“Parkinson’s disease destroys neurons in the brain that are essential for controlling movement. As a result, people may have shaking, stiffness, and difficulty with walking, balance, and coordination. Symptoms usually begin gradually and get worse over time.”

National Institute of Health/NIH Research Matters (https://www.nih.gov)

“Parkinson’s disease is a progressive nervous system disorder that affects movement. Symptoms start gradually, sometimes starting with a barely noticeable tremor in just one hand. Tremors are common, but the disorder also commonly causes stiffness or slowing of movement.  Parkinson’s Disease has stages”.

MAYO CLINIC

Parkinson Disease (PD) is a chronic and progressive movement disorder, meaning that symptoms continue and worsen over time. Nearly one million people in the US are living with Parkinson’s disease. The cause is unknown, and although there is presently no cure, there are treatment options such as medication and surgery to manage its symptoms.

Parkinson’s involves the malfunction and death of vital nerve cells in the brain, called neurons. Parkinson’s primarily affects neurons in an area of the brain called the substantia nigra. Some of these dying neurons produce dopamine, a chemical that sends messages to the part of the brain that controls movement and coordination. As PD progresses, the amount of dopamine produced in the brain decreases, leaving a person unable to control movement normally.

There are three types of Parkinson’s disease and they are grouped by age of onset:

 1-Adult-Onset Parkinson’s Disease – This is the most common type of Parkinson’s disease. The average age of onset is approximately 60 years old. The incidence of adult onset PD rises noticeably as people advance in age into their 70’s and 80’s.

2-Young-Onset Parkinson’s Disease – The age of onset is between 21-40 years old. Though the incidence of Young-Onset Parkinson’s Disease is very high in Japan (approximately 40% of cases diagnosed with Parkinson’s disease), it is still relatively uncommon in the U.S., with estimates ranging from 5-10% of cases diagnosed.

3-Juvenile Parkinson’s Disease – The age of onset is before the age of 21. The incidence of Juvenile Parkinson’s Disease is very rare.

Parkinson’s disease can significantly impair quality of life not only for the patients but for their families as well, and especially for the primary caregivers. It is therefore important for caregivers and family members to educate themselves and become familiar with the course of Parkinson’s disease and the progression of symptoms so that they can be actively involved in communication with health care providers and in understanding all decisions regarding treatment of the patient.

According to the American Parkinson’s Disease Association, there are approximately 1.5 million people in the U.S. who suffer from Parkinson’s disease – approximately 1-2% of people over the age of 60 and 3-5% of the population over age 85. The incidence of PD ranges from 8.6-19 per 100,000 people. Approximately 50,000 new cases are diagnosed in the U.S. annually. That number is expected to rise as the general population in the U.S. ages. Onset of Parkinson’s disease before the age of 40 is rare. All races and ethnic groups are affected.

Knowledge is Critical when Dealing with a Life-Altering Condition such as Parkinson’s Disease and being able to make the changes to last longer and at your optimal level of functioning! First step is accept you have it!

If you or a loved one has been diagnosed with Parkinson’s disease, it’s critical to learn everything you possibly can about this condition so that you can make informed decisions about your treatment. That’s why the Medifocus Guidebook on Parkinson’s Disease was developed, a comprehensive 170 page patient Guidebook that contains vital information about Parkinson’s disease and is so helpful.

The Medifocus Guidebook on Parkinson’s Disease starts out with a detailed overview of the condition and quickly imparts fundamentally important information about Parkinson’s disease, including:

 The theories regarding the underlying causes of Parkinson’s disease.

What Are the Possible Risk factors that can be a cause of Parkinson’s Disease?

 The Parkinson’s Disease Foundation notes even after decades of intense study, the causes of Parkinson’s disease are not really understood. However, many experts believe that the disease is caused by several genetic and environmental factors, which can vary in each person.

1-Genetic Factors

For some patients, genetic factors could be the primary cause; but in others, there could be something in the environment that led to the disease. Scientists have noted that aging is a key risk factor. There is a 2-4% risk for developing the disease for people over 60. That is compared to 1-2% risk in the general population.

2-Environmental Factors

Some scientists believe that PD can result from overexposure to environmental toxins, or injury. Research by epidemiologists has identified several factors that may be linked to PD. Some of these include living in rural areas, drinking well water, pesticides and manganese.

Some studies have indicated that long term exposure to some chemicals could cause a higher risk of PD. These include the insecticides permethrin and beta-hexachlorocyclohexane (beta-HCH), the herbicides paraquat and 2,4-dichlorophenoxyacetic acid and the fungicide maneb. In 2009, the US Veterans Affairs Department stated that PD could be caused by exposure to Agent Orange.

