I really feel good about obtaining a BLS Provider Card! Yes I admit, I feel great about it because the whole purpose of it is to save lives of those in cardiac arrest. During our power hour, I was first trying to save an adult for almost an hour. The more I hear myself counting my compressions, the more determined I am to bring my patient to life. It is tiring for the arms but I became so connected to my patient like as if he is a loved one or simply my brother. I will do my very best to help him/her. By the end of the power hour, I was asked to help an infant. During the compressions and breathings, it made me think of my own kids. It is heartbreaking. I am so grateful that i can be an instrument in the cause and purpose of CPR and AED.
Monday, July 25, 2016
Osteoarthritis also known as OA is the most common form of arthritis. Millions of people worldwide are affected by this. It is sometimes called the "wear and tear" arthritis. But scientists now believe that it is a disease of the joint. Osteoarthritis happens when the cartilage or cushion tears or wears down leading to physical distress, difficulty moving and swelling pain. Joint tenderness can be felt during or after movement. Clicking and cracking sound are also signs of osteoarthritis. These negative effects may affect one's performance of ordinary tasks at home or at work. Simple activities such as fixing bed, opening a canned food, grasping a computer mouse, vacuuming a carpet or driving a car can be difficult to do. When lower body joints are affected, normal activities like walking, climbing stairs or lifting objects can also become difficult to do. When hand joints are affected, activities that involves grasping can be difficult as well. The most common areas of osteoarthritis are hips, knees, fingers and feet. Being active, healthy weight and other treatments can slow the development of this disease.
Many people believe that the effects of osteoarthritis can't be avoided. But hopefully, they can manage pain, stop joint damage and increase flexibility because their daily life, family and social life can be affected badly. The pain, reduced mobility and the side effects of medications can lead to other negative health problems. Hip or knee pain can cause the patient to sit for long periods of time which may lead to weight gain and obesity. Being overweight or obese can cause heart problems and diabetes.
People with osteoarthritis is in a dangerous situation of falling because of decreased function, muscle weakness and impaired balance. In fact, they have a chance of 30% more falls and 20% chance of getting a fracture than those without osteoarthritis. Medications like narcotic pain relievers can lead to fall because of dizziness and unbalanced position.
One of the factors of the development of Osteoarthritis is genetics. There are those people that inherit this rare defect of abnormal production of collagen in the body. Collagen is the protein that makes up the cartilage. This abnormal condition can lead to the development of osteoarthritis as early as the age of 20. Defects in the way bones fit together wears away the cartilage faster than usual.
As you get older, the risk of developing osteoarthritis increases. Women though are more prone to this disease.
Another factor is weight. Too much weight puts more pressure to the hips and knees. Being overweight for a long time can cause the cartilage to break down faster. Extra weight puts stress to weight bearing joints such as hips and knees. Research also showed that extreme amount of fat tissues produce inflammatory chemicals called cytokines that can destroy the joints.
Joint injuries and movements that are repetitious. e.g. fractures, surgeries or ligament tears. certain careers such as those athletes that repeatedly break their joints, ligaments and tendons and also those movements that require standing for a long time, bending and heavy lifting can speed up cartilage breakdown. Bone and joint disorders are also factors that contribute to the development of osteoarthritis.
Osteoarthritis diagnosis involves physical examination of the affected joint, checking of joint performance for tenderness, swelling and range of motion. The Doctor will also gather information of personal and family medical history which includes description of the symptom, how or when the pain started, information about other medical problems, location of the pain or swelling and how it affects your activities of daily living (ADL) and the medications currently taking. The Doctor may recommend imaging or lab tests to confirm diagnosis of the disease. These include: Joint aspiration, where the Doctor numb the affected area and then insert a needle to withdraw fluid. The fluid will be tested for crystals or joint deterioration; X-ray where cartilage loss is seen as well as bone spurs around a joint. Magnetic Resonance Imaging (MRI) produces detailed images of bone and soft tissues including cartilage. Blood tests and joint fluid analysis can help confirm the diagnosis.
