Archive | May 2015

What are STENTS

stent

A stent is a wire mesh tube that is used to help hold open an artery. To simple understanding this concept think of a plumber or a mechanic. With a plumber sometimes they have to replace a certain area of a pipe that connects the water or like a mechanic replacing a certain area of piping (like the muffler piping connected infront of the muffler than can either can be replaced or just welded with piece of piping welded just to save money. Well a stent opens the artery that was clogged and its put in that place to reinforce that area of the artery to remain open to allow blood to get to that heart from that coronary artery and it will stay there life to keep the artery permanently patent to prevent the blockage from happening again with the synthetic mesh piece.

Description

Stents are used to hold open diseased coronary arteries (these arteries supply blood to the heart), as well as diseased arteries of the peripheral vascular system (PVS). Peripheral means away from the heart the PVS is the arteries that supply blood to the rest of the body (again away from the heart all the way down to the hands and feet).

There are variety of stents currently available.

For a surgeon to find out if you even need one, first usually a angiogram is performed and this is a catheter simply from the femerol artery or from your arm to the coronary arteries. If the MD sees you show a blockage 80% or more an angioplasty is performed which is a balloon at the end of this catheter that blows up and decompresses to give the effect like punching gloves. The balloon inflates and deflates over and over again till the blockage breaks open free and then a stent is put in that area to help keep it open permanently (patent).

Some stents have been compressed onto the outside of an angioplasty balloon catheter and delivered by inflating the balloon in the desired location. Other stents are “self- expanding” spring-loaded devices, which expand automatically upon deployment.

Stents remain in arteries permanently. The tissue lining the arteries actually grows over the metal mesh to cover the inner lumen of the stent.

Stent procedures have become very common like tonsillectomies were in childhood. Stents are sometimes used as an alternative to coronary artery bypass surgery, if the patient is a candidate. Stents are often used in combination with balloon angioplasty. One leads to the other depending on what the angioplasty displays for the surgeon on the T.V. in when they are doing the procedure and if the come up to a blockage high enough to perform the angioplasty followed with a stent it will be done.

Stents are used in cases of “restenosis”, which refers to the re-closing of arteries after balloon angioplasty. In carefully selected patients, the use of stents can dramatically reduce restenosis following balloon angioplasty or other catheter-based procedures. Stents are used frequently to hold open the arteries that have been damaged, torn, or dissected by balloon angioplasty or other catheter-based procedures. Like plumber or mechanic, get it.

Stents allow angioplasty to be done in patients with severe and long-segment obstruction of coronary arteries. As soon as the I initial part of the block is widened, a stent is place, which holds it open allowing further opening to proceed. Stents have also allowed angioplasty to be performed in patients with blocks of multiple vessels, and in multiple blocks in a single artery.

Risks

Risks include the standard risks of an interventional, catheter-based procedure, which should be specifically discussed with your doctor. Lesions treated with stents can “restenosis” (re- narrow with in weeks to months after the procedure) similar to restenosis associated with angioplasty. This is why patients after having a stent put in they are on a medication for example like Plavix for life to prevent this occurrence from happening. It is a anti platelet medication, meaning it doesn’t allow clotting to happen in the stent so blockage doesn’t reoccur through clotting.

Many new technologies are being tested to reduce the problem of restenosis. These technologies include coating and coverings for the stent, new materials, and radiation. These new technologies are primarily experimental at this point and will reach soon to the market if not already. Technology allows the medical field to continuously expand and this will be replaced at one point but isn’t yet. Just give it time. At one point we had no CABG (coronary artery bypass) but now the stent in certain cases is replaced by angiograms to further expanding to angioplasties and stents furthering allowing the surgery to take place 1x hopefully if the patient is compliant in diet, exercise, and following the doctors orders with meds, activity and follow up visits (which are so vital).   A lot is up to the patient in caring or themselves to prevent having this take place again.

Follow up Instructions

Your doctor will recommend blood thinning medications following your stent procedure. These agents are usually given for one month post procedure along with aspirin and then continued indefinitely. Your doctor may also prescribe antibiotics for a period of time after the stent procedure, to be taken anytime you have a medical or dental procedure. Preventing infection.

MRI tests should not be done for at least eight weeks without your doctor’s approval. Metal detectors do not present a problem. Stents appear to be safe in the long-term; there are no long-term complications associated with a permanent stent.

