Health Care and Sleep Apnea

One of the most challenging aspects of sleeping soundly is a health issue known as sleep apnea. It is a common disorder that causes interruptions in breathing during sleep, preventing oxygen from reaching the brain. Sufferers wake hundreds of times per night, each time normal breathing is interrupted and the brain is depleted of oxygen.

As a result, they never feel rested and experience excessive daytime grogginess. It is not a disease but increases risks of contracting other diseases and conditions. There are three types: obstructive, central and complex, which is a combination of the first two, according to SimpleSleepSolutions.com.

Central Sleep Apneais caused when the brain fails to properly signal the muscles to breath. It is very uncommon and snoring is generally not a symptom.

Obstructive sleep apnea (OSA) is the most common form of sleep apnea, with some estimates at 1 in 7 people in the U.S being afflicted with some form of OSA. In OSA, the muscles around the throat and airway relax, causing the airway to collapse. Sometimes the tongue falls back and obstructs the airway. The brain can no longer receive oxygen and sends a signal to the muscles to open, often causing the person to wake up with a gasp or a snort. Most of the time, sufferers do not recall waking up during these episodes.

More than 18 million adults have sleep apnea, according to the National Sleep Foundation. It is very difficult at present to estimate the prevalence of childhood OSA because of widely varying monitoring techniques, but a minimum prevalence of 2 to 3% is likely, with prevalence as high as 10 to 20% in habitually snoring children. More information is located at this website: https://sleepfoundation.org/sleep-disorders-problems/sleep-apnea/page/0/1.

Sleep apnea can make you wake up in the morning feeling tired or unrefreshed even though you have had a full night of sleep, according to the American Academy of Sleep Medicine. During the day, you may feel fatigued, have difficulty concentrating or you may even unintentionally fall asleep. This is because your body is waking up numerous times throughout the night, even though you might not be conscious of each awakening.

The lack of oxygen your body receives can have negative long-term consequences for your health. This includes:

·         High blood pressure

·         Heart disease

·         Stroke

·         Pre-diabetes and diabetes

·         Depression

If you sleep on your back, gravity can cause the tongue to fall back. This narrows the airway, which reduces the amount of air that can reach your lungs. The narrowed airway causes snoring by making the tissue in back of the throat vibrate as you breathe. Obstructive sleep apnea in adults is considered a sleep-related breathing disorder. Causes and symptoms differ for obstructive sleep apnea in children and central sleep apnea. More info is available at this site: http://www.sleepeducation.org/essentials-in-sleep/sleep-apnea.

Anyone can develop it, regardless of gender or age, and even children can be afflicted, according to Simple Sleep Solutions. The most common risk factors include:

·         Excess weight, especially obesity – about half of all OSA sufferers are overweight

·         Male, although recent research has indicated that women’s risk increases to about the same level as men once they reach post-menopausal age

·         Over the age of 60

·         Smoking

·         Enlarged tonsils and adenoids, one of the most common factors for children with OSA, particularly overweight children

·         Having certain anatomical features such as a thick neck, narrowed airway, deviated spectrum or a receding chin

·         Using alcohol, sedatives and tranquilizers, all of which relax the muscles in the airway

·         Having asthma, in adults and children, particularly if they are overweight

·         Race and ethnicity can play a part as well – some studies have indicated African Americans, Hispanics and other races have a slightly higher risk

·         Allergies and chronic nasal congestion

Only a doctor or sleep specialist can confirm if you or a loved one is suffering from sleep apnea. More information is available at this website: http://www.simplesleepservices.com/what-is-sleep-apnea/.

According to the National Institutes for Health (NIH), Doctors diagnose sleep apnea based on medical and family histories, a physical exam, and sleep study results. Your primary care doctor may evaluate your symptoms first, and will then decide whether you need to see a sleep specialist. Sleep specialists are doctors who diagnose and treat people who have sleep problems. Examples of such doctors include lung and nerve specialists and ear, nose, and throat specialists. Other types of doctors also can be sleep specialists.

If you think you have a sleep problem, consider keeping a sleep diary for 1 to 2 weeks. Bring the diary with you to your next medical appointment. Write down when you go to sleep, wake up, and take naps. Also write down how much you sleep each night, how alert and rested you feel in the morning, and how sleepy you feel at various times during the day. This information can help your doctor figure out whether you have a sleep disorder.

Sleep studies are tests that measure how well you sleep and how your body responds to sleep problems. These tests can help your doctor find out whether you have a sleep disorder and how severe it is. Sleep studies are the most accurate tests for diagnosing sleep apnea. There are different kinds of sleep studies.