There is no cure for osteoarthritis but treatments are available. Physical activities such as range of motion exercises, aerobic exercise, gentle stretching of the joints and walking around the neighborhood and easy body exercises can help ease pain, achieve healthy weight, maintain and improve flexibility and reduce stiffness. Yoga and tai chi can also help manage stiffness. Pain and anti-inflammatory medications are available for relief. Pain relievers such as analgesic which include acetaminophen, opioids (narcotics) and tramadol are available over the counter and through prescription. Over the counter Nonsteriodal Anti-inflammatory Drugs (NSAIDs) including ibuprofen (e.g. advil, motrin etc) and naproxen sodium can be taken at recommended dosage. Duloxetine (Cymbalta) is an anti-depressant that can treat chronic pain of osteoarthritis. Corticosteroid are strong anti-inflammatory medicines that can be injected or taken by mouth. Physical therapists can help with pain management. They can help create an individualized exercise program that will strengthen your muscles around your joints, increase range of motion and flexibility. Other exercise that s such as swimming or brisk walk can also help with the pain. Assistive devices such as scooters, canes, walkers, splints, shoe orthotics or helpful tools such as jar openers, long-handled shoe horns or steering wheel grips can help with functions and mobility. Nutritional supplements like avocado-soybean unsaponifiables, acupuncture and acupressure, massage, relaxation techniques and hydrotherapy are natural and alternative therapies that can help improve your well-being. An occupational therapist can give you advices that can help you face daily tasks or do your job that will prevent stress to your affected joints. According to research, tai chi and yoga reduce osteoarthritis pain and improve movement. If conservative treatments don’t help, there are procedures that can be performed. Cortisone injection is performed by numbing the area around the joint, then places the needle within the joint and injects the medication. This may relieve joint pain. But you can only have three or four injections each year because it will eventually worsen the joint damage. Hyaluronic acid injection may also give pain relief. Knee osteotomy can be performed by a surgeon when one knee is damaged. The surgeon cuts across the bone above or below the knee and then removes and adds a wedge of bone. Arthroplasty is the replacement surgery of the damaged joint being replaced by a plastic or metal parts.
The Osteoarthritis Research Society International (OARSI) established a standardized definition of Osteoarthritis. The purpose is to provide communication across the field and help advance drug development for OA. This will be recognized globally. They expect that this would help make the communication among industry and non-industry researchers, regulatory agencies, funding agencies, third party payers and patients easier. The definition is maintained by OARSI, and under their jurisdiction can be regularly refined as new scientific advances demands. The Foundation for National Institutes of health (FNIH) Osteoarthritis (OA) Biomakers Consortum project had significant progress in improving clinical outcomes for nearly 30 million people in the US that have OA of the knee and for those at risk. The Biomakers Consortum is a union of experts from the National Institutes of health (NIH), Food and Drug Administration, biotech and pharmaceutical companies, academia and diseased-focused non-profit organizations. The FNIH quest is to attain more exact ways to measure the progression of the disease and produce the expected and intended result of new treatments. The project is ongoing, discovering additional quantitative and semi-quantitative image assessments of the bones and cartilage in the knee joint. This was in the mid of 2013. That year there were 27 million Americans with OA. The knee OA is greater than the other medical condition to people age 65 and above. By year 2020, the number of people with OA will be doubled due to old age and obesity.
Friday, July 22, 2016
For the very first time in real life scenario, I had the opportunity to apply the skills that I have been learning at school in Carrington College as Medical Assistant on April 2, 2016. I volunteered in this big event of giving people free medical service. I did triaging and a lot of capillary puncture for blood sugar testing. I felt really good working with medical practitioners in helping others for their health care needs.
Tuesday, July 19, 2016
Hypertension or high blood pressure is a widespread state of health in which the power exerted of the blood against the artery walls is strong enough that later on may cause health problems. Blood pressure is the amount of blood the heart pumps and the amount of resistance to blood flow in the arteries. The more blood the heart pumps and the narrower the arteries are, the higher the blood pressure is. High blood pressure is called the "silent killer" because in many cases it has no warning signs or symptoms. Hypertension is also called "raised" blood pressure in which the blood vessels have constantly high pressure thus, putting them in greater stress.
