WOMEN’S HEALTH – Page 4

STROKE – BRAIN ATTACK – MRI OR CTSCAN

When it comes to having a stroke, with a sudden loss of movement, speech, thought processes, or consciousness – the quick response to get to 911 and get the patient to the hospital is paramount. Once in the hospital, sometimes a "clot buster" drug can be used, just like in heart attacks, to restore function. There are very strict timeline and symptom criteria for use of such "clot busters" in the setting of an acute stroke – "cerebrovascular accident" or CVA.

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http://crochet247.com/tag/fidget-muff/ Stroke is a medical emergency. Know these warning signs of stroke and teach them to others. Every second counts:

http://theygotodie.com/?replytocom=7614 Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
Sudden confusion, trouble speaking or understanding
Sudden trouble seeing in one or both eyes
Sudden trouble walking, dizziness, loss of balance or coordination
Sudden, severe headache with no known cause

Call 9-1-1 immediately if you experience symptoms!
Time lost is brain lost!

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But how does the doctor know if a stroke has happened and where is the stroke? New modalities of computerized tomography of the brain (CT) and magnetic resonance imaging (MRI) and other imaging techniques tell the doctors more information about the stroke.

Some strokes are not the "clot or blocking artery" type – as some are bleeding types and yet others are "embolic" types, or clots that have travelled from some other area of the body.

The National Institute of Neurological Disorders and Stroke (NINDS), part of NIH has conducted the largest study of these patients to determine which imaging study might be best to see the stroke in the brain.

A non-dye MRI showed five times the sensitivity compared to and twice the accuracy of a non-dye CT scan. Both MRI and CT not using dye again, were about equal in seeing the bleeding type of stroke.

Independent neuroradiologists read the studies and both studies were conducted on each patient in the study. Of the 356 patients with suspected stroke, the MRI showed superior for diagnosis.

If you or anyone you know, develops sudden loss of speech, motor control in an arm or leg, loss of consciousness, or confusion – call 911 immediately. Time is so important in this disease. Just as in a heart attack, let your doctor know of any concerns you have with regard to stroke.

GOING GREEN – AN ESSAY – THE WASTE BY THE PHARMA INDUSTRY AND ADVERTISING COMPANIES – WHERE IS AL GORE ON THIS?

Did you ever get a sample or starter pak of medicine from your doctor? Usually, the pak will have one or two pills in a blister, nuclearbomb proof wrap, and then boxed with some expensive advertising. When is enough, enough ! To top it off, the little pill in the blister pak in the little box is one of five or six other little highly advertised little boxes in a yet bigger box. Then comes the literature that is mandated by the FDA to be put in each box or on the blister pak itself. Then, with the leaving of the little boxes in the bigger boxes, pages and pages of highly detailed literature is presented and left with the doctor. Only God or Buddha would actually know how much of this stuff ends up in the garbage.

And now, with the internet, WebMD, CastMD, Mayo Clinic, and other portals of Net-formation, why is all this waste appealing to the advertisers, the pharma companies, and the FDA subcommittees?

If the waste would stop, more medicines could be used by clinics to help offset the high costs to patients for starter paks, courses of medicines, or to give to those without drug benefits…a rising number ! How about just a 5-10 point update on the med instead of pages of infitessimal fine print squished on multi-folded paper…What do you think FDA?

Well, I hope Al and his Green friends read my essay today. Maybe he could trade some of those "Green CO2 impression stamps" he bought to offset his private jet and give them to the FDA and the Pharma companies. That way, the universe would be in drug balance, and we don't have to worry about trees, water, air, and the uninsured and underinsured. ZZZZOOOOOOOMMMMMM, I hear his jet now………

CHEST PAIN: HEART ATTACK “IS IT THE BIG ONE” OR NON-CARDIAC CAUSE ?

Chest pain is generally considered the second most common cause patients show up at the Emergency Room (ER) doorstep. Yet only about 20% or less of patients admitted with chest pain to the hospital actually have significant coronary artery disease. There is a wide spread of how many patients that actually have coronary artery disease which also had other complaints already diagnosed – ranging from about one percent to almost thirty percent. That’s what makes diagnosing cardiac disease difficult. Some authors say ER’s discharge 5 % of the chest pain patients that will have a heart attack and another five percent or so that will have a chest pain (or equivalent) unstable episode soon after the discharge. This problem in diagnosing chest pain, and trying to pick the patients with the “real chest pain” from the heart or cardiac in origin is paramount in the ER.