If your doctor thinks you have sleep apnea, he or she may recommend a polysomnogram (also called a PSG) or a home-based portable monitor. Testing can show patterns and symptoms that can help lead to a diagnosis and treatment options. More information is available at this site: https://www.nhlbi.nih.gov/health/health-topics/topics/sleepapnea.

According to HelpGuide.org, if your sleep apnea is moderate to severe, or you’ve tried self-help strategies and lifestyle changes without success, a sleep doctor may help you find an effective treatment. Treatment for sleep apnea has come a long way in recent times, so even if you were unhappy with sleep apnea treatment in the past, you may now find something that works for you.

Treatments for central and complex sleep apnea usually include treating any underlying medical condition causing the apnea, such as a heart or neuromuscular disorder, and using supplemental oxygen and breathing devices while you sleep. Treatment options for obstructive sleep apnea include:

·         CPAP

·         Other breathing devices

·         Dental devices

·         Implants

·         Surgery

Medications are only available to treat the sleepiness associated with sleep apnea, not the sleep apnea itself. Much more material on this health care issue can be found at this website: http://www.helpguide.org/articles/sleep/sleep-apnea.htm.

According to this website: http://vjpillow.com/sleep-health-benefits-science/, there are at least 8 reasons why sleep is important to you. Check out how you benefit from getting good sleep; it's important to your health.  

Since so many people suffer from sleep apnea, it is perceived as a very common problem, but not that many take steps to deal with the problem. As sleep apnea can result in long term more severe health issues, it is advisable to see your doctor for a solution that is to your benefit. If you have it, or think you do, get help. You’ll sleep better for it.

Until next time. 

Health Care and Fainting

Have you ever passed out, or fainted? What caused it, and did you get a doctor to help you with a possible diagnosis? Do you remember what happened right before you blacked out, or is that memory still foggy? Was it caused by an accident or an illness? Have you had repetitive occasions of fainting spells? These are very common questions that you may hear from a doctor that examines you after you’ve fainted.

According to Healthline.com, fainting happens when you lose consciousness for a short amount of time because your brain isn’t getting enough oxygen. The medical term for fainting is syncope, but it’s more commonly known as “passing out.” A fainting spell generally lasts from a few seconds to a few minutes. They have listed 41 possible scenarios that can lead to this situation. Read more at this site:   http://www.healthline.com/symptom/fainting .

Fainting can happen to anyone at any age. When someone faints, it's usually because changes in the nervous system and circulatory system cause a temporary drop in the amount of blood reaching the brain. When the blood supply to the brain is decreased, a person loses consciousness and falls over. After lying down, a person's head is at the same level as the heart, which helps restore blood flow to the brain. So the person usually recovers after a minute or two, according to Kidshealth.org.

Fainting is pretty common in teens. The good news is that most of the time it's not a sign of something serious. More details are available at this site: http://kidshealth.org/en/teens/fainting.html .

When you faint, you not only lose consciousness, you also lose muscle tone and the color in your face, according to the NY Times. Before fainting, you may also feel weak, nauseated, and have the sense that your vision is constricting (tunnel vision) or noises are fading into the background. Fainting may occur while or after you:

• Cough very hard
• Have a bowel movement (especially if you are straining)
• Have been standing in one place for too long
• Urinate
• Fainting can also be related to:
• Emotional distress
• Fear
• Severe pain

Other causes of fainting can be attributed to these events:
• Certain medicines, including those used for anxiety, depression, high blood pressure, and allergies (these drugs may cause a drop in blood pressure)
• Drug or alcohol use
• Hyperventilation
• Low blood sugar
• Seizures
• Sudden drop in blood pressure (such as from bleeding or being severely dehydrated)
• Standing up very suddenly from a lying position

Less common but more serious reasons for fainting include heart disease (such as abnormal heart rhythm or heart attack) and stroke. These conditions are more likely in persons over age 65. More info on fainting can be found at this website: http://www.nytimes.com/health/guides/symptoms/fainting/overview.html .

According to the American Heart Association, Some forms of syncope suggest a serious disorder:
• Those occurring with exercise.
• Those associated with palpitations or irregularities of the heart.
• Those associated with family history of recurrent syncope or sudden death.

What is neurally mediated syncope? Neurally mediated syncope (NMS) is called also neurocardiogenic, vasovagal, vasodepressor or reflex mediated syncope. It's a benign (and the most frequent) cause of fainting. However, life-threatening conditions may also manifest as syncope. NMS is more common in children and young adults, although it can occur at any age. NMS happens because blood pressure drops, reducing circulation to the brain and causing loss of consciousness.