All of us can be affected by high blood pressure. Hypertension affects all adults especially those over 65 years old. 76.4 million people have high blood pressure in the US. It is a public health challenge in the US. It develops over many years. If it is uncontrolled, there is risk to serious problems like heart attack, enlargement of the heart and then eventually heart failure. You may develop bulges and weak spots in your blood vessels that might possibly clog and explode. Blood may leak out into the brain and cause stroke because of the pressure in the blood vessels. Hypertension can also result in kidney failure, blindness and cognitive impairment. Other factors that increase heart attack are tobacco, unhealthy diet, alcohol, lack of physical activity, obesity, cholesterol and diabetes mellitus. Luckily, hypertension can easily be detected and can be controlled through the help of your doctor.
Normal adult blood pressure is 120 mm hg when the heart beats (systolic) over 80 ccmm hg when the heart relaxes (diastolic). When systolic blood pressure is equal or above 140 and the diastolic blood pressure is equal or above 90, blood pressure is said to be high. Blood pressure is usually higher when you first wake up, after exercise or when you are under stress.
There are two types of hypertension. Primary (Essential hypertension) can develop gradually over many years. Secondary hypertension tends to appear suddenly. Conditions such as obstructive sleep apnea, kidney failure, adrenal gland tumors, thyroid problems, certain defects in blood vessels (congenital) and medications such as birth control pills, cold remedies, decongestants, OTC pain relievers and some prescription drugs, illegal drugs like coccaine and amphetamines, alcohol abuse or chronic alcohol use are causes of secondary hypertension.
The risk factors of hypertension are:
- Age. Hypertension is more common in men. Women are more prone to it after age 65.
- Race. High blood pressure is particularly common in blacks.
- Family. Hypertension runs in family.
- Being overweight or obese. More weight demands more blood that carries oxygen and nutrients to the body. The pressure in the artery walls increases when the volume of blood in the blood vessels increases.
- Inactive physically. This can make your blood rate high. When this happens, your heart needs to work harder.
- Tobacco. Smoking increases your blood pressure. It can damage the lining of the arteries.
- Too much sodium in diet. This can cause fluid retention in the body which increases blood pressure.
- Too little potassium in diet. This can result in too much accumulation of salt in the blood.
- Too much alcohol. Heavy drinking of alcohol can eventually damage the heart. It will affect the blood pressure.
- Stress and certain chronic conditions can increase the blood pressure.
- Pregnancy can contribute to high blood pressure. Children can also have hypertension because of kidney or heart problems.
- Other reasons are poor and unhealthy diet.
To diagnose hypertension, the doctor will measure your blood pressure 3 times on separate appointments. And he will do it by measuring it in both arms. He may suggest "ambulatory blood pressure monitoring". This is done by measuring the blood pressure at regular intervals over 24 hours. By so doing, they will be able to have a better picture of the blood pressure changes day and night. The doctor will study your medical history and will perform physical examination. He will also recommend urinalysis, blood test, cholesterol test and EKG. He may also recommend Echo-cardiogram to check for more signs of heart disease.
Maintaining a healthy weight can also help control high blood pressure. Increased physical activities can help lower high blood pressure. The Department of Health and Human Services advised the healthy adults to aerobic activity for 75 minutes a week. Limit your alcohol intake. Quit smoking. manage stress by doing relaxation, deep breathing or meditation. You may want to monitor your blood pressure at home to see if your medication is working and or simply be aware of high blood pressure measurement.
The medications use to treat high blood pressure are:
- Thiazide diuretics.
- Medications that work on kidneys to help the body get rid of sodium and water.
- Beta Blockers. These medications lower the workload of the heart and opens the blood vessels. This will make the heart beats slower and with less force. Acebutelol and atenolo are some of these medications.
- Angiotensin-converting enzyme (age) inhibitors. These medications help the blood vessels to relax. It blocks the production of a natural chemical that narrow the blood vessels. Some of these medications are lisinopril, benazepril, captopril etc.
