The CDC says, “Brighten the holidays by making your health and safety a priority. Take steps to keep you and your loved ones safe and healthy—and ready to enjoy the holidays.

1. Wash hands often to help prevent the spread of germs. It’s flu season. Wash your hands with soap and clean running water for at least 20 seconds.
2. Bundle up to stay dry and warm. Wear appropriate outdoor clothing: light, warm layers, gloves, hats, scarves, and waterproof boots.
3. Manage stress. Give yourself a break if you feel stressed out, overwhelmed, and out of control. Some of the best ways to manage stress are to find support, connect socially, and get plenty of sleep.
4. Don’t drink and drive or let others drink and drive. Whenever anyone drives drunk, they put everyone on the road in danger. Choose not to drink and drive and help others do the same.
5. Be smoke-free. Avoid smoking and secondhand smoke. Smokers have greater health risks because of their tobacco use, but nonsmokers also are at risk when exposed to tobacco smoke.
6. Fasten seat belts while driving or riding in a motor vehicle. Always buckle your children in the car using a child safety seat, booster seat, or seat belt according to their height, weight, and age. Buckle up every time, no matter how short the trip and encourage passengers to do the same.
7. Get exams and screenings. Ask your health care provider what exams you need and when to get them. Update your personal and family history.
8. Get your vaccinations. Vaccinations help prevent diseases and save lives. Everyone 6 months and older should get a flu vaccine each year.
9. Monitor children. Keep potentially dangerous toys, food, drinks, household items, and other objects out of children’s reach. Protect them from drowning, burns, falls, and other potential accidents.
10. Practice fire safety. Most residential fires occur during the winter months, so don’t leave fireplaces, space heaters, food cooking on stoves, or candles unattended. Have an emergency plan and practice it regularly.
11. Prepare food safely. Remember these simple steps: Wash hands and surfaces often, avoid cross-contamination, cook foods to proper temperatures and refrigerate foods promptly.
12. Eat healthy, stay active. Eat fruits and vegetables which pack nutrients and help lower the risk for certain diseases. Limit your portion sizes and foods high in fat, salt, and sugar. Also, be active for at least 2½ hours a week and help kids and teens be active for at least 1 hour a day.”

Reference: CDC

ENJOY YOUR THANKSGIVING!!

“All things in moderation, as the saying goes. The problem with the holiday season is that we often experience too much of a good thing. While stress itself is necessary for our survival and zest for life (researchers call this positive type of stress “eustress”), too much stress has a negative impact on our health, both mental and physical.”.

Love to Know (https://stress.lovetoknow.com under “Thanksgiving Stress Busters”.

“Its International Survivors of Suicide Loss Day.  Suicide is the 10th leading cause of death in the USA. The rate of suicide is highest in middle-aged white men. Remembers 93% of adults surveyed in the U.S. think suicide can be prevented.”.

American Foundation for Suicide Prevention-https://afsp.org

Our topic all weekend is the topic Suicide in America.

“Quitting smoking isn’t easy. It takes time. And a plan. You don’t have to stop smoking in one day. Start with day one. Let the Great American Smokeout event on the third Thursday in November be your day to start your journey toward a smoke-free life. Lung cancer (both small cell and non-small cell) is the second most common cancer in
both men and women (not counting skin cancer1).”.

American Cancer Society-https://www.cancer.org

You smoke? Well why don’t you just drink poison?