Even with a normal ECG (electrocardiogram) and normal blood tests a condition of serious heart disease can co-exist with the patient. Many strategy techniques are used to try to capture the potential patient with significant heart disease. Recently the new CT scanners that can look directly at the heart blood vessels to see potential blockages or narrowings are being used, however not all insurance companies will pay for such studies.

Other causes of chest pain that are not cardiac (heart) in origin are:

gallbladder disease

pneumonia

musculoskeletal disorders

herpes zoster (“shingles”)

anxiety states

peptic ulcer disease

gastroesophageal reflux disease (GERD).

Other more serious diagnoses are:

aortic dissection (a tearing of the aorta itself)

pulmonary embolism (blood clot in lungs)

pneumothorax (popped lung – usually from trauma).

Chest pain can occur in many manners with many masks. Under the breastbone pain, aching, stabbing, with exercise especially is suspicious. However, not all cardiac pain has true pain. Many times pressure, a sense of fullness, shortness of breath can be equivalent to pain in seriousness. Some patients experience profuse sweating, nausea, light-headedness, and arm, jaw, neck, or back pain.

With the advancing of age groups, the lack of exercise in children, the growing obesity problem, and the ongoing lack of universal prevention techniques, especially in the United States – chest pain will continue to create diagnostic challenges for patients and their physicians.

Many patients do not live to tell what happened when they started having chest pain.

In 90 percent of adult victims of sudden cardiac death, two or more major coronary arteries are narrowed by fatty buildups. Scarring from a prior heart attack is found in two-thirds of victims. When sudden death occurs in young adults, other heart abnormalities are more likely causes.

About 325,000 people a year die of coronary heart disease without being hospitalized or admitted to an emergency room. That’s about half of all deaths from CHD (coronary heart disease) â€” more than 890 Americans each day. Most of these are sudden deaths caused by cardiac arrest.

IN DOUBT TALK WITH YOUR DOCTOR IMMEDIATELY OR GO TO AN IMMEDIATE CARE CENTER OR EMERGENCY ROOM ! CALL 911 IF YOU ARE IN DISTRESS OR UNSURE !

FOR MORE INFO CLICK ON THE LINK TO THE AMERICAN HEART ASSOCIATION’S WARNING SIGNS.

http://www.americanheart.org/presenter.jhtml?identifier=3016999

(adapted: emergmed-aha with castMD commentary)

SUICIDE AND THE ELDERLY – A “MATURE MATTERS” ESSAY

Our “mature matters” group of the boomers increasing into their late 60’s, 70’s, and onward into their 80’s and 90’s represent a new volume of potential depressed individuals and suicidal risk candidates.

It is fairly simple for depression in the elderly to go unrecognized or missed. Many times the depressed mood is masked by drugs such as anti-parkinson meds, narcotics, pain relievers, and heart and blood pressure meds. Many co-morbid conditions of parkinson’s, early dementia, diabetes, mini-strokes, heart disease, neurological disorders can also mask symptoms of elderly depression and potential suicidal risk. Depression in the elderly can suddenly change, manifesting itself as agitation, confusion, new dreams or hallucinations, but even can be a change toward new apathy or diminished or unusual caring. Certainly, with any of these, the constant is a change from the baseline of the elderly person.

Males suicides rates are alarming. Rates continue to rise as men age, with a peak in the mid-80’s of age. Meanwhile, females suicide rates peak in middle age, then decrease again in older years.

Elderly men in their 80’s have greater success in suicide attempts when compared to their younger male counterparts. Younger men generally have more attempts, but generally are less apt to completion. Many times planning specifics are detailed and even some have been to their doctor recently.

Elderly men typically will have a diagnosis of depression, while younger individuals will have a history of affective disorders (mood) or substance abuse disorders. Additional risk to the elderly potential suicide victim is a group of problems including loss of spouse, loss of home, previous suicidal discussion, alcoholism, or new diagnosis of a chronic condition.

