“Among the U.S. population overall, crude estimates for 2021 were:

• 38.4 million people of all ages—or 11.6% of the U.S. population—had diabetes.
• 38.1 million adults aged 18 years or older—or 14.7% of all U.S. adults—had diabetes (Table 1a; Table 1b).
• 8.7 million adults aged 18 years or older who met laboratory criteria for diabetes were not aware of or did not report having diabetes (undiagnosed diabetes, Table 1b). This number represents 3.4% of all U.S. adults (Table 1a) and 22.8% of all U.S. adults with diabetes.
• The percentage of adults with diabetes increased with age, reaching 29.2% among those aged 65 years or older (Table 1a).”

Center for Disease Control and Prevention – CDC (https://www.cdc.gov/diabetes/php/data-research/index.html)

Diabetes Mellitus (DM) is a complex chronic disease involving disorders in carbohydrate, protein, and fat metabolism and the development of macro-vascular, micro-vascular, neurological complications that don’t occur over a few nights or weeks or months.  It is a metabolic disorder in where the pancreas organ ends up causing many disruptions in proper working of our body.  The pancreas is both an endocrine and exocrine gland.

The problem with diabetes is due to the endocrine part of the pancreas not working properly.  More than 1 million islet cells are located throughout this organ.  The three types of endocrine cells that the pancreas excretes into our blood stream are alpha, beta, and delta cells.  The alpha cells secrete glucagon (stored glucose), beta secrete insulin, and delta secrete gastrin and pancreatic somatostatin.

A person with DM has minimal or no beta cells secreted from the pancreas, which shows minimal or no insulin excreted in the person’s bloodstream.  Insulin is necessary for the transport of glucose, amino acids, potassium, and phosphate across the cell membrane getting these chemical elements into the cell.  When getting these elements into the cells it is like the cell eating a meal and the glucose, being one of the ingredients in the meal, is used for energy=fuel to our body; the glucose inside the cells gets carried to all our tissues in the body to allow the glucose to be utilized into all our tissues so they can do their functions (Ex. Getting glucose into the muscle tissue allows the muscles to have the energy to do the range of motion in letting us do our daily activities of living, like as simple as type or walk).  The problem with diabetes is the glucose doesn’t have the insulin being sent into the bloodstream by the pancreas to transfer the glucose across the cell membrane to be distributed as just discussed.  Instead what results is a high glucose levels in the blood stream outside the cells causing hyperglycemia.  Remember when a doctor has you go to the lab or even in his office getting blood drawn from your arm to check blood levels of electrolytes (like glucose, potassium, sodium) or even drug levels, its measuring only these elements outside the cell. We cannot measure the levels of these elements inside the cell or we would have to break the cell destroying it which makes no logic or help in diagnosing.

It should be apparent that when there is a deficit of insulin, as in DM, hyperglycemia with increased fat metabolism and decreased protein synthesis occur ( Our body being exposed to this type of environment over  years causes the development of many chronic conditions that would not have occurred if DM never took place in the body, all due to high glucose levels starting with not being properly displaced in the body as it should be normally since insulin loss didn’t allow the glucose to go into the cells but remained outside the cells.).

People with normal metabolism upon awaking and before breakfast are able to maintain blood glucose levels in the AM ranging from 60 to 110mg/dl.  After eating food the non-diabetic’s blood glucose may rise to 120-140 mg/dl after eating (postprandial), but these then rapidly return back to normal.  The reason for this happening is you eat food, it reaches the stomach, digestion takes place during digestion the stomach breakes down fats, carbohydrates, and sugars from compound sugars to simple sugars (fructose and glucose).  Than the sugars transfer from the stomach into the bloodstream causing an increase in sugar levels.  Now, your body uses the sugar it needs at that time throughout the entire body for energy and if still extra sugar left in the bloodstream that isn’t needed at that time to be utilized it now needs to go somewhere out of the bloodstream to allow the glucose blood level to get back between 60-110mg/dl.  That extra glucose first gets stored up in the liver 60-80%. How this happens is the extra glucose in the blood stream not needed now fills up the liver (like filling up your gas tank) but limits the amount it can take. When the glucose goes in the liver it goes from active sugar to inactive by getting converted from glucose to glycogen=inactive sugar now. Now when the liver can store no more then the extra glucose left in the bloodstream after all tissues utilized the digested sugar sent to the bloodstream after digestion and the next place for storage gets stored in our fat tissue=fat storage=weight increase. That is the logic behind eating small meals properly dispensed with protein/CHOs/sugars/fat every 6hrs. This limits the amount of food to digest down to prevent excess sugar in the bloodstream preventing hyperglycemia from occurring and most of your small meal if not all is utilized by our muscle tissues preventing both hyperglycemia and high fat distribution of the glucose to prevent weight increase, also.

