Health Care and Pseudobulbar Affect

Have you seen those TV commercials lately with actor Danny Glover talking about a neurological disorder that causes people to break out into uncontrollable laughter or crying? This health care issue is known as pseudobulbar affect or PBA, and its debilitating characteristics effects tens of thousands of newly diagnosed cases per year.

Pseudobulbar affect(PBA), emotional lability, labile affect, or emotional incontinence refers to a neurologic disorder characterized by involuntary crying or uncontrollable episodes of crying and/or laughing, or other emotional displays. PBA occurs secondary to a neurologic disease or brain injury. 

Patients may find themselves crying uncontrollably at something that is only moderately sad, being unable to stop themselves for several minutes. Episodes may also be mood-incongruent: a patient might laugh uncontrollably when angry or frustrated, for example.

PBA episodes can be described in two key ways, according to PBAinfo.com:

·         PBA outbursts can be inappropriate: The crying or laughing episodes are inappropriate to the situation in which they occur. Sometimes these are spontaneous crying or laughing eruptions that don’t reflect the way a person is actually feeling.

·         PBA outbursts can be exaggerated: Another characteristic of PBA episodes is that though the crying or laughing may be appropriate for a given situation, they’re exaggerated – they’re more intense or last longer than the situation calls for.

One of the jobs of the brain is to figure out how we feel in the moment. That information is then sent down to the brainstem, also known as the “bulb.” The brainstem then sends signals to the face and other parts of the body that show emotion.

PBA is believed to be the result of a disruption of these signals. When people have certain neurologic conditions or brain injuries, it can cause damage in the brain tissue that creates a disconnection between the parts of the brain that express emotion and those that control emotion.

The result is the frequent outbursts of involuntary crying or laughing known as pseudobulbar affect. If you break the term down literally, “pseudo” means false, “bulbar” refers to the brainstem and “affect,” describes how the body shows mood or emotion. More details can be found at this website: http://www.pbainfo.org/science.

The side-effects for PBA sufferers include feelings of emotional exhaustion and, frequently, social isolation, according to Psychology Today. Without realizing that they have a medical problem, people with PBA often adapt their lives to avoid things that trigger the response, including interacting with others unless they absolutely have to. With social isolation comes more negative emotion that can over time manifest as depression.  

While all of this may sound like new knowledge about a recently discovered disease, PBA has actually been well-documented in the medical literature for more than 100 years, though it has been labeled at least ten different things during that time. More detailed material is found at this site: https://www.psychologytoday.com/blog/neuronarrative/201110/not-all-crying-is-depression-understanding-pseudobulbar-affect.

According to the National Institutes of Health, although it is most commonly misidentified as a mood disorder, particularly depression or a bipolar disorder, there are characteristic features that can be recognized clinically or assessed by validated scales, resulting in accurate identification of PBA, and thus permitting proper management and treatment. Mechanistically, PBA is a disinhibition syndrome in which pathways involving serotonin and glutamate are disrupted.

This knowledge has permitted effective treatment for many years with antidepressants, particularly tricyclic antidepressants and selective serotonin reuptake inhibitors. A recent therapeutic breakthrough occurred with the approval by the Food and Drug Administration of a dextromethorphan/quinidine combination as being safe and effective for treatment of PBA.

Side effect profiles and contraindications differ for the various treatment options, and the clinician must be familiar with these when choosing the best therapy for an individual, particularly elderly patients and those with multiple comorbidities and concomitant medications. A much more detailed clinical explanation and overview is available at this site: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3849173/.

To distinguish PBA from depression or other causes, doctors may administer a questionnaire rating episode frequency, duration, voluntary control and appropriateness to context and inner feelings. Additional details can be found at this website: http://alsn.mda.org/article/pba-symptoms-no-laughing-matter.

According to the American Stroke Association, in January 2011, the FDA approved a new drug called Nuedexta™ (dextromethorphan quinidine) specifically for PBA. In clinical trials, it proved effective against placebo, but it has not been compared directly to antidepressants. Analyzing data across studies, it appears to be faster acting than the anti-depressants with few side effects. Nuedexta™ is not recommended for patients with certain arrhythmias: prolonged Q-T interval, complete heart block, history of torsades de point (a type of ventricular tachycardia) or heart failure.

As with any new drug, there is a considerable cost difference when compared to older, off-patent medications. Nuedexta™ is manufactured by Avanir Pharmaceuticals and costs $200–300 for a month’s supply. The SSRIs mentioned in the article are $10–$12/month. Though off-patent antidepressants are often used in treating PBA, Nuedexta™ is the only prescription drug currently indicated specifically for PBA by the FDA. Avanir, like many pharmaceutical companies, does have a Patient Assistance Program. More detail on this medication and PBA is available at this website: http://www.strokeassociation.org/STROKEORG/LifeAfterStroke/RegainingIndependence/EmotionalBehavioralChallenges/Pseudobulbar-Affect-PBA_UCM_467457_Article.jsp

One of the best ways to deal with PBA is to tell your friends, co-workers, and family that you have it. Explain what PBA is and what causes it. Let the people around you know that you may have uncontrolled emotional outbursts. That way, when you suddenly burst into tears or start laughing they won’t be surprised or shocked. And you won’t have to always worry about losing control at the wrong moments, according to HealthLine.com.

