Medical Hodgepodge

Meet Me in the Rest Room

2009-04-17T08:40:00.001-06:00

http://www.friendfeed.com/…-rest-room

Chat planned for Tuesday April 21 from 5-6 PM US Mountain Time. (UTC-7)

The Rest Room is a general topics chat room. You can bring up anything you want, from the book to affiliate marketing to ??? It's a free-for-all! The only rule is courtesy.

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Synvisc

2009-03-22T07:41:00.002-06:00

This stuff sounds like a real breakthrough. A 98 year old resident where I work has just gotten the injections. She had no cartilage left in her knees and sometimes you could hear the bones grind together--very painful. She told me that over the course of the week the liquid that was injected will form into a soft solid, acting as an artificial cartilage. It sounds very beneficial for those for whom surgery might be counterindicated due to extremely advanced age or other complicating conditions.
Every now and then, the medical community comes up with something really wonderful. Synvisc seems like it's one of those things.

Warehousing the Elderly

2009-03-17T05:14:00.001-06:00

This was my reply to a friends' post about moving a lady to an assisted living facility. You can read his post here.

http://analytixman.blogspot.com/…dying.html

Sadly, most assisted living and long term care facilities have rooms such as you describe. While the fat cats' pockets get fatter, our elderly and disabled continue to get the shaft.

The apartments in the place where I work are not like this. But said apartments are, to be blunt, hella expensive. The apartments in the independent living area are about $3500 a month. The ones in assisted living are $6000, and the rooms in long term care are $9000. I don't know about you, but I have a hard time managing the $1100 I pay between mortgage and lot rent on my mobile home. (I know you wouldn't do this, but if anyone else feels the need to refer to me as 'trailer park trash,' so be it.)

None of the people I work with could afford an apartment or room in the place where we work.

Its scary. I have long term care insurance and a retirement plan but when I look at what this brings as compared to the cost, it ain't much. I do try to save but there's not that much if anything left over to save when the bills are paid.

I worry about what's going to happen with my father. He had a stroke four and a half years ago and is badly handicapped. My mother is his 24-7 caregiver. No home health agency will deal with him because he's so difficult to do transfers with. I pulled a muscle in my chest helping to transfer him. If something happened to my mother he'd have to go into a care facility because he needs someone with him 24-7. My brother lives in a different state and of course I work a full time job. There's no way we could swing it. And that's a sad thing to have to admit.

My parents had $300,000 in savings which sounds like a lot but its quickly being eaten up by my fathers' medical costs.

I don't know just how it can be done but something really needs to change in the way our most vulnerable populations are treated.

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Happy birthday to my brother

2009-03-17T04:05:00.002-06:00

My younger brother was born at 4 PM on March 17, 1965. My mother had a precipitous labor with my brother. A precipitous labor is the kind where things move fast and it often isn't as painful as a normal length labor.
My mother and I were at the grocery store and she started feeling nauseous and a bit dizzy. The lady standing in front of her asked her if she was all right. We went home and as she later told me "I went to the bathroom and thought that it seemed like I was peeing forever. Then I realized what was going on."
She called my father and he came home. Not long after, maybe 20 minutes, my brother was born. I was in the room. I was four years old and to me there was nothing traumatic or awful. There was no screaming, maybe a bit of groaning, which is more typical of a precipitous labor. My brother was fine though he was three weeks early and he did have the cord wrapped around his neck. My father was able to remove it quickly and right away he started hollering.
Maybe it was because my brother and I had four years between us that there was never any great sibling rivalry. I was always very maternal towards him--until he got older and then we wrestled and climbed trees and such. Anyone who calls me a tomboy gets a can of whoop ass opened on them. My name was never Tom and I was never a boy. I was an active girl who liked playing with toy trucks as much as I liked playing with dolls. I've never been a "girly girl," it doesn't suit me. But I don't think I've ever presented as "masculine," much though society might like to apply that label to me because I don't fit the label its created for "femininity."
I have never been as much of a daredevil as my brother. He's done things such as hang gliding and sky diving, and he's a firefighter/paramedic/SWAT medic. Unfortunately he will have to have back surgery to fuse 5 discs together in his spine next month. When he was coming off the engine he had a bad fall backwards and torqued the hell out of his back.
My brother once tried to teach me to ride his dirt bike and I nearly killed both of us. He declared me a hopeless case. Which is probably a pretty accurate assessment!
My brother is a pretty busy guy. I hope that one day we might be able to be in touch a little better than we've been over the past 20 years. We're in touch, but not very often. Maybe someday he'll come into the Information Age and learn how to use that newfangled Email stuff.
Happy birthday to my brother.

Lymphoma and Multiple Sclerosis

2009-03-04T21:26:00.001-07:00

A question on the Winzy site was postulated as to the similarities between non-Hodgkin's lymphoma and multiple sclerosis. Those interested in medical matters might find this to be worthy of thought. Personally I couldn't think of any similarities between the two. They affect different systems of the body and the mechanism of each is different. This was my answer.

A lymphoma is a cancer of the lymphocytes. A lymphocyte is a type of white blood cell. The trouble often begins in the lymph nodes. Lymphoma is often discovered because of tumors in the lymph nodes. There are actually many classifications of lymphomas rather than just two as is the common belief. Hodgkin's lymphoma was discovered by Thomas Hodgkin in 1832. There are actually 16 varieties of non-Hodgkin's lymphoma. There is a great deal of information to be found on Wikipedia about the subject.

http://en.wikipedia.org/…i/Lymphoma

Multiple sclerosis is an autoimmune disorder which destroys the myelin sheath of the nerves. The term "sclerosis" refers to the scars that are formed in the white matter of the brain and spinal cord. It eventually results in paralysis in many sufferers.

Thus, lymphoma is a type of cancer and MS is a destructive autoimmune disease that affects the nervous system. I can't think of any direct similarities between them.

http://adjix.com/4725 Try Winzy, a real search engine that gives you chances to win prizes. Earn points every time you search.

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At Work

2009-02-28T01:48:00.001-07:00

Nothing exciting to say, just here at work procrastinating. Have to do rounds. Had to send a guy to the hospital a couple hours ago. He was dizzy and blood pressure elevated.

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medhodgepodge

2009-02-25T16:13:00.001-07:00

Must get ready to go to school. Have exams. Whine whine, feel lousy. Would never by choice take morning classes when I work nights.

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medhodgepodge

2009-02-25T15:56:00.001-07:00

www.change.org/myfundraising/wfmhchange My drive to raise $500 for WFMH by the end of the year.

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medhodgepodge

2009-02-25T15:52:00.001-07:00

http://adjix.com/e3ek Make your own healthy baby food. Wonderful recipe e-book only $10.

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medhodgepodge

2009-02-25T15:33:00.001-07:00

The air in the building where I work is so dry. I often drink a half gallon of water in a night when I'm working.

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medhodgepodge

2009-02-25T14:27:00.001-07:00

http://ping.fm/3fKnW Got something interesting and informative to say? Trade your intelligence for back links at Qassia!

