Archive | May 2025

Part II What is Gout? Knowing what can increase uric acid in the body causing gout & what severe conditions can develop with gout & what risk factors puts you at risk for gout.

May23

 

The diagnosis gout, a prevalent form of inflammatory arthritis that affects over 9 million Americans. It highlights the condition’s primary cause—uric acid buildup in joints, which leads to painful attacks.

May 22 is recognized as Gout Awareness Day, an initiative led by the Alliance for Gout Awareness to spread knowledge about the condition and its impact.

You’re more likely to develop gout if you have high levels of uric acid in your body.

Factors that increase the uric acid level in your body include:

  • Medical conditions. Certain diseases and conditions make it more likely that you’ll develop gout. These include untreated high blood pressure and chronic conditions such as diabetes, metabolic syndrome, and heart and kidney diseases.
  • Family history of gout. If other members of your family have had gout, you’re more likely to develop the disease.
  • Age and sex. Gout occurs more often in men, primarily because women tend to have lower uric acid levels. After menopause, however, women’s uric acid levels approach those of men. Men also are more likely to develop gout earlier — usually between the ages of 30 and 50 — whereas women generally develop signs and symptoms after menopause.

People with gout can develop more-severe conditions, such as:

  • Recurrent gout.

    Some people may never experience gout signs and symptoms again. But others may experience gout several times each year. Medications may help prevent gout attacks in people with recurrent gout. If left untreated, gout can cause erosion and destruction of a joint.

  • Advanced gout.

    Untreated gout may cause deposits of urate crystals to form under the skin in nodules called tophi (TOE-fie). Tophi can develop in several areas such as your fingers, hands, feet, elbows or Achilles tendons along the backs of your ankles. Tophi usually aren’t painful, but they can become swollen and tender during gout attacks.

  • Kidney stones.

    Urate crystals may collect in the urinary tract of people with gout, causing kidney stones. Medications can help reduce the risk of kidney stones.

Too much uric acid in the blood can result in uric acid crystals being formed and deposited in and around joints = gout.

Risk Factors for the Development of Gout:

1 – Diet can play a big factor when eating a diet that’s high in meat and seafood and high in beverages sweetened with fruit sugar (fructose) promotes higher levels of uric acid, which increases your risk of gout.

Beer (including nonalcoholic beer) and liquor

Foods and drinks containing high fructose corn syrup

Certain foods and drinks containing high fructose corn syrup

Certain foods (such as anchovies, asparagus, consomme, herring, meat gravies and broths, mushrooms, mussels, all organ meats, sardines, and sweetbreads)  High proteins in the blood stream is the ending digestion result.

Low dairy intake

Other  risk factors putting you at risk for gout:

2 – Certain cancers and blood disorders (such as lymphoma, leukemia, and hemolytic anemia)

Certain drugs (such as thiazides diuretics – commonly used to treat hypertension and low-dose aspirin also can increase uric acid levels – commonly in geriatrics the 81mg oral of Bayer given for pt with Atrial Fibrillation or a heart condition to thin the blood to make the heart pump easier and less stress to that organ which is the engine of the human body.  Another certain medications that can increase uric acid in the blood stream are cyclosporine, pyrazinamide, ethambutal, nictotinic acid and so can the use of anti-rejection drugs prescribed for people who have undergone an organ transplant.

3 – An under-active thyroid=hypothyroidism

4 – Lead poisoning

5 – If you are overweight, your body produces more uric acid and your kidneys have a more difficult time eliminating uric acid, which greatly increases your risk of gout.

6 -Psoriasis

7 – Radiation therapy

8 – Cancer chemotherapy

9 – Certain Chronic kidney disease

10 – Certain rare enzyme abnormalities

11 – Starvation.

12 – For unknown reasons, not all people who have hyperuricemia develop gout.

13 – Recent trauma and surgery – Experiencing recent surgery or trauma has been associated with an increased risk of developing gout.