You can gain some control over your symptoms with a few simple tricks. When you start feeling the urge to laugh or cry, try to distract yourself. Think about something different. If you’re crying, try to focus on something upbeat or funny. For example, you could think about a funny movie you saw recently. Take slow, deep breaths. And relax the muscles that start to tense up whenever you have an episode. More info is located at this site: http://www.healthline.com/health/multiple-sclerosis/pseudobulbar-affect#Medicines8.

PBA can have an enormous impact on a person's social life. Emotional episodes caused by the disease can be embarrassing and can damage interpersonal relationships. The Brain Injury Association of America study indicates that 60% of people with brain injuries feel that PBA and its accompanying outbursts make it hard for them to initiate and maintain friendships. The disease was also the cited culprit in being housebound for 40% of people in the survey.

For caregivers of people with PBA, it can be difficult trying to deal with a person who feels isolated and alone because of their disease.  PBAinfo.org offers a few tips for caregivers to help them interact positively with emotionally explosive loved ones:

·         Let them know that you support them and they are not alone. Reassure them that many people suffer from the symptoms of PBA.

·         Remind them that their outbursts are caused by a physical disease, not a mental condition.

·         Indicate your willingness to listen to their frustrations and concerns.

·         Keep an "episode diary." By recording PBA episodes, you can ensure better communication with your doctor and help him or her make an accurate diagnosis.

According to the American Stroke Association, these episodes can strike a person up to 100 times a day. They can be a few seconds to a few minutes long. More information about this topic for seniors and others is available at this website: https://www.agingcare.com/Articles/crying-is-not-always-depression-148580.htm.

Psuedobulbar Affect has been identified in several million patients, both men and women. It is a disease that can be managed, but not readily identified unless the doctor knows what to look for and how to treat it. More people suffer every day from PBA. The good news is that there are therapies to help overcome PBA and its impact on the lives of those who have it. If you think you may be symptomatic, or know someone whom you may suspect exhibits the symptoms, see your healthcare provider to get a proper diagnosis.

Until next time.

Health Care and Hypertension

Hypertension, or high blood pressure as it is commonly called, is a dangerous health care issue, and can be a killer. Tens of millions of men and women, as well as some children, suffer from this malady on a daily basis; and for some, hypertension is a lifelong struggle.

Hypertension (HTN or HT), also known as high blood pressure or arterial hypertension, is a chronic medical condition in which the blood pressure in the arteries is persistently elevated. Blood pressure is expressed by two measurements, the systolic and diastolic pressures, which are the maximum and minimum pressures, respectively, in the arterial system.

The systolic pressure occurs when the left ventricle is most contracted; the diastolic pressure occurs when the left ventricle is most relaxed prior to the next contraction, according to JAMA, the Journal of the American Medical Association. The publication has a lot of info about this medical topic, and you can locate it at this site: http://jama.jamanetwork.com/journal.aspx .

According to the American Society of Hypertension, hypertension--the most prevalent cause of stroke and kidney failure--is part of a bigger disease conglomerate almost always accompanied by obesity, diabetes, kidney disease or many other co-existing problems involving lifestyle and/or genetics. More details are located at this site: http://www.ash-us.org/About-Hypertension/Hypertension-Information.aspx

Here are some statistics provided by the Centers for Disease Control at this site http://www.cdc.gov/nchs/fastats/hypertension.htm :

·         Percent of adults ages 20 and over with hypertension (measured high blood pressure and/or taking antihypertensive medication): 32.5% (2011-2012).

·         Number of visits to physician offices with essential hypertension as primary diagnosis: 38.9 million.

·         Number of visits to hospital outpatient departments with essential hypertension as primary diagnosis: 3.7 million.

·         Number of deaths from essential hypertension and hypertensive renal disease: 30,770.

·         Deaths per 100,000 population from essential hypertension and hypertensive renal disease: 9.7.

One in three Americans are at risk for hypertension, according to the American Heart Association. Science has identified several factors that can increase your risk of developing hypertension, or high blood pressure. One big contributor is that it may be in your genes. Family history has a lot to do with your risk of hypertension. Height, hair and eye color runs in families --- so can high blood pressure. If your parents or close blood relatives have had hypertension, you are more likely to develop it, too.

