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Part I Multiple Sclerosis Awareness Month

To understand Multiple Sclerosis (MS) lets understand first it attacks the nervous system at the what we call the myelin shealth.  The myelin sheath does this first the Myelin is a fatty white substance that surrounds the axon of some nerve cells, forming an electrically insulating layer. It is essential for the proper functioning of the nervous system. It is an outgrowth of a type of glial cell. The production of the myelin sheath is called myelination or myelinogenesis.  The myelin sheath is a multi-layered membrane, unique to the nervous system, that functions as an insulator to greatly increase the efficiency of axonal impulse conduction.

Multiple sclerosis (MS) is a potentially disabling disease of the brain and spinal cord (central nervous system).

In MS, the immune system attacks the protective sheath (myelin) that covers nerve fibers and causes communication problems between your brain and the rest of your body. Eventually, the disease can cause the nerves themselves to deteriorate or become permanently damaged.

 Signs and symptoms of MS vary widely and depend on the amount of nerve damage and which nerves are affected. Some people with severe MS may lose the ability to walk independently or at all, while others may experience long periods of remission without any new symptoms.

There’s no cure for multiple sclerosis. However, treatments can help speed recovery from attacks, modify the course of the disease and manage symptoms.

Multiple sclerosis signs and symptoms may differ greatly from person to person and over the course of the disease depending on the location of affected nerve fibers. They may include:

  • Numbness or weakness in one or more limbs that typically occurs on one side of your body at a time, or the legs and trunk
  • Partial or complete loss of vision, usually in one eye at a time, often with pain during eye movement
  • Prolonged double vision
  • Tingling or pain in parts of your body
  • Electric-shock sensations that occur with certain neck movements, especially bending the neck forward (Lhermitte sign)
  • Tremor, lack of coordination or unsteady gait
  • Slurred speech
  • Fatigue
  • Dizziness
  • Problems with bowel and bladder function

When to see a doctor

See a doctor if you experience any of the above symptoms for unknown reasons.

 

QUOTE FOR FRIDAY:

“Our nervous system is divided in two components: the central nervous system (CNS), which includes the brain and spinal cord, and the peripheral nervous system (PNS), which encompasses nerves outside the brain and spinal cord. These two components cooperate at all times to ensure our lively functions: we are nothing without our nervous system!

Unlike the brain and the spinal cord of the central nervous system that are protected by the vertebrae and the skull, the nerves and cells of the peripheral nervous system are not enclosed by bones, and therefore are more susceptible to trauma.

If we consider the entire nervous system as an electric grid, the central nervous system would represent the powerhouse, whereas the peripheral nervous system would represent long cables that connect the powerhouse to the outlying cities (limbs, glands and organs) to bring them electricity and send information back about their status.”

University of Queensland (https://qbi.uq.edu.au/brain/brain-anatomy/peripheral-nervous-system)

Part II Understanding the Nervous System.

What are the parts of the nervous system?

The nervous system has two main parts:

1 – Central nervous system (CNS): Your brain and spinal cord make up your CNS. Your brain reads signals from your nerves to regulate how you think, move and feel.

2 – Peripheral nervous system (PNS): Your PNS is made up of a network of nerves. The nerves branch out from your spinal cord. This system relays information from your brain and spinal cord to your organs, arms, legs, fingers and toes.

Your peripheral nervous system (PNS) is that part of your nervous system that lies outside your brain and spinal cord. It plays key role in both sending information from different areas of your body back to your brain, as well as carrying out commands from your brain to various parts of your body.

Some of those signals, like the ones to your heart and gut, are automatic. Others, like the ones that control movement, are under your control.

What’s the difference between the peripheral and central nervous systems?

Your nervous system consists of two main parts: your central nervous system and your peripheral nervous system.

Your central nervous system includes two organs, your brain and spinal cord.

Your peripheral nervous system is everything else and includes nerves that travel from your spinal cord and brain to supply your face and the rest of your body. The term “peripheral” is from the Greek word that means around or outside the center.

There are two parts to your peripheral nervous system:

  • The somatic nervous system guides your voluntary movements.

Your somatic nervous system is a subdivision of your peripheral nervous system, which is all of your nervous system except your brain and spinal cord. Your somatic nervous system allows you to move and control muscles throughout your body. It also feeds information from four of your senses — smell, sound, taste and touch — into your brain.

  • The autonomic nervous system regulates the activities you do without thinking about them (involuntary movements).

Your autonomic nervous system is a network of nerves throughout your body that control unconscious processes. These are things that happen without you thinking about them, such as breathing and your heart beating. Your autonomic nervous system is always active, even when you’re asleep, and it’s key to your continued survival.

