented. However, there are some things that can reduce the risk for developing Type 2 and gestational diabetes, including:

• Eat a healthy diet high in fiber and non-starchy vegetables.
• Be physically active. Aim for 30 minutes most days of the week.
• Maintain a healthy weight.
• Quit smoking.
• Get seven to nine hours of sleep per day.
• Lower stress. Try deep breathing, meditation, yoga, tai chi or another relaxation technique.

Patti DiPanfilo

A Closer Look At Pancreatic Cancer

November 17th, 2022

November is Pancreatic Cancer Awareness Month, so let’s take a few minutes to ponder this deadly disease. First, let’s learn a little bit about the pancreas and its important contributions to the body’s day-to-day functioning.

The pancreas is an oblong organ that sits across the back of the abdomen, between the stomach and the spine. It consists primarily of two types of cells. Exocrine cells make key enzymes for digestion, which they release into tiny tubes called ducts. Endocrine cells produce hormones such as insulin and glucagon, which help the body absorb glucose (sugar) for energy and control glucose levels in the blood. Endocrine cells release their hormones directly into the bloodstream.

Pancreatic cancer develops when abnormal cells grow out of control and form a mass, or tumor. About 95 percent of pancreatic cancers start in the exocrine cells. These are called pancreatic adenocarcinomas. About 7 percent of pancreatic cancers begin in the endocrine cells. Those are called pancreatic neuroendocrine tumors, or PNETs.

According to the American Cancer Society, pancreatic cancer accounts for about 3 percent of all cancer diagnoses in the US and is responsible for 7 percent of cancer deaths. The society estimates that about 62,210 Americans will be diagnosed with pancreatic cancer in 2022 and about 49,830 people will die from it.

Pancreatic cancer is often called a “silent cancer” because it generally has no detectable symptoms in early stages. Consequently, it typically progresses and affects other organs and tissues before it is diagnosed.

When present, pancreatic cancer symptoms can include yellowing of the skin or eyes (jaundice), dark urine, pain in the abdomen or lower back, digestive upset (nausea, vomiting or indigestion), fatigue, depression, blood clots, decreased appetite, unexplained weight loss and sudden onset of diabetes.

The cause is unknown, but certain factors have been identified that increase the risk for developing this cancer. These include smoking cigarettes, being obese, not exercising regularly, eating a diet high in fat and processed meats, drinking heavily, being exposed to chemicals and pesticides, having Type 2 diabetes or a chronically inflamed pancreas, being African American, being male, being older than 55 and having a family history of pancreatic cancer.

To diagnose pancreatic cancer, a doctor will begin with a thorough review of the patient’s symptoms and medical history. The doctor will likely order a CT or MRI scan to get a detailed image of the pancreas. Other tests may include endoscopic ultrasound and endoscopic retrograde cholangiopancreatography (ERCP).

These tests are performed through an endoscope – a thin, flexible tube with a tiny camera attached to its end that is passed down the throat and into the digestive system. During these endoscopic procedures, a doctor can obtain a sample of tissue to study under a microscope to look for cancer cells. This is called a biopsy.

Blood tests are also used to look for certain tumor markers that may indicate pancreatic cancer. Tumor markers are substances that are often found in high concentrations when cancer is present. Tumor marker CA 19-9 may be helpful in diagnosing pancreatic cancer. Carcinoembryonic antigen (CEA) is another tumor marker for pancreatic cancer, but it’s not used as often as CA 19-9.

Once a diagnosis of pancreatic cancer has been made, the doctor will assign a stage based on test results. The stage of a cancer indicates the size of the tumor and how far it has spread from where it originated. The stages of pancreatic cancer include:

• Stage 0 – Abnormal cells that could become cancerous are present in the pancreas.
• Stage 1 – Tumors are in the pancreas only.
• Stage 2 – Tumors have spread to nearby abdominal tissue or lymph nodes.
• Stage 3 – The cancer has spread to major blood vessels and lymph nodes.
• Stage 4 – The cancer has spread to other organs, such as the liver.

Treatment for pancreatic cancer depends on the stage. The goals of treatment are to kill the cancer cells, prevent the spread of the disease and relieve symptoms. Treatment may include surgery, chemotherapy, radiation therapy, targeted drug therapy and immunotherapy.

If the cancer is localized to the pancreas, it may be possible to eliminate the cancer cells by surgically removing all or part of the pancreas. A common procedure for pancreatic cancer is the Whipple procedure during which the surgeon removes the head of the pancreas and sometimes the entire pancreas, along with a portion of the stomach, the first part of the small intestine, the gallbladder, the bile duct and other tissue.