In may not be just one factor but a many or few you have or simply go to your MD and get checked on your uric acid level and see if it is high and see how high it is and what factors you could stop of decrease in making the uric acid level go down.  See your doctor and do a preventative measure before any symptoms like Gout even occur.  Take care of your self no one else will do it for you unless your a child with a mom and dad or just one parent.

Revised on 5/05/25 by Elizabeth Lynch RN BSN

QUOTE FOR THURSDAY:

May22

“Gout is a form of inflammatory arthritis that causes pain and swelling in your joints. Gout happens when there’s a buildup of uric acid in your body.

You’re more likely to experience gout if you:

  • Have a biological parent or grandparent who has gout.
  • Eat a lot of animal proteins — especially animal flesh, shellfish and foods that contain organ meat.
  • Drink alcohol regularly.
  • Take a diuretic medication (water pills).”

Cleveland Clinic (Gout: Symptoms, Treatment & Prevention)

Part I What is Gout. Understanding the disease, its symptoms, and how uric acid is involved in creating Gout in your body.

May22

What is Gout?

It is characterized by sudden, severe attacks of pain, redness and tenderness in joints, often the joint at the base of the big toe.

Gout — a complex form of arthritis — can affect anyone. Men are more likely to get gout, but women become increasingly susceptible to gout after menopause.

An attack of gout can occur suddenly, often waking you up in the middle of the night with the sensation that your big toe is on fire. The affected joint is hot, swollen and so tender that even the weight of the sheet on it may seem intolerable.

Fortunately, gout is treatable, and there are ways to reduce the risk that gout will recur.

The signs and symptoms of gout almost always occur suddenly — often at night — and without warning.

They include:

  • Intense joint pain. Gout usually affects the large joint of your big toe, but it can occur in your feet, ankles, knees, hands and wrists. The pain is likely to be most severe within the first four to 12 hours after it begins.
  • Lingering discomfort. After the most severe pain subsides, some joint discomfort may last from a few days to a few weeks. Later attacks are likely to last longer and affect more joints.
  • Inflammation and redness. The affected joint or joints become swollen, tender, warm and red.
  • Limited range of motion. Decreased joint mobility may occur as gout progresses.

What actually causes gout?

Gout occurs when urate crystals accumulate in your joint, causing the inflammation and intense pain of a gout attack. Urate crystals can form when you have high levels of uric acid in your blood.

Your body produces uric acid when it breaks down purines — substances that are found naturally in your body, as well as in certain foods, such as steak, organ meats and seafood. Other foods also promote higher levels of uric acid, such as alcoholic beverages, especially beer, and drinks sweetened with fruit sugar (fructose).

 Normally, uric acid dissolves in your blood and passes through your kidneys into your urine. But sometimes your body either produces too much uric acid or your kidneys excrete too little uric acid. When this happens, uric acid can build up, forming sharp, needle-like urate crystals in a joint or surrounding tissue that cause pain, inflammation and swelling.
Stay tune for Part II GOUT in the next article!
Revised 4/02/24 Elizabeth Lynch RN BSN

QUOTE FOR WEDNESDAY:

May21

“There is no treatment to cure Huntington’s disease or slow its progression. Several treatments are being tested to see if they can at least slow the progression of the disease.

Therapies can lessen the severity of symptoms. These include speech therapy and physical therapy.

Medications can help to control mood and involuntary movements.”

Harvard Health Publishing / Harvard Medical School (Huntington’s Disease (Chorea) – Harvard Health)

Part IV Huntington’s Disease – What treatments are involved to help the patient manage and the family dealing with this Dx!

May21

No treatments can alter the course of Huntington’s disease. But medications can lessen some symptoms of movement and psychiatric disorders. And multiple interventions can help a person adapt to changes in his or her abilities for a certain amount of time.

Medications will likely evolve over the course of the disease, depending on overall treatment goals. Also, drugs that treat some symptoms may result in side effects that worsen other symptoms. Treatment goals will be regularly reviewed and updated.

