Most of us think that big breasts stand for beauty with femininity. But why women ask for reduction mammaplasty? In order to find that out you could to really listen to women who are have experience with big breasts and understand what sort of experience is that. Most of you will be astonished to hear about constant back and neck pain, gouges in their shoulders that were made by bra, worsening posture with low readiness to attend many crucial activities due to overly sized breasts. After that it is quite easy to figure out why those women decide to have reduction mammaplasty procedure. For these women, overly sized breasts are a nuisance.
Breast reduction surgery is taken in case of breast hypertrophy. Breast hypertrophy typically happens in both breasts and happens at puberty or couple of years after puberty is over. Sometimes it occurs during pregnancy, it's not often, but enlargement does happen.
Plastic surgery can treat these occurrences and solve the threat if the the woman is feeling unpleasant with her appearance and condition. In case a woman feels it's a solution to have reduction mammaplasty, a cosmetic surgeon must acknowledge that decision and go for a process of evaluating is the woman in question capable for cosmetic operation.
Who Can Have Breast Reduction Surgery?
Reduction mammaplasty is for women who have oversized breasts and wish to put an end to one or more of the following problems they have:
1. constant back, neck and shoulder pain
2. Poor posture
3. Skin rash under the breasts
4. Deep grooves in the shoulders from bra strap pressure
5. Restricted levels of activity
6. Low self-esteem
7. Problems with fitting into certain bras
It needs to be mentioned that nearly half of all men today have gynecomastia, which is an enlargement of both breasts. Gynecomastia usually is caused by several different factors, some of them being anti-depressants, blood-pressure medicine, steroids and few others. Gynecomastia may not be changed with diet and physical activity. The breast reduction can be solved by liposuction.
Breast reduction procedure is a highly successful surgery and women are very happy with the results they receive. But, there are always risks of this cosmetic surgery. Most often are: bleeding, infection and an adverse reaction to the anesthesia. Besides those there are some other risks that are connected with breast reduction surgery:
1. Loss of feeling in breasts
2. Low blood supply to the breasts, leading to scarring
3. Inability to breast-feed
4. Asymmetry in shape
5. Changed body image and a period of adjustment to the change in woman's appearance
In preparation for breast reduction procedure itself, a cosmetic surgeon measures and puts marks on patient's breasts. It improves the planning and makes it possible for cosmetic surgeon to finish his job. Breast reduction operation mostly lasts 2 to 3 hours, while a patient is under general anesthesia. With completion of surgery, patient wakes up in a recovery room, where he's being monitored for any problems.
Concerning the costs of this surgery, they vary over a wide range, which depends upon the plastic surgeon, your region, the type of your procedure and similar important factors. Be aware that it is not possible to give an exact number so we will leave that to you. First check hospitals nearby and and learn about the information. It's best to compare the terms, prices and similar conditions to see what what gives you most for your money.
After that you have to meet with a board certified plastic surgeon who can give you information that's specific to your plastic surgery. A talk with plastic surgeon will help you to realize what your choices are and to develop realistic expectations about breast reduction surgery results, dangers, prices and results.
Saturday, November 21, 2009
Lose Weight, Build Muscle
People think that the only way to muscle up is if you spend hours and hours in the gym. You do need to work out to build muscle but you do not need to spend your whole life in the gym. In fact if you workout too much you can actually decrease the size of your muscles. Your body needs energy to build muscle. If you workout too much, your body will actually take that energy from your muscles, making them shrink.
If you want to lose weight, build muscle, and get healthy it is actually better for you to work out in short, intense periods. Another misconception on losing weight and building muscle is that you have to starve yourself to lose weight. Eating less can be a great way to lose weight, but it can also make you look sickly. If you want to turn your fat into muscle and get healthy, you might actually have to increase the amount of food that you eat. The body needs energy to workout. You need to feed your body so it can feed your muscles. A diet that is rich in protein and carbohydrates is a great way to make sure you have a good body building diet.
Natural Detoxification With A Body Cleanse Diet
A body cleanse diet aids your body in ejecting harmful toxins such as caffeine, food additives, nicotine and alcohol. In case you have been consuming a poor diet, you might want to try a cleanse diet that is bound to change the way your body system works. The importance of a detox cannot be underestimated. It is the surest cure for such maladies as indigestion, bloating, fatigue, weight gain and headaches.Even individuals with a defunct or low immunity could benefit from a detox diet. A body cleansing diet ranges from a mild levels to an extreme level based on the volume of toxins accumulated in the body. It is however advisable to begin from a basic diet and build on it slowly as you progress.
In the initial stages, a detox diet could be unpleasant. That however is a perfect indication that you require a detoxification since the body is opposing the status quo. You have to tread carefully on any body cleanse diet you come across though. It can be dangerous in case it is not structured in the right way. Consulting with your physician prior to beginning the detoxification is a smart idea. Once you have made up your mind to follow a detox diet, you must commit yourself to the whole body cleanse program from the first day. When it comes to a mild cleansing diet, consistency is the key to absolute success.
A body cleanse diet is not that hard to formulate. You only need to understand the elements involved. You have to start the process by drinking one or two glasses of warm water some hours before a breakfast. You can add some freshly squeezed lemon juice to the water. This aids in increasing the flow of bile into the stomach. Bile aids the liver in the breakdown of excessive fat. The glass of water and lemon is also important since it helps the body in the elimination of toxins. Having jump-started the metabolism process, whatever else you eat during the day will be broken down fast and efficiently.
During the afternoons, you can add some chlorophyll to a glass of water and have it as it is. This is because chlorophyll is a wonderful detoxifier. A derivative of the alfalfa, chlorophyll appears mostly in antioxidant products. It is known to support the body cell health as well as increasing the production of red blood cell. Besides that, chlorophyll boosts your energy levels.
While following a body cleanse diet, ensure that include eat a lot of fiber-rich foods in the daily diet. This will help to regulate your bowel movements and also in eliminating excess toxins. Bran, ground flaxseed and oat are great sources of natural fiber that you can add to cereals or blend with applesauce. You can consider tossing a little bran or oat into the blender for some more fiber if you enjoy smoothies. Don't forget to use the foods that benefit the liver during a cleansing diet. These foods include celery, carrots, lemons and beet roots.
Friday, October 16, 2009
Bodybuilding and Testosterone Diet
The testosterone diet is simply making sure you help your body take advantage of the nutrition you provide in a way that maximizes your testosterone levels. If you're in the beginning stages of bodybuilding, then you may need to adjust your testosterone diet to decrease the carbs at first, so that you can begin to see your six-pack as the fat falls off of your body. A testosterone diet is easy to maintain, as long as you are aware of what constitutes good foods to increase your testosterone levels. The testosterone diet is simply making sure you help your body take advantage of the nutrition you provide in a way that maximizes your testosterone levels. The best way to maximize your testosterone diet is to break your meals up into smaller meals throughout the day.
Healthy Diet
Eating a healthy diet should give you enough fiber to stay healthy. We basically are not aware of the fact that a little change in our diet can actually do wonders for us in achieving weight loss. Now it's really important that everyone who is looking at this article simply recognizes that you ALWAYS have to do your OWN due diligence when starting a new diet, based on whatever specifics needs, circumstances or even unusual conditions that may be unique to you. Then you just need a good combination of diet and exercise to realize your goal; no supplement is needed if you really are taking care of your diet.
The calories you consume on a testosterone diet will vary from person to person depending on weight, age, and other factors. Vitamins are another staple to any testosterone booster diet. You may be able to get plenty of vitamins from the foods on your testosterone diet, but using daily bodybuilding supplements can't hurt. Try adding more fresh fruit, vegetables and nuts into your diet. Chances are this will bring your fiber intake closer to what it should be since most people only eat about half the fiber they should, and will not really be a "high" fiber diet.
The Testosterone Diet explains that while many anabolic hormones in the body influence muscle growth – growth hormone and insulin come to mind – testosterone is the hands-down most important. Not only does it drive muscle growth, but testosterone also keeps you lean, since it elevates metabolism and increases the release of fat from fat cells and inhibits its storage in the body. If you're taking testosterone enhancer supplements , in any form, you need to make sure you avoid water retention and give your body enough fluids to generate a good workout. Herbal Testosterone is an effective and safe way to multiply your testosterone by 500%.
Testosterone
Remember that you shall have to adopt lots of measures to shed body fat. Then the only one way for you is bodybuilding. Now there are several ways to build your body and among them one is weight lifting. If you have been lifting weights to no avail, and have hit a plateau from time to time, then it may be that you need to go on the testosterone diet. Did you know that you can ruin your bodybuilding goals by adding foods to your testosterone diet that actually a cause of low testosterone. Alcohol, food that is high in fat, and phytosterols, which are found in some plants, can all take a toll on your testosterone diet. Most men on a testosterone diet think about the food when building muscle, and forget the need for ample amounts of water.
You should never avoid carbs in a testosterone diet. But you need to add carbohydrates combined with protein to your testosterone diet in order to give you energy. If you're in the beginning stages of bodybuilding, then you may need to adjust your testosterone diet to decrease the carbs at first, so that you can begin to see your six-pack as the fat falls off of your body. Part of your testosterone diet may include natural or prescription testosterone.
Healthy Diet
Eating a healthy diet should give you enough fiber to stay healthy. We basically are not aware of the fact that a little change in our diet can actually do wonders for us in achieving weight loss. Now it's really important that everyone who is looking at this article simply recognizes that you ALWAYS have to do your OWN due diligence when starting a new diet, based on whatever specifics needs, circumstances or even unusual conditions that may be unique to you. Then you just need a good combination of diet and exercise to realize your goal; no supplement is needed if you really are taking care of your diet.
The calories you consume on a testosterone diet will vary from person to person depending on weight, age, and other factors. Vitamins are another staple to any testosterone booster diet. You may be able to get plenty of vitamins from the foods on your testosterone diet, but using daily bodybuilding supplements can't hurt. Try adding more fresh fruit, vegetables and nuts into your diet. Chances are this will bring your fiber intake closer to what it should be since most people only eat about half the fiber they should, and will not really be a "high" fiber diet.
The Testosterone Diet explains that while many anabolic hormones in the body influence muscle growth – growth hormone and insulin come to mind – testosterone is the hands-down most important. Not only does it drive muscle growth, but testosterone also keeps you lean, since it elevates metabolism and increases the release of fat from fat cells and inhibits its storage in the body. If you're taking testosterone enhancer supplements , in any form, you need to make sure you avoid water retention and give your body enough fluids to generate a good workout. Herbal Testosterone is an effective and safe way to multiply your testosterone by 500%.
Testosterone
Remember that you shall have to adopt lots of measures to shed body fat. Then the only one way for you is bodybuilding. Now there are several ways to build your body and among them one is weight lifting. If you have been lifting weights to no avail, and have hit a plateau from time to time, then it may be that you need to go on the testosterone diet. Did you know that you can ruin your bodybuilding goals by adding foods to your testosterone diet that actually a cause of low testosterone. Alcohol, food that is high in fat, and phytosterols, which are found in some plants, can all take a toll on your testosterone diet. Most men on a testosterone diet think about the food when building muscle, and forget the need for ample amounts of water.
You should never avoid carbs in a testosterone diet. But you need to add carbohydrates combined with protein to your testosterone diet in order to give you energy. If you're in the beginning stages of bodybuilding, then you may need to adjust your testosterone diet to decrease the carbs at first, so that you can begin to see your six-pack as the fat falls off of your body. Part of your testosterone diet may include natural or prescription testosterone.
Causes of Joint Pain
Many of you reading this article right now are affected by poor joint health or probably know someone who is. According to the United States Bone and Joint Decade, 1 out of 7 people in America, suffer from some type of joint pain resulting in restriction of movements.
Whatever the cause of joint ache, the physiology behind the discomfort is generally the same. Joint discomfort is due to the degeneration of the joint that takes place due to wear and tear of the cartilage, weak muscles and tendons, insufficient synovial fluid to cushion the joints. In more severe cases, bone begins to rub against bone making movement extremely strenuous. Gradually, the discomfort may grow so intense that it debilitates and restricts an active lifestyle.
What are some of the common reasons that lead to poor joint health?
Overweight: Being even slightly overweight can cause stress on load-bearing joints such as the hips and knees. Did you know that losing an extra pound of body weight can lead to a reduction of 4 pounds of stress on the knees? This is what the journal of Arthritis & Rheumatism reported in its July 2005 issue. Joint health experts agree.
Heredity: Joint discomfort can be hereditary. If you know that poor joint health exists in your family, you can take early proactive measures which include exercise, the right diet and nutritional supplementation for joint health.