You might also pass that risk factor on to your children. That's why it's important for children as well as adults to have regular blood pressure checks. You can't control heredity, but you can take steps to live a healthy life and lower your other risk factors. Lifestyle choices have allowed many people with a strong family history of HBP (hypertension/high blood pressure) to avoid it themselves.  Much more detail can be found at this site: http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/UnderstandYourRiskforHighBloodPressure/Understand-Your-Risk-for-High-Blood-Pressure_UCM_002052_Article.jsp .

You'll likely have your blood pressure taken as part of a routine doctor's appointment. Ask your doctor for a blood pressure reading at least every two years starting at age 18, according to the Mayo Clinic. Blood pressure generally should be checked in both arms to determine if there is a difference. Your doctor will likely recommend more frequent readings if you've already been diagnosed with high blood pressure or other risk factors for cardiovascular disease. Children age 3 and older will usually have blood pressure measured as a part of their yearly checkups.

If you don't regularly see your doctor, you may be able to get a free blood pressure screening at a health resource fair or other locations in your community. You can also find machines in some stores that will measure your blood pressure for free. Public blood pressure machines, such as those found in pharmacies, may provide helpful information about your blood pressure, but they may have some limitations.

The accuracy of these machines depends on several factors, such as a correct cuff size and proper use of the machines. More information about hypertension can be found at this website: http://www.mayoclinic.org/diseases-conditions/high-blood-pressure/basics/definition/con-20019580 .

According to the Cleveland Clinic, approximately 1% of Americans with hypertension are estimated to be affected by hypertensive crises. Hypertensive crisis broadly covers both hypertensive urgency and emergency. Hypertensive emergencies are more common in patients with essential hypertension (20%-30% in Caucasians and 80% in African Americans). Factors such as renal failure, heart failure, cerebrovascular accidents, and nonadherence to antihypertensive therapy are associated with hypertensive crisis. Illicit drug use is an important cause for hypertensive crisis.

One in 3 Americans over the age of 18 years suffers from hypertension. The prevalence is higher among older individuals, women and non-Hispanic blacks. The prevalence of hypertension increases progressively with age. Significant clinical data is available for review at this site: http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/nephrology/arterial-hypertension/

About 72 million Americans are estimated to have high blood pressure. High blood pressure occurs more often in blacks—in 41% of black adults compared with 28% of whites and 28% of Mexican Americans. It also occurs with high frequency in people whose ancestors are from China, Japan, and other East Asian or Pacific areas (such as Koreans, Thais, Polynesians, Micronesians, Filipinos, and Maori), according to Merck.

The consequences of high blood pressure are worse for blacks. High blood pressure occurs more often in older people—in about two thirds of people aged 65 or older, compared with only about one fourth of people aged 20 to 74. People who have normal blood pressure at age 55 have a 90% risk of developing high blood pressure at some point in their life. High blood pressure is twice as common among people who are obese as among those who are not. 

In the United States, only an estimated 81% of people with high blood pressure have been diagnosed. Of people with a diagnosis of high blood pressure, about 73% receive treatment, and of the people receiving treatment, about 51% have adequately controlled blood pressure. Although many have a solution, a significant number still do not.

To many people, the word hypertension suggests excessive tension, nervousness, or stress. In medical terms, hypertension refers to high blood pressure, regardless of the cause. This site has a substantial amount of info about hypertension: http://www.merckmanuals.com/home/heart-and-blood-vessel-disorders/high-blood-pressure/high-blood-pressure.  Because it usually does not cause symptoms for many years—until a vital organ is damaged—hypertension has been called "the silent killer." Here is the high level overview of hypertension as a summary:

·         Often no cause for high blood pressure can be identified, but sometimes it occurs as a result of an underlying disorder of the kidneys or a hormonal disorder.

·         Obesity, a sedentary lifestyle, stress, smoking, and excessive amounts of alcohol or salt in the diet all can play a role in the development of high blood pressure in people who have an inherited tendency to develop it.

·         In most people, high blood pressure causes no symptoms.

·         Doctors make the diagnosis after measuring blood pressure on two or more occasions.

·         People are advised to lose weight, stop smoking, and decrease the amounts of salt and fats in their diets.

·         Antihypertensive drugs are given.

Hypertension, or high blood pressure, should not be ignored. If you feel that you may be suffering from symptoms, then see your doctor. If you have hypertension, follow your physician’s directions on how to treat it or how you can get rid of it if possible. Each person needs to have a diagnosis specific to him/her, but hypertension can kill you if you’re not careful. Don’t be another statistic.

Until next time. 

Health Care and Spices

One essential element of most cooking is spice, and they are as varied as there are types. A spice is a dried seed, fruit, root, bark, or vegetable substance primarily used for flavoring, coloring or preserving food. Spices are distinguished from herbs, which are parts of leafy green plants used for flavoring or as a garnish. Many spices have antimicrobial properties.

