Friday, January 29, 2010

Health Care and Dental Implants

One of the most requested new dental procedures that has become very popular over the past few years is dental implants. All the young hip kids are talking about it, and dentists. Dental implants are artificial tooth replacements used to counter tooth loss, according to YourDentistryGuide.com. The procedure is categorized as a form of prosthetic (artificial replacement) dentistry, though it also falls into the category of cosmetic dentistry as well. Although you have a number of restorative options for the treatment of missing teeth, none have proven to be as functionally effective and durable as implants. In many cases, dental implants may be the only logical choice for the restoration of all necessary functionality of the teeth and supporting structures.

Replicating the natural function and appearance of your lost teeth can be very difficult to accomplish, according to DentalImplants.org. Historically, dentures or bridge restorations would be used as replacements, but with limited results. Dental implants, however, are natural-looking replacements for missing teeth that also provide the same function as your natural tooth root. They have also been used to anchor these other types of restorations for greater success and patient satisfaction. A dental implant is a small, sturdy, titanium post that acts as the root structure would for a natural tooth. A dental implant is placed into your upper or lower jaw bone. After the bone has grown around the implant, implants can hold a crown, bridge or over-denture just like roots hold natural teeth in place. Implants are very durable and can last a lifetime. They require the same maintenance as natural teeth; this includes brushing, flossing and regular dental check-ups. A single tooth or a full arch of teeth which have been lost due to injury or disease can be replaced with dental implants. Titanium metal is used because of its compatibility with bone and oral tissues. Dental implants have shown a 90 percent success rate and long-term studies continue to show improving success.

According to DentalImplants.org, here are some reasons you may want to consider dental implants:
--To replace one or more teeth.
--To provide support for a partial denture.
--To increase the support and stability of full upper or lower denture.
--To enhance chewing comfort.
--To increase confidence while smiling, talking and eating.
--To improve your overall psychological health.
--To improve esthetic appearance and regain over all confidence.

Dental implants are an ideal option for people in good general oral health who have lost a tooth or teeth due to periodontal disease, an injury, or some other reason, according to the American Academy of Periodontology (http://www.perio.org/). While high-tech in nature, dental implants are actually more tooth-saving than traditional bridgework, since implants do not rely on neighboring teeth for support. Dental implants are so natural-looking and feeling, you may forget you ever lost a tooth. You know that your confidence about your teeth affects how you feel about yourself, both personally and professionally. Perhaps you hide your smile because of spaces from missing teeth. Maybe your dentures don't feel secure. Perhaps you have difficulty chewing. If you are missing one or more teeth and would like to smile, speak and eat again with comfort and confidence, there is good news! Dental implants are teeth that can look and feel just like your own! Under proper conditions, such as placement by a periodontist and diligent patient maintenance, implants can last a lifetime. Long-term studies continue to show improving success rates for implants.

Procedural advancements, including the development of narrower “mini” implants, mean that more people than ever before are finding themselves candidates for implantation, according to YourDentistryGuide.com. However, candidacy for implantation still varies, meaning that your dentist may determine that you should opt for an alternative restoration. Keep in mind, too, that dentists do not need a specific license by law in order to perform implant dentistry. A general or restorative dentist may perform the crown and bridge placement that is associated with implant restoration. However, prosthodontists are the specialists who often complete this crucial procedure. Periodontists and oral surgeons perform the implant surgical procedure itself.

Today's dental implants are virtually indistinguishable from other teeth, according to YourDentistryGuide.com. This appearance is aided in part by the structural and functional connection between the dental implant and the living bone. Implants are typically placed in a single sitting but require a period of osseointegration, the process by which direct anchorage of a dental implant root and the bone of the jaw occurs. Osseointegrated implants are the most commonly used and successful type of dental implant. An osseointegrated implant takes anywhere from three to six months to anchor and heal, at which point your dentist can complete the procedure with the placement of a crown. Once the implant has anchored with the jawbone, artificial prosthesis may be attached and the process is done. If osseointegration does not occur, the implant will fail.

This procedure is a team effort between you, your dentist and your periodontist, according to Perio.org. Your periodontist and dentist will consult with you to determine where and how your implant should be placed. Depending on your specific condition and the type of implant chosen, your periodontist will create a treatment plan tailored to meet your needs. Here are considerations for various implant dental procedures based on your individual need:
--Replacing a Single Tooth: If you are missing a single tooth, one implant and a crown can replace it. A dental implant replaces both the lost natural tooth and its root.
--Replacing Several Teeth: If you are missing several teeth, implant-supported bridges can replace them. Dental implants will replace both your lost natural teeth and some of the roots.
--Replacing All of Your Teeth: If you are missing all of your teeth, an implant-supported full bridge or full denture can replace them. Dental implants will replace both your lost natural teeth and some of the roots.
--Sinus Augmentation: A key to implant success is the quantity and quality of the bone where the implant is to be placed. The upper back jaw has traditionally been one of the most difficult areas to successfully place dental implants due to insufficient bone quantity and quality and the close proximity to the sinus. Sinus augmentation can help correct this problem by raising the sinus floor and developing bone for the placement of dental implants.
--Ridge Modification: Deformities in the upper or lower jaw can leave you with inadequate bone in which to place dental implants. To correct the problem, the gum is lifted away from the ridge to expose the bony defect. The defect is then filled with bone or bone substitute to build up the ridge. Ridge modification has been shown to greatly improve appearance and increase your chances for successful implants that can last for years to come.

Dental implants are among the most successful procedures in dentistry, according to YourDentistryGuide.com. There is no guarantee that an implant procedure will be successful, but studies have shown a five-year success rate of 95% for lower jaw implants and 90% for upper jaw implants. The success rate for upper jaw implants is slightly lower because the upper jaw (especially the posterior section) is less dense than the lower jaw, making successful implantation and osseointegration potentially more difficult to achieve. Lower posterior implantation has the highest success rate for all dental implants. Dental implants may fail for a number of reasons. The cause is often related to a failure in the osseointegration process. For example, if the implant is placed in a poor position, osseointegration may not take place. Dental implants may break or become infected (like natural teeth) and crowns may become loose. If you are a smoker who is considering a dental implant, your dentist will likely advise you to give up smoking before undergoing the process because smokers face a higher risk of implant failure. Since the procedure can be extremely expensive, you risk wasting your money on dental implants if you do not give up the habit. On the plus side, dental implants are not susceptible to the formation of cavities; still, poor oral hygiene can lead to the development of peri-implantitis around dental implants. This disease is tantamount to the development of periodontitis (severe gum disease) around a natural tooth.

Dental implants are typically very expensive, and many dental plans do not include the procedure in their coverage. You will want to explore costs and payment options for dental implants, and consider how to leverage the best pricing, dental plans, and payment vehicles before having the procedure done. Insurance plans usually have a waiting period before you can have dental implants done, and the average dental insurance product usually has a maximum amount it will pay for major dental or cosmetic procedures, if at all. One consideration would be to join a discount plan that allows immediate access to use your plan, and you get a savings for the work to be done with participating dentists and specialists. Careington International (http://www.careington.com/) has a dental plan that includes dental implants at a 20% discount off the procedure costs, and the dental plan is available for just a few dollars a month.

Making the initial dental appointment is the first step in evaluating if dental implants are right for you, according to DentalImplants.org. Usually a prosthodontist, periodontist, or an oral surgeon are the dentists to look for after consulting with your general dentist. There are a few general dentists with specialized training qualified to place implants. Check with each doctor to make sure of their specialization or their certification with implantology. On the first appointment a full mouth exam will be completed with a complete medical and dental history, and you’ll receive X-rays and possibly a CT scan, which will give the dentist a good idea of your bone density and the shape of your jaw. Finally, you’ll discuss the options available to you and be educated by the dental staff about the whole implant procedure. They’ll discuss if you’d be a good candidate for a dental implant. You must also commit to a meticulous oral hygiene regime with regular dental visits. Finding out if you’re a good candidate for dental implants begins with a simple step. With motivation, care and willingness, dental implants can give the confidence and security to last a lifetime.

Dental implants, if you can afford them, may be the best option for you if your dentist suggests this procedure to help save your smile. Talk to your dental care provider to see if you are a good candidate, and then investigate your options. A great smile, and your health, are worth the money.

Until next time. Let me know what you think.