Repeated Stress Injury (RSI): Joint discomfort can occur when the same joint is used repeatedly for long periods of time. Athletes and sports enthusiasts may suffer from RSI or overuse of joints. RSI can take place due to your occupation, for example typing or mechanical work that requires the use of the same joints every day. Baseball players may suffer from RSI in the shoulder.
Joint Injury: A fracture or even a sprain weakens the joints. An injury like this tends to accelerate joint degeneration. Degeneration can take place over years. If you had a joint injury in childhood, you may find signs of discomfort as you get older.
A Weak Auto-Immune System: The body’s immune system may react upon itself causing poor joint health and lead to severe joint discomfort.
Improper Workouts: When workouts are not done with the proper pre- and post care, it may result in injury to the joints. Some examples: Not warming up before an exercise routine, exercising for too long, prolonged lifting of heavy weights, wrong forms of exercise, not enough recovery time between workouts.
Inactive Lifestyle: Oddly enough, not being active or lack of exercise may also cause joints to degenerate faster. This is because exercise helps increase blood circulation to the body providing the necessary nutrients to all organs and joints. Exercising the joints also helps them to be naturally lubricated. Muscles and tendons are strengthened and help the joint to bear the brunt of body weight and movements.
Wrong Kind of Footwear: Using the wrong kind of footwear can put a strain on the joints, for instance, constant use of improper footwear for running or jogging, high heeled shoes for daily wear. Medical experts believe that “turf toe” could be caused playing sports on artificial turf, wearing footwear that does not support forefoot joints.
Poor Posture: Excess stress is put on the joints due to poor sitting or standing postures. This is especially significant if your job requires you to stand or sit for long periods of time. Today, people are used to sitting in front of computer screens for long hours. Care should be taken to follow precautionary measures to avoid joint discomfort.
Physical Labor: Short-term joint pains can be caused by sporadic periods of hard work involving heavy lifting, or using muscles and joints that are not normally used!
Lack of Proper Nutrition: Vitamins and minerals are needed for joint health, but the body also needs specific nutrients for the repair and maintenance of cartilage and production of synovial fluid without which joints will degenerate. Without this kind of nutrition, cartilage becomes thin and easily tears. The production of synovial fluid declines. There are natural nutrients found in the joints which the body needs for proper joint functions.
• Type II Collagen makes up 70 percent of the cartilage.
• Glucosamine sulfate, a natural nutrient, found in the joint helps to repair and maintain cartilage.
• Hyal Joint, another nutrient, helps to lubricate the joint.
• MSM is essential for the building of cartilage and connective tissue.
All of these nutrients, as oral supplements, have been researched well and indicate efficacy in helping to support joint functions and help ease joint discomfort. In addition Green lipped mussel extract, rich in omega 3 fatty acids, helps support mobility of joint. Grape seed extract supports blood circulation.
Supplements like GoFlex are physician-approved and contain all the nutrients and herbs required for maintaining the ten joints in your body that are most prone to injury and joint discomfort. The free topical cream contains an FDA approved pain-relieving ingredient called capsaicin. Capsaicin penetrates deep into the skin all the way to the joints to provide instant joint pain relief. The oral supplements nourish your joints from the inside for long term support of joint health!
Go Flex provides comprehensive health care through nutritional joint health supplements and topical analgesic application.
Whatever the cause of joint ache, the physiology behind the discomfort is generally the same. Joint discomfort is due to the degeneration of the joint that takes place due to wear and tear of the cartilage, weak muscles and tendons, insufficient synovial fluid to cushion the joints. In more severe cases, bone begins to rub against bone making movement extremely strenuous. Gradually, the discomfort may grow so intense that it debilitates and restricts an active lifestyle.
What are some of the common reasons that lead to poor joint health?
Overweight: Being even slightly overweight can cause stress on load-bearing joints such as the hips and knees. Did you know that losing an extra pound of body weight can lead to a reduction of 4 pounds of stress on the knees? This is what the journal of Arthritis & Rheumatism reported in its July 2005 issue. Joint health experts agree.
Heredity: Joint discomfort can be hereditary. If you know that poor joint health exists in your family, you can take early proactive measures which include exercise, the right diet and nutritional supplementation for joint health.
Repeated Stress Injury (RSI): Joint discomfort can occur when the same joint is used repeatedly for long periods of time. Athletes and sports enthusiasts may suffer from RSI or overuse of joints. RSI can take place due to your occupation, for example typing or mechanical work that requires the use of the same joints every day. Baseball players may suffer from RSI in the shoulder.
Joint Injury: A fracture or even a sprain weakens the joints. An injury like this tends to accelerate joint degeneration. Degeneration can take place over years. If you had a joint injury in childhood, you may find signs of discomfort as you get older.
A Weak Auto-Immune System: The body’s immune system may react upon itself causing poor joint health and lead to severe joint discomfort.
Improper Workouts: When workouts are not done with the proper pre- and post care, it may result in injury to the joints. Some examples: Not warming up before an exercise routine, exercising for too long, prolonged lifting of heavy weights, wrong forms of exercise, not enough recovery time between workouts.
Inactive Lifestyle: Oddly enough, not being active or lack of exercise may also cause joints to degenerate faster. This is because exercise helps increase blood circulation to the body providing the necessary nutrients to all organs and joints. Exercising the joints also helps them to be naturally lubricated. Muscles and tendons are strengthened and help the joint to bear the brunt of body weight and movements.
Wrong Kind of Footwear: Using the wrong kind of footwear can put a strain on the joints, for instance, constant use of improper footwear for running or jogging, high heeled shoes for daily wear. Medical experts believe that “turf toe” could be caused playing sports on artificial turf, wearing footwear that does not support forefoot joints.
Poor Posture: Excess stress is put on the joints due to poor sitting or standing postures. This is especially significant if your job requires you to stand or sit for long periods of time. Today, people are used to sitting in front of computer screens for long hours. Care should be taken to follow precautionary measures to avoid joint discomfort.
Physical Labor: Short-term joint pains can be caused by sporadic periods of hard work involving heavy lifting, or using muscles and joints that are not normally used!
Lack of Proper Nutrition: Vitamins and minerals are needed for joint health, but the body also needs specific nutrients for the repair and maintenance of cartilage and production of synovial fluid without which joints will degenerate. Without this kind of nutrition, cartilage becomes thin and easily tears. The production of synovial fluid declines. There are natural nutrients found in the joints which the body needs for proper joint functions.
• Type II Collagen makes up 70 percent of the cartilage.
• Glucosamine sulfate, a natural nutrient, found in the joint helps to repair and maintain cartilage.
• Hyal Joint, another nutrient, helps to lubricate the joint.
• MSM is essential for the building of cartilage and connective tissue.
All of these nutrients, as oral supplements, have been researched well and indicate efficacy in helping to support joint functions and help ease joint discomfort. In addition Green lipped mussel extract, rich in omega 3 fatty acids, helps support mobility of joint. Grape seed extract supports blood circulation.
Supplements like GoFlex are physician-approved and contain all the nutrients and herbs required for maintaining the ten joints in your body that are most prone to injury and joint discomfort. The free topical cream contains an FDA approved pain-relieving ingredient called capsaicin. Capsaicin penetrates deep into the skin all the way to the joints to provide instant joint pain relief. The oral supplements nourish your joints from the inside for long term support of joint health!
Go Flex provides comprehensive health care through nutritional joint health supplements and topical analgesic application.
Colon Cleanse and Weight Loss
For many of us, beginning a weight loss program can be very difficult. Often we lack motivation or lose energy and inspiration somewhere in the initial stages of the program. There are a number of colon cleansers that advertise weight loss anywhere from 10 to 25 pounds in just a few days.
Does this sound incredible? These claims of easy yet substantial weight loss warrant questioning—are they too good to be true?
Colon cleansers can help you feel slimmer by helping to lose some bloating due to gas and waste matter in your gut. There is no doubt that a thorough evacuation of waste accumulated in the bowels can help you feel lighter—and in turn you may even feel more energetic. Some people report a feeling of mental freshness and alertness as well. But more importantly, an effective colon cleanser may very well help you to get the motivation and inspiration you need to begin a healthy weight loss program.
Read about some of the health benefits associated with herbal colon cleansing. Constipation and accumulated waste in the body can affect how you feel--this can lead to a sense of tiredness and a lack of motivation. Herbal colon cleansers can work with your body’s natural processes for effective removal of waste. Various herbs can also help to promote bowel regularity. Some colon cleansers offer special herbs that may aid the body’s eliminatory system. Some herbs can assist your body in bringing your digestive health back on track. It is possible that if we are living on a perpetual diet that consists of processed foods, saturated fats, sugars, sweetened sodas, and fried foods, the digestive system can become sluggish because of a lack of fiber and healthy nutrition.
Processed foods, which often contain chemicals and preservatives, can add to the load of unhealthy waste in the body. Digestive herbs, including fiber and probiotics, can aid the body’s digestive system and help support healthy cholesterol levels absorb nutrients and restore a healthy microflora through probiotics.
Dietary fiber found in most herbal colon cleansers can bind waste in the intestines for effective elimination from the body. It also promotes feelings of satiety, so you feel fuller, longer. Many users who have used an effective herbal colon cleanse program report feeling a sense of being “lighter”, having more energy, and feeling less abdominal bloating.
These positive feelings that are sometimes associated with an effective colon cleanser can give you the motivation to start and maintain a healthy, balanced diet and exercise regimen!
Does this sound incredible? These claims of easy yet substantial weight loss warrant questioning—are they too good to be true?
Colon cleansers can help you feel slimmer by helping to lose some bloating due to gas and waste matter in your gut. There is no doubt that a thorough evacuation of waste accumulated in the bowels can help you feel lighter—and in turn you may even feel more energetic. Some people report a feeling of mental freshness and alertness as well. But more importantly, an effective colon cleanser may very well help you to get the motivation and inspiration you need to begin a healthy weight loss program.
Read about some of the health benefits associated with herbal colon cleansing. Constipation and accumulated waste in the body can affect how you feel--this can lead to a sense of tiredness and a lack of motivation. Herbal colon cleansers can work with your body’s natural processes for effective removal of waste. Various herbs can also help to promote bowel regularity. Some colon cleansers offer special herbs that may aid the body’s eliminatory system. Some herbs can assist your body in bringing your digestive health back on track. It is possible that if we are living on a perpetual diet that consists of processed foods, saturated fats, sugars, sweetened sodas, and fried foods, the digestive system can become sluggish because of a lack of fiber and healthy nutrition.
Processed foods, which often contain chemicals and preservatives, can add to the load of unhealthy waste in the body. Digestive herbs, including fiber and probiotics, can aid the body’s digestive system and help support healthy cholesterol levels absorb nutrients and restore a healthy microflora through probiotics.
Dietary fiber found in most herbal colon cleansers can bind waste in the intestines for effective elimination from the body. It also promotes feelings of satiety, so you feel fuller, longer. Many users who have used an effective herbal colon cleanse program report feeling a sense of being “lighter”, having more energy, and feeling less abdominal bloating.
These positive feelings that are sometimes associated with an effective colon cleanser can give you the motivation to start and maintain a healthy, balanced diet and exercise regimen!
Tuesday, October 13, 2009
Eat a High-Protein Diet
Now the big question is, how often and how much protein should we eat each day? Well, it’s a fact that muscles grow because of net protein synthesis, which is the difference between protein degradation and synthesis. In the average couch potato, this net difference is zero. He or she isn’t causing any muscle damage, so protein requirements are the same day in and day out. If we’re bodybuilding or weight training intensely and correctly, we should be causing a good deal of muscle fiber damage, and thus we need extra protein to repair this damage.
As to how much protein we need, some studies show that to elicit muscle growth beyond what we’d normally achieve, we need quite a bit more than the RDA of 70 or so grams. I personally make sure to get at least one gram per pound of my lean body weight. For example, if I weigh 200 pounds and have a body fat percentage of 5 percent, my lean body mass is 190 pounds, so I’d make sure to get at least 190 grams of protein, preferably more, each day divided among my six meals
Disorders of the Kidney
Your kidneys have tremendous excess capacity to do their job. In fact, you can lose more than 50 percent of your renal (kidney) function and remain healthy. However, serious health problems occur when renal function drops to 20 percent, and either a kidney transplant or dialysis is required if renal function drops below 10 to 15 percent. Once nephrons (the filtering units of the kidneys) have been destroyed, either suddenly through injury or poisoning or gradually after years of kidney disease, they can never be regenerated or repaired.