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Better fast food

2009-02-25T13:22:00.001-07:00

Let's face it, I'm no cook. Most fast food is pretty much an artery clogging fat load, but something like a baked potato and chili from Wendy's is actually not a bad meal. I get the baked potato (yes, I use sour cream. Because life is too short to eat a !*!&$( DRY POTATO!) and a large chili with onions and cheese. I pour the chili on the potato. Chili is loaded with fiber and nutrients. Potatoes have B vitamins and potassium, especially if you eat the skin. So this is actually a reasonably healthy meal. You can also get a side salad with Italian dressing and make it complete. Well, get whatever dressing you want, but I tend to roll with the oil and vinegar based ones. Ranch is bad because it contains MSG. On my soapbox. MSG is not a "spice." It technically has no flavor of its own. MSG IS A NEUROTOXIN! It alters the brain chemistry of the person eating it. No joke, look it up. Many people are intolerant of this vile substance. For most, it causes intestinal distress to one degree or another. Sometimes it can even cause respiratory distress. I used to be on several asthma meds until I started watching out for MSG in foods. I was able to get off ALL asthma meds. I still have mild asthma but it tends to only be triggered by extreme cold or exercise and does not require medication.

At any rate, yes, you can find healthy alternatives at fast food joints. I know this. I just don't always take them...

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Irresponsible and Reprehensible

2009-02-08T09:57:00.002-07:00

The story from MSNBC is about a doctor who performed an abortion on an 18 year old client at 23 weeks. The fetus emerged alive. The clinic's owner cut the cord and placed the newborn and the afterbirth in a garbage bag. Read the story first and then the Curmudgeon's Comment.

The Crusty Curmudgeon sez: Once the fetus was born alive, it was the responsibility of the clinic staff to immediately get medical care for it. Also, it was irresponsible of these doctors to do an abortion at this stage of pregnancy unless there was a compelling medical reason. My belief is that abortion should be available on demand after counseling about all options and possible effects both physical and psychological during the first trimester. After the first trimester, it should be available only if there is a viable medical reason for doing so.

It was reprehensible of the clinic staff to agree to do an abortion so far along without sound medical reason in the first place. It was diabolical of them to not get immediate emergency medical care for the live infant. They should all be stripped of their licenses and jailed immediately.

Monosodium Glutamate: It Straight UP Sucks!

2009-02-07T07:39:00.001-07:00

We all should be concerned with getting MSG out of our food supply. This stuff is quite literally a neurotoxin. It does NOT add flavor to food. It alters the brain chemistry of the individual eating a food to which it has been added, so said individual perceives the food as tasting stronger.

MSG generally causes headaches and irritable bowel, but it can also cause respiratory problems. I used to be on several asthma medications. When I became aware of MSG's ill effects, I started reading labels and if it was in something, I passed it up. I was able to get off all asthma meds.

There are studies that suggest that the number of children with autism and ADHD may be related to monosodium glutamate in our food supply. It became widely used after 1950 in the United States. The number of children with such problems rose sharply after that time. Hmmmmm....

As little as 2 tablespoons of MSG can cause animals such as dogs to have seizures.

Do we really need this crap in our food? I think not!

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Correction

2009-01-19T00:23:00.001-07:00

http://www.openzine.com/…rangeworld Mistake on the original link to the zine. Sorry about that, y'all

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Got something to say?

2009-01-18T22:49:00.001-07:00

http://jobkiller.qassia.com/ Share your articles, stories, poems, rants, and well-written promotions on Qassia and earn links to your own blog or website.

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New Strange World Mini-Zine Issue #2

2009-01-18T21:46:00.001-07:00

http://newstrangeworld.openzine.com/ Issue #2 of my mini-zine is ready. Info about bipolar disorder and supplements, plus cool vids and funny pix. Dig in!

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Facebook Cause: Drive for WFMH

2009-01-10T16:07:00.001-07:00

http://apps.facebook.com/…ses/190050

Please join my drive to raise money and awareness for the World Federation for Mental Health.

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Affordable insurance plans

2009-01-09T21:24:00.001-07:00

http://adjix.com/qrr

Don't have insurance? Check out these plans. As low as $49.95/month. In business since 1982.

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Aqualyte

2009-01-01T16:22:00.001-07:00

http://TwitPWR.com/aqualyte/

Yes, this is a product that I sell. I use it myself. Aqualyte is coral calcium. It helps strengthen your bones, of course, but it also alkalizes water or juice. Research shows that alkalizing your diet has wonderful health benefits including the reduction of inflammation in your muscles and digestive tract. Aqualyte comes in easy to use tea bag style sachets, no inconvenient powders, no nasty taste. You can give it to your pets too, and the used sachets can be put in your potted plants to nourish them as well. As little as $25 per month for an individual supply. No hard sell, just check out the web site and decide for yourself.

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Mental Illness = A Crime?

2009-01-01T16:13:00.001-07:00

http://www.care2.com/…ail/961442

Is being mentally ill a crime? Please read Mary's story. Her mentally ill brother, a heart patient, died in prison. She wants the justice department to investigate and is being stonewalled. Do not persons with mental illness deserve at least the basic rights? Have we not at least come that far?

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Medication, dependence and addiction

2008-12-21T12:31:00.001-07:00

All medications are drugs. Many have potential for dependence and some have potential for addiction. Dependence and addiction are not the same thing. When a person develops a dependence on a medication they will need to taper off use of it. Dependence is a purely physiological condition. Addiction has both physiological ans psychological components. With addiction, a person needs increasing amounts of a substance for it to continue having the desired affect. While a person can experience some distress in discontinuing a medication that they are dependent on, the distress is markedly worse in withdrawing from a medication or substance that they are addicted to.

Statistically, less than 1 percent of people become addicted to any medication. The medications with the greatest potential for addiction are opiate painkillers, not psychoactive medications such as antidepressants.

Why I Hate MSG (from the Experience Project

2008-12-21T12:19:00.000-07:00

F or many people, monosodium glutamate causes digestive distess. I am certainly one of those. If I ingest this vile substance, I will be sitting doubled over in agony on that certain throne for a couple of hours.

But worse, MSG also causes respiratory distress. For me it sometimes causes numbness of the lips and tongue. I used to be on asthma medication before I discovered that MSG could cause respiratory distress. When I started being careful to check for MSG on the food ingredient lists, I was able to stop taking asthma medication. However, MSG may be in the "spices" or "flavorings" in certain products. It is (astoundingly) considered a GRAS (generally regarded as safe) food additive.

Studies show that just two tablespoons of MSG can cause seizures in dogs . And since MSG was introduced as a common food additive in 1948, cases of autism and ADHD have risen sharply.

Certain foods contain naturally occurring trace amounts of MSG. Unless a person has a severe glutamine intolerance, these foods will never be a problem. Soy sauce is often vilified, but it would be difficult to use enough that it would become problematic except in the case of a severe intolerance. Foods like soy sauce are not the problem. Added MSG is the problem. MSG is a far from harmless food additive. In my humble opinion, it should be banished from use.

I love the night shift

2008-12-13T22:46:00.001-07:00

#Night #shift is the right shift, most of the time. But it can be rough. This website has some tips for #night #owls. http://enw.org/…tShift.htm

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The Flu Shot and Anti-viral medications

2008-12-12T23:18:00.002-07:00

This is a reply I posted in response to a post by the Lazy Iguana. I decided to duplicate it here, because unlike my previous post, this is news you can use!