Thursday, January 28, 2010

HEALTH CARE AND FISH OIL

Fish oil supplements are constantly touted for their seemingly miraculous health benefits because they contain omega-3 fatty acids, according to ABC News. For people with heart disease, omega-3 acids can greatly reduce the risk of heart attack or dying from heart failure. Consumers should not necessarily avoid fish oil supplements because of PCB concerns from elevated levels of toxins like mercury in the ocean. But if someone has a low risk of heart disease and is concerned, then he or she could stop taking the supplements until further testing is done on specific fish oil supplements. follow the guidelines from the American Heart Association to find other sources of omega-3 acids such as fatty fish.

According to WellnessLetter.com, healthy people are best off to get their omega-3s from fish—about 12 ounces a week. The following people should consider taking fish oil supplements, with their doctor’s approval: those who have coronary artery disease (1 gram a day of omega-3s on days when they don’t eat fish); those with high triglycerides (2 to 4 grams a day); those with rheumatoid arthritis, psoriasis, or other auto-immune disorders (3 grams a day). Large doses of fish oil supplements have potential side effects that include nausea, diarrhea, belching, and a bad taste in the mouth. Large doses of fish oil can also increase the risk of hemorrhagic stroke, suppress the immune system, and decrease glucose control in people with diabetes. Fish oil capsules contain two omega-3 fatty acids, eicosapentenoic acid (EPA) and docosahexenoic (DHA). Like aspirin, they make platelets in the blood less likely to stick together and may reduce inflammatory processes in the blood vessels.

According to NaturalNews.com, these fatty acids stimulate the body's anti-inflammatory processes and help relieve joint pain, much the same as NSAIDs and COX-2 inhibitors, but without the side effects. An excess of proinflammatory messenger molecules causes joint pain, and consumption of fish oil prevents this build up.Both EPA and DHA are necessary for many functions in the body, but are not manufactured in the body in quantities sufficient for their use. Eicosapentaenoic acid, or EPA, aids in the anti-inflammatory response of the body to pain. The fatty acid is converted to messenger molecules that relive both pain and inflammation in joints. EPA has the additional effect of preventing omega-6 fats from causing pain and inflammation.

One of the causes of joint pain is the over-consumption of omega-6 fats in the modern American diet, according to NaturalNews.com. Omega-6 fats are a necessary part of the diet; however, vegetable oils and overprocessed foods sway the balance that the body needs between omega-6 and omega-3 fatty acids. The best ratio for health is an omega-6:omega-3 ratio of 3 to 1, but most Americans consume a ratio of 15 to 1. This is the cause of much chronic inflammatory joint and back pain. Fish oil can be obtained from fatty fish, such as salmon, or in food supplements. Because of the pollution in the ocean, the source of the fresh fish must be evaluated to ensure that the fish does not contain mercury. One way to ensure this is by purchasing food supplements containing EPA and DHEA and the proper balance of omega-3 to omega-6 fatty acids. Be certain to note if the fish oil supplements are fresh and free of mercury, as tested in labs meeting the international pharmaceutical standards. Fresh fish oil should not have a bitter or fish-like taste. More details about the benefits of taking Omega-3 can be found at http://www.naturalnews.com/027285_omega-3_depression_fatty_acids.html.

According to OilofPisces.com, scientists were first alerted to the many benefits of fish oils in the early 1970s when Danish physicians observed that Greenland Eskimos had an exceptionally low incidence of heart disease and arthritis despite the fact that they consumed a high-fat diet. Intensive research soon discovered that two of the fats (oils) they consumed in large quantities, EPA and DHA, were actually highly beneficial. More recent research has established that fish oils (EPA and DHA) play a crucial role in the prevention of atherosclerosis, heart attack, depression, and cancer. Clinical trials have shown that fish oil supplementation is effective in the treatment of many disorders including rheumatoid arthritis, diabetes, ulcerative colitis, and Raynaud's disease. An extensive medical literature testifies to the fact that fish oils prevent and may help to ameliorate or reverse atherosclerosis, angina, heart attack, congestive heart failure, arrhythmias, stroke, and peripheral vascular disease. Fish oils help maintain the elasticity of artery walls, prevent blood clotting, reduce blood pressure, stabilize heart rhythm and help combat inflammation. There is also considerable evidence that fish oil consumption can reduce the risk of breast and prostate cancer and help slow their progression. Daily supplementation with fish oils has been found effective in preventing the development of colon cancer and has also been found to help combat depression.

It is clear that consuming a diet rich in oily fish or alternatively, supplementing with fish oils is one of the most important steps one can take to ensure vibrant and lasting health, according to OilofPisces.com. However, pollution of fresh water lakes and even the oceans is now so extensive that a growing number of species should not be consumed regularly as they contain large amounts of mercury and other industrial pollutants. Fresh, wild pacific salmon is still an excellent source of safe fish oil, but if that is not available then a high quality fish oil is the answer to ensuring that daily needs for EPA and DHA are met. Only fresh, highly purified fish oils (molecular distilled, pharmaceutical grade) stabilized with vitamin E should be consumed. Some very recent British research has shown that emulsified fish oils are absorbed at twice the rate of non-emulsified oils. Low quality oils should be avoided as they are unstable and may contain significant amounts of mercury, pesticides, and undesirable oxidation products.

According to SFGate.com, toxicity can vary widely in fish oil, depending on what kind of fish is used and the contamination in its habitat waters, scientists say. Older, bigger fish tend to build up more PCBs in their fatty tissues than smaller fish, but habitat is still key. Deciphering which products are safest is not easy for consumers. Not all manufacturers state what kind of fish their oil is derived from, and few state which waters the fish come from. The public is increasingly turning to fish oil supplements as a source of omega-3 fatty acids, according to the Environmental Defense Fund (EDF). But which major U.S. producers of fish oil supplements purify their products to reduce or remove contaminants like mercury and dioxins? Responses indicate that the majority are purifying their fish oils to meet stringent safety standards. More details about the companies and their products can be found at http://www.edf.org/page.cfm?tagID=16536.

Fish oils can be obtained from eating fish or by taking supplements, according to WebMD.com; fish that are especially rich in the beneficial oils known as omega-3 fatty acids include mackerel, tuna, salmon, sturgeon, mullet, bluefish, anchovy, sardines, herring, trout, and menhaden. They provide about 1 gram of omega-3 fatty acids in about 3.5 ounces of fish. Fish oil supplements are usually made from mackerel, herring, tuna, halibut, salmon, cod liver, whale blubber, or seal blubber. Fish oil supplements often contain small amounts of vitamin E to prevent spoilage, and they might also be combined with calcium, iron, or vitamins A, B1, B2, B3, C, or D.

Scientific evidence suggests that fish oil really does lower high triglycerides, according to WebMD,com; and it also seems to help prevent heart disease and stroke when taken in the recommended amounts. Ironically, taking too much fish oil can actually increase the risk of stroke. Fish may have earned its reputation as “brain food” because some people eat fish to help with depression, attention deficit-hyperactivity disorder (ADHD), Alzheimer’s disease, and other thinking disorders.Some people use fish oil for dry eyes, glaucoma, and age-related macular degeneration (AMD), a very common condition in older people that can lead to serious sight problems. Women sometimes take fish oil to prevent painful periods; breast pain; and complications associated with pregnancy such as miscarriage, high blood pressure late in pregnancy, and early delivery. Fish oil is also used for diabetes, asthma, developmental coordination disorders, movement disorders, dyslexia, obesity, kidney disease, weak bones (osteoporosis), certain diseases related to pain and swelling such as psoriasis, and preventing weight loss caused by some cancer drugs. Fish oil is sometimes used after heart transplant surgery to prevent high blood pressure and kidney damage that can be caused by the surgery itself or by drugs used to reduce the chances that the body will reject the new heart. Fish oil is sometimes used after coronary artery bypass surgery. It seems to help keep the blood vessel that has been rerouted from closing up. When fish oil is obtained by eating fish, the way the fish is prepared seems to make a difference. Eating broiled or baked fish appears to reduce the risk of heart disease, but eating fried fish or fish sandwiches not only cancels out the benefits of fish oil, but may actually increase heart disease risk.

The bottom line is that if you are in a high risk health situation that may benefit from using fish oil, use it in moderation. Talk with your primary care physician or medical provider. However, if you are concerned about the toxicity of some supplements or certain fish oils, do research to find out what are acceptable forms or brands to take. Fish oil can be beneficial, but only in certain circumstances that do not affect your overall or individual health and well being. Stay away from fish oils that are not good for you, and make sure that your doctor gives you a green light to take them before making a purchase. There are many high quality brands on the market in the form of supplements. Plus, be careful of the types of fish you eat and how they are prepared before consuming them. Fish oils are not good for everyone, but find out if they work for you to help increase your ability to live a healthier lifestyle.

Until next time. Let me know what you think.