Preparing for your doctor’s appointment

If you have any signs or symptoms associated with Huntington’s disease, you’ll likely be referred to a neurologist after an initial visit to your family doctor.

A review of your symptoms, mental state, medical history and family medical history can all be important in the clinical assessment of a potential neurological disorder.

What you can do

Before your appointment, make a list that includes the following:

  • Signs or symptoms — or any changes from what is normal for you — that may be causing concern
  • Recent changes or stresses in your life
  • All medications — including over-the-counter drugs and dietary supplements — and doses you take
  • Family history of Huntington’s disease or other disorders that may cause movement disorders or psychiatric conditions

You may want a family member or friend to accompany you to your appointment. This person can provide support and offer a different perspective on the effect of symptoms on your functional abilities.

What to expect from your doctor

Your doctor is likely to ask you a number of questions, including the following:

  • When did you begin experiencing symptoms?
  • Have your symptoms been continuous or intermittent?
  • Has anyone in your family ever been diagnosed with Huntington’s disease?
  • Has anyone in your family been diagnosed with another movement disorder or psychiatric disorder?
  • Are you having trouble performing work, schoolwork or daily tasks?
  • Has anyone in your family died young?
  • Is anyone in your family in a nursing home?
  • Is anyone in your family fidgety or moving all the time?
  • Have you noticed a change in your general mood?
  • Do you feel sad all of the time?
  • Have you ever thought about suicide?

Medications used for Huntington’s Disease

Medications for movement disorders

Drugs to treat movement disorders include the following:

  • Drugs to control movement include tetrabenazine (Xenazine) and deutetrabenazine (Austedo), which have been specifically approved by the Food and Drug Administration to suppress the involuntary jerking and writhing movements (chorea) associated with Huntington’s disease. These drugs don’t have any effect on the progression of the disease, however. Possible side effects include drowsiness, restlessness, and the risk of worsening or triggering depression or other psychiatric conditions.
  • Antipsychotic drugs, such as haloperidol (Haldol) and fluphenazine, have a side effect of suppressing movements. Therefore, they may be beneficial in treating chorea. However, these drugs may worsen involuntary contractions (dystonia), restlessness and drowsiness.Other drugs, such as risperidone (Risperdal), olanzapine (Zyprexa) and quetiapine (Seroquel), may have fewer side effects but still should be used with caution, as they may also worsen symptoms.
  • Other medications that may help suppress chorea include amantadine (Gocovri ER, Osmolex ER), levetiracetam (Keppra, Elepsia XR, Spritam) and clonazepam (Klonopin). However, side effects may limit their use.

Medications for psychiatric disorders

Medications to treat psychiatric disorders will vary depending on the disorders and symptoms. Possible treatments include the following:

  • Antidepressants include such drugs as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem) and sertraline (Zoloft). These drugs may also have some effect on treating obsessive-compulsive disorder. Side effects may include nausea, diarrhea, drowsiness and low blood pressure.
  • Antipsychotic drugs such as quetiapine (Seroquel), risperidone (Risperdal) and olanzapine (Zyprexa) may suppress violent outbursts, agitation, and other symptoms of mood disorders or psychosis. However, these drugs may cause different movement disorders themselves.
  • Mood-stabilizing drugs that can help prevent the highs and lows associated with bipolar disorder include anticonvulsants, such as divalproex (Depakote), carbamazepine (Carbatrol, Epitol, others) and lamotrigine (Lamictal).

Types of therapies for Huntington’s Disease

Psychotherapy

A psychotherapist — a psychiatrist, psychologist or clinical social worker — can provide talk therapy to help with behavioral problems, develop coping strategies, manage expectations during progression of the disease and facilitate effective communication among family members.

Speech therapy

Huntington’s disease can significantly impair control of muscles of the mouth and throat that are essential for speech, eating and swallowing. A speech therapist can help improve your ability to speak clearly or teach you to use communication devices — such as a board covered with pictures of everyday items and activities. Speech therapists can also address difficulties with muscles used in eating and swallowing.