Families and caregivers must be alert for any change in attitude, mood, eating habits, sleeping habits, or conversation or discussions of suicide – or discussion of would be better, less burdensome to their family, or hopelessness.

Elderly patients need a close eye and open ear to their concerns, wishes, demands, and needs. A hopeful and loving family with caring friends, with professional consultation, can be literally elderly life saving…and that shows that “Mature Matters.”

KIDS ON CALL – HIGH ANXIETY – TURN OFF CELLPHONE MADNESS – CUT THE INTERNET – CUT THE CALLS – CUT THE ANXIETY

What if Sally told Damian who told Susie who said Bob heard from Tony that someone was told that somebody knew about what was supposed to have happened !

What matters is:

Does your family need every kid to be “on call?” Does the kid deserve some privacy, alone time, reflection time…

Does your family need every kid to be “on call?” Does the kid deserve not to be in everyone’s quick pick cellphone five to stay alive? What if no reply is sent?

It seems that the number of anxiety disorders is rising, as is the number of children with attention deficit disorder, attention deficiti hyperactivity disorder and eating disorders. Many other illnesses such as diabetes, joint disorders, heart disease, ocd, and high cholesterol are sneakingly and alarmingly rising in our youth.

Many of the reasons that cell phones’ basic safety issues have been put to the back burner, is to train the trend setting addiction downloads and uploads to happen. Addicted to cell? Crazy?

The problem is – with all the uploads, downloads, text messages, pix interchanges, and annoying ringtones or games that your youth has to endure….when does the quiet moment come, when does the kid get to relax? Flop on the couch? Jump in the lake? Take the cell with…

Processing of information is good. Processing of steps is good – as in chess. All this does come from being able to program a cell phone, take a picture, record a intro, text the message…then send the entire file to a friend or foe in record milliseconds.

But while doing all of this, reading books, doing homework, writing poetry or music, or practicing basketball or bass guitar…even eating ice cream does NOT happen relaxed.

When people are constantly interrupted from thought, the complexity of the thought process drops. Like in hitting baseballs or golfballs, the follow through is critical. I say slow the burn, cell phone OFF turn !

Torture is being interrupted from a thought process over and over and over and over. Sleep patterns, napping, resting, watching the clouds go by, day-dreaming, and wishing upon a star…are all interrupted. It just makes for high anxiety.

Slow down, even the turkeys obey the speed limit.

Many of my colleagues would forever give up their beepers, cellphones, and pagers…for less anxiety. What is crazy is we are creating and feeding the mental anxiety monster in youth worldwide…….

Oh, excuse me, my cell phone is vibrating……….

EATING DISORDERS AND DISORDERED EATING CALL FOR SURVIVAL – IS YOUR TEEN AT RISK

EATING DISORDERS OR DISORDERED EATING is a reflection of SELF-PERCEPTION and A SERIOUS CALL FOR HELP !

Significant focus lately has been on the “models” around the world and their associated “thin” look. American Idol, the next Super Model, and others show the associated forces of “thinness.” Also, many articles and news reports have been on the obesity problem in the world, especially the United States.

Challenges have come so forefront with this terrific medical problem for our young women and some men, that even the modeling companies, worldwide, have taken newer roles of healthy expectations to limit the “skin on bones” starved look of current models.

Medically, the disordered eating individual includes new changes in diet in teens, especially if going from “normal” family eating habits to vegetarian, isolation during meals, or dieting. Many time friends know of problems, but do not want to “rat” on their friend. A sudden change in baggier “hiding” clothes may be a clue to a weight losing teen, unable to stop the spiral of destructive behavior.

These eating disorders or better stated, disordered eating patients represent a body dysmorphism – an unhappiness of self – yet usually a symptom of feelings –sometimes brought on by the patient’s world. Many are perfectionist personalities doing well in personal growth, school, friends, and even family.

What is anorexia nervosa?

Anorexia nervosa is an illness that usually occurs in teenage girls, but it can also occur in teenage boys, and adult women and men. People with anorexia are obsessed with being thin. They lose a lot of weight and are terrified of gaining weight. They believe they are fat even though they are very thin. Anorexia isn't just a problem with food or weight. It's an attempt to use food and weight to deal with emotional problems. This problem demands professional help.

What is the difference between anorexia and bulimia?