Spices are more commonly used in warmer climates and why the use of spices is prominent in meat, which is particularly susceptible to spoiling. A spice may have other uses, including medicinal, religious ritual, cosmetics or perfume production.  

The spice trade developed throughout South Asia and Middle East in around 2000 BC with cinnamon and pepper, and in East Asia with herbs and pepper. The Egyptians used herbs for embalming and their demand for exotic herbs helped stimulate world trade. The word spice comes from the Old French word espice, derived from Latin. By 1000 BC, medical systems based upon herbs could be found in China, Korea, and India. Early uses were connected with magic, medicine, religion, tradition, and preservation. Over thousands of years, spices have been used for many reasons.

In healthcare, certain spices are used to help treat various maladies, especially in holistic or naturopathic medicine. For example, spices that help treat inflammation are tumeric, ginger, cinnamon, garlic, cayenne, black pepper, and clove. As with the other supplements, you should talk to your healthcare clinician before adding large amounts of cinnamon or oregano to your diet. Your discussion will help you avoid medication interactions or complications with a pre-existing condition. More details about these spices and other info can be found at this website: http://ministryhealth.org/HC/Home/2015/Winter2015/Spices.nws .

Another site has similar information with a bit more detail on these spices. Spices and herbs can do a lot more than add pizzazz to your cooking -- they can also promote heart health, fight cancer, reduce inflammation, and more. Visit this website: https://www.caring.com/articles/spices-with-healing-powers .

                                                                                                  

Heart patients need to know more about spices in particular. Herbs and spices contain trace amounts of sodium, according to Emory Healthcare. Their website shows herb and spice recommendations to infuse into your current recipes in place of salt: http://www.emoryhealthcare.org/heart-failure/self-care-strategies/salt-substitutes.html .

Spices not only just excite your taste buds but are composed of an impressive list of phyto-nutrients, essential oils, antioxidants, minerals and vitamins that are essential for overall wellness. Spices have been integral part part of our food since centuries, and today, even become more relevant for us. Thanks to the Arab and European explorers, whose contributions in spreading them from their place of origin to the rest of the planet has immensely broaden their use and popularity all over the world, according to this website: http://www.nutrition-and-you.com/healthy_spices.html. Here are some reasons why they say you should include spices in your diet:

·         Spices contain an impressive list of plant-derived chemical compounds that are known to have disease preventing and health promoting properties. They have been in use since ancient times for their anti-inflammatory, carminative, anti-flatulent properties.

·         The components in the spices have been found to have anti-clotting action (prevent clogging of platelets in the blood vessels) and thus help easing blood flow, preventing stroke and coronary artery disease.

·         The active principles in the spices may help in smooth digestion through augmenting intestinal tract motility as well as increasing the digestion power by stimulating excessive secretion of gastro-intestinal enzymes inside the gut.

·         Throat gargling with tepid thyme water can help relieve sore throat and bronchitis symptoms. Thyme is also being used as an anti-septic mouthwash in the treatment of caries and gingivitis.

·         Decoction of certain healthy spices is taken by mouth for the treatment of colds, influenza, mild fevers, indigestion, stomach upset, and painful menstruation.

·         Spices are also known to have natural anti-helminthes (control worm infestation) function in traditional medicines.

·         The essential volatile oils in certain spices (cloves, peppers, etc.) may work as a rubefacient (soothes skin around the site of application and improves the local blood circulation), increasing the flow of blood to make the skin feel warmer. They are being applied as a popular home remedy for arthritis and sore muscles, and used either as poultice or in hot baths.

·         Spice's essential oils are being used in the aromatherapy as well as de-odorants in the perfume industry.

·         Spices contain a good amount of minerals like potassium, manganese, iron, and magnesium. Potassium is an important component of cell and body fluids that helps in controlling heart rate and blood pressure. Manganese is used by the body as a co-factor for the antioxidant enzyme, superoxide dismutase.

According to the Washington Post, spices last a while, but they lose their flavor over time, so buy them in usable quantities. The ground versions lose flavor faster than their whole counterparts. Seal tightly in glass containers, and store in the dark, away from the heat of the oven, for optimal freshness. 

Many plastic spice containers contain the harmful chemical BPA, so glass is best. Never buy a spice rack with spices in it! Chances are they are not fresh, and there might be ones you won’t use. Choose the spices you desire and look for expiration dates. More details are located at this site: https://www.washingtonpost.com/lifestyle/wellness/spices-and-their-health-benefits/2014/01/07/4f074f24-6f2d-11e3-aecc-85cb037b7236_story.html

Herbs and Spices have antibacterial and antiviral properties and many are high in B-vitamins and trace minerals, according to Wellness Mama. True sea salt, for instance, contains 93 trace minerals. Most herbs and spices also contain more disease-fighting antioxidants than fruits and vegetables. The problem in America is that the most potent and healthy herbs are rarely used, mainly from lack of knowledge about them, while the least potent (salt and pepper) are the most commonly used seasonings. More details are found at this website: http://wellnessmama.com/1092/health-benefits-of-herbs-spices/.