 

QUOTE FOR THE WEEKEND:

There are a few main population groups who have a higher risk for sciatica than the rest of us. At highest risk are people between the ages of 30 and 50 years old. These people may be very active, which increases the possibility of injury. But they are also beginning to age, and that can mean degenerative changes in the spine.

What is sciatica nerve damage?

Sciatica2

Sciatica is pain, tingling, or numbness produced by an irritation of the sciatic nerve including the roots that start from the beginning of the sciatica nerve which can go all the way down the leg depending on the individual’s damage. The sciatic nerve is formed by the nerve roots coming out of the spinal cord into the lower back. It goes down through the buttock, then its branches extend down the back of the leg to the ankle and foot. When something presses on the sciatica nerve, like a herniated disc, it presses on that nerve which causes the pain from the buttock that can radiate all the way down to the foot. The intensity of the pressure on the nerve and where its pressed decides if it goes to the foot or less. Other causes of sciatica nerve damage:

The most common cause -a bulging or ruptured disc in the spine pressing against the nerve roots that lead to the sciatic nerve.

-Sciatica Nerve Damage can be a symptom of other conditions that affect

*Narrowing of the spinal canal due to spinal stenosis. This spinal canal narrowing pinches on the sciatica nerve.

*Bone spurs-they are growths that are small forming along joints caused by arthritis.

*Simply injury (like a car accident or fall) causing nerve root compression=again the same result-pinching the sciatica nerve.

*Pregnancy-not as common as a cause as the others listed.

*Rarely but also tumors could cause the problem also.

 

What are the symptoms?

Symptoms of sciatica include pain that begins in your back or buttock and moves down your leg and may move into your foot.

*Weakness, tingling, or numbness in the leg may also occur.

*At times a inconsistent stabbing feeling or pricking feeling in the ankle or foot

*Sitting, standing for a long time, and movements that cause the spine to flex (such asexercises using the knee to chest) which may make symptoms worse.

*Walking, lying down, and movements that extend the spine (such as press-ups) may relieve symptoms.

How is sciatica diagnosed?

Sciatica is diagnosed with a medical history and physical exam. Sometimes x-rays and other tests such as magnetic resonance imaging (MRI) are done to help find the cause of the sciatica.

What are the Complications?

Although most people recover fully from sciatica, often without any specific treatment, sciatica can potentially cause permanent nerve damage. Seek immediate medical attention if you experience:

-Loss of feeling in the affected leg                                                                                               -Weakness in the affected leg

-Loss of bowel or bladder function

How is it treated?

In many cases, sciatica will improve and go away with time. Initial treatment usually focuses on medicines and exercises to relieve pain. You can help relieve pain by:

*Avoiding sitting (unless it is more comfortable than standing).

*Alternating lying down with short walks. Increase your walking distance as you are able to, without pain.  

* Takingacetaminophen (tylenol) or Motrin (Ibuporfen) or Advil or Aleve (Naproxen). All are nonsteroidal anti-inflammatory drugs which decrease the swelling of the inflammation around the area or injury to the back which will decrease the pain. More inflammation=more pinching on the nerve.

*Using a heating pad on a low or medium setting for 15 to 20 minutes every 2 or 3 hours. Try a warm shower in place of one session with the heating pad. You can also buy single-use heat wraps that last up to 8 hours. You can also try an ice pack for 10 to 15 minutes every 2 to 3 hours. There is not strong evidence that either heat or ice will help, but you can try them to see if they help you.

*Additional treatment for sciatica depends on what is causing the nerve irritation. If your symptoms do not improve, your doctor may suggest physical therapy, injections of medicines such as steroids, stronger medicines such as muscle relaxants or opiates.                                                                                                                                                

*Physical Therapy or chiropracter therapy or some form of therapy for 6 to 8 weeks.

* If the therapy is uneffective than the last resort in most cases is surgery that ranges from:

– laser surgery

– scrapping of the vertebrae pinching the nerve with leaving the rest of the vertebrae spacing the spinal cord in place or removing the vertebrae pinching the nerve and replacing it with cement (not cement we use for sidewalks that we know of).   It’s natural to want to return to your regular activities as soon as possible after surgery, but a lot depends on the type of operation you get.