We should remember that simple exposure to a single toxin in the environment is probably not enough to cause PD. Most people who are exposed to such toxins do not develop PD.

“Irritable bowel syndrome (IBS) is a problem that affects the large intestine. It can cause abdominal cramping, bloating, and a change in bowel habits. Some people with the disorder have constipation. Some have diarrhea. Others go back and forth between the two. Although IBS can cause a great deal of discomfort, it does not harm the intestines.

IBS is common. It affects about twice as many women as men and is most often found in people younger than 45 years. No one knows the exact cause of IBS. There is no specific test for it. Your doctor may run tests to be sure you don’t have other diseases.”

NIH National Library of Medicine/Medline Plus (https://medlineplus.gov/irritablebowelsyndrome.html)

Treatments and drugs

Because it’s not clear what causes irritable bowel syndrome, treatment focuses on the relief of symptoms so that you can live as normally as possible.

In most cases, you can successfully control mild signs and symptoms of irritable bowel syndrome by learning to manage stress and making changes in your diet and lifestyle. Try to avoid foods that trigger your symptoms. Also try to get enough exercise, drink plenty of fluids and get enough sleep.

If your problems are moderate or severe, you may need more than lifestyle changes. Your doctor may suggest medications.

Dietary changes:

• Eliminating high-gas foods. If you have bothersome bloating or are passing considerable amounts of gas, your doctor may suggest that you cut out such items as carbonated beverages, vegetables — especially cabbage, broccoli and cauliflower — and raw fruits.
• Eliminating gluten. Research shows that some people with IBS report improvement in diarrhea symptoms if they stop eating gluten (wheat, barley and rye). This recommendation remains controversial, and the evidence is not clear.
• Eliminating FODMAPs. Some people are sensitive to types of carbohydrates such as fructose, fructans, lactose and others, called FODMAPs (fermentable oligo-, di-, and monosaccharides and polyols). FODMAPs are found in certain grains, vegetables, fruits and dairy products. However, often people are not bothered by every FODMAP food. You may be able to get relief from your IBS symptoms on a strict low FODMAP diet and then reintroduce foods one at time.

Medications:

• Fiber supplements. Taking fiber supplements, such as psyllium (Metamucil) or methylcellulose (Citrucel), with fluids may help control constipation. Fiber obtained from food may cause much more bloating compared with a fiber supplement. If fiber doesn’t help symptoms, your doctor may prescribe an osmotic laxative such as milk of magnesia or polyethylene glycol.
• Anti-diarrheal medications. Over-the-counter medications, such as loperamide (Imodium), can help control diarrhea. Some people will benefit from medications called bile acid binders, such as cholestyramine (Prevalite), colestipol (Colestid) or colesevelam (Welchol), but these can lead to bloating.
• Anticholinergic and antispasmodic medications. These medications, such as hyoscyamine (Levsin) and dicyclomine (Bentyl), can help relieve painful bowel spasms. They are sometimes used for people who have bouts of diarrhea, but they can worsen constipation and can lead to other symptoms, such as difficulty urinating. They should also be used with caution among people with glaucoma.
• Antidepressant medications. If your symptoms include pain or depression, your doctor may recommend a tricyclic antidepressant or a selective serotonin reuptake inhibitor (SSRI). These medications help relieve depression as well as inhibit the activity of neurons that control the intestines.

If you have diarrhea and abdominal pain without depression, your doctor may suggest a lower than normal dose of tricyclic antidepressants, such as imipramine (Tofranil) or nortriptyline (Pamelor). Side effects of these drugs include drowsiness and constipation. SSRIs, such as fluoxetine (Prozac, Sarafem) or paroxetine (Paxil), may be helpful if you’re depressed and have pain and constipation.

• Some people whose symptoms are due to an overgrowth of bacteria in their intestines may benefit from antibiotic treatment. Some people with symptoms of diarrhea have benefited from rifaximin (Xifaxan), but more research is needed.
• You may benefit from counseling if you have depression or if stress tends to worsen your symptoms.

Medication specifically for IBS

Two medications are currently approved for specific cases of IBS:

• Alosetron (Lotronex). Alosetron is designed to relax the colon and slow the movement of waste through the lower bowel. The Food and Drug Administration (FDA) removed it from the market for a time, but has since allowed alosetron to be sold again.

