Secrets of the Heart

In the last two issues of the newsletter, we’ve discussed the anatomy of the heart and the things that can go wrong with the heart. (If you have not read them yet, it would be helpful, but not essential, before reading on.) In this issue, we’re going to conclude our series by examining how your doctor unravels the secrets of your heart when you visit his/her office. My goal is not to turn you into doctors, but to take some of the mystery out of diagnosis so that you know what your doctor is looking at, listening to, and analyzing when he/she is looking at your heart — to arm you with some basic diagnostic knowledge so you are not totally at the mercy of the medical mystique when the results of your next physical are pronounced.

A definition

Before we launch into our subject, though, we have to define two terms that will be referenced throughout the newsletter: systole and diastole:

– Systole refers to the contraction of the chambers of your heart.

– Diastole refers to the relaxation of those chambers.

In fact, you can have systole and diastole in all four heart chambers, but in most cases, doctors focus on the left ventricle — the chamber that pumps blood throughout your entire body — when using the terms. Also, there are two kinds of systole and diastole: electrical and mechanical. Electrical systole is the electrical activity that precedes actual contraction. It’s what stimulates the heart muscle of the different chambers to actually contract. The delay between electrical stimulation and actual contraction is about a tents of a second.

The same is true of diastole, the relaxation of the heart muscles. Electrical diastole is the recovery and repolarization of the heart in preparation for the next beat. Mechanical diastole is the actual relaxation of the muscle that follows electrical diastole. This distinction becomes important when you look at your ECG.

Incidentally, the increased pressure produced in your circulatory system by the mechanical systole (contraction) of the left ventricle is referred to as systolic pressure. The reduced pressure during relaxation is called diastolic pressure. These are the two numbers your doctor gives you when reading your blood pressure (e.g., 120 over 70). We’ll explore that in detail in the next series of newsletters when we explore the circulatory system.

The Sounds of Your Heart

The most basic tool your doctor has for evaluating the health of your heart is the stethoscope. It is so fundamental to medicine that it has been around in various forms for almost 200 years and is probably the most recognizable symbol of doctors in the world today. Before the stethoscope, physicians would just listen to the heart by pressing their ears against the patient’s chest — not very efficient, and often very unclean.

And what do doctors hear through a stethoscope?

Surprise! It’s actually not the beating of your heart. The heartbeat itself is virtually soundless. That thump…thump your doctor listens to is the sound of blood dashing against the inner walls of the heart chambers. This is a very useful distinction. Hearing the movement of blood reveals far more than would be the case if all we heard was a mechanical contraction.

More precisely, the thump…thump of your heartbeat is the sound of the turbulence of blood against the walls of the heart and the valves during systole (contraction). In fact, thump…thump is not an entirely accurate description of the sound. As it turns out, each thump is, in reality, comprised of separate sounds in both the atria and the ventricles. But because the sound in the ventricles is so loud, it drowns out the other sounds…unless there is a problem.

For example, if there’s stenosis (hardening) of the mitral valve, part of the heartbeat is slowed down because it takes longer for the stiff valve to close so that the multiple sounds start to separate. Instead of the normal thump…thump, you hear something that sounds more like thump…pa pa. On the other hand, if you have incomplete closer of a valve, as in aortic regurgitation, you lose the clean thump and get sort of a chortling “woosh” sound as in whoosh…thump. (If you’re interested, here’s a link to more heart sounds.)

Invariably, then, listening to your heart through a stethoscope is one of the fundamental parts of any checkup. It provides the first clues as to the health of your heart.

Note: for those of you interested in coaching your doctor through anything they may have forgotten in medical school, here’s a more detailed tutorial.

The ECG/EKG

When most people think of heart tests, they think of the ECG. ECG stands for electrocardiogram. It’s also called an EKG, from the German elektrokardiogram. Although it may look like an ECG is recording heartbeats, it’s not. In fact, it records the electrical activity (the electrical triggers, if you will) that presage the actual heartbeat. The mechanical beats follow the electrical triggers by about a tenth of a second — unless, of course, there’s a problem. Or to state it in “medicalese,” electrical systole and diastole precede mechanical systole and diastole (contraction and relaxation) of the heart by about a tenth of a second.

The ECG is an important tool for your doctor, but is hardly complete and comes with several limitations.

It’s a static test, which means it doesn’t necessarily identify problems that appear only when the patient’s heart is under stress. An example would be a patient complaining of intermittent chest pain. This might actually be an indicator of a severe underlying problem, and yet a standard ECG could easily read as perfectly normal.

ECG readings indicate only general problems. In most cases, abnormalities in the reading are non-specific as to cause, and in fact, many times, may mean nothing all.

Bottom line:

– A normal ECG reading doesn’t necessarily mean that there is no problem.

– An abnormal reading doesn’t necessarily mean that there is.

– It’s merely a piece of the puzzle that can help point the doctor in a direction.

That said, an ECG provides four primary pieces of information for your doctor.

First, an ECG can show how fast your heart is beating — or more accurately, how fast the electrical activity is moving through your heart. By measuring the intervals between beats, your doctor can determine if the electrical signal is moving through your heart too slow or too fast.

It also shows the strength and timing of the beat. By measuring the amount of electrical activity passing through your heart muscle, your doctor can get an indication as to which parts of your heart are too large or are overworked or if it’s not pumping forcefully enough.

It can provide evidence of damage to various parts of the heart muscle caused by:

– Previous heart attacks.

– Congenital heart abnormalities.

– Diseases such as thyroid problems, rheumatic fever, diabetes, and high blood pressure.

– Inflammation to either the heart muscle or its lining (inside and out).

– Very low or very high levels of electrolytes including calcium, magnesium, and potassium.

– And it can indicate problems with impaired blood flow in the coronary arteries supplying oxygen to your heart muscle.

Reading the ECG

Your doctor performs an ECG by hooking you up to a series of electrodes scattered over your chest, arms, and legs. (Accurate placement is important.) Each electrode reads the same signal, but because of its unique vantage point, provides a different view of that signal. Think of it like watching a speeding train from the front coming at you, from behind racing away, and from the side whizzing by. It’s the same train, at the same point in time, but each vantage point provides very different information about the train.

Here’s a snippet of an EKG showing several electrodes tracking a heart. Notice how the electrodes start providing noticeably different information concerning the same beat about 2/3 of the way through.

All well and good you might say, but what does it mean? How do I read it? Does it mean I’m healthy or unhealthy? Can I run a marathon, or do I need bypass surgery? All good questions.

In order to understand better what your doctor sees when he looks at an ECG printout, let’s focus on a single beat from a single electrode.