Let’s start with what smoking actually does to the body. Smoking harms nearly every organ of the body. Smoking causes many diseases and reduces the health of smokers in general. It primarily starts at the lungs. How?   Well think of your lung tissue with openings all over which are air sacs called alveoli. This is an anatomical structure that has the form of a hollow cavity which does the exchange of oxygen and carbon dioxide in and out of our body, when we inhale and exhale. The thing to know about this tissue is that before you start smoking the alveoli are expandable (think of it like a rubber band) allowing the person to get a good exchange of oxygen getting in the body to go to all our tissues and carbon dioxide getting out of the body (O2=oxygen being the fuel to our tissues and without it causes cellular starvation, carbon dioxide=CO2 being an acid / toxin to the human body and exhaled by the lungs).   After years of smoking the alveoli stretches out not allowing a good exchange of O2 and CO2. The sad thing for a smoker is the alveoli cannot REVERSE back after damage has already occurred unless you had a lung transplant with continuing to smoke, which no M.D. or health insurance would allow. More realistic would be QUIT the bad habit. The tissue doesn’t get completely better but it improves when you quit. So the pt with Emphysema has alveoli that can’t exchange oxygen and carbon dioxide from the blood like it use to at the bottom of the lungs, prior to even starting to smoke. Also, after smoking years and when diagnosed with COPD you have difficulty breathing (that is why smoking is a major cause of bronchitis or Emphysema=types of chronic obstructive pulmonary disease=COPD and it is not REVERSIBLE). Emphysema is the worst type of COPD you can get. COPD is the third leading cause of death in the U.S., and the economic burden of COPD in the U.S. in 2007 was $42.6 billion in health care costs and lost productivity. Isn’t this reason enough to stop smoking?

Emphysema is an enlargement of the air spaces distal to the terminal bronchioles, with destruction of their walls. People with emphysema have historically been known as “Pink Puffers”, due to their pink complexion.

Chronic bronchitis is defined in clinical terms as a cough with sputum production on most days for 3 months of a year, for 2 consecutive years. People with advanced COPD that have primarily chronic bronchitis were commonly referred to as “Blue Bloaters” because of the bluish color of the skin and lips (cyanosis) along with hypoxia and fluid retention.

Know when the lungs get effected in time the heart gets effected. One affects the other in time. The heart can’t live without the lungs and vice versa.

Now knowing just this you’ll understand why smoking alone can cause the following conditions, Through the Centers for Disease Control and Prevention. They state the following:

Smoking and Increased Health Risks

Compared with nonsmokers, smoking is estimated to increase the risk of—

• Coronary heart disease by 2 to 4 times, ^(causing atherosclerosis=thickening of the vessels or due to arteriosclerosis=hardening of the arteries and remember smoking causes vasoconstriction of the vessels = increase pressure in the vessels = high B/P.
• Stroke by 2 to 4 times (Due to causing the above problems listed under coronary heart disease.)
• Men developing lung cancer by 23 times,
• Women developing lung cancer by 13 times(cancers due to constant irritation of the tissues) , and
• Dying from chronic obstructive lung diseases (such as chronic bronchitis and emphysema) by 12 to 13 times. ( Explained at the top)

Smoking and Cardiovascular Disease

• Smoking causes coronary heart disease, the leading cause of death in the United States.
• Cigarette smoking causes reduced circulation by narrowing the blood vessels (arteries) and puts smokers at risk of developing peripheral vascular disease (i.e., obstruction of the large arteries in the arms and legs that can cause a range of problems from pain to tissue loss or gangrene) This pain to gangrene to amputation is due to lack of oxygenated blood getting to the tissue caused by the vasoconstriction the cigarette smoking caused.
• Smoking causes abdominal aortic aneurysm (i.e., a swelling or weakening of the main artery of the body—the aorta—where it runs through the abdomen). An aneurysm with constant vasoconstriction (increases pressure) puts the aneurysm at risk for rupture because the aneurysm area isn’t as strong as the other vessels=Rupture of the aortic aneurysm

Smoking and Respiratory Disease

• Smoking causes lung cancer.
• Smoking causes lung diseases (e.g., emphysema, bronchitis, chronic airway obstruction) by damaging the airways and alveoli (i.e., small air sacs) of the lungs.

Smoking and Cancer

Smoking causes the following cancers: (in alphabetical order)

• Acute myeloid leukemia
• Bladder cancer
• Cancer of the cervix
• Cancer of the esophagus
• Kidney cancer
• Cancer of the larynx (voice box)
• Lung cancer
• Cancer of the oral cavity (mouth)
• Pancreatic cancer
• Cancer of the pharynx (throat)
• Stomach cancer

Smoking and Other Health Effects

Smoking has many adverse reproductive and early childhood effects, including increased risk for—

• Infertility
• Preterm delivery
• Stillbirth
• Low birth weight
• Sudden infant death syndrome (SIDS).^1,2,9Smoking is associated with the following adverse health effects:¹
• Postmenopausal women who smoke have lower bone density than women who never smoked.Women who smoke have an increased risk for hip fracture than women who never smoked.