Diabetes and hypertension (high blood pressure) are the two leading causes of kidney disease. In diabetes, blood flow through the kidneys increases, causing the kidneys to enlarge, and the excess sugar in the blood damages the glomeruli (tiny blood vessels that are part of the nephrons). High blood pressure can cause kidney disease by damaging the small blood vessels needed for filtering and reabsorption of fluids. Conversely, hypertension can result from kidney disease if blood flow through the kidneys is obstructed or slowed, resulting in the release of hormones that cause blood pressure to rise.
Kidney Stones
A healthy kidney removes extra electrolytes and other minerals from the blood. Normally the chemical composition of urine and prompt urination prevent these electrolytes and minerals from forming crystals and building up on the inner surfaces of the kidney. Some crystals that form may pass through the urinary tract unnoticed. However, others may accumulate until they have formed kidney stones.
Why kidney stones form in some people and not in others remains unknown. Men, especially white men, develop kidney stones more frequently than women. Kidney stones usually develop between ages 20 and 40, and once one stone has been diagnosed, more are likely to develop. A family history of kidney stones increases the risk, as do certain disorders of the kidney and recurrent kidney infections. Other diseases (such as gout and chronic inflammatory disorders) and certain medications (such as diuretics and calcium-based antacids) also can cause kidney stones.
The warning signs of kidney stones are unmistakable. Stones that are not causing symptoms may be found by chance on an X-ray or ultrasound image. Most kidney stones can be passed through the urinary system by drinking plenty of water (2 to 3 quarts per day), and taking over-the-counter pain medication as needed. If you ever pass a kidney stone, be sure to save it for testing: knowing the composition of the stone will help your doctor determine the appropriate treatment and recommend steps to prevent future stones.
Surgery is rarely needed to remove or to break up kidney stones. However, if a stone does not pass through the ureter and blocks urine flow, or if a stone causes ongoing urinary tract infection, medical treatment will be required. Extracorporeal shockwave lithotripsy (ESWL) passes shock waves through the body until they strike the stones and reduce them to the consistency of sand so they can be excreted in the urine. Lithotripsy usually is done on an outpatient basis. The procedure is performed using either intravenous sedation or epidural (spinal) anesthesia. Some lithotripsy devices require the patient to be in a water bath during the procedure, while others require that the patient lie on a soft cushion or pad.
A procedure called percutaneous nephrolithotomy may be performed when stones are especially large or when they are in tissues that make lithotripsy ineffective. In this procedure the surgeon makes a tiny incision in the patient’s back and inserts a nephroscope (a special type of viewing tube) to locate and remove the stone. For stones that are lower in the ureter, a thin, flexible viewing tube (called a ureteroscope) is passed up through the urethra and the bladder to the stone; the stone is then either removed or shattered. Both of these procedures are performed using general or epidural anesthesia, and both require either a short hospital stay or are done on an outpatient basis.
Additional kidney stones are likely to develop unless preventive measures are taken. The chemical composition of the first stone must be analyzed so the doctor can determine appropriate dietary changes and prescribe appropriate medications. Often the person is asked to collect a couple of 24-hour urine samples for analysis. The doctor also will advise the person to drink plenty of fluids (at least eight 8-ounce glasses per day), especially water. Additional treatment will be required if an underlying cause for the stones is diagnosed. Regular urinalysis will be important for monitoring the effectiveness of preventive measures and treatment.
Glomerular Diseases
Blood enters the kidneys through arteries that branch off inside the kidneys into tiny clusters of looping blood vessels called glomeruli. The glomerulus is part of the nephron, the basic filtering unit of the kidney. When the glomeruli are damaged, protein and, in some cases, red blood cells leak into the urine. When a certain type of protein called albumin is lost in the urine, the body is less able to remove excess fluid; the excess fluid causes edema (swelling) in the face, hands, feet, or ankles. Diseases that affect kidney function by damaging these filtering clusters of blood vessels are called glomerular diseases. When the attached renal tubules are affected, a condition known as nephrotic syndrome develops.
In glomerulonephritis, the membranous tissue in the kidney that serves as a filter becomes inflamed. In glomerulosclerosis, the tiny blood vessels that form the clusters become hardened or scarred. Signs of a glomerular disease include facial puffiness, hematuria (blood in the urine), or foamy urine caused by excretion of extra protein. Nephrotic syndrome is marked by very high levels of protein in the urine, low levels of protein in the blood, swelling (usually of the face, hands, or feet), and high levels of cholesterol in the blood. Blood tests, urinalysis, and other specialized tests can determine the type and the location of damage.
Glomerular diseases also can result from infection in other parts of the body, such as “strep” throat, endocarditis (inflammation of the lining of the heart), and human immunodeficiency virus (HIV) infection. Treatment varies according to the underlying cause and the tissues affected.
Kidney Failure
During acute renal failure, the kidneys may suddenly lose their ability to remove wastes, concentrate urine, and conserve water and essential nutrients. Urine production decreases or stops completely. Often there is blood in the urine. Protein waste products quickly accumulate in the blood, damaging tissues and reducing organ function throughout the body. This condition, known as uremia, can be fatal if kidney function is not restored promptly and if the blood is not filtered and cleansed. Symptoms of this toxic reaction include drowsiness, confusion, loss of appetite, nausea and vomiting, and seizures. The onset of symptoms is rapid, often occurring within days, but the condition can be reversed if diagnosed and treated quickly.
Disorders of the kidney itself also can lead to acute renal failure. These disorders include direct injury to the kidney, a urinary tract infection such as acute pyelonephritis, kidney stones, renal cell cancer, and any obstruction of the urinary tract. Acute renal failure also can be caused by reduced blood flow, which can occur after an injury, during complicated surgery, when there is uncontrolled bleeding elsewhere in the body, following severe burns, or as a result of another serious illness. Exposure to poisons, solvents, certain medications, or a blood transfusion can cause injury to the kidney tubules and, in turn, acute renal failure. Severe infections, autoimmune diseases, and uncontrolled high blood pressure are other possible causes of renal failure.
Both kidney failure and its underlying cause must be treated promptly. Dialysis may be required to cleanse the blood mechanically and prevent complications such as congestive heart failure. If you experience acute kidney failure, you will be placed on a diet that is low in protein, potassium, and sodium, and your fluid intake will be closely matched to your fluid output. You may recover adequate kidney function within 2 months, although your kidneys will not return to full normal function for much longer, perhaps a year.
In chronic renal failure, the kidneys lose the same amount of function as in acute renal failure, but the loss occurs slowly over many years. The loss of kidney function is continuous and progressive and may eventually lead to end-stage renal disease. In the early stages of chronic renal failure, there are no symptoms because of the excess capacity of the kidneys to do their job. When symptoms finally appear, the damage already done is irreversible, so treatment focuses on preventing additional damage to the kidneys and slowing the progression of the disease.
Diabetes and high blood pressure are major causes of chronic renal failure. Polycystic kidney disease, sickle-cell disease, glomerular diseases, obstructive disorders, kidney stones, the urinary tract infection pyelonephritis, and analgesic nephropathy all can lead to chronic renal failure.
In addition to treating the underlying cause of chronic renal failure, the doctor will take steps to prevent or treat complications that may result from limited kidney function. You may be given erythropoietin (epoetin alfa), a hormone that stimulates bone marrow to produce more red blood cells. You will be placed on a diet that is low in protein, phosphorus, potassium, sodium, and fluids to reduce the strain on your kidneys. If you continue to lose kidney function and progress to end-stage renal disease, you and your doctor will discuss your treatment options so you can make an informed decision.
End-Stage Renal Disease
People in end-stage renal disease (ESRD) have limited options. Because their kidneys have stopped working, they must have their blood cleansed by some means or they will die. They can undergo either hemodialysis or peritoneal dialysis, or they can have a kidney transplant. Many people who have the choice will opt for transplantation because it offers a better quality of life over the long term.
Kidney transplantation succeeds in most cases. Unless they are causing high blood pressure or are frequently infected, your own kidneys usually are left in place and the new kidney is placed between them and your bladder. The surgeon connects the artery and vein of the transplanted kidney to one of your arteries and one of your veins and connects the new kidney’s ureter to your bladder. The transplanted kidney may start working right away, or it may take up to a few weeks to produce urine.
The donated kidney must match your blood type and be very similar to your kidneys’ tissue type. Often a blood relative (a parent, sibling, or child) can supply a kidney for transplantation. Sometimes a spouse or a friend can provide a close match. Otherwise you will need to wait for a donation from someone who has recently died but who has healthy kidneys that match yours.
The surgery will take 3 to 6 hours, and you will stay in the hospital for up to 2 weeks afterward. Your doctor will give you immunosuppressant drugs to reduce the chance of your body rejecting the new kidney. You will take these drugs for the rest of your life. If your body does not accept the new kidney, you will need to continue using dialysis until another donor kidney can be found.
Kidney Cancer
Kidney cancer is the eighth most common type of cancer among men. Twice as many men as women develop kidney cancer. The cause of this type of cancer remains unknown. Possible risk factors include smoking (which doubles the risk of kidney cancer), exposure to asbestos or cadmium, a family history of kidney cancer, eating a high-fat diet, being overweight, and undergoing long-term dialysis.
Different types of cancer can occur in the kidneys. The most common form of kidney cancer in adults is called renal cell cancer. As renal cell cancer grows, it may invade nearby organs, such as the liver, colon, or pancreas, or it may spread via the blood or the lymphatic system to other parts of the body, such as the lungs or the bones. A less common type of cancer, transitional cell cancer, can occur in the kidneys, but occurs more often in the bladder.
Initially renal cell cancer does not cause symptoms. As the tumor grows, however, symptoms may develop, including blood in the urine, a lump near the affected kidney, fatigue, loss of appetite, weight loss, recurrent fevers, pain in the side, and a vague feeling of being ill. If you have any of these symptoms— which could point to many of the urinary tract disorders your doctor will perform tests to identify the cause of the problem. The earlier cancer is diagnosed and treated, the better the chances for recovery.
Once cancer is detected, your doctor will want to determine whether it has spread. This will influence your treatment options. Often, all or part of the cancerous kidney is removed surgically, along with the adrenal gland and any nearby lymph nodes. If the tumor cannot be removed, the doctor may try to block blood flow to the tumor by clogging the renal artery that supplies blood to the diseased kidney; this will starve the tumor of the blood it needs. In either case, the remaining healthy kidney will do the work of both kidneys.
Radiation therapy, while not a cure, may be used to shrink large tumors or to treat metastases (cancer that has spread to other parts of the body) in the bones. Immunotherapy (treatment in which the body’s immune system is stimulated to destroy cancer cells), chemotherapy (treatment with powerful anticancer drugs), and hormone therapy (treatment involving hormones that affect the growth of cancer cells) all attack the cancer at the systemic level. This means that the entire body is treated at the same time. Treating cancer at the systemic level may cause more unpleasant side effects (including nausea, vomiting, and hair loss) than other forms of treatment.
Diabetes and hypertension (high blood pressure) are the two leading causes of kidney disease. In diabetes, blood flow through the kidneys increases, causing the kidneys to enlarge, and the excess sugar in the blood damages the glomeruli (tiny blood vessels that are part of the nephrons). High blood pressure can cause kidney disease by damaging the small blood vessels needed for filtering and reabsorption of fluids. Conversely, hypertension can result from kidney disease if blood flow through the kidneys is obstructed or slowed, resulting in the release of hormones that cause blood pressure to rise.
Kidney Stones
A healthy kidney removes extra electrolytes and other minerals from the blood. Normally the chemical composition of urine and prompt urination prevent these electrolytes and minerals from forming crystals and building up on the inner surfaces of the kidney. Some crystals that form may pass through the urinary tract unnoticed. However, others may accumulate until they have formed kidney stones.
Why kidney stones form in some people and not in others remains unknown. Men, especially white men, develop kidney stones more frequently than women. Kidney stones usually develop between ages 20 and 40, and once one stone has been diagnosed, more are likely to develop. A family history of kidney stones increases the risk, as do certain disorders of the kidney and recurrent kidney infections. Other diseases (such as gout and chronic inflammatory disorders) and certain medications (such as diuretics and calcium-based antacids) also can cause kidney stones.
The warning signs of kidney stones are unmistakable. Stones that are not causing symptoms may be found by chance on an X-ray or ultrasound image. Most kidney stones can be passed through the urinary system by drinking plenty of water (2 to 3 quarts per day), and taking over-the-counter pain medication as needed. If you ever pass a kidney stone, be sure to save it for testing: knowing the composition of the stone will help your doctor determine the appropriate treatment and recommend steps to prevent future stones.