Alright, I agree. That’s certainly pretty meaningless at first glance. However, with a little decoding, it starts to make much more sense. In fact, the heartbeat as represented in an ECG breaks down into four primary pieces: the PR interval, the Q wave, the QRS complex, and the T wave. Let’s explore them for a bit. (Refer back to the graphic as needed.)

The PR interval on the left side of the graph shows the electrical impulse for the contraction of the atria, immediately followed by its depolarization (or clearing of the electrical charge to that part of the heart muscle) so it can relax and gear up for the next contraction. As mentioned earlier, the actual contraction of the muscle follows the signal by about 1/10 of a second — in this case during the PR segment.

The Q wave (labeled Q above) is the initial downward (negative) deflection related to the initial phase of depolarization of the ventricular heart muscle. Again, depolarization is preparation for receiving an electrical stimulus.

The QRS complex in the center of the graphic shows the electrical stimulation of the ventricles, immediately followed by their depolarization. Not surprisingly (considering how much more powerful ventricular contraction is), the amplitude of the electrical signal for the ventricles is much larger than that of the atria.

The T wave on the right side shows the repolarization of the ventricles in preparation for the next beat. Note: The ST segment represents the period from the end of ventricular depolarization to the beginning of ventricular repolarization. In English, the T wave represents the recovery period of the ventricle in preparation for the next beat.

Now, if you’ve really been paying attention, you might be asking yourself an obvious question, “Where’s the corresponding T wave for the atria following their PR interval. Don’t the atria have to repolarize just like the ventricles?” And the answer is, “Yes, they do.” Good call there! The problem is that the repolarization of the atria happens during the QRS complex, and because the ventricular signal is so much stronger than the atrial signal, you can’t see the atrial repolarization — kind of like a flashlight turned on during the midday sun. Give yourself a pat on the back for catching its existence though.

And lastly, we have the QT interval. The QT interval is not a separate section, but is a combination of the QRS complex and its following T wave. It represents the time between the start of ventricular depolarization and the end of ventricular repolarization. It is useful as a measure of the duration of repolarization.

So what’s your doctor looking for when she examines your ECG? To put it simply, she’s looking for normal intervals and normal amplitudes in all key segments of the wave. For example:

The PR interval is indicative of the movement of the cardiac impulse from the atria to the ventricles via the atrioventricular node (see The Anatomy of the Heart), which is normally between 0.12 – 0.20 sec (3 – 5 small boxes wide). If the PR interval is greater than 0.20 sec, that’s an indicator that an AV block is present (see Heart Problems).

The QT interval will vary depending on the heart rate, age, and gender of the patient. It increases with bradycardia (slow heartbeat) and decreases with tachycardia (rapid heartbeat). Men have shorter QT intervals (0.39 sec) than women (0.41 sec). The QT interval is also influenced by the electrolyte balance, drugs, and ischemia. Your doctor will be looking for any interval outside the norm.

A QRS interval of 0.04 to 0.10 seconds — no larger than half a large box — and of normal amplitude.

Differences in the sizes of the Q waves read from different electrodes at the same point in time are indicative of previous heart attacks — the differences are usually caused by areas of dead muscle tissue. A trained cardiologist can accurately pinpoint the area of damage according to which leads are producing which signals.

Inverted T waves may indicate ischemia, or low blood flow to the heart.

Deviations in the ST segment can show ischemia and infarction (i.e., lack of blood flow to the heart muscle and dead muscle tissue). In general, a depression in the ST segment indicates ischemia while an elevation indicates infarction.

If you got lost in the last few bullet points, don’t worry about it. The important point is to understand the “kinds” of anomalies your doctor is looking for — not necessarily to identify them yourself.

However, for those of you interested in keeping up with your doctor, here’s a more detailed tutorial.

And for those of you who just want to walk away with something to hold onto, you can use your ECG to easily calculate your heart rate by counting the number of large squares between R waves (the high point in each beat).

1 square = 300 bpm

2 squares = 150 bpm

3 squares = 100 bpm

4 squares = 75 bpm

5 squares = 60 bpm

6 squares = 50 bpm

The easiest way to do this is find an R wave that coincides with the beginning of a large box and then simply count over to the next R wave. In our ECG snippet (two graphics above), we can find such a point in the middle of the graph. A quick count to the right shows 5 large boxes, or approximately 60 beats per minute. Is that cool or what? You can now read a good chunk of an ECG — and without going to medical school.

Seeing the Heart

Listening to your heart and monitoring its electrical activity, may not be enough. Your doctor may also want to see the heart, and there are several ways to do that.

The most basic heart picture is the chest X-ray. Skilled doctors can actually interpret a great deal from an X-ray, but that’s also the problem with the technology — it requires a great deal of interpretation. That means its accuracy, at times, can be less than desirable.

Arteriogram/angiogram

You can think of the arteriogram (AKA angiogram, angiograph, etc.) as an X-ray on steroids. It’s a procedure that uses a special dye (contrast material) and X-rays to see how blood flows through your heart.

An area of your body, usually the arm or groin, is cleaned and numbed with a local anesthetic. An IV (intravenous) line is inserted into the area. A thin hollow tube called a catheter is placed through the IV and carefully moved up into one of the heart’s arteries. (X-ray images help the doctor see where the catheter should be placed.)

Once the catheter is in place, the dye (contrast material) is injected into the IV. X-ray images are taken to see how the dye moves through the artery. The dye helps highlight any blockages (dark areas) in blood flow.

Thallium Stress Test

Sometimes heart problems do not show up during normal activity; they only manifest under stress (i.e., an increased load on the heart). In those cases, an arteriogram won’t reveal the problem. The thallium stress test, then, is used by your doctor to determine whether exercise causes a decreased blood flow to the heart muscle. This test incorporates elements from the ECG, the angiogram, and an MRI. An IV is inserted into your hand and ECG wires are hooked up to your chest. You then walk on a treadmill until you experience symptoms such as chest pain or shortness of breath, or until you are too tired to continue walking. During the whole procedure, your blood pressure and ECG are monitored continuously. Approximately one minute before you stop walking on the treadmill, the thallium is injected. Thallium is an isotope which is “taken up” by the heart and the coronary arteries. (It flows more easily through non-diseased arteries.) You then lie down on a table, and a scanner takes a picture of your heart. Areas where blood can’t flow easily under stress appear dark. (See below, lower left corner.)

The thallium stress test certainly provides more information than a simple ECG. Unfortunately, stress tests do not detect atheromata present throughout the heart or other body arteries, nor do they reveal the vulnerable plaques, which are typically flat against the walls of the arteries and which are the cause of most heart attacks.