However, alosetron can be prescribed only by doctors enrolled in a special program and is intended for severe cases of diarrhea-predominant IBS in women who haven’t responded to other treatments. Alosetron is not approved for use by men. It has been linked to rare but important side effects, so it should only be considered when other treatments are not successful.

• Lubiprostone (Amitiza). Lubiprostone works by increasing fluid secretion in your small intestine to help with the passage of stool. It is approved for women age 18 and older who have IBS with constipation. Its effectiveness in men is not proved, nor its long-term safety. Common side effects include nausea, diarrhea and abdominal pain. Lubiprostone is generally prescribed only for women with IBS and severe constipation for whom other treatments haven’t been successful.

“Irritable bowel syndrome (IBS) is the most common functional gastrointestinal (GI) disorder with worldwide prevalence rates ranging generally in the area of 10–15%. Functional GI disorders are disorders that occur because of abnormal functioning of the GI tract, which can affect motility, sensation, and brain–gut communication.”

International Foundation for Gastrointestinal Disorders – iffgd

(https://aboutibs.org/what-is-ibs/facts-about-ibs/statistics/)

Irritable bowel syndrome (IBS) is a common disorder that affects the large intestine (colon). Irritable bowel syndrome commonly causes cramping, abdominal pain, bloating, gas, diarrhea and constipation. IBS is a chronic condition that you will need to manage long term.

Even though signs and symptoms are uncomfortable, IBS — unlike ulcerative colitis and Crohn’s disease, which are forms of inflammatory bowel disease — doesn’t cause changes in bowel tissue or increase your risk of colorectal cancer.

Only a small number of people with irritable bowel syndrome have severe signs and symptoms. Some people can control their symptoms by managing diet, lifestyle and stress. Others will need medication and counseling.

The signs and symptoms of irritable bowel syndrome can vary widely from person to person and often resemble those of other diseases. Among the most common are:

• Abdominal pain or cramping
• A bloated feeling
• Gas
• Diarrhea or constipation — sometimes alternating bouts of constipation and diarrhea
• Mucus in the stool
• For most people, IBS is a chronic condition, although there will likely be times when the signs and symptoms are worse and times when they improve or even disappear completely.

When to see a doctor:

Although as many as 1 in 5 American adults has signs and symptoms of irritable bowel syndrome, fewer than 1 in 5 who have symptoms seek medical help. Yet it’s important to see your doctor if you have a persistent change in bowel habits or if you have any other signs or symptoms of IBS because these may indicate a more serious condition, such as colon cancer.

Symptoms that may indicate a more serious condition or tell you see an MD even call 911:

• Rectal bleeding
• Abdominal pain that progresses or occurs at night
• Weight loss

Causes of IBS:

The exact cause  of irritable bowel syndrome (IBS) has not been determined, although there are several theories. One theory is that IBS may be an immune disorder, or one in which the intestines of the affected person are highly sensitive in responding to stress and bacteria. Certain foods are thought to trigger IBS flare-ups, including dairy products and gluten, which is present in wheat, barley and rye.

The epithelial layer, or lining, of the large intestine controls the amount of fluid in the bowel. In IBS, there appears to be a disruption in the function of fluid absorption. This can result in excessive fluid in the colon, which causes diarrhea and watery stools. Or, if the lining of the colon absorbs too much fluid from the colon contents, the stool may become dry, leading to constipation.

The MAYO clinic says Triggers vary from person to person.

Stimuli that don’t bother other people can trigger symptoms in people with IBS — but not all people with the condition react to the same stimuli. Common triggers include:

• Foods. The role of food allergy or intolerance in irritable bowel syndrome is not yet clearly understood, but many people have more severe symptoms when they eat certain things. A wide range of foods has been implicated — chocolate, spices, fats, fruits, beans, cabbage, cauliflower, broccoli, milk, carbonated beverages and alcohol to name a few.
• Stress. Most people with IBS find that their signs and symptoms are worse or more frequent during periods of increased stress, such as finals week or the first weeks on a new job. But while stress may aggravate symptoms, it doesn’t cause them.
• Hormones. Because women are twice as likely to have IBS, researchers believe that hormonal changes play a role in this condition. Many women find that signs and symptoms are worse during or around their menstrual periods.
• Other illnesses. Sometimes another illness, such as an acute episode of infectious diarrhea (gastroenteritis) or too many bacteria in the intestines (bacterial overgrowth), can trigger IBS.

