Archive | September 2019

What is Parkinson Disease?

Parkinson's Disease1  Parkinson's Disease 2

Parkinson Disease (PD) is a chronic and progressive movement disorder, meaning that symptoms continue and worsen over time. Nearly one million people in the US are living with Parkinson’s disease. The cause is unknown, and although there is presently no cure, there are treatment options such as medication and surgery to manage its symptoms.

Parkinson’s involves the malfunction and death of vital nerve cells in the brain, called neurons. Parkinson’s primarily affects neurons in an area of the brain called the substantia nigra. Some of these dying neurons produce dopamine, a chemical that sends messages to the part of the brain that controls movement and coordination. As PD progresses, the amount of dopamine produced in the brain decreases, leaving a person unable to control movement normally.

There are three types of Parkinson’s disease and they are grouped by age of onset:

 

1-Adult-Onset Parkinson’s Disease – This is the most common type of Parkinson’s disease. The average age of onset is approximately 60 years old. The incidence of adult onset PD rises noticeably as people advance in age into their 70’s and 80’s.

 

2-Young-Onset Parkinson’s Disease – The age of onset is between 21-40 years old. Though the incidence of Young-Onset Parkinson’s Disease is very high in Japan (approximately 40% of cases diagnosed with Parkinson’s disease), it is still relatively uncommon in the U.S., with estimates ranging from 5-10% of cases diagnosed.

 

3-Juvenile Parkinson’s Disease – The age of onset is before the age of 21. The incidence of Juvenile Parkinson’s Disease is very rare.

 

Parkinson’s disease can significantly impair quality of life not only for the patients but for their families as well, and especially for the primary caregivers. It is therefore important for caregivers and family members to educate themselves and become familiar with the course of Parkinson’s disease and the progression of symptoms so that they can be actively involved in communication with health care providers and in understanding all decisions regarding treatment of the patient.

 

According to the American Parkinson’s Disease Association, there are approximately 1.5 million people in the U.S. who suffer from Parkinson’s disease – approximately 1-2% of people over the age of 60 and 3-5% of the population over age 85. The incidence of PD ranges from 8.6-19 per 100,000 people. Approximately 50,000 new cases are diagnosed in the U.S. annually. That number is expected to rise as the general population in the U.S. ages. Onset of Parkinson’s disease before the age of 40 is rare. All races and ethnic groups are affected.

Knowledge is Critical when Dealing with a Life-Altering Condition such as Parkinson’s Disease and being able to make the changes to last longer and at your optimal level of functioning! First step is accept you have it!

If you or a loved one has been diagnosed with Parkinson’s disease, it’s critical to learn everything you possibly can about this condition so that you can make informed decisions about your treatment. That’s why we created the Medifocus Guidebook on Parkinson’s Disease, a comprehensive 170 page patient Guidebook that contains vital information about Parkinson’s disease that you won’t find anywhere in a single source.

The Medifocus Guidebook on Parkinson’s Disease starts out with a detailed overview of the condition and quickly imparts fundamentally important information about Parkinson’s disease, including:

The theories regarding the underlying causes of Parkinson’s disease.

 

What Are the Possible Risk factors that can be a cause of Parkinson’s Disease?

 

The Parkinson’s Disease Foundation notes that even after decades of intense study, the causes of Parkinson’s disease are not really understood. However, many experts believe that the disease is caused by several genetic and environmental factors, which can vary in each person.

1-Genetic Factors

In some patients, genetic factors could be the primary cause; but in others, there could be something in the environment that led to the disease. Scientists have noted that aging is a key risk factor. There is a 2-4% risk for developing the disease for people over 60. That is compared to 1-2% risk in the general population.

2-Environmental Factors

Some scientists believe that PD can result from overexposure to environmental toxins, or injury. Research by epidemiologists has identified several factors that may be linked to PD. Some of these include living in rural areas, drinking well water, pesticides and manganese.

Some studies have indicated that long term exposure to some chemicals could cause a higher risk of PD. These include the insecticides permethrin and beta-hexachlorocyclohexane (beta-HCH), the herbicides paraquat and 2,4-dichlorophenoxyacetic acid and the fungicide maneb. In 2009, the US Veterans Affairs Department stated that PD could be caused by exposure to Agent Orange.