Unless there is a really heinous potentially deadly even to normally healthy people strain of the flu going around, I do not get the flu shot. The flu shot is pretty well a crap shoot. If you are immunocompromised or over 65, you should get the flu shot, because even healthy older people are more prone to the flu becoming pneumonia due to less hardy immune systems, lower lung capacity, and a general slowing of healing functions. But for the rest of us, it isn't as essential.

All this annoying medical training has taught me one thing: the new anti-viral medications are very safe and very effective. The one caveat is that you have to take them as soon as you realize you're really sick. Not just the coughing-stuffy head-sore throat-minor upper chest congestion kind of sick. The kind where you have a cough that feels like you're going to hack up one of your lungs, which may feel like you inhaled sludge. Also there is usually fever and muscle ache with the flu. There isn't a stuffy nose. There might be a sore throat, but it's usually from coughing. At any rate, get ye to the doctor and ask for an antiviral. It won't destroy the viruses that are already in your system but will stop them from replicating so you will get well faster. Rather expensive stuff but very effective. One of the few medications to come along where I've said "this stuff really rules!"

Urinary Incontinence

2008-11-05T11:34:00.003-07:00

Here are the results of an exciting quiz that I took at everydayhealth.com

Do You Have an Overactive Bladder?
High risk.
Your responses indicate that you have significant difficulty controlling your bladder, and therefore you are probably experiencing an overactive bladder or some other problem with incontinence. You should make an appointment to discuss your symptoms and concerns with your doctor as soon as possible.

An overactive bladder is characterized by a recurring, strong, and sudden need to urinate. A person with an overactive bladder tends to urinate eight to ten or more times a day, and is also likely to experience leakage in between. The urgent need to urinate, also known as urge incontinence, is a major symptom of an overactive bladder.

This type of incontinence is most common among elderly people, but it’s not a normal part of the aging process, as many mistakenly believe; urge incontinence is caused by other conditions or disorders. The National Institute on Aging reports that it commonly occurs as a result of diabetes, stroke, Alzheimer’s disease, Parkinson’s disease, and multiple sclerosis, and that it can sometimes be an early sign of bladder cancer.

There are three other types of incontinence that might possibly be contributing to your symptoms.

* Stress incontinence: Stress on the lower stomach muscles causes urine leakage. This is most common among younger and middle-aged women.
* Overflow incontinence: An overfilled bladder causes a constant dripping of urine. This can occur, for example, when an enlarged prostate blocks a man’s urethra.
* Functional incontinence: The normal ability to control urination is compromised by an inability to get to the bathroom quickly enough.

In general, women are more likely than men to experience urinary incontinence, mainly as a result of childbirth complications, medical treatment, trauma, and changes that occur in the body with the onset of menopause. But there are many medical problems that can cause incontinence, including weakened or overactive pelvic muscles; bladder nerve damage; limited mobility; urinary tract, kidney, and bladder infections; diabetes; and high calcium levels.

Lifestyle problems, such as obesity, poor eating habits, and smoking can also contribute to incontinence. Obesity has been linked to urinary difficulties in both men and women, but studies show that women with a high body mass index (a BMI of 30 or higher) are more likely to experience stress incontinence. Avoiding bladder irritants, such as citrus and spicy foods, as well as anything sweetened with aspartame (NutraSweet), carbonated drinks, and diuretics such as caffeine and alcohol can make a difference. Quitting or cutting down on smoking may also reduce symptoms of stress incontinence, since female smokers are twice as likely as nonsmokers to develop this type of incontinence.

Additionally, keep in mind that certain medications and pelvic or abdominal surgeries can also cause incontinence, so be sure to discuss any risks as well as possible alternatives with your doctor.

These days, many options are available for treating incontinence, and the treatments are improving all the time. Even if your attempts to solve your incontinence problems were unsuccessful in the past, the health care community’s management of incontinence, including the methods of diagnosis and treatment, has greatly improved in recent years. You don’t have to suffer from the inconveniences and discomforts associated with an overactive bladder or incontinence. You’ve already taken the first step by taking this quiz and starting to educate yourself about incontinence. Next, make an appointment with your doctor, and start down the road to recovery!

My comments: Yes, I do have some issues with urinary incontinence. I am not elderly yet. And I'm not going to take the medications for it. The side effects are worse than the problem. Nor am I going to get that procedure where they inject silicone into the urethra. Are you fucking kidding me? Nobody is sticking a needle in there!
I think I developed this problem mostly due to my tendency to hold my pee for long periods of time when I was younger because of the types of jobs I worked. It would sometimes be a couple of hours beyond when I felt the urge before I would get to the bathroom. When I was in my late 30's it became harder and harder to hold it and by the time I was 40, I had sprung a leak. I use Poise-type pads. For me it seems better than the alternatives!

Dangerous Drugs according to Docs

2008-08-12T01:49:00.002-06:00

This article originally found on MSNBC. I'm passing it on in its whole form because I think it's important and relevant. I do NOT claim to have written it.

8 Drugs Doctors Would Never Take
If they won't use these medications, why should you?
By Morgan Lord, Men's Health

Prescription For Danger?
With 3,480 pages of fine print, the Physicians' Desk Reference (a.k.a. PDR) is not a quick read. That's because it contains every iota of information on more than 4,000 prescription medications. Heck, the PDR is medication — a humongous sleeping pill.

Doctors count on this compendium to help them make smart prescribing decisions — in other words, to choose drugs that will solve their patients' medical problems without creating new ones. Unfortunately, it seems some doctors rarely pull the PDR off the shelf. Or if they do crack it open, they don't stay versed on emerging research that may suddenly make a once-trusted treatment one to avoid. Worst case: You swallow something that has no business being inside your body.

Of course, plenty of M.D.'s do know which prescription and over-the-counter drugs are duds, dangers, or both. So we asked them, "Which medications would you skip?" Their list is your second opinion. If you're on any of these meds, talk to your doctor. Maybe he or she will finally open that big red book with all the dust on it.

Advair
It's asthma medicine... that could make your asthma deadly. Advair contains the long-acting beta-agonist (LABA) salmeterol. A 2006 analysis of 19 trials, published in the Annals of Internal Medicine, found that regular use of LABAs can increase the severity of an asthma attack. Because salmeterol is more widely prescribed than other LABAs, the danger is greater — the researchers estimate that salmeterol may contribute to as many as 5,000 asthma-related deaths in the United States each year. In 2006, similarly disturbing findings from an earlier salmeterol study prompted the FDA to tag Advair with a "black box" warning — the agency's highest caution level.

Your New Strategy
No matter what you may have heard, a LABA, such as the one in Advair, is not the only option, says Philip Rodgers, Pharm.D., a clinical associate professor at the University of North Carolina school of pharmacy. For instance, if you have mild asthma, an inhaled corticosteroid such as Flovent is often all you need. Still wheezing? "Patients can also consider an inhaled corticosteroid paired with a leukotriene modifier," says Dr. Rodgers. This combo won't create dangerous inflammation, and according to a Scottish review, it's as effective as a corticosteroid-and-LABA combo.

Avandia
Diabetes is destructive enough on its own, but if you try to control it with rosiglitazone — better known by the brand name Avandia — you could be headed for a heart attack. Last September, a Journal of the American Medical Association (JAMA) study found that people who took rosiglitazone for at least a year increased their risk of heart failure or a heart attack by 109 percent and 42 percent, respectively, compared with those who took other oral diabetes medications or a placebo.

