QUOTE FOR THURSDAY:

“Signals from your peripheral nerves – the nerves located outside of the brain and spinal cord – are responsible for a host of functions, from perceiving sensations to allowing movements and supporting balance. But sometimes these signals get disrupted for various reasons. The result is a condition known as peripheral neuropathy.

Peripheral neuropathy can be caused by health conditions such as diabetes, rheumatoid arthritis, lupus, kidney disease, Lyme disease, shingles, and hepatitis. Other conditions that can cause peripheral neuropathy include having poor blood flow to the legs (often caused by peripheral arterial disease, or PAD), an underactive thyroid gland (hypothyroidism), metabolism problems, nutritional deficiencies, and growths or tumors that press on nerves.”

Harvard Health Publishing (Peripheral neuropathy: Causes, symptoms, treatment, and prevention – Harvard Health)

 

 

Part II Peripheral Neuropathy – how its diagnosis, the treatment for it, prevention of it and management of it!

   

 

Peripheral Neuropathy Diagnosis:

The symptoms and body parts affected by peripheral neuropathy are so varied that it may be hard to make a diagnosis. If your healthcare provider suspects nerve damage, he or she will take an extensive medical history and do a number of neurological tests to determine the location and extent of your nerve damage. These may include:

  • Blood tests
  • Spinal fluid tests
  • Muscle strength tests
  • Tests of the ability to detect vibrations

Depending on what basic tests reveal, your healthcare provider may want to do more in-depth scanning and other tests to get a better look at your nerve damage. Tests may include:

  • CT scan
  • MRI scan
  • Electromyography (EMG) and nerve conduction studies
  • Nerve and skin biopsy

Peripheral Neuropathy Treatment:

Usually a peripheral neuropathy can’t be cured, but you can do a lot of things to prevent it from getting worse. If an underlying condition like diabetes is at fault, your healthcare provider will treat that first and then treat the pain and other symptoms of neuropathy.

In some cases, over-the-counter pain relievers can help. Other times, prescription medicines are needed. Some of these medicines include mexiletine, a medicine developed to correct irregular heart rhythms; antiseizure drugs, such as gabapentin, phenytoin, and carbamazepine; and some classes of antidepressants, including tricyclics such as amitriptyline.

Lidocaine injections and patches may help with pain in other instances. And in extreme cases, surgery can be used to destroy nerves or repair injuries that are causing neuropathic pain and symptoms.

Peripheral Neuropathy Prevention:

Lifestyle choices can play a role in preventing peripheral neuropathy. You can lessen your risk for many of these conditions by avoiding alcohol, correcting vitamin deficiencies, eating a healthy diet, losing weight, avoiding toxins, and exercising regularly. If you have kidney disease, diabetes, or other chronic health condition, it is important to work with your healthcare provider to control your condition, which may prevent or delay the onset of peripheral neuropathy

Peripheral Neuropathy Management:

Even if you already have some form of peripheral neuropathy, healthy lifestyle steps can help you feel your best and reduce the pain and symptoms related to the disorder. You’ll also want to quit smoking, not let injuries go untreated, and be meticulous about caring for your feet and treating wounds to avoid complications, such as the loss of a limb.

In some cases, non-prescription hand and foot braces can help you make up for muscle weakness. Orthotics can help you walk better. Relaxation techniques, such as yoga, may help ease emotional as well as physical symptoms.

QUOTE FOR WEDNESDAY:

“Are you like millions of Americans who feel tingling and numbness in your limbs? Does it feel like needles are constantly picking your hands and feet? These might be early warning symptoms of a neuropathy, also referred to as peripheral neuropathy.

While the causes of neuropathy vary, including diabetes, autoimmune diseases or chemical exposure, the symptoms are often similar. Here are 5 the most common symptoms of neuropathy to look for:

1. Persistent Tingling And Numbness
2. Loss of balance and coordination
3. Weak muscles
4. Burning pain
5. Changes in sensation

Recognizing these signs on peripheral neuropathy is the first step towards finding relief. If you are experiencing these signs, there are ways to reduce the nerve damage and regain your comfort.

NervePainDiscovery .com (Nerve ReGen)

Part I Peripheral Neuropathy – Learn what it is, the causes, the types of peripheral neuropathy and the symptoms!

Peripheral neuropathy is a type of damage to the nervous system. Specifically, it is a problem with your peripheral nervous system. This is the network of nerves that sends information from your brain and spinal cord (central nervous system) to the rest of your body.