Chemotherapy uses drugs to kill cancer cells. Radiation therapy destroys cancer by focusing high-energy rays on the cancer cells. These treatments may be used before surgery to shrink tumors or after surgery to eliminate any remaining traces of the cancer.

Targeted drug therapy is a type of cancer treatment that targets proteins that control how cancer cells grow, divide and spread. Immunotherapy works the immune system to recognize and destroy cancer cells.

Because pancreatic cancer is typically not diagnosed until it is in its advanced stages, it continues to be difficult to treat and cure. Fortunately, the outlook for people with this cancer is improving. Ongoing research and clinical trials, along with new treatments, are expanding the average five-year survival rate for people with pancreatic cancer.

Patti DiPanfilo

A Little Epilepsy Education

November 9th, 2022

This is National Epilepsy Awareness Month. In observance, we dedicate this blog to providing a little education on the disorder. Epilepsy is a chronic brain disease characterized by recurring, unprovoked seizures, which are sudden, unexpected alterations in consciousness and behavior. Epilepsy seizures are caused by sudden surges of abnormal electrical activity within the brain initiated by damaged brain cells.

According to the Epilepsy Foundation, epilepsy is the fourth most common neurological disorder, after migraine, stroke and Alzheimer’s disease. In the United States, it’s estimated that 1.2 percent of the population has active epilepsy. That works out to 3.4 million Americans. Worldwide, about 65 million people have the disorder. Epilepsy can develop at any age, but diagnosis most often occurs in early childhood or after age 60.

Seizures are usually classified into two groups: focal and generalized. Focal, or partial, seizures start in a A localized area on one side of your brain. Generalized seizures affect a wide area on both sides of your brain at the same time. There are multiple subtypes of focal and generalized seizures.

Recurring seizures is the main symptom of epilepsy. Seizure symptoms vary by subtype, but some general signs and symptoms include a temporary loss of consciousness; uncontrolled muscle movements (spasms); blank stare; alterations to the sense of taste, smell, sight, hearing or touch; dizziness; changes in breathing; and performance of repetitive movements, such as lip-smacking, chewing and hand-rubbing.

Some people with epilepsy have identified certain factors or situations that trigger their seizures. Some common triggers include lack of sleep, illness or fever, stress, bright or flashing lights, caffeine, alcohol or alcohol withdrawal, recreational drug use, skipping meals or overeating, hormonal changes, dehydration and use of certain medications, such as diphenhydramine, a common ingredient in over-the-counter cold, allergy and sleep remedies.

To help you uncover your triggers, try keeping a seizure journal. Record the date and time, everything you were doing, everything that was going on around you and what you were feeling before your seizure began. Share your journal with your doctor.

Epilepsy has many causes, including genetics. Certain types are more likely to run in families. Other potential causes include head injuries, brain infections, stroke, brain tumors, dementia, lack of oxygen to the brain, drug use during pregnancy, lack of oxygen at birth and blood vessel abnormalities in the brain. In up to 70 percent of cases, the cause is unknown.

Epilepsy is typically diagnosed after an individual has experienced at least two seizures that cannot be attributed to a known medical condition. Besides epilepsy, other conditions that can cause seizures include a brain infection or injury, high fever, drug abuse, electric shock and hypoglycemia (low blood sugar).

To help make the diagnosis, your doctor will perform a physical exam and ask about your seizure symptoms. The doctor will likely order blood tests to rule out other disorders as the source of your seizures. Your doctor may recommend an electroencephalogram (EEG), which measures the electrical activity in your brain, and an MRI or CT scan of your brain, which can reveal tumors and blood vessel abnormalities.

There are several treatment options for epilepsy. The goal of treatment is to reduce the number of seizures or stop them completely. Initial options include anti-epileptic medications and dietary therapy. If your epilepsy is resistant to those approaches, surgery to remove or disconnect the part of your brain causing the seizures may be recommended.

Between 70 and 80 percent of people with epilepsy can successfully control their seizures through medication or surgical techniques.

Another method for treating epilepsy seizures is deep brain stimulation. This involves surgically implanting electrodes into the specific areas of your brain where the seizures originate. These areas are identified through special neurological testing called brain mapping. A generator is also implanted into your chest. The generator sends electrical impulses to the electrodes in your brain to help reduce seizures.