 

In two common methods, vertebroplasty and kyphoplasty, your surgeon makes a small cut in your back, which lets you recover faster. If you get spinal fusion surgery, the cut is larger, and it will take a longer time to heal.

 

-small endoscopic surgery that is microsurgery removing pieces of the vertebraepinching which has a test called a discogram (injecting a dye right into the injured disc and than a ultrasound of the area is done to show the surgeon the exact route he has to follow to cure the problem. The surgeon numbs the area that he will repair with the pt wide awake; he makes a incision about 2/10 of an inch, using the cat scan as a guide for his eyes inserting a scope inserting a grabber that goes in the scope removing disc fragments that are pressing on the nerves causing the pain. It takes about 30 minutes for this procedure with only a small bandage covering the incision followed with the patient leaving the hospital in less than a few hours

*Other self-care treatments that may be helpful include:

-Cold packs. Initially, you may get relief from a cold pack placed on the painful        area for up 20 minutes several times a day. Use an ice pack or a package of frozen peas wrapped in a clean towel.

-Hot packs. After two to three days, apply heat to the areas that hurt. Use hot packs, a heat lamp or a heating pad on the lowest setting. If you continue to have pain, try alternating warm and cold packs.

-Stretching. Stretching exercises for your low back can help you feel better and may help    relieve nerve root compression. Avoid jerking, bouncing or twisting during the stretch and try to hold the stretch at least 30 seconds.

-Over-the-counter medications. Pain relievers such as ibuprofen (Advil, Motrin, others) and naproxen (Aleve) are sometimes helpful for sciatica.

References:

National Cancer Society

Web MD

Mayo Clinic

Dr. Bruce Hensel M.D. (chief medical editor channel 4)

Dr. David Ditsworth Surgeon – does back scoping

Robert Forrest Physical Therapy in Santa Monica, California.In this article

 

QUOTE FOR FRIDAY:

“A stent is a tiny, metal mesh tube that is placed with a catheter and permanently embedded within the artery wall to prop open and prevent it from collapsing.”

You & Your Stent” is provided compliments of Daiichi Sankyo/Eli Lilly in Partnership with SCAI. Copyright © 2013 Daiichi Sankyo, Inc. and Lilly

QUOTE FOR THURSDAY:

“Cardiac arrest is reversible in most victims if treated within a few minutes. It’s critical to recognize the symptoms and act quickly.”

The American Heart Association

QUOTE FOR WEDNESDAY:

Sodium plays a key role in your body. It helps maintain normal blood pressure, supports the work of your nerves and muscles, and regulates your body’s fluid balance.

MAYO CLINIC

What is hyponatremia and how does it affect the human body?

sodium

Hyponatremia is a condition that occurs when the level of sodium in your blood is abnormally low. Sodium is an electrolyte, and it helps regulate the amount of water that’s in and around your cells.

In hyponatremia, one or more factors — ranging from an underlying medical condition to drinking too much water during endurance sports causes the sodium in your body to become diluted. When this happens, your body’s water levels rise, and your cells begin to swell. This swelling can cause many health problems, from mild to life-threatening.

Hyponatremia treatment is aimed at resolving the underlying condition. Depending on the cause of hyponatremia, you may simply need to cut back on how much you drink. In other cases of hyponatremia, you may need intravenous fluids and medications.

Sodium we know what systems it effects from yesterday’s article on sodium in general of how it works in the human body.  If you don’t know and didn’t get a chance to read it yesterday stop this article going to yesterday’s to read over the general information of how sodium works and effects the human body.  This will help you understand the signs and symptoms easier.

Hyponatremia signs and symptoms may include:

  • Nausea and vomiting
  • Headache
  • Confusion
  • Loss of energy and fatigue
  • Restlessness and irritability
  • Muscle weakness, spasms or cramps
  • Seizures
  • All the way to a ComaA normal sodium level is between 135 and 145 milliequivalents per liter (mEq/L) of sodium. Hyponatremia occurs when the sodium in your blood falls below 135 mEq/L.
  • Many possible conditions and lifestyle factors can lead to hyponatremia, including:
  • Sodium plays a key role in your body. It helps maintain normal blood pressure, supports the work of your nerves and muscles, and regulates your body’s fluid balance playing a particular role in acid and base balances inside our blood stream working with in particular potassium.
  • Certain medications. Some medications, such as some water pills (diuretics), antidepressants and pain medications, can cause you to urinate or perspire more than normal.  Medications that increase your risk of hyponatremia include thiazide diuretics as well as some antidepressants and pain medications. In addition to the recreational drug Ecstasy has been linked to fatal cases of hyponatremia.
  • Heart, kidney and liver problems. Congestive heart failure and certain diseases affecting the kidneys or liver can cause fluids to accumulate in your body, which dilutes the sodium in your body, lowering the overall level.
  • Syndrome of inappropriate anti-diuretic hormone (SIADH). In this condition, high levels of the anti-diuretic hormone (ADH) are produced, causing your body to retain water instead of excreting it normally in your urine.
  • Chronic, severe vomiting or diarrhea. This causes your body to lose fluids and electrolytes, such as sodium.
  • Drinking too much water. Because you lose sodium through sweat, drinking too much water during endurance activities, such as marathons and triathlons, can dilute the sodium content of your blood. Drinking too much water at other times can also cause low sodium.
  • Dehydration. Taking in too little fluid can also be a problem. If you get dehydrated, your body loses fluids and electrolytes.
  • Hormonal changes. Adrenal gland insufficiency (Addison’s disease) affects your adrenal glands’ ability to produce hormones that help maintain your body’s balance of sodium, potassium and water. Low levels of thyroid hormone also can cause a low blood-sodium level.
  • The recreational drug Ecstasy. This amphetamine increases the risk of severe and even fatal cases of hyponatremia. In acute hyponatremia, sodium levels drop rapidly — resulting in potentially dangerous effects, such as rapid brain swelling, which can result in coma and death.Seek emergency care for anyone who develops severe signs and symptoms of hyponatremia, such as nausea and vomiting, confusion, seizures, or lost consciousness.
  • Call your doctor if you know you are at risk of hyponatremia and are experiencing nausea, headache, cramping or weakness. Depending on the extent and duration of these signs and symptoms, your doctor may recommend seeking immediate medical care.
  • Premenopausal women appear to be at the greatest risk of hyponatremia-related brain damage. This may be related to the effect of women’s sex hormones on the body’s ability to balance sodium levels.
  • In chronic hyponatremia, sodium levels drop gradually over 48 hours or longer — and symptoms and complications are typically more moderate.
  • Also for older adults they may have more contributing factors for hyponatremia, including age-related changes, taking certain medications and a greater likelihood of developing a chronic disease that alters the body’s sodium balance.

QUOTE FOR TUESDAY

Heart disease is the leading cause of death in the United States for both men and women.

Robert F. Malacoff, M.D (is a Board-certified Cardiologist and Electrophysiologist who treats patients at Orange Regional Medical Group and Catskill Regional Medical Group and has been providing exceptional care for more than 35 years)

Part 2 Post traumatic stress disorder

ptsd Part 2

Many risk factors revolve around the nature of the traumatic event itself.

Traumatic events are more likely to cause PTSD when they involve a severe threat to your life or personal safety: the more extreme and prolonged the threat, the greater the risk of developing PTSD in response. Intentional, human-inflicted harm—such as rape, assault, and torture— also tends to be more traumatic than “acts of God” or more impersonal accidents and disasters. The extent to which the traumatic event was unexpected, uncontrollable, and inescapable also plays a role.

Women’s changing role in our military

A growing number of women are serving in the US military. In 2008, 11 of every 100 Veterans (or 11%) from the Afghanistan and Iraq military operations were women. These numbers are expected to keep rising. In fact, women are the fastest growing group of Veterans.

What stressors do women face in the military?

Here are some stressful things that women might have gone through while deployed:

-Combat Missions.                                                                                                                                                                               –Military -Sexual Trauma (MST). A number of women (and men) who have served in the military experience MST. MST includes any sexual activity where you are involved against your will, such as insulting sexual comments, unwanted sexual advances, or even sexual assault.

-Feeling Alone. In tough military missions, feeling that you are part of a group is important.

-Worrying About Family. It can be very hard for women with young children or elderly parents to be deployed for long periods of time. Service members are often given little notice. They may have to be away from home for a year or longer. Some women feel like they are “putting their lives on hold.”

Because of these stressors, many women who return from deployment have trouble moving back into civilian life. While in time most will adjust, a small number will go on to have more serious problems like PTSD.