Typical NMS occurs while standing and is often preceded by a sensation of warmth, nausea, lightheadedness and visual "grayout." If the syncope is prolonged, it can trigger a seizure. Placing the person in a reclining position will restore blood flow and consciousness and end the seizure. More details are located here: http://www.heart.org/HEARTORG/Conditions/Arrhythmia/SymptomsDiagnosisMonitoringofArrhythmia/Syncope-Fainting_UCM_430006_Article.jsp#.V-Um5XlTGUk

According to this website, http://familydoctor.org/familydoctor/en/diseases-conditions/fainting.printerview.all.html , before fainting, you may feel lightheaded, dizzy, like the room is spinning, sick to your stomach. You may also have blurry vision or a hard time hearing. If you feel like you're going to faint, lie down. If you can't lie down, sit and bend forward with your head between your knees. This helps get the blood flowing to your brain. Wait until you feel better before trying to stand up. When you stand up, do so slowly.

Your doctor will probably ask you about what was happening or what you were doing when you fainted. He or she may ask you for details about how you felt right before and right after you fainted. Your doctor will probably also want to examine you and may perform some tests to find out why you fainted.

If you have a history of fainting, follow your health care provider's instructions for how to prevent fainting, according to the University of Maryland Medical Center (UMMC). For example, if you know the situations that cause you to faint, avoid or change them. You can also take immediate treatment steps when someone else has fainted:

• Check the person's airway and breathing. If necessary, call 911 and begin rescue breathing and CPR.
• Loosen tight clothing around the neck.
• Raise the person's feet above the level of the heart (about 12 inches).
• If the person has vomited, turn him or her onto their side to prevent choking.
• Keep the person lying down for at least 10 to 15 minutes, preferably in a cool and quiet space. If this is not possible, sit the person forward with the head between the knees.

Call 911 if the person who fainted:

• Fell from a height, especially if injured or bleeding.
• Does not become alert quickly (within a couple of minutes).
• Is pregnant.
• Is over age 50.
• Has diabetes (check for medical identification bracelets).
• Feels chest pain, pressure, or discomfort.
• Has a pounding or irregular heartbeat.
• Has a loss of speech, vision problems, or is unable to move one or more limbs.
• Has convulsions, a tongue injury, or a loss of bladder or bowel control.

Even if it is not an emergency situation, you should be seen by a provider if you have never fainted before, if you faint often, or if you have new symptoms with fainting. Call for an appointment to be seen as soon as possible. More info on fainting is at this website:  http://umm.edu/health/medical/ency/articles/fainting .

Fainting is usually temporary situation, but it may be a symptom of a more serious medical condition. For serious syncope episodes, get immediate medical attention. At a minimum, consult your family physician or a healthcare professional when you have any fainting occurrence. It pays to be aware of your health and any potential problems for any reason.

Until next time.

Health Care and Tetanus

One of the most painful medical conditions you can get is tetanus. Also known as lockjaw, tetanus is an infection characterized by muscle spasms. In the most common type, the spasms begin in the jaw and then progress to the rest of the body. These spasms usually last a few minutes each time and occur frequently for three to four weeks.

According to the Mayo Clinic, tetanus is a serious bacterial disease that affects your nervous system, leading to painful muscle contractions, particularly of your jaw and neck muscles. Tetanus can interfere with your ability to breathe and can threaten your life. Thanks to the tetanus vaccine, cases of tetanus are rare in the United States and other parts of the developed world. However, the disease remains a threat to those who aren't up to date on their vaccinations, and is more common in developing countries. There's no cure for tetanus. Treatment focuses on managing complications until the effects of the tetanus toxin resolve.

See your doctor for a tetanus booster shot if you have a deep or dirty wound and you haven't had a booster shot in five years. If you aren't sure of when your last booster was, get a booster. Or, see your family physician about a tetanus booster for any wound — especially if it might have been contaminated with dirt, animal feces or manure — if you haven't had a booster shot within the past ten years or aren't sure of when you were last vaccinated. Much more detailed info is available at this website: http://www.mayoclinic.org/diseases-conditions/tetanus/home/ovc-20200456.

The Clostridium bacteria live in soil, saliva, dust, and manure. The bacteria can enter the body through a deep cut, like those you might get from stepping on a nail, or through a burn, according to the National Institutes for Health (NIH). In the US, where 50 or fewer cases of tetanus occur each year, deaths are more likely to occur in persons 60 years of age and older and in persons who are diabetic. More material on tetanus is available at these two websites: https://www.nlm.nih.gov/medlineplus/tetanus.html, and http://www.adultvaccination.org/tetanus_vaccine_vaccination_adult_immunizations.htm.

According to Nemours, Once the bacteria are in the body, they produce a neurotoxin (a protein that acts as a poison to the body's nervous system) that causes muscle spasms. The toxin can travel throughout the body via the bloodstream and lymph system. As it circulates more widely, the toxin interferes with the normal activity of nerves throughout the body, leading to generalized muscle spasms. Spasms can be so forceful that they tear muscles or even cause spine fractures. Without treatment, tetanus can be fatal.