Most seizures don’t require emergency medical attention. However, have someone call 911 if your seizure lasts for more than five minutes or if you have a series of seizures in a row without a recovery period in between.

Patti DiPanfilo

Highlighting Pulmonary Hypertension

November 4th, 2022

November is Pulmonary Hypertension Awareness Month. Pulmonary hypertension is high pressure in your pulmonary arteries, the blood vessels that carry blood from your heart to your lungs. Oxygen-poor blood returns to the right side of your heart. The lower chamber — the right ventricle — pumps the blood into the pulmonary arteries and into the lungs to be enriched with oxygen. Your heart then pumps the oxygen-rich blood to your body’s organs and tissues.

When your pulmonary pressure is consistently high, the arteries in your lungs can narrow, and your heart must work harder to pump blood into the lungs. Over time, this extra work weakens your heart and you can develop heart failure, a condition in which your heart can no longer pump enough oxygen-rich blood for your body’s daily needs.

Many things can cause pulmonary hypertension. These include certain congenital heart defects; connective tissue disease; coronary artery disease; liver disease, such as cirrhosis; hypertension (high blood pressure); blood clots in the pulmonary arteries; HIV; pulmonary fibrosis (a condition causing scarring in the lungs); chronic lung disease, such as emphysema; heart failure; and genetics.

Pulmonary hypertension may not cause any signs or symptoms at first. In many cases, shortness of breath or lightheadedness during activity is the first symptom. As the condition progresses, signs and symptoms may become more noticeable and may include:

• Increased shortness of breath, first with activity and eventually even at rest.
• Bluish lips and skin.
• Dizziness or fainting.
• Fatigue.
• Decreased appetite.
• Chest pain or pressure.
• Palpitations (rapid, pounding heartbeats).
• Swelling of the ankles, legs and belly.

The early signs and symptoms, such as shortness of breath and fatigue, are common to many other medical conditions. Therefore, diagnosis is often delayed until more serious symptoms develop.

Because pulmonary hypertension may be caused by many medical conditions, your doctor will perform a thorough medical history and physical exam, including a detailed discussion of your symptoms. This helps the doctor rule out other disorders.

Your doctor may order certain tests to aid in the diagnosis. These include blood tests; lung function tests; and imaging exams, such as a chest x-ray, CT or MRI, to get a closer look at your lungs and right ventricle. The doctor may recommend an echocardiogram, which uses sound waves to create moving pictures of your beating heart. This shows blood flow through your heart. A right heart catheterization can confirm the diagnosis of pulmonary hypertension.

There is no cure for pulmonary hypertension, but treatment is available to help improve signs and symptoms and slow the progression of the disorder. The treatment you receive will depend, in part, on the cause of your condition and will focus on treating the cause. However, certain treatments are generally used no matter what the cause.

Medications such as diuretics, or water pills, reduce fluid buildup in your body. Anticoagulants, or blood thinners, help prevent blood clots from forming or growing larger. Inotropic agents improve the heart’s pumping ability. Vasodilators relax and open narrowed blood vessels and improve blood flow. A drug called digoxin helps your heart beat stronger and pump more blood. Your doctor may recommend therapy to raise the level of oxygen in your blood.

If medications don’t control your signs and symptoms, your doctor may recommend surgery. Surgical procedures includes atrial septostomy, an open-heart surgery in which the surgeon creates an opening between the upper left and right chambers of the heart (atria) to ease the pressure on the right side of the heart.

A lung or heart-lung transplant may be recommended in severe cases that don’t respond to any treatments. In these cases, your lungs or your heart and lungs are removed and replaced with healthy organs from a donor.

Certain lifestyle changes can also help improve your life with pulmonary hypertension. Consider making these changes:

• Quit smoking.
• Eat a healthy diet. Include a variety of fruits, vegetables, whole grains and lean protein. Ask your doctor if you need to limit anything in your diet, such as salt or vitamin K. Vitamin K, for instance, can affect how well blood-thinning medications work.
• Be physically active. Incorporate regular activity such as walking into your daily routine. Ask your doctor if there are any activities, such as lifting heavy objects, you should avoid.
• Seek emotional support. Living with a serious, chronic disorder such as pulmonary hypertension can cause emotional issues, such as anxiety and depression. Tell your doctor how you feel. He or she can direct you to the appropriate resources (counseling, medication, patient support group).

