Symptoms of Heart Disease

Heart disease or cardiovascular disease is the leading health problem in the Western world today, claiming more than one million lives annually. Heart disease is when the heart and blood vessels fail to maintain the minimal amount of blood circulation throughout the body due to the narrowing of blood vessels. Cardiovascular Disease is a major concern in almost every family today, as nearly everyone has been touched by the traumatic events following a Heart Attack of a family member.

Heart health contributes to health longevity because it affects not only the body but also the mind, and therefore has a long-term role in anti-aging.

Different Types of Heart Disease:

Coronary Heart Disease

Myocardial Infarction (heart attack)

Congestive Heart Failure

Heart Valve Disease

Angina

Coronary heart disease, or coronary artery disease is the accumulation of fatty deposits along the coronary arteries. The fatty deposits may have developed in your childhood, and continue to thicken and enlarge throughout your adult lifespan. That thickening narrows your arteries and can decrease or block the flow of blood to your heart.

Symptoms may include heaviness, tightness, pressure, and/or pain in your chest..

A heart attack, or myocardial infarction, occurs when your heart muscle experiences a severe or prolonged lack of oxygen caused by blocked blood flow to the heart muscle.

The blockage is often a result of a build up of cholesterol and other fatty substances, which obstruct the flow of blood and oxygen to your heart, thus reducing the flow to the rest of your body.

If the blood and oxygen supply is cut off severely or for a long period, the muscle cells of your heart may suffer damage and even die, the result of which is dysfunction of the muscles of your heart in the area affected by the lack of oxygen supply.

Symptoms may include

Severe pressure, fullness, squeezing, pain and/or discomfort in the center of the chest that lasts for more than a few minutes

Pain or discomfort that spreads to the shoulders, neck, arms, or jaw

Chest pain that increases in intensity, not relieved by rest. and/or sweating, paleness, shortness of breath, nausea or vomiting, dizziness or fainting, weakness or fatigue.

Indigestion, bloating, burping and irregular pulse.

Congestive Heart failure is another type of heart disease. It is when the heart is not supplying the other organs of the body with enough oxygenated blood, and can be the result of high blood pressure, high sodium intake, heart valve disease, previous heart attacks ,to name a few.

Symptoms include:

weight gain,

swelling of legs and ankles,

shortness of breath,

fatigue,

loss of appetite

nausea,

persistent cough.

Yet another type of cardiovascular disease can be the result of malfunctioning heart valve.

When the heart valves malfunction, it prevents the flow of blood in and out of the heart. This is called Heart Valve Disease. This can be due to damage from a previous heart attack.

Symptoms include:

chest pain,

palpitations,

shortness of breath,

fatigue,

migraines and dizziness.

Angina is when a part of the heart is not receiving enough blood. It is identified by recurring chest pain. It is a symptom of coronary heart disease.

Symptoms include:

squeezing or crushing pain in the chest,

pain in the arms, shoulders, jaw, neck and back.

Heart health contributes to health longevity because it affects not only the body but also the mind, and therefore has a long-term role in anti-aging.

Doctors must diagnose correctly if one is to receive proper and beneficial treatment for heart disease. Some common methods for diagnosing heart disease are, electrocardiogram(EKG), where a set of sensory pads are placed on strategic areas of your chest and a record of the heart’s beating patterns are recorded.

Another method is the Stress Electrocardiogram(Stress EKG), where one is put under physical stress , like running on a treadmill, where abnormalities in the beat of the heart are recorded.

Angiocardiography is another method which is used to diagnose the condition of the arteries. A catheter is inserted into the artery and dye is released into the blood stream. Blockages and other abnormalities are discovered on a monitor, by observing the dye flowing through the arteries.

It is always best to have a heart check up every year as part of the normal annual check up regardless of age, as heart disease can strike at any time.

Life After a Severe Heart Attack – Can You Safely Have a Normal Work Life?

Once you have had a severe heart attack your outlook and your life undergo many radical changes…or at least probably should. While you cannot do anything about the genetic component of your vulnerability to heart attacks there is a great deal you can do about the lifestyle part. Before I go on, allow me to introduce myself so that you know who is writing to you. My name is David Herman and I am not a doctor by any stretch of the imagination. I have no medical credentials at all. In fact, the only qualification I have is that I am living this myself. Everything in here is simply my experience and my opinion. It is my sincere desire that my words help you in some way but please do not wander off the path set by the professionals around your case or set by your own good judgment. I had a severe heart attack at 44 years old, resulting in a fair amount of permanent heart damage. My career, while something I loved to do, was highly stressful, required very long hours for success and the lack of time and focus available for other areas of my life left me very off balance, alone, unhealthy and vulnerable to a heart attack. I did not know or feel any of that at the time. All I knew was that I was doing well in my career and working to build a solid future.

Then, out of the blue (not really but it felt that way to me at the time), heart attack! As the days after stretched on, I was not initially getting any stronger and the medication side effects seemed to weaken and scatter me even further. I simply had zero ability to do my work and when I tried, up shot the blood pressure and on came the pressure and pain in my chest. This situation was not exactly in line with the demands of my work. Within a month or two I had lost the vast majority of my clients. They were nice about it but they moved on to consultants that could produce what they needed when they needed it. I do not blame them. Quite frankly I would have done the same back then.