In the United States, most cases of tetanus follow a contaminated cut or deep puncture injury, such as a wound caused by stepping on a nail. Sometimes the injury is so small the person never even sees a doctor. Injuries that involve dead skin (such as burns, frostbite, gangrene, or crush injuries) are more likely to cause tetanus. Wounds contaminated with soil, saliva, or feces — especially if not properly cleaned — and skin punctures from non-sterile needles (such as with drug use or self-performed tattooing or body piercing) are also at increased risk.

Another form of tetanus, neonatal tetanus, occurs in newborns who are delivered in unsanitary conditions, especially if the umbilical cord stump becomes contaminated. Prior to immunizations, neonatal tetanus was much more common in the United States. Now, routine immunizations for tetanus produce antibodies that mothers pass to their unborn babies. These maternal antibodies and sanitary cord-care techniques have made newborn tetanus very rare in developed countries. Much more information is available at this site: http://kidshealth.org/en/parents/tetanus.html.

Tetanus leads to death in about 1 in 10 cases. Several vaccines are used to prevent tetanus among children, adolescents, and adults including DTaP, Tdap, DT, and Td, according to the Centers for Disease Control (CDC). The Advisory Committee on Immunization Practices (ACIP) recommends 5 doses of diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine for infants and children. One dose of DTaP vaccine is recommended at each of the following ages: 2 months, 4 months, 6 months, 15 through 18 months, 4 through 6 years old. DTaP vaccine may be given at the same time as other vaccines.

Some children should not get DTaP vaccine or should wait:

·         Children with minor illnesses, such as a cold, may be vaccinated. But children who are moderately or severely ill should usually wait until they recover before getting DTaP vaccine.

·         Any child who had a life-threatening allergic reaction after a dose of DTaP should not get another dose.

·         Any child who suffered a brain or nervous system disease within 7 days after a dose of DTaP should not get another dose.

According to the CDC, you should talk with your doctor if your child:

·         Had a seizure or collapsed after a dose of DTaP

·         Cried non-stop for 3 hours or more after a dose of DTaP

·         Had a fever over 105 degrees Fahrenheit after a dose of DTaP.

Ask your health care provider for more information. Some of these children should not get another dose of pertussis vaccine, but may get a vaccine without pertussis, called DT. DTaP should not be given to anyone 7 years of age or older. Much more info is available at this website: http://www.cdc.gov/vaccines/vpd-vac/tetanus/.

According to the National Vaccine Information Center, tetanus bacteria do not survive in the presence of oxygen, which is why puncture wounds, which do not bleed very much and are protected by tissue and skin from direct exposure to the air, are a perfect environment for tetanus bacteria to multiply and cause infection. The incubation period for tetanus infection, from time of exposure to appearance of the first symptoms, can be three days to three weeks.

From 1972 to 2001, 52% of all tetanus cases reported in the U.S., and 76% of all deaths from tetanus were in persons over age 65. From 1987 to 2008, persons with diabetes accounted for 13% of all reported tetanus cases and 29% of all tetanus deaths. Intravenous drug abusers accounted for 15% of all cases during that time period. In 2009 there were 19 tetanus cases reported with two related deaths.

Vaccination is not completely foolproof and can cause some serious side effects in certain cases. The good news is that cases of tetanus have been vastly reduced over the last few decades. The bad news is that there have been some serious repercussions in a very small percentage of the overall population:

·         As of September 1, 2015, there had been 5,277 claims filed in the federal Vaccine Injury Compensation Program (VICP) for injuries and deaths following vaccination with tetanus or tetanus-containing vaccines combined with diphtheria vaccine, including 842 deaths and 4,344 serious injuries.

·         Using the MedAlerts search engine, as of September 30, 2015 there had been 22,686 serious adverse events reported to the Vaccine Adverse Events Reporting System (VAERS) in connection with tetanus and tetanus-containing vaccines combined with diphtheria vaccine since 1990.

·         Over 70%  of those serious tetanus vaccine-related adverse events occurring in children six years old and under. Of these tetanus-vaccine related adverse event reports to VAERS, 2,678 were deaths, with over 90% of the deaths occurring in children under six years of age.

Currently, there are 15 different tetanus-containing vaccines manufactured by various drug companies, which are licensed in the U.S.  More detailed material about tetanus is available at this website: http://www.nvic.org/Vaccines-and-Diseases/Tetanus.aspx.