Surgery is rarely needed to remove or to break up kidney stones. However, if a stone does not pass through the ureter and blocks urine flow, or if a stone causes ongoing urinary tract infection, medical treatment will be required. Extracorporeal shockwave lithotripsy (ESWL) passes shock waves through the body until they strike the stones and reduce them to the consistency of sand so they can be excreted in the urine. Lithotripsy usually is done on an outpatient basis. The procedure is performed using either intravenous sedation or epidural (spinal) anesthesia. Some lithotripsy devices require the patient to be in a water bath during the procedure, while others require that the patient lie on a soft cushion or pad.
A procedure called percutaneous nephrolithotomy may be performed when stones are especially large or when they are in tissues that make lithotripsy ineffective. In this procedure the surgeon makes a tiny incision in the patient’s back and inserts a nephroscope (a special type of viewing tube) to locate and remove the stone. For stones that are lower in the ureter, a thin, flexible viewing tube (called a ureteroscope) is passed up through the urethra and the bladder to the stone; the stone is then either removed or shattered. Both of these procedures are performed using general or epidural anesthesia, and both require either a short hospital stay or are done on an outpatient basis.
Additional kidney stones are likely to develop unless preventive measures are taken. The chemical composition of the first stone must be analyzed so the doctor can determine appropriate dietary changes and prescribe appropriate medications. Often the person is asked to collect a couple of 24-hour urine samples for analysis. The doctor also will advise the person to drink plenty of fluids (at least eight 8-ounce glasses per day), especially water. Additional treatment will be required if an underlying cause for the stones is diagnosed. Regular urinalysis will be important for monitoring the effectiveness of preventive measures and treatment.
Glomerular Diseases
Blood enters the kidneys through arteries that branch off inside the kidneys into tiny clusters of looping blood vessels called glomeruli. The glomerulus is part of the nephron, the basic filtering unit of the kidney. When the glomeruli are damaged, protein and, in some cases, red blood cells leak into the urine. When a certain type of protein called albumin is lost in the urine, the body is less able to remove excess fluid; the excess fluid causes edema (swelling) in the face, hands, feet, or ankles. Diseases that affect kidney function by damaging these filtering clusters of blood vessels are called glomerular diseases. When the attached renal tubules are affected, a condition known as nephrotic syndrome develops.
In glomerulonephritis, the membranous tissue in the kidney that serves as a filter becomes inflamed. In glomerulosclerosis, the tiny blood vessels that form the clusters become hardened or scarred. Signs of a glomerular disease include facial puffiness, hematuria (blood in the urine), or foamy urine caused by excretion of extra protein. Nephrotic syndrome is marked by very high levels of protein in the urine, low levels of protein in the blood, swelling (usually of the face, hands, or feet), and high levels of cholesterol in the blood. Blood tests, urinalysis, and other specialized tests can determine the type and the location of damage.
Glomerular diseases also can result from infection in other parts of the body, such as “strep” throat, endocarditis (inflammation of the lining of the heart), and human immunodeficiency virus (HIV) infection. Treatment varies according to the underlying cause and the tissues affected.
Kidney Failure
During acute renal failure, the kidneys may suddenly lose their ability to remove wastes, concentrate urine, and conserve water and essential nutrients. Urine production decreases or stops completely. Often there is blood in the urine. Protein waste products quickly accumulate in the blood, damaging tissues and reducing organ function throughout the body. This condition, known as uremia, can be fatal if kidney function is not restored promptly and if the blood is not filtered and cleansed. Symptoms of this toxic reaction include drowsiness, confusion, loss of appetite, nausea and vomiting, and seizures. The onset of symptoms is rapid, often occurring within days, but the condition can be reversed if diagnosed and treated quickly.
Disorders of the kidney itself also can lead to acute renal failure. These disorders include direct injury to the kidney, a urinary tract infection such as acute pyelonephritis, kidney stones, renal cell cancer, and any obstruction of the urinary tract. Acute renal failure also can be caused by reduced blood flow, which can occur after an injury, during complicated surgery, when there is uncontrolled bleeding elsewhere in the body, following severe burns, or as a result of another serious illness. Exposure to poisons, solvents, certain medications, or a blood transfusion can cause injury to the kidney tubules and, in turn, acute renal failure. Severe infections, autoimmune diseases, and uncontrolled high blood pressure are other possible causes of renal failure.
Both kidney failure and its underlying cause must be treated promptly. Dialysis may be required to cleanse the blood mechanically and prevent complications such as congestive heart failure. If you experience acute kidney failure, you will be placed on a diet that is low in protein, potassium, and sodium, and your fluid intake will be closely matched to your fluid output. You may recover adequate kidney function within 2 months, although your kidneys will not return to full normal function for much longer, perhaps a year.
In chronic renal failure, the kidneys lose the same amount of function as in acute renal failure, but the loss occurs slowly over many years. The loss of kidney function is continuous and progressive and may eventually lead to end-stage renal disease. In the early stages of chronic renal failure, there are no symptoms because of the excess capacity of the kidneys to do their job. When symptoms finally appear, the damage already done is irreversible, so treatment focuses on preventing additional damage to the kidneys and slowing the progression of the disease.
Diabetes and high blood pressure are major causes of chronic renal failure. Polycystic kidney disease, sickle-cell disease, glomerular diseases, obstructive disorders, kidney stones, the urinary tract infection pyelonephritis, and analgesic nephropathy all can lead to chronic renal failure.
In addition to treating the underlying cause of chronic renal failure, the doctor will take steps to prevent or treat complications that may result from limited kidney function. You may be given erythropoietin (epoetin alfa), a hormone that stimulates bone marrow to produce more red blood cells. You will be placed on a diet that is low in protein, phosphorus, potassium, sodium, and fluids to reduce the strain on your kidneys. If you continue to lose kidney function and progress to end-stage renal disease, you and your doctor will discuss your treatment options so you can make an informed decision.
End-Stage Renal Disease
People in end-stage renal disease (ESRD) have limited options. Because their kidneys have stopped working, they must have their blood cleansed by some means or they will die. They can undergo either hemodialysis or peritoneal dialysis, or they can have a kidney transplant. Many people who have the choice will opt for transplantation because it offers a better quality of life over the long term.
Kidney transplantation succeeds in most cases. Unless they are causing high blood pressure or are frequently infected, your own kidneys usually are left in place and the new kidney is placed between them and your bladder. The surgeon connects the artery and vein of the transplanted kidney to one of your arteries and one of your veins and connects the new kidney’s ureter to your bladder. The transplanted kidney may start working right away, or it may take up to a few weeks to produce urine.
The donated kidney must match your blood type and be very similar to your kidneys’ tissue type. Often a blood relative (a parent, sibling, or child) can supply a kidney for transplantation. Sometimes a spouse or a friend can provide a close match. Otherwise you will need to wait for a donation from someone who has recently died but who has healthy kidneys that match yours.
The surgery will take 3 to 6 hours, and you will stay in the hospital for up to 2 weeks afterward. Your doctor will give you immunosuppressant drugs to reduce the chance of your body rejecting the new kidney. You will take these drugs for the rest of your life. If your body does not accept the new kidney, you will need to continue using dialysis until another donor kidney can be found.
Kidney Cancer
Kidney cancer is the eighth most common type of cancer among men. Twice as many men as women develop kidney cancer. The cause of this type of cancer remains unknown. Possible risk factors include smoking (which doubles the risk of kidney cancer), exposure to asbestos or cadmium, a family history of kidney cancer, eating a high-fat diet, being overweight, and undergoing long-term dialysis.
Different types of cancer can occur in the kidneys. The most common form of kidney cancer in adults is called renal cell cancer. As renal cell cancer grows, it may invade nearby organs, such as the liver, colon, or pancreas, or it may spread via the blood or the lymphatic system to other parts of the body, such as the lungs or the bones. A less common type of cancer, transitional cell cancer, can occur in the kidneys, but occurs more often in the bladder.
Initially renal cell cancer does not cause symptoms. As the tumor grows, however, symptoms may develop, including blood in the urine, a lump near the affected kidney, fatigue, loss of appetite, weight loss, recurrent fevers, pain in the side, and a vague feeling of being ill. If you have any of these symptoms— which could point to many of the urinary tract disorders your doctor will perform tests to identify the cause of the problem. The earlier cancer is diagnosed and treated, the better the chances for recovery.
Once cancer is detected, your doctor will want to determine whether it has spread. This will influence your treatment options. Often, all or part of the cancerous kidney is removed surgically, along with the adrenal gland and any nearby lymph nodes. If the tumor cannot be removed, the doctor may try to block blood flow to the tumor by clogging the renal artery that supplies blood to the diseased kidney; this will starve the tumor of the blood it needs. In either case, the remaining healthy kidney will do the work of both kidneys.
Radiation therapy, while not a cure, may be used to shrink large tumors or to treat metastases (cancer that has spread to other parts of the body) in the bones. Immunotherapy (treatment in which the body’s immune system is stimulated to destroy cancer cells), chemotherapy (treatment with powerful anticancer drugs), and hormone therapy (treatment involving hormones that affect the growth of cancer cells) all attack the cancer at the systemic level. This means that the entire body is treated at the same time. Treating cancer at the systemic level may cause more unpleasant side effects (including nausea, vomiting, and hair loss) than other forms of treatment.
Disorders of the Knee
The knee is a modified hinge joint between the femur (thighbone) and the tibia (shin bone). The knee allows you to bend and straighten your leg. It also allows slight rotation of the lower leg when the knee is bent. Your hamstring muscles bend the knee, while your quadriceps muscles straighten the knee. Strong ligaments join your femur to your lower leg bones (tibia and fibula) and limit side-to-side movement, overextension, and overbending of the knee. The ligaments also limit sliding movement between the bones. Your knee also has two menisci (crescent-shaped disks of cartilage) to reduce friction and distribute the weight-bearing load evenly during walking or running. The knee joint is vulnerable to injury from the front or either side, as well as from overextension. Injury can affect the menisci or any of the ligaments, bursae, cartilage, bones, or tendons that form the knee. The knee is prone to a number of disorders and injuries because of its special design and because it bears weight and provides movement.
Torn Ligament
A torn ligament usually results from a severe twist or a forceful blow to the knee when the knee is bent and then straightened. It also can occur when the foot is placed firmly on the ground and the leg is straightened while the knee is twisted. Each ligament in the knee is subjected to tremendous stress and strain. Injuries to ligaments usually cause immediate pain that is present even at rest. The pain increases when the knee is bent or when weight is put on the knee. The joint also may be swollen and warm. There may be stiffness, and movement may be limited. You may hear or feel a “pop,” and your knee may give out when the ligament tears. Injury to a ligament on the side of the joint causes pain in that side of the knee. Injury to a ligament within the joint causes pain deep inside the knee.
Ligament injuries are first treated with RICE. You also must use some form of support (such as crutches or a cane) to avoid putting weight on the injured knee joint. In some cases a splint or a brace is needed for long-term immobilization of the joint. Nonsteroidal anti-inflammatory drugs such as aspirin or ibuprofen will help relieve pain and reduce inflammation. Arthroscopy (search arthroscopy for more info) often is needed to repair the ligament. Your knee joint may be unstable after this injury and may be more susceptible to recurring ligament or cartilage tears. Your doctor may recommend working with a physical therapist or an athletic trainer on exercises that will stabilize the ligaments and tendons and strengthen the leg muscles.
Torn Cartilage
Either meniscus in the knee can be torn during sharp, rapid, twisting motions. The incidence of this type of injury rises with age and participation in sports that require quick, reactive movements, such as basketball, downhill skiing, and soccer. Certain knee motions cause a popping sensation, sometimes accompanied by swelling, warmth, and instability in the joint. Treatment for torn cartilage is similar to treatment for a torn ligament. A torn meniscus is often repaired using arthroscopy.
Other Knee Disorders
Tendinitis can occur in the front of your knee below the patella (kneecap) or in the back of the knee at the popliteal tendon. As with ligament injury, tendinitis is treated with RICE and nonsteroidal antiinflammatory medication such as aspirin or ibuprofen. Rehabilitative exercise programs can begin when the swelling is gone. Because corticosteroid injections can rupture knee tendons, they are rarely, and very carefully, given. Surgical repair of a severely ruptured tendon may be necessary.
Bursitis of the knee commonly occurs on the inside of the knee and on the front of the kneecap. Treatment is similar to that for the ligament and tendon injuries described above. Osteoarthritis is a common cause of pain and inflammation in the knees. In severe cases, surgery to replace the damaged knee joints may be necessary
Torn Ligament
A torn ligament usually results from a severe twist or a forceful blow to the knee when the knee is bent and then straightened. It also can occur when the foot is placed firmly on the ground and the leg is straightened while the knee is twisted. Each ligament in the knee is subjected to tremendous stress and strain. Injuries to ligaments usually cause immediate pain that is present even at rest. The pain increases when the knee is bent or when weight is put on the knee. The joint also may be swollen and warm. There may be stiffness, and movement may be limited. You may hear or feel a “pop,” and your knee may give out when the ligament tears. Injury to a ligament on the side of the joint causes pain in that side of the knee. Injury to a ligament within the joint causes pain deep inside the knee.