I was very tempted to reduce or remove the medications that were interfering with my energy, memory and ability to focus. However, these are the same medications that are protecting my heart from further damage! In the end, I turned out to be smart enough to follow my medication plan to the letter (and activity plan and diet plan but those are not part of this particular set of musings). It was then and is now my intention to live out a long and fulfilling life both personally and in my career and there is no way I can do that if I am not alive or if my condition deteriorates in any area over which I have any control.

So, before I finally get to the purpose of this letter to the world, let me just say this. It is hard to follow the doctor’s recommendations on diet and activity. It is hard, and expensive, to follow the medication directions (especially when they turn you into a zombie part of every day) but DO IT! It is worth it in reduced vulnerability to further trouble and it is worth it in allowing your body to heal what it can. The side effects of the medication can be overcome with some discipline and reordering of how you conduct your life. And as far as food and activity, we all should be following those recommendations even if we don’t have a heart attack. They are simple and healthy. Give up the crap food and follow the doctor’s orders and the cardiac rehab therapist’s exercise plan.

Back to the question of how to safely continue your career after suffering from a severe heart attack…

Take a good hard look at what you have been doing for a living and see how it lines up with the new requirements of your life. In order to heal and recover as quickly and completely as possible the work component of your life should be flexible enough to allow you to produce when you can and rest when you must. Your work also will need to be something you feel good about, or at least not bad about. Your healing won’t thrive in a negative environment, especially an internal one. Last, you need work that allows you to maintain the balance in your life and spend time with people you love and who love you. Let’s take a closer look at these to enable you to see how your current work lines up or could be made to line up and so that you understand why these are important to your life now (they actually always were but now you need them a whole lot more!).

The first characteristic of your work that you need now is flexibility. You need to be allowed to produce when your mind and body are in gear and allowed to rest when your blood pressure is on the rise and you are fatigued or scattered (and in some jobs that is just plain dangerous in its own right). To a small extent you can schedule when you take your medications (with your doctor’s approval) so that your strongest side effects are at times when it is okay to be the least productive. However, that is not much of a solution and if you are anything like me at all in your reaction to the medications…that alone won’t be able to match up your productivity and your energy and focus in a rigid work schedule. You will need to do your work according to your new inner cycles and schedule if you want to be as productive as you were. Also, your work needs to be flexible from a physical perspective. While you do need to exercise to regain your health, the demands of physical activity at work can easily go beyond your current capacity as dictated by both your doctor and your body (through fatigue, shortness of breath and chest pain or pressure among other things). If your job is entirely hard physical labor this is going to be a tough road on which to find balance and regain health.

Your work needs to make you feel good (or at least not make you feel bad). If you can see how your work is making a positive difference in some way then it will be far easier to maintain the positive outlook that is so important to the healing process. It might have been okay to hate your work before your heart attack. However, now the level of stress caused by hated work and the lack of positive energy around you are only going to slow down or stop your healing at best and, at worst, can be lethal. Don’t put yourself through that. Either find a way to see something positive in what you do now or do something else. Job satisfaction is largely an internal thing. If you are not interested in a career change but still have (and hate) your old job, it is time to look at that job long and hard and figure out why it has positive value in the world and to you. Your heart is counting on your success in this challenge!

Last, and in my opinion most importantly, your work MUST allow you to achieve balance in your life. If you are anything like me at all, there was work, then both before and after that there was thinking about or preparing for work and then there was sleep (sometimes). You cannot heal well in that environment. It is a very long road to getting back to as much strength as your heart is capable of…don’t make it longer by being out of balance as a person. The healing power of being around the people you love and who love you is immeasurable. Make absolutely sure your work leaves you with focus and energy enough to truly be with your loved ones, not just in the same room dozing off. This quality time with them will pay huge dividends in terms of finding the balance in your new life and allow the healing process to take you as far as you can go.

So, can you safely go back to what you previously considered a normal work life after a severe heart attack? How did your work stack up with the information in the last three paragraphs? Can your work be modified to allow for these things? If not, are you willing to live with the consequences of putting your work before your health? I used to be very willing to put my work before my health, until my health suffered. Now I want only to live a balanced, happy AND productive life and get as strong as the condition of my heart will permit. In order to do that I looked around and considered working alternatives that offer the necessary flexibility, positivity and balance. I also promised my mother I would outlive her so I better follow my Healing Plan!

Type 2 Diabetes – Medication Precautions in Diabetes

People with diabetes need to observe special precautions when taking medications because some of these may alter their blood sugar level. There are medications that can increase blood sugar levels while others may decrease the glycemic control at an alarming rate.

Antibiotics are one of the most notorious medications that may result in undesired blood sugar level changes in anyone with Type 2 diabetes using oral hypoglycemic medications. However, negative drug interactions are rarely seen in diabetics who use insulin to control their blood sugar level.

What are the usual concerns noted with antimicrobial therapy and oral hypoglycemic agents?

  • severely ill patients and elderly individuals are more prone to an alteration in their glycemic control compared to patients in the younger age group, and those who feel apparently well despite their infectious disease.
  • people suffering from diabetes and tuberculosis at the same time have a higher treatment failure compared to non-diabetics. This is due to a decreased serum concentration of rifampicin in people with diabetes, particularly those who are having problems with their weight as well.
  • treatment failure with may also occur in obese people with diabetes if the dosage is not computed based on their weight.