Spices are good for you, and have certain benefits for your health. However, not everyone can use them. Check with your healthcare provider or personal physician before using spices for any reason, especially if you have certain food allergies, have a compromised immune system, or are taking any prescription medications. Better safe than sorry, even if you want to use spices to spice up your life.

Until next time.  

Health Care and Suntan Lotion

In the waning days of Summer, there are still a few good days of sun worshipping available to those people who want to glean every last drop of tanning available until the cooler winds of autumn begin to blow. Of course, any time you’re outside, you should consider wearing some form of sun block to protect your skin, even if it’s a small number of sunscreen to block the harmful UVA and UVB rays that can cause damage to you. Using a good suntan lotion is one good way to protect yourself.

According to EWG, sunscreens can only provide partial protection against harmful effects of the sun. Limiting sun exposure and wearing protective clothing are more important for protecting your skin from cancer and premature aging. Be extra careful about spending time in the sun between 10 a.m. and 4 p.m., when the sun’s rays are most intense.

And remember that UVA radiation doesn’t decline as much as UVB when the sun is lower in the sky or it’s overcast. UVA penetrates glass. Apply sunscreen generously 30 minutes before going outside and reapply it often – at least every two hours. Even the best sunscreen won’t work well if you don’t use it correctly. Much more detailed info can be found at this website: http://www.ewg.org/2015sunscreen/faqs-your-sunscreen-questions-our-answers/.

Sunscreen (also commonly known as sun screen, sunblock, suntan lotion, sunburn cream, sun cream or block out) is a lotion, spray, gel or other topical product that absorbs or reflects some of the sun's ultraviolet (UV) radiation and thus helps protect against sunburn. Skin-lightening products have sunscreen to protect lightened skin because light skin is more susceptible to sun damage than darker skin. A number of sunscreens have tanning powder to help the skin to darken or tan; however, tanning powder does not provide protection from UV rays.

Depending on the mode of action, sunscreens can be classified into physical sunscreens (i.e., those that reflect the sunlight) or chemical sunscreens (i.e., those that absorb the UV light).

Medical organizations such as the American Cancer Society recommend the use of sunscreen because it aids in the prevention of squamous cell carcinomas. Suntan lotion is a variation of the liquids, sprays or gels that are available in most retail locations, or can be ordered online.

Many sunscreens do not block UVA radiation, which does not primarily cause sunburn but can increase the rate of melanoma and photodermatitis. The use of broad-spectrum (UVA/UVB) sunscreens can address this concern. Diligent use of sunscreen can also slow or temporarily prevent the development of wrinkles and sagging skin. Additional significant details can be located at this site: https://en.wikipedia.org/wiki/Sunscreen.

Although the words suntan lotion and sunscreen are commonly used interchangeably, according to pediatric specialist, Dr. Vincent Iannelli, you won't find any products claiming to be suntan lotions anymore. Instead, a product that is considered to be a suntan lotion is usually a sunscreen with an SPF of less than 15. These 'tanning' sunscreens, which typically have an SPF 4 to SPF 8, do not provide enough sun protection, especially for kids.

Some dark tanning oils do not even contain any sunscreen ingredients and may even include a tanning accelerator. Suntan lotion products and tanning oils include:

·         Bain de Soleil Mega Tan Sunscreen With Self Tanner, SPF 4

·         Coppertone Sunscreen Lotion, SPF 4

·         Banana Boat Dark Tanning Oil Spray (Contains No Sunscreen)

·         Banana Boat UltraMist Continuous Spray Sunscreen, Deep Tanning Dry Oil, SPF 8

·         Hawaiian Tropic Dry Oil Clear Spray Sunscreen, SPF 6

·         Panama Jack Trophy Oil, Full Sun Continuous Oil Spray (Contains No Sunscreen)

Since they don't provide enough sun protection, instead of a suntan lotion or tanning oil, kids should only use a sunscreen that provides broad spectrum UVA and UVB protection. Much more detailed information can be found at this website: http://pediatrics.about.com/od/sunscreen/a/710_suntan_lotion.htm.

According to the LiveStrong Foundation, if you perspire heavily or engage in outdoor physical activity, pick a waterproof or sport sunscreen. To protect your face, check labels to find products for sensitive skin or faces. If too many choices lead you to indecision, keep it simple. Choose a broad spectrum sunscreen with a sun protection factor of at least 30 and wear it daily. The Foundation provides an overview of the top 10 sunscreens on the market available to consumers. More information about that material is available at this site: http://www.livestrong.com/article/140532-top-10-suntan-lotions/.