We should remember that simple exposure to a single toxin in the environment is probably not enough to cause PD. Most people who are exposed to such toxins do not develop PD.

QUOTE FOR THE WEEKEND:

“Antithyroid medication, radioactive iodine, and surgery are all effective treatments and can restore thyroid function to normal. Radioactive iodine and surgery also can “cure” the hyperthyroidism by removing the thyroid.”

American Thyroid Association

Part III Thyroid Cancer Treatment

Treatment

Your thyroid cancer treatment options depend on the type and stage of your thyroid cancer, your overall health, and your preferences.

Most cases of thyroid cancer can be cured with treatment.

Surgery

Most people with thyroid cancer undergo surgery to remove all or most of the thyroid. Operations used to treat thyroid cancer include:

  • Removing all or most of the thyroid (thyroidectomy). In most cases, doctors recommend removing the entire thyroid in order to treat thyroid cancer. Your surgeon makes an incision at the base of your neck to access your thyroid.In most cases, the surgeon leaves small rims of thyroid tissue around the parathyroid glands to reduce the risk of parathyroid damage. Sometimes surgeons refer to this as a near-total thyroidectomy.
  • Removing lymph nodes in the neck. When removing your thyroid, the surgeon may also remove enlarged lymph nodes from your neck and test them for cancer cells.
  • Removing a portion of the thyroid (thyroid lobectomy). In certain situations where the thyroid cancer is very small, your surgeon may recommend removing only one side (lobe) of your thyroid.

Thyroid surgery carries a risk of bleeding and infection. Damage can also occur to your parathyroid glands during surgery, which can lead to low calcium levels in your body. There’s also a risk of accidental damage to the nerves connected to your vocal cords, which can cause vocal cord paralysis, hoarseness, soft voice or difficulty breathing.

Thyroid hormone therapy

After thyroidectomy, you’ll take the thyroid hormone medication levothyroxine (Levoxyl, Synthroid, others) for life.

This medication has two benefits: It supplies the missing hormone your thyroid would normally produce, and it suppresses the production of thyroid-stimulating hormone (TSH) from your pituitary gland. High TSH levels could conceivably stimulate any remaining cancer cells to grow.

You’ll likely have blood tests to check your thyroid hormone levels every few months until your doctor finds the proper dosage for you. Blood tests may continue annually.

Radioactive iodine

Radioactive iodine treatment uses large doses of a form of iodine that’s radioactive.

Radioactive iodine treatment is often used after thyroidectomy to destroy any remaining healthy thyroid tissue, as well as microscopic areas of thyroid cancer that weren’t removed during surgery. Radioactive iodine treatment may also be used to treat thyroid cancer that recurs after treatment or that spreads to other areas of the body.

Radioactive iodine treatment comes as a capsule or liquid that you swallow. The radioactive iodine is taken up primarily by thyroid cells and thyroid cancer cells, so there’s a low risk of harming other cells in your body.

Side effects may include:

  • Nausea
  • Dry mouth
  • Dry eyes
  • Altered sense of taste or smell
  • Fatigue

Most of the radioactive iodine leaves your body in your urine in the first few days after treatment. You’ll be given instructions for precautions you need to take during that time to protect other people from the radiation. For instance, you may be asked to temporarily avoid close contact with other people, especially children and pregnant women.

External radiation therapy

Radiation therapy can also be given externally using a machine that aims high-energy beams, such as X-rays and protons, at precise points on your body (external beam radiation therapy). This treatment is typically administered a few minutes at a time, five days a week, for about five weeks. During treatment, you lie still on a table while a machine moves around you.

External beam radiation therapy may be an option if you can’t undergo surgery and your cancer continues to grow after radioactive iodine treatment. Radiation therapy may also be recommended after surgery if there’s an increased risk that your cancer will recur.

Chemotherapy

Chemotherapy is a drug treatment that uses chemicals to kill cancer cells. Chemotherapy is typically given as an infusion through a vein. The chemicals travel throughout your body, killing quickly growing cells, including cancer cells.

Chemotherapy is not commonly used in the treatment of thyroid cancer, but it may benefit some people who don’t respond to other therapies. For people with anaplastic thyroid cancer, chemotherapy may be combined with radiation therapy.