What can potentially delay the diagnosis of a potential drug interaction?

Severely ill patients that have systemic complications may have hypoglycemia or hyperglycemia, and this may result in the added difficulty in the diagnosis of a possible drug interaction.

What are the most common antibiotics that can alter your blood sugar level?

1. Fluoroquinolones:

  • such as gatifloxacin, levofloxacin, ciprofloxacin and moxifloxacin, may result in both hypoglycemia and hyperglycemia in certain patients and, in most cases, the alteration in blood sugar level is dose dependent.
  • may enhance the release of insulin from the pancreas thereby decreasing the blood sugar level.

Among the fluoroquinolones, gatifloxacin has the most prominent effect on the blood sugar level. The next in line is levofloxacin, so it may be unsuitable for diabetics who have unstable blood sugar and those who are severely ill. Ciprofloxacin may have the least effect on blood sugar control; therefore it can be used safely for people with diabetes.

2. Macrolides (azythromycin, erythromycin, and clarithromycin):

  • clarithromycin, a type of macrolide, can increase the effect of repaglinide, causing an excessive decrease in the blood sugar level. To prevent this from happening, the replaglinide dosage must be adjusted when using clarithromycin.
  • macrolides may also increase the serum concentration of sulfonylureas, another type of oral hypoglycemic agent. Doctors should always consider decreasing the sulfonylurea dosage when also prescribing a macrolide.

3. Rifampicin:

  • rifampicin may significantly decrease the effect of some oral hypoglycemic agents such as nateglinide, rosiglitazone, pioglitasone, sulfonylureas and repaglinide, resulting in a decreased effect of the said drugs. Therefore, when rifampicin is used in diabetics with tuberculosis, a higher dose of anti-diabetic medication may be necessary.

4. Cephalexin:

  • an increased blood concentration of metformin can be noticed with the intake of cephalexin. However, the clinical significance of this problem is still unknown.

If you are given a new medication and suddenly find your blood sugar is significantly higher or lower than usual, ask your doctor to check for the possibility the new medication has a definite glucose-lowering or glucose-raising effect.

The Growth of In Home Health Care

It’s no secret that healthcare is expensive. But many new innovations are making the cost of healthcare more feasible for the average American. Home healthcare is one such development. Although this has been around for quite some time, in home healthcare has recently exploded in popularity. Consider how many of these providers there were in 1990 (5,730), and compare this number to the latest evaluation that took place in 2007 (9,024). As you can see, the number of in home healthcare providers has almost doubled in the given period.

As the economy has contracted over the last few years, the healthcare sector has actually increased steadily in size. This has occurred even in the face of thousands of jobs vanishing all over the United States. During 2010 alone, the hospitals across our nation added about 50,000 jobs bringing the total number of people in the industry up to well over 4.7 million workers. In home healthcare too has increased its workforce. What started out as a fledgling, low-demand industry has quickly blossomed into a large source of employment itself. In 2010, this industry grew by about 40,000 jobs to just over 1 million.

The main reasoning behind this growth is economics. Home healthcare is much cheaper than a hospital visit. This is true concerning both patients and healthcare providers. Services looking to reduce their overhead cost have found that they can save money by traveling to people’s homes and providing care there. Likewise, this process is cheaper for the person receiving care as they do not have to pay the built in cost of maintaining the facility they are visiting.

The in home healthcare trend is not going to disappear. This has proven to be a great resource for those needing daily care that does not necessarily require a hospital visit. By reducing the cost for all parties involved, it is clear that this is not only a convenience to patients, it is a necessity for many providers to continue business during times of a rough economy. As the American workforce ages, it has been said that an estimated one out of every two individuals will require some sort of long term care. In home healthcare provides the greatest opportunity for those of us requiring a lesser degree of care to get the most convenient and affordable help.

While the demand grows, so will the industry. Healthcare is an industry that will forever be in demand; as people age, the need for healthcare will only grow. Once the numbers for 2011 are released you can be sure that the in home healthcare industry will once again have increased in size. A poor economy and the ever increasing ease of obtaining such help have guaranteed this.

Back Pain – How It Affects Your Lungs

Upper back pain, also known as thoracic back pain, used to be less common than lower back or lumbar pain. That is not the case at present. The percentage of people grumbling and grousing about upper back pains has become even greater. The intricacies of that anatomical region make it more worthy of medical attention. Thoracic back pain manifests a lot of symptoms similar to that found in patients suffering from lumbar back pain. Arthritis also affects the upper back area. Pulled muscles and disc problems might also arise. Since the thoracic back secures the thoracic cavity, a discomfort in it is greatly linked with the aches and pains of the lungs and as well as the organs. If one part hurts, it might also cause a corresponding pain in the surrounding areas.

For example, coughing attributed to a congested lung might not be an isolated problem for it also affects the ribs to become sore, the head to hurt and ultimately the back to become painful. This in turn would make it hard for an individual to enjoy his daily activities. A simple task such as picking up a piece of paper from the floor may prove to become painful.

Upper back or thoracic back pain is usually caused by incorrect posture such as slouching or straining the muscles like in the case of carrying very heavy objects.