“Stress creates a natural physical response in our bodies that is part of our response to danger. When we feel stress, our blood vessels narrow while pulse and blood pressure rise. Breathing increases and the body releases hormones like adrenaline and cortisol into the blood stream. These symptoms can all lead to serious health problems when they continually occur over a long period of time. To fight these negative effects use stress management techniques to help moderate your response to stress and help you stay healthy.   Perhaps the best way to reduce stress and live a healthier life is to laugh.”

PROMEDICA – https://balance.promedicaseniorcare.org

“A heart attack (myocardial infarction) happens when a part of the heart muscle doesn’t get enough blood.The more time that passes without treatment to restore blood flow, the greater the damage to the heart muscle.”

South Dakota Dept. of Health (https://doh.sd.gov)

People who are at risk for the development of coronary artery disease and myocardial infarction include those who fall into any of the categories listed below:

-People with a history of heart disease.

-Males.

-Smokers.

-People with high cholesterol.

-People with high blood pressure.

-Obese people.

-People with diabetes.

-People who suffer stress.

-People who live a sedentary life style.

-Heredity is a powerful factor that contributes to early heart disease. Being male is a risk factor, but the incidence of heart disease in women increases dramatically after menopause.

-The risk factors to concentrate upon are those that can be modified. These include cigarette smoking, high blood pressure, cholesterol, obesity, sedentary life style and stress. Cigarette smoking causes many deaths from myocardial infarction and other heart diseases. Smoking contributes to almost half of the heart attacks of women under age 55.

-Stopping smoking can greatly reduce your chances of having a heart attack. Controlling blood pressure can reduce your risk of heart attack. Lowering cholesterol to safe levels through diet and medications can reduce your risk and may even lead to some regression of the plaques already present. Lean body weight and a regular exercise program are helpful.

-If you are diabetic, precise control of your diabetes will help reduce your risk of blood vessel damage due to diabetes. Stress is a risk factor that is common, difficult to quantify and difficult to control effectively over time. Methods of stress reduction include meditation, regular exercise, time management, and a supportive environment.

How is a heart attack diagnosed?

Chest pain is the most common symptom of a heart attack. The chest pain is usually a burning or pressure sensation beneath the mid or upper breast bone. The pain may radiate into the upper mid back, neck, jaw or arms. The pain may be severe but often is only moderate in severity.

There may be associated shortness of breath or sweating. If patients have had angina previously, the heart attack pain will feel the same as their usual angina only stronger and more prolonged. If you have a pain like this that lasts longer than 15 minutes, it is best to be evaluated immediately.

Calling your medic unit is the fastest and safest way to ask for help. If you have symptoms like this that wax and wane, this is often a warning sign that a heart attack is about to occur and prompt medical attention is needed.

Once you are in an emergency room or a doctor’s office an electrocardiogram (ECG or EKG) will be obtained. This is often helpful in diagnosing a heart attack. Sometimes, however, the test is normal even when the heart injury is present but usually a great diagnostic tool.

When heart cells die, certain enzymes present in heart cells are released into the bloodstream that serve as a marker of heart injury (troponin I and CPK or CK-MB). These enzymes can be measured by blood tests. The amount of enzyme released into the blood stream also helps assess how much heart damage has occurred.

TREATMENT:

The best way to limit the size of a heart attack is to restore the flow of blood to the heat muscle as fast as possible. There are two basic methods to do this.

Because most heart attacks are caused by clots forming within the coronary artery, dissolving the clot quickly will restore blood flow. Drugs called thrombolytics are quite effective OR having a angiogram to angioplasty to remove the blockage.

The sooner these drugs are given, the quicker the blood flow will be restored. An alternative method involves the use of balloon angioplasty.

Angiogram to angioplasty involves taking the heart attack victim promptly to the cardiac cath lab in the hospital.

An angiogram is performed to show the blocked blood vessel leading to the heart attack. Then a balloon catheter is placed across the blockage and flow is restored.

Sometimes a stent (a device that assists in holding the blood vessel open) is placed to create a large channel.

Smaller heart attacks, often those not producing significant abnormalities on the ECG are often treated with bedrest and blood thinners such as heparin as well as drugs to reduce the work the heart does.

These heart attacks are called non-transmural myocardial infarctions. Before discharge, x-ray studies of the heart arteries are often carried out to see if angioplasty or surgery will be necessary.

Following thrombolytic (clot reducing) therapy, angiogram are often performed to outline the coronary anatomy to help determine if additional therapy such as angioplasty or bypass surgery is indicated. This may be done during the initial hospitalization or later as an outpatient procedure.