Echocardiogram

An echocardiogram uses high frequency ultrasound waves to produce a moving image of your heart. Such an image can help your doctor assess:

– The size of your heart — both the thickness of the heart muscle and the size of the pumping chambers.

– How well your heart is pumping blood.

– Any valve problems: An echocardiogram can easily detect valve leaks and incomplete closure.

– Blood clots or tumors inside the chambers of the heart.

– Any holes in the walls of the heart.

– It’s the same technology used to look at babies in the womb. Check it out.

Full Motion MRI

The big new gun in heart diagnostics is the moving MRI. Recent advances in the technology now allow for full motion images of the heart that can be done quickly enough to even accommodate emergency room patients. This tool is proving to be one of the most accurate heart assessment tools yet.

Sometimes technology really does work.

Conclusion

The purpose of this newsletter (in fact, this entire series on the heart, covering anatomy, physiology, and concluding in this issue with diagnostics) was not to turn you into a doctor. My goal was merely to take away some of the mystery and fear that comes from not knowing what’s being done to you when it comes to your heart. There’s no question that ignorance and the sense of fear and victimization that come with it contribute greatly to both the anxiety and depression so often associated with heart disease and its treatment. Now, though, you should be able to partner to some degree with your doctor when it comes to your treatment — to be proactive, and less anxious.

Keep in mind, there are some doctors who won’t like the fact that you can now ask questions and participate in your own healing — to question a diagnosis or treatment option. Unfortunately, insecurity does not brook a challenge. My advice is to stop working with those doctors. Find a doctor that will work with you. Good doctors welcome informed patients.

And that concludes our discussion of the heart. When we return to our series on the human body, we will take on the circulatory system.

Polyphenol Power: Nature’s Disease Busters

The Degenerative Disease Dilemma

Just about every day, one can always find in the mainstream media, some kind of mention of degenerative diseases: whether its the cause of death of a prominent high profile public figure or a celebrity. Commercials are flooded with specialized treatment care in attempt to manage of what appears to be: a rampant medical scourge of our times. At last count, there have been hundreds of health cases reported, ranging from cardiovascular and diabetes to carcinogenic illnesses. Why hasn’t a real effective cure been found yet?

We are what we breathe

All life on this planet as we know it, uses the essential element of oxygen for proper energy production. Whenever for some reason an anomalous reaction such as ‘oxidation’ occurs, then the damaging effects of toxicity is introduced. Consequently, it is of utmost important, that a balance must be maintained between the toxic production of free radicals, and beneficial antioxidant defense enzymes. It is when when the dangerous free radicals exceed the antioxidant capacity of living organisms, that the degenerative destructive diseases are let loose. Systemic organ injury occurs affecting cellular tissue growth. This resultant consequent damage is known as: oxidative stress.

Oxidative stress: A serious human health issue

As mentioned previously, it is always dangerous when free radicals outstrip the body’s free radicals production capacity. This is especially true under stressful conditions. Physiological systems can undergo profound impactive changes when ROS ‘reactive oxygen species’ occur. This can directly affect cell signaling transduction and modulation. One highly significant byproduct of this reaction is a compound called: peroxynitrite… the most potent rapid non-enzymatic reactions in all of biology and implicated as a crucial pathogenic mechanism or smoking gun in conditions such as stroke, myocardial infarction, chronic heart failure, diabetes, circulatory shock, chronic inflammatory diseases, cancer, and neurodegenerative disorders. Only recently, has oxidative stress been seriously studied as a major etiological agent in catastrophic degenerative diseases.

Polyphenols to the rescue

The fact that mounting recent evidence for ROS or ‘reactive oxygen species’ as a causal disease agent, has caught the real attention of scientists, clinicians and the general public alike, and even more significantly: that antioxidants can in fact, prevent these kinds of diseases and maintain human health. It is antioxidant’s potent defense properties to deactivate and stabilize free radicals..before they wreck biological cellular havoc. Consequently, an interest in naturally occurring antioxidants in foodstuffs has increased. More specifically, the focus of attention has been on an antioxidant class called: polyphenols.

In 2005, the 1st International Conference on Polyphenols and Health, held a symposium with cumulative evidence detailing the strong supportive role polyphenols have in preventing degenerative disorders such as cancer and heart disease. A quote from one of the speakers on cancer


“Polyphenols can also block the action of enzymes that cancers need for growth and they can deactivate substances that promote the growth of cancers,”

And another regarding heart disease:

“Increased consumption of polyphenols has been associated with a reduced risk of cardiovascular disease, and possibly cancer and stroke.”

Polyphenol Food Sources

Clearly, the best way to protect oneself against some of these diseases such as atherosclerosis and others, is to have a diet that is rich in polyphenol compounds. Green tea, cocoa, apples, berries and other fruits can enhance the body’s immune system and safeguarding one’s health. Vegetables such as garlic, asparagus, and carrots and fruits such as pears and prunes also are good sources of polyphenols.

Blueberry Polyphenols and neurodegenerative diseases

Of particular interest, are the polyphenol properties of blueberries and their positive effects on certain brain disorders. A recent study suggests that a diet rich in blueberries can improve motor functions like coordination and balance. Brain plasticity can be enhanced by improving neuronal communication and stimulating neurogenesis. These revelations are important factors in any Alzheimer’s disease prevention and care regimen. It is of paramount importance that neuroinflammation and oxidative stress be reduced in patients with this kind of condition and especially the elderly. Nutritional intervention with blueberries can be a powerful arsenal and valuable asset in the war against age-related neurodegenerative diseases.

Failure To Diagnose Heart Attacks

A heart attack occurs when the blood supply to part of the heart muscle itself – the myocardium – is severely reduced or stopped. The reduction or stoppage happens when one or more of the coronary arteries supplying blood to the heart muscle is blocked. This is usually caused by the buildup of plaque (deposits of fat-like substances), a process called atherosclerosis. The plaque can eventually burst, tear or rupture, creating a “snag” where a blood clot forms and blocks the artery. This leads to a heart attack. If the blood supply is cut off for more than a few minutes, muscle cells suffer permanent injury and die. This can kill or disable someone, depending on how much heart muscle is damaged.

10 Frightening Facts about Heart Attacks: A heart attack occurs about every 20 seconds. Death caused by a heart attack occurs about every minute. Almost 14 million Americans have a history of heart attack or angina. One in 50 heart attack victims are mistakenly sent home by emergency room doctors. Women are the most common victims of failed diagnosis or misdiagnosis of heart conditions. More than 233,000 women die annually from heart disease. Women don’t experience chest pain. Instead, they frequently experience nausea and even vomiting during a heart attack, which leads emergency room doctors to incorrectly diagnose it as a gastric disorder. Emergency treatments are denied or delayed way too often when the heart attack victim is a woman. According to a recent study, women waited an average of 23 minutes longer than men for clot-buster treatments, which can stop a heart attack. Frequently, when a patient is rushed to the emergency room complaining of discomfort, doctors attribute it to indigestion, fatigue, or stress, which delays prompt medical attention. A misdiagnosis or failure to diagnose a heart condition puts the patient as risk for paralysis, stroke, and potentially — death.