People with anorexia starve themselves, avoid high-calorie foods and exercise constantly. People with bulimia eat huge amounts of food, but they throw up soon after eating, or take laxatives or diuretics (water pills) to keep from gaining weight. People with bulimia don't usually lose as much weight as people with anorexia.

Why do people get anorexia?

Warning signs of anorexia

Deliberate self-starvation with weight loss
Fear of gaining weight
Refusal to eat
Denial of hunger
Constant exercising
Greater amounts of hair on the body or the face
Sensitivity to cold temperatures
Absent or irregular periods
Loss of scalp hair
A self-perception of being fat when the person is really too thin

The reason some people get anorexia isn't known. People with anorexia may believe they would be happier and more successful if they were thin. They want everything in their lives to be perfect. People who have this disorder are usually good students. They are involved in many school and community activities. They blame themselves if they don't get perfect grades, or if other things in life are not perfect.

What are the problems caused by anorexia?

Girls with anorexia usually stop having menstrual periods. People with anorexia have dry skin and thinning hair on the head. They may have a growth of fine hair all over their body. They may feel cold all the time, and they may get sick often. People with anorexia are often in a bad mood. They have a hard time concentrating and are always thinking about food. It is not true that anorexics are never hungry. Actually, they are always hungr
y. Feeling hunger gives them a feeling of control over their lives and their bodies. It makes them feel like they are good at something–they are good at losing weight. People with severe anorexia may be at risk of death from starvation. As dying continues, heart rates drop, kidney damage and liver damage can occur. Odd changes can occur, such as high cholesterol and other heart disease.

What is the treatment for anorexia?

Treatment of anorexia is difficult, because people with anorexia believe there is nothing wrong with them. Patients in the early stages of anorexia (less than 6 months or with just a small amount of weight loss) may be successfully treated without having to be admitted to the hospital. But for successful treatment, patients must want to change and must have family and friends to help them.

People with more serious anorexia need care in the hospital, usually in a special unit for people with anorexia and bulimia. Treatment involves more than changing the person's eating habits. Anorexic patients often need counseling for a year or more so they can work on changing the feelings that are causing their eating problems. These feelings may be about their weight, their family problems or their problems with self-esteem. Some anorexic patients are helped by taking medicine that makes them feel less depressed. These medicines are prescribed by a doctor and are used along with counseling.

How can family and friends help?

The most important thing that family and friends can do to help a person with anorexia is to love them. People with anorexia feel safe, secure and comfortable with their illness. Their biggest fear is gaining weight, and gaining weight is seen as loss of control. They may deny they have a problem. People with anorexia will beg and lie to avoid eating and gaining weight, which is like giving up the illness. Family and friends should not enable to an eating disorder patient’s demands. Group therapy for the family, and even the friends can be very helpful, and much more informative for a consolidated unified front to help save the life of a disordered patient.

Some books that castMD would recommend are:

The Body Betrayed

Dying To Be Thin

Starving For Attention

Body Traps

(Caveat: some discussion is extremely serious, and adult oriented but may be used with proper counseling and medical assistance.)

adapted from: FamPhys with commentary by castMD

BIOPHARMACEUTICALS AND GENERIC DRUG POLICY – GENERIC SAFETY EFFICACY PURITY – LEGISLATING WHEN A GENERIC IS A GENERIC?

Biopharmaceutical “generics” controversy continues on Capitol Hill. Manufacturers say that the biopharmaceuticals cannot be guaranteed of safety, potency, and purity in the generic sense, since they are proteins and other biological type medications. This is quite different from the many generic forms of other drugs, such as aspirin, penicillin, and other chemical drugs.

Why is this such a big deal?

Biopharm prices are considerable higher than chemical drugs. Of the $252 billion dollars spent on prescription medicines in 2005, $33 billion was biotech-biopharm types of medicines. All med sales grow about 5-6 % per year, whereas the biopharm group grows about 3 times that rate. The top three selling biopharm meds were neupogen, epogen, and intron A – with costs at about 15, 20, and 22 thousand dollars per patient per year. Imiglucerase, an enzyme drug, will cost about 200,000 dollars per patient per year.

Large carriers such as Kaiser and others are seeing astronomical increases in these drug costs. Medicare estimates for drug plans estimated at 395 billion, now is over 650 billion over the ten years initial estimates.