Wednesday, January 27, 2010

Health Care and Digestion

Ever think about what happens to the food you eat or the liquids you drink? Have you ever been curious to know how your body handles that deep dish pepperoni and sausage pizza or the triple chocolate chip cookie dough ice cream? Do you know what it takes for your stomach to process all those soft drinks, energy bars, smoothies, pasta bowls, and fried rice? That process is called "Digestion," and it miraculously transforms all the junk food or the healthy meals that you consume every day of your life into small particles that your internal organs and bodily systems can handle. As long as what you eat is not poisonous, toxic, contaminated, or otherwise fatal, the human body has the capability to take all that you eat or drink and get rid of it in a way that keeps you functioning without getting drastically ill--most of the time.

When you eat foods—such as bread, meat, and vegetables—they are not in a form that the body can use as nourishment. Food and drink must be changed into smaller molecules of nutrients before they can be absorbed into the blood and carried to cells throughout the body, according to the National Institutes for Health (NIH). Digestion is the process by which food and drink are broken down into their smallest parts so the body can use them to build and nourish cells and to provide energy. Digestion involves mixing food with digestive juices, moving it through the digestive tract, and breaking down large molecules of food into smaller molecules. Digestion begins in the mouth, when you chew and swallow, and is completed in the small intestine.

According to the NIH, the digestive system is made up of the digestive tract—a series of hollow organs joined in a long, twisting tube from the mouth to the anus—and other organs that help the body break down and absorb food. Organs that make up the digestive tract are the mouth, esophagus, stomach, small intestine, large intestine—also called the colon—rectum, and anus. Inside these hollow organs is a lining called the mucosa. In the mouth, stomach, and small intestine, the mucosa contains tiny glands that produce juices to help digest food. The digestive tract also contains a layer of smooth muscle that helps break down food and move it along the tract. Two “solid” digestive organs, the liver and the pancreas, produce digestive juices that reach the intestine through small tubes called ducts. The gallbladder stores the liver’s digestive juices until they are needed in the intestine. Parts of the nervous and circulatory systems also play major roles in the digestive system.

The first step in the digestive process happens before you even taste food, according to KidsHealth.org. Just by smelling that homemade apple pie or thinking about how delicious that ripe tomato is going to be, you start salivating — and the digestive process begins in preparation for that first bite. Food is your fuel, and its nutrients give your bodies' cells the energy and substances they need to operate. But before food can do that, it must be digested into small pieces the body can absorb and use. The smooth muscle in the walls of the tube-shaped digestive organs rhythmically and efficiently moves the food through the system, where it is broken down into tiny absorbable atoms and molecules. During the process of absorption, nutrients that come from the food (including carbohydrates, proteins, fats, vitamins, and minerals) pass through channels in the intestinal wall and into the bloodstream. The blood works to distribute these nutrients to the rest of the body. The waste parts of food that the body can't use are passed out of the body as feces. Every morsel of food you eat has to be broken down into nutrients that can be absorbed by the body, which is why it takes hours to fully digest food. In humans, protein must be broken down into amino acids, starches into simple sugars, and fats into fatty acids and glycerol. The water in your food and drink is also absorbed into the bloodstream to provide the body with the fluid it needs.

According to the NIH, the large, hollow organs of the digestive tract contain a layer of muscle that enables their walls to move. The movement of organ walls can propel food and liquid through the system and also can mix the contents within each organ. Food moves from one organ to the next through muscle action called peristalsis. Peristalsis looks like an ocean wave traveling through the muscle. The muscle of the organ contracts to create a narrowing and then propels the narrowed portion slowly down the length of the organ. These waves of narrowing push the food and fluid in front of them through each hollow organ. The first major muscle movement occurs when food or liquid is swallowed. Although you are able to start swallowing by choice, once the swallow begins, it becomes involuntary and proceeds under the control of the nerves. Swallowed food is pushed into the esophagus, which connects the throat above with the stomach below. At the junction of the esophagus and stomach, there is a ringlike muscle, called the lower esophageal sphincter, closing the passage between the two organs. As food approaches the closed sphincter, the sphincter relaxes and allows the food to pass through to the stomach.

The stomach has three mechanical tasks, according to the NIH. First, it stores the swallowed food and liquid. To do this, the muscle of the upper part of the stomach relaxes to accept large volumes of swallowed material. The second job is to mix up the food, liquid, and digestive juice produced by the stomach. The lower part of the stomach mixes these materials by its muscle action. The third task of the stomach is to empty its contents slowly into the small intestine.

Now, several factors affect emptying of the stomach, including the kind of food and the degree of muscle action of the emptying stomach and the small intestine, according to the NIH. For example, carbohydrates, spend the least amount of time in the stomach, while protein stays in the stomach longer, and fats the longest. As the food dissolves into the juices from the pancreas, liver, and intestine, the contents of the intestine are mixed and pushed forward to allow further digestion. Finally, the digested nutrients are absorbed through the intestinal walls and transported throughout the body. The waste products of this process include undigested parts of the food, known as fiber, and older cells that have been shed from the mucosa. These materials are pushed into the colon, where they remain until the feces are expelled by a bowel movement.
Much more information about the technicality of digestion can be found at this website: http://digestive.niddk.nih.gov/ddiseases/pubs/yrdd/.

According to NaturalNews.com, many people experience gas and bloating after eating. Gas can accumulate in the stomach or the intestines, causing pain, rumbling and indigestion. Gas is a product of incomplete digestion and an indication that food is fermenting in the gut, instead of being digested properly and assimilated into the body as nutrients. As people age, their levels of digestive enzymes decrease. Many individuals find they need to add digestive supplements to meals. Digestive enzymes come in many forms. Certain foods contain natural digestive aids, such as pineapple and papaya. Adding a few bites of these foods to every meal can aid digestion. Also as the body ages, the amount of hydrochloric acid secreted to aid in digestion decreases. This leads to a condition known as hypochlorhydria. Hypochlorhydria begins as a gut deficiency and is one of the leading causes of gas and indigestion, and it can lead to many diseases and chronic inflammation. Without this important stomach acid, protein cannot be digested and many nutrients cannot be absorbed. In addition, acid from the stomach is a signal to the pancreas to perform its function, so hypochlorhydia can lead to problems in the pancreas as well. Diseases associated with low stomach acid include asthma, lupus, anemia, psoriasis, arthritis, ulcers, and many more. Indicators of low stomach acid can be simple gas and bloating, or more complex conditions, such as food allergies, constipation, anemia, and nausea. Food allergies may also cause gas. Many people are allergic to wheat and/or dairy. Allergy tests can confirm this but a simpler method is to remove suspected foods from the diet. If digestion returns to normal, eliminate the allergic foods for a few months and then begin to slowly reintroduce them. Food sensitivities can be healed in this manner, by removing the irritating food for a few months. True allergies may not respond to this technique.

You should also provide for healthy intestinal transit, according to WHFoods.com. The movement of the food, or chyme, through the digestive tract is very important. Healthy intestinal transit is supported, in part, by the short-chain fatty acids produced by fermentation of prebiotic fibers in the colon. Fiber, in general, supports overall transit of the chyme and healthy elimination. Some fibers, like those found in rye, wheat and flax, also can bind to environmental toxins, such as pesticides, and carry them through the digestive tract for direct elimination, decreasing the amount that is absorbed into your body.

Also, according to WHFoods.com, you should learn how to deal with stress effectively. Research has shown that the intestine responds negatively to stress, during which the intestinal lining becomes leaky, absorption is less effective, and your body is unable to selectively take up the nutrients it needs. The reasons for these effects of stress on the intestinal tract are not entirely known, however many neurotransmitters (brain-produced signaling molecules) are found surrounding the intestinal tract. Furthermore, neurotransmitter receptors, which can bind and respond to these signaling molecules, are located along the intestinal tract. Therefore, it is known that brain signaling molecules can affect the intestinal tract. Foods with a calming effect include herb teas, like chamomile. Alcohol, caffeine, and refined carbohydrates, like table sugar, should be avoided. Eating meals at regular times and in a relaxed environment can also help decrease stress. A host of more valuable material concerning digestion can also be found at this website: http://www.whfoods.com/genpage.php?tname=faq&dbid=16. Additionally, a great site for kids to understand the digestive process can be found at: http://kidshealth.org/parent/general/body_basics/digestive.html.