- Angiotensin II Receptor Blockers (ARBs). These medications block the activity of the natural chemical that narrows blood vessels thus, making them to relax. Some of these medications are candesartan, losartan etc.
- Calcium channel blockers. these medications also help the muscles of the blood vessels to relax. Amlodipine, diltiazem etc are some of these medications that work better to older people.
- Renin inhibitors. These medications reduce the creation of renin enzyme that the kidneys are producing. Renin enzyme creates a series of chemical movement that increases the blood pressure.
- Alpha blockers. These medications like doxazosin, prazosin etc also reduce the effect of the chemicals that narrow the blood vessels.
- Alpha bet blockers. These medications reduce the nerve impulses of the blood vessels and slow the heartbeat resulting to the decrease amount of blood that is being pumped in the blood vessels. Carvedilol, labetalol etc are some of these medications.
- Central-acting agents. These medications stop the brain from commanding the nervous system to increase the heart rate and narrow the blood vessels. Clonidine, guanfacine and methyldopa are some of these medications.
- Aldosterone antagonists. Spironolactone and eplerenone are these drugs that help stop the chemicals that cause salt and fluid retention.
Resistant hypertension is when your blood pressure is still high despite the medications you are taking. However, there is still chance to improve it. Your doctor or hypertension specialist can help you do this by evaluating the medications you are taking. You may observe the right combination of medicines and the right dose for you. You and your doctor should also evaluate the other medications and supplements you are taking to lower your blood pressure.
One of the most common forms of cancer is breast cancer. It is the number one cancer affecting women with over two hundred thousand women affected. Over 40,000 women die from breast cancer every year. Breast cancer can be identified by abnormal growth of certain cells within the breast.
There are four stages of breast cancer. In Stage I, the tumor size is 2 cm (3/4 inch) in diameter or about the size of a peanut. It has not spread into the lymph nodes and outside the breast. In Stage II the tumor size is 2 to 5 cm in diameter. Stage II A breast tumor is less than 2 cm in diameter but the cancer has not spread to the axillary lymph nodes while in Stage II B, the tumor is less than 2 cm in diameter and the cancer has spread to the axillary lymph nodes. Stage III breast cancer is an advanced cancer. In Stage III A, the tumor is larger than 5 cm and the cancer cells have spread to the axillary lymph nodes. In Stage III B, the tumor is smaller than 5 cm and the cancer has spread to the axillary lymph nodes above the collar bone. Inflammatory breast cancer is also classified as Stage III breast cancer where cancer cells block the lymphatic vessels in breast skin causing redness, swelling and ridged or dimpled like the orange skin. The most advanced form of breast cancer is Stage IV where breast cancer often spreads to the bones, brain, liver and lungs.
Being able to recognize the personal risk factors can help reduce the likelihood of contracting the disease. Several factors include sex, diet, exercise, race and genetics. When the disease is contracted, various treatments are used to eliminate the cancer and prevent its return.
Self breast examinations are the most frequent types of examination for detecting the disease. This can be practiced at virtually any time. Self examination includes observations of changes in the breast. Symmetry, discharges from the nipple, lumps or bumps, abnormal firmness and change in size are important factors to check every time one does a self-examination. Males can also perform a breast examination specially if there are many risk factors associated with the individual's lifestyle and genetics.
When a medical professional examines the breasts, they will not note any masses or lumps. Their size, location, shape, consistency in addition to their mobility and tenderness. Lumps may not be cancerous. Cancerous lumps are usually firm in texture and non mobile, have irregular border, are typically painless, and as with more cancer types, grow constantly.While the precise causes of breast cancer is not well understood, there are a number of correlating factors, that if avoided, may reduce the chances of contraction. One of the most common factors is sex. While males can contract breast cancer, females are primarily the hosts to this disease. Breast cancer is more common for adult women but younger women can contract the disease as well.