Unfortunately this doesn’t take place with a diabetic since there is very little or no insulin being released by the pancreas and over time due to the high blood glucose blood levels (called hyperglycemia) problems arise in the body over years.   When diabetes occurs there is a resolution and you have the disease the rest of your life.  You need to control your glucose level through proper dieting for a diabetic with balancing exercise and rest. Exercise uses up your glucose also in the body. Increase activity the body needs energy the gas for the body is glucose, like gas in our auto vehicles in the tank.

TWO TYPES OF Diabetes Mellitus:

1.)Diabetes I

 2.) Diabetes ll

We have risk factors that can cause disease/illness; there are unmodified and modified risk factors.

With unmodified risk factors we have no control in them, which are 4 and these are:

1-Heredity 2-Sex 3-Age 4-Race.

Now modified risk factors which are factors we can control.  They are

1.)Weight 2.)Diet 3.)Health Habits (which play a big role in why many people get diabetes II)  5.)Physical Inactivity 6.)Hyperlipidemia and Hypertension

Stayed tune for part III tomorrow on more knowledge of this disease.

“There are two main types of seizures: generalized and focal seizures.

These types describe where a seizure starts in the brain and how it may affect a person.

Call 911 if a seizure (of any type) lasts more than 5 minutes or if the person does not wake up fully between seizures.”

Centers for Disease Control and Prevention (https://www.cdc.gov/epilepsy/about/types-of-seizures.html)

Old Lists Below on Seizure Classification:

Most Updated List on Classifications of Seizures by the Epilepsy Foundation:

Types of seizures whether with a etiology or unknown:

I-Partial seizures (seizures beginning local)

1-simple partial seizures-(the person is conscious and not impaired).  With motor symptoms, autonomic symptoms and even psychic symptoms.

2.)-Complex partial seizures-(the person is with impairment of consciousness)

II-Generalized seizures-(bilaterally symmetrical and without local onset).

3.) Tonic clonic seizures – Grand Mal

See Above the most updated,being 2017, on classifications of seizures list by the Epilepsy Foundation.

Treatment:

1-Epilepsy is sometimes referred to as a long-term condition, as people often live with it for many years, or for life. Although generally epilepsy cannot be ‘cured’, for most people, seizures can be ‘controlled’ (stopped) so that epilepsy has little or no impact on their lives. So treatment is often about managing seizures in the long-term.

Most people with epilepsy take anti-epileptic drugs (AEDs) to stop their seizures from happening. However, there are other treatment options for people whose seizures are not controlled by anti-epileptic drugs (AEDs).

2-The ketogenic diet is one treatment option for children with epilepsy whose seizures are not controlled with AEDs. The diet may help to reduce the number or severity of seizures and can often have positive effects on behaviour.

3-Vagus nerve stimulation therapy is a treatment for epilepsy that involves a stimulator (or ‘pulse generator’) which is connected, inside the body, to the left vagus nerve in the neck. The stimulator send regular, mild electrical stimulations through this nerve to help calm down the irregular electrical brain activity that leads to seizures.

There are several ways to treat epilepsy. How well each treatment works varies from one person to another. Vagus nerve stimulation therapy is a form of treatment for people with epilepsy whose seizures are not controlled with medication.