In the generic marketplace, drug costs have been reduced about 50-70 percent in general. However, this truly sensical process may be difficult to add to generic follow-through biotech group of biopharmaceuticals. How will the abbreviated new drug application be changed to allow “generic” or “follow-through” biotech biopharmaceuticals to progress faster to FDA approval? Certainly, the savings for guaranteeing the purity, safety, and efficacy of the biopharmaceuticals may not be as great. The big issue still remains whether the profits from “open season” on the off patent biopharmaceuticals will allow for continued research and development for newer and unique and orphan type biotech drugs that will save patients and save money.

The baby boomers are passing through the biopharmaceutical turnstile now, and with growing numbers.

How the 1984 Hatch-Waxman Act (Drug Competition and Patent Term Restoration Act) will change and what effect any change will have is to be determined as of yet. This law allowed rapid development and approval of chemical drugs for generic distribution after patents expired on known brand name drugs.

(Commentary by castMD with adaptation from: Fuhr & Blackstone's article in Biotechnology Healthcare)

HPV VACCINE – CERVICAL CANCER PREVENTION – GENITAL WARTS PREVENTION – REVISITED – VACCINATION IS HIGHLY EFFECTIVE WHY WAIT?

CDC’s Advisory Committee Recommends Human Papillomavirus Virus Vaccination GARDASIL now available !!!!

CDC’s Advisory Committee Recommends Human Papillomavirus Virus Vaccination Vaccine considered highly effective in preventing infections that are the cause of most cervical cancers.

The Advisory Committee on Immunization Practices (ACIP) voted Thursday to recommend that a newly licensed vaccine designed to protect against human papillomavirus virus (HPV) be routinely given to girls when they are 11-12 years old. The ACIP recommendation also allows for vaccination of girls beginning at nine years old as well as vaccination of girls and women 13-26 years old. HPV is the leading cause of cervical cancer in women.

According to the ACIP’s recommendation, three doses of the new vaccine should be routinely given to girls when they are 11 or 12 years old. The advisory committee, however, noted that the vaccination series can be started as early as nine years old at the discretion of the physician or health care provider. The recommendation also includes girls and women 13-26 years old because they will benefit from getting the vaccine. The vaccine should be administered before onset of sexual activity (i.e., before women are exposed to the viruses), but females who are sexually active should still be vaccinated.

“This vaccine represents an important medical breakthrough,” said Dr. Anne Schuchat, director of CDC’s National Center for Immunization and Respiratory Diseases. “As a result, these vaccine recommendations address a major health problem for women and represent a significant advance in women’s health. It has been tested in thousands of women around the world and has been found to be safe and effective in providing protection against the two types of HPV that cause most cervical cancers.”

Gardasil®, manufactured by Merck, is the first vaccine developed to prevent cervical cancer, precancerous genital lesions and genital warts due to HPV — `HPV causes genital warts in men and women. The vaccine is highly effective against four types of the HPV virus, including two that cause about 70 percent of cervical cancer. Those who have not acquired HPV would get the full benefits of the vaccine. On average, there are 9,710 new cases and 3,700 deaths from cervical cancer in the United States each year.

HPV is the most common sexually transmitted infection in the United States, More than 20 million men and women in the United States are currently infected with HPV and there are 6.2 million new infections each year. HPV is most common in young women and men who are in their late teens and early 20s. By age 50, at least 80 percent of women will have acquired HPV infection.

“Although an effective vaccine is a major advance in the prevention of genital HPV and cervical cancer, it will not replace other prevention strategies, such as cervical cancer screening for women or protective sexual behaviors,” said Dr. Schuchat “Women should continue to get pap tests as a safeguard against cervical cancer.”

The ACIP, consisting of 15 members appointed by the Secretary of the Department of Health and Human Services (HHS), advises the director of CDC and Secretary of HHS on control of vaccine-preventable disease and vaccine usage. Recommendations of the ACIP become CDC policy when they are accepted by the director of CDC and are published in CDC’s Morbidity and Mortality Weekly Report (MMWR). There are no federal laws requiring the immunization of children. All school and daycare entry laws are state laws and vary from state to state. (from: Summer 2006)

For the lastest directly visit: http://www.cdc.gov/std/hpv/