Most people do not take into account that poor or incorrect posture can set off upper back pains. Even the way a person bends instigate a shooting pain in the upper torso.

Some illnesses, like pneumonia and arthritis, might also cause upper back pain. Take pneumonia as an example. An upper respiratory infection caused by bacteria, virus, parasites, fungi, etc., such as pneumonia concerns the lungs as well. Physical manifestations of such illnesses include difficulty in breathing, coughing, pain in the chest area and fever. So a person infected with pneumonia can attribute the upper back pain to it.

Rib fractures can also trigger back pains. Since the ribs are instrumental in securing the upper portion of the body, whatever happens to it will also greatly affect the adjoining organs or body parts. A fracture in the ribs might entail having a crack or a splinter in the bone/bones which are found in the structure also known as the thoracic cage. Rib fractures commonly occur in the middle ribs. These are usually due to direct trauma like when a hard objects e.g baseball bat hits your middle ribs directly and with great force. It can also be a product of indirect crushing injury. Even prolonged heavy coughing might cause a chip in the ribs. It can also be rooted to medical conditions such as cancer, infections and other diseases. The presence of osteoporosis and other diseases of the bones will further aggravate the situation. Upper back pain, a rasping sound or painful lungs when moving or breathing might be an indication of fractured ribs. Since there no prescribed treatment for a cracked ribs, this condition is usually managed by installing supportive structures and the administration of painkillers.

Bronchitis Medicine – Some Alternative Bronchitis Medicines

If you have bronchitis and want to get well quickly, then you might want to take a look at some alternative bronchitis medicines. These medicines are derived from herbs and some eastern philosophy. Many people swear that alternative treatment, when coupled with western medicine, works wonders.

Here are some of the alternative treatments you might want to look into:

1) Aromatherapy – Adding a few scented oils such as eucalyptus or peppermint to a humidifier or vaporizer can help make breathing a whole lot easier for you. Aromatherapy can also help you relax, enabling you to sleep without waking up every five minutes to cough. This means you should be able to reserve your energy for recovery.

2) Herbal tea – Tea is actually very beneficial to someone suffering from bronchitis. Cough is actually caused by irritants in the bronchioles and trachea. By taking in tea, you ease the irritation and inflammation, expanding your airways and easing your breathing. Herbal tea also helps you hydrate, enabling your body to melt down the phlegm and expel it from your body. There are different types of herbs in teas which could also serve to relieve symptoms and kill the virus causing bronchitis.

3) Ginger – Ginger is known in traditional Chinese medicine as a great way to ease coughing and sore throat. There are many ways to take ginger as an alternative bronchitis medicine, but all of them involve having to experience the fresh heat from the root. The first way is actually cutting a piece of the ginger root and sucking on it like a candy. You probably would say no to that. A better way is to boil a bit of crushed ginger root into a tea. You can add a bit of sugar to the resulting brew if you like -the tea is very effective for getting rid of built up phlegm.

4) Acupuncture – Did you know that the World Heath Organization actually has bronchitis on the list of illnesses treatable by acupuncture? By stimulating your nerves, an acupuncturist can help ease your symptoms and give your immune system a huge boost. This alternative bronchitis medicine can certainly inspire awe.

What Are the Most Common TMJ Symptoms?

There are many different TMJ symptoms that can affect you. If you do not already know, TMJ stands for Temporomandibular Joint. This refers to problems related to the jaw. This can cause pain and other problems in the ear, neck, and other facial muscles. There are many different symptoms that may be a sign of this disorder.

TMJ can sometimes be treated at home. A diet of soft foods can help to make chewing and swallowing easier. Slowly moving ones jaw from side to side and up and down while applying warm compresses to the area. That should be repeated three to five times a day. Using over the counter pain medications can also help alleviate the pain as well as the inflammation from the disorder.

One common symptom associated with TMJ disorder is pain in the facial muscles. This can be from the joints being overstretched. Pain may occur each time you chew, talk, or even yawn. Usually the pain radiates outward from the front of the ear

The least troublesome symptom is the hearing of sounds. These sounds are often reported as being clicking and popping noises. Usually this is because the disc has been somewhat dislocated. Sounds alone may not require treatment, provided that they do not cause any pain.

The ears can be heavily affected as well. Ear pain and ringing have been reported. There is also a chance that hearing loss could occur. It might be easy to confuse TMJ pain for an ear infection, which is why it is important to get a proper diagnoses before attempting to treat any pain. Infections of the ear can be nasty as well, but are not generally associated with TMJ.

In some people, the face and mouth may swell. This can look very odd, as it will likely only hit the side of the face that has been hit with the syndrome. Not all swelling of the face is related to this disorder. Most swelling in the face is caused by allergic reactions to something you have recently come into contact with.

Sometimes there will be problems with swallowing. This is because of muscle spasms that are occurring in the jaw. Any problems with swallowing may become very dangerous, as a chocking risk could be involved.

The jaw will sometimes lock in place, or not open fully. There could be the chance that one side of your jaw may open normally while the other is in too much pain to get fully open. A person who is suffering from TMJ may not be able to get their teeth to line up correctly anymore, either. These symptoms can come on very suddenly.