Your autonomic nervous system is a part of your overall nervous system that controls the automatic functions of your body that you need to survive. These are processes you don’t think about and that your brain manages while you’re awake or asleep.

What does the nervous system look like?

Nerve cells (neurons) are the basis of your nervous system. There are 100 billion neurons in your brain. These cells connect throughout your entire body.

Imagine your nervous system as a tree. Your central nervous system is the trunk of the tree that contains your brain and spinal cord. The tree branches are your peripheral nervous system (nerves). The branches extend from the truck (brain and spinal cord) to reach all parts of your body.

Signs and symptoms of nervous system conditions vary by type but may include:

  • Movement and coordination changes.
  • Memory loss.
  • Pain, numbness or a pins and needles feeling.
  • Behavioral and mood changes.
  • Difficulty with thinking and reasoning.
  • Seizures.

Some conditions, like a stroke, are medical emergencies that need treatment quickly. If you notice the following symptoms, contact 911 or your local emergency services number:

  • Muscle weakness or paralysis in one side of your body.
  • Sudden vision loss.
  • Slurred speech.
  • Confusion.

 

QUOTE FOR THURSDAY:

“The nervous system is the major controlling, regulatory, and communicating system in the body. It is the center of all mental activity including thought, learning, and memory. Together with the endocrine system, the nervous system is responsible for regulating and maintaining homeostasis. Through its receptors, the nervous system keeps us in touch with our environment, both external and internal.

Like other systems in the body, the nervous system is composed of organs, principally the brain, spinal cord, nerves, and ganglia. These, in turn, consist of various tissues, including nerve, blood, and connective tissue. Together these carry out the complex activities of the nervous system.”

National Cancer Institute (https://training.seer.cancer.gov/anatomy/nervous/)

Part I Understanding the Nervous System.

Your nervous system is your body’s command center. It’s made up of your brain, spinal cord and nerves. Your nervous system works by sending messages, or electrical signals, between your brain and all the other parts of your body. These signals tell you to breathe, move, speak and see, for example. Your nervous system keeps track of what’s going on inside and outside of your body and decides how to respond to any situation you’re in.

Your nervous system regulates complicated processes like thoughts and memory. It also plays an essential role in the things your body does without thinking, like blushing, sweating and blinking.

Your nervous system’s main function is to send messages from various parts of your body to your brain, and from your brain back out to your body to tell your body what to do. These messages regulate your:

  • Thoughts, memory, learning and feelings.
  • Movements (balance and coordination).
  • Senses (how your brain interprets what you see, hear, taste, touch and feel).
  • Wound healing.
  • Sleep.
  • Heartbeat and breathing patterns.
  • Response to stressful situations, including sweat production.
  • Digestion.
  • Body processes, such as puberty and aging.

How does the nervous system work?

Your nervous system uses nerve cells called neurons to send signals, or messages, all over your body. These electrical signals travel among your brain, skin, organs, glands and muscles.

The messages help you move your limbs and feel sensations, like pain. Your eyes, ears, tongue, nose and the nerves all over your body take in information about your environment. Then, nerves carry that data to and from your brain.

There are different types of neurons. Each type of neuron has a different job:

  • Motor neurons take signals from your brain and spinal cord to your muscles. They help you move. They also assist with breathing, swallowing and speaking.
  • Sensory neurons take information from your senses (what you see, touch, taste, etc.) to your brain.
  • Interneurons communicate between motor and sensory neurons. These neurons regulate your movement in response to sensory information (like moving away from a hot surface) and play a role in how you learn, think and remember.

QUOTE FOR WEDNESDAY:

“Endometriosis is derived from the word “endometrium,” which is the tissue that lines the uterus. Patients with endometriosis have endometrial-type tissue outside of the uterus.

Women with endometriosis are more likely to have infertility or difficulty getting pregnant

Symptoms of endometriosis may include: excessive menstrual cramps, abnormal or heavy menstrual flow and pain during intercourse.

Laparoscopy, a minimally invasive surgical procedure, can be used to definitively diagnose and treat endometriosis.”

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

Part II Endometriosis Month Awareness!

Endometriosis Risk Factors:

Research shows that there are some things that put a person at higher risk of developing endometriosis, including having:

  • A mother, sister or daughter who has endometriosis
  • An abnormal uterus, which is diagnosed by a doctor
  • Early menstruation (before age 11)
  • Shorter menstrual periods (less than 27 days on average)
  • Heavy menstrual periods lasting more than seven days

Some things that can lower the risk of endometriosis include:

  • Pregnancy and breastfeeding
  • Having your first period after age 14
  • Eating fruits, especially citrus fruits

Endometriosis prevention:

Endometriosis is an idiopathic condition, meaning there is no known cause. There are also no specific ways to prevent endometriosis. However, being aware of the symptoms and whether you could be at higher risk can help you know when to discuss it with a doctor.