Skin cancer is the most common cancer in the U.S where 1 in 8 people will get skin cancer in their lifetime and 1 in 50 will get melanoma. This makes skin protection important for everyone, according to Dr. Aaron Hartman with Family Practice Associates in Virginia. The best sunscreens are those that block both UVA and UVB light from damaging your skin and will last all day without reapplying. Think of UVA as the “aging” rays and UVB as the “burning” rays. Most sunscreens protect against UVB rays, while not really protecting against UVA.

This explains why often people would spend a day in the sun and not burn, but notice the freckles on their skin got darker or they became more tan/brown. Most commercial sunscreens today use chemicals that absorb UVA or UVB but then over a few hours they break down and no longer work. They also often only block UVA2 and not UVA1 which also can affect your skin. The best sun protectants are sunblocks that contain titanium dioxide or zinc oxide. These block both UVA1/UVA2 and UVB and, if applied correctly and you do not sweat or get into water, they can last all day.

SPF measures only UVB protection, which causes sunburns, but does not reflect UVA protection. UVA exposure has been associated with melanoma and other kinds of skin cancer. A SPF of “2” blocks 50% of UVB radiation, a SPF of “10” blocks 90%, SPF 15 blocks 93% and SPF 30 blocks 97%. So you can see that once you get to a SPF of 15 you don't get much additional sunburn protection. You should look for a product with excellent UVA protection.  More details can be found at this website: http://www.fampracticeassociates.com/what-suntan-lotion-is-best-for-summertime.

Suntan lotion, sunscreens, and sun blocks are used year round, but those products need scrutiny by you for your use and for your protection from the sun’s rays. When purchasing products like these, it pays to do your homework. Sometimes, cheaper isn’t always better, especially when your health is at risk. If you need more guidance, consult your family doctor or a healthcare specialist. Fun in the sun can be great, but it has its risks. Be careful to protect yourself and your loved ones from serious skin injuries by using quality sun protection products.

Until next time.

Health Care and Sonograms

When expectant mothers go to the doctor to check on their pregnancy, one of the first procedures that the OB/GYN schedules is a sonogram. This unique tool allows the technician, the physician, and the Mom to see how the baby is developing. In some cases, the sonogram tech can predict the due date of the baby more accurately than the physician.

Technically, the sonogram is an image orgraph representing a sound, showing the distribution of energy at different frequencies—a diagnostic medical image created using ultrasound echo (sonographic), equipment.

A sonogramis the image generated during ultrasonography, which is a diagnostic imaging technique that uses ultrasound to visualize anything inside the body. Ultrasoundis sound with a frequency above the range audible to humans, about 20 kHz. In common parlance, both words are used to refer to the ultrasonography procedure, according to Diffen. The sonogram also helps physicians observe growth of a fetus, calculate age and due date and see presence of multiple fetuses. Plus, it’s used to diagnose pelvic bleeding or locate cancerous cells.

According to the American Pregnancy Association, an ultrasound exam is a procedure that uses high-frequency sound waves to scan a woman’s abdomen and pelvic cavity, creating a picture (sonogram) of the baby and placenta. Although the terms ultrasound and sonogram are technically different, they are used interchangeably and reference the same exam.

There are basically seven different ultrasound exams, but the principle process is the same. Here are the various types of exams:

·         Transvaginal Scans – Specially designed probe transducers are used inside the vagina to generate sonogram images. Most often used during the early stages of pregnancy.

·         Standard Ultrasound –Traditional ultrasound exam which uses a transducer over the abdomen to generate 2-D images of the developing fetus .

·         Advanced Ultrasound – This exam is similar to the standard ultrasound, but the exam targets a suspected problem and uses more sophisticated equipment.

·         Doppler Ultrasound – This imaging procedure measures slight changes in the frequency of the ultrasound waves as they bounce off moving objects, such as blood cells.

·         3-D Ultrasound – Uses specially designed probes and software to generate 3-D images of the developing fetus.

·         4-D or Dynamic 3-D Ultrasound –Uses specially designed scanners to look at the face and movements of the baby prior to delivery.

·         Fetal Echocardiography –Uses ultrasound waves to assess the baby’s heart anatomy and function. This is used to help assess suspected congenital heart defects.

Your healthcare provider will use hormone levels in your blood, the date of your last menstrual period and, in some cases, results from an ultrasound to generate an expected date of conception. However, many differences in each woman’s cycle may hinder the accuracy of the conception date calculation. Much more detailed information about this subject can be found at this website: http://americanpregnancy.org/prenatal-testing/ultrasound/ .

In many pregnancy cases, especially when there is thought about aborting the baby, an actual-size sonogram at nearly seven weeks' gestation is usually done; 33 percent of abortions occur before then. Sonograms are a vital tool in showing the growth and any movement of the baby in the womb.