The reason? While there have been some reports that Avandia use may cause dangerous fluid retention or raise artery-clogging LDL cholesterol, no one is sure if these are the culprits. That's because the results of similar large studies have been mixed. So the FDA has asked GlaxoSmithKline, the maker of Avandia, to conduct a new long-term study assessing users' heart risks. There's only one problem: The study isn't expected to start until later this year.

Your New Strategy
Stick with a proven performer. "I prefer metformin, an older, cheaper, more dependable medication," says Sonal Singh, M.D., the lead author of the JAMAstudy. "Avandia is now a last resort." Dr. Singh recommends that you talk to your doctor about cholesterol-lowering medicines, such as statins or the B vitamin niacin. Swallowing high doses (1,000 milligrams) of niacin daily may raise your HDL (good) cholesterol by as much as 24 percent, while at the same time lowering your LDL and triglyceride levels.

Celebrex
Once nicknamed "super aspirin," Celebrex is now better known for its side effects than for its pain-relieving prowess. The drug has been linked to increased risks of stomach bleeding, kidney trouble, and liver damage. But according to a 2005 New England Journal of Medicine study, the biggest threat is to your heart: People taking 200 mg of Celebrex twice a day more than doubled their risk of dying of cardiovascular disease. Those on 400 mg twice a day more than tripled their risk, compared with people taking a placebo.

And yet Celebrex, a COX-2 inhibitor, is still available, even though two other drugs of that class, Bextra and Vioxx, were pulled off the market due to a similar risk of heart damage. The caveat to the consumer? In 2004, the FDA advised doctors to consider alternatives to Celebrex.

Your New Strategy
What you don't want to do is stop swallowing Celebrex and begin knocking back ibuprofen, because regular use of high doses of nonsteroidal anti-inflammatory drugs (NSAIDs) can lead to gastrointestinal bleeding. A safer swap is acupuncture. A German study found that for people suffering from chronic lower-back pain, twice-weekly acupuncture sessions were twice as effective as conventional treatments with drugs, physical therapy, and exercise. The strategic needling may stimulate central-nervous-system pathways to release the body's own painkillers, including endorphins and enkephalins, says Duke University anesthesiologist Tong-Joo Gan, M.D. You can find a certified acupuncturist in your area at medicalacupuncture.org/findadoc/index.html.

CONTINUED: More input for your second opinion.

Ketek
Most bacteria in the lungs and sinuses don't stand a chance against Ketek, but you might not either. This antibiotic, which has traditionally been prescribed for respiratory-tract infections, carries a higher risk of severe liver side effects than similar antibiotics do. "Ketek can cause heart-rhythm problems, can lead to liver disease, and could interact poorly with other medications you may be taking," says Dr. Rodgers. "Unfortunately, it's still available, and although many doctors are aware of the risks, some may still prescribe it without caution." In February 2007, the FDA limited the usage of Ketek to the treatment of pneumonia.

Your New Strategy
Can't imagine catching pneumonia? The last time the Centers for Disease Control and Prevention calculated the top 10 killers of men, this deadly lung infection (along with the flu) came in seventh. Avoid backing yourself into a corner where you might need Ketek by always signing up for your annual flu shot — if you have pneumonia, it'll reduce your risk of dying of the infection by 40 percent. And if you still end up staring at a scrip for Ketek, Dr. Rodgers recommends asking to be treated with one of several safer alternatives, such as Augmentin or the antibiotics doxycycline or Zithromax.

Prilosec and Nexium
Heartburn can be uncomfortable, but heart attacks can be fatal, which is why the FDA has investigated a suspected link between cardiac trouble and the acid-reflux remedies Prilosec and Nexium. In December 2007, the agency concluded that there was no "likely" connection. Translation: The scientific jury is still out. In the meantime, there are other reasons to be concerned. Because Prilosec and Nexium are proton-pump inhibitors, they are both incredibly effective at stopping acid production in the stomach — perhaps too effective.

A lack of acid may raise your risk of pneumonia, because the same stuff that makes your chest feel as if it's burning also kills incoming bacteria and viruses. You may also have an elevated risk of bone loss — in the less acidic environment, certain forms of calcium may not be absorbed effectively during digestion. "The risk of a fracture has been estimated to be over 40 percent higher in patients who use these drugs long-term, and the risk clearly increases with duration of therapy," says Dr. Rodgers.

Your New Strategy
When you feel the fire, first try to extinguish it with Zantac 150 or Pepcid AC. Both of these OTC products work by blocking histamine from stimulating the stomach cells that produce acid. Just know that neither drug is a long-term fix.

"To really cure the problem, lose weight," says Michael Roizen, M.D., chief wellness officer at the Cleveland Clinic and coauthor of YOU: The Owner's Manual. That's because when you're overweight, excess belly fat puts pressure on and changes the angle of your esophagus, pulling open the valve that's supposed to prevent stomach-acid leaks. This in turn makes it easier for that burning sensation to travel up into your chest.

Visine Original
What possible harm to your peepers could come from these seemingly innocuous eyedrops? "Visine gets the red out, but it does so by shrinking blood vessels, just like Afrin shrinks the vessels in your nose," says Thomas Steinemann, M.D., a spokesman for the American Academy of Ophthalmology. Overuse of the active ingredient tetrahydrozoline can perpetuate the vessel dilating-and-constricting cycle and may cause even more redness.

Your New Strategy
If you still want to rely on Visine, at least make sure you don't use too many drops per dose and you don't use the stuff for more than 3 or 4 days. But you'd really be better off figuring out the underlying cause of the redness and treating that instead. If it's dryness, use preservative-free artificial tears, recommends Dr. Steinemann. Visine Pure Tears Portables is a good choice for moisture minus side effects. On the other hand, if your eyes are itchy and red because of allergies, pick up OTC antiallergy drops, such as Zaditor. It contains an antihistamine to interrupt the allergic response but no vasoconstrictor to cause rebound redness.

Pseudoephedrine
Forget that this decongestant can be turned into methamphetamine. People with heart disease or hypertension should watch out for any legitimate drug that contains pseudoephedrine. See, pseudoephedrine doesn't just constrict the blood vessels in your nose and sinuses; it can also raise blood pressure and heart rate, setting the stage for vascular catastrophe. Over the years, pseudoephedrine has been linked to heart attacks and strokes. "Pseudoephedrine can also worsen symptoms of benign prostate disease and glaucoma," says Dr. Rodgers.

Your New Strategy
Other OTC oral nasal decongestants can contain phenylephrine, which has a safety profile similar to pseudoephedrine's. A 2007 review didn't find enough evidence that phenylephrine was effective. Our advice: Avoid meds altogether and clear your nasal passages with a neti pot, the strangely named system that allows you to flush your sinuses with saline ($15, sinucleanse.com). University of Wisconsin researchers found that people who used a neti pot felt their congestion and head pain improve by as much as 57 percent. Granted, the flushing sensation is odd at first, but give it a chance. Dr. Roizen did: "I do it every day after I brush my teeth," he says.

More About Medications on MSN Health & Fitness

Are Generic Drugs Safe?
Rx for Safety
The Health Mistake Too Many Americans Make

The Cheese Is In The House

2008-06-11T00:17:00.001-06:00

Which House Character Are You?