Injecting alcohol into cancers

Alcohol ablation involves injecting small thyroid cancers with alcohol using imaging such as ultrasound to ensure precise placement of the injection. This treatment is helpful for treating cancer that occurs in areas that aren’t easily accessible during surgery. Your doctor may recommend this treatment if you have recurrent thyroid cancer limited to small areas in your neck.

Targeted drug therapy

Targeted drug therapy uses medications that attack specific vulnerabilities in your cancer cells.

Targeted drugs used to treat thyroid cancer include:

  • Cabozantinib (Cometriq)
  • Sorafenib (Nexavar)
  • Vandetanib (Caprelsa)

These drugs target the signals that tell cancer cells to grow and divide. They’re used in people with advanced thyroid cancer.

Supportive (palliative) care

Palliative care is specialized medical care that focuses on providing relief from pain and other symptoms of a serious illness. Palliative care specialists work with you, your family and your other doctors to provide an extra layer of support that complements your ongoing care. Palliative care can be used while undergoing other aggressive treatments, such as surgery, chemotherapy or radiation therapy.

When palliative care is used along with all of the other appropriate treatments, people with cancer may feel better and live longer.

Palliative care is provided by a team of doctors, nurses and other specially trained professionals. Palliative care teams aim to improve the quality of life for people with cancer and their families. This form of care is offered alongside curative or other treatments you may be receiving.

QUOTE FOR FRIDAY:

“Even though the diagnosis of cancer is terrifying, the prognosis for most patients with papillary and follicular thyroid cancer is usually excellent.”

American Thyroid Association

Part II Thyroid Cancer Month- Dx.

Diagnosing Thyroid Cancer

Thyroid cancer may be diagnosed after a person goes to a doctor because of symptoms, or it might be found during a routine physical exam or other tests. If there is a reason to suspect you might have thyroid cancer, your doctor will use one or more tests to confirm the diagnosis.

This would include:

Family History and Physical Exam

Imaging tests may be done for a number of reasons:

  • To help find suspicious areas that might be cancer
  • To learn how far cancer may have spread
  • To help determine if treatment is working

People who have or may have thyroid cancer will get one or more of these tests.

-Ultrasound

Ultrasound uses sound waves to create images of parts of your body. You are not exposed to radiation during this test.

This test can help determine if a thyroid nodule is solid or filled with fluid. (Solid nodules are more likely to be cancerous.) It can also be used to check the number and size of thyroid nodules as well as help determine if any nearby lymph nodes are enlarged because the thyroid cancer has spread.

For thyroid nodules that are too small to feel, this test can be used to guide a biopsy needle into the nodule to get a sample. Even when a nodule is large enough to feel, most doctors prefer to use ultrasound to guide the needle.

Radioiodine scan

Radioiodine scans can be used to help determine if someone with a lump in the neck might have thyroid cancer. They are also often used in people who have already been diagnosed with differentiated (papillary, follicular, or Hürthle cell) thyroid cancer to help show if it has spread. Because medullary thyroid cancer cells do not absorb iodine, radioiodine scans are not used for this cancer.

For this test, a small amount of radioactive iodine (called I-131) is swallowed (usually as a pill) or injected into a vein. Over time, the iodine is absorbed by the thyroid gland (or thyroid cells anywhere in the body). A special camera is used several hours later to see where the radioactivity is.

For a thyroid scan, the camera is placed in front of your neck to measure the amount of radiation in the gland. Abnormal areas of the thyroid that have less radioactivity than the surrounding tissue are called cold nodules, and areas that take up more radiation are called hot nodules. Hot nodules usually are not cancerous, but cold nodules can be benign or cancerous. Because both benign and cancerous nodules can appear cold, this test by itself can’t diagnose thyroid cancer.

After surgery for thyroid cancer, whole-body radioiodine scans are useful to look for possible spread throughout the body. These scans become even more sensitive if the entire thyroid gland has been removed by surgery because more of the radioactive iodine is picked up by any remaining thyroid cancer cells.