Patti DiPanfilo

SIDS: A Silent Killer

November 2nd, 2022

Sudden Infant Death Syndrome is the sudden, unexpected and unexplained death of a seemingly healthy baby less than 1 year old. SIDS is sometimes called crib death because it usually occurs when babies are asleep in their cribs. SIDS is a silent killer.

Reduce the risk of SIDS by laying your baby on his or her back at bedtime.

About 2,300 babies die of SIDS each year in the US. It is the most common cause of death in babies between the ages of 2 weeks to 1 year. It most often occurs in babies between 2 months and 4 months old. It occurs more often in African American and Native American babies than in Caucasian babies and is slightly more common in boys than in girls.

SIDS doesn’t have any recognizable symptoms. It happens to babies that appear healthy. A diagnosis of SIDS is one of exclusion. The diagnosis is generally made if no clear cause of death can be determined after a thorough investigation that includes an autopsy.

There are certain factors that increase a baby’s risk of dying from SIDS. The most important is laying down a baby to sleep on the stomach or side rather than the back. Other factors that increase risk include:

• A family history of SIDS.
• Being overheated with blankets or a high room temperature.
• Co-sleeping (sharing a bed with a parent or caretaker).
• Having a mattress that’s too soft.
• Having soft objects in the crib, such as stuffed toys, bumper pads, quilts and pillows
• Being born prematurely or having a low birth weight.
• A mother younger than 20 years old.
• A mother who received inadequate or no prenatal care.
• A mother who smoked, drank alcohol or took drugs during pregnancy.
• Exposure to secondhand smoke.

The cause of SIDS is unknown but researchers are studying certain theories. Many believe that SIDS is related to a baby’s inability to arouse from sleep when not getting sufficient oxygen from breathing. As a result, carbon dioxide builds up in the bloodstream. A high level of carbon dioxide can lead to death. Some researchers believe this occurs because the center in the baby’s brain that controls arousal is not fully developed.

The proposed “Triple-Risk Model” suggests that three factors combine to cause SIDS. This theory holds that SIDS occurs when an underlying brain abnormality and a triggering event, such as a poor sleep position (sleeping on the stomach), occur during a vulnerable stage in a baby’s development, essentially the first six months of life.

It may be frightening to know that there’re no symptoms to be alert for and no clear cause of SIDS, so there’s no way to prevent it from happening. But there are some tips for reducing a baby’s risk for SIDS. These include:

• Lay your baby on his or her back when putting him or her down for a nap and at night.
• Avoid overheating your baby. Don’t tightly swaddle your baby in a blanket and keep the room temperature at a level that’s comfortable for a lightly clothed adult.
• Don’t co-sleep with your baby or let your baby sleep with other children or adults.
• Choose a firm, safety-approved crib mattress and use a fitted sheet.
• Keep toys, bumper pads, fluffy blankets, quilts and pillows out of the crib when the baby is sleeping.
• Don’t smoke, drink or take drugs while pregnant and if breastfeeding.
• Get proper prenatal care during pregnancy.
• Don’t let anyone smoke around your baby.
• Set up your baby’s sleep area close to you but separate from your bedroom or those of other children.

In addition, make sure everyone who cares for your baby – including grandparents and other relatives, babysitters and friends – knows these recommendations. And consider sharing these tips with other parents and caregivers of infants.

Patti DiPanfilo

Concerning Sudden Cardiac Arrest

October 26th, 2022

A sudden cardiac arrest, or SCA, is sometimes referred to as a “massive heart attack,” but that moniker is not quite accurate. It’s true that SCA affects the heart, but it’s not a true heart attack. A heart attack occurs when blood flow to a part of the heart is stopped or slowed, generally due to a blockage in the coronary arteries, causing the death of heart muscle tissue.

Generally, there are signs and symptoms signaling a heart attack, and in most cases those hearts continue to beat after the event. But with SCA, people just collapse and 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.

Arrhythmia (Irregular Heartbeat): How It Causes Sudden Cardiac Arrest

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 right atrium, or upper chamber, and is carried through designated pathways to the heart muscle cells. The cells then all contract at once to produce a heartbeat.

If there’s an interruption anywhere along that electrical 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 to stop beating.