Ligament injuries are first treated with RICE. You also must use some form of support (such as crutches or a cane) to avoid putting weight on the injured knee joint. In some cases a splint or a brace is needed for long-term immobilization of the joint. Nonsteroidal anti-inflammatory drugs such as aspirin or ibuprofen will help relieve pain and reduce inflammation. Arthroscopy (search arthroscopy for more info) often is needed to repair the ligament. Your knee joint may be unstable after this injury and may be more susceptible to recurring ligament or cartilage tears. Your doctor may recommend working with a physical therapist or an athletic trainer on exercises that will stabilize the ligaments and tendons and strengthen the leg muscles.
Torn Cartilage
Either meniscus in the knee can be torn during sharp, rapid, twisting motions. The incidence of this type of injury rises with age and participation in sports that require quick, reactive movements, such as basketball, downhill skiing, and soccer. Certain knee motions cause a popping sensation, sometimes accompanied by swelling, warmth, and instability in the joint. Treatment for torn cartilage is similar to treatment for a torn ligament. A torn meniscus is often repaired using arthroscopy.
Other Knee Disorders
Tendinitis can occur in the front of your knee below the patella (kneecap) or in the back of the knee at the popliteal tendon. As with ligament injury, tendinitis is treated with RICE and nonsteroidal antiinflammatory medication such as aspirin or ibuprofen. Rehabilitative exercise programs can begin when the swelling is gone. Because corticosteroid injections can rupture knee tendons, they are rarely, and very carefully, given. Surgical repair of a severely ruptured tendon may be necessary.
Bursitis of the knee commonly occurs on the inside of the knee and on the front of the kneecap. Treatment is similar to that for the ligament and tendon injuries described above. Osteoarthritis is a common cause of pain and inflammation in the knees. In severe cases, surgery to replace the damaged knee joints may be necessary
West Nile Virus
Symptoms
West Nile virus rarely kills, but about one in 150 people who get it will develop its potentially deadly encephalitis or MENINGITIS. Most people who are infected with the virus will not get sick; about a fifth of those will develop a fever, headache, body aches, and sometimes a rash and swollen lymph glands. Symptoms for West Nile encephalitis or meningitis include headache, high fever, neck stiffness, disorientation, and sometimes paralysis.
Cause
The virus is transmitted to humans via the bite of infected mosquitoes, which become infected when they feed on infected birds. The virus is located in the mosquito’s salivary glands. During feeding, the virus may be injected, multiplying in a person’s blood and crossing the blood-brain barrier to reach the brain, where it inflames brain tissue and interferes with central nervous system function. Among those with severe illness due to West Nile virus, the fatality rates range from 3 percent to 15 percent.
However, even in areas where mosquitoes do carry the virus, very few mosquitoes (less than 1 percent) are infected. If the mosquito is infected, less than 1 percent of people who get bitten and become infected will be severely ill. The chances that any one person will become severely ill from a single mosquito bite are extremely small.
The virus is not spread by touching or kissing a person who has the disease, or from a health-care worker who has treated someone with the disease. Although ticks infected with West Nile virus have been found in Asia and Africa, their role in the transmitting the virus is uncertain. There is no information to suggest that ticks played any role in the cases identified in the United States.
While experts do not know where the U.S. virus originated, it is most closely related genetically to strains found in the Middle East. West Nile virus was first isolated from a feverish woman in the West Nile district of Uganda in 1937. The virus became recognized as a cause of severe inflammation of the spinal cord and brain in elderly patients during an outbreak in Israel in 1957. Equine disease was first noted in Egypt and France in the early 1960s. It first appeared in North America in 1999, with encephalitis reported in humans and horses.
West Nile virus has been described in Africa, Europe, the Middle East, west and central Asia, and most recently, North America. Recent outbreaks of West Nile virus encephalitis in humans have occurred in the Democratic Republic of the Congo in 1998, Russia in 1999, the United States in 1999–2001, and Israel in 2000.
Although the vast majority of infections have been identified in birds, the virus can infect horses, cats, bats, chipmunks, skunks, squirrels, and domestic rabbits. While there is no evidence that a person can get the virus from handling live or dead infected birds, people should avoid bare-handed contact when handling any dead animals and use gloves or double plastic bags to place the carcass in a garbage can. Normal veterinary infection control precautions should be followed when caring for a horse suspected to have this or any viral infection.
Prevention
To prevent being bitten by infected mosquitoes, people should:
• stay indoors at dawn, dusk, and in the early evening
• wear long-sleeved shirts and long pants outdoors
• spray clothing with repellents containing permethrin or DEET
• apply insect repellent sparingly to exposed skin. An effective repellent contains 35 percent DEET (higher concentrations provide no additional protection).
Von Hippel–Lindau disease
Blood vessels usually grow like branches on a tree, but in children with VHL they form small tumors called angiomas. Doctors carefully monitor angiomas because in certain areas they can cause other medical problems. For example, angiomas on the retina of the eye may lead to permanent vision loss.
Diagnosis
VHL is diagnosed using a special type of X ray called magnetic resonance imaging (MRI) or a computerized tomography (CT) scan. A thorough physical examination and blood tests are also performed.
Symptoms
There are many symptoms of VHL, and they depend on the size and location of the angiomas. Symptoms include headaches, balance problems, dizziness, weakness, vision problems, and high blood pressure. Fluid-filled cysts or tumors (benign or cancerous) may develop around the angiomas, worsening these symptoms. Children with this disorder have a higher risk of developing cancer, especially kidney cancer.
Treatment
VHL is treated depending on the size and location of the angiomas. The goal of treatment is to treat the tumors while they are small and before they put pressure on any of the major organs, such as the brain and the spine. Surgery may be required to remove the tumors before they create severe problems.
Prognosis
The prognosis for VHL patients depends on both the location and the complications caused by the tumors. If untreated, VHL may result in blindness or permanent brain damage. Fortunately, early detection and treatment can improve a child’s treatment outcome.
Sunday, October 11, 2009
Diagnostic Procedures
• Gastrointestinal series. A gastrointestinal (GI) series is an examination that is used to diagnose or monitor problems in the digestive tract. An upper GI series examines the esophagus, stomach, and duodenum; a lower GI series examines the colon and rectum. These examinations are used to identify blockages, growths, ulcers, inflammation, and other structural abnormalities. Both procedures use barium sulfate to coat the lining of the digestive tract and provide clear images of the digestive tract on a fluoroscope (a special video monitor) or on X-ray film. For an upper GI series, you drink a barium mixture (a thick, white, chalky liquid called barium meal or barium swallow); for a lower GI series, a barium mixture (called a barium enema) is injected into the colon through the anus and rectum. You may be asked to change positions during the examination as the barium reaches different locations in your digestive tract. Usually you can go home immediately after the procedure and should experience no side effects other than constipation and white or gray stools until the barium is completely out of your system.
• Endoscopy. Endoscopy is a diagnostic examination in which a doctor uses a long, thin, flexible lighted tube called an endoscope to look inside the esophagus, stomach, and duodenum. You will be awake during this procedure, but before the examination begins, your throat will be sprayed with a numbing agent so you do not gag when the endoscope is passed down your throat. You also will receive pain medication and a sedative to help you relax. The endoscope has a precision optical system that works like a video camera, allowing the doctor to see inside each organ as it travels through the digestive tract. The endoscope also can blow air into the digestive tract to inflate it and make it easier to examine. Tiny surgical instruments then can be passed through the endoscope to remove tissue for microscopic examination. This procedure is usually brief—about 20 to 30 minutes—but you will need to lie quietly afterward at the doctor’s office for an additional hour or two until the sedative wears off. You may have a sore throat after the procedure.
• Endoscopic retrograde cholangiopancreatography (ERCP). This diagnostic procedure allows your doctor to examine your liver, gallbladder, bile ducts, and pancreas using an endoscope. In ERCP, the initial steps are the same as those described for endoscopy. However, when the endoscope reaches your duodenum, the doctor injects contrast medium (a type of dye) through the endoscope and into your bile ducts. X rays are taken as soon as the contrast medium is injected. If the doctor sees a gallstone or narrowing of the ducts, he or she can pass tiny surgical instruments through the endoscope to remove the obstruction or widen the duct.
• Colonoscopy. Colonoscopy is a diagnostic examination of the entire length of the large intestine, from the rectum all the way up through the colon to the ileum. Colonoscopy can be used to look for polyps in the colon or to diagnose colon cancer. The procedure is performed with a special type of endoscope called a colonoscope. Before the procedure, you will receive pain medication and a sedative to help you relax. While you lie on your left side, your doctor will insert the colonoscope into your rectum and guide it up through the entire large intestine. As the doctor slowly withdraws the colonoscope, he or she examines your colon directly through the colonoscope or on a video monitor. Air can be blown through the colonoscope to inflate the colon and give the doctor a better view. Instruments can be passed through the colonoscope to take tissue samples or to remove polyps. If there is any blood in the colon, your doctor can use a special instrument or drug to stop the bleeding. Colonoscopy usually takes about 30 to 60 minutes, and you will need to lie quietly for an additional hour or two after the examination. Because of the medication you have been given, you should make arrangements in advance for someone to take you home after the procedure.
• Sigmoidoscopy and proctoscopy. As an alternative to a colonoscopy, your doctor may use a type of endoscope called a sigmoidoscope to examine only the rectum and the sigmoid (lower) colon. Or your doctor may use a type of endoscope called a proctoscope to examine only the anus and rectum. These procedures are similar to colonoscopy, but they examine only a limited portion of the gastrointestinal tract, and each procedure takes only about 10 to 20 minutes.
Drink Lots of Water
Those are the basic nutritional principles in the Fitness Made Simple program. Following them will help build muscle and burn fat. However, if you are particularly concerned with fat loss, you need to consider one additional factor.
Surgical Sterilization
Sterilization is a procedure that makes a person incapable of reproducing. Surgical sterilization is the most common method of birth control among Americans. Surgical sterilization for a man is called vasectomy. This procedure involves cutting both vas deferens, the tubes that carry sperm from the testicles. This procedure can be performed on an outpatient basis in a hospital, clinic, or doctor’s office. It takes about 20 minutes and requires only a local anesthetic. An incision is made on both sides near the base of the penis. On each side, the vas deferens is freed from the spermatic cord, pulled up through the incision, made into a loop, cut, and tied. (The vas deferens may also be cauterized, or sealed off, with an electric current.) The incision is closed with three or four sutures. When the local anesthetic wears off, the man may experience a mild, dull ache or pain for a few days. The man still ejaculates but the semen does not contain sperm.
The man is usually advised to rest in bed for 24 hours. Complications from vasectomy are rare (fewer than 5 percent of cases); the most common complications are bleeding and swelling of the scrotum. Most men return to work within a few days. Some doctors advise wearing tight-fitting underwear or a jock strap for 4 to 6 weeks to prevent swelling and pain in the scrotum.
It is important to remember that viable sperm may still be present in the seminal vesicles (the small sacs that store semen) after a vasectomy. For this reason, a man or his partner should continue to use some other form of contraception until those sperm are either ejaculated or die. The man is considered sterile only after a laboratory test confirms that two successive samples of ejaculate, collected 2 to 4 months after the procedure, are free of sperm.
Contrary to what some men believe, vasectomy does not interfere with ejaculation, orgasm, or sex drive. In fact, several studies have shown that many men who have this procedure experience an increase in sexual desire. Vasectomy has been known occasionally to be associated with psychological problems or regrets about having the procedure. When these problems affect sexual performance, counseling is advised.
Women are sterilized by tubal ligation—the cutting and tying of the fallopian tubes, which carry the egg from the ovaries to the uterus. A variety of procedures are currently being used in the United States: abdominal tubal ligation, tubal coagulation by laparoscopy, and minilaparotomy. The first two methods require hospitalization and usually are performed under general anesthesia; the third can be performed on an outpatient basis.
Currently, the trend is for more tubal ligations done by laparoscopy. A thin tube (laparoscope) is inserted through a small incision in the woman’s abdomen (usually through the navel). The doctor cuts the fallopian tubes and ties off the ends. (The ends of the tubes also may be cauterized.) The woman usually goes home the same day. Complication rates for this procedure are very low.
About a third of all married couples in the United States who use family planning methods choose sterilization of either partner. It is the method most often chosen by couples in which the woman is more than 30 years old. Vasectomy is more common than tubal ligation because it is simpler, just as effective, less expensive, and has fewer potential complications.