According to the Mayo Clinic, stomach noise — such as rumbling, gurgling and growling — typically is due to normal digestion. Stomach growling can occur when you're hungry. But it can also occur after eating or between meals when food is passing through your intestines. Hunger and appetite are controlled by a complex system of hormone-like substances primarily made by your digestive system. When you haven't eaten for a while, these substances are released and cause a part of your brain called the hypothalamus to "switch on" your desire to eat. A message is then sent to your stomach and intestines. This triggers muscle contractions and the release of acids and other digestive fluids — which causes the rumbling, grumbling sounds you hear — as your body prepares for you to eat. The thought, sight or smell of food also can trigger this response. Sometimes excessive stomach noise can be a symptom of an underlying gastrointestinal disorder, such as irritable bowel syndrome. But in such cases, stomach noise usually is accompanied by other signs and symptoms such as bloating, cramping, diarrhea or excess gas.

Digestion time varies depending on the individual, according to the Mayo Clinic. For healthy adults, it's usually between 24 and 72 hours. After you eat, it takes about six to eight hours for food to pass through your stomach and small intestine. Food then enters your large intestine (colon) for further digestion and absorption of water. Elimination of undigested food residue through the large intestine usually begins after 24 hours. Complete elimination from the body may take several days. The digestive system is a pretty important part of your body, according to KidsHealth.org, and without it, you couldn't get the nutrients you need to stay healthy. The next time you sit down to lunch, you'll know where your food goes — from start to finish!

Until next time. Let me know what you think.

Tuesday, January 19, 2010

Health Care and Fright

Ever been so afraid that you could not speak or move, or worse, experience symptoms of not being able to breath or faint? Have you ever been so scared that you thought you might die? Well, the worst situation you ever encountered that caused you to be scared out of your mind may have given you heart palpitations, severe sweating, or weakness in all your muscles and more. According to Answers.com, Fright, a state of sudden, extreme fear, is provoked either by a situation experienced as an external danger or by the feeling of a high probability of danger. Situations capable of causing fright are often associated with a risk of physical or mental death.

There are many things to be afraid of in life, according to ExploreFaith.org. Losing a loved one. Going broke. Growing old. Being diagnosed with a terminal illness. Dying. These are some of the more common fears we all face, and to ignore these threats is to live in denial. Fear is hardwired into our brains as a mechanism for self-preservation. For example, we might be driving down the street and suddenly another car pulls in front of us. Fear is what activates our bodies and minds to deal with that threat, so we instinctively swerve out of the way to avoid a collision. In this sense, fear can save our lives. This is healthy fear—an awareness and respect for what is dangerous in life.

There is, however, an unhealthy kind of fear. According to ExploreFaith.org, you can be fearful of what others will think of you, and decide to avoid contact with them. You can be fearful of not having the comforts of life, and spend your best energies collecting possessions to ensure your comfort. You can be fearful of not feeling loved by someone, and attempt to control them to ensure that you feel loved. You can be fearful of your emotional pain, and use drugs and alcohol to numb yourself to ensure you don’t feel that pain. You can be fearful of those who are different from you, and develop prejudice, even hatred, to strengthen your sense of superiority over them. Rather than protecting your life, these kinds of fear diminish and undermine yourself and the lives of others. Unhealthy fear is fear that controls you and consumes you.

In the 1890s, Sigmund Freud identified fright as a severe element of fear. He found links between certain forms of hysteria and traumatic neurosis, combined in the term traumatic hysteria, according to Answers.com. Unlike the physical expression of hysteria, the affect of fright is mental trauma. In a clinical context, fright is accompanied by a state of shock and stupor or, more rarely, by disordered agitation. But ever since Freud, psychoanalytic clinical practice and theory have always emphasized the passivity of fright and total lack of preparedness of the subject in the face of the situation, which are due as much to the totally unforeseeable nature of the event as to the potential for concrete danger. It is in this sense that fright must be differentiated from fear (a concept implying a definite object) and anxiety (a central psychoanalytic concept connoting the anxious expectation of an external or internal danger that needs to be confronted). As with many concepts, this distinction between internal and external is primarily metaphoric. Fright is associated with the splitting of the ego, the castration complex, and the perception of reality.

Additionally, many senior citizens have a fear of night time, especially if they are dealing with certain health issues such as dementia. According to MichiganHomeCare.com, nighttime can be very frightening for seniors – especially those who live alone. Many problems that occur at night with seniors are rooted in physical changes that result from aging, many of which are often connected to sleep disorders. Seniors’ sleep problems can be rooted in many sources. There are physiological changes occurring with age, such as decreased amounts of time spent in certain stages of sleep. However, it’s not necessarily the aging process that disturbs sleep, but rather the many physiological changes that accompany getting older. In addition to those medical illnesses and medications common in older adults, there can be psychiatric problems and changes in circadian rhythms. These rhythms help determine when you sleep, and they change as you age.

Fear and anxiety effect automatically, according to Sey7.com. Your autonomic nervous system regulates how body organs work. Chiefly a part of the autonomic nervous system, called ’sympathetic’, automatically interacts with your mind when you worry, experience anxiety, fear. When fear is felt the mind signals a threat, danger, or emergency physically (e. g. a hand raised in anger) or psychologically (e. g. distrust); the sympathetic nervous system immediately comes into action to help protect or defend ourselves to your best possible advantage. Suddenly automatically you breath more oxygen which, with cyclic biochemical reactions, energizes your ‘electron transport chain’ and synthesises with other substances in our body, upon that fear signal. This synthesizing upon that fear signal urgently turns on electrical impulses which fire from cell to cell at very high speeds communicating that fear to the control center in the brain.
In your fear and anxiety, the brain instantly issues commands to the organs to take action. Your organs immediately divert and concentrate energies from other organs to those relevant to your fear and anxiety. The pupils of your eyes grow bigger to see better, the blood vessels expand to more and faster supply, to enable your muscles to react. In aid of that the body produces adrenaline to enhance alertness and your actions for ‘flight’ or ‘fight’, as your values dictate, and as you feel directed by your fear, anxiety.

According to the Olin Health Center at the University of Michigan, the human body has an inborn, "pre-wired" response for dealing with dangerous situations - it is called the "fight or flight" response. Both fighting and fleeing require the same activities on the part of the body's organs. The purpose of this response is to prepare the individual for vigorous muscular activity in response to a perceived threat. By itself, this response is normal, healthy, and adaptive. It is when the "fight/flight" response occurs too frequently or is greatly prolonged that you begin to experience the negative effects of stress. Too much "fight/flight" activity without corresponding rest and relaxation is what distress is all about.

According to ChangingMinds.org, when you perceive a significant threat to you, then your body gets ready either for a fight to the death or a desperate flight from certain defeat by a clearly superior adversary. Fight or flight effects include:
--Your senses sharpening. Pupils dilate (open out) so you can see more clearly, even in darkness. --Your hairs stand on end, making you more sensitive to our environment (and also making you appear larger, hopefully intimidating your opponent).
--The cardio-vascular system leaping into action, with the heart pump rate going from one up to five gallons per minutes and your arteries constricting to maximize pressure around the system while the veins open out to ease return of blood to the heart.
--The respiratory system joining in as the lungs, throat and nostrils open up and breathing speeding up to get more air in the system so the increased blood flow can be re-oxygenated. The blood carries oxygen to the muscles, allowing them to work harder. Deeper breathing also helps you to scream more loudly!
--Fat from fatty cells and glucose from the liver being metabolized to create instant energy.
--Blood vessels to the kidney and digestive system being constricted, effectively shutting down systems that are not essential. A part of this effect is reduction of saliva in the mouth. The bowels and bladder may also open out to reduce the need for other internal actions (this might also dissuade our attackers!).
--Blood vessels to the skin being constricted reducing any potential blood loss. Sweat glands also open, providing an external cooling liquid to our over-worked system. (this makes the skin look pale and clammy).
--Endorphins, which are the body's natural pain killers, are released (when you are fighting, you do not want be bothered with pain–-that can be put off until later.)
--The natural judgment system is also turned down.

According to EzineArticles.com, finding smart ways of dealing with fear and anxiety effectively is of great importance to millions of people worldwide. Most people who are dealing with fear and anxiety still have a vivid visual image of the traumatizing event seared into their memory. There are many examples of fear and anxiety issues, for instance the person who refuses to drive because they had a serious automobile accident many years ago, the person who won't venture above the second floor due to fear of heights, the person who won't eat fish because they got sick after a meal, or the golfer who missed that key short put in the big tournament and now has a bad case of the yips (tendency to miss short puts). The list of examples is endless and there are many ways for dealing with fear and anxiety issues. Some good, some bad, and some downright wacky.

