QUOTE FOR TUESDAY:

“Men tend to develop disease in the main arteries that feed the heart (CAD), while women are more likely to develop disease in the smaller arteries (microvascular disease). When plaques exist in the main arteries, they behave differentlyMen are more likely to have plaque ruptures, while women more frequently have plaque erosions.”

The Society of Thoracic Surgeons (ctsurgerypatients.org)

QUOTE FOR MONDAY:


“Reye syndrome is a rare illness that can affect the blood, liver, and brain of someone who has recently had a viral infection. It always follows another illness. Although it mostly affects children and teens, anyone can get it. It can develop quickly and without warning. It is most common during flu season.”.

U.S.. Library of Medicine / Medline

QUOTE FOR THE WEEKEND:

“Bleeding disorders are a group of conditions that result when the blood cannot clot properly.  In normal clotting, platelets, a type of blood cell, stick together and form a plug at the site of an injured blood vessel. Bleeding can result from either too few or abnormal platelets, abnormal or low amounts of clotting proteins, or abnormal blood vessels.”

American Society of Hematology

QUOTE FOR FRIDAY:

“Hemophilia is a rare disorder in which your blood doesn’t clot normally because it lacks sufficient blood-clotting proteins (clotting factors). If you have hemophilia, you may bleed for a longer time after an injury than you would if your blood clotted normally.

Small cuts usually aren’t much of a problem. If you have a severe deficiency of the clotting factor protein, the greater health concern is deep bleeding inside your body, especially in your knees, ankles and elbows. That internal bleeding can damage your organs and tissues, and may be life-threatening.”.

MAYO CLINIC

Part III Stoke Awareness – Treatment and How to prevent a stroke!

TREATMENT OF STROKES

If you’re having a stroke, it’s critical that you get medical attention right away. Immediate treatment may minimize the long-term effects of a stroke and prevent death.

Ischemic Stroke Treatment

tPA, the Gold Standard

The only FDA approved treatment for ischemic strokes is tissue plasminogen activator (tPA, also known as IV rtPA, given through an IV in the arm). tPA works by dissolving the clot and improving blood flow to the part of the brain being deprived of blood flow. If administered within 3 hours(and up to 4.5 hours in certain eligible patients), tPA may improve the chances of recovering from a stroke. A significant number of stroke victims don’t get to the hospital in time for tPA treatment; this is why it’s so important to identify a stroke immediately.

 

 

Endovascular Procedures
Another treatment option is an endovascular procedure* called mechanical thrombectomy, strongly recommended, in which  trained doctors try  removing a large blood clot by  sending a wired-caged device called a stent retriever, to the site of the blocked blood vessel in the brain. To remove the brain clot, doctors thread a catheter through an artery in the groin up to the blocked artery in the brain. The stent opens and grabs the clot, allowing doctors to remove the stent with the trapped clot. Special suction tubes may also be used. The procedure should be done within six hours of acute stroke symptoms, and only after a patient receives tPA.

*Note: Patients must meet certain criteria to be eligible for this procedure.

Image courtesy of Medtronic

Hemorrhagic Stroke Treatment

Endovascular Procedures
Endovascular procedures may be used to treat certain hemorrhagic strokes similar to the way the procedure is used for treating an ischemic stroke. These procedures are less invasive than surgical treatments, and involve the use of a catheter introduced through a major artery in the leg or arm, then guided to the aneurysm or AVM; it then deposits a mechanical agent, such as a coil, to prevent rupture.

Surgical Treatment
For strokes caused by a bleed within the brain (hemorrhagic stroke), or by an abnormal tangle of blood vessels (AVM), surgical treatment may be done to stop the bleeding. If the bleed is caused by a ruptured aneurysm (swelling of the vessel that breaks), a metal clip may be placed surgically at the base of the aneurysm to secure it.

How to prevent a stroke!

Treatment is also aimed at other factors that put you at risk, including high blood pressure, diabetes, and high cholesterol. But it takes more than just your doctor’s efforts. You also have an important role to play in preventing stroke. It’s up to you to make lifestyle changes that can lower your risk.

What you can do to prevent a stroke is this:

1-Control your blood pressure.

2-Lose Weight to the point that your in a healthy weight for your height.   If you’re overweight, losing as little as 10 pounds can have a real impact on your stroke risk.              Try to eat no more than 1,500 to 2,000 calories a day (depending on your activity level and your current body mass index).  Increase the amount of exercise you do with such activities as walking, golfing, or playing tennis, and by making activity part of every single day.