Tests to See if You Are Having A Heart Attack

Electrocardiogram (ECG or EKG)

This is a graphic record of the electrical activity of the heart as it contracts and rests.It can often detect areas of damage, inadequate blood flow,heart enlargement, and abnormal heartbeats. The ECG does not always show the damage that is occurring, particularly if it involves the left side or back walls of the heart. In such cases,blood tests or other studies that can “image” the heart’sblood flow are used.

Blood tests

Blood tests are often used to check for “biochemicalmarkers” that are released into the blood within the first few hours after heart damage occurs.In some cases, some of these blood tests can identify “highrisk” conditions in which a heartattack may be imminent.

Nuclear scan

This is sometimes used to show damaged areas of the heart and reveal problems with its pumping action, which is particularly helpful in cases where the ECG does not detect the damage. A small amount of radioactive material is injected into a vein,usually in the arm. A scanning camera positioned over the heart records the nuclear material, which is delivered by the coronary arteries and either taken up by the heart muscle(healthy areas)or not taken up (damaged areas). In particular cases, the camera can also evaluate how the heart muscle as a unit pumps the blood.This test can be done during both rest and exercise.

Coronaryangiography (or arteriography)

This test is used to take detailed pictures of the coronary arteries. A fine tube(catheter) is threaded through an artery of an arm or leg up into the heart.A fluid that shows up on x-ray is then injected,and the heart and blood vessels are filmed as the heart pumps.The picture is called an angiogram or arteriogram. It can show problems such as a blockage caused by atherosclerosis.

Common Heart Attack Misdiagnoses

A doctor’s failure to diagnose or misdiagnosis of a heart attack may occur if the symptoms are confused with another health condition. In our experience we have seen doctors misdiagnose a heart attack as:

*Heart Burn

*Anxiety Attack

*Pneumonia

*Gallstones

*Bronchitis

Another reason why doctors fail to properly diagnose patients with heart attacks is they fail to consider heart attacks in younger patients and overlook how common it is for women to suffer from heart attacks. It is a common misconception that heart attacks in women are rare. However, heart disease actually kills five times more women than breast cancer. Additionally, doctors are likely to misdiagnose a woman’s heart attack as a gastrointestinal condition because women typically suffer symptoms of nausea, while men usually have chest pain.

What Is Medical Malpractice?

The definition of medical malpractice is an act or omission by a health care provider that deviates from what is the accepted standards of practice in the medical community. This act or omission then causes injury to the patient. Medical malpractice is basically professional negligence by a health care professional that leads to an injury or complications on the part of the patient. In a medical malpractice suit there is the plaintiff and the defendant. The plaintiff is the patient or the family of the patient while the defendant is the health care provider. For a case to meet the medical malpractice definition the plaintiff must be able to prove their case. Some of the things that the plaintiff will need to prove include:

*A duty was owed by the hospital or health care provider.

*The duty was not acted upon. In short, the provider failed to provide the standard of care.

*The breach of duty caused an injury to the patient

*Losses. The plaintiff must be able to prove that there were damages, otherwise a medical malpractice suit is not applicable even if the provider was negligent.

If you or a loved one has suffered serious injuries, or even death, as a result of being misdiagnosed by a doctor, please do not hesitate to contact me directly at 516.358.6900 or RJaffe@lcjLawFirm.com

Heart Disease: Tips to Avoid the Number One Killer

Let’s face it; the subject of heart disease should terrify anyone. What most people don’t know is that heart disease can affect individuals at a young age. For most people who reach forty this is a subject to consider in order to maintain good health.

There are two ways to understand this problem that affects millions of people in the world. First is how is the disease treated, and the second part and even more important point, is prevention of the disease from the start!

How do doctors treat me if I’ve already developed heart disease?

This is by far the more scary of the two subjects; treatment versus prevention. As treatment implies, you already have the disease. How is heart disease treated becomes the main focus.

Today, doctors have several ways of analyzing the situation and determining the course of treatment. A blood lipid panel is the most basic starting point. The next step can include a stress test to determine the degree of coronary blockage and how the heart is working.

The stress test is only accurate in determining blockage somewhere in the sixty percent range. As a backup to the stress test, often a cardiologist will recommend doing a test that involves what is called nuclear medicine.

In this procedure, a tiny amount of isotope in injected into the blood stream. What this does is determine how heart disease is treated by revealing in great detail the degree of coronary blockage from inside the heart. This test while sounding scary is actually very accurate. I can attest to this from personal experience!

What other measures are available for treatment of heart disease?

Assuming the tests have determined that you are indeed suffering from heart disease, another treatment option is to insert a stent into one or more arteries to effectively re-inflate the artery in order to increase blood flow. Obviously this is more intensive and is usually in lieu of a complete surgery to repair damage.

The drawback to this option is that over time the stent wears out and the procedure needs to be repeated again. This can be emotionally as well as physically draining.

Are there options to reverse heart disease?

Depending on the degree and type of heart disease, there are options available to help reverse early stage heart disease. In order to reverse damage to your heart, your doctor may recommend a regimen of statin drugs that reduce cholesterol which is the main cause of coronary blockage.

Your medical team also has clot buster drugs at their disposal. These meds are given through the veins and referred to as thrombolytic therapy to break up blood clots in the coronary artery. These are effective steps to reverse heart disease assuming that reversal is still a possibility.

Aspirin therapy is also another option in a whole range of measures to reverse heart disease. Nobody should think that simply popping an aspirin at home is going to reverse heart disease by itself; but there are many benefits to taking a low dose aspirin on a daily basis.

Prevention of heart disease

We have saved prevention for last to illustrate the entire trauma that can be avoided by simply making a few lifestyle changes. Better to avoid the problem completely by getting moderate exercise on a daily basis, and eating a healthy diet including the benefits of Omega 3 fatty acids!

By avoiding saturated fat in animal fat products like too much red meat and dairy products, and eating more Omega 3 rich foods like vegetables and fruit, you can lower your cholesterol. Remember, cholesterol is the number one contributor to heart disease!

The fatty acids contained in Omega 3 fish oil include DHA and EPA. These fatty acids fight bad cholesterol by promoting HDL cholesterol or the good cholesterol at the expense of the bad cholesterol known as LDL.