Most people at risk for SCA have coronary artery disease (CAD), although some don’t know they have it. There are other preexisting heart conditions that can lead to SCA, including cardiomyopathy, or an enlarged heart, valvular heart disease and a congenital heart condition, a problem 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 and/or high cholesterol; being overweight or obese; and living a sedentary lifestyle. Drinking more than two drinks 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 a family history of SCA. If you’ve had a heart attack or a family history of heart disease, your risk for SCA increases. The risk also 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 trigger SCA. This is called commotio cordis. Strenuous physical activity can trigger SCA, but in most cases, there is an underlying heart problem. This is often the case when athletes in top physical condition experience SCA.

About 95 percent of SCA sufferers die, often within minutes. Rapid treatment is critical, not only for survival but also to minimize damage to the brain from being without oxygenated blood. When the heart stops beating, blood flow to the rest of the body 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 (AED) are available in many public places, including shopping malls, buses, 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 necessary to restore normal rhythm.

If you witness someone experiencing 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.

If you survive an SCA or are at very high risk for SCA, your doctor may choose to place an implantable cardioverter defibrillator (ICD). An ICD goes 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 coronary artery disease, 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 lifestyle changes to reduce your risk of CAD and SCA. Lifestyle behaviors to put into practice 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.

Patti DiPanfilo

Living With Your Liver

October 20th, 2022

Your liver is the second largest organ in your body, behind only your skin. The liver is also the largest gland. It makes and secretes chemicals that are used by other parts of your body to perform key processes. Your liver sits just under your ribcage on your right side. It’s about the size of a football and weighs on average about 3.5 pounds.

The liver is essential for life. It performs more than 500 vital functions that keep your body healthy and working properly. These functions include storing nutrients; removing toxins, waste products and worn-out cells from your blood; filtering and processing chemicals in food, alcohol and medications; and producing bile, a fluid that helps in digestion.

Liver disease is any disorder that negatively impacts the healthy performance of your liver. There are many disorders that fall under this umbrella. They include:

• Viral infections, such as hepatitis.
• Diseases associated with consuming too many toxins, including alcohol-related liver disease and fatty liver disease.
• Inherited diseases, such as hemochromatosis, Wilson disease and alpha-1 antitrypsin deficiency.
• Conditions that occur when your immune system mistakenly attacks your liver, such as autoimmune hepatitis, primary sclerosing cholangitis and primary biliary cholangitis.
• Liver cancer (hepatocellular carcinoma), a condition in which the cells in your liver develop abnormally and grow out of control.
Cirrhosis, a condition in which your liver is severely scarred and permanently damaged.

Without treatment, these conditions can ultimately lead to liver failure, when large parts of your liver become damaged and can’t function anymore. At this point, you may require a liver transplant, when your diseased liver is removed and replaced with a healthy liver from a donor.

Certain factors increase your risk for liver disease. The most well-known is heavy drinking, which is defined by the Centers for Disease Control and Prevention as more than eight alcoholic drinks per week for women and more than 15 drinks per week for men.

Other risk factors include:

• A family history of liver disease.
• Diabetes or high cholesterol.
• A job that exposes you to blood and other body fluids.
• Being overweight or obese.
• Taking certain supplements or herbs, especially in large amounts.
• Mixing certain medications with alcohol.
• Taking more than the recommended dose of certain medications.
• Sharing needles for drug use.
• Having unprotected sex.

Each liver disease has its own signs and symptoms, but some common ones to be aware of include jaundice, a yellowing of the skin and whites of the eyes; bleeding or easy bruising; swelling of the legs or ankles; pain in the abdomen; itchy skin; dark urine; pale, bloody or black stools; a buildup of fluid in the belly, called ascites; and fatigue.

To diagnose liver disease, your doctor will review your history and symptoms and perform a thorough physical examination. The doctor will also recommend certain tests, bloodwork to measure liver enzymes. Abnormal levels may indicate problems with your liver function.

Your doctor may also use imaging tests, such as ultrasound, MRI or CT, to look for signs of damage, scarring or tumors in your liver. Another test your doctor may suggest is a liver biopsy, during which a needle is used to remove a small sample of liver tissue for analysis.

Treatment depends on the type of disease and how far it has progressed. In general, treatment for includes medications and lifestyle changes. Medications may include antiviral drugs to treat hepatitis, steroids to reduce inflammation, antibiotics and other medications to target specific symptoms. An organ transplant is a last resort for liver failure.

While not all diseases can be prevented, you can help keep your liver healthy by making some key lifestyle choices, such as:

• Eat a liver-friendly diet rich in fruits and vegetables, lean proteins, whole grains and fiber.
• Exercise regularly.
• Limit alcohol consumption.
• Avoid smoking and using drugs.
• Maintain a healthy weight.
• Practice safe sex.
• Don’t take more than the recommended dose of medications.
• Drink more water to help remove toxins and flush liver tissues
• Visit a doctor annually for a physical and bloodwork.