4-There are different kinds of epilepsy surgery. One kind of surgery involves removing a specific area of the brain which is thought to be causing the seizures. Another kind involves separating the part of the brain that is causing seizures from the rest of the brain.

Surgery may be possible for both adults and children, and might be considered if:

• you have tried several AEDs and none of them have stopped or significantly reduced your seizures; and
• a cause for your epilepsy can be found in a specific area of your brain, and this is an area where surgery is possible.

Whether you are suitable for surgery is something that you may like to talk about with your GP or neurologist. If you meet these criteria and are considered for surgery, you will need to have further tests before you can have the surgery.

If you are referred for surgery you will probably go to a specialist centre for tests. There are many different pre-surgical tests you might have before you can be given the go-ahead for surgery. This could include further MRI scans, an EEG (electroencephalogram) and video telemetry (an EEG while also being filmed). Other types of scans may also be done, which trace a chemical injected into the body. This can show detailed information about where seizures start in the brain.

Memory and psychological tests are also used to see how your memory and lifestyle might be affected after the surgery. These types of tests also help the doctors to see how you are likely to cope with the impact of having this type of surgery.

The tests will confirm whether:

• the surgeons can reach the epileptogenic lesion during surgery and can remove it safely without causing new problems;
• other parts of your brain could be affected by the surgery, for example the parts that control your speech, sight, movement or hearing;
• you have a good chance of having your seizures stopped by the surgery; and
• you have any other medical conditions that would stop you from having this kind of surgery.

The results from the pre-surgical tests will help you and your neurologist decide whether surgery is an option for you, and what the result of the surgery might be.

Your specialist will also talk with you about the possible risks and benefits of having surgery.

For many people the results show that surgery is not an option: the majority of people who are recommended for surgery, and have these tests carried out, are unable to have surgery.

Take the action and make your life one without seizures occurring putting your life on HOLD you need to TAKE CARE OF YOURSELF!    That is all up to you, the patient diagnosed with it or questioning if they have seizures.

“Seizures are unpredictable. When a person has a seizure, it is usually not in a doctor’s office or other medical setting where health care providers can observe what is happening, so diagnosing seizures is a challenge. Accurate diagnosis depends on taking a careful medical history and using brain imaging and other tests to assess abnormal patterns of electrical activity in the brain. Proper diagnosis of seizures and epilepsy is essential for effective treatment. Diagnostic tests can help determine if and where a lesion in the brain is causing seizures. . In the majority of cases, there may be no cause that can be discovered for epilepsy or in some cases there are actual causes.”

John Hopkins Medicine (https://www.hopkinsmedicine.org/health/conditions-and-diseases/epilepsy)

Possible causes of Epilepsy:

Their epilepsy that is diagnosed with a IDIOPATHIC cause – meaning unknown cause and the patient could grow out of it in childhood in some cases (not all) depending on the type of seizure disorder and if the child doesn’t grow out of it the condition becomes chronic (for life).

Genetic influence (heredity). Some types of epilepsy run in families. In these instances, it’s likely that there’s a genetic influence. Researchers have linked some types of epilepsy to specific genes. But some people have genetic epilepsy that isn’t hereditary. Genetic changes can occur in a child without being passed down from a parent.For most people, genes are only part of the cause of epilepsy. Certain genes may make a person more sensitive to environmental conditions that trigger seizures.

• A genetic tendency, passed down from one or both parents (inherited).
• A genetic tendency that is not inherited, but is a new change in the person’s genes.

Although heredity has been known since antiquity to cause epilepsy, the progress to date in identifying the genetic basis of epilepsy has been limited primarily to the discovery of single gene mutations that cause epilepsy in relatively rare families. For the more common types of epilepsy, heredity plays a subtler role, and it is thought that a combination of mutations in multiple genes likely determine an individual’s susceptibility to seizures, as well as the responsiveness to antiepileptic medications.