Radioiodine scans work best if patients have high blood levels of thyroid-stimulating hormone (TSH, or thyrotropin). For people whose thyroid has been removed, TSH levels can be increased by stopping thyroid hormone pills for a few weeks before the test. This leads to low thyroid hormone levels (hypothyroidism) and causes the pituitary gland to release more TSH, which in turn stimulates any thyroid cancer cells to take up the radioactive iodine. A downside of this is that it can cause the symptoms of hypothyroidism, including tiredness, depression, weight gain, sleepiness, constipation, muscle aches, and reduced concentration. One way to raise TSH levels without withholding thyroid hormone is to give an injectable form of thyrotropin (Thyrogen®) before the scan.

Because any iodine already in the body can affect this test, people are usually told to avoid foods or medicines that contain iodine for a few days before the scan.

Radioactive iodine can also be used to treat differentiated thyroid cancer, but it is given in much higher doses. This type of treatment is described in Radioactive iodine (radioiodine) therapy.

Chest x-ray

If you have been diagnosed with thyroid cancer (especially follicular thyroid cancer), a plain x-ray of your chest may be done to see if cancer has spread to your lungs.

Computed tomography (CT) scan

The CT scan is an x-ray test that makes detailed cross-sectional images of your body. It can help determine the location and size of thyroid cancers and whether they have spread to nearby areas, although ultrasound is usually the test of choice. A CT scan can also be used to look for spread into distant organs such as the lungs.

One problem using CT scans is that the CT contrast dye contains iodine, which interferes with radioiodine scans. For this reason, many doctors prefer MRI scans for differentiated thyroid cancer.

Magnetic resonance imaging (MRI) scan

MRI scans use magnets instead of radiation to create detailed cross-sectional images of your body. A MRI can be used to look for cancer in the thyroid, or cancer that has spread to nearby or distant parts of the body. But ultrasound is usually the first choice for looking at the thyroid. MRI can provide very detailed images of soft tissues such as the thyroid gland. MRI scans are also very helpful in looking at the brain and spinal cord.

Positron emission tomography (PET) scan

A PET scan can be very useful if your thyroid cancer is one that doesn’t take up radioactive iodine. In this situation, the PET scan may be able to tell whether the cancer has spread.

Biopsy

The actual diagnosis of thyroid cancer is made with a biopsy, in which cells from the suspicious area are removed and looked at in the lab.

Part I Thyroid Cancer Month

The thyroid is a small gland located below the voice box in the front of the neck. It is made up of two lobes and is shaped like a butterfly. As part of your endocrine system, this gland makes hormones that affect your heart rate, temperature, mental function, and metabolism.

If cells in the thyroid gland grow uncontrollably, they form a nodule (tumor). Most (90 percent) of thyroid nodules are benign (noncancerous). But 1 out of 10 are malignant (cancerous).

Approximately 62,500 people are diagnosed with thyroid cancer in the United States each year. The disease usually affects people between the ages of 20 and 55. Women are nearly three times more likely than men to develop thyroid cancer.

Types of Thyroid Cancer

The disease can be hard to catch at first because many thyroid tumors don’t cause symptoms.

Many people with thyroid cancer don’t have any signs or symptoms of the disease.

Some notice small, painless lumps or swellings called nodules in the front of the neck.

Other symptoms can include:

  • hoarseness
  • trouble swallowing
  • breathing problems
  • pain in the throat or neck that doesn’t go away
  • a cough that doesn’t go away

Thyroid Cancer Risk Factors

A risk factor for thyroid cancer is a condition, behavior, or other part of your life that increases the likelihood of developing the disease.

It’s important to understand what risk factors you have for developing thyroid cancer so that your doctors can decide which treatment approach will be most effective for you.

The different types of thyroid cancer have different risk factors.

Risk factors for papillary thyroid cancer include:

  • Radiation exposure. People who were exposed to radiation when they were children have a higher chance of developing papillary thyroid cancer.
  • Inherited conditions. People with a family history of multiple colon growths because of inherited conditions may be at an increased risk for papillary thyroid cancer. An example of this is familial adenomatous polyposis.
  • Family history. For about 5 percent of people who develop papillary thyroid cancer, the disease runs in the family. Researchers are still trying to figure our which gene is to blame.
  • Gender. It’s unclear why, but papillary thyroid cancer occurs about three times more often in women than in men. When it does happen in men, it usually grows and spreads more quickly.