Another correlating factor is the person's diet. Diets that include alcohol and tobacco can increase risk. Medications for hormone therapy may also increase risk. On the other hand, estrogen blocking medications can reduce the risk.
Exercise can also help reduce the risk and improve outcomes during and after treatment. A regular exercise routine can be helpful in prevention as well as in recovery.
While often considered a taboo topic politically, there are correlations with race and breast cancer. While females are the most likely to contract this cancer at 122 per 100,000 people. This is followed closely by black females at 124. Asians are the least likely at 88 per 100,000. Differences in contraction rates are thought to have to do with lifestyles as well as physiological factors such as age of first period, age of menopause, age at first childbirth and others. White women can be of higher risk because of their tendencies to put off childbirth and to have less children overall when compared to black, hispanic or asian race.
As the field of genetics continuous to advance, scientists have observed several genetic markers that can indicate a higher risk especially when combined with diet and lifestyle factors. For example, mutations in the BRCA 1 and BRCA 2 are called "high penetrance" because they are highly correlated with the risk of developing several cancers including breast and ovarian cancer. These genes are mutation that can be passed onto offspring. BRCA 1 and BRCA 2 are genes responsible for repairing damaged DNA. Mutations caused by radiation or by mistakes in cellular reproductions in these genes make it difficult to repair tumor causing DNA mutations. Despite genes being a factor, inheritance is not thought to be a major cause. Most breast cancer is related to mutations that occur later in life as a result of the many other risk factors.
When cancer has been diagnosed, a suitable treatment plan needs to be implemented. Numerous factors are relevant when analyzing the appropriate treatment plan including the age and overall health of the patient, how fast the cancer cells are reproducing, the type and stage of breast cancer. If the cancer is localized, surgical mastectomy is one treatment option to remove the affected tissue. Radiation therapy, in which the gamma rays and other high-energy photons, neutrons and protons may be used to kill the cells in the affected area. Doctors may recommend this therapy after mastectomy for large breast cancer or cancer that spreads to the lymph nodes. The side effects are fatigue, a red sunburn like rash and the breast tissue may appear swollen or more firm. Drugs that kill certain cell types are also an option. This is known as "chemotherapy". Sometimes this is done first to patients with larger breast tumors before mastectomy. The goal is to shrink the tumors. Other situation is when the cancer cells has spread to the lymph nodes. Often a combination of treatments will be used. The common side effects of chemotherapy includes hair loss, nausea, vomiting, fatigue and an increased risk to infections.
For cancer cells that are sensitive to hormones, hormone therapy or more accurately "hormone blocking therapy" is an option. Cells can be either estrogen receptor positive or progesterone receptor positive. Medications that inhibit the receptors from binding to estrogen or progesterone can stop the growth or even shrink the cancer growth. Some medications such as fulvestrant will not only block the receptors but signal the cell to destroy the receptor. Other medications reduce the amount of estrogen or progesterone that the body creates. This is a treatment option for postmenopausal women. In some cases, the ovaries themselves can be removed surgically permanently stopping the body from producing estrogen. There are serious long-term side effects related to oophorectomy (removal of the ovaries) because of the loss of essential hormones. This loss can be supplemented by medicine, but not without risk.
As our understanding of the risk factors and especially genetic research improves over time, cancer incidents may start going down and incidents of successful recovery may increase. Scientists may continue to identify new risk factors and research into a more efficient and cheaper ways to test for BRCA 1 and BRCA 2 mutations in accelerating. One young area of study is in the environmental factors. Another long term study aims to observe lifestyle, environmental and genetic differences between sisters one of which has breast cancer over a ten year period.
Chemoprevention is another promising area of future development. Drugs similar to vitamin A are being studied as a method of breast cancer risk prevention. Estrogen inhibitors (aromatase inhibitors) are also being studied as a prevention method. There are side effects of their usage, however, such as osteoporosis under study is the potential relationship between Vitamin D deficiency and incidents of breast cancer. An early study found that many patients with early-stage breast cancer were deficient in Vitamin D.
With a combination of prevention, early identification and treatment, incidents of breast cancer can be reduced for this serious disease.