Tetanus is a serious medical condition and should be treated as a deadly healthcare situation. Do not go without vaccination, but see your pediatrician or family medical practitioner to talk about all the available options and what they recommend as the best course of action for you and your family. Although all vaccinations carry some risk, the risk of going without preventive care is even greater. Talk with your doctor whenever you have any questions about tetanus.

Until next time.

Health Care and Inflammation

Do you ever suffer from joint pain or other maladies caused by inflammation? It’s more common than you may think. Inflammation is typically defined as a localized physical condition in which part of the body becomes reddened, swollen, hot, and often painful, especially as a reaction to injury or infection.

According to LiveScience, inflammation is a vital part of the body's immune response. It is the body's attempt to heal itself after an injury; defend itself against foreign invaders, such as viruses and bacteria; and repair damaged tissue. Without inflammation, wounds would fester and infections could become deadly. 

Inflammation can also be problematic, though, and it plays a role in some chronic diseases. Inflammation is often characterized by redness, swelling, warmth, and sometimes pain and some immobility. Much more detailed information is located at this website: http://www.livescience.com/52344-inflammation.html.

In a delicate balance of give-and-take, inflammation begins when pro-inflammatory hormones in your body call out for your white blood cells to come and clear out infection and damaged tissue, according to WomenToWomen. These agents are matched by equally powerful, closely related anti-inflammatory compounds, which move in once the threat is neutralized to begin the healing process.

Acute inflammation that ebbs and flows as needed signifies a well-balanced immune system. But symptoms of inflammation that don’t recede are telling you that the “on” switch to your immune system is stuck. It’s poised on high alert — even when you aren’t in imminent danger. In some cases, what started as a healthy mechanism, like building scar tissue or swelling, just won’t shut off. More material about inflammation is available at this website: https://www.womentowomen.com/inflammation/causes-of-inflammation/.

According to Prevention Magazine, scientists refer to the immune response gone rogue as chronic inflammation and have identified it as a contributor to a wide range of conditions, including heart disease, asthma, and joint pain. Since studies started making these links in the early 2000s, the term inflammation has become somewhat of a buzzword, bandied about by health nuts and doctors alike.

Some physicians consider it such an important predictor of poor health that they monitor patients' blood for a marker of inflammation, called C-reactive protein, as part of a standard workup. This testing is still uncommon, and it's somewhat controversial, but more and more doctors are adjusting to the idea of quantifying how sick is their patient…really. One hundred million Americans suffer from chronic pain, and they deal with it day after day with no clear fix. Twenty-one million have depression, and for many of them, medication and therapy help only so much.

Meanwhile, scientists are still exploring what inflammation is and how it might be responsible for so many health problems like depression and depression symptoms. Much more detail on the connection between inflammation and depression is located at this site: http://www.prevention.com/health/health-concerns/.

Inflammation has become a medical hot topic, according to Women’s Health Magazine. More and more research shows that chronic inflammation is involved in heavy-hitting illnesses like the following:

·         Cancer

·         Heart disease

·         Diabetes

·         Depression

·         Allergies

It all starts with the immune system, the body's first line of defense against any kind of harm. When you're injured or sick, your bone marrow dispatches veritable SWAT teams of white blood cells to root out infection and jump-start the healing process. Sometimes, however, the immune system gets a faulty distress signal and deploys an unnecessary first-aid squad. Those misguided white blood cells still mobilize just like they would if you were actually under the weather, but because there's no infection for them to attack, they end up just hanging around, often for a long, long time.

However, the problem is that your body isn't made to accommodate this kind of unfocused immune activity, and eventually those white blood cells can start damaging your internal organs. They can also needlessly assault other cells the body routinely uses to push off disease, leaving the door cracked open for illnesses such as cancer. More information on inflammation is located at this website: http://www.womenshealthmag.com/health/chronic-inflammation.

For centuries, scientists have debated whether inflammation is good or bad for you, according to New Yorker Magazine. Now they believe that it’s both: too little, and microbes fester and spread in the body, or wounds fail to heal; too much, and nearby healthy tissue can be degraded or destroyed. The fire of inflammation must be tightly controlled—turned on at the right moment and, just as critically, turned off.

Understanding and controlling inflammation has become a central goal of modern medical investigation. The internal research arm of the National Institutes of Health recently designated inflammation a priority, mobilizing several hundred scientists and hundreds of millions of dollars to better define its role in health and disease. More detailed material about this topic is available at this site: http://www.newyorker.com/magazine/2015/11/30/inflamed.

According to BodyEcology, there are many reasons why you may suffer from inflammation:

·         Chronic low-grade food allergies or food sensitivities that may cause a few symptoms.

·         An imbalance of bacteria and fungi in your gastrointestinal tract, also known as dysbiosis. This causes your immune system to overreact to bacteria in your gut and can be without notable symptoms.