3-Exercise More-Exercise contributes to losing weight and lowering blood pressure, but it also stands on its own as an independent stroke reducer. Exercise at a moderate intensity 5x/wk and if you can’t do ½ hr as day spread it out into 2 15minute exercise moments for the day.

4- Drink-in moderation What you’ve heard is true. Drinking can make you less likely to have a stroke—up to a point. “Studies show that if you have about one drink per day, your risk may be lower.  I am not saying drink one glass of liquor a day but if you have to limit it to one glass a day.  Red wine your first choice, because it contains resveratrol, which is thought to protect the heart and brain.

5-Atrial Fibrillation-Atrial fibrillation is a form of irregular heartbeat that causes clots to form in the heart. Those clots can then travel to the brain, producing a stroke. “Atrial fibrillation carries almost a fivefold risk of stroke, and should be taken seriously; take your anticoagulant medication the MD orders to keep the blood thin to prevent clotting.

6-Treat diabetes –Having high blood sugar over time damages blood vessels, making clots more likely to form inside them putting the person at higher risk for a stroke.  So simply keep your sugar under control.

7-QUIT Smoking-Along with a healthy diet and regular exercise, smoking cessation is one of the most powerful lifestyle changes that will help you reduce your stroke risk

 

 

QUOTE FOR THURSDAY:

“Adults with Von Willebrand disease (VWD), an inherited bleeding disorder that makes it difficult to form blood clots.1 VONVENDI is the first and only recombinant treatment for VWD, meaning it’s made without using human blood.”

VONVENDI® [von Willebrand factor (Recombinant)] – Treatment for Adults With VWD

QUOTE FOR WEDNESDAY:

“Difference between plantar fasciitis and heel spurs lies in the source of the pain. Pain from plantar fasciitis is typically felt in the arch of the foot and the heel due to damage or overuse of the plantar fascia. Heel spurs, or tiny jagged calcium deposits on the heel bone, develop in response to the trauma to the plantar fascia and are localized to the heel.   Plantar fasciitis is most commonly caused by repetitive strain injury to the ligament of the sole of the foot.  Heel Spurs are caused by long- term straining of the muscles and ligaments around the heel”

Heel that pain (heelthatpain.com)

 

What’s the difference between Plantar Fasciitis versus Heel Spurs?

   Plantar Fasciiitis                                                         

These two diagnoses are related, they are not the same.

Plantar Fasciitis:

Plantar fasciitis refers to the inflammation of the plantar fascia–the tissue that forms the arch of the foot.

Causes: 

The condition is a result of excessive stretching of plantar fascia ligament. It may be caused due to:

  • Over-use: too much physical activity; running, walking or standing for a long time particularly if there is a rapid increase in activity over a short period of time
  • Obesity
  • Aging
  • Shoes without cushions
  • Walking barefoot on hard surfaces
  • Occupations like teaching or working in a factory that requires walking or standing for longer periods

Plantar fasciitis can also be caused by certain diseases, including reactive arthritis and ankylosing spondylitis.

One of the most common causes of heel and arch pain is overuse/ repetitive exertion with inadequately supportive shoes.

Symptoms:

Heel pain is the primary symptom of plantar fasciitis, especially evident in the following conditions:
  • Pain in your foot usually near the heel
  • Pain can span the entire bottom
  • Pain and stiffness in the morning that gets worse as the day progresses
  • Pain also is at its worse when first waking up in the morning or after a long period of rest of the feel since the ligament is overstretched to torn and it will tighten during rest.
  • Pain which would get worse when climbing stairs or standing on toes
  • Pain after standing for long time on flat surfaces

Treatment:

Most people who have plantar fasciitis recover in several months with conservative treatment, including resting, icing the painful area and stretching.  Always upon getting up where a cushioned footwear for support; flat surfaces walking on barefoot is not good at all.

Heel Spurs:

A heel spur is a foot condition that’s created by a bony-like growth, called a calcium deposit, that extends between your heel bone and arch.

Heel spurs often start in the front of and underneath your heel. They eventually affect other parts of your foot. They can get up to half an inch in length. They may not necessarily be visible to the naked eye.

Detecting heel spurs can be challenging. Heel spurs don’t always cause pain, and not all heel pain is related to spurs. Keep reading to learn more about these bony growths and what causes them.

Causes:

One of the most common causes of heel and arch pain is overuse/ repetitive exertion with inadequately supportive shoes. Once again, most heel pain is caused by a condition known as plantar fasciitis.