So powerful is the efficacy of treatment with Omega 3 fish oil in combating bad cholesterol, that in Rome, at the San Filippo Neri Hospital, heart attack patients are given fish oil rich with DHA and EPA Omega 3 fatty acids as a standard regimen to reverse bad heart health.

Diets rich with Omega 3 fatty acids are one of the primary ways to avoid heart disease from ever developing in the first place. Remember we are what we eat.

Conclusion

Now that you know the facts, doesn’t it make sense to avoid poor heart health by taking preventative measures starting from today onward? The single best way to take care of your heart is to eat a healthy diet and watch your weight while making sure to consume healthy Omega 3 fatty acids. What are you waiting for?

German Cockroach Infestations

The German Cockroach (Blattella germanica)

What does a German cockroach look like?

They are brown with two dark stripes on thorax, they have wings that are body length or that slightly overlap in both the male and female cockroaches

Is it true that cockroaches carry disease?

Yes. Although there is no clear-cut evidence to implicate cockroaches with outbreaks of infectious diseases, some disease organisms which cockroaches have been found to be carrying include the following:

  • Salmonella – which causes food poisoning in humans
  • Mycobacterium tuberculosis – which causes tuberculosis
  • Entamoeba histolytica – which causes amoebic dysentry
  • Escherichia coli – which causes gastro-enteristis
  • Ancylostoma sp. – Dog and human hookworms
  • Taenia sp. – Tapeworms

How do you know if you have a cockroach infestation?

Cockroach marks:These are liquid excreta produced by cockroaches when water is readily available. The marks are usually brown, irregular in shape, often in the form of streaks and usually much larger than the circular marks left by the house fly.

Faecal pellets: These are produced when the is less water available (instead of liquid excreta) and usually found by wall-floor junctions where cockroaches tend to move along. The pellets are less than 2mm long and are usually brown or black.

Egg cases(oothecae): The empty egg cases of the German cockroach are often hidden in harbourages, unhatched oothecae are rarely found as they are carried by the female until just before they hatch.

Live Insects: Live or recently dead adults or nymphs trapped on insect detectors may help provide clues to the extent of the infestation.

What is the most favorable condition for German cockroaches?

The German cockroach species prefers hot and steamy conditions, thus the perfect place for them to infest would be around kitchen equipment, sinks, around water pipes and radiators, behind wall tiles, and in fridge and freezer motors.

How can German cockroaches be prevented?

The ERDM Principal can be applied to treating cockroaches. ERDM stands for: Exclusion, Restriction, Destruction, Monitoring

Exclusion: Prevent cockroaches from gaining access by inspections of laundry, deliveries, new appliances etc

Restriction: Good housekeeping, cleanliness and proper waste management will prevent a food supply for cockroaches

Destruction: Use of insecticides, fumigation and insect detectors

Monitoring: Constant monitoring to make sure that there is no further infestation

Winter Lawn Care Tips

Winter draws in and the days of relaxing in the sunshine on your beautifully manicured lawn are a distant memory, replaced by the sight of wet, cold and soggy grass and leaves and the nagging thought that you should be doing some work – maybe our winter lawn care tips will help. It is not too late to spend a few hours ensuring your turf survives in the best way and comes out fighting when spring finally arrives, heralding a new year of fresh growth.

We will cover what you should be doing in the five main areas of lawn care as well as a final top tip for anyone considering laying a new lawn in the spring.

Tip #1: Mowing

As autumn turns to winter and before the first snowfall hits, it is time to start dropping the height of your mower blade to take off any of the final young growth of the year. This young grass is less robust than the crown at the base of the plant and is easily affected by snow and frost which can lead to winter diseases finding an accommodating home.

Mowing back this young growth can be done gradually over a number of weeks to minimize the shock to the turf.

Throughout the rest of winter, the grass becomes mostly dormant and only in extended periods of milder weather will the grass start to grow and may need a very slight trim to keep it in check. If so, raise the blade height up to just cut the tips.

Tip #2: Feeding

Generally, the advice here is to not feed your lawn over winter. The turf is in a state of almost hibernation over the cold period and isn’t putting any new growth out as it is too vulnerable to the weather and winter diseases that can attack damaged and broken blades. Spring and summer nitrogen based feeds will cause the grass to sprout. If you are preparing for the spring and must feed, there are some potash and phosphorus based fertilizers specifically designed for autumn and winter can encourage healthy growth. These specialist winter lawn fertilizers are available from normal outlets.

Tip #3: Aeration

After a summer and autumn of hard use, some parts of your lawn may have become compacted. As discussed in the lawn aeration section, a healthy lawn needs to get air, moisture and nutrients down to the roots so a light session of aeration before the first snows and frosts come can help prepare the turf for winter and the coming spring. Simply walk it with some lawn aeration shoes or use a hollow tine or drum aerator for larger lawns to break up the soil.

You will notice that worms are relatively inactive in the winter as they head deeper away from the cold. When you start to see the worm casts appear in spring you know it is time to get ready to spruce the lawn up again as winter is ending.

Tip #4: Scarifying

The continuous damp weather of winter is the ideal breeding ground for many diseases that can effect your turf. Clearing moss, leaves and other debris before the first snows and frosts and then keeping the turf as clear as possible can minimize these issues and leave the grass ready to spring back in the new year.

Tip #5: Watering

As with feeding your lawn over winter, you shouldn’t need to water it either saving another chore. The grass will slow down its requirements for water and food and as it effectively hibernates through the cold patch, storing its energy in the base of the blade and the roots. If it has been a very dry autumn before, water well when the snows and frost clear in early spring to maximize the turfs ability to bounce back.

Tip #6: Preparation for a new lawn

If you are preparing to lay a new lawn in the spring, breaking the ground up in the winter is a great way to get the earth loosened up and full of air pockets. As moisture seeps in between the grains of soil and then freezes, the water expands as it becomes ice and forces the grains apart splitting any stubborn, hard clumps of soil. Prepared this way, you start the new year with a well aerated, loose soil perfect for early seeding and saving you a lot of backbreaking work.

Summary

Winter is a great time to sit back and leave the lawn be as the natural processes slow to a minimum and the inclement weather keeps you indoors. After you have prepared the turf for the new year with our winter lawn care tips, it is the perfect time to contemplate next years tasks and sit back and learn with a lawn care book!

Benign Vs Malignant Tumors

When you notice an abnormal growth in your body, it can be frightening. Unregulated cell growth produces a mass called a tumor, which can press on other areas of your body. There are two types of tumors: benign and malignant.