According to CCCOE.net, here are a few tips to deal with fear:
1. Identify what is making you afraid.
2. Get in touch with your physical feelings. How do you feel fear?
3. Decide if you are in physical danger right now. Do you need to move away now?
4. Are you feeling a milder form of fear, such as anxiety or intimidation?
5. Breathe deeply and try to remain calm.
6. Seek out another caring adult. Share your concerns with him or her.
7. Think of ways you can avoid this danger (flight) or overcome your doubts (fight).

When you think about fear, you think of being frightened, scared and being afraid, according to SacredMint.com. Those are all feelings and emotions that people experience from time to time and are completely normal. You can go into a theatre and watch a scary movie, and although in your conscience mind you know it's not real, your emotions and feelings can get caught up in the story and become literally afraid and scared. Fear in itself is not wrong, even the Bible talks about fearing God is the beginning of wisdom and how you are to fear punishment and repent. It's what that fear leads you to is what makes you or breaks you. Does it keep you on the right path, or does it cripple you and hold you back from enjoying life?

Being afraid can be legitimate, based on the circumstances. You can be frightened by situations that are out of your control. You can fear the unknown, and the uncertainties of life in general. However, the phobias that exist in your life can be defeated, or control you if you let them. When you consider all that is scary in the world, learn to lean upon a Higher Power to help you win over the frightening things in life.

Until next time. Let me know what you think.

Friday, January 15, 2010

Health Care and Kosher Food

Ever want to know if something is right, or Kosher? The word "kosher" is not only used for food, however. Kosher, according to WiseGeek.com, basically means that something follows all the Jewish legal guidelines. The word has even gained a place in American slang to mean appropriate, legitimate, or proper; instead of saying "that's not right," one might say "that's not kosher." Kosher food is food that meets Jewish dietary laws, or kashrut, which comes from the Hebrew word for "fit" or "proper." Any food can be called kosher food if it adheres to Jewish law, or halacha. Conversely, foods typically labeled as "Jewish" aren't necessarily kosher. Jewish foods are generally those dishes that are traditionally Jewish.

According to Jewfaq.org, contrary to popular misconception, rabbis or other religious officials do not "bless" food to make it kosher. There are blessings that observant Jews recite over food before eating it, but these blessings have nothing to do with making the food kosher. Food can be kosher without a rabbi or priest ever becoming involved with it: the vegetables from your garden are undoubtedly kosher (as long as they don't have any bugs, which are not kosher!). However, in the modern world of processed foods, it is difficult to know what ingredients are in your food and how they were processed. Therefore, it is helpful to have a rabbi examine the food and its processing and assure kosher consumers that the food is kosher. Much more detailed explanation of how to prepare kosher foods can be found at this website: http://www.jewfaq.org/kashrut.htm.

According to WiseGeek.com, Kosher food laws are rather extensive. Some are derived directly from the Bible and others through rabbinic interpretations over the years. Here are some of the laws governing kosher food:
--According to the Torah (also known as the five books of Moses, the Old Testament, or the Pentateuch) cloven hoofed, cud-chewing mammals are kosher. Deer, sheep and goats, for example are all kosher, while pig and rabbit, for example, are not.
--Only certain birds are considered kosher in the United States. This includes chicken, duck, goose, and turkey.
--Lobster lovers might be dismayed to find that for seafood or fish to be kosher, it must have fins and easily removable scales. Shellfish generally, and lobsters, shrimp, and clams, specifically are not kosher. Fish, on the other hand, such as tuna, carp, and herring, are kosher, but only if they are prepared by a kosher fish monger with kosher cutting implements and machines. --

There's more, according to WiseGeek.com. In most cases, scales must be present on the fish in order to be purchased by the consumer. Also:
--Fish and meat cannot be served together.
--Milk and meat cannot be served together. Rabbinic law includes poultry in this prohibition, however fish is excluded. This gives rise to the popular, and kosher, bagel, lox, and cream cheese combination.
--Processed food must be prepared in the presence of a rabbi.
--Poultry and meat must be slaughtered under strict guidelines called "shechita." This means the animals are slaughtered without pain. Only those who are trained and qualified are allowed to slaughter kosher animals. Once the animal is no longer alive, another team of experts will examine the animal to be sure the animal is without illness, abnormalities or anything else that can be considered unsanitary. The lungs in particular must be pure. In addition, all blood, nerves, and most fat must be removed.
--Kosher kitchens must maintain separate sets of utensils, pots, pans, dishes, and anything else that comes in contact with food. In addition, dishes and utensils in a kosher kitchen can't be washed together. If a kitchen has two sinks, it is an ideal setup for a kosher family. If not, separate wash buckets are often used. Dishes and utensils must be dried using separate racks or dishtowels as well.

The basic laws of Kashrus (a Hebrew word referring to kosher and its application) are of Biblical origin (Leviticus 11 and Deuteronomy 17). For thousands of years, Rabbinic scholars have interpreted these laws and applied them to contemporary situations. In addition, Rabbinic bodies enacted protective legislation to safeguard the integrity of kosher laws, according to the Orthodox Union. Given the complex nature of the laws of kashrus, one should consult an Orthodox Rabbi whenever a kashrus issue arises. Though an ancillary hygienic benefit has been attributed to the observance of kashrus, the ultimate purpose and rationale is to conform to the Divine Will, as expressed in the Torah. Not too long ago, most food products were made in the family kitchen, or in a small factory or store in the local community. It was relatively easy to ascertain if the product was reliably kosher. If Rabbinical supervision was required, it was attended to by the rabbi of the community, who was known to all. Today, industrialization, transcontinental shipping and mass production have created a situation where most of the foods we eat are treated, processed, cooked, canned or boxed commercially in industrial settings, which can be located hundreds or thousands of miles away from home.

What adds further complication is that it is generally not possible to judge the kosher status of an item on the basis of the information provided in the ingredient declaration for a variety of reasons, according to OU.org (Orthodox Union). First, the product may be made from kosher ingredients, but processed on non-kosher equipment. Second, the USDA does not require the listing of certain processing aids, such as pan liners and oils that serve as release agents. Though not legally classified as ingredients, these items could nonetheless render the product non-kosher. Third, many ingredients can be kosher or non-kosher, depending on their source of origin. For example, glycerin and emulsifiers are made from either vegetable or animal oils. Finally, many ingredients are listed only in broad terms, with no breakdown of the many complex components that make up the actual item. For example, a chocolate flavor may contain 50 ingredients, but the ingredient declaration will list this entire complex of ingredients as "flavors".Unless a person is an expert in food production, the average consumer cannot possibly make an evaluation of the kosher status, which is why it is important to purchase only those products that have the endorsement of a reliable kosher agency. More info for a kosher food primer is available at their site: http://www.ou.org/kosher/primer.html.

According to WhatsKosher.com, All around the world there are millions of individuals who only eat kosher food. Despite the large number of people who do eat it, there are even more who have no idea what kosher food is. Kosher food is often termed a Jewish food. Jewish followers are the most common kosher food consumers, but they are not the only ones. There are individuals who eat kosher food simply because the food is often considered better than traditional food. Jewish law is used to determine exactly what food is kosher and what is not.

If you are interested in ordering Kosher foods, there are plenty of websites available that offer high quality items to order, including the following and more:
1.) http://www.kosher.com/
2.) http://www.aviglatt.com/
3.) http://www.mykoshermarket.com/
4.) http://www.scandikosherfood.com/
5.) http://www.aromamarket.net/
Plus, the New York Times has a huge amount of information about kosher foods, found at: http://topics.nytimes.com/topics/reference/timestopics/subjects/k/kosher_foods/index.html.
In the grocery store you will find all sorts of foods labeled as Kosher, but the most common are Kosher hot dogs and Kosher pickles, according to HowStuffWorks.com. Heinz Ketchup has been Kosher for decades. You will often find a U with a circle around it on Kosher products. There is also the word Pareve or Parve on many foods, and this is a form of Kosher labeling as well. If you are interested in preparing kosher foods, more info can also be found at http://jewishrecipes.org/.

But interest in kosher food isn't limited to special seasons such as Passover, when the law says Jews should avoid all leavened foods, according to BeliefNet.com. Non-Jews with dietary restrictions and consumers who want more inspection of the foods they eat are among those looking year-round for the kosher seal of approval. Walk the aisles of a mainstream market, and you'll see kosher certification symbols on hundreds of products, ranging from salsa and wasabi to boxes of macaroni and cheese. They're evidence that kosher is second only to organic food when it comes to the fastest-growing food categories. About 2,000 products are added to the list of approved kosher foods each year, and the list already numbers more than 111,000. And, vegans and people who are intolerant of gluten or dairy are most likely to see a kosher symbol on products targeting their specialized diet. Passover foods, in particular, often are considered gluten-free.