Joint damage from osteoarthritis is the most common cause of bone spurs. As osteoarthritis breaks down the cartilage cushioning the ends of your bones, your body attempts to repair the loss by creating bone spurs near the damaged area.

Symptoms:

  • Pain and stiffness in the morning that gets worse as the day progresses
  • Pain which would get worse when climbing stairs or standing on toes
  • Pain after standing for long time
  • Pain can be unbearable
  • The pain is worse with obesity when standing up on the feet doing whatever activity, more weight is on the feet.
  • The affected area may also feel warm to the touch.
  • These symptoms may spread to the arch of your foot.
  • Eventually, a small bony protrusion may be visible.

The pain is most intense when resuming activity after rest and tends to decrease with continued motion. This is due to the fact that the plantar fascia (the ligament that is strained in heel pain) tightens as we sleep. When we first step down again, a shocking tight pain can be felt!

Some heel spurs may cause no symptoms at all. You may also not see any changes in soft tissues or bones surrounding the heel. Heel spurs are often discovered only through X-rays and other tests done for another foot issue.

Treatment:

Because heel spurs are usually not the direct cause of heel pain, there is usually not many good reasons to surgically remove heel spurs. You can achieve relief from heel pain (plantar fasciitis) without ever removing the spurs! If you can figure out what the underlying cause is, you may be able to get rid of your pain.

Heel spurs are treated by measures that decrease the associated inflammation and avoid reinjury. Local ice applications both reduce pain and inflammation. Anti-inflammatory medications, such as naproxen (Aleve) and ibuprofen (Advil), or injections of cortisone, are often helpful.  Do not walk  barefoot or with just socks on anywhere.  Again always upon getting up where a cushioned footwear for support.  Walking on flat surfaces barefoot are not good at all.

Of course if you can’t easily figure out what the cause is and resolve it go to the expert the Podiatrist!

 

QUOTE FOR TUESDAY:

“The Charles Shor Epilepsy Center has one of the largest, most comprehensive programs in the world for the evaluation, medical and surgical treatment of epilepsy.”

Cleveland Clinic (clevelandclinic.org)

Part II Epilepsy – How heredity can relate to it and treatments with potential future Rx’s..

In Part 11 What is discussed is Idiopathic Epilepsy (Unknown Cause) and the Rx of all causes!

Than their is the epilepsy that is diagnosed with a IDIOPATHIC cause – meaning unknown cause and the patient could grow out of it in childhood depending on the type of seizure disorder or not–in where the condition becomes chronic (for life).

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 than 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 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 or where a healthy diet with exercise balanced with rest and stress well controlled is on their priority list in living.

Treatment

Doctors generally begin by treating epilepsy with medication. If medications don’t treat the condition, doctors may propose surgery or another type of treatment.

Medication

Most people with epilepsy can become seizure-free by taking one anti-seizure medication, which is also called anti-epileptic medication. Others may be able to decrease the frequency and intensity of their seizures by taking a combination of medications.

Many children with epilepsy who aren’t experiencing epilepsy symptoms can eventually discontinue medications and live a seizure-free life. Many adults can discontinue medications after two or more years without seizures. Your doctor will advise you about the appropriate time to stop taking medications.

Finding the right medication and dosage can be complex. Your doctor will consider your condition, frequency of seizures, your age and other factors when choosing which medication to prescribe. Your doctor will also review any other medications you may be taking, to ensure the anti-epileptic medications won’t interact with them.

Your doctor likely will first prescribe a single medication at a relatively low dosage and may increase the dosage gradually until your seizures are well-controlled.

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; 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 or under control by medications preventing the seizure.)

Along with your test results, your doctor may use a combination of analysis techniques to help pinpoint where in the brain seizures start:

  • Statistical parametric mapping (SPM). SPM is a method of comparing areas of the brain that have increased metabolism during seizures to normal brains, which can give doctors an idea of where seizures begin.
  • Curry analysis. Curry analysis is a technique that takes EEG data and projects it onto an MRI of the brain to show doctors where seizures are occurring.
  • Magnetoencephalography (MEG). MEG measures the magnetic fields produced by brain activity to identify potential areas of seizure onset.

Accurate diagnosis of your seizure type and where seizures begin gives you the best chance for finding an effective treatment.

When medications fail to provide adequate control over seizures, surgery may be an option. With epilepsy surgery, a surgeon removes the area of your brain that’s causing seizures.