Our bodies naturally produce new cells. In fact, during the course of a year, we replace almost every single cell in our bodies. The frequency of this turnover depends on the location. For example, stomach cells divide rapidly because of the wear and tear they receive from stomach acid. However, normally cells die off as new ones replace them in order to keep our body at a normal size. Sometimes, though, this growth can become unregulated and lead to a mass of cells.

Proteins in the body tell cells when they should grow, double their chromosomes, and divide into to distinct cells. In somatic cells, or the cells of the body besides egg and sperm, this process is called mitosis. Because each cycle of mitosis leads to one cell becoming two, this growth can quickly accumulate if unrestricted.

Cells lose the ability to regulate growth if their genetic information is mutated, or changed, due to exposure to carcinogens like radiation or asbestos. This mutation can lead to two different types of tumors, benign and malignant. The form of the tumor depends on the type of growth that it undergoes.

Benign tumors cause an estimated 13,000 deaths each year in the United States, even though they are not cancerous. Benign tumors are basically areas of extreme cell growth, although this can happen at a slow rate. The group of cells proliferates, but does not metastasize to other parts of the body. They are usually not harmful. Doctors may decide to wait on a benign tumor to see if it will continue growing, or they may remove the growth. Often, the tumor does not return. However, benign tumors can hurt someone when they press against organs, blood vessels, and nerves in the area.

Malignant tumors are the type associated with cancer. Cancerous tumors have the ability to metastasize. This means that they can break off into pieces and spread throughout the body. Once they adhere to a spot inside the body, malignant tumors have the ability to harm the body not only by pressing on nearby tissues, but also invading them and interfering with their normal tasks. Additionally, they can contribute to infection in healthy tissue as well as secrete substances that kill off the normal tissue.

Some malignant tumors can be caused by exposure to asbestos. Asbestos that is ingested or inhaled can lead to two types of malignant tumors, mesothelioma and lung cancer. Mesothelioma has the ability to spread throughout the body by attacking the serous linings of the body.

If you or someone that you know has developed malignant mesothelioma due to illegal exposure to asbestos, you should speak to a lawyer about your rights. For more information, talk to a mesothelioma attorney at the firm of Williams Kherkher today.

How to Get Rid of a Cold Sore Fast at Home – Tips to Help You Look Better Sooner

Cold sores come with their own unique set of symptoms. The redness, swelling and pain of a cold sore are unmistakable. It’s hard to hide one on your lip and most women will attest to the fact that make up doesn’t even help. If you have a fever blister right now and you want it gone as soon as possible, then you definitely want to know how to get rid of a cold sore fast at home. You may be surprised to find out that some simple items can bring fast and effective relief to a fever blister.

When you are thinking about how to get rid of a cold sore fast at home ice might not have crossed your mind. Ice is ideal to help take down the swelling that often accompanies a fever blister. Simply wrap an ice cube in a soft cloth and apply it directly to the fever blister for a few minutes. Be certain to put the cloth in for laundering right after you’re done as the virus is so contagious and you don’t want to risk infecting anyone else.

When it comes to how to get rid of a cold sore fast, don’t overlook the power of regularly applying a good quality lip balm. Lip balms work great for helping to keep the area around the cold sore moisturized. If this skin becomes too dry it can make the fever blister burn and itch even more. The moisturizing ingredients in the balm can help heal the sore faster than if you left it completely uncovered. Be certain to toss the lip balm into the trash once your cold sore begins to heal. Using it over again may result in a new sore popping up.

A milk compress is another way to treat a cold sore fast. Soak a piece of gauze or a cotton ball in milk and then apply that right onto the area. Hold it there for several minutes and you can do this a few times a day. It will help to soothe the area and relieve some of the pain and redness. Again, you’ll want to discard the compress as soon as you’re done using it to avoid spreading the virus.

The Interesting History of Sunrooms

But then, someone came up with the bright idea of enclosing an area at the front of the house so that such a pleasure could be indulged in even when the weather was not so kind. And of course, there was the problem of mosquitoes and bugs. The earliest sunrooms were simply porches, some of which were given removable or opening and closing windows to allow air to enter the room and give some degree of control over it.

But the sunroom really came into its own when some clever designers studied the beneficial effects of greenhouses on plant growth, and decided they could devise a way of harnessing those same effects for our therapeutic benefit.

Once this was realized, hospitals quickly caught on to the idea of having a bright, airy space where patients could sit and relax while getting the benefits of feeling the sun. Doctors often advised patients suffering from a range of ailments, including   pleurisy  and even the common cold, to spend time in these rooms, and the patients certainly weren’t about to complain about the thought of getting out of their hospital bed and spending some time basking in the natural heat and light of the sun!

As adding to and improving our homes has become easier and more cost-effective, the appeal of an area of the home which brings together the best parts of indoor and outdoor living has grown massively.

All this means that a sunroom is today expected to be much more than just a place for relaxing. It’s a true extra room, and is expected to do the same work as all others in our homes, be that functioning as an office, games room, children’s playroom or observatory.

In short, a sunroom is our own little backyard haven, and its design and role are as individual as our own homes. When you’re ready to add a sunroom to your home, make sure your first call is the online resources. We can find the most suitable company in your area to carry out your sunroom project, taking care of the legwork for you, and leaving you to plan your new addition around your lifestyle.

Choosing Proper Winter Clothing

Most people prefer winter clothing versus summer clothing. Apart from the weather condition itself that people enjoy, winter clothing is much fashionable than any type of clothing. It includes sweater, coat and jersey which are made up of different colors and designs that show individual personalities.

In cold countries, people wear and like two types of clothing garment namely wool and velvet. Coat made of wool can keep you warm in cold season. Wool is a type of garment that can be worn by anyone regardless of the age and gender. There are hundreds of styles and designs that can be created out of wool. Velvet is the most popular garment that is used by fashion designers in order to create new fashion clothing. It is soft and easy to use for clothing. The best qualities of velvet which differentiate it from the rest of the garment are the soft texture and rich appearance. Velvet provides us different colors that can make us appear stylish. Wool and Velvet are indeed designed for cold weather conditions apart from giving you the fashionable style.

Winter can push a child in catching chest problems such as pneumonia due to inappropriate or less quality garments. Due to the sensitivity in seasonal changes, it is important to cover the children otherwise they might catch cold to the very least. Thus, it is also important that children are dressed up in comfort as they often pass their time in playing.

One of the perfect types of winter clothing is snow suit. It is made to provide the body warmth necessary to fight cold weather. It creates a warm layer inside which does not allow the cool air to penetrate. A child can remain safe from the cold winter season by using snow suit. It is best for children of age between 6 months to 10 months. Water proof jackets are best for children in order to prevent snowflakes or rain drops. Winter jackets should be worn with bonnet which keeps the body completely comfortable and warm. By ensuring proper clothing is worn, especially for children, the body is protected against the harmful elements of the winter season.