·         Stress! Constant psychological, emotional or physical stress raises the level of cortisol, creating inflammation.

·         Environmental toxicity from air, water, food pollutants and toxic metals like mercury and lead all contribute to inflammation and have been linked to diseases as varied as endometriosis and cancer.

·         Diet and lifestyle: too much fat, sugar, and protein in your diet, constant dehydration, consumption of too many sodas or caffeine, inactivity, and lack of sleep can all increase inflammation in your body.

If you reduce inflammation in your body, you'll not only look and feel younger, but you'll significantly lower your risk for chronic disease. More info on this subject is located at this site: http://bodyecology.com/articles/inflammation_cause_of_disease_how_to_prevent.php.

According to Mercola, the presence of inflammation is what makes most disease perceptible to an individual. It can and often does occur for years before it exists at levels sufficient to be apparent or clinically significant. How long it has been smoldering really determines the degree of severity of a disease and often the prognosis assuming the inflammation can be controlled.

Inflammation is rampant. In fact 1 in 12 women and 1 in 24 men are dealing with full blown autoimmune mediated inflammation. The number of undiagnosed people is going to be much higher. People with inflammation in the early phases of autoimmunity will often claim no dietary involvement. This is an inaccurate assumption however because the autoimmunity is often triggered by factors not strictly related to diet and the diet can become a secondary trigger later in the development of the condition.

If you are dealing with inflammation, then get a comprehensive professional medical evaluation to look at what is perpetuating your personal situation. More information is located at this website: http://articles.mercola.com/sites/articles/archive/2013/03/07/inflammation-triggers-disease-symptoms.aspx.

Inflammation can be good for you when it’s controlled. When it is out of control, then your natural healing process needs help. See your doctor in cases of acute or ongoing inflammation, and recognize the symptoms of how your personal situation have developed. Diagnosis and treatment in a timely manner are worth the time and effort to discover the cause and possible options for your own healthcare when you suffer from inflammation.

Until next time.

Health Care and Lithotripsy

When a kidney stone gets too big to pass in the urinary tract system, trying to migrate from the kidney to the bladder, your doctor or urologist may suggest a procedure known as a lithotripsy. Surgery was the only method to remove stones too large to pass until lithotripsy was developed and replaced it as the most frequent treatment beginning in the 1980s.

The introduction of lithotripsy in the early 1980s revolutionized the treatment of patients with kidney stone disease, according to Johns Hopkins Medicine. Patients who once required major surgery to remove their stones could be treated with lithotripsy, and not even require an incision. As such, lithotripsy is the only non-invasive treatment for kidney stones, meaning no incision or internal telescopic device is required. More information is available at this website: http://www.hopkinsmedicine.org/healthlibrary/test_procedures/urology/lithotripsy_92,p07720/ .

Kidney stones occur when minerals and other substances in the blood crystallize in the kidneys, forming solid masses (stones). Stones may consist of small, sharp-edged crystals, or smoother, heavier formations that resemble polished river rocks. They usually exit the body naturally during urination, according to Healthline.

However, sometimes the body can’t pass larger formations through urination. This can lead to kidney damage. People with kidney stones may experience bleeding, severe pain, or urinary tract infections. When stones begin to cause these types of problems, your doctor may suggest lithotripsy. More info about lithotripsy is located at this site: http://www.healthline.com/health/lithotripsy#Overview1 .

According to the National Kidney Foundation, extracorporeal shock wave lithotripsy (ESWL) is a technique for treating stones in the kidney and ureter that does not require surgery. Instead, high energy shock waves are passed through the body and used to break stones into pieces as small as grains of sand. Because of their small size, these pieces can pass more easily from the body along with the urine.

There are two ways to remove stones using shock wave treatment. In one method, the patient is placed in a tub of lukewarm water. Using x-rays or ultrasound to pinpoint the location of the stones, the body is positioned so that the stones are targeted precisely. In the second, more common method, the patient lies on top of a soft cushion or membrane through which the waves pass. About 1-2 thousand shock waves are needed to crush the stones. The complete treatment takes about 45 to 60 minutes. Much more detail about this process is located at this website: https://www.kidney.org/atoz/content/lithotripsy.

ESWL is usually an outpatient procedure, according to Healthwise. You go home after the treatment and do not have to spend a night in the hospital. After ESWL, stone fragments usually pass in the urine for a few days and cause mild pain. If you have a larger stone, you may need more ESWL or other treatments. ESWL may be used on a person who has a kidney stone that is causing pain or blocking the flow of urine.