Physical therapy

A physical therapist can teach you appropriate and safe exercises that enhance strength, flexibility, balance and coordination. These exercises can help maintain mobility as long as possible and may reduce the risk of falls.

Instruction on appropriate posture and the use of supports to improve posture may help lessen the severity of some movement problems.

When the use of a walker or wheelchair is required, the physical therapist can provide instruction on appropriate use of the device and posture. Also, exercise regimens can be adapted to suit the new level of mobility.

Occupational therapy

An occupational therapist can assist the person with Huntington’s disease, family members and caregivers on the use of assistive devices that improve functional abilities. These strategies may include:

  • Handrails at home
  • Assistive devices for activities such as bathing and dressing
  • Eating and drinking utensils adapted for people with limited fine motor skills

 Lifestyle and home remedies

Managing Huntington’s disease is demanding on the person with the disorder, family members and other in-home caregivers. As the disease progresses, the person will become more dependent on caregivers. A number of issues will need to be addressed, and strategies to cope with them will evolve.

Eating and nutrition

Factors regarding eating and nutrition include the following:

  • Difficulty maintaining a healthy body weight. Difficulty eating, higher caloric needs due to physical exertion or unknown metabolic problems may be the cause. To get adequate nutrition, you may need to eat more than three meals a day or use dietary supplements.
  • Difficulty with chewing, swallowing and fine motor skills. These problems can limit the amount of food you eat and increase the risk of choking. Problems may be minimized by removing distractions during a meal and selecting foods that are easier to eat. Utensils designed for people with limited fine motor skills and covered cups with straws or drinking spouts also can help.

Eventually, a person with Huntington’s disease will need assistance with eating and drinking.

Managing cognitive and psychiatric disorders

Family and caregivers can help create an environment that may help a person with Huntington’s disease avoid stressors and manage cognitive and behavioral challenges. These strategies include:

  • Using calendars and schedules to help keep a regular routine
  • Initiating tasks with reminders or assistance
  • Prioritizing or organizing work or activities
  • Breaking down tasks into manageable steps
  • Creating an environment that is as calm, simple and structured as possible
  • Identifying and avoiding stressors that can trigger outbursts, irritability, depression or other problems
  • For school-age children or adolescents, consulting with school staff to develop an appropriate individual education plan
  • Providing opportunities for the person to maintain social interactions and friendships as much as possible

Coping and support

A number of strategies may help people with Huntington’s disease and their families cope with the challenges of the disease.

Support services

Support services for people with Huntington’s disease and families include the following:

  • Nonprofit agencies, such as the Huntington’s Disease Society of America, provide caregiver education, referrals to outside services, and support groups for people with the disease and caregivers.
  • Local and state health or social service agencies may provide daytime care for people with the disease, meal assistance programs or respite for caregivers.

Planning for residential and end-of-life care

Because Huntington’s disease causes the progressive loss of function and death, it’s important to anticipate care that will be needed in the advanced stages of the disease and near the end of life. Early discussions about this type of care enable the person with Huntington’s disease to be engaged in these decisions and to communicate his or her preferences for care.

Creating legal documents that define end-of-life care can be beneficial to everyone. They empower the person with the disease, and they may help family members avoid conflict late in the disease progression. Your doctor can offer advice on the benefits and drawbacks of care options at a time when all choices can be carefully considered.

Matters that may need to be addressed include:

  • Care facilities. Care in the advanced stages of the disease will likely require in-home nursing care or care in an assisted living facility or nursing home.
  • Hospice care. Hospice services provide care at the end of life that helps a person approach death with as little discomfort as possible. This care also provides support and education to family members to help them understand the process of dying.
  • Living wills. Living wills are legal documents that enable a person to spell out care preferences when he or she isn’t able to make decisions. For example, these directions might indicate whether or not the person wants life-sustaining interventions or aggressive treatment of an infection.
  • Advance directives. These legal documents enable you to identify one or more people to make decisions on your behalf. You may create an advance directive for medical decisions or financial matters.