For couples who know that they do not want more children, sterilization is the most effective way to prevent pregnancy. Because the surgical procedures to reverse either vasectomy or tubal ligation are complicated and expensive, the results should be considered permanent. Although researchers are studying ways to easily reverse these procedures, they are not yet available.
If you have questions about any contraceptive method, ask your primary care doctor, a urologist (a physician who specializes in treating disorders of the urinary tract), or a gynecologist (a physician who specializes in treating disorders of the female reproductive system).
The man is usually advised to rest in bed for 24 hours. Complications from vasectomy are rare (fewer than 5 percent of cases); the most common complications are bleeding and swelling of the scrotum. Most men return to work within a few days. Some doctors advise wearing tight-fitting underwear or a jock strap for 4 to 6 weeks to prevent swelling and pain in the scrotum.
It is important to remember that viable sperm may still be present in the seminal vesicles (the small sacs that store semen) after a vasectomy. For this reason, a man or his partner should continue to use some other form of contraception until those sperm are either ejaculated or die. The man is considered sterile only after a laboratory test confirms that two successive samples of ejaculate, collected 2 to 4 months after the procedure, are free of sperm.
Contrary to what some men believe, vasectomy does not interfere with ejaculation, orgasm, or sex drive. In fact, several studies have shown that many men who have this procedure experience an increase in sexual desire. Vasectomy has been known occasionally to be associated with psychological problems or regrets about having the procedure. When these problems affect sexual performance, counseling is advised.
Women are sterilized by tubal ligation—the cutting and tying of the fallopian tubes, which carry the egg from the ovaries to the uterus. A variety of procedures are currently being used in the United States: abdominal tubal ligation, tubal coagulation by laparoscopy, and minilaparotomy. The first two methods require hospitalization and usually are performed under general anesthesia; the third can be performed on an outpatient basis.
Currently, the trend is for more tubal ligations done by laparoscopy. A thin tube (laparoscope) is inserted through a small incision in the woman’s abdomen (usually through the navel). The doctor cuts the fallopian tubes and ties off the ends. (The ends of the tubes also may be cauterized.) The woman usually goes home the same day. Complication rates for this procedure are very low.
About a third of all married couples in the United States who use family planning methods choose sterilization of either partner. It is the method most often chosen by couples in which the woman is more than 30 years old. Vasectomy is more common than tubal ligation because it is simpler, just as effective, less expensive, and has fewer potential complications.
For couples who know that they do not want more children, sterilization is the most effective way to prevent pregnancy. Because the surgical procedures to reverse either vasectomy or tubal ligation are complicated and expensive, the results should be considered permanent. Although researchers are studying ways to easily reverse these procedures, they are not yet available.
If you have questions about any contraceptive method, ask your primary care doctor, a urologist (a physician who specializes in treating disorders of the urinary tract), or a gynecologist (a physician who specializes in treating disorders of the female reproductive system).
West Nile Virus Encephalitis
The future impact of West Nile virus is uncertain. States on the eastern bird flyway have received federal funding to conduct monitoring activities and perform diagnostic assays. This effort will be expanded nationwide. While all residents of areas where virus activity has been identified are at risk of getting West Nile encephalitis, people over age 50 are at highest risk of severe disease.
Cause
The virus, which normally circulates in birds and mosquitoes, crosses to humans who are bitten by an infected mosquito. The virus then multiplies in the person’s blood and eventually crosses the bloodbrain barrier to reach the brain. At this point, the virus interferes with normal central nervous system functioning and inflames brain tissue.
Symptoms
Most human illness from West Nile infection is mild, but severe disease is more common in the very young and very old, or those people with a weakened immune system. From three to 15 days after infection, symptoms may appear including fever, headache, and body aches, occasionally with skin rash and swollen lymph glands. More severe infection may be marked by headache, high fever, neck stiffness, stupor, disorientation, coma, tremors, convulsions, muscle weakness, paralysis, and, rarely, death.
Less than 1 percent of those infected with West Nile virus will develop severe illness; of those who do, between 3 percent and 15 percent will die.
Diagnosis
Patients who are at high risk and who have symptoms of West Nile encephalitis will have a sample of their blood sent to a lab to confirm the diagnosis.
Treatment
Treatment is supportive for the encephalitis or meningitis associated with the infection. Severely ill patients may be hospitalized and given intravenous fluids, airway management, a ventilator, and perhaps antibiotics to prevent secondary infection.
Whooping Cough
Before the vaccine was available in the 1940s about 200,000 children got sick each year and about 8,000 died. Because the disease can be deadly in infants, babies should be isolated from anyone with whooping cough.
While the number of cases has declined since the introduction of the vaccine, it is far from eradicated. In the year 2000 there were nearly 1,900 cases of whooping cough, including 16 deaths in infants under six months of age.
Whooping cough is most serious in infants, who may often develop pneumonia; babies younger than three months of age get the worst cases. Seventy percent of deaths occur in young babies; about one in 200 infected babies will die. The most infectious time is right at the beginning of the illness.
Doctors must report any suspected or confirmed cases of whooping cough to the health department. If the child attends school or child care, the parent must notify the principal so staff and other children can be given preventive medicine.
Cause
The disease is caused by a rod-shaped bacterium called Bordetella pertussis, which produces a toxin that invades the lining of the throat, windpipe, and bronchial tubes. The tissue damage produces a very thick, irritating mucus leading to severe coughing spells as the child tries to expel it. The thick mucus often leads to pneumonia. A similar but less common bacterium called iB. parapertussis may cause a milder form of the disease.
The disease is spread during coughing, which spews the bacteria outward for several feet. These bacteria can survive on tissue or bed covers for a short time; the disease also can be passed on when another person touches these items. Whooping cough is infectious enough that it will be spread to everyone in the household from one infected patient.
Symptoms
Whooping cough occurs in three stages in children: the first stage starts slowly with cold-like symptoms (sneezing, red or sore eyes, and a lowgrade fever). This occurs with an irritating dry cough for one or two weeks (during which the child is most infectious).
These first symptoms are followed by intense, violent spasms of repeated coughing with no time to breathe between spasms. There is a repetitive series of eight or 10 rapid coughs on one breath that often end in gagging or vomiting. The coughs may end in a characteristic “whoop” as the patient tries to take a breath. Babies under six months of age will choke but will not make the whooping sound; these youngest patients can become very sick. The infected child may appear blue, with bulging eyes and a dazed, apathetic expression. Infants may temporarily stop breathing after a coughing spasm. The periods between coughing are comfortable; there is little fever. This stage may last about two weeks.
The final stage dwindles down into a chronic cough for three to four weeks; some children experience a cough of more than two months.
Complications
A child with the disease may have an ear infection or pneumonia. About one in 500 children younger than six months may develop seizures, coma, or brain damage. The chronic cough may cause nosebleeds and bleeding from blood vessels on the surface of the eyes; recurrent vomiting can cause dehydration and malnourishment.
Diagnosis
The disease is diagnosed by identifying the bacterium in a culture grown from a nasal swab taken in the early stages of the illness. There are two tests, neither of which is 100 percent accurate, and there are many false negatives. The rapid test gives results in a few minutes; a blood test done in mid-disease may identify the bacterium or detect antibodies.
Treatment,
If the illness is recognized early enough, antibiotics such as erythromycin or clarithyromycin are often given; they may shorten the duration of illness and the period of contagiousness, although they are not particularly helpful once the severe coughing stage of the illness has begun.
Patients should be kept warm, given frequent small meals and plenty to drink, and protected from things that produce coughing, such as smoke. An infant or child who becomes blue or keeps vomiting after coughing needs to be admitted to the hospital.
Back pain Surgery
In traditional medicine, back pain is often treated by surgery. And it often doesn't work. So often, in fact, that back pain surgery is the only category of surgery that actually has a clinical term for failure: Failed Back Surgery Syndrome.
If you ask me, any treatment that actually expects failure is not a treatment at all.
I don't care what type of surgery you're considering. With any treatment that only addresses the symptoms - in this case, pain - the question is not what symptoms you have but what caused them.
3 Reasons Surgery Doesn't Work
I'm not going to tell you that you should not have surgery. I can assure you, however, that once you have surgery, everything changes. You will never be the same, even if the surgery is a success.
There are maybe a dozen or so types of surgical procedures for back pain, and all of them attempt to do one of two things: remove the pressure on the nerve or stabilize the spine. Let's take a herniated disc, for example. You have pain because the disc is pressing on the nerve. Your doctor says that the only thing he can do is remove the part of the disc that's touching the nerve.
Your first thought probably is: Good-bye pain!
Not so fast.
1. Once the operation is completed, your body will go through a recovery process that includes a lot of pain and awkward movement just to get you through each day. This is going to be your first potential source of trouble. Because your body now has to contort itself, you'll be putting unnatural wear and tear on other areas of your body. As a result, you may begin to have problems above or below the surgery site or in other joints such as the hips or sacroiliac.
2. All surgeries produce scar tissue. But because back pain surgery occurs so close to nerves, the scar tissue often builds up and makes contact with a nerve. This can cause as much pain as if the disc itself were still putting pressure on the nerve.
3. The rehab you're likely to get soon after the operation is only going to address your postoperative pain. It will help you improve your functional skills to perform what are called "activities of daily living," which include bathing, dressing, going to the bathroom, and the like. This is fine and necessary so you can go home and be safe. But it doesn't address the long-term cause of the pain.
The Causes of Back Pain
Most back pain conditions have to do with something called "postural dysfunctions." Postural dysfunctions are similar to a car's tire being out of proper alignment. In the body, improper alignment is seen as abnormal curvature of the spine and abnormal positioning of the pelvis.
The great news is that we know what cause these postural dysfunctions and how to correct them.
To get our bodies back into balance so they can function normally again, we need to get our muscles back into alignment.
5 Important Questions to Ask
If you are considering surgery, I'd recommend finding a qualified therapist first. Give yourself 60 days to work on stretching and strengthening before you decide whether or not to go under the knife.
If you still opt for surgery, tell both your therapist and your surgeon that you want your postoperative rehab to address both short-term and long-term goals. It must not only work on decreasing your pain so you can safely go home. It also must answer the following five questions related to the root cause or causes of your pain.
1. Which postural dysfunction did you identify? Ask the surgeon and therapist to examine you for dysfunction, including the following two potential abnormalities.
2. How would you describe the curvature of my spine from top to bottom?
3. How would you describe the position of my pelvis (level or tipping)?
4. What are my muscle imbalances? The therapist must explain how your muscles are out of balance - which muscles are strong, weak, flexible or tight in relation to one another.
5. Which muscles do I need to stretch and which ones do I need to strengthen? (Be sure the therapist explains what each muscle group does so you know how to do the exercises correctly.)
Have both your surgeon and your therapist write everything down as part of your long-term goal and ask for a copy.
The Path to Success
If you eventually do decide to have surgery, understand that the number one reason why back pain sufferers fail to get long-term relief -- and by that I mean more than five years -- is that this very simple principle of muscle imbalance was not addressed seriously.
Once you do address it, though, then you really are on the path to a pain-free life.
If you ask me, any treatment that actually expects failure is not a treatment at all.
I don't care what type of surgery you're considering. With any treatment that only addresses the symptoms - in this case, pain - the question is not what symptoms you have but what caused them.
3 Reasons Surgery Doesn't Work
I'm not going to tell you that you should not have surgery. I can assure you, however, that once you have surgery, everything changes. You will never be the same, even if the surgery is a success.
There are maybe a dozen or so types of surgical procedures for back pain, and all of them attempt to do one of two things: remove the pressure on the nerve or stabilize the spine. Let's take a herniated disc, for example. You have pain because the disc is pressing on the nerve. Your doctor says that the only thing he can do is remove the part of the disc that's touching the nerve.
Your first thought probably is: Good-bye pain!
Not so fast.
1. Once the operation is completed, your body will go through a recovery process that includes a lot of pain and awkward movement just to get you through each day. This is going to be your first potential source of trouble. Because your body now has to contort itself, you'll be putting unnatural wear and tear on other areas of your body. As a result, you may begin to have problems above or below the surgery site or in other joints such as the hips or sacroiliac.
2. All surgeries produce scar tissue. But because back pain surgery occurs so close to nerves, the scar tissue often builds up and makes contact with a nerve. This can cause as much pain as if the disc itself were still putting pressure on the nerve.
3. The rehab you're likely to get soon after the operation is only going to address your postoperative pain. It will help you improve your functional skills to perform what are called "activities of daily living," which include bathing, dressing, going to the bathroom, and the like. This is fine and necessary so you can go home and be safe. But it doesn't address the long-term cause of the pain.