October is Liver Awareness Month. Follow these suggestions and live with a healthier liver.

Patti DiPanfilo

A Short Discourse On Down Syndrome

October 12th, 2022

All cells in your body contain genes, which are made up of DNA, the molecule that holds the instructions for how your body grows, works and looks. Genes are contained in tiny, spaghetti-like structures called chromosomes inside the cell’s nucleus. Typically, there are 46 chromosomes in each cell, 23 that are passed on from your mother and 23 from your father.

A baby born with Down syndrome has an extra copy of a specific chromosome: chromosome 21. This extra genetic material can impact how the brain and body mature and leads to varying degrees of intellectual and developmental disability.

Children with Down syndrome can learn and develop skills, but reach goals at a different pace than most kids.

The extra chromosome also puts the baby at increased risk for certain health conditions, including heart defects, hearing loss, vision problems, seizures, sleep disorders, infections and thyroid problems, typically hypothyroidism (underactive thyroid).

People with Down syndrome often have distinctive physical features. These include a flattened face with a flat nose, almond-shaped eyes that slant upward, tiny white spots on the iris (colored part of the eye), poor muscle tone or loose joints, small stature, short neck, small hands and feet, small ears, and a single line across the palms of the hands (called a palmar crease).

People with Down syndrome typically have some degree of developmental disability, but it’s generally mild to moderate. They may be slow to reach developmental milestones such as crawling, walking and talking. Mental and social delays may result in impulsive behavior, poor judgment, short attention spans and slow learning.

The syndrome is named for English physician John Langdon Down, who published an accurate description of a person with the ailment and originally classified it in the 1860s. In 1959, French physician Jérôme Lejeune identified Down syndrome as a chromosomal condition.

Each year, about 6,000 babies in the United States are born with the condition. That works out to about one in every 700 babies (less than 1 percent). More than 400,000 people are living with Down syndrome in the US today. It’s the most common chromosomal condition diagnosed in the country.

There are three types of Down syndrome:

Trisomy 21 is the most common, affecting about 95 percent of people with Down syndrome. With trisomy 21, each cell in the body has an extra copy of chromosome 21.
Translocation Down syndrome affects about 3 percent of people with the syndrome. In this case, an extra part or entire extra chromosome 21 is present, but it’s attached to — or “translocated” — to a different chromosome, often chromosome 14.
Mosaic Down syndrome is rare, occurring in only about 1 percent of cases. “Mosaic” means “mixture” or “combination.” With mosaic Down syndrome, some of the body’s cells have three copies of chromosome 21 and others have the typical two copies.

Researchers believe that many factors contribute to the development of Down syndrome but don’t know exactly how it occurs. They do know that the risk of having a baby with Down syndrome increases with the age of the expectant mother – especially 35 or older. The risk is also higher if the mother previously had a baby with Down syndrome.

Health care providers typically offer testing for Down syndrome as part of routine prenatal care. There are two types of tests: screening and diagnostic. Screening tests, which include blood tests and ultrasound, can help determine a baby’s risk for Down syndrome.

Physicians can confirm a diagnosis of Down syndrome using a karyotype, a lab-produced image of chromosomes created from a blood sample.

If the screening tests show the baby is at high risk, the parent may decide to undergo diagnostic testing, which can confirm Down syndrome is present. Diagnostic tests involve taking a sample of the baby’s blood, amniotic fluid or tissue for testing. However, with diagnostic testing — which includes chorionic villus sampling (CVS), amniocentesis and percutaneous umbilical blood sampling (PUBS) — there is some risk of miscarriage, fetal injury and preterm labor.

The doctor can also diagnose Down syndrome after birth based on the physical signs of the ailment. The doctor will also take a blood sample and send it to a lab for a chromosomal analysis called a karyotype to confirm the diagnosis.

There is no treatment for Down syndrome. Experts recommend early intervention with specialized services to help the child maximize potential and have the best outcome. These services include an Individualized Education Program (IEP), which addresses the child’s special needs in school, and physical, occupational, speech and behavioral therapy.

Children with Down syndrome can learn and develop skills; they just reach goals at a different pace than typical kids. With ongoing therapy and support, most people with Down syndrome can attend school, work and become active members of their community.