TMJ symptoms may also include headaches and dizziness. This can make people feel nauseous and even cause vomiting. People experiencing these symptoms should consult a medical expert for more information on how to treat them. Having this disorder does not need to completely disrupt your life, but it is important to take it easy on the jaw while experiencing the symptoms.

Chiropractic Treatment For Shoulder and Arm Pain

At times, shoulder and arm pain occur due to obvious reasons. We do something ourselves by mistake to injure the arm or shoulder and there is a sudden pain. At times, the pain develops in a few days. Eventually, you find out that you may have broken a bone or there might be dislocation in your shoulder.

Over reacting or over exerting your arm like while playing sports, straining tendons or ligaments for too long by carrying heavy weight or lifting heavy things, keeping your arm in different weird positions or sleeping on your shoulder are some of the reasons that can cause shoulder pain and arm pain. The pain may result in irritation and frustration and can end up in making it hard for you to use the arm that is injured. There are very less chances of these injuries to turn into a serious problem.

Shoulder and arm pain can also evolve due to pain in some other part of your body. For example, a person suffering from a heart attack also suffers pain in the left shoulder and left arm. The pain can also be induced from nerves that are associated with the upper spine joints or particular points in the back. These are responsive to spinal adjustments by chiropractors.

Your chiropractor will determine the cause of your shoulder or am pain by doing some tests and conducting diagnosis. It is important to first find out the cause of the pain and then start treatment accordingly as varied situations have varied seriousness and causes. Your chiropractor will also determine if the problem is easy to handle and mild or is serious and will require immediate consideration and will stay for a long time. There are different ways to treat different problems like for broken bones and tendonitis and bursitis. Gout and arthritis are treated differently than pain that originates in nerves supplying the arm and the shoulder. Your chiropractor will be in a position to put you under the right kind of treatment.

Chiropractic treatment can be used to treat frozen shoulder, a bad inflammation which is also known as adhesive capsulitis. Doctors of chiropractic are well trained to treat pain and trigger points that are located between the shoulder and the spine. Professional and novice athletes that injure their arms or shoulders need to undergo proper treatment care and rehabilitation and chiropractors who have additional training in sports medicine can treat them well. Chiropractors also help you by giving advice as to how to change your lifestyle so that you can prevent shoulder and arm injuries in the future.

Code for Splinting Only If No Restorative Treatment Is Administered

Recently, a three-year-old presented to our office with a history of falling off a chair and injuring his right wrist. After carrying out a physical, the pediatrician orders an x-ray which shows a buckle fracture of the right wrist. For the time being, the doctor protects the injury with a forearm splint and refers the established patient to an orthopedic surgeon for restorative treatment. Here, can I code for the splinting?

Since the pediatrician provides only the initial splinting without restorative treatment, you can code for the forearm splinting with 29125 (Application of short arm splint [forearm to hand]; static). As an alternative, if the pediatrician carried out the definitive fracture care, including the pre- and post-operative fracture care, the global fracture code 25600, Closed treatment of distal radial fracture [example., Colles or Smith type] or epiphyseal separation, includes closed treatment of fracture of ulnar styloid, when performed; without manipulation) would include the initial cast or splint.

In both situations, the pediatrician can still code for the x-ray (73090, Radiologic examination; forearm, two views). Even though the splint is also a separately billable service, some plans may consider the forearm splint (A4590, Special casting material [for instance fiber glass] DME and not pay the physician unless he has obtained DME certification.

In order to report an E/M for the evaluation from the fall, the pediatrician would have to have performed and documented a medically necessary significant and separately identifiable E/M service above and beyond the minor E/M already included in 29125. You would use modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the day of the procedure or other service) to the evaluation & management service that you report with 29125.

According to CPT, you can report further significant identifiable services carried out at the time of the cast/splint application. A fall from a chair may engage checking for possible head injury and any other wounds, and will most likely call for an expanded problem focused history and exam, which could support 99213-25.

For more specialty-specific articles to assist your pediatric coding and for other medical coding updates, sign up for a coding resource like Coding Institute.

Arthroscopic Shoulder Surgery – Who Needs It in India?

An introduction to arthroscopic surgery of the shoulder

‘Arthros’ means joint in Greek. The arthroscope is an instrument used by orthopaedic surgeons to look into joints. It is about 8- 10 inches long and is as thick as a pencil. There is a fibre optic lens system which transmits light from a cold light source outside and relays the interior image to a medical television monitor. In other words the arthroscope serves as a camera device to look into structures inside a joint. It is possible to diagnose pathological conditions not seen on X rays and sometimes even on MRI scans.

Who needs arthroscopy?

a) Rotator cuff tears, partial and complete

b) Recurrent dislocations

c) Frozen shoulder and adhesive capsulitis

d) Calcium deposition

e) Loose bodies

f) Osteoarthritis

Advantages

As there are no formal large incisions, post operative pain is minimal. Since muscles and tissues are not removed from their origins on bone, again the amount of inflammation is minimal. Recovery can be faster as it is not necessary for muscles to heal back. Cosmetically the procedure is very satisfying. There are no mental scars of open surgery. Return to sport or work is faster, hospital stays are shorter and hence bills are smaller. However arthroscopic equipment is expensive to hire or possess and the surgeon has to recover the cost of dispensable items like shavers, suture anchors. This is offset by enormous patient satisfaction.