Peripheral means away from the core (heart meaning from the core or the brain or spinal cord that is from the area that sends messages causing symptoms away from those organs) and the furthest away from the core or the brain or SC is your feet to understand what peripheral neuropathy effects.

There are more than 100 types of peripheral neuropathy, each with its own set of symptoms and prognosis. Peripheral neuropathy has many different causes.

Most common causes of peripheral neuropathy in the U.S. is diabetes.

Symptoms can range from tingling or numbness in a certain body part to more serious effects, such as burning pain or paralysis.

Peripheral neuropathy has many different causes. Some people inherit the disorder from their parents. Others develop it because of an injury or another disorder.

In many cases, a different type of problem, such as a kidney condition or a hormone imbalance, leads to peripheral neuropathy. One of the most common causes of peripheral neuropathy in the U.S. is diabetes.

CAUSES OF PERIPHERAL NEUROPATHY:

#1 DIABETES

Trauma: Injuries from falls, car accidents, fractures or sports activities can result in neuropathy. Compression of the nerves due to repetitive stress or narrowing of the space through which nerves run are other causes.

Autoimmune disorders and infections: Guillain-Barré syndrome, lupus, rheumatoid arthritis, Sjogren’s syndrome and chronic inflammatory demyelinating polyneuropathy are autoimmune disorders that can cause neuropathy. Infections including chickenpox, shingles, human immunodeficiency virus (HIV), herpes, syphilis, Lyme disease, leprosy, West Nile virus, Epstein-Barr virus and hepatitis C can also cause neuropathy.

Other health conditions: Neuropathy can result from kidney disorders, liver disorders, hypothyroidism, tumors (cancer-causing or benign) that press on nerves or invade their space, myeloma, lymphoma and monoclonal gammopathy.

Medications and poisons: Some antibiotics, some anti-seizures medications and some HIV medications among others can cause neuropathy. Some treatments, including cancer chemotherapy and radiation, can damage peripheral nerves. Exposure to toxic substances such as heavy metals (including lead and mercury) and industrial chemicals, especially solvents, can also affect nerve function.

Vascular disorders: Neuropathy can occur when blood flow to the arms and legs is decreased or slowed by inflammation, blood clots, or other blood vessel disorders. Decreased blood flow deprives the nerve cells of oxygen, causing nerve damage or nerve cell death. Vascular problems can be caused by vasculitis, smoking and diabetes.

Abnormal vitamin levels and alcoholism: Proper levels of vitamins E, B1, B6, B12, and niacin are important for healthy nerve function. Chronic alcoholism, which typically results in lack of a well-rounded diet, robs the body of thiamine and other essential nutrients needed for nerve function. Alcohol may also be directly toxic to peripheral nerves.

Inherited disorders: Charcot-Marie-Tooth (CMT) disease is the most common hereditary neuropathy. CMT causes weakness in the foot and lower leg muscles and can also affect the muscles in the hands. Familial amyloidosis, Fabry disease and metachromatic leukodystrophy are other examples of inherited disorders that can cause neuropathy.

No known cause: Some cases of neuropathy have no known cause.

There are types of Peripheral Neuropathy:

There are more than 100 types of peripheral neuropathy, each with its own set of symptoms and prognosis. To help doctors classify them, they are often broken down into the following categories:

  • Motor neuropathy. This is damage to the nerves that control muscles and movement in the body, such as moving your hands and arms or talking.
  • Sensory neuropathy. Sensory nerves control what you feel, such as pain, temperature or a light touch. Sensory neuropathy affects these groups of nerves.
  • Autonomic nerve neuropathy. Autonomic nerves control functions that you are not conscious of, such as breathing and heartbeat. Damage to these nerves can be serious.
  • Combination neuropathies. You may have a mix of 2 or 3 of these other types of neuropathies, such as a sensory-motor neuropathy.

Signs and Symptoms remember vary from patient to patient:

The symptoms of peripheral neuropathy vary based on the type that you have and what part of the body is affected. Symptoms can range from tingling or numbness in a certain body part to more serious effects such as burning pain or paralysis.

  • Muscle weakness, Cramps, Muscle twitching to Loss of muscle and bone
  • Changes in skin, hair, or nails
  • Numbness, Loss of sensation or feeling in body parts
  • Loss of balance or other functions as a side effect of the loss of feeling in the legs, arms, or other body parts
  • Loss of pain or sensation that can put you at risk, such as not feeling an impending heart attack or limb pain
  • Emotional disturbances, Sleep disruptions
  • Inability to sweat properly, leading to heat intolerance
  • Loss of bladder control, leading to infection or incontinence
  • Dizziness, lightheadedness, or fainting because of a loss of control over blood pressure
  • Diarrhea, constipation, or incontinence related to nerve damage in the intestines or digestive tract
  • Trouble eating or swallowing
  • Life-threatening symptoms, such as difficulty breathing or irregular heartbeat

The symptoms of peripheral neuropathy may look like other conditions or medical problems. Always see your healthcare provider for a diagnosis.