Let’s celebrate them during this National Down Syndrome Awareness Month.

Patti DiPanfilo

https://www.cdc.gov/ncbddd/birthdefects/downsyndrome.html
https://www.ndss.org/about-down-syndrome/down-syndrome/
https://www.medicalnewstoday.com/articles/145554
https://kidshealth.org/en/parents/down-syndrome.html
https://www.marchofdimes.org/complications/down-syndrome.aspx
https://my.clevelandclinic.org/health/diseases/17818-down-syndrome

The Bottom Line On Breast Cancer

October 3rd, 2022

By now, it’s common knowledge that October is Breast Cancer Awareness Month, an observance commemorated worldwide. Simply put, breast cancer is the uncontrolled growth of abnormal cells in the tissues of the breast. The abnormal cells ultimately form a lump, or tumor, in the breast.

Breast cancer is the second most common cancer in women in the United States, behind skin cancer. It accounts for about 30 percent of all new cancers in females each year. While breast cancer is much more common in women, men can be affected as well.

According to the American Cancer Society, about 287,850 new cases of invasive breast cancer and about 51,400 new cases of noninvasive breast cancers are expected to be diagnosed in women in 2022. About 43,250 women are expected to die from breast cancer in 2022. In addition, about 2,710 new cases of invasive breast cancer are expected to be diagnosed in men in 2022, and about 530 men are expected to die from it.

Each breast is composed of three main parts: lobules, ducts and connective tissue. The lobules are glands that produce breast milk. The ducts are tiny tubes that carry the milk to the nipple, and the connective tissue holds all the breast tissues in place. Most breast cancers begin in the ducts and lobules and are called invasive ductal carcinoma and invasive lobular carcinoma. Invasive ductal carcinoma makes up 70 to 80 percent of all breast cancers.

Ductal carcinoma in situ (DCIS) is a breast disease that may lead to invasive breast cancer. It is also referred to as stage 0 breast cancer because the abnormal cells are only found in the lining of the ducts. They haven’t spread to other tissues in the breast or other parts of the body.

Symptoms of breast cancer can vary from person to person. Some people experience no signs or symptoms. Possible warning signs include a change in the size, shape or contour of the breast; a mass or lump in the breast or underarm; a rash around or on a nipple; discharge from a nipple that may contain blood; armpit or breast pain that doesn’t change with the menstrual cycle; and irritation or dimpling of the skin of the breast.

Doctors don’t know what causes abnormal cells in the breast to divide and multiply, but genetics seems to play a role in the development of some breast cancers.

Researchers have also identified several factors that increase the risk for developing breast cancer. These include age (risk is higher in those 55 and older); family history of breast cancer; smoking; alcohol use; obesity; previous radiation exposure, especially to the head, neck or chest; and hormone therapy. Women who use hormone replacement therapy (HRT) after menopause or the pill for contraception are at an increased risk.

Breast cancer screening can detect signs or symptoms. It cannot prevent breast cancer, but it can catch it in its early stages when it’s easier to treat. Screening begins with you. Examine your breasts regularly to look for changes in size and shape. Also feel your breasts for lumps.

The most common screening test for breast cancer is the mammogram, which is an x-ray of the breast to look for abnormalities, including tumors. Another screening test is ultrasound, which uses sound waves to create pictures of the insides of the breasts. Ultrasound can differentiate between a solid mass and a fluid-filled cyst.

The doctor may follow up with a breast MRI, which provides detailed images of the inside of the breast. An MRI can help a doctor identify cancer and other abnormalities within the breasts. If a tumor is detected, the doctor may take a sample of its tissue to analyze under a microscope, a process called biopsy.

Treatment options for breast cancer include surgery, chemotherapy, radiation therapy, hormone therapy, immunotherapy and targeted drug therapy. The treatment or combination of treatments chosen depends on the type of breast cancer and how far it has spread from its original site.

There are different types of surgery for breast cancer. A lumpectomy removes the tumor and an area of healthy tissue surrounding it. A mastectomy is the removal of the entire breast, which is often followed by a breast reconstruction. Other procedures remove lymph nodes affected by the cancer.

Chemotherapy may be recommended before surgery to help shrink tumors or after surgery to kill remaining cancer cells. Radiation therapy is typically used after surgery to destroy remaining cancer cells.

Some types of breast cancer feed on hormones, such as estrogen and progesterone. Hormone therapy is used to either lower these hormone levels or stop the hormones from attaching to cancer cells. This is often used after surgery to prevent hormone-sensitive cancers from recurring.