Endometriosis Stages:

Doctors classify endometriosis from stage 1 to stage 4. The stages are based on where endometrial tissue occurs in the body, how far it has spread and how much tissue is in those areas.

Having a more advanced stage of endometriosis does not always mean you will have more severe symptoms or more pain. Some women with stage 4 endometriosis have few or no symptoms, while those with stage 1 can have severe symptoms.

Endometriosis Treatment:

There is no lasting treatment for endometriosis, but doctors can offer treatments that help you manage it. Finding the right treatment depends on many different factors, including your age and symptoms. Doctors will also discuss whether you want to have children, which can help determine the best treatment options.

Nonsurgical endometriosis treatments

The most common treatments for endometriosis that do not require surgery are hormone therapy and pain management.

Endometriosis tissues are affected by hormones in the same way as endometrial tissues inside the uterus. Hormone changes that occur with a menstrual cycle can make endometriosis pain worse.

Treatments that include hormone therapy can alter hormone levels or stop your body from producing certain hormones. Hormone therapy can affect your ability to get pregnant, so it may not be right for everyone.

Hormone therapy can be taken as pills, shots or a nasal spray. The most common options include:

  • Oral contraceptives with estrogen and progesterone to control hormones
  • Progestins to stop menstrual periods and endometrial tissue growth
  • Gonadotropin-releasing hormone antagonist to limit ovarian hormones
  • Gonadotropin-releasing hormone agonist to stop ovarian hormones

Pain medications, including nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, can be effective for managing endometriosis pain. A doctor can also discuss whether you need prescription medications for more severe pain.

Laparoscopy for endometriosis

Patients who have more advanced endometriosis, pain that does not resolve with other treatments or are trying to conceive may need surgery. Laparoscopy is the most common surgery doctors use to treat endometriosis.

During this procedure, a surgeon makes a few small incisions in your abdomen. In one incision they insert a thin tube with a light and a camera. In the other incisions they insert small tools. These tools can remove endometrial tissue (excision) or use intense heat to destroy the tissues (ablation).

The surgeon can also remove any scar tissue that has built up in the area. Laparoscopic surgeries usually have a shorter recovery time and smaller scars compared with traditional open surgery (laparotomy).

Laparotomy for endometriosis

In some cases, a doctor may need to do a laparotomy for endometriosis instead of laparoscopy. That means the doctor will make a larger incision (cut) in the abdomen to remove the endometrial tissue. This is uncommon.

Removing endometrial tissues with laparoscopy or laparotomy can provide short-term pain relief. However, the pain may come back.

Hysterectomy for endometriosis

A hysterectomy is a surgical procedure to remove the uterus. Doctors may recommend this as an option to treat endometriosis. Your doctor may also recommend removing the ovaries (oophorectomy) with or without a hysterectomy. This will stop the release of hormones and should definitively treat endometriosis, but it will put you into menopause.

Removing the ovaries will significantly lower estrogen levels and slow or stop endometrial tissue growth. But it does come with the risks and side effects of menopause, including hot flashes, bone loss, heart disease, decreased sexual desire, memory problems, and depression or anxiety. For those reasons, the decision to proceed with oophorectomy is one made between the patient and their physician based on case-specific factors and the patient’s personal goals.

After a hysterectomy, you will no longer have a uterus, and you will not be able to become pregnant or carry a pregnancy. If you are interested in having a child, talk with your doctor about other treatment options.

Women who have an oophorectomy (ovary removal) but still have their uterus may be able to get pregnant with IVF. Doctors can harvest eggs from your ovaries before the surgery and preserve those eggs for fertilization and implantation in your uterus later, or an egg donor can be used.

A Total Abdominal Hysterectomy Bilingual Salpingo Oophorectomy is a total hysterectomy and both fallopian tubes with ovaries removed.   This is sometimes needed.

QUOTE FOR TUESDAY:

“Endometriosis affects roughly 10% (190 million) of reproductive age women and girls globally.

It is a chronic disease associated with severe, life-impacting pain during periods, sexual intercourse, bowel movements and/or urination, chronic pelvic pain, abdominal bloating, nausea, fatigue, and sometimes depression, anxiety, and infertility.

There is currently no known cure for endometriosis and treatment is usually aimed at controlling symptoms.