The most common type of peripheral neuropathy is diabetic neuropathy, caused by a high sugar level and resulting in nerve fiber damage in your legs and feet.

 

 

 

QUOTE FOR TUESDAY:

“Viral hepatitis often shows no symptoms, so many won’t know they have it until it’s too late.

Chronic hepatitis B and C are the world’s leading cause of liver cancer. More than 1.3 million people die because of hepatitis B or C each year – that’s the most of any communicable disease.

Each year, there are nearly two million new cases.

But hepatitis is preventable and treatable. We have fast and accurate tests, effective and affordable treatments, and a proven vaccine for hepatitis B. We already have everything we need to eliminate it.

What’s holding us back? Low awareness, misinformation, myths and stigma are stopping people from accessing hepatitis services – and leading to a lack of action by decision makers.”

World Hepatitis Alliance (Home – World Hepatitis Day)

World Hepatitis Day (WHD)!

The Center for Disease Control and Prevention states the following:

“Viral hepatitis affects nearly 300 million people globally, with approximately 1.3 million deaths each year from hepatitis B and hepatitis C. Despite effective vaccines, evidence-based prevention strategies and medications, deaths from viral hepatitis are increasing globally.

CDC and other organizations around the world recognize WHD by raising awareness about viral hepatitis, the burdens people with hepatitis face, ongoing work to combat viral hepatitis across the globe, and actions people can take to prevent future transmission.

WHD is recognized annually on July 28, the birthday of Dr. Baruch Blumberg, who discovered the hepatitis B virus in 1967. Two years later, he developed the first hepatitis B vaccine. Dr. Blumberg won the Nobel Prize in Physiology or Medicine in 1976.

CDC provides scientific and public health leadership in the United States and to countries around the world in advancing efforts to eliminate viral hepatitis as a public health threat. CDC helps countries build capacity for viral hepatitis surveillance, testing, care, and treatment and assists with development and implementation of national control and elimination programs.

CDC’s global viral hepatitis work protects the United States. Persons who were not born in the United States account for 3 out of 4 people with hepatitis B virus infections.

CDC’s global viral hepatitis work protects the United States. Persons who were not born in the United States account for 3 out of 4 people with hepatitis B virus infections. Simulation studies suggest that since 2000, progress in expanding global hepatitis B vaccination among all countries with people who immigrate to the United States could prevent almost 900,000 hepatitis B virus infections and over 67,000 hepatitis B-related deaths if global 2030 vaccination targets are achieved and sustained; this would save the United States $8.1 billion in estimated costs by 2070.

CDC’s support to other countries makes America stronger by fortifying international partnerships, advancing innovation, and using lessons from other countries to advance the elimination of hepatitis C in the United States. Notably, global work has provided examples of the usefulness for tests at point-of-care, such as a viral test for hepatitis C diagnosis that can be used to link people to care and curative treatment in real time. Evaluations of use of hepatitis C self-testing (i.e. for antibody to hepatitis C virus) has shown strong usability and acceptance in the country of Georgia providing lessons for potential use in other low- and middle-income countries to identify persons exposed to hepatitis C who do not typically access health care services.

CDC has supported the first national viral hepatitis serosurveys to estimate the burden of hepatitis B, hepatitis C, and hepatitis D in Georgia, the Kyrgyz Republic, Uzbekistan, Malawi, and Botswana, providing data that guide the development of national strategic plans, identify strategic priorities needed to achieve elimination of viral hepatitis, and measure progress toward the elimination of hepatitis B and hepatitis C.”

  

QUOTE FOR MONDAY:

“Heart disease is often seen as a chronic, intractable condition — but the reality is more complex. While coronary artery disease (CAD), the most common form, is not yet curable, modern medicine has made it far more manageable than in the past. The key insight is that prevention is far more effective than cure — the best heart disease is the one you never develop.”

Cleveland Clinic (Can Heart Disease Be Cured?)

An eye opener on Heart Disease; a condition that should be rare & cured.

 

Heart disease what is it?

Your arteries can get stretched in high blood pressure and it puts the arteries at risk for an auto immune response which allows LDL particles to go in these stretched out areas causing build up of bad cholesterol in the arteries and imbeds fat causing the placque build up = narrowing of the arteries.