Americans are snapping up kosher food products across the country, prompted by health concerns and a belief that kosher meats and poultry — prepared under strict Jewish dietary laws — are a safer choice amid fears of mad cow disease and bacterial contamination, according to SafeToRemember.com. Kosher laws are stricter than U.S. Department of Agriculture standards when it comes to the health of animals that can be eaten. The number of health-conscious consumers who seek out kosher products has been steadily rising. Because the U.S. Jewish population is holding steady, the kosher industry attributes the extra demand to buyers who are not motivated by religion but by health and food safety concerns.

Until next time. Let me know what you think.

Monday, January 11, 2010

Health Care and Osteoporosis

Ever wonder why the older people get, the shorter they appear as they age? A major contributor to the height question is from a debilitating disease that can be treated and prevented called Osteoporosis, commonly found in more women than men. And, according to the National Osteoporosis Foundation (NOF), this ailment is a disease in which bones become fragile and more likely to break. If not prevented or if left untreated, osteoporosis can progress painlessly until a bone breaks. These broken bones, also known as fractures, occur typically in the hip, spine, and wrist; any bone can be affected, but of special concern are fractures of the hip and spine. A hip fracture almost always requires hospitalization and major surgery. It can impair a person's ability to walk unassisted and may cause prolonged or permanent disability or even death. Spinal or vertebral fractures also have serious consequences, including loss of height, severe back pain, and deformity.

The NOF provides some very simple guidelines to help prevent osteoporosis:
--EAT RIGHT:Get your daily recommended amounts of Calcium and Vitamin D.
--EXERCISE: Engage in regular weight-bearing and muscle strengthening exercise.
--MAINTAIN A HEALTHY LIFESTYLE: Avoid smoking and excessive alcohol consumption.
--TALK TO YOUR HEALTHCARE PROVIDER: Talk to your healthcare provider about bone health.
--GET TESTED:Have a bone density test and take medication when appropriate.

Osteoporosis, according to the Mayo Clinic, which means "porous bones," causes bones to become weak and brittle — so brittle that a fall or even mild stresses like bending over or coughing can cause a fracture. In many cases, bones weaken when you have low levels of calcium and other minerals in your bones. It's never too late — or too early — to do something about osteoporosis. You can take steps to keep bones strong and healthy throughout life. Because osteoporosis rarely causes signs or symptoms until it's advanced, the National Osteoporosis Foundation recommends a bone density test if you are:
--A woman older than age 65 or a man older than age 70, regardless of risk factors.
--A postmenopausal woman with at least one risk factor for osteoporosis.
--A man between age 50 and 70 who has at least one osteoporosis risk factor.
--Older than age 50 with a history of a broken bone.
--Take medications, such as prednisone, aromatase inhibitors or anti-seizure drugs, that are associated with osteoporosis.
--A postmenopausal woman who has recently stopped taking hormone therapy.
--A woman who experienced early menopause.

According to the National Institutes of Health (NIH), there are risk factors. Those include the following:
--Getting older.
--Being small and thin.
--Having a family history of osteoporosis.
--Taking certain medicines.
--Being a white or Asian woman.
--Having osteopenia, which is low bone mass.

According to eMedicineHealth.com, osteoporosis is often considered to be a condition that frail elderly women develop. However, the damage from osteoporosis begins much earlier in life. Because peak bone density is reached at approximately 25 years of age, it is important to build strong bones by that age, so that the bones will remain strong later in life. Adequate calcium intake is an essential part of building strong bones. In the United States, nearly 10 million people already have osteoporosis. Another 18 million people have low bone mass that places them at an increased risk for developing osteoporosis. As our population ages, these numbers will increase. About 80% of those with osteoporosis are women. Of people older than 50 years of age, one in two women and one in eight men are predicted to have an osteoporosis-related fracture in their lifetime. According to the World Health Organization, the prevalence of osteoporosis among U.S. white women past menopause is estimated to be 14% in those 50-59 years of age, 22% in those 60-69 years of age, 39% in those 70-79 years of age, and 70% in those 80 years of age and older. Significant risk has been reported in people of all ethnic backgrounds. White and Asian racial groups, however, are at greatest risk.

According to FamilyDoctor.org, treatment for osteoporosis starts with changes to your diet. You want to take in more calcium. Your doctor will suggest ways to get more calcium through food, drink and possibly a calcium supplement. He or she may also suggest you take a vitamin D supplement, which helps your body process calcium. Your doctor will want you to increase your physical activity, especially weight-bearing exercise. This helps increase bone density. Examples of weight-bearing exercise include walking, jogging and climbing steps. There are medicines available to treat osteoporosis. They include the following:
--Biophosphonates: These medicines help reduce the risk of breaks and fractures, as well as increase bone density in the hips and spine. They can be taken in orally (in pill form) of intravenously (with an injection). Side effects include nausea, abdominal pain and irritation of the esophagus (the tube that connects the mouth to the stomach). People who cannot take biophosphonates include people who have kidney disease, low levels of calcium in their blood and women who are pregnant or nursing.
--Calcitron: This is a hormone that helps slow the breakdown of bone. It is available as an injection or nasal spray. Side effects include irritation of the lining of the nose and headache (with use of the nasal spray) and diarrhea, abdominal pain, nausea and vomiting (with use of the injection).Raloxifene. This medicine is used to prevent and treat osteoporosis in women by increasing bone density. It is not a hormone, but it mimics some of the effects of estrogen. Side effects may include hot flashes and a risk of blood clots.
--Teriparatide: This medicine is a synthetic form of parathyroid hormone and helps new bone to grow. It comes in an injectable form, and is injected once a day in the thigh or abdomen. It can be used in both women and men for the treatment of osteoporosis. Common side effects may include nausea, abdominal pain, headache, muscle weakness, fatigue and loss of appetite.
--Alendronate and Risedronate: These medicines are used to help prevent and treat osteoporosis. They help reduce the risk of fractures by decreasing the rate of bone loss. They are taken orally in pill form. Their most common side effect is an upset stomach.
--Ibandronate: This medicine helps to slow bone loss and increases bone density. It is available both as a pill or as an injection. If you take the pill, you have 2 options: a daily pill or a monthly pill (the pill you take each month has a greater dose of ibandronate than the pill you take daily). If you take the injection, your doctor or nurse will give you a shot every 3 months. Some of the possible side effects include lower back or side pain, shortness of breath, tightness in the chest, and bloody or cloudy urine.

It is hard to grow new bone after it is lost, so prevention is important according to the American Congress of Obstetricians and Gynecologists (ACOG). Slowing bone loss helps build strong bones. To prevent osteoporosis, focus on building and keeping as much bone as you can. This can be done by doing weight-bearing exercises and choosing foods with enough calcium and Vitamin D. After menopause, your doctor may suggest medication to protect against bone loss if your bones show signs of early osteoporosis. Bone loss can increase if your diet is low in calcium. Calcium slows the rate of bone loss. If the amount of calcium in the bloodstream is too low, it will be taken from the bones to supply the rest of the body. Good sources of calcium are dairy products, such as milk and yogurt. Other sources are leafy green vegetables, nuts, seafood, and juices and cereals that are fortified with calcium. A well-balanced diet is very healthy for bones. Most women do not consume enough calcium in their diets. In fact, many women get only one half of the daily amount of calcium they need. You may need to take calcium supplements. Ask your pharmacist to suggest one that is right for you. Calcium cannot be absorbed without vitamin D; milk that is fortified with vitamin D, including lactose-free milk, is one of the best sources. And, another is sunlight. Being in the sun for just 15 minutes a day helps your skin produce vitamin D and activates vitamin D in your body. You also can use vitamin D supplements.

To increase your chances of staying healthy, you have an important goal—to prevent bone loss, according to ACOG. Exercise every day, even if you walk only a few blocks, and get enough calcium. Talk with your doctor about methods to prevent, diagnose, and treat osteoporosis.

Until next time. Let me know what you think.

Tuesday, January 5, 2010

Health Care and E Coli

The news media loves to report on sensational stories, and the more drastic the news the higher ratings are estimated to be for any type of story. Health care news is top of the table coverage for media outlets especially now. On occasion, you will see reporters talk about outbreaks of E. Coli in the nation's food supply. According to the Centers for Disease Control (CDC), Escherichia Coli (abbreviated as E. coli) are a large and diverse group of bacteria. Although most strains of E. coli are harmless, others can make you sick. Some kinds of E. coli can cause diarrhea, while others cause urinary tract infections, respiratory illness and pneumonia, and other illnesses. Still other kinds of E. coli are used as markers for water contamination—so you might hear about E. coli being found in drinking water, which are not themselves harmful, but indicate the water is contaminated. It does get a bit confusing—even to microbiologists.