When a pregnancy is planned, a sonogram marks a joyful beginning, according to Glamour Magazine. Soon-to-be parents post the grainy images on Facebook, tape them up on refrigerator doors, or paste them into baby books as first entries. But for the 3.4 million women across the country who face an unintended pregnancy every year, the scan can be a different story. This is where a sonogram complicates that decision to move forward with aborting the new life now growing in the mother.

Sonogram laws, which require doctors to offer or perform an ultrasound before any abortion, are part of a dramatic increase in antiabortion legislation sweeping the country. As of late 2014, over 220 of these restrictions have passed—35 more than in the entire previous decade:Some of them ban the procedure outright after 20 weeks of pregnancy; others mandate that facilities meet specifications such as a certain width for hallways.

Although the images have become politically charged, the science behind sonograms is straightforward. When an ultrasound sensor is placed inside a woman's vagina or on her belly during an exam, the sound waves produce a moving picture. At six weeks the sonogram can often show a fetal heartbeat.

At eight weeks—the point at which two thirds of abortions have occurred—a distinct shape is just starting to emerge. At nine weeks the beginnings of arms and legs are visible. By 13 weeks—when 92 percent of abortions will have taken place—the fetus weighs nearly an ounce, with a hint of facial features.

Most abortion providers routinely use ultrasound to help determine how far along a pregnancy is, but now in several states the test is required in virtually all cases. In Texas, Louisiana, and Wisconsin, the law mandates that women be shown the image and hear it described (a doctor will detail the exact dimensions of the embryo, for example, or the internal organs of the fetus). In the nine other states (Alabama, Arizona, Florida, Indiana, Kansas, Mississippi, North Carolina, Ohio, and Virginia), women must be offered a view of the sonogram.

In most of these states, if the women don't want to look, they must sign a waiver. More details about the use of sonograms by abortion clinics is found at this site: http://www.glamour.com/inspired/2014/11/how-women-seeking-abortions-feel-about-viewing-a-sonogram

Ultrasound images are captured in real-time, allowing them the ability to show the structure and movement of the body’s internal organs, as well as blood flowing through the vessels. Ultrasound scans are completely noninvasive, and unlike x-rays, they do not use ionizing radiation, according to Envision Radiology.

Ultrasound scans help physicians diagnose and treat a variety of medical conditions, and help evaluate symptoms such as pain, swelling, and infection. Ultrasound is useful in examining many of the body’s organs, including the heart and blood vessels, gallbladder, spleen, pancreas, kidneys, liver, bladder, thyroid, uterus, ovaries, and scrotum.  Most ultrasound procedures are fast and painless, being completed within 30 to 60 minutes.

Sonogram machines emit sound waves, often known as ultrasound waves, that bounce off of organs, bones, and muscles. The machines are able to calculate the distance between waves in order to generate a very accurate picture, which is displayed on a specialized computer screen, according to WiseGEEK. In most cases, the waves are both sent and received from a wand-like instrument known as a transducer.

A trained technician will usually gently touch the wand to the skin above the area of interest. Jelly or lubricant is often applied first, both to help the wand glide and to amplify the sound waves to generate a clearer, more accurate picture. Most sonogram sessions result in pictures from many different angles, which technicians and medical professionals look at in sequence to get an idea of what is happening internally.

To mitigate the possible risks to a developing child, most medical professionals use sonograms only intermittently in pregnancy. Though parents often want to see images of their growing baby at each doctor visit, this is not usually permitted unless there is a legitimate medical need. Limiting the number of sonograms administered is one of the ways that medical professionals protect babies from potential risks.

Listening to the fetal heartbeat and monitoring the mother’s blood work are often just as effective at making sure the baby stays healthy as a real-time picture is. More information about this topic can be found at this website: http://www.wisegeek.com/what-is-a-sonogram.htm.

Sonograms can and should be used for any type of non-invasive medical evaluation, including pregnancy, cancer, and other health care needs. As long as you use a certified technician qualified to do the procedure, you should have minimal discomfort. The results that are generated can give a clearer picture of what is going on inside your body. For all medical situations, visit a certified medical or health care practitioner.

Until next time.

Health Care and Nose Bleeds

Have you ever had a nose bleed? Some people get them more often than others. And, there is a variety of reasons why your nose would all of a sudden start to bleed for no apparent reason. Naturally, if you got punched in the nose on purpose or by accident, it may start to bleed. If you broke your nose for any reason, no doubt you would have a nose bleed. But what causes your nose to start bleeding just because?

The nose is an area of the body that contains many tiny blood vessels (or arterioles) that can break easily, according to the American Academy of Otolaryngology. In the United States, one of every seven people will develop a nosebleed some time in their lifetime. Nosebleeds can occur at any age but are most common in children aged 2-10 years and adults aged 50-80 years. Nosebleeds are divided into two types, depending on whether the bleeding is coming from the front or back of the nose. More info can be found at this site: http://www.entnet.org/content/nosebleeds.