Risk factors for follicular thyroid cancer include:

  • A low-iodine diet. People are more likely to develop follicular carcinoma if they live in a place where iodine isn’t added to salt that’s used in food.
  • Familial conditions. Inherited disorders, such as Werner’s syndrome and Cowden’s syndrome, sometimes include thyroid cancer as part of the disease process.

Risk factors for medullary thyroid cancer (MTC):

  • Family history. Approximately 25 percent of people with MTC have inherited a mutation in a gene called RET.

Information about your health and family medical history can help in figuring out your risk for thyroid cancer. This information is important for building a treatment plan that makes sense for you.

 

 

QUOTE FOR WEDNESDAY:

Reye’s syndrome is a rare disorder that causes brain and liver damage. Although it can happen at any age, it is most often seen in children. Reye’s syndrome usually occurs in children who have had a recent viral infection, such as chickenpox or the flu.”

MAYO CLINIC

To help prevent this get the Flu Vaccine.

 

 

Reye’s Syndrome

Reye’s syndrome is a rare but serious disease that causes swelling in the liver and brain. It can affect people of any age, but it is most often seen in children and teenagers recovering from a virus such as the flu or chickenpox.

Studies have found that the main risk factor for Reye’s syndrome is taking aspirin or other related drugs, called salicylates.

Because of this, doctors recommend that children and teenagers recovering from viral infections should avoid taking aspirin.

What Causes It?

Doctors don’t fully understand what causes Reye’s syndrome. They do know that some people are prone to get it when they take aspirin for a virus.

Others have a greater chance of getting it if they:

  • Have a disorder that affects how their bodies break down fatty acids
  • Have been exposed to certain toxins, including paint thinners and products to kill insects and weeds

When Reye’s syndrome strikes, cells throughout your body become swollen and build up fats. In turn, your blood sugar levels drop. Ammonia and acid levels in the blood rise. These changes can hit many organs, such as the brain and liver, where severe swelling can occur.

Symptoms

The signs of Reye’s typically appear 3 to 5 days after the start of a viral infection.

In children younger than age 2, early symptoms may include diarrhea and rapid breathing. In older children and teenagers, early symptoms may include ongoing vomiting and unusual sleepiness

As the syndrome goes on, symptoms can become more severe, and may include:

  • Personality changes (more irritable or aggressive)
  • Confusion or hallucinations
  • Weakness or inability to move arms or legs
  • Seizure or convulsions
  • Extreme tiredness
  • Loss of consciousness

Reye’s can be life-threatening. You should call 911 if you see these severe symptoms. Early diagnosis and treatment is crucial.

The syndrome can be mistaken for other conditions, including meningitis (a swelling of membranes covering the brain and spinal cord), a diabetes reaction, or poisoning.

Diagnosis

Doctors don’t have a specific test for Reye’s. They usually do urine and blood tests. They also screen for disorders involving fatty acids.

Other tests may include:

  • Spinal taps (a needle is inserted into a space below the end of the spinal cord to collect fluid)
  • Liver biopsies (a needle is pushed through the abdomen into the liver to get a sample of tissue)
  • Skin biopsies (a doctor scrapes a small skin sample to test)
  • CT or MRI scans (which can also rule out other problems)

Is There a Treatment?

There’s no single treatment that will stop Reye’s syndrome, but doctors can do some things to make sure it is managed. They can also try to prevent more severe symptoms and see that brain swelling is held down. These steps include:

  • Intravenous (IV) fluids
  • Diuretics to help your body get rid of salt and water (and stop swelling)
  • Medications to prevent bleeding
  • Vitamin K, plasma, and platelets (tiny blood cells that help form clots) in instances of liver bleeding

 

QUOTE FOR TUESDAY:

“Diagnosing idiopathic pulmonary fibrosis (IPF) is often a long and difficult process. That’s because IPF is a rare disease that some doctors may not recognize easily. Its symptoms—including a persistent cough, shortness of breath, and fatigue—are common and found in many respiratory and other diseases, making it easy to confuse IPF with other conditions.”

Lungs&You  (www.lungsandyou.com)