Epilepsy can be caused by genetic factors (inherited) or acquired (a etiology—cause) , although in most cases it arises in part from both. The neurology and neurological sciences of Stanford Epilepsy Center Dr. Robert S. Fischer Ph D. presents in the article Genetic Causes of Epilepsy.

He also presents in this article our genes are the instruction set for building the human body. Genes reside on chromosomes.

Going to the basics is every person has 46 chromosomes, carrying a total of about 30,000 genes. We get half our chromosomes from our mother and half from our father. While genes determine the structure of our body, they also control the excitability of our brain cells. Defective genes can make hyperexcitable brain cells, which are prone to seizures.

In recent years, several epilepsy conditions have been linked to mutations in genes, but the matter is complicated by the fact that different genes may be involved in different circumstances.

In general, the most common epilepsy conditions, including partial seizures, seem to be more acquired than genetic.

Gene testing will soon be able to identify predispositions to epilepsy, allowing doctors to help a patient get treatment and to assist with family counseling. One day, doctors may simply be able to swap a patient’s cheek, test his or her genes, and predict response to various epilepsy medicines, eliminating much of the trial and error in medication choice that goes on today. Eventually, we may even be able to repair or replace defective genes that predispose a person to epilepsy, a process called gene therapy.

Lastly, Dr. Robert Fischer Ph D presented in his article, that I found very interesting, the general population has about a 1% risk of developing epilepsy.  Meanwhile, children of mothers with epilepsy have a 3 to 9% risk of inheriting this disease, while children of fathers have a 1.5 to 3% risk of inheritence. Still, the actual risk is upon the specific type of epilepsy. For example, partial seizures are less likely to run in families than are generalized seizures. In any event, with the usual forms of epilepsy, even if a parent does have the condition, there is more than a 90% chance that their child will not. So most epilepsies are acquired than inherited.

Clearly, genes determine a great deal of who we are, including our possible risk for epilepsy but slim versus a actual cause. But what happens to us in life and what we do is still the larger part of the risk for epilepsy.

A person given this diagnosis in the 1970’s, or before  and even up to the early 1990’s was quiet about ever letting people know about this since in the 1970’s and back with lack of knowledge, information to the public and definitely technology versus now.  Epilepsy is much more an accepted disease in the overall community compared to 20-25 years ago and back.  Heck in the 1970’s and back these patients when having a seizure episode were characterized as “Freaks”.  This was due to ignorance and lack of information to society/community but due to the past 20 to 25 years with the computer used more as a must in our lives with media, television and even our government they all have made it possible for society everywhere in the world to learn and understand diseases with acceptance in wanting to help those, particularly the US, but we still need a healthier America. It will take time to get there with the many multicultural lives that all live in the U.S. which practice differently on how important a healthy diet is with exercise balanced with rest.  Also including stress well controlled is not always in America on their top priority list in living.  Stress can even be a catalyst for a seizure but not the cause.

For a person diagnosed with or without a cause of epilepsy these steps in learning about the disease with higher technology and continuous research with medications over the years has allowed them to be able to live a completely healthy life doing the same things other people do without the disease but only if the patient is UNDER COMPLETE CONTROL  which includes being COMPLIANT with your Rx; this does exist in America.

Compliant meaning taking their medications everyday as ordered by their neurologist with yearly or sooner follow-up visits with blood levels of the anti-seizure medications there on.  This is the only way one with chronic epilepsy is guaranteed that living this way MAY stop the seizures from occurring (inactive epilepsy you can call it — meaning you’ll always have the disease but can put the seizure activity in a remission by medications preventing the seizure.)

How Epilepsy is Diagnosed:

The purpose for intial visits is for the Neurologist to determine if the patient is having a seizure or something else and to determine what diagnotic tooling tests to start with to help the doctor to find out the problem.  Apart from the description of the seizure, there are other things that can help to explain why your seizures have happened. Your medical history and any other medical conditions will also be considered as part of your diagnosis.

If you have a seizure you may not remember what has happened. It can be helpful to have a description of what happened from someone who saw your seizure, to pass on to your GP or specialist.