According to About-ecoli.com, More than 700 serotypes of E. coli have been identified. The different E. coli serotypes are distinguished by their “O” and “H” antigens on their bodies and flagella, respectively. The E. coli serotypes that are responsible for the numerous reports of contaminated foods and beverages are those that produce Shiga toxin (Stx), so called because the toxin is virtually identical to that produced by another bacteria known as Shigella dysenteria type 1 (that also causes bloody diarrhea and hemolytic uremic syndrome [HUS] in emerging countries like Bangladesh). The best known and most notorious Stx-producing E. coli is E. coli O157:H7. It is important to remember that most kinds of E. coli bacteria do not cause disease in humans, indeed, some are beneficial, and some cause infections other than gastrointestinal infections, such urinary tract infections.

Shiga toxin is one of the most potent toxins known to man, so much so that the Centers for Disease Control and Prevention (CDC) lists it as a potential bioterrorist agent (CDC, n.d.). It seems likely that DNA from Shiga toxin-producing Shigella bacteria was transferred by a bacteriophage (a virus that infects bacteria) to otherwise harmless E. coli bacteria, thereby providing them with the genetic material to produce Shiga toxin. Although E. coli O157:H7 is responsible for the majority of human illnesses attributed to E. coli, there are additional Stx-producing E. coli (e.g., E. coli O121:H19) that can also cause hemorrhagic colitis and post-diarrheal hemolytic uremic syndrome (D+HUS). HUS is a syndrome that is defined by the trilogy of hemolytic anemia (destruction of red blood cells), thrombocytopenia (low platelet count), and acute kidney failure. Stx-producing E. coli organisms have several characteristics that make them so dangerous. They are hardy organisms that can survive several weeks on surfaces such as counter tops, and up to a year in some materials like compost. They have a very low infectious dose meaning that only a relatively small number of bacteria (less than 50) are needed “to set-up housekeeping” in a victim’s intestinal tract and cause infection.

The Centers for Disease Control and Prevention (CDC) estimates that every year at least 2000 Americans are hospitalized, and about 60 die as a direct result of E. coli infections and its complications. A recent study estimated the annual cost of E. coli O157:H7 illnesses to be $405 million (in 2003 dollars) which included $370 million for premature deaths, $30 million for medical care, and $5 million for lost productivity. The CDC has estimated that 85% of E. coli O157:H7 infections are foodborne in origin. In fact, consumption of any food or beverage that becomes contaminated by animal (especially cattle) manure can result in contracting the disease. Foods that have been sources of contamination include ground beef, venison, sausages, dried (non-cooked) salami, unpasteurized milk and cheese, unpasteurized apple juice and cider, orange juice, alfalfa and radish sprouts, lettuce, spinach, and water.

According to FamilyDoctor.org, symptoms start about 7 days after you are infected with the germ. The first sign is severe abdominal cramps that start suddenly. After a few hours, watery diarrhea starts. The diarrhea causes your body to lose fluids and electrolytes (dehydration). This makes you feel sick and tired. The watery diarrhea lasts for about a day. Then the diarrhea changes to bright red bloody stools. The infection makes sores in your intestines, so the stools become bloody. Bloody diarrhea lasts for 2 to 5 days. You might have 10 or more bowel movements a day. Some people say their stools are "all blood and no stool." You may have a mild fever or no fever. You may also have nausea or vomiting. If you have any of these symptoms -- watery, bloody diarrhea, cramps, fever, nausea or vomiting -- get to your doctor right away. The most common complication is called hemolytic uremic syndrome. People with this problem get hemolytic anemia (which is a low red blood cell count), thrombocytopenia (which is a low platelet count) and renal failure (which is kidney damage).Hemolytic uremic syndrome is more common in children. It can cause acute renal failure in children. This problem starts about 5 to 10 days after the diarrhea starts. People with this problem must go to a hospital for medical care. The diagnosis is made by finding E. coli in a stool culture. If you have bloody diarrhea, see your doctor as soon as possible. Your doctor will do a culture to find out if you have E. coli in your intestines. The culture has to be taken in the first 48 hours after the bloody diarrhea starts.

You can help prevent E. coli infection by handling and cooking meat in a safe way, according to FamilyDoctor.org. For your protection, follow these rules:
--Wash your hands carefully with soap before you start cooking.
--Cook ground beef until you see no pink anywhere.
--Don't taste small bites of raw ground beef while you're cooking.
--Don't put cooked hamburgers on a plate that had raw ground beef on it before.
--Cook all hamburgers to at least 155°F. A meat thermometer can help you test your hamburgers.
--Defrost meats in the refrigerator or the microwave. Don't let meat sit on the counter to defrost.
--Keep raw meat and poultry separate from other foods. Use hot water and soap to wash cutting boards and dishes if raw meat and poultry have touched them.
--Don't drink raw milk.
--Keep food refrigerated or frozen.
--Keep hot food hot and cold food cold.
--Refrigerate leftovers right away or throw them away.
--People with diarrhea should wash their hands carefully and often, using hot water and soap, and washing for at least 30 seconds. People who work in day care centers and homes for the elderly should wash their hands often, too.
--In restaurants, always order hamburgers that are cooked well done so that no pink shows.

Now, if the meat is ground, you have a much more risky situation, according to the University of Kansas. Any bacterial cells originally only on the surface of the meat, will now be distributed throughout the preparation. It is very important in this case to thoroughly cook the meat - until the juices run absolutely clear. Actually, the latest recommendation is that each hamburger pattie must reach an internal temperature of 160 degrees F. Apparently, viable (living) E. coli have been isolated from hamburger meat cooked to the point of "juices running clear". This procedure is very similar to that one would use to cook pork or perhaps a Thanksgiving turkey, e.g., observe the internal temperature of the meat before it is served. Just remember, if you like your meat and especially hamburgers, "rare", you are taking a significant risk. It is also important to realize that meat may not be the only source of contamination with such bacteria or other dangerous bacteria - any contaminated water source or contaminated person can load these bacteria onto vegetables, etc. So, it is a good idea to be careful with everything - wash fresh fruit, vegetables, etc., thoroughly before eating. This last statement is very important, since as mentioned above, recent cases of O157:H7 infection have been found associated with non-pasteurized apple juice. This organism is apparently spreading around and about. So, it is important to be vigilant and aware.

According to the Mayo Clinic, for illness caused by E. coli O157:H7, no current treatments can cure the infection, relieve symptoms or prevent complications. For most people, the best option is to rest and drink plenty of fluids to help with dehydration and fatigue. Avoid taking an anti-diarrheal medication — this slows your digestive system down, preventing your body from getting rid of the toxins. Follow these tips to prevent dehydration and reduce symptoms while you recover:
--Clear liquids. Drink plenty of clear liquids, including water, clear sodas and broths, gelatin, and juices. Avoid apple and pear juices, caffeine and alcohol.
--Add foods gradually. When you start feeling better, stick to low-fiber foods at first. Try soda crackers, toast, eggs or rice.
--Avoid certain foods. Dairy products, fatty foods, high-fiber foods or highly seasoned foods can make symptoms worse.

The vast majority of cases involving E. coli are preventable. Use common sense and the tips listed in this blog to help keep you safe.

Until next time. Let me know what you think.

Monday, January 4, 2010

Health Care and Blood Clots

Ever have a paper cut? If you remember, they sting and hurt and cause you to bleed. More severe lacerations result in heavier blood loss, and major bleeding can be catastrophic. The human body, with its capacity to offer resistance to certain health related emergencies, automatically starts a process to stem the flow of that precious red liquid of life. Clotting is a natural mechanism that kicks in when you start to bleed. However, there are some individuals that have health issues that prevent the natural clotting process when these events take place and need medications or other medically necessary procedures that prevent "bleeding out." When severe blood loss occurs, clotting is significant in its urgency to prevent the end of life.

According to MedicineNet.com, blood is a liquid that flows within blood vessels. It is constantly in motion as the heart pumps blood through arteries to the different organs and cells of the body. The blood is propelled back to the heart in the veins. When muscles contract, they squeeze the veins and allow the blood to be pushed back to the heart. Blood clotting is an important mechanism to help the body repair injured blood vessels. Blood consists of:
--red blood cells containing hemoglobin that carry oxygen to cells and remove carbon dioxide,
--white blood cells that fight infection, and
--platelets that are part of the clotting process of the body, and
--blood plasma, which contains fluid, chemicals and proteins that are key to bodily functions.