More on House. Created by BuddyTV

The rest of it fits, but actually I'm not the cheating kind. I'm quite monogamous by nature.

IBS = Fun (NOT!!!!)

2008-05-10T02:21:00.000-06:00

Warning: graphic, crude, visceral humor as a way with coping with a messy and painful condition.
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According to medical textbooks, IBS stands for Irritable Bowel Syndrome. My son has more accurate words to assign to those hated letters. Those words are I Be Shittin'. And it is the truth. But if that were the only problem, it would just be an annoyance. However, with those excessive bowel movements comes screamingly painful abdominal cramps, sweating, chills, shaking legs, and a desire to drive a harpoon through one's abdomen and end the agony.
This has, comparatively, been less bad than some occasions when the pain was bad enough to rival labor cramps, but still, no picnic. There have been a couple times when the pain was so bad I thought about going to the ER. This time I just have a hot abdomen, some painful cramps although not knock-me-over painful, and the inconvenience of having to go to the can every 15 minutes.
How do I know its IBS and not just something I ate?
The bowel movements with IBS, at least in my case, are often normal consistency, they are just too frequent, and there are accompanying abdominal cramps. I sometimes have constipation, sometimes diarrhea. But whatever the case, this shit sucks. I guess I just have to count my blessings that a bad bout generally only happens about once a month. Some people have to face the horror daily.

Blood Pressure

2008-04-26T17:12:00.003-06:00

I watched a forensic pathology show which featured the tragic story of a man in his late 30's who had developed schizophrenia after 2 severe head injuries in his youth. He ended up in a halfway house. While there he died in his sleep. The medical examiner found that untreated high blood pressure had contributed to atherosclerosis, which in turn contributed to thickening of his heart, which in turn contributed to fluid on his lungs. That scared me into finding my blood pressure cuff. My blood pressure has been high normal to borderline high for a couple of years. Today it was 157/85 while resting. That ain't too good. My brother had to start taking blood pressure meds when he was 35. He is not overweight. I am overweight, but I'm not sure how much is the weight and how much is heredity. I could definitely stand to lose a pound or 50.
I'm going to monitor my blood pressure daily for the next week and make an appointment with the doctor. My current doctor is pretty conservative about prescribing medications so if he thinks I should try a blood pressure med, I will. My mother, unfortunately, has had a terrible time with side effects from blood pressure meds. I tend to be pretty intolerant of most meds as a rule, so it could be a challenge.
I used to take Inderal for hand tremors but then discovered that the tremors only happened around the time of my period, so I stopped. The only side effect was that it made me tired, but I'm tired all the time anyway. I'll take it again if I have to. It's better than developing atherosclerosis, which also happened to my father, who had untreated high blood pressure and ended up having a hemorrhagic stroke 4 years ago. I've been having more heart palpitations recently and it's kinda worrying me.

My Apology

2008-04-04T05:27:00.001-06:00

I submitted this on Joe Apology in August of 08. It still applies.

To the Residents in My Care
Though you never see me grumble to your face, I do it behind your back before I come into your room when you need something. It isn't you personally. It's just that I'm tired all the time and never get enough rest. This position is so easy compared to what I used to do that I really don't have the right to be grumbling but to be honest I'd rather be napping or writing or playing computer games than taking care of you. Sorry I'm such an asshole. I actually do care about what happens to you. I'm just old before my time and crusty inside.

Ear Wax

2008-03-11T22:48:00.000-06:00

This worked so well for me that I want to spread the word about it in case it can help someone else. The problem? Excess ear wax. Kind of embarrassing to talk about but I've suffered from it for all my life, to the point of having to have drainage tubes in my ears to prevent the multiple infections that were actually threatening my hearing as a child, and ending up in the ER once around New Year's Eve of 2006 thinking I was having a stroke or something, but it was actually excess ear wax pressing on my ear drum, which caused me to be dizzy, nauseous, have trouble walking, and my blood pressure spiked to 210/100.
The cure?
Alpha Lipoic Acid.
My mother read about this recently. She told me and I thought it was worth a try. Most of these "miracle cures" are half-assed at best and really costly, but this literally worked within five days. I still get ear wax (we do need some) but it's drier, far less copious, and way more manageable.
Alpha Lipoic Acid is a simple antioxidant. It costs around $10 for 100 capsules and is available in any natural food store. I'm not being comped in any way for saying this. I use the Now brand, which is usually the least expensive of the natural supplements brands. I just wanted to let anyone else who might be troubled by excess ear wax know that there is a possible, very inexpensive solution that may work for you too!

Aides and Techs

2008-03-10T22:49:00.003-06:00

Aides and techs usually get the ass end of everything, from the patient themselves to the way they are treated by some doctors and nurses. But without these VERY NECESSARY people, those with the more respected licensure would be having to take care of all the ass end stuff themselves, so it's time to show more respect to the "foot soldiers" of the medical world.

This is a comment I made on a friend's blog regarding my maternal grandmother.

My grandmother had an 8th grade education because she had to go to work early on. She always thought that she was stupid. She wasn't. She worked as an orderly in a mental hospital until she was forced to retire at age 65, and she actually liked working with the patients. She knew more about them than the psychiatrists did. It's sad how society de-values people in essential positions like this.

My grandmother, unfortunately, had a very low self-esteem. Being born a girl in a very large farm family, she learned early on that boys were thought to be more valuable. All of her life she worked very hard. She took some physical abuse from her frustrated mother, who probably had psychological problems. There is a history of psych issues in that family. My grandmother suffered from periods of depression throughout her life and after she was forced to retire, she suffered from alcoholism.

Unfortunately, my grandmother's low self-esteem kept her from making decisions that might have helped her at least feel a bit better about herself. At one point the state of New York was allowing medical aides to take a test to be able to get their LPN license without having to go through training. My grandmother thought that she was "too stupid," so she never took the test. I'm quite certain that with her experience, she could have passed.

Many people who work as aides seem to come from difficult circumstances and to feel that they are a lesser kind of person, not just as far as their rank at work but as far as their rank in life. Costs for schooling are often prohibitive even with financial aid, and many aides are single mothers and finding the time to go to school is nearly if not completely impossible. It's a shame.

Working as an aide is very difficult. It's little wonder that so many become burnt out and frustrated.

I always hate it when people tell me I'm a "special person" for doing this work. Hell, I'm just buying my time looking for an out. I'm not special at all. The ones who are special are the ones who really like doing it and who are really committed to it in spite of the shit pay and the shit treatment they receive. Now those are the folks that deserve our total respect and admiration. Not some silly twat gallavanting around from party to party, forgetting her thong somewhere along the way. *cough*ParisHilton*cough* Nor some overpaid, ill-tempered sports figure or spoiled Hollywood star. No, the folks that deserve the "star treatment" are those who are overlooked at every turn--the people who care for the elderly and infirm, and who are truly devoted to their profession. They are truly a rare breed and the world is better for their having been here.

The people whom my grandmother cared for would say a million thanks if they could, I'm sure. I bet that there were a lot of sad folks at the state hospital the day that she retired. Because she really was an advocate for them. And people in that position have so few in their lives who really care. For some of them, my grandmother may have been the first and only one who did.