Here are some questions that may help you or someone who witnessed your seizure to record useful information about what happened:

Before the seizure

• Did anything trigger (set off) the seizure – for example, did you feel tired, hungry, or unwell?
• Did you have any warning that the seizure was going to happen?
• Did your mood change – for example, were you excited, anxious or quiet?
• Did you make any sound, such as crying out or mumbling?
• Did you notice any unusual sensations, such as an odd smell or taste, or a rising feeling in your stomach?
• Where were you and what were you doing before the seizure?
• TIME the seizure when it started and ended to tell the MD if not in the hospital!!

During the seizure

• Did you appear to be ‘blank’ or stare into space?
• Did you lose consciousness or become confused?
• Did you do anything unusual such as mumble, wander about or fiddle with your clothing?
• Did your colour change (become pale or flushed) and if so, where (face or lips)?
• Did your breathing change (for example, become noisy or look difficult)?
• Did any part of your body move, jerk or twitch?
• Did you fall down, or go stiff or floppy?
• Did you wet yourself?
• Did you bite your tongue or cheek?

After the seizure

• How did you feel after the seizure – did you feel tired, worn out or need to sleep?
• How long was it before you were able to carry on as normal?
• Did you notice anything else?

For F/U (follow up) visits is for the neurologist to see how well your seizures are under control by taking drug blood levels of the anti seizure medication your taking to make sure the medication is in a therapeutic drug level and if not he or she will make dose changes in the med(s) your on.  Possible do a EEG (electroencephalogram); the only test to decipher if you have spikes in your brain waves indicating you had a seizure determining from which lobe of the brain is having the seizures (a 26 lead to wires on the brain, which is painless).  Go to the expert for keeping you on the right track.  Its just like based on the principle why a person gets a check up on there car by seeing the mechanic (the car’s doctor) who fixes it.  The expert,  the Neurologist,  fix your seizures or get them under control.

What is epilepsy?

 Most people with epilepsy are otherwise healthy; as long as it’s well controlled like most other diseases.  A seizure is a physical manifestation of paroxysmal and abnormal electrical firing of neurons in the brain.  Think of it as numerous voltage (hyperexcitability of neurons) going throughout the brain meaning brain waves going in all directions with the brain saying its too much activity going through my organ and can’t think normally; instead the brain goes through a shock.   In simpler terms the brain is  getting too much brain wave excitability for the organ to register in what to do causing the brain to go into a type of a seizure.

When the seizure occurs there is a decrease in oxygen since the brain isn’t capable to send messages during the seizure.  The problem it too much electrical stimulation is happening in the brain causing the type of seizure to come on.  If the seizure continues to repeat one right after another the person is in status epilepticus and if the seizures do not stop the person can lead to a neuronal death;  like John Travolta’s son who died of this for example.

The term seizure disorder may refer to any number of conditions that result  in such a paroxysmal electrical discharge.  These conditions could be metabolic or structural in nature.

For example, if a metabolic condition this could be “Canavan disease” which is primarily a disease of demyelination.  Your myelin sheath that protects and insulates the nerves is being destroyed and can cause a seizure as one of the symptoms.

*Another example being metabolic is thought to be caused by brain acetate deficiency resulting from a defect of N–acetylaspartic acid (NAA) catabolism (meaning breakdown is occurring).  Accumulation of NAA, a compound thought to be responsible for maintaining cerebral fluid balance, can lead to cerebral edema and neurological injury, like a seizure as one symptoms of the disease.

*Sometimes there is a known cause and than there is just idiopathic, unknown cause for the epilepsy which if starts in childhood can resolve by the child growing out it, like in petite mal seizures but other times that is not the case and goes into motor/focal or grand mal that is permanent so the individual needs Rx for life.

Remember, not all seizures are due to epilepsy. Other conditions that can look like epilepsy include fainting, or very low blood sugar in some people being treated for diabetes.