Stones that are between 4 mm (0.16 in.) and 2 cm (0.8 in.) in diameter are most likely to be treated with ESWL. ESWL may work best for kidney stones in the kidney or in the part of the ureter close to the kidney. Your surgeon may try to push the stone back into the kidney with a small instrument (ureteroscope) and then use ESWL. More info is available at this site: http://www.webmd.com/kidney-stones/extracorporeal-shock-wave-lithotripsy-eswl-for-kidney-stones .

As with any medical procedure, there are always inherent risks to patients. According to the American Urological Association, although manifestations of chronic injury have been identified, it seems likely that the full spectrum of long-term injury—the form and severity of chronic adverse effects—has yet to be determined. It is intuitive that chronic effects derive from acute tissue damage, but very little is known about the progression of tissue changes that link the two.

There is also limited information about treatment dose and the development of chronic effects and whether specific risk factors exist that predispose an individual to long-term effects. Much more clinical data and research is available at this site: https://www.auanet.org/education/guidelines/shock-wave-lithotripsy.cfm .

According to the University of Florida Medical Center, here are some post surgery symptoms you may experience after going through lithotripsy:

·         Flank Pain: Most patients experience some degree of discomfort for a day or two after ESWL. The pain is usually described as a dull ache or soreness over the kidney or flank area, and is typically at its worst the evening following surgery. The pain lessens over the following days.

·         Blood in Urine: It is normal to see visible blood in the urine for days to several weeks after surgery. It is important during this time of bleeding that you avoid strenuous activity, blood thinning medications, and drink plenty of fluid.

·         Fevers: Low grade fevers are not uncommon following any surgical procedure and anesthesia. If you have fevers >101o F, please notify your surgeon and ask to be connected to the urologist on call.

There are some patients who are not suited to undergo lithotripsy. Patients who are pregnant, have active urinary infection, obstruction of the kidney or are on blood thinning medications that cannot be discontinued are not ideal candidates for ESWL treatment. Patients with particular known stone composition including cystine and certain types of calcium phosphate stones are not ideal candidates as these stone types may not fragment well with ESWL due to their dense nature. Much more detailed material is available at this website: http://urology.ufl.edu/patient-care/stone-disease/procedures/extracorporeal-shock-wave-lithotripsy-eswl/ .

If your child needs this procedure, follow the directions of your child’s doctor and nurse for caring for your child at home after the treatment. According to AboutKidsHealth, they will usually instruct that your child:

·         Drink plenty of fluids, especially water.

·         Change their diet, if needed.

·         Take medication to manage pain and nausea.

·         Get plenty of rest.

If your child is toilet trained, your child’s doctor or nurse may also instruct you to strain your child’s urine for several days and will explain how to do this. Straining the urine will enable you to collect any stone particles so that they can be analyzed in a laboratory. Your child’s doctor will use the information about the make-up of the stone to monitor your child and make recommendations (such as changes in diet) to prevent the kidney stones from recurring. A lot of additional material on this healthcare subject is located at this site: http://www.aboutkidshealth.ca/En/HealthAZ/TestsAndTreatments/Procedures/Pages/shock-wave-lithotripsy.aspx.

Kidney stones are very painful, and those that don’t pass easily are even worse. As one option for treatment, lithotripsy has its merits in spite of the associated risks. However, if your family has a history of kidney stones, you may possibly encounter this situation at some point. Educate yourself on how to deal with the medical options, the procedure, and its outcome.

Until next time.

Health Care and Dehydration

When your body doesn’t have enough fluid to maintain its equilibrium to sustain itself, you may be suffering from dehydration. According to osteopathic physician, Dr. Joseph Mercola, your body requires water to work well. In fact, up to 60 percent of your entire body is made of water, 83 percent of your lungs is water and 73 percent of your brain and heart are composed of water. Water is very important to your ability to function, think, breathe and live. More information is found at this website: http://articles.mercola.com/sites/articles/archive/2016/05/14/urine-dehydration.aspx#_edn1

Summertime means outdoor activities, prolonged exposure to the sun, and excessive sweating—all of which can lead to dehydration, according to Medicine in Motion. Although dehydration can happen any time of the year, the summer months are of particular concern because of the higher temperatures. When a person has lost more than two percent of their body weight during activity, they are considered to be dehydrated.

The best way to battle dehydration, of course, is to drink lots of water or sports drinks before, during and after any intense physical activity or prolonged exposure to hot temperatures. If ignored, dehydration can lead to other problems such as heat exhaustion, muscle cramps, fatigue or even heat stroke. More information is located at this site: http://www.newson6.com/story/31979569/austin-sports-medicine-practice-provides-warning-signs-and-life-saving-tips-for-dehydration.