Caregiver Stress

2008-03-04T16:53:00.002-07:00

This is from the Life Script Healthy Advantage Newsletter. My mother is caregiver for my father, who suffered a hemorrhagic stroke that left him partially paralyzed on his right side. She has developed high blood pressure and often says "I swear that taking care of him is going to kill me!"
My mother is basically quite healthy, other than having had a hip replacement a year and a half ago and cataract surgery six months ago. But my father has a lot of needs and has always been sort of a "high maintenance" individual.
Here is the article.

Sick Spouse Shortens One's Life
Having a spouse or partner who suffers from debilitating illness raises one's own risk of premature death, a new study finds. The study, conducted by Harvard Medical School researchers, was recently published in the New England Journal of Medicine. Researchers studied medical records from more than 500,000 elderly couples, tracking the health status of both partners over the course of nine years. According to the results of their study, researchers concluded that the phenomenon known as the "bereavement effect" or "caregiver burden" appears to be grounded in statistics. Men and women with sick spouses were up to five times more likely than their peers to die from a variety of causes, including suicide, accidents, infections and undiagnosed conditions.

"Aging In Place"

2008-03-03T23:58:00.003-07:00

Completely exhausted and don't see any sign of it letting up any time soon. This is the second job I've had that I've kept for more than about a year and a half but things around here get stupider every day thanks to the fact that my boss Alvin N. Chipmunkk really doesn't know jack shit about health care (he ran a failing landscaping business before one of his buddies hired him as an administrator here) and he kowtows to all the family members who insist that their falling-apart loved ones don't need more care.

We currently have one woman who fell a dozen times within a week. We're doing night checks on her. I don't know why the hell she isn't being assessed for neurological problems. She's o.k. if she is the one that calls us, but the idea of taking her to the bathroom at scheduled times is right out because she can be a real bitch if she hasn't called us.

This is supposed to be the "independent living" part of the facility. People who are here are supposed to either be able to handle most things on their own with a modicum of assistance, such as having medications delivered or a stand-by assist for a shower, things of that nature. Or they are supposed to have home care because in this part of the facility there is one aide 24 hours a day for some 200 apartments and a nurse for 8-10 hours. We aren't supposed to act in an assisted living or health care capacity--that's what assisted living and health care are for! But with Alvin, these rules aren't really enforced. He's more about telling the families what they want to hear and kissing ass to the CEO's, who also don't happen to know jack shit about health care, just about the bottom line.

I'm waiting for this woman who keeps falling to break her hip or such. Or for one of these people that keeps leaving the stove on to set the place on fire. And then there are people like the demented lady who takes off her Depends and then the inevitable happens. At least the family finally got a part time aide for her, but when the aide isn't here, she will do things like leave her stove on. She once got out a wine glass which she subsequently broke. She was found stark naked trying to clean up the pieces of glass. Its a miracle she didn't cut herself.

But CEO Gloria Bee thinks that "aging in place" sounds so very wonderful. And it does sound wonderful. And maybe it could even work--if she would listen to the people who have to deal with it! But that ain't gonna happen. Any more than junior CEO Agnes Tin-Horne is going to stop throwing her weight around or Alvin is going to grow a backbone when it comes to pushy family members. In the end they will lose frustrated staff (we're already a skeleton crew) and replace them with the kind of "crack crew" that the good workers at the casino where I used to work ended up being replaced with. In other words, some crackhead that walks in off the street. And beyond that, the residents will be the ones who end up suffering all for some paper-pusher's idea of something that sounds great in theory but in reality is far more complex than they can possibly imagine.

Breast Cancer Patient Protection Act

2008-03-03T05:25:00.002-07:00

This is an email I got from a friend. Here is a post on her blog regarding a woman who endured a double mastectomy recently and was given the boot shortly after she woke up from anesthesia.

Something important for you to consider.

From a nurse:

I'll never forget the look in my patients eyes when I had to tell them they had to go home with the drains, new exercises and no breast.
I remember begging the Doctors to keep these women in the hospital longer, only to hear that they would, but their hands were tied by the insurance companies.
So there I sat with my patients, giving them the instructions they needed to take care of themselves, knowing full well they didn't grasp half of what I was saying, because the glazed, hopeless, frightened look spoke louder than the quiet 'Thank You' they muttered.

A mastectomy is when a woman's breast is removed in order to remove cancerous breast cells/tissue.
If you know anyone who has had a Mastectomy, you may know that there is a lot of discomfort and pain afterwards.
Insurance companies are trying to make mastectomies an outpatient procedure.
Let's give women the chance to recover properly in the hospital for 2 days after surgery.

It takes 2 seconds to do this and is very important .. Please take the time and do it really quick!
Please send this to everyone in your address book.
If there was ever a time when our voices and choices should be heard, this is one of those times.
If you're receiving this, it's because I think you will take the 30 seconds to go to vote on this issue and send it on to others.
You know who will do the same.

There's a bill called the Breast Cancer Patient Protection Act which will require Insurance Companies to cover a minimum 48-hour hospital stay for patients undergoing a mastectomy. It's about eliminating the 'drive-through mastectomy' where women are forced to go home just a
few hours after surgery, against the wishes of their doctor, still groggy from anesthesia and sometimes with drainage tubes still attached.

Lifetime Television has put this bill on their Web page with a petition drive to show your support. Last year over half the House signed on.

PLEASE!! Sign the petition by clicking on the Web site below. You need not give more than your name and zip code number.

http://www.lifetimetv.com/breastcancer/petition/signpetition.php

This takes about 2 seconds.
PLEASE PASS THIS ON to your friends and family, and on behalf of all women, THANKS!!! :-)

There isn't always a positive outcome

2008-02-25T00:51:00.003-07:00

This is a piece of a response to a friend whose husband died of cancer in December. While at a parade, the American Cancer Society was tossing t-shirts and she happened to get one that said "survivor," and it infuriated her. Can't blame her there. The shirt actually served to remind her that her husband did not survive, but she did and now has to go on without him. This did not inspire Pollyanna "the sun will come out tomorrow" feelings, it inspired sorrow and hopelessness. Maybe "that which doesn't kill you makes you stronger," but like any cliche, it also pisses you off.

I did say more than is written below but this is the only part that's relevant to the point I want to make.

My father gets the Stroke Connection magazine and he feels about it's approach the way you felt about the t-shirt. Not everyone survives cancer, and not everyone who has a stroke makes a full recovery and is able to go back to a productive life. While giving hope these organizations should also not be forgetting about the reality, about the people grieving the loved ones lost to cancer, about people grieving the functions lost to stroke.

Stroke Connection tends to focus on stories of people who have made good recoveries, in order to give new survivors hope, I think. In 2004, my father had a hemorrhagic stroke that affected the basal ganglion area of his brain. He did make some recovery, but he still walks very slowly and must use a walker. He never did get much function back in his right hand. He feels very bitter and disappointed. He wrote to Stroke Connection and told them that they should include stories about the other half of the people who had a stroke and did not have a miraculous recovery, who are enduring day to day. And I agree with him. The magazine is basically a good thing and he likes reading it, but he'd like to hear about more people like him who have to deal with being permanently quite handicapped.

I'm not trying to condemn the good works done by the American Cancer Society and the American Heart Association, just imparting a thought.

Hemorrhages on the Sclera

2008-02-24T02:32:00.003-07:00

This is what my eye looks like right now. This actually isn't my very own eye, but, interestingly, the picture I found is the same color as my eyes. So, this is what my eye looks like right now.