Wearing of boots is also a usual thing for us during winter season. It protects your feet from freezing. Most boots would have a sole that is designed to create friction when you walk on a slippery snowy ground. Winter hand gloves should also be included on your list of protection against the cold night. Our body’s appendages are susceptible to freezing hence should be covered when outside.

There are a lot of usual choices in winter clothing. Whatever keeps you warm should take care of protecting the body. Let us consider prioritizing health and safety by ensuring that we are properly dressed for the night. We can make that happen by choosing the best quality of clothing. Consider it an investment to always go for safe yet fashionable winter attire. It only happens quarter of the year. Enjoy your winter!

Basics of COPD Treatment

Unfortunately, there is no cure for COPD, or chronic obstructive pulmonary disease, and no way to reverse damage it has already caused in the lungs and airways. However, treatment for COPD is available, and a number of therapy options can relieve symptoms, and more importantly, slow the progression of the disease.

If you have chronic obstructive pulmonary disease, your doctor will set several goals for treatment. They include the following.

  • Stop or slow the progress of the disease and the lung destruction it’s causing.
  • Improve lung function.
  • Reduce the number of COPD exacerbations. An exacerbation is considered to be a worsening of symptoms.
  • Improve overall quality of life.

The first and most critical step in COPD treatment is to get the patient to stop smoking. There’s no doubt that smoking causes far more cases of COPD than anything else. Unless the patient gives up the habit, there’s little chance of a successful outcome to treatment.

A number of medications are available that reduce chronic obstructive pulmonary disease symptoms. These can be effective with shortness of breath and fighting respiratory infections. These include bronchodilators, corticosteroids and antibiotics.

Bronchdilators are usually the first step in treatment of COPD. Bronchodilators relax the muscles around the bronchi, which are the air passages leading to the lungs from the throat area. This permits easier breathing.

Medications called anticholinergics are usually given through inhalers (known to COPD patients as puffers). This treatment usually works for four to six hours. There are minimal side effects, although one often-prescribed anticholinergic drug, known as ipratropium bromide or Atrovent, can cause coughing and nervousness.

Beta 2-agonists offer another COPD treatment option. These work through the nervous system. Beta2-agonists cause the air passages to expand, allowing for better air flow. There are two types: Short-acting and long acting.

Some bronchodilators combine the benefits of anticholinergic and short-acting beta2-agonists. These are known as combination bronchodilators. They work by acting on the part of the nervous system that controls airway size and muscles around the airways. This can be more efficient than either component alone. There could be some side effects though, including bronchitis, upper respiratory tract infections, and headaches.

A bronchodilator called theophylline can be taken orally. It affects muscle, heart, and various other components and systems of the body. Theophylline opens the airways, improves muscle endurance and reduces muscle fatigue. It used to be the most prescribed treatment for COPD, but this is no longer true because it has more side effects than newer medications. There is still an option, but mostly for those patients who can’t use aerosol therapy. Side effects may include nausea, vomiting, headaches and insomnia.

Corticosteroids are still used sometimes for COPD treatment, but they’re only appropriate for a small group of COPD patients. Corticosteroids improve lung function for about 1 in 10 patients. They’re prescribed more frequently for asthma, and they may have side effects which include upper respiratory infections, headaches and pharyngitis.

Antibiotics may have some value as a treatment of COPD where the patient has an acute bacterial infection of the respiratory tract. They can also be helpful in the treatment of COPD exacerbations when there are symptoms of an infection such as fever or cough.

Oxygen therapy is another way to treat chronic obstructive pulmonary disease symptoms. A number of devices are available that provide concentrated oxygen to COPD patients. This lengthens longevity in those with advanced COPD and severely reduced oxygen levels in their blood. Oxygen therapy is most effective when done around the clock, but using oxygen 12 hours a day also has benefits. Oxygen therapy may also improve problems with dyspnea, or shortness of breath.

This article has been intended for those who wish to obtain a basic and purely introductory knowledge of COPD treatment. Your best source of information on COPD treatment is, naturally, your doctor or a respiratory specialist of your choice.

Domestic Violence Abuse – What Is Domestic Violence?

Clare is an upper middle class suburban semi-retiree, enjoying a second career of loving and promoting art. She thought that domestic abuse was about hitting until the day she awaken unto the fact that her marital pain was due to psychological and emotional abuse.

She had no idea that the day in and day out mental manipulations and twisting of her heart strings was all about psychological control. The emotional dependency cultivated in her relationship blindsided her to the personal oppression and financial abuse ahead.

Clare never thought of herself as a victim of spousal abuse. For crying out loud, she was an educated woman of means who had never been hit by a man or even called a…(you know what). And then, a friend rooted in the domestic violence literature informed her otherwise. It was indeed a wake-up call to learn that her inner crippling was clearly domestic abuse.

Hitting As the Icing on the Cake

I’d never have to practice my profession again if I had a dollar for every person that told me that they thought domestic violence was about getting hit. Most people believe that the “black and blue” defines domestic violence.

There is certainly some truth to this belief in law enforcement. For example, when the police show up at your door, the first thing they look for is “actual” evidence. That is a sign of one party injured by another. Is there a scratch, bleeding tissue, a developing bruise, broken bone…a dislocated jaw? These are the things that constitute and substantiate domestic violence when the cops come to your door.

But this, my friend, is not domestic violence. This is the manifestation of domestic abuse. You see domestic abuse is all about control. When the intimate partner abuser senses he/she is losing control over their partner, violence will escalate so as to re-establish their power and control.

Domestic Abuse Violation

Now, the tricky word her is “violence.” By this word, most people see black and blue and all the physical violations associated with it. Don’t stop looking here.

It is definitely true that physical violence does indeed escalate over time in an abuse dynamic. And it is also accurate that emotional and verbal abuse can progress into physical violence with the escalation of intimate partner abuse.

But, the point I wish to make here is that domestic violence, whether emotional, verbal or physical is about escalating violations intended to exert control within an intimate relationship. It can begin with an emotional threat of abandonment, or a character assault of one’s very person, appearance or their sexuality. Or, it may be the covert grooming of a gross distortion of your belief about past facts for the very purpose of confusing your present.

It doesn’t even have to be about name-calling or telling you that you are ugly or stupid, as Clare thought when told that she is a victim of domestic abuse. It can be the intentional mental manipulations of “gas-lighting” in which you are conditioned to believe your reality is something other than what it is. Or, it can be that your assets are dissipated without your knowledge or consent, as was the case for Clare.