Complex mechanisms exist in the bloodstream to form clots where they are needed, according to MedicineNet.com. If the lining of the blood vessels becomes damaged, platelets are recruited to the injured area to form an initial plug. These activated platelets release chemicals that start the clotting cascade, activating a series of clotting factors. Ultimately, fibrin is formed, the protein that crosslinks with itself to form a mesh that makes up the final blood clot. The medical term for a blood clot is a thrombus (plural= thrombi). When a thrombus is formed as part of a normal repair process of the body, there is little consequence. Unfortunately, there are times when a thrombus (blood clot) will form when it is not needed, and this can have potentially significant consequences. A very highly detailed technical explanation of clotting also is available at http://themedicalbiochemistrypage.org/blood-coagulation.html .

According to FamilyDoctor.org, there are proteins in your body that are supposed to keep your blood from clotting too much. Some people do not make enough of these proteins. In other people, these proteins are not doing their job properly, or a person may have extra proteins in their blood that causes too much clotting. Some people are born with a tendency to develop clots. This tendency is inherited (which means it runs in your family). Certain situations or risk factors can make it easier for your blood to clot too much. These situations include the following:
--Sitting on an airplane or in a car for a long time.
--Prolonged bed rest (several days or weeks at a time), such as after surgery or during a long hospital stay.
--Surgery (which can slow blood flow).
--Cancer (some types of cancer increase the proteins that clot your blood).
--Pregnancy (which increases the pressure in your pelvis and legs and can cause blood clots to form).
--Using birth control pills or receiving hormone replacement therapy (which can slow blood flow).
--Smoking (which affects clotting).

According to MedicineNet.com, blood clots form when there is damage to the lining of a blood vessel, either an artery or a vein. The damage may be obvious, such as a laceration, or may occur on the microscopic level. As well, blood will begin to clot if it stops moving and becomes stagnant, such as in the following examples:
1.) Venous thrombosis or blood clots in a vein occur when a person becomes immobilized and muscles are not contracting to push blood back to the heart. This stagnant blood begins to form small clots along the lining walls of the vein that gradually grow to partially or completely occlude the vein. An analogy to this process is a slow moving river. Over time, weeds and algae start to accumulate along the banks of the river where the water flows more slowly. Gradually, as the weeds start to grow, they begin to invade the center of the river because they can withstand the pressure of the water.
2.) Arterial thrombi (blood clots in an artery) occur by a different mechanism. For those with atherosclerotic disease, plaque deposits form along the lining of the artery and grow to cause narrowing of the vessel. This is the disease process that may cause heart attack, stroke, and peripheral artery disease. If a plaque ruptures, a blood clot can form at the site of the ruptured plaque that can completely or partially occlude the blood flow at that point.
3.) Blood clots can also form in the heart. In atrial fibrillation, the atrium or upper chamber of the heart does not beat in an organized manner. Instead, it jiggles, and blood tends to become stagnant along the walls of the atrium. Over time, this may cause small blood clots to form. Clots can also form in the ventricle after a heart attack when part of the heart muscle is injured and unable to contract normally. Since the damaged area doesn't contract with the rest of the heart, blood can start to pool or stagnate, leading to clot formation.

As people age, particularly after age 55 for men and age 60 for women, blockages in arteries and veins become more common, according to Merck.com. The reason for the increase is unclear. Atherosclerosis, which becomes more common as people age, may partly explain the increase of blockages in arteries, but not that in veins. Normally, blood clots in response to injury. Clots form to plug breaks in blood vessels and prevent blood from leaking out of the blood vessels. Platelets are crucial to clotting. When a blood vessel breaks, platelets are activated. They become sticky and change from rounded to spiny. These changes enable platelets to stick to the broken blood vessel wall and to each other, helping form a plug at the break. At the same time, platelets release proteins and other substances that promote further clotting. After an injured blood vessel heals, other reactions help stop the clotting process and dissolve clots. These reactions also involve proteins dissolved in the blood. Without this control system, minor blood vessel injuries could trigger widespread clotting throughout the body, which occurs in some disorders.

Symptoms depend on which blood vessels are blocked by the clots, according to Merck. For example, an arm or a leg may swell or become painful and red. If a leg remains severely swollen, the skin on the lower leg may become itchy and turn a reddish brown. This skin is easily injured, often resulting in an ulcer. These symptoms may result when clots permanently damage the deep veins in a leg (a disorder called chronic venous insufficiency). Less commonly, the abdomen or face swells. People with disseminated intravascular coagulation can have symptoms related to both clotting and bleeding. Shortness of breath may develop as small blood vessels of the lungs leak or clots form in them. The skin, lining of the mouth, and whites of the eyes (sclera) may become yellowish (jaundice) if clotting and bleeding occur in the liver. Often, many tiny red dots appear in the skin on the lower legs. People may bruise easily. The gums may bleed, and blood may appear in the stool or urine. Small blackened areas may develop in the fingers and toes if fibrin, a component of clots, is deposited in the blood vessels there. Gangrene can result.

According to Physorg.com, a key protein that causes the blood to clot is produced by blood vessels in the lungs and not just the liver, according to new research published in the journal PLoS One, led by scientists at Imperial College London. The findings may ultimately help scientists to develop better treatments for conditions where the blood's ability to clot is impaired, including deep vein thrombosis, where dangerous blood clots form inside the body, and haemophilia A, where the blood cannot clot sufficiently well.

According to Merck, a blood clot may be detected when it causes symptoms or when a routine examination is done. An imaging test is usually needed to confirm the presence of clots. If clotting in veins is suspected, ultrasonography is useful for confirming clotting and for locating the clots. Magnetic resonance imaging (MRI) may be done if ultrasonography results are unclear. If results are still unclear, venography may be needed. For this test, special x-rays are taken after contrast dye is injected into a vein. When clotting in arteries is suspected, clotting may be confirmed using blood tests or arteriography. For arteriography, special x-rays are taken after contrast dye is injected into arteries. The cause must be identified. Blood tests can help. The amount and activity of different proteins that control clotting are measured. The platelet count and the time blood takes to clot may be determined. These tests are usually done after a blood clot has been treated. If the cause is another disorder or a drug, the clotting problems may subside when the disorder is treated or the drug is discontinued. If a hereditary disorder is the cause, people who have had one or more clots are often advised to take the anticoagulant warfarin for the rest of their life. Sometimes people who have had only one clot are advised to take warfarin or another anticoagulant, heparin, only when the risk of clots is high and special treatment is required. For example, they should take an anticoagulant when they need bed rest for a long time. Because taking anticoagulants increases the risk of excessive bleeding, people who take them must have blood tests periodically to check whether blood is taking too long to clot. Doctors then adjust the dose of the anticoagulant if needed.

According to Merck, clotting in arteries may be treated with a drug that makes platelets less likely to clump and thus makes blood clots less likely to form. These drugs, called antiplatelet drugs, include aspirin, clopidogrel, and dipyridamole. If a clot is still present or if a person has atrial fibrillation, heparin or warfarin is used. If a clot causes blood pressure to fall dangerously low or blocks blood flow to the brain or other vital organs, emergency treatment is needed. Treatment may involve giving drugs to dissolve clots (thrombolytic drugs) or, rarely, performing surgery to remove a clot from a blood vessel. However, these treatments can have dangerous, even life-threatening side effects, especially in older people. If disseminated intravascular coagulation develops suddenly, it requires emergency treatment for clotting and bleeding. If bleeding is severe, transfusions of red blood cells, platelets, and clotting factors are given to replace those that are used up and to stop the bleeding. If clotting is more of a problem than bleeding, heparin may be given.

Moderate exercise such as walking or swimming is recommended if you have suffered from blood clots and are taking anticoagulants. A return to your normal exercise routine depends on your physical condition before the clot and the severity and location of your clots. Refrain from crossing your legs which interferes with circulation. Do not sit for more than 2 hours at a time. In an automobile, stop every hour or so and walk for several minutes. On a plane, try to sit where you can stretch your legs (aisle seat, exit aisle, bulkhead seats, business class, etc.). Periodically, get up and walk the aisle(s) for several minutes. It is also a good idea to wear compression stockings when traveling. For any dental work, definitely tell the dentist when you make an appointment. Every dentist handles the issue of anticoagulants differently. Much more detail about using anticoagulants can be found at http://www.stoptheclot.org/learn_more/blood_clot_treatment.htm .

Blood clots are serious business. Deciding to take action if you feel that you are suffering from one is the best course to stay safe. Follow up immediately with your doctor or nearest health care provider. Avoiding care with blood clots is not advised. Seek medical attention at your earliest opportunity so you can maintain your health and avoid illness or death.

Until next time. Let me know what you think.