Arthroscopic surgery by its simple nature provides an opportunity to the orthopaedic surgeon to examine the interior of a joint. After Knee arthroscopy, the shoulder is the joint which is suited for arthroscopic surgery. Other joints are the ankle, wrist and elbow. Indians and Asians in the Gulf get only short spells of leave to spend with their near and dear ones. They would benefit from undergoing Arthroscopic shoulder surgery for shoulder pain as the recovery is shorter.

The conditions treated by open surgery earlier are now treatable by arthroscopic surgery with remarkable success. Some hitherto unknown conditions have been diagnosed after the advent of arthroscopic surgery.

Any painful or unstable condition of the shoulder except end stage arthritis can be treated by arthroscopic surgery. Shoulder replacement is not yet possible arthroscopically, but with minimally invasive orthopaedic surgery catching up, that may not be far off. It is certainly possible to introduce prosthesis for fracture fixation through key hole incisions and the same may be extended to joint replacement as well.

Arthroscopy can be diagnostic to confirm or make the diagnosis. X -rays do not reveal soft tissue pathology and many patients are frustrated when their orthopaedic surgeon dismisses their pain as of no significance just because the X-ray is normal. MRI and ultra sound are useful non invasive investigations but is operator dependent and need good musculo skeletal radiologists to interpret them.

Rotator cuff disease, instability, impingement due to bony outgrowths from the clavicle or the acromio clavicular joint can be trimmed arthroscopically. Infections can be drained. Recalcitrant calcium deposits can be needled and a frozen shoulder can be released arthroscopically. SLAP lesions are debrided and reconstructed by this method through small key hole incisions.

How is the procedure done?

Arthroscopic surgery is an elective or planned surgery. It is done under general anaesthesia. It is done as a day case which means that you may be discharged the same day (Day care or surgery). The instrument is introduced into the joint through small incisions about half centimeter long. Other instruments are also introduced and maneuvered to achieve the therapeutic goal.

Advantages

As there are no formal large incisions, post operative pain is minimal. Since muscles and tissues are not removed from their origins on bone, again the amount of inflammation is minimal. Recovery can be faster as it is not necessary for muscles to heal back. Cosmetically the procedure is very satisfying. There are no mental scars of open surgery. Return to sport or work is faster, hospital stays are shorter and hence bills are smaller. However arthroscopic equipment is expensive to hire or possess and the surgeon has to recover the cost of dispensable items like shavers, suture anchors. This is offset by enormous patient satisfaction.

Cerebral Palsy Diagnosis – What Tests Are Involved?

In order to properly diagnose cerebral palsy (CP) there needs to be a series of tests run.  The tests consist of many physical and neurological tests.  A child is usually diagnosed at an early stage because the symptoms become more evident then.  For example, delays in a child’s development and problems moving are the first signs that are connected to cerebral palsy.  These can be recognized within the first couple years after birth.  If your child if experiencing developmental delays or other abnormal symptoms you need to take your child to see a medical specialist to be evaluated.

What is Cerebral Palsy?

CP is a group of disorders affecting a person’s movements.  What actually causes brain damage is unknown however CP is caused by damage to the brain.  In some situations brain damage can occur during labor and delivery.  This is called medical malpractice.

Every year thousands of babies and children get diagnosed with CP.  In some of these cases, the condition could have been prevented if proper procedures were followed.

How is Cerebral Palsy Diagnosed?

Diagnosing CP requires a series of tests performed by a doctor.  The following tests listed are used to make a diagnosis:

Reflex tests – Plantar, Moro Reflex, and rooting flexes are tests given to diagnose CP.  For instance, infants experience the Moro Reflex (a kind of reflex) when they are startled, however if the reflexes persist into early childhood they need to be taken for these tests. 

Hand preference test – After one year of age a child normally will favor one hand over the other however if you child is showing hand preference before age one it can be a symptom of cerebral palsy.  In cases where children have hemiplegia, one side of the body is stronger.

Computed tomography, CT scan – CT scans are used to take images of the brain. Doctors can determine any lack of development or damage to the brain.

Electroencephalography, EEG – With this test doctors can identify the presence of any seizures.  Seizures are common in cerebral palsy.

Magnetic resonance imaging, MRI – MRI scans are given to test any abnormalities in the brain. 

Other tests may be given depending on your child’s symptoms.  A physical exam will be given and the tone of their muscles will be looked at and other developmental delays along with their medical history all will be considered.

After a Diagnosis

If your child has received a CP diagnosis and it is possible the injury occurred during or after birth you should take your case to a medical malpractice attorney.  They will evaluate your case for free and if they determine the cause of your child’s condition was medical neglect they will then advise you of your legal rights.

Success Tips For Hiatal Hernia Surgery

A hiatal hernia can be an exhausting problem for people causing heartburn and return bouts of acid reflux. Not only is it irritating and uncomfortable, it can cause a person to stop eating properly and have sleepless nights due to the heartburn. If you are not sure what a hiatal hernia is, it is a protrusion of your stomach through the chest wall in a weakness that occurs in the opening of the diaphragm called the hiatus. The symptoms can be controlled by taking over-the -counter medications, but when the symptoms become severe the best treatment may be hiatal hernia surgery.