Intimate Partner Abuse

If you are wondering if you are a victim of domestic abuse, take a hard and fast look at the core characteristics of intimate partner violence. Is your partner outrageously possessive, controlling, excessively jealous, non-empathic toward your experience, hypersensitive, manipulative and unreasonably demanding. Does he/she isolate you from all other sources of support beyond which he/she controls? And does your partner consistently blame you for the mishaps between the two of you?

If this description resonates with you, wake up, as Clare did, because you are another vulnerable, invisible domestic abuse survivor.

Knee Dislocation Surgery

 Dislocation  of the knee or more specifically the patella is a common knee injury that is typically caused by a sudden trauma in the form of a twist or direct hit on the knee, causing the patella to pop out of its usual position in the femoral groove towards the end of the femur. Knee  dislocation  will be accompanied by a sudden acute pain followed by periods of immobility leading to disability. In order to treat it, open or arthroscopy surgery will be required to repair the damages.

Almost immediately following injury, the extent of injury will be unable to be determined accurately due to the swelling and pain present. Therefore, surgery will not be recommended until a few weeks later. In the mean time, physical therapy will need to be performed in order to strength the thigh and quad muscles to provide a better support and prevent muscle wastage. Once the injured knee is strengthened and swelling has subsided, knee  dislocation  surgery can then be carried out and there are many types out there:

Bone realignment

In mild cases where the extent of injury is not severe and there is not much damage to the ligaments and tissues, bone realignment may be all that is needed. The tibial tubercle which is at the shin bone will simple have to be shifted and this will cause the position to be pulled towards the inner part of the knee.

Lateral Release

Lateral release is a common type of knee surgery performed to stabilise the patellar. When the knee is dislocated, it pulls the knee cap to the outside of the knee. Lateral release surgery seeks to cut the retinaculum in order to centre the knee cap back into the grooves.

Reefing

Reefing or medical imbrications is a surgical procedure performed with the intention to tighten the soft tissues that are located towards the inner portion of the knee. It is often done in conjunction with Lateral Release with the latter loosening the exterior part while the former tightening the interior part.

Trocheleoplasty

Trocheleoplasty is a less common surgery which works by deepening the grooves on the femur for the patellar. This will require the removal of some bone and increasing the depth of the grooves in which the patellar can then be held firmly in place with the aid of biodegradable stitches which will be reabsorbed into the body after a period of time.

Patellar  dislocations  can still happen after surgery but this is less than 5% of all cases. Patients are usually able to return to pre-injury level of activities after a couple of months if a disciplined recovery plan is followed religiously.

Bone Fracture

A bone fracture occurs when a bone, anywhere in the human body, is cracked or broken. The break affects the continuity of the bone itself and also causes mild to severe pain at the break and throughout the body. Bone fractures are caused by a few different factors. They are a high-powered collision, osteoporosis or certain kinds of cancer.

There are two types of fractures; open or closed. An open fracture is broken skin with a piece of the bone exposed. A closed fracture is still a broken bone but without exposure through the skin. An open fracture is the most dangerous fracture because there is a likelihood for the exposed bone to become infected. Treatment for an open fracture comes in the form of antibiotics and surgery. During surgery the doctor will clean the infected area and remove any dirt, contamination and the dead tissue.

Fractures can also be simple or multi-fragmentary. A simple fracture is a break of a bone in only one place; splitting the bone into two sections. A multi-fragmentary fracture is a break that splits the bone into more than one piece.

There are complete fractures, where the bone fragments completely separate during the injury or an incomplete fracture, where the bone does not come completely detached. A spiral fracture is one in which one part of the bone has been twisted during the injury and a compacted fracture is when bone fragments are forced into each other during an injury.

The healing process of a bone fracture is very important to a patient. The healing process gets underway when the injured bone and surrounding tissues begin to bleed. A blood clot is formed between the broken fragments and new blood vessels begin to grow in the area of the clot. The new blood vessels bring in white blood cells which remove any non-viable material from the area. Collagen then replaces the blood clot, which allows bone to move slightly. Now, there are crystals that begin to form in between the bones, which turns the collagen into new bone.

Healing the bone in this way can sometimes take up to 18 months but adults are already 80 percent healed after only three months. Patients with bone fractures should avoid nicotine usage during the healing process while having an adequate intake of calcium will aid the healing process.

Treatment for bone fractures come in different forms. Doctors will stabilize the break by placing a finger or hand in a splint, placing the broken bone area into a fiberglass cast, snapping the bones back into place or using screws, nails, or plates to hold the bones together if the fracture requires surgery.

Bone fractures are not the most dangerous problems patients could deal with health-wise since they are so easy to treat and not difficult to heal. Bone fractures can be dangerous if they are an open fracture and not taken of properly. An infection could cause deterioration of the bone and require major surgery. Bone fractures can be easy to treat if taken care of properly.

Casual Mandy Moore Hairstyles Tips

Keeping up with different Mandy Moore hairstyles can be hard, since she loves to change her hair almost every time the season changes. She has gone from golden blonde to dark brown, from long hair down her back to a razor cut short style, and then back again. She is well known for her long, beautiful locks, but she loves to change her style frequently in order to bring out certain characteristics with each different style.

One of the most common Mandy Moore hairstyles is the short pixie cut, which she normally wears in a dark golden brown. It is easy to maintain since it can be worn in a number of different ways, depending on each individual occasion. Her hair falls just around her ears, making it easy to tuck it behind when wearing it down for a more casual look. Cute pins or clips can be use to pull back top sections for a more fun look, or it can be curled for some added sophistication. Spray gel or wax can be used to add some definition to the ends when wearing it down, for a more punk look that is both fun and flirty.

Mandy Moore is also well known for her long and beautiful hair, which she loves to wear in a number of different styles. She normally wears her hair in a more natural, un-maintained style, which makes it look both soft and gorgeous. She can use a curling iron to add some volume when her hair is down, and sometimes she likes to pull back the front of her hair to draw attention to her face and collarbone. Bangs can also be worn with the many long Mandy Moore hairstyles, and they look great straight down or swept to the side.

Mandy Moore has gone from a blonde, to brunette, back to blonde, and then brunette again. The different colors work to strengthen certain characteristics, and certain colors look better with certain styles. Mandy Moore’s dark hair helps to make it look thicker than it actually is, but her wispy hairs in the front still leave it looking soft and healthy. The blonde actually helps to bring out her flawless complexion, and helps to make her glow during the summer months. There are many different Mandy Moore hairstyles that can be easily maintained, all they all work great to cover up flaws and bring out other characteristics.