Fluid concentration does not have to experience a major change before dehydration can occur. Dehydration is mostly caused by fever, serious sweating (after an intense workout, especially in summers), and diarrhea. Dehydration can occur in any age group, but it is most common in young children and older adults. The signs and symptoms of dehydration can be mild or severe. The good news is that your body will notify you if you are getting dehydrated. More details are available at this website: http://fatalsymptoms.com/10-symptoms-of-dehydration/?gclid=CL621JfU3swCFZCIaQod4NEBbg.

According to the Mayo Clinic, mild to moderate dehydration is likely to cause the following symptoms:

·         Dry, sticky mouth

·         Sleepiness or tiredness — children are likely to be less active than usual

·         Thirst

·         Decreased urine output

·         No wet diapers for three hours for infants

·         Few or no tears when crying

·         Dry skin

·         Headache

·         Constipation

·         Dizziness or lightheadedness

The Mayo Clinic also reports that severe dehydration, a medical emergency, can cause these symptoms:

·         Extreme thirst

·         Extreme fussiness or sleepiness in infants and children; irritability and confusion in adults

·         Very dry mouth, skin and mucous membranes

·         Little or no urination — any urine that is produced will be darker than normal

·         Sunken eyes

·         Shriveled and dry skin that lacks elasticity and doesn't "bounce back" when pinched into a fold

·         In infants, sunken fontanels — the soft spots on the top of a baby's head

·         Low blood pressure

·         Rapid heartbeat

·         Rapid breathing

·         No tears when crying

·         Fever

·         In the most serious cases, delirium or unconsciousness

Unfortunately, thirst isn't always a reliable gauge of the body's need for water, especially in children and older adults. A better indicator is the color of your urine: Clear or light-colored urine means you're well hydrated, whereas a dark yellow or amber color usually signals dehydration. More details about this health care issue are located at this site: http://www.mayoclinic.org/diseases-conditions/dehydration/basics/symptoms/con-20030056.

According to the New York Times, there are some ways to help prevent dehydration:

·         Drink plenty of fluids every day, even when you are well. Drink more when the weather is hot or you are exercising.

·         If anyone in your family is ill, pay attention to how much they are able to drink. Pay close attention to children and older adults.

·         Anyone with a fever, vomiting, or diarrhea should drink plenty of fluids. DO NOT wait for signs of dehydration.

·         If you think you or someone in your family may become dehydrated, call your health care provider. Do this before the person becomes dehydrated.

For more severe dehydration or heat emergency, you may need to stay in a hospital and receive fluid through a vein (IV). Your health care provider will also treat the cause of the dehydration. Dehydration caused by a stomach virus should get better on its own after a few days. More information is available at this website: http://www.nytimes.com/health/guides/disease/dehydration/overview.html.

According to Everyday Health, when it comes to total water intake, which includes water gained from foods and other beverages like tea and milk, the  Institute of Medicine recommends that most women get about 2.7 liters of water a day (or about 12 cups), and most men get about 3.7 liters a day (or about 15 cups). Much more detailed information is available at this site: http://www.everydayhealth.com/news/unusual-signs-of-dehydration/.

According to Merck Manuals, seniors are more susceptible to dehydration.  In older people, common causes of dehydration include the following:

·         Confusion

·         Disorders that make obtaining fluids difficult (usually because of restricted mobility)

Additionally, older people sense thirst more slowly and less intensely than younger people do, so even those who are otherwise well may not drink enough fluids. Seniors usually have a higher percentage of body fat. Because fat tissue contains less water than lean tissue, the total amount of water in the body tends to decrease with age. More detailed material is available at this website: http://www.merckmanuals.com/home/hormonal-and-metabolic-disorders/water-balance/dehydration.

Children are especially prone to dehydration. Be alert for the warning signs of dehydration in children, and notify the pediatrician immediately if any of them develop. More info is located at this site: https://www.healthychildren.org/English/health-issues/injuries-emergencies/Pages/dehydration.aspx.

Should you be concerned about dehydration during pregnancy? According to the American Pregnancy Association, the answer is YES. Dehydration is the result of your body losing water faster than you are taking it in. It is a serious issue for the health and wellness of anyone, but for pregnant women, it is especially important to stay well-hydrated.

Pregnant women need more water than the average person, since water plays an important role in the healthy development of your baby. Water helps to form the placenta, which is what a baby relies on to receive nutrients during pregnancy. Water is also used to form the amniotic sac later in pregnancy. Therefore, it is important to avoid dehydration during pregnancy. More information on this topic is located at this site: http://americanpregnancy.org/pregnancy-complications/dehydration-pregnancy/.

Dehydration can be prevented if common sense safety precautions are observed. Don’t let yourself or someone you know lose too much fluid without replacing it right away. Dehydration can happen quickly and unexpectedly. It pays to know the symptoms and how to react when you suffer the symptoms.

Until next time.