The Causes of Back Pain
Most back pain conditions have to do with something called "postural dysfunctions." Postural dysfunctions are similar to a car's tire being out of proper alignment. In the body, improper alignment is seen as abnormal curvature of the spine and abnormal positioning of the pelvis.
The great news is that we know what cause these postural dysfunctions and how to correct them.
To get our bodies back into balance so they can function normally again, we need to get our muscles back into alignment.
5 Important Questions to Ask
If you are considering surgery, I'd recommend finding a qualified therapist first. Give yourself 60 days to work on stretching and strengthening before you decide whether or not to go under the knife.
If you still opt for surgery, tell both your therapist and your surgeon that you want your postoperative rehab to address both short-term and long-term goals. It must not only work on decreasing your pain so you can safely go home. It also must answer the following five questions related to the root cause or causes of your pain.
1. Which postural dysfunction did you identify? Ask the surgeon and therapist to examine you for dysfunction, including the following two potential abnormalities.
2. How would you describe the curvature of my spine from top to bottom?
3. How would you describe the position of my pelvis (level or tipping)?
4. What are my muscle imbalances? The therapist must explain how your muscles are out of balance - which muscles are strong, weak, flexible or tight in relation to one another.
5. Which muscles do I need to stretch and which ones do I need to strengthen? (Be sure the therapist explains what each muscle group does so you know how to do the exercises correctly.)
Have both your surgeon and your therapist write everything down as part of your long-term goal and ask for a copy.
The Path to Success
If you eventually do decide to have surgery, understand that the number one reason why back pain sufferers fail to get long-term relief -- and by that I mean more than five years -- is that this very simple principle of muscle imbalance was not addressed seriously.
Once you do address it, though, then you really are on the path to a pain-free life.
Back pain
Back pain is very common and most people suffer from it at some time, however, most back problems heal naturally. The spinal cord which carries nerves from the brain the rest of the body travels in a canal through the ‘vertebrae’. These are the bones that make up the ‘spinal column’. This is what you feel if you run your fingers up the centre of your back.
What causes back pain and who is at risk?
Pain from the back may have a single cause, such as a blow, a fall or over-exertion, but is far more likely to be caused by a gradual accumulation of stress and strain on the back over a long period. Occasionally, back pain may be caused by pressure on the nerves in the spine, usually from a damaged vertebral disc.
General causes of back pain include:
Prolonged standing or bending at work
Badly designed seating, especially during sedentary work
Stress
Specific causes of back pain include:
Lifting, pulling, pushing or carrying objects incorrectly or that are too heavy
An accident, such as a fall
Menstruation or pre- menstrual syndrome (PMS)
Arthritis
Causes of lumbar pain include:
Pressure on a nerve in the lower back
Bladder infection, an enlarged prostate or prostate cancer
A damaged (‘ruptured’) vertebral disc
Degeneration of the vertebrae (spondylosis)
Inflammation of the vertebrae (spondylitis)
Some other conditions can cause pain:
Inflammation of the pancreas (pancreatitis)
Aortic aneurysm (enlargement and weakening of the major artery called the aorta)
Heartburn
How do doctors recognise back problems?
Pain that travels down the legs below the knee
Weakness or numbness in one or both legs
Loss of control of the bowel or bladder
You should also seek your doctor’s advice if:
You have persistent pain after a severe blow, a fall or an injury
Your back pain lasts longer than a week.
If damage to the nerves of the spinal cord is suspected, you may need additional tests or treatment. These may include X-rays, CT (computerised tomography) scans, MRI (magnetic resonance imaging) or a myelogram (a special X-ray) which shows the nerves and spinal cord (see separate factsheets for descriptions of these investigations).
What is the treatment for back pain?
Self-care action plan
The best way to prevent common back problems is to stay fit and active. An exercise programme should include stretching and strengthening specifically for the back, and aerobic exercises. A physiotherapist, osteopath, chiropractic or fitness trainer can suggest which exercises are best for each individual but remember: any exercise should be gentle and you should never be forced to strain your back.Rest the feet flat on the floor or use a foot support to prevent the weight of the lower legs being supported by the front of the thighs.
To lift safely:
Make a firm base with the feet, keeping them about shoulder width apart
Lift with the legs, bending the knees rather than the back
Do not kneel or overbend the knees
Keep the chin held in and raised as this helps keep the back straight
Ensure the load is as close to the body as possible
Complementary therapy
The Alexander technique can help you adopt a posture that puts less strain on the back.
What causes back pain and who is at risk?
Pain from the back may have a single cause, such as a blow, a fall or over-exertion, but is far more likely to be caused by a gradual accumulation of stress and strain on the back over a long period. Occasionally, back pain may be caused by pressure on the nerves in the spine, usually from a damaged vertebral disc.
General causes of back pain include:
Prolonged standing or bending at work
Badly designed seating, especially during sedentary work
Stress
Specific causes of back pain include:
Lifting, pulling, pushing or carrying objects incorrectly or that are too heavy
An accident, such as a fall
Menstruation or pre- menstrual syndrome (PMS)
Arthritis
Causes of lumbar pain include:
Pressure on a nerve in the lower back
Bladder infection, an enlarged prostate or prostate cancer
A damaged (‘ruptured’) vertebral disc
Degeneration of the vertebrae (spondylosis)
Inflammation of the vertebrae (spondylitis)
Some other conditions can cause pain:
Inflammation of the pancreas (pancreatitis)
Aortic aneurysm (enlargement and weakening of the major artery called the aorta)
Heartburn
How do doctors recognise back problems?
Pain that travels down the legs below the knee
Weakness or numbness in one or both legs
Loss of control of the bowel or bladder
You should also seek your doctor’s advice if:
You have persistent pain after a severe blow, a fall or an injury
Your back pain lasts longer than a week.
If damage to the nerves of the spinal cord is suspected, you may need additional tests or treatment. These may include X-rays, CT (computerised tomography) scans, MRI (magnetic resonance imaging) or a myelogram (a special X-ray) which shows the nerves and spinal cord (see separate factsheets for descriptions of these investigations).
What is the treatment for back pain?
Self-care action plan
The best way to prevent common back problems is to stay fit and active. An exercise programme should include stretching and strengthening specifically for the back, and aerobic exercises. A physiotherapist, osteopath, chiropractic or fitness trainer can suggest which exercises are best for each individual but remember: any exercise should be gentle and you should never be forced to strain your back.Rest the feet flat on the floor or use a foot support to prevent the weight of the lower legs being supported by the front of the thighs.
To lift safely:
Make a firm base with the feet, keeping them about shoulder width apart
Lift with the legs, bending the knees rather than the back
Do not kneel or overbend the knees
Keep the chin held in and raised as this helps keep the back straight
Ensure the load is as close to the body as possible
Complementary therapy
The Alexander technique can help you adopt a posture that puts less strain on the back.
Fight like a Spartan
Over the centuries many people have tried to emulate the Spartan's warrior culture, and to say the least it isn't easy. It requires a whole society to be based around producing the best warriors and little else. Still though they have taught us much about how to prepare for combat and you don't need to stand naked in the snow to prepare yourself for combat in the modern world. Whether you just want to walk down the block to pick up some milk or patrol with confidence you too can train like the ancient Greek warriors. At the end of the day it is all about keeping it simple and brutal.
A Spartan warrior's training regiment rivaled many other warrior cultures of its day, and they started young. Now you don't need to abuse your children to toughen them up for the harsh realities of the outside world, but you can inform them of the real dangers. Let them know to find an adult when there is an emergency or approached by a stranger, and they're never too young to start learning the fundamentals of self defense. Train with your children so if your family is attacked they will react and get help while the adults protect them, and don't rely on just one family member to do all the fighting. Prepare yourself and your children to deal with the worst, and don't sugar coat things.
One of the reasons the Spartans were so successful in battle was that their tactics, and at Battle of Thermopylae their tactics were only enhanced by the terrain. When you get in a fight the conditions are seldom ideal, so practice in different environments. If your self defense techniques don't work in the snow or in the woods they aren't effective, so practice and find out what works in the most situations. When you're in a new place make note of your surrounding and look at your options for escape and defense. Nobody likes to think they'll get in a fight, but brawls can happen anywhere and criminals are always looking for opportunities.
Some martial artists have mastered over 30 different deadly weapons, and while that is impressive it isn't necessary to protect yourself. The Spartan warrior trained with his spear, sword, and shield almost exclusively, and by keeping his training simple he soon became the best with his weapons. When you train have a few primary weapons you practice with all the time, and make them practical choices. A swords and staffs are great weapons, but you can't take those weapons most places. Know your weapons well and practice with them regularly.
When it comes to self defense keep it simple and keep it brutal and the Spartans based their whole way of life around that belief. While you should always strive to be the best in your training you don't have to be the best to defend yourself. Learn simple and effective techniques and prepare yourself for the worse. By training you will make yourself tougher, and you will be confident in the face of danger just like the warriors of old.
A Spartan warrior's training regiment rivaled many other warrior cultures of its day, and they started young. Now you don't need to abuse your children to toughen them up for the harsh realities of the outside world, but you can inform them of the real dangers. Let them know to find an adult when there is an emergency or approached by a stranger, and they're never too young to start learning the fundamentals of self defense. Train with your children so if your family is attacked they will react and get help while the adults protect them, and don't rely on just one family member to do all the fighting. Prepare yourself and your children to deal with the worst, and don't sugar coat things.
One of the reasons the Spartans were so successful in battle was that their tactics, and at Battle of Thermopylae their tactics were only enhanced by the terrain. When you get in a fight the conditions are seldom ideal, so practice in different environments. If your self defense techniques don't work in the snow or in the woods they aren't effective, so practice and find out what works in the most situations. When you're in a new place make note of your surrounding and look at your options for escape and defense. Nobody likes to think they'll get in a fight, but brawls can happen anywhere and criminals are always looking for opportunities.
Some martial artists have mastered over 30 different deadly weapons, and while that is impressive it isn't necessary to protect yourself. The Spartan warrior trained with his spear, sword, and shield almost exclusively, and by keeping his training simple he soon became the best with his weapons. When you train have a few primary weapons you practice with all the time, and make them practical choices. A swords and staffs are great weapons, but you can't take those weapons most places. Know your weapons well and practice with them regularly.
When it comes to self defense keep it simple and keep it brutal and the Spartans based their whole way of life around that belief. While you should always strive to be the best in your training you don't have to be the best to defend yourself. Learn simple and effective techniques and prepare yourself for the worse. By training you will make yourself tougher, and you will be confident in the face of danger just like the warriors of old.
Sleep Disorder
During normal breathing, air passes through the throat on its way to the lungs. The air travels past the soft palate, uvula, tonsils, and tongue. When a person is awake, the muscles in the back of the throat tighten to hold these structures in place preventing them from collapsing and/or vibrating in the airway. During sleep, the uvula and soft palate frequently vibrate causing the distinctive sounds of snoring.
The LAUP procedure is a laser surgical procedure designed to sequentially trim and shorten these structures, thus preventing or reducing snoring.
Risks and ComplicationsYou have the right to be informed that the surgery may involve risks of unsuccessful results, complications, or injury from both known and unforeseen causes. Because individuals vary in their tissue circulation and healing processes, as well as anesthetic reactions, ultimately there can be no guarantee made as to the results or potential complications. The following complications have been reported in the medical literature. This list is not meant to be inclusive of every possible complication. They are listed here for your information only, not to frighten you, but to make you aware and more knowledgeable concerning this surgical procedure.
1. Failure to resolve the snoring. Most surgeons feel that about 85% of patients who undergo a LAUP will have a significant or complete resolution in their snoring; and an additional percentage of patients will notice reduced levels of snoring such that their sleep partners will report that it's level is no longer offensive.
2. Failure to cure sleep apnea or other pathological sleep disorders. Pathological sleep disorders, like sleep apnea, are medical problems which may have associated serious complications. At this time, the LAUP procedure has not been proven to cure these disorders.
3. Bleeding. In very rare situations, a need for blood products or a blood transfusion. You have the right, should you choose, to have autologous or designated donor directed blood pre-arranged. You are encouraged to consult with your doctor if you are interested.
4. Nasal regurgitation, a change in voice, or velopharyngeal insufficiency when liquids may flow into the nasal cavity during swallowing (rare).
5. Failure to resolve coexisting sinus, tonsil, or nasal problems.
6. Need for revision, or further and more aggressive surgery.
7. Prolonged pain, impaired healing, and the need for hospitalization
Friday, October 9, 2009
Treating acne with Accutane
Many people of all ages are troubled by irritating outbreaks of acne and are searching for a cure, once and for all. Very often, in severe cases of acne, their search leads them to Accutane. Also known as Isotretinoin, Accutane is taken orally, and is available only by prescription. It is a five month treatment regimen for severe cystic acne.