We need to reduce inflammation in the arteries.  To prevent, reduce, and treat heart disease if already diagnosed with.  Reduce all sugars, cut back on fatty foods, exercise daily, increase of your whole grains, fresh fruits, and vegetables.

We need to use all 4 food groups but eat the healthy ones in the right portions.  Which I can provide to you later how to go about this.

Coronary artery disease can cause a heart attack. If you have a heart attack, you are more likely to survive if you know the signs and symptoms, call 9-1-1 immediately, and get to a hospital quickly. People who have had a heart attack can also reduce the risk of future heart attacks or strokes by making lifestyle changes and taking medication.   Don’t put off the chest pain or discomfort in the chest or pain down the L arm for if your right you want to prevent the heart attack before it occurs and if you already had an attack the sooner treated the better.  Reperfusion of blood to the heart is the KEY in treatment.  Chest pain to the heart is lack of oxygen getting to the heart tissue=ischemia.  This is due to lack of oxygenated blood to the heart that causes the ischemia. We alone can’t treat it but we can prevent it before CAD even sets in through good health practices daily, healthy dieting daily and balancing rest with exercise daily is the key to prevent Heart Disease.                                              

Look at our diet alone in America:

Take the elements that are in our foods=Sugars or Carbohydrates or Fats.  Simple CHO likes bread, rice, pasta along with fats and complex sugars all convert to simple sugars in the stomach and when it goes through digestion the simple sugar reaches the blood stream filling it up with sugar which first does get utilized to our tissues and cells but if still extra sugar in the blood stream (which is caused to excess in the size of your meal or too many eating moments in the day) that sugar has to go somewhere which is by filling up the liver with it.  In the liver the glucose gets converted from active sugar=glucose to glycogen=inactive sugar that stores in this organ.  This is so if and when the body needs extra sugar for energy in our body and we don’t eat the inactive glucose glycogen will get released back into the blood stream and change to glucose and be used.  Since we eat so much in America it usually isn’t the case.  Obesity is so large in our country and this is why.   When it reaches full and can’t store anymore glucose extra glucose in the blood stream has to go somewhere.  So now the glucose gets stored in our fatty tissue=weight gain.  This is what you see with eating through on a regular basis day in & day out too much food compared to the activity or exercise you do for the day.  If no daily exercise then your  fat storage build up is high=weight gain.How do we go about preventing CAD and getting healther.  Well see if this makes sense to you, it did to me.  First, genetic abnormalities contribute to the risk for certain types of heart disease, which in turn may lead to heart failure.  However, in most instances, a specific genetic link to heart failure has not been identified.  SO THE KEY IS TO PREVENTION for Heart Disease.

Cornary artery disease (CAD) IS TO LIVE AS HEALTHY AS POSSIBLE IN YOUR ROUTINE HABITS,  YOUR DIETING OF THE 4 FOOD GROUPS, MAINTAINING YOUR WEIGHT IN A THEREPEUTIC RANGE (look as calculating BMI online for free to find out what your weight range is for your height), and BALANCING REST WITH EXERCISE TO HELP DECREASE THE CHANCE OF GETTING HEART FAILURE.

Just like a car the better you take care of it the longer it lasts same principle for heart diseases unless genetically inherited.  So prevention is the key!

 

 

QUOTE FOR THE WEEKEND:

“Acromegaly (called gigantism in children) is a rare condition in which the whole body or parts of the body, particularly the hands and feet, grow larger than normal. More than 95 percent of all cases of acromegaly are the result of a growth hormone–secreting pituitary adenoma.

Growth hormone–secreting pituitary adenomas begin in the somatotropic cells of the pituitary gland. Also called GH, the growth hormone secreted by these tumors triggers the liver to produce insulin-like growth factor 1, or IGF-1. IGF-1 is involved in bone and tissue growth, metabolism, and other processes of the body. When the body produces too much IGF-1, it leads to a range of symptoms known as acromegaly.”

Memorial Sloan Kettering Center (Acromegaly (Growth Hormone–Secreting Pituitary Adenomas) | Memorial Sloan Kettering Cancer Center)

Gigantism, also knows as Acroemegaly – learn the s/s, diagnostic tests and treatment!

 

Gigantism is described as accelerated growth during childhood from the production of excess growth hormone. By definition, gigantism must occur during childhood before the growth plates in the long bones of the body (for example, the femur or humerus) have closed. In adults, the condition is called acromegaly.