According to eMedicineHealth.com, nosebleeds (epistaxis, nose bleed) can be dramatic and frightening. Fortunately, most nosebleeds are not serious and usually can be managed at home, although sometimes medical intervention may be necessary. Nosebleeds are categorized based on where they originate, and are described as either anterior (originating from the front of the nose) or posterior (originating from the back of the nose).

Anterior nosebleeds make up most nosebleeds. The bleeding usually originates from a blood vessel on the nasal septum, where a network of vessels converge (Kiesselbach plexus). Anterior nosebleeds are usually easy to control, either by measures that can be performed at home or by a health care practitioner.

Posterior nosebleeds are much less common than anterior nosebleeds. They tend to occur more often in elderly people. The bleeding usually originates from an artery in the back part of the nose. These nosebleeds are more complicated and usually require admission to the hospital and management by an otolaryngologist (an ear, nose, and throat specialist).

Nosebleeds tend to occur more often during winter months and in dry, cold climates. They can occur at any age, but are most common in children aged 2 to 10 years and adults aged 50 to 80 years. For unknown reasons, nosebleeds most commonly occur in the morning hours. More details can be found at this website: http://www.emedicinehealth.com/nosebleeds/article_em.htm

Nosebleeds are common. Most often they are a nuisance and not a true medical problem. But they can be both, according to the Mayo Clinic. Here are a few tips how to stop them:

·         Sit upright and lean forward. By remaining upright, you reduce blood pressure in the veins of your nose. This discourages further bleeding. Sitting forward will help you avoid swallowing blood, which can irritate your stomach.

·         Pinch your nose. Use your thumb and index finger to pinch your nostrils shut. Breathe through your mouth. Continue to pinch for five to 10 minutes. Pinching sends pressure to the bleeding point on the nasal septum and often stops the flow of blood.

·         To prevent re-bleeding, don't pick or blow your nose and don't bend down for several hours after the bleeding episode. During this time remember to keep your head higher than the level of your heart.

·         If re-bleeding occurs, blow out forcefully to clear your nose of blood clots and spray both sides of your nose with a decongestant nasal spray containing oxymetazoline (Afrin, Mucinex Moisture Smart, others). Pinch your nose again as described above and call your doctor.

You should seek emergency care if the bleeding lasts for more than 20 minutes, or if the nosebleed follows an accident, a fall or an injury to your head, including a punch in the face that may have broken your nose. Much more detailed information about nose bleeds can be located at this site: http://www.mayoclinic.org/first-aid/first-aid-nosebleeds/basics/art-20056683.

Children are especially susceptible to nose bleeds. If your child gets a lot of nose bleeds, ask your pediatrician about using saltwater (saline) nose drops every day. Doing so may be particularly helpful if you live in a very dry climate, or when the furnace is on in your home. In addition, a humidifier or vaporizer will help maintain your home’s humidity at a level high enough to prevent nasal drying. Also tell your child not to pick his nose, according to the American Academy of Pediatrics. Also, you should contact your child’s doctor in the following situations:

·         You think your child may have lost too much blood. (But keep in mind that the blood coming from the nose always looks like a lot.)

·         The bleeding is coming only from your child’s mouth, or he’s coughing or vomiting blood or brown material that looks like coffee grounds.

·         Your child is unusually pale or sweaty, or is not responsive. Call your pediatrician immediately in this case, and arrange to take your child to the emergency room.

·         He has a lot of nosebleeds, along with a chronically stuffy nose. This may mean he has a small, easily broken blood vessel in the nose or on the surface of the lining of the nose, or a growth in the nasal passages.

Your child is almost certain to have at least one nosebleed—and probably many—during these early years. Some preschoolers have several a week. This is neither abnormal nor dangerous, but it can be very frightening. If blood flows down from the back of the nose into the mouth and throat, your child may swallow a great deal of it, which in turn may cause vomiting. For more details, visit this website: https://www.healthychildren.org/English/health-issues/conditions/ear-nose-throat/Pages/Chronic-Nosebleeds-What-To-Do.aspx.

Frequent nosebleeds may mean you have a more serious problem. For example, nosebleeds and bruising can be early signs of leukemia. Nosebleeds can also be a sign of a blood clotting or blood vessel disorder, or a nasal tumor (both cancerous and non-cancerous), according to this website: http://familydoctor.org/familydoctor/en/diseases-conditions/nosebleeds.html.

Your doctor will try to find out where the bleeding is coming from in your nose. He or she will probably ask you some questions and examine your nose. If the bleeding doesn't stop on its own or when pressure is applied, your doctor may cauterize the bleeding vessel or pack your nose to stop the bleeding. That should help your situation, although it’s uncomfortable for a little while. An occasional nosebleed may make you worry, but there's no need to panic. If it becomes problematic or chronic, see your doctor for other options.

Until next time.