This can happen from trauma, even trauma such as a really forceful cough, but in my case it happens spontaneously when I am very exhausted and/or under a lot of stress.

Today I told my son that if it weren't for the fact that I take B vitamins and eat meat, I would think I was anemic as exhausted as I was feeling. I slept most of the day away. (well, I do work nights...) Tonight when I saw myself in the mirror, my eye looked like this. Ah hell...

As for stresses, well, the financial ones never end. It's on my mind constantly.

The Chubby Curmudgeon Strikes Back

2008-02-20T05:22:00.000-07:00

Here was my forum response to this article. I liked what poured out of my slimy little brain, so I'll repeat it!
I am a 43 year old person who has, sadly, put on quite a bit of weight over the last 15 years, in part due to admittedly less than perfect eating habits, in part due to medication and health conditions such as hypothyroidism and polycystic ovarian syndrome. However, I am no less healthy than my slimmer co-workers. I have only called in sick twice in the past three years. I had to go to the emergency room once a little over a year ago--for ear wax that was pressing against the ear drum and caused me vertigo and also a frightening blood pressure spike. Hypertension runs in my family, but it doesn't seem to have anything to do with weight. My brother, who is now 39, had to start taking blood pressure medication in his early 30's, and he is not overweight. My blood pressure is on the borderline and I'm watching it. But I still don't have to take medication for it yet. The medications I take are lithium for bipolar disorder (which does cause weight gain) and thyroid medication. I am also fairly active, so the myth that all heavy people do is sit around eating is just that--a myth. Most of the big people I have known have been hard-working folk. Rather than engaging in prejudiced behavior against one segment of the population, let us try to find a solution that works for everybody.

Terrible and Funny Tales From The E.R.

2008-02-16T17:00:00.000-07:00

For a good time click here.

How Low Can You Go?

2008-02-12T18:52:00.001-07:00

Does it get any lower than stealing from the poor and the elderly?

The people in the retirement community where I work like displaying decorations and knick-knacks on the doors and shelves outside their apartments. Usually nothing gets taken. But one lady likes to display wreaths on her door for various holidays. Her Valentine wreath had a bunch of tiny dolls among the decorative pink and white heart garland. Some lowlife clipped all the dolls from the wreath.
Why would anyone do that?
In another incident, a woman had been "working" retirement communities in the area. Our building is locked at night but during the day it is open. This woman came in, knocked on one of the residents' doors and pretended she was looking for someone, asking the resident if she could help. The perpetrator then said she was thirsty and asked for a glass of water. While the resident was getting the water, the woman stole her purse. She then proceeded to chat with the resident for a few more minutes before leaving. A few days later there were reports in the paper of similar incidents at other retirement homes.
None of this helped calm the unfortunate victim of this unsettling crime, who was an Austrian immigrant that had lived through the horrors of World War II. Her cognitive abilities were declining and that in itself was causing severe anxiety. The night after the incident she called me to her apartment. I talked to her for 20 minutes in an attempt to calm her but I fear I wasn't able to do much good. Then her abilities to care for herself at all began to decline. I'll never be sure how much of this was psychosomatic. She ended up in the hospital and from there was transferred to our facility's health care center. She never returned to her apartment, dying in the health care center a few months later. She completely shut down emotionally and her physical faculties followed.
Granted, "Gwenda's" short term memory was beginning to fail her, but before this incident she would walk around the building twice a day for exercise and every morning before I went home she would be there at the office for her medicines with a cheery "Gud Mornink, how are you?" After she was victimized, she became a terrified shell of herself. While she didn't say so, I'm sure that the invasion of her home brought back memories of a frightening time in her existence, perhaps some that she had repressed for years. Her drastic decline following her victimization was shocking and, I think, completely unnecessary.
Shame on those who victimize the most vulnerable so callously! But due to the fact that they have no conscience, I suppose that they feel no shame.

Virus Du Jour

2008-02-03T03:57:00.000-07:00

There's some sort of ugly virus going around. It seems to mostly affect the upper respiratory system, particularly the throat, although there are signs that it might eventually move to the bronchi. I had an explosive, uncontrollable dry cough all day. I thought it was allergies. But tonight my throat became sore and I lost my voice. I also had a rasping wheeze for most of the night. When this disappeared it actually freaked me out a bit. I think this is due to the fact that 5.5 years ago I had pneumonia. The combination of the coughing and being on inhaled steroids for several months eventually caused a severe laryngospasm and I ended up in the emergency room with severe stridor. I tried to tell the ER attendants that my lungs were filling up just fine, it was my throat that was the problem (felt like breathing through a cocktail straw) but they treated as for asthma. The albuterol only made my throat tighten worse. I told them this was the case and they gave me epinephrine, which dilated the tissues and blood vessels, providing relief. It turns out that the tissues in my larynx were so irritated that the cold air caused my larynx to constrict. Although not as severe, tonight's sensations reminded me of that frightening incident and I started having a panic attack. Luckily I was able to to stop it using homeopathic and herbal means, in this case Hylands Calms Forte and Kava. I don't like to take Valium if at all possible. It makes me feel funny and kind of fuzzy. But I like going to the ER even less.
At this point I'm trying not to cough because it will only cause worse irritation to the tissues in my throat and unwanted choking sensations. At this point the cough is semi-productive although there isn't any discomfort in my lungs, i.e. bronchitis. So far I'm pretty sure this is a virus and not strep. My throat isn't that sore and I'm not running a fever.
If you find yourself having to cough constantly, particularly an explosive dry cough, do what I should have done and nip it in the bud with some cough syrup so your throat doesn't end up as irritated as I let mine become. Normally I let minor cold and cough run their course, but I would have been advised to stop this one. Now I need to allow my throat to heal and deal with the unsettling gagging sensations that come with having irritating the tissue with so much coughing.

Genetic mutation stuff--eyes

2008-01-31T22:32:00.000-07:00

I will freely admit that this is a direct rip-off from this article on MSN. I can't be arsed to rephrase it. But I find the information interesting. I'm very fascinated by genetics, but they lose me at the point when you get into all the ACGTU's. It becomes too mathematical for my addled mind.

Genetic mutation makes those brown eyes blue
Scientists find that blue-eyed individuals have a single, common ancestor

Carolyn Kaster / AP file
By Jeanna Bryner

updated 12:01 p.m. MT, Thurs., Jan. 31, 2008

How did actress Reese Witherspoon get those big blue eyes? A team of scientists has found that blue eyes are linked to a genetic mutation that occurred between 6,000 and 10,000 years ago.

People with blue eyes have a single, common ancestor, according to new research.

A team of scientists has tracked down a genetic mutation that leads to blue eyes. The mutation occurred between 6,000 and 10,000 years ago, so before then, there were no blue eyes.

"Originally, we all had brown eyes," said Hans Eiberg from the Department of Cellular and Molecular Medicine at the University of Copenhagen.

The mutation affected the so-called OCA2 gene, which is involved in the production of melanin, the pigment that gives color to our hair, eyes and skin.

"A genetic mutation affecting the OCA2 gene in our chromosomes resulted in the creation of a 'switch,' which literally 'turned off' the ability to produce brown eyes," Eiberg said.