QUOTE FOR TUESDAY:

May20

“People with HD show a wide range of symptoms at the onset of the disease. While most people with HD develop the motor symptoms in their forties and fifties, subtle changes may arise much earlier. Knowledge of the typical age of onset sometimes leads physicians to miss the diagnosis, mistakenly believing the person to be too old or too young to develop HD. About 10% have onset of motor symptoms after age 60 and 10% have Juvenile onset HD, where symptoms manifest before age 20.”

Huntington’s Disease Society of American (Age of Onset – Huntington’s Disease Society of America)

QUOTE FOR MONDAY:

May19

“More than 30,000 Americans are living with HD.  Everyone has two Huntington (HTT) genes, one from each parent.  Huntington disease develops when one of those genes carries the mutation. In some families, appearance of symptoms happens early and earlier with each generation. The symptoms usually appear between the ages of 30-50.”

Honestly HD (https://www.honestlyhd.com/hd-overview?gclid=bc1d72d4cc7f10a028831af07b0f59e8&gclsrc=3p.ds&msclkid=bc1d72d4cc7f10a028831af07b0f59e8&utm_source=bing&utm_medium=cpc&utm_campaign=USA_MA_SEM_NB_PH_HonestlyHD-DTC-Research-Info-All-All-NANBA.All&utm_term=prevalence%20of%20huntingtons%20disease%20in%20the%20us&utm_content=Core)

 

QUOTE FOR THE WEEKEND:

May17

“Huntington´s Disease (HD) is a rare, hereditary, neurodegenerative illness that affects people of all races worldwide. The disease was named after Dr. George Huntington, a physician from Long Island, United States of America, who first published a description of “hereditary chorea” in 1872.

Huntington´s Disease is a hereditary disorder.  Each child of a parent who has HD has a 50% chance of inheriting it.  HD occurs in all races.  Males and females are equally at risk.  Carriers of the HD gene will eventually develop the disease should they live long enough.

According to Dr. Ira Shoulson, the progress of HD can be divided into five stages that are flexible after diagnosed.

Globally, there is estimated to be between 3.6 and 5.7 people with HD for every 100,000 of population.”

huntington-disease.org (https://huntington-disease.org)

QUOTE FOR FRIDAY:

May16

“Substance Abuse Statistics:

Among Americans aged 12 years and older, 37.309 million were current illegal drug users (used within the last 30 days) as of 2020.

  • 13.5% of Americans 12 and over used drugs in the last month, a 3.8% increase year-over-year (YoY).
  • 59.277 million or 21.4% of people 12 and over have used illegal drugs or misused prescription drugs within the last year.
  • 138.543 million or 50.0% of people aged 12 and over have illicitly used drugs in their lifetime.
  • Usership among people aged 12 and over is down 0.4% YoY.
  • 138.522 million Americans 12 and over drink alcohol.
  • 28.320 million or 20.4% of them have an alcohol use disorder.
  • 57.277 million people use tobacco or nicotine products (vape).
  • 25.4% of illegal drug users have a drug disorder.
  • 24.7% of those with drug disorders have an opioid disorder; this includes prescription pain relievers or “pain killers” and heroin).

National Center for Drug Abuse NCDAS (NCDAS: Substance Abuse and Addiction Statistics [2023])

QUOTE FOR THURSDAY:

May15

“Lupus is a disease that occurs when your body’s immune system attacks your own tissues and organs (autoimmune disease). Inflammation caused by lupus can affect many different body systems — including your joints, skin, kidneys, blood cells, brain, heart and lungs.

Lupus can be difficult to diagnose because its signs and symptoms often mimic those of other ailments. The most distinctive sign of lupus — a facial rash that resembles the wings of a butterfly unfolding across both cheeks — occurs in many but not all cases of lupus.

Some people are born with a tendency toward developing lupus, which may be triggered by infections, certain drugs or even sunlight.”

MAYO Clinic (Lupus – Symptoms & causes – Mayo Clinic)