Remember, etiology (the cause) of Epilepsy can be generally a sign of underlying pathology involving the brain–knowing the cause.  To find this out diagnostic tooling be a neurologist who specializes in epilepsy is the best resource to go to.  The epilepsy may be the first sign of a nervous system disease (ex. Brain tumor), or it may be a sign of a systemic or metabolic derangement.  Where the treatment may be able to resolve the seizure symptom completely where this wasn’t a seizure disorder or epilepsy but just a symptom due to another disorder that may be 100% cured, like a operable tumor removed surgically from the brain.

Check out Part II tomorrow!

“Lung cancer diagnosis often starts with an imaging test to look at the lungs. If you have symptoms that worry you, a healthcare professional might start with an X-ray. If you smoke or used to smoke, you might have an imaging test to look for signs of lung cancer before you develop symptoms.  People with an increased risk of lung cancer may consider yearly lung cancer screening using low-dose CT scans. Lung cancer screening is generally offered to people 50 and older who smoked heavily for many years. Screening also is offered to people who have quit smoking in the past 15 years. Discuss your lung cancer risk with your healthcare professional. Together you can decide whether lung cancer screening is right for you.  Treatment for lung cancer usually begins with surgery to remove the cancer. If the cancer is very large or has spread to other parts of the body, surgery may not be possible. Treatment might start with medicine and radiation instead. Your healthcare team considers many factors when creating a treatment plan.”

MAYO CLINIC (https://www.mayoclinic.org/diseases-conditions/lung-cancer/diagnosis-treatment/drc-20374627)

For many people, the first sign that they may have lung cancer is the appearance of a suspicious spot on a chest x-ray or a CT scan. But an image alone is not enough to tell you whether you have cancer and, if so, what type of cancer it is.

Most people who come to us for a lung cancer diagnosis first meet with a surgeon. He or she will work with pathologists, radiologists, and other lung cancer specialists to determine the specific type of lung cancer you have and how advanced it is. These findings help your disease management team develop the most successful treatment plan for you.

The first step is for your doctor to get a tissue sample using one of several biopsy methods. Then a pathologist — a type of doctor who specializes in diagnosing disease —who focuses on lung cancer studies the tissue under a microscope to determine whether you have lung cancer and, if so, what type. He or she will be able to tell this by looking closely at the cancer cells’ shape and other features.

Knowing which type of lung cancer you have will help your doctors to stage the tumor accurately and to begin identifying the best treatment approach. Understanding what type of cancer you have is also important because each type responds differently to certain chemotherapy drugs.

Testing healthy people for lung cancer

Several organizations recommend people with an increased risk of lung cancer consider annual computerized tomography (CT) scans to look for lung cancer. If you’re 55 or older and smoke or used to smoke, talk with your doctor about the benefits and risks of lung cancer screening.

Tests to diagnose lung cancer

If there’s reason to think that you may have lung cancer, your doctor can order a number of tests to look for cancerous cells and to rule out other conditions. In order to diagnose lung cancer, your doctor may recommend:

• Imaging tests. An X-ray image of your lungs may reveal an abnormal mass or nodule. A CT scan can reveal small lesions in your lungs that might not be detected on an X-ray.
• Sputum cytology. If you have a cough and are producing sputum, looking at the sputum under the microscope can sometimes reveal the presence of lung cancer cells.
• Tissue sample (biopsy). A sample of abnormal cells may be removed in a procedure called a biopsy.Your doctor can perform a biopsy in a number of ways, including bronchoscopy, in which your doctor examines abnormal areas of your lungs using a lighted tube that’s passed down your throat and into your lungs; mediastinoscopy, in which an incision is made at the base of your neck and surgical tools are inserted behind your breastbone to take tissue samples from lymph nodes; and needle biopsy, in which your doctor uses X-ray or CT images to guide a needle through your chest wall and into the lung tissue to collect suspicious cells.A biopsy sample may also be taken from lymph nodes or other areas where cancer has spread, such as your liver.

Treatment Options for Lung Cancer Patients