The genetic switch is located in the gene adjacent to OCA2 and rather than completely turning off the gene, the switch limits its action, which reduces the production of melanin in the iris. In effect, the turned-down switch diluted brown eyes to blue.

If the OCA2 gene had been completely shut down, our hair, eyes and skin would be melanin-less, a condition known as albinism.

"It's exactly what I sort of expected to see from what we know about selection around this area," said John Hawks of the University of Wisconsin-Madison, referring to the study results regarding the OCA2 gene. Hawks was not involved in the current study.

Baby blues
Eiberg and his team examined DNA from mitochondria, the cells' energy-making structures, of blue-eyed individuals in countries including Jordan, Denmark and Turkey. This genetic material comes from females, so it can trace maternal lineages.

They specifically looked at sequences of DNA on the OCA2 gene and the genetic mutation associated with turning down melanin production.

Over the course of several generations, segments of ancestral DNA get shuffled so that individuals have varying sequences. Some of these segments, however, that haven't been reshuffled are called haplotypes. If a group of individuals shares long haplotypes, that means the sequence arose relatively recently in our human ancestors. The DNA sequence didn't have enough time to get mixed up.

"What they were able to show is that the people who have blue eyes in Denmark, as far as Jordan, these people all have this same haplotype, they all have exactly the same gene changes that are all linked to this one mutation that makes eyes blue," Hawks said in a telephone interview.

Melanin switch
The mutation is what regulates the OCA2 switch for melanin production. And depending on the amount of melanin in the iris, a person can end up with eye color ranging from brown to green. Brown-eyed individuals have considerable individual variation in the area of their DNA that controls melanin production. But they found that blue-eyed individuals only have a small degree of variation in the amount of melanin in their eyes.

"Out of 800 persons we have only found one person which didn't fit — but his eye color was blue with a single brown spot," Eiberg told LiveScience, referring to the finding that blue-eyed individuals all had the same sequence of DNA linked with melanin production.

"From this we can conclude that all blue-eyed individuals are linked to the same ancestor," Eiberg said. "They have all inherited the same switch at exactly the same spot in their DNA." Eiberg and his colleagues detailed their study in the Jan. 3 online edition of the journal Human Genetics.

That genetic switch somehow spread throughout Europe and now other parts of the world.

"The question really is, 'Why did we go from having nobody on Earth with blue eyes 10,000 years ago to having 20 or 40 percent of Europeans having blue eyes now?" Hawks said. "This gene does something good for people. It makes them have more kids."

New Changes

2008-01-30T17:01:00.001-07:00

Once again I've decided it's best to combine the Medical Hodgepodge and Gerri Atrik Retirement Community blogs into one. Anecdotes about work and school as well as interesting things I learn will go here. All in one place. I like diversity, but enough's enough already.

World's Shortest Wedding

2007-12-18T04:45:00.001-07:00

Wow, even Britney Spears' 10 hour wedding lasted longer than this! I decided to keep this the Medical Hodgepodge blog. I kind of like posting about my studies all on their own. My battle stories about the retirement community will now merge with the Strange Daze blog. Yeah, I know...who gives shit? Probably besides me, nobody. But I like to keep track.

It's A Nice Day for a Blog Wedding

2007-12-18T04:45:00.000-07:00

Now hear this! The Medical Hodgepodge blog and the Gerri Atrik Retirement Community Blog have merged and become one for the sake of simplicity. The blog is now Caretaker's Hell. Read it and weep.

Genetically Modified Foods

2007-12-09T22:44:00.001-07:00

This is from a biology class discussion on genetically modified foods.

While there might be advantages to having crops that are pest resistant, would the same mutations that make them pest resistant also produce negative effects in humans? For instance, might these foods take on qualities that may be carcinogenic? While there is no problem with creating hybrid foods that are already eaten by humans, for instance an apple with mixed qualities of two different apples or if the aspects of an orange and a grapefruit were combined, I personally don't wish to eat foods that have been altered in ways that might be detrimental and until the products of an insect-resistant super-crop are proved not to be detrimental to humans and domestic animals, I don't want to be consuming it.
I personally don't use products such as milk containing BGH. Maybe there is nil negative effect, but maybe not. Wherever possible, when it comes to food, I prefer not to mess with Mother Nature.

allelic frequency

2007-12-09T22:44:00.000-07:00

This is from a discussion of genotype variation in the biology class that I have been taking. Today was the last day of the class. I didn't expect to feel this way but I'm kind of sorry its over. The subject matter was actually starting to become interesting to me.

The allelic frequencies in a population such as the US will have greater shifts than a country such as China due to the greater range of genetic variation. Persons of various racial backgrounds reside in a country such as the United States whereas a country such as China is reasonably homogenous for phenotype and thus presumably also fairly homogenous in it range of genotypes. If there were an influx of immigrants of other racial types to China over the next 25 years, there would be new alleles introduced into the offspring of couples of mixed racial types. This would cause a greater variation in alleles.

Mitosis and Meiosis

2007-11-22T16:43:00.000-07:00

In MITOSIS, the 2 daughter cells formed in the division have the same in genetic makeup as the parent cell. They have the same DNA and thus make the same proteins and behave the same.
In MEIOSIS the cells are not identical. The gametes, eggs and sperm, are products of meiosis. There is a blend of genetic material from the mother via the egg and father via the sperm. Meiosis is necessary for genetic diversity. It also explains why an individual may have traits from a grandparent. The parent may not have that trait but carries it in their genes.
Meiosis can be a complicated subject because we have 2 of every chromosome and therefore 2 of every gene even before the DNA replication that preceeds mitosis. As well, there's a chance that 2 copies of the same gene are different. An example is a trait which appears in both a grandparent and a grandchild although the parent does not have the same trait. The parent was a carrier of said trait although he or she does not present with it.
The mixing of genetic material comes about after the DNA replicates in preparation for cell division. This involves chromosomes breaking apart and joining back together.
Here is an animated movie of meiosis at http://www.biology.yale.edu/animatedMeiosis.nclk Note the red and green chromosomes at the beginning and the mixed ones at the end.

Medical Genius

2007-11-18T01:06:00.001-07:00

Get a Cash Advance

cellular respiration

2007-10-28T07:47:00.000-06:00

This site breaks down the process of cellular respiration. It is written in a way that a person with some understanding of biology will be able to learn the process. I appreciated it because the chapter in my textbook was a bit convoluted.

Exciting Info about Reproduction

2007-10-22T04:57:00.000-06:00

Sexual reproduction provides genetic diversity through recombination. This genetic diversity may serve the population well as the environment changes or as the population expands into new environments. The adaptability resulting from genetic diversity is the major advantage of sexual reproduction over asexual reproduction, although sexual reproduction can also break up well-adapted combinations of alleles through the same process of recombination.
Asexual reproduction is the only way of raising plants such as navel oranges, all of which have been reproduced from a single tree found in on a plantation on the Brazilian coast in the early 19th century.
http://www.filefarmer.com/2/successus/Books/Ch39.pdf

Alkalinity and acidosis of the blood

2007-10-15T01:45:00.000-06:00

In humans, a normal pH of all tissues and fluids of the body is slightly alkaline. The most critical pH is in the blood. All other organs and fluids fluctuate in their range in order to keep the blood at between 4.35 and 7.45 pH

If the blood becomes too acidic then it robs some of the alkaline forming elements from the enzymes in the small intestine