Gigantism is most often caused by a benign tumor on the pituitary gland called a pituitary adenoma. However, it can also be caused by the following disorders:

  • Neurofibromatosis
  • McCune-Albright syndrome (MAS)
  • Carney complex
  • Multiple endocrine neoplasia type 1

Sign and Symptoms of Gigantism:

  • Abnormally tall stature
  • Abnormal growth of the face, hands and feet
  • Thickened facial features
  • Irregular menstrual cycle
  • Excessive perspiration with slight activity
  • Delayed puberty
  • Double vision
  • Deafness
  • Headache

How Gigantism is Diagnosed:

Magnetic resonance imaging (MRI) is used to determine the size and location of your child’s tumor if it is suspected that the disease is caused by a pituitary adenoma.

Furthermore, several blood tests can provide a diagnosis. High levels of prolactin or increased amounts of insulin growth factor-1 (IGF-1) can suggest acromegaly, as can high levels of growth hormone in the blood after oral administration of a large dose of glucose. Low levels of cortisol, thyroid hormone, testosterone (in boys), and estradiol (in girls) can also suggest involvement of the pituitary gland.

Treatment for Gigantism:

Surgery

Surgery is the best form of treatment and cures 80 percent of the cases of gigantism. Your child’s surgeon will gain access to your child’s pituitary gland using the transsphenoidal approach—so named because the route crosses, or transects, the sphenoid bone. This bone is located behind your child’s nose, mostly within their skull.

Using precise surgical instruments, the surgeon will make an incision through your child’s nasal cavity to create an opening in the sphenoid bone. Once the surgeon gains access to your child’s sphenoid sinus (the air-filled area behind the sphenoid bone), further incisions will be made until a hole is created in the sella turcica—the bone that cradles and protects the pituitary gland.

After your child’s pituitary gland is in the operative field, removal of the tumor can proceed. Your child’s surgeon will use high magnification to readily distinguish normal pituitary tissue from the tumor.

Once the tumor has been removed, your child’s surgeon will clean the tumor cavity and seal it.

At Barrow Neurological Institute at Dignity Health St. Joseph’s Hospital and Medical Center, our surgeons specialize in two types of surgery for adenomas:

  • Microsurgery uses a powerful operating microscope to help your child’s surgeon distinguish between tiny structures in and around the pituitary gland.
  • Endoscopic surgery uses small tubes and a tiny camera to help your child’s surgeon remove the tumor in small pieces.

Most patients are able to return home the day after their surgery for removal of a pituitary adenoma, and nasal packing is seldom required.

Pharmacological Treatment and Hormone Therapy

Treatment with a prescription medication is possible if surgery does not cure your child’s gigantism or if surgery is not recommended. Medicines are also sometimes prescribed before surgery to improve the likelihood of a good outcome.

  • Octreotide or lanreotide are synthetic forms of the hormone somatostatin and stop the release of growth hormone. They are often effective for the long-term control of gigantism, but they can only be administered by injection every two to four weeks. If your child’s tumor is particularly large, these drugs may be administered before surgery. Due to the side effects of these drugs and their expense, surgery to achieve a long-term cure is preferable.
  • Bromocriptine and cabergoline are from a class of drugs called dopamine agonists. They can lower IGF-1 and growth hormone levels in about half of the people treated with them (although your symptoms could improve even if your IGF-1 and growth hormone levels do not decrease). Although not as effective as the synthetic hormones octreotide and lanreotide, they are less expensive and more convenient to administer, because no injection is required. They can be combined with octreotide in children with no adverse effects on long-term health.
  • Pegvisomant is a recently developed drug that blocks the action of growth hormone in your body, thereby lowering IGF-1 levels. It must be administered by subcutaneous (beneath the skin) injection daily. It is another option if your child does not respond to surgery or other medications, or if your child cannot tolerate these treatments for other reasons.

Gamma Knife

Gamma Knife radiosurgery is a highly advanced form of radiotherapy that is used to achieve similar results to the traditional surgical techniques described above. However, with Gamma Knife it can take several years for growth hormone and levels to return to normal, rather than days or weeks as with traditional surgery. It is typically a treatment of last resort in patients with gigantism.

The ‘knife’ in this surgery is actually made up of many small beams of radiation focused on a single point. Each individual beam too weak enough to damage healthy tissue, but at the point where the beams converge they deliver a dose of radiation that is lethal to the tumor.

Gamma Knife is an outpatient procedure, does not involve any incisions, and requires only brief sedation under general anesthetic.

However, there are additional considerations for pediatric Gamma Knife surgery. These are best discussed with your child’s neurosurgeon.