Taken once daily with food, Accutane works by decreasing the amount of oils produced by the glands. Acne may worsen before it gets better, and it usually takes about two months on Accutane to notice improvements in symptoms.
While it can be very effective, Accutane has many significant side effects, ranging from mildly irritating to severely life-threatening.
The most frequent side effects reported by Accutane users are:
The most dangerous side effect of Accutane is severe birth defects if taken during pregnancy. It is strongly recommended to avoid becoming pregnant during treatment and for at least one month after stopping Accutane.
Accutane is not guaranteed to cure acne. Reports have found 1 in 10 Accutane users have reoccurrences of acne one year later and 1 in 4 users after two years. It may be prescribed again for reoccurrences of acne.
Taken once daily with food, Accutane works by decreasing the amount of oils produced by the glands. Acne may worsen before it gets better, and it usually takes about two months on Accutane to notice improvements in symptoms.
While it can be very effective, Accutane has many significant side effects, ranging from mildly irritating to severely life-threatening.
The most frequent side effects reported by Accutane users are:
- Dry, chapped, or peeling lips
- Dry, itchy skin
- Dry nose, mild nosebleeds
- Irritation of the eyelids and/or dry eyes
- Joint and muscle pain
- Thinning of the hair
- Rash
- Intestinal problems
- Urinary problems
- Headache
- Increased skin sensitivity to light and sunburn
- Decreased night vision, which may continue
after completing treatment regimen - Depression and/or thoughts of suicide
The most dangerous side effect of Accutane is severe birth defects if taken during pregnancy. It is strongly recommended to avoid becoming pregnant during treatment and for at least one month after stopping Accutane.
Accutane is not guaranteed to cure acne. Reports have found 1 in 10 Accutane users have reoccurrences of acne one year later and 1 in 4 users after two years. It may be prescribed again for reoccurrences of acne.
Preventing Heart Disease
You should always keep in mind that whatever actions you take today can either help to prevent, delay or minimize the effect of heart disease or worsen it. The key is to control risk factors.
Granted that you cannot control every risk factor for heart disease such as family history but you can definitely do something about your behavior. Age and gender also influence your risk of heart disease.
The Major Risk Factors Of Heart Disease
Granted that you cannot control every risk factor for heart disease such as family history but you can definitely do something about your behavior. Age and gender also influence your risk of heart disease.
The Major Risk Factors Of Heart Disease
- Cholesterol Levels
Cholesterol is a type of a lipid, a soft, fatlike substance that serves as a source of fuel. Excessive cholesterol can cause buildup of atherosclerotic plaque. Accumulation of plaque in arteries can block blood flow and lead to a heart attack.
LDL cholesterol, the so-called "bad" cholesterol, is transported to sites throughout the body, where it's used to repair cell membranes or to make hormones. LDL cholesterol can accumulate in the walls of your arteries.
HDL cholesterol, the so-called "good" cholesterol, transports cholesterol to the liver, where it's altered and removed from the body.
- Blood Pressure
Normal blood pressure level is defined as less than 130 millimeters of mercury (mm Hg) for systolic blood pressure and less than 85 mm Hg for diastolic blood pressure. The higher the blood pressure, the more likely it is to take a toll on the heart and on the brain.
Blood pressure should be checked whether or not your levels are high. For normal, check once every two years. For high-normal, check once a year. If extremely high, you should get immediate care. Then get multiple measurements to know if a high level is sustained over time.
- Diabetes
Another risk factor for heart disease is diabetes, a chronic disease of insulin deficiency or resistance. Type 2 diabetes, the most common type, is associated with obesity and may be prevented by maintaining ideal body weight through exercise and balanced nutrition.
- Stop Smoking - The effect of smoking on your lungs can cause almost every other medical condition.
- Exercise - Routine physical activity is highly recommended and helpful in controlling obesity. Try to perform 30 minutes of moderate physical activity every day. Fast walking is one of the best way to prevent heart disease.
If you can lose even a small amount of weight, five pounds for example, it may have a positive effect on lipid levels and blood pressure preventing heart disease.
- Limit Alcohol Consumption - Limit daily alcohol intake to three ounces or fewer to prevent heart disease. People who drink large amounts of alcohol (six to eight ounces a day) tend to have higher blood pressure.
- Watch What You Eat - Eat five helpings of fruits and vegetables daily to prevent heart disease. Maintain adequate dietary potassium, calcium and magnesium intake. Reduce saturated fats and cholesterol to stay away from heart disease.
Treating Lower Back Pain
One of the most common ailments people suffer from is lower back pain. Approximately 8 out of 10 people will have to deal with back pain at some point in their life. That’s a lot of people - are you one of them?
Of all of the various forms of back pain that we endure, lower back pain is the most common by far and there’s a logical explanation for it. Can you guess what it is?
The number one cause of back pain is lack of movement! I bet your chiropractor or orthopedic specialist didn’t tell you that, did they?
The lack of frequent movement in various muscles over the years leads to muscle imbalances and uneven wear and tear on your body, most of all the spine. For example, how many times each day do you bend, lean, or twist?
This is an example of a typical person’s day:
The key to getting rid of back pain (or virtually any ache or pain for that matter) is to identify the muscle imbalances that are pulling the spine, bones, and joints out of place and then learn how to stretch the tight muscles and strengthen the weak ones.
How do I know about this? As a post-rehabilitation specialist and certified personal fitness trainer, I have worked with hundreds of people who have back pain and conditions that included sciatic pain, bulging discs, spinal fusion, and more. While helping these people I discovered these startling facts:
pain, I have also had my own personal experiences with back pain and other painful conditions such as tendonitis, muscle strains and sprains, and more.
In every single case, the traditional treatments only treated the symptoms, and they were often unsuccessful. The only approach that gave me lasting improvements and relief was using targeted exercises and stretches.
Have you used traditional treatments for back pain and found little relief? I am not saying these treatments are ineffective at temporarily reducing the inflammation or pain, but I am saying that almost all fail to get rid of the underlying cause of the back pain.
So how do you identify the muscle imbalances that are causing your back pain? Well, it isn’t easy, but with a fundamental understanding of just how your body works you can at least begin looking at your particular situation and find out which muscles are being over worked, which ones are too strong and/or tight, and which ones aren't strong enough and stretched out.
It is also beneficial to seek out a qualified health professional who specializes in identifying muscle imbalances. The problem is, there are still very few professionals who use what I prefer to call the “common sense approach.”
Your best bet is to search for a personal fitness trainer that is trained and certified in post-rehabilitation, an osteopath, or a manual physical therapist. And don’t be afraid to ask questions because you must take charge of your own health care. Be sure to quiz them on what type of approach they take in treating back pain.
I also recommend my informative video, "Lose the Back Pain" which shows you, step-by-step, how to identify the real cause of your back pain and which specific exercises and stretches you need to perform in order to correct it.
Of all of the various forms of back pain that we endure, lower back pain is the most common by far and there’s a logical explanation for it. Can you guess what it is?
The number one cause of back pain is lack of movement! I bet your chiropractor or orthopedic specialist didn’t tell you that, did they?
The lack of frequent movement in various muscles over the years leads to muscle imbalances and uneven wear and tear on your body, most of all the spine. For example, how many times each day do you bend, lean, or twist?
This is an example of a typical person’s day:
- Wake up
- Get out of bed
- Eat breakfast (hopefully)
- Commute to work
- Sit at a desk
- Eat lunch
- Return to the desk
- Commute back home
- Eat supper
- Lounge around on the sofa and watch television
- Go to bed
The key to getting rid of back pain (or virtually any ache or pain for that matter) is to identify the muscle imbalances that are pulling the spine, bones, and joints out of place and then learn how to stretch the tight muscles and strengthen the weak ones.
How do I know about this? As a post-rehabilitation specialist and certified personal fitness trainer, I have worked with hundreds of people who have back pain and conditions that included sciatic pain, bulging discs, spinal fusion, and more. While helping these people I discovered these startling facts:
- Many individuals who seek professional help for their back pain are subsequently mis-diagnosed and end up with a treatment plan that fails to get rid of the cause of their back pain.
- Virtually all of the people I worked with were able to eliminate their back pain altogether or greatly improve their condition even though all of the traditional treatments (physical therapy, chiropracty, injections of cortisone, anti-inflammatory drugs, surgery, etc.) had failed to help them.
Amazingly, most of these people were able to completely eliminate their back pain in just a few days or weeks simply by doing a few well-designed exercises and stretches!
These weren’t your basic exercises or the standard back stretches and stomach exercises that are recommended by most “experts”. These were specific exercises and stretches that I prescribed for each individual to help eliminate their back pain.
Many of these people had suffered for several years with
aches, pains, and stiffness. They had lived inactive lives because of their back pain.
- Most treatment plans offered only address the symptoms
and don’t address the cause, which usually delivers just
temporary relief for the individual.
pain, I have also had my own personal experiences with back pain and other painful conditions such as tendonitis, muscle strains and sprains, and more.
In every single case, the traditional treatments only treated the symptoms, and they were often unsuccessful. The only approach that gave me lasting improvements and relief was using targeted exercises and stretches.
Have you used traditional treatments for back pain and found little relief? I am not saying these treatments are ineffective at temporarily reducing the inflammation or pain, but I am saying that almost all fail to get rid of the underlying cause of the back pain.
So how do you identify the muscle imbalances that are causing your back pain? Well, it isn’t easy, but with a fundamental understanding of just how your body works you can at least begin looking at your particular situation and find out which muscles are being over worked, which ones are too strong and/or tight, and which ones aren't strong enough and stretched out.
It is also beneficial to seek out a qualified health professional who specializes in identifying muscle imbalances. The problem is, there are still very few professionals who use what I prefer to call the “common sense approach.”
Your best bet is to search for a personal fitness trainer that is trained and certified in post-rehabilitation, an osteopath, or a manual physical therapist. And don’t be afraid to ask questions because you must take charge of your own health care. Be sure to quiz them on what type of approach they take in treating back pain.
I also recommend my informative video, "Lose the Back Pain" which shows you, step-by-step, how to identify the real cause of your back pain and which specific exercises and stretches you need to perform in order to correct it.
Bleeding Disorders in Women
Bleeding disorders are a group of disorders associated with a lack of any number of clotting elements in the blood. These proteins work together as a domino effect to blood clotting, so any disruption along that line can lead to a bleeding disorder.
Hemophilia is the most well known bleeding disorder, recognized since biblical times, occurs almost exclusively in males, although it's inherited through the mother on the X chromosome. People with hemophilia have problems associated with internal bleeding into the joints, muscles and organs. Another form of hemophilia, known as hemophilia B is associated with a missing clotting factor known as factor IX. Although it's very rare, hemophilia can occur in women.
Von Willebrand disease, vWD, identified in 1925 by a Finnish doctor, affects both men and women in equal numbers. It's actually more common than hemophilia, but less well known. The disease involves an inability of platelets to form a stable clot, which prevents a person to stop bleeding. The most common type of vWD is Type I, a mild form of the disease. Affected people typically have symptoms of bleeding in the intestines and gums. In men with Type I vWD serious bleeding is not usually a problem except in severe trauma. In women, however, because of pregnancies or
In women the main symptoms of Von Willebrand's Disease is menorrhagia, which means heavy bleeding during menstruation or after childbirth. Other causes of menorrhagia are medications, tumors, intra-uterine devices (IUD) and other diseases. Out of the 15-20 percent of U.S. women who suffer from menorrhagia, as many as 20 percent of them may have a bleeding disorder.
The definition and diagnosis of heavy menstrual bleeding in women is tricky, because how one defines "heavy bleeding" is such a relative concept. Since bleeding disorders tend to run in families, having a heavy menstrual flow may be considered normal in that family and not thought as a serious medical problem. However, if your heavy bleeding started at or near your first period, there is a high probability that it's caused by a coagulopathy (bleeding disorder).
Because heavy periods are often considered by doctors to be a problem with the uterus, rather then a bleeding problem, women are often misdiagnosed and subjected to unnecessary and dangerous surgical procedures such as dilation and curettage (D&C) and hysterectomy. In one study of females with Von Willebrand's disease, 25 percent of these women had undergone hysterectomy, often to alleviate the heavy menstrual bleeding. Correct diagnosis can help a woman avoid potentially dangerous complications and surgery. All that is needed to diagnose Von Willebrand's disease is a simple blood test.
Luckily there is a treatment for vWD. Taking
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