References:

1. S. Department of Health and Human Services. The Health Consequences of Smoking: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2004 [accessed 2013 June 28].
2. S. Department of Health and Human Services. How Tobacco Smoke Causes Disease: What It Means to You. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2010 [accessed 2013 June 28].
3. Centers for Disease Control and Prevention. Annual Smoking-Attributable Mortality, Years of Potential Life Lost, and Productivity Losses—United States, 2000–2004. Morbidity and Mortality Weekly Report 2008;57(45):1226–8 [accessed 2013 June 28].
4. Centers for Disease Control and Prevention. QuickStats: Number of Deaths from 10 Leading Causes–National Vital Statistics System, United States, 2010. Morbidity and Mortality Weekly Report 2013:62(08);155. [accessed 2013 June 28].
5. Mokdad AH, Marks JS, Stroup DF, Gerberding JL. Actual Causes of Death in the United States. JAMA: Journal of the American Medical Association 2004;291(10):1238–45 [cited 2013 June 28].
6. S. Department of Health and Human Services. Reducing the Health Consequences of Smoking: 25 Years of Progress. A Report of the Surgeon General. Rockville (MD): U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 1989 [accessed 2013 June 28].
7. Ockene IS, Miller NH. Cigarette Smoking, Cardiovascular Disease, and Stroke: A Statement for Healthcare Professionals from the American Heart Association. Circulation 1997;96(9):3243–7 [accessed 2013 June 28].
8. Institute of Medicine. Secondhand Smoke Exposure and Cardiovascular Effects: Making Sense of the Evidence. [PDF–707 KB] Washington: National Academy of Sciences, Institute of Medicine, 2009 [accessed 2013 June 28].
9. S. Department of Health and Human Services. Women and Smoking: A Report of the Surgeon General. Rockville (MD): U.S. Department of Health and Human Services, Public Health Service, Office of the Surgeon General, 2001 [accessed 2013 June 28].

“Cigarette smoking harms nearly every organ of the body, causes many diseases, and reduces the health of smokers in general. Quitting smoking lowers your risk for smoking-related diseases and can add years to your life. Cigarette smoking causes more than 480,000 deaths each year in the United States. This is nearly one in five deaths.”.

Centers for Disease Control and Prevention

“Pancreatic cancer has often progressed to an advanced stage by the time it is diagnosed. Many patients come to NewYork-Presbyterian for pancreatic cancer care because of our innovative and aggressive approach. Patients who have been turned down for surgery at other centers have been successfully treated at NewYork-Presbyterian.

The care of people with pancreatic cancer is best handled by a multidisciplinary team of specialists with expertise in diagnosing and treating this disease and relieving symptoms. This is the approach we take at NewYork-Presbyterian.

NewYork-Presbyterian is home to two of the world’s most accomplished pancreatic programs.”

New York-Columbia Presbyterian Hospital Manhattan, NY

Pancreatic Cancer, its incidence cuts across all racial and socio-economic barriers and is nearly always fatal. 90% die within the 1st yr of diagnosis.

STAGING OF PANCREATIC CANCER

Stage is a term used in cancer treatment to describe the extent of the cancer’s spread. The stages of pancreatic cancer are from 0 to IV.

The best treatment for pancreatic cancer depends on how far it has spread, or its stage. The stages of pancreatic cancer are easy to understand. What is difficult is attempting to stage pancreatic cancer without resorting to major surgery. In practice, doctors choose pancreatic cancer treatments based upon imaging studies, surgical findings, and an individual’s general state of well being.

“Montefiore is a leader in diagnostic techniques, using cutting-edge fusion scan technology. With this imaging technique, we are able to assess the status of tumors both before and after surgical treatment more accurately than ever before. In addition, we employ state-of-the-art intra-operative imaging techniques that provide a clear picture of the tumor during the treatment itself, so that we can adjust our efforts as needed.”