Access to early diagnosis and effective treatment of endometriosis is important, but is limited in many settings, including in low- and middle-income countries.”

World Health Organization WHO (https://www.who.int/news-room/fact-sheets/detail/endometriosis)

Part I March Awareness of Endometriosis.

What is Endometriosis?

The uterus is a female reproductive organ located between the bladder and the rectum, in the pelvic area. The uterus has three layers: the inner lining (endometrium); the middle muscular layer (myometrium); and the outer layer (perimetrium). The uterus is connected to the fallopian tubes, the cervix and (via the cervix) the vagina.

Endometriosis is a painful, chronic disease that affects at least 6.3 million women and girls in the U.S., 1 million in Canada, and millions more worldwide. It occurs when tissue like that which lines the uterus (tissue called the endometrium) is found outside the uterus.  The symptoms occur during menses and the endometrial tissue outside the uterus will be painful like the uterus cramps due to the period.

What Causes Endometriosis?

The cause of endometriosis is unknown. The retrograde menstruation theory (transtubal migration theory) suggests that during menstruation some of the menstrual tissue backs up through the fallopian tubes, implants in the abdomen, and grows.  Some experts believe that all women experience some menstrual tissue backup and that an immune system problem or a hormonal problem allows this tissue to grow in the women who develop endometriosis.

Another theory suggests that endometrial tissue is distributed from the uterus to other parts of the body through the lymph system or through the blood system. A genetic theory suggests that it may be carried in the genes in certain families or that some families may have predisposing factors to endometriosis.

Surgical transplantation has also been cited in many cases where endometriosis is found in abdominal scars, although it has also been found in such scars when accidental implantation seems unlikely.

Another theory suggests that remnants of tissue from when the woman was an embryo may later develop into endometriosis, or that some adult tissues retain the ability they had in the embryo stage to transform reproductive tissue in certain circumstances.

Research by the Endometriosis Association revealed a startling link between dioxin (TCCD) exposure and the development of endometriosis. Dioxin is a toxic chemical byproduct of pesticide manufacturing, bleached pulp and paper products, and medical and municipal waste incineration. The EA discovered a colony of rhesus monkeys that had developed endometriosis after exposure to dioxin. 79% of the monkeys exposed to dioxin developed endometriosis, and, in addition, the more dioxin exposure, the more severe the endometriosis.

Endometriosis tissus found outside of the uterus:

  • Outside and back of your uterus.
  • Fallopian tubes.
  • Ovaries.
  • Vagina.
  • Peritoneum (the lining of your abdomen and pelvis).
  • Bladder and ureters.
  • Intestines.
  • Rectum.
  • Diaphragm (a muscle near the bottom of your chest that plays an important role in breathing).
  • Less commonly they are found in the lung, arm, thigh, and other locations.

This misplaced tissue develops into growths or lesions which respond to the menstrual cycle in the same way that the tissue of the uterine lining does: each month the tissue builds up, breaks down, and sheds. Menstrual blood flows from the uterus and out of the body through the vagina, but the blood and tissue shed from endometrial growths has no way of leaving the body. This results in internal bleeding, breakdown of the blood and tissue from the lesions, and inflammation — and can cause pain, infertility, scar tissue formation, adhesions, and bowel problems.

Pain before and during period: Pain with sex, Infertility, Fatigue, Painful urination during periods, Painful bowel movements during periods and Other Gastrointestinal upsets such as diarrhea, constipation, nausea.

In addition, many women with endometriosis suffer from:

  • Allergies
  • Chemical sensitivities
  • Frequent yeast infections

Diagnosis:

Diagnosis is considered uncertain until proven by laparoscopy, a minor surgical procedure done under anesthesia. A laparoscopy usually shows the location, size, and extent of the growths. This helps the doctor and patient make better treatment choices.

 

QUOTE FOR MONDAY:

“U.S. adult women age 18 and older (33%) are more likely than men (27%) to wake up every night and more likely to stay up late every night (31% vs. 20%).

More than half of women ages 25-44 with children get less than 7 hours of sleep per night, compared to 38% of men in this group.

Men in this group also get 30 minutes more sleep per night than the women.

Within this group, twice as many women are woken every night to care for others compared to men.

Nearly a quarter of women ages 18-24 lose sleep due to premenstrual syndrome (PMS), while more than half of women ages 45-54 lose sleep due to perimenopause or menopause.

Women (51%) are more likely than men (42%) to attribute their sleep issues to anxiety and depression.”

SleepFoundation.org

(https://www.sleepfoundation.org/sleep-news/the-sleep-gender-gap-nighttime-disparities-between-women-and-men)