Immunotherapy energizes the body’s infection-fighting immune system to fight cancer cells. Targeted drug therapy uses certain drugs that target specific cell characteristics that lead to cancer.

Unfortunately, there is no way to prevent breast cancer. However, there are steps that can significantly lower the risk for developing the disease. These include limiting alcohol consumption, eating a healthy diet with plenty of fruits and vegetables, exercising regularly, maintaining a healthy weight and following doctor recommendation for screening exams, including mammograms.

With more emphasis on screening and improved treatments, the survival rates for people with breast cancer are increasing. That’s the best news to celebrate this Breast Cancer Awareness Month.

Patti DiPanfilo

It’s Childhood Cancer Awareness Month

September 23rd, 2022

Childhood Cancer Awareness Month is observed every September by cancer organizations around the globe. According to the American Cancer Society, about 10,470 children in the US younger than 15 will be diagnosed with cancer in 2022, and about 1,050 children in that age group are expected to die from it. After accidents, cancer is the second leading cause of death in children ages 1 to 14.

The most common cancers in children are not the same as those seen most often in adults. When adults get cancer, it often begins in the lungs, breast, colon, prostate or skin. But in children, cancer tends to affect their white blood cells, nervous system, brain, bones, lymphatic system, muscles or kidneys.

How cancer spreads and is treated is typically different for children, too. That’s mostly due to children’s unique response to treatment. Another difference between childhood cancers and adult cancers is that the recovery rate is higher in children. Most children with cancer can be cured.

Thanks to advances in diagnosis and treatment over the years, 85 percent of children that are diagnosed with cancer now survive five years or longer. In the 1970s, that figure stood at 58 percent, so we’ve come a long way.

Acute lymphoblastic leukemia (ALL) is the most common childhood cancer, accounting for approximately 34 percent of all cancers in children. Leukemia is a cancer that begins in the bone marrow and spreads to the blood. From there, it can travel to other parts of the body. Three out of four leukemia cases are ALL.

Tumors of the brain and nervous system are also common in children, making up about 27 percent of childhood cancers. Central nervous system tumors are cancers of the brain and spinal cord. CNS tumors are the most common solid tumors in childhood, and they have the highest mortality rate of the childhood cancers.

Lymphoma is a less common childhood cancer that affects special cells called lymphocytes that are part of the body’s immune system. Lymphomas target the lymphatic system, the network of vessels, organs and tissues that carry clear fluid called lymph, which contains disease-fighting white blood cells through the body.

There are two main types of lymphoma: Hodgkin lymphoma, also called Hodgkin disease, and non-Hodgkin lymphoma. Hodgkin lymphoma is a cancer of the lymph nodes. It can start almost anywhere in the body and then spread to just about any organ or tissue. These often include the liver, bone marrow and spleen.

Non-Hodgkin lymphoma affects the T and B lymphocytes, which are the immune system’s natural killer cells. These cells are produced in the bone marrow, then travel to the lymph glands and to the thymus gland, intestinal tract, tonsils and spleen. Non-Hodgkin lymphoma can start in any of those areas.

Fortunately, childhood lymphoma is rare. Only about 8 percent of childhood cancers are lymphomas: 5 percent of children with cancer will have non-Hodgkin lymphoma while 3 percent will have Hodgkin lymphoma.

Certain cancers in adults and children are hereditary. But in adults, many other factors can contribute to the development of cancer. These include lifestyle and environment influences such as exposure to cigarette smoke, asbestos and ultraviolet radiation from the sun.

But in children, cancer is most often the result of DNA mutations that occur very early in the life or while the child is developing in the womb. As such, lifestyle and environmental factors play only a minor role in the development of childhood cancers.

There are multiple treatment options for childhood cancer. The treatment options depend on the type of cancer and how advanced it is. Among the types of cancer treatment are surgery, chemotherapy, radiation therapy, immunotherapy and stem cell transplants.

Each childhood cancer has its own signs and symptoms, but there are some general ones. Possible signs and symptoms include:

• An unusual lump or swelling
• Easy bruising or bleeding
• An ongoing pain in one area of the body
• Unexplained fever or illness that doesn’t go away
• Frequent headaches, often with vomiting
• Sudden unexplained weight loss

A child displaying any of these signs and symptoms should be taken to a physician for an evaluation. Early detection helps ensure a positive outcome from childhood cancer.

Patti DiPanfilo

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