Many people have tried taking medications to control their acid reflux and heartburn symptoms only to find out these medications are not helping. If you feel you may have a hernia and need hiatal hernia surgery, your best bet is to talk to you doctor.

What causes the hiatal hernia?

There are a couple of important factors that can lead to this condition and one of the most prevalent is being overweight. The excess weight around the waist can cause your diaphragm to be pushed upward therefore causing the hiatus opening to become pressured and start to open more than normal. If you really want to rid yourself of the problem the best thing to do is to control your weight.

Another risk factor is smoking; smoking causes the muscles to become less effective and therefore makes it easier for the stomach to protrude through the opening.

One more risk factor is eating foods that can cause the reflux to be more frequent. Cutting down on the amount of acidic food you eat can reduce the symptoms of the heartburn but will not cure the hernia; sometimes the only option is hiatal hernia surgery.

How is the surgery performed?

The procedure is not that difficult and consists of returning the stomach to its place while adding sutures around the hiatus opening to make it less likely of the hernia recurring. This procedure can be done on an inpatient basis as it does require general anesthesia.

Will I have to have surgery?

Many times the surgery can be avoided if you follow a diet and exercise program that helps you reduce the risks. Quitting smoking and taking better care of your body is the way to overcome the problem and live hernia free.

The object of the lifestyle change is to take the pressure off of the opening so the muscles have time to recuperate and heal. It can be done but you need to remain vigil.

Finally, if you are having symptoms of heartburn or acid reflux, it is best to consult with your doctor so the proper tests may be run. Your doctor will be able to discuss all of your options and will probably suggest the lifestyle changes that will allow your hiatus to heal. Never take on a diet plan or exercise routine without talking to your doctor first. Hiatal hernia surgery can be avoided if you follow the simple tips suggested.

Back Brace For Bad Posture – Why Orthopedic Support Can Help – Where To Get Spinal Braces Near You

Do you suffer from poor posture?

Are you looking for a way to help yourself stand more straight?

1.) Reasons For Bad Posture

People can get tired and they begin to slouch. You know the scenario, your shoulders roll forward, your abdominal muscles relax and whether you are always conscious of it or not, your posture is compromised. At some point, we all have been victims of bad posture, for this reason. – Other people have back problems, whether they suffer from tired back muscles or not. Sometimes it has nothing to do with your musculature. – One reason why people suffer from bad posture is osteoporosis. A compression fracture in your spine may also promote bad posture as well. – These are just a few reasons why you might have a “sagittal l imbalance”, or poor posture.

2.) Benefits to Using Back Braces For Bad Posture

The positive reason for getting a back support for poor posture is obvious; you will stand straighter. When you stand straighter, on a consistent basis, you may allow your body a chance to heal from certain conditions. One of these conditions could be a compression fracture, which is partly caused by flexion of your spine.

3.) Down Sides To Using Back Support for Bad Posture

There are not really many reasons why back braces are bad for you. However, if we had to give some downsides to the use of back braces for poor posture it is that people can get way to use to the support. – If you are conscious of the fact over use (of nearly anything) is bad, then you should be fine. – Wearing a brace loosely or wrong (not following instructions on usage) can also cause problems for people.

4.) Where To Get A Quality Othopedic Support Near You

If you are looking for a quality back support for bad posture, then it is important to visit a licensed orthotist in your area. An orthotist is an individual that has studied orthotics (external supports) and they are the best and most experienced people to see when it comes to back braces. Orthotists are essentially specialists in the field of bracing.

Another reason why it is important to visit a licensed brace provider in your area is that they can bill your insurance for the device. They are not always fully covered by insurance, but many times a large portion of the orthopedic support is covered. It all depends on the terms of your health insurance policy.

Note: This is health information. Not medical advice. People suffer from poor posture for many reasons and it is best to be evaluated by a physician, before considering getting a back support.

Mini Bike Modification Guide

It is common these days to see mini bikes being sold in stores already with performance parts fitted, such as K&N style air filters and performance exhausts, however there is always still more work to be done to these bikes.

They are incredible easy to work on and with such a basic engine the only knowledge needed to work on them is knowing how to use a spanner or a screwdriver.

Here is a list of modifications recommended in order to increase the overall power of the bike, as well as improving the handling and feel of the bike.

It would be an idea to start modifying the mini bike with the larger mods, as with these more performance is gained for the money spent. The biggest modification which can be done to a Mini bike is to get it bored out to a larger engine displacement. Most of these bikes will come with a 47cc (which is actually only 39cc). These engines can be bored out with a racing kit to 49cc. This will improve the power of the engine due to the larger displacement, improving acceleration and top end.

If the mini bike is already 49cc there are kits for sale which take the engine up to 58cc again having the same effects as before.

The next modification it would be wise to make to the mini bike is with a performance exhaust, these come in many makes and models and each style will have a different output to the next, so it is best to look around before jumping in and buying one straight away.

These exhausts work as they have an expansion chamber, which improves performance on any 2-stroke engine. These exhausts are not usually over expensive; the cheaper systems can be bought for under £50, and go up to over £200 for the more expensive systems. These are great bolt on performance parts, and can improve the acceleration of the bike with higher low and mid range revs, whilst increasing top end by up to 10 mph.