How many women Veterans have PTSD?

Among women Veterans of the conflicts in Iraq and Afghanistan, almost 20 of every 100 (or 20%) have been diagnosed with PTSD. We also know the rates of PTSD in women Vietnam Veterans. An important study found that about 27 of every 100 female Vietnam Veterans (or 27%) suffered from PTSD sometime during their postwar lives. To compare, in men who served in Vietnam, about 31 of every 100 (or 31%) developed PTSD in their lifetime.

What helps? Research shows that high levels of social support after the war were important for those women Veterans.

What can you do to find help?

If you are having a hard time dealing with your wartime memories, there are a number of things that you can do to help yourself. There are also ways you can seek help from others.

  • Do things to feel strong and safe in other parts of your life, like exercising, eating well, and volunteering.
  • Talk to a friend who has been through the war or other hard times. A good friend who understands and cares is often the best medicine.
  • Join a support group. It can help to be a part of a group. Some groups focus on war memories. Others focus on the here and now. Still others focus on learning ways to relax.
  • Talk to a professional. It may be helpful to talk to someone who is trained and experienced in dealing with aging and PTSD. There are proven, effective treatments for PTSD. Your doctor can refer you to a therapist. You can also find information on PTSD treatment within VA at: VA PTSD Treatment Programs.
  • Tell your family and friends about LOSS and PTSD. It can be very helpful to talk to others as you try to place your long-ago wartime experiences into perspective. It may also be helpful for others to know what may be the source of your anger, nerves, sleep, or memory problems. Then they can provide more support.

Don’t be afraid to ask for help. Most of all, try not to feel bad or embarrassed to ask for help. Asking for help when you need it is a sign of wisdom and strength.

Don’t let PTSD get in the way of your life, hurt your relationships, or cause problems at work or school.

PTSD treatment can help.

Learn what treatment is like to help you make choices about what’s best for you.

If you suspect that you or a loved one has post-traumatic stress disorder (PTSD), it’s important to seek help right away. The sooner PTSD is confronted, the easier it is to overcome. If you’re reluctant to seek help, keep in mind that PTSD is not a sign of weakness, and the only way to overcome it is to confront what happened to you and learn to accept it as a part of your past.

OTHER TYPES OF TREATMENT:

  • Trauma-focused cognitive-behavioral therapy. Cognitive-behavioral therapy for PTSD and trauma involves carefully and gradually “exposing” yourself to thoughts, feelings, and situations that remind you of the trauma. Therapy also involves identifying upsetting thoughts about the traumatic event–particularly thoughts that are distorted and irrational—and replacing them with more balanced picture.
  • Family therapy. Since PTSD affects both you and those close to you, family therapy can be especially productive. Family therapy can help your loved ones understand what you’re going through. It can also help everyone in the family communicate better and work through relationship problems caused by PTSD symptoms.
  • Medication is sometimes prescribed to people with PTSD to relieve secondary symptoms of depression or anxiety. Antidepressants such as Prozac and Zoloft are the medications most commonly used for PTSD. While antidepressants may help you feel less sad, worried, or on edge, they do not treat the causes of PTSD.
  • EMDR (Eye Movement Desensitization and Reprocessing) incorporates elements of cognitive-behavioral therapy with eye movements or other forms of rhythmic, left-right stimulation, such as hand taps or sounds. Eye movements and other bilateral forms of stimulation are thought to work by “unfreezing” the brain’s information processing system, which is interrupted in times of extreme stress.
  • When looking for a therapist for post-traumatic stress disorder (PTSD), seek out mental health professionals who specialize in the treatment of trauma and PTSD. You can start by asking your doctor if he or she can provide a referral to therapists with experience treating trauma. You may also want to ask other trauma survivors for recommendations, or call a local mental health clinic, psychiatric hospital, or counseling center.

You have to remember the problem is not you, but the traumatic experience you went through whether it was a few weeks ago, a few years ago or 40 years ago. This  has left you in a black hole that you can’t get out of. You need to get that bad experience you went through that’s left in your brain  under control or with some form of closure. To do that you first need to recognize you need help and you are better off doing it with a group or a counselor. For you to help anyone else you have to help yourself.  If you don’t you can’t help anyone or escape from this black hole. Take the step that will help you move on and live a happier life.