Montefiore Hospital in Bronx, NY

6.) Angiography

This is an x-ray test that looks at blood vessels. A small amount of contrast dye is injected into an artery to outline the blood vessels, and then x-rays are taken.

An angiogram can show if blood flow in a particular area is blocked by a tumor. It can also show abnormal blood vessels (feeding the cancer) in the area. This test can be useful in finding out if a pancreatic cancer has grown through the walls of certain blood vessels.  Usually the catheter is put into an artery in your inner thigh and threaded up to the pancreas.

Blood Tests

Several types of blood tests can be used to help diagnose pancreatic cancer or to help determine treatment options if it is found.

Liver function tests: Jaundice (yellowing of the skin and eyes) is often one of the first signs of pancreatic cancer. Doctors often get blood tests to assess liver function in people with jaundice to help determine its cause. Certain blood tests can look at levels of different kinds of bilirubin (a chemical made by the liver) and can help tell whether a patient’s jaundice is caused by disease in the liver itself or by a blockage of bile flow (from a gallstone, a tumor, or other disease).

Tumor markers: Tumor markers are substances that can sometimes be found in the blood when a person has cancer. Tumor markers that may be helpful in pancreatic cancer are:

• CA 19-9
• Carcinoembryonic antigen (CEA), which is not used as often as CA 19-9

Neither of these tumor marker tests is accurate enough to tell for sure if someone has pancreatic cancer. Levels of these tumor markers are not high in all people with pancreatic cancer, and some people who don’t have pancreatic cancer might have high levels of these markers for other reasons. Still, these tests can sometimes be helpful, along with other tests, in figuring out if someone has cancer.

In people already known to have pancreatic cancer and who have high CA19-9 or CEA levels, these levels can be measured over time to help tell how well treatment is working. If all of the cancer has been removed, these tests can also be done to look for signs the cancer may be coming back.

Other blood tests: Other tests, like a CBC or chemistry panel, can help evaluate a person’s general health (such as kidney and bone marrow function). These tests can help determine if they’ll be able to withstand the stress of a major operation.

Biopsy

A person’s medical history, physical exam, and imaging test results may strongly suggest pancreatic cancer, but usually the only way to be sure is to remove a small sample of tumor and look at it under the microscope. This procedure is called a biopsy. Biopsies can be done in different ways.

Percutaneous (through the skin) biopsy: For this test, a doctor inserts a thin, hollow needle through the skin over the abdomen and into the pancreas to remove a small piece of a tumor. This is known as a fine needle aspiration (FNA). The doctor guides the needle into place using images from ultrasound or CT scans.

Endoscopic biopsy: Doctors can also biopsy a tumor during an endoscopy. The doctor passes an endoscope (a thin, flexible, tube with a small video camera on the end) down the throat and into the small intestine near the pancreas. At this point, the doctor can either use endoscopic ultrasound (EUS) to pass a needle into the tumor or endoscopic retrograde cholangiopancreatography (ERCP) to place a brush to remove cells from the bile or pancreatic ducts.

Surgical biopsy: Surgical biopsies are now done less often than in the past. They can be useful if the surgeon is concerned the cancer has spread beyond the pancreas and wants to look at (and possibly biopsy) other organs in the abdomen. The most common way to do a surgical biopsy is to use laparoscopy (sometimes called keyhole surgery). The surgeon can look at the pancreas and other organs for tumors and take biopsy samples of abnormal areas.

Some people might not need a biopsy

Rarely, the doctor might not do a biopsy on someone who has a tumor in the pancreas if imaging tests show the tumor is very likely to be cancer and if it looks like surgery can remove all of it. Instead, the doctor will proceed with surgery, at which time the tumor cells can be looked at in the lab to confirm the diagnosis. During surgery, if the doctor finds that the cancer has spread too far to be removed completely, only a sample of the cancer may be removed to confirm the diagnosis, and the rest of the planned operation will be stopped.

If treatment (such as chemotherapy or radiation) is planned before surgery, a biopsy is needed first to be sure of the diagnosis.