These exhausts will really benefit the bike if it has been bored out as well and the difference in performance will be evidently noticeable.

The next modification which could be made to the carburettor, and increasing air flow through the bike. Firstly, add a free flow air filter,(K&N style ones). This will mean the bike can take in more air, and the rule of thumb for any engine is – increased air intake + increased fuel flow = increased BHP.

Therefore this part will help with the performance of the bike, however if an air filter is fitted then the carb will need to be up jetted in order to cope with the extra air, performance is likely to decrease if these changes aren’t made. Buying new jets for the mini bike increases performance as these jets will allow more fuel to be sent through the carburettor. Tuning will need to be done with this to get the air:fuel ratio correct.

It is recommended that if modifying the air and fuel intake of the engine that a carb upgrade is purchased. The standard carburettors in these bikes do not have as many adjustment screws as the performance carbs and therefore cannot be tuned as highly, and the performance benefits will not be as evident.

With these changes the bike should have better throttle response with better acceleration and also higher top end speed. This works very well with the performance exhaust and the extra performance with the bike should be easily recognisable.

Once the Mini bike has been up jetted and a free flow filter and new carb have been fitted then it is time to make some smaller adjustments to fine-tune the bike.

The next adjustment which could be made to the bike would be to add a rocket key, this allows the bikes timing to be improved for pulling away and accelerating, meaning that the throttle response and acceleration will be improved.

It is also likely that the gearing of the bike will need to be changed depending on where it is used. This is mainly done through different sized sprockets, and this will be changed depending on how the rider wants the bike to perform

If a larger sprocket is put on the front or rear of the bike then the top end will be improved whilst making accelerating slightly slower, however if the Mini bike is fitted with smaller sprockets then the acceleration will be improved whilst losing some top end. These sprockets can be changed depending on what track is being raced on.

Due to the modifications made to the bike to improve performance, some other changes will need to be made to the bike so it can cope with the extra power and maintain that good performance. Items such as an NGK spark plug or similar could be used. The standard plugs in Mini bikes are not very reliable and will not be able to cope with the power the bike is producing.

Also doing this will improve the starting of the bike as well as keeping the bike performing at its best all the time. Whilst changing this is it also a good idea to change the lead and coil going to the spark plug for maximum benefits.

Another aspect of the Mini bikes which could be tuned is the clutch system. The clutches on the bikes are automatic centrifugal clutches, which will wear very quickly if modifications are made to the bike. It is advisable to upgrade the clutch to a heavy duty clutch with heavy duty springs, these will last a lot longer and also can improve acceleration and throttle response of the bike.

With all this power now added to the bike it is advisable that you make changes to the brake systems on these bikes. Most of them come with half descent disk brakes anyway but upgrading the brakes may be a good idea, imagine racing around a track doing over 50 mph, and then coming to brake and the brakes just ain’t man enough to handle the speed, this is why this change is recommended.

Once all this is done the bike will have been modified a great deal without going too mechanically into it and the extra performance of the bike will leave other bikes standing.

Just remember to always ride on Private land with the owner’s permission and wear protective clothing.

So Similar Yet Different – Can You Tell Between Herpes And Shingles?

Many people attach negative associations to the term ‘herpes’. In fact, there are small differences between shingles and herpes, which produce variations of the identical infection.

The sexually transmitted disease, genital herpes, normally occurs when a person has unprotected sex with numerous partners but it can occur in anybody who has had sex even if only once and their partner has the infection. Genital herpes is caused by the HSV (Herpes simplex virus).

There are almost 100 different types of herpes which affect humans – genital herpes or HSV-2 is only one, while other highly contagious herpes infections can be transmitted via casual contact.

For example, HSV-1 generally causes oral cold sores and may be contracted from infected people through sharing eating utensils or drinking glasses, a casual kiss or having skin to skin contact like wiping a child’s mouth if you have tears or saliva on the tips of your fingers.

Research shows that about 98% of healthy people carry and shed the HSV-1 virus without having an active outbreak. Research reveals how highly contagious it is and also how prevalent it is.

The cytomegalovirus is a herpes virus which causes flu like conditions in adults but may have devastating effects on unborn children.

Herpes varicella-zoster causes chicken pox in children. Prior to vaccine development, family and friends held ‘chicken pox parties’ so that children between 4 to 6 years were infected to prevent them contracting the disease when they grew older when it became a bigger health risk which could result in permanent damage and even death (in their 20’s and older). It produces greater discomfort and pain in older people while lasting longer.

Herpes varicella-zoster will most likely lie dormant for many years after an initial infection and has the potential to reactivate in certain conditions. The reactivated virus causes Shingles which is most common in people over 60 years old who may have considerable stress levels, younger people whose immune systems have been compromised, recipients of organ transplants, cancer victims or effects of medication on immune systems.

Shingles infection mostly presents in the body’s trunk or buttocks alongside specific nerve dermatomes and stays on one side following a specific nerve bundle pathway. Shingles and herpes differ in that shingles is not commonly reactivated a second time after healing (provided the person’s immune system is not compromised) while herpes can reoccur many times.

Shingles is normally painful and often clears on its own requiring supportive pain treatment. Herpetic neuralgia occurs sometimes when the pain does not disappear as the skin clears. It can cause nerve pain which is severe and difficult to control and treat.