Doctors usually perform surgery when tests show that:

  • Your seizures originate in a small, well-defined area of your brain
  • The area in your brain to be operated on doesn’t interfere with vital functions such as speech, language, motor function, vision or hearing

Although many people continue to need some medication to help prevent seizures after successful surgery, you may be able to take fewer drugs and reduce your dosages.

In a small number of cases, surgery for epilepsy can cause complications such as permanently altering your thinking (cognitive) abilities. Talk to your surgeon about his or her experience, success rates, and complication rates with the procedure you’re considering.

Therapies

Apart from medications and surgery, these potential therapies offer an alternative for treating epilepsy:

  • Vagus nerve stimulation. In vagus nerve stimulation, doctors implant a device called a vagus nerve stimulator underneath the skin of your chest, similar to a heart pacemaker. Wires from the stimulator are connected to the vagus nerve in your neck.The battery-powered device sends bursts of electrical energy through the vagus nerve and to your brain. It’s not clear how this inhibits seizures, but the device can usually reduce seizures by 20 to 40 percent.Most people still need to take anti-epileptic medication, although some people may be able to lower their medication dose. You may experience side effects from vagus nerve stimulation, such as throat pain, hoarse voice, shortness of breath or coughing.
  • Ketogenic diet. Some children with epilepsy have been able to reduce their seizures by following a strict diet that’s high in fats and low in carbohydrates.In this diet, called a ketogenic diet, the body breaks down fats instead of carbohydrates for energy. After a few years, some children may be able to stop the ketogenic diet — under close supervision of their doctors — and remain seizure-free.Consult a doctor if you or your child is considering a ketogenic diet. It’s important to make sure that your child doesn’t become malnourished when following the diet.Side effects of a ketogenic diet may include dehydration, constipation, slowed growth because of nutritional deficiencies and a buildup of uric acid in the blood, which can cause kidney stones. These side effects are uncommon if the diet is properly and medically supervised.

    Following a ketogenic diet can be a challenge. Low-glycemic index and modified Atkins diets offer less restrictive alternatives that may still provide some benefit for seizure control.

  • Deep brain stimulation. In deep brain stimulation, surgeons implant electrodes into a specific part of your brain, typically your thalamus. The electrodes are connected to a generator implanted in your chest or your skull that sends electrical pulses to your brain and may reduce your seizures.

Potential future treatments

Researchers are studying many potential new treatments for epilepsy, including:

  • Responsive neurostimulation. Implantable, pacemaker-like devices that help prevent seizures are under investigation. These responsive stimulation or closed loop devices analyze brain activity patterns to detect seizures before they happen and deliver an electrical charge or drug to stop the seizure.
  • Continuous stimulation of the seizure onset zone (subthreshold stimulation). Subthreshold stimulation — continuous stimulation to an area of your brain below a level that’s physically noticeable — appears to improve seizure outcomes and quality of life for some people with seizures. This treatment approach may work in people who have seizures that start in an area of the brain that can’t be removed because it would affect speech and motor functions (eloquent area). Or it might benefit people whose seizure characteristics mean their chances of successful treatment with responsive neurostimulation are low.
  • Minimally invasive surgery. New minimally invasive surgical techniques, such as MRI-guided laser ablation, show promise at reducing seizures with fewer risks than traditional open-brain surgery for epilepsy.
  • Stereotactic laser ablation or stereotactic radiosurgery. For some types of epilepsy, stereotactic laser ablation or stereotactic radiosurgery may provide effective treatment when an open procedure may be too risky. In these procedures, doctors direct radiation at the specific area in the brain causing seizures to destroy that tissue in an effort to better control the seizures.
  • External nerve stimulation device. Similar to vagus nerve stimulation, this device would stimulate specific nerves to reduce frequency of seizures. But unlike vagus nerve stimulation, this device would be worn externally so that no surgery to implant the device is needed.

In treatment FOLLOW UP VISITS  are part of it, go to the neurologist not a general practitioner and that is a must!!!

The purpose for F/U (follow up) visits is for the neurologist to see how good of a therapeutic drug level your anti-seizure med is in (you get the blood test before the F/U visit).  Possible do a EEG (electroencephalogram); the only test to decipher if you have spikes in your brain waves indicating you had a seizure (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).

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

For those with epilepsy make your life one without seizures occurring putting your life on HOLD you need to TAKE CARE OF YOURSELF and take the meds including see your neurologist yearly or sooner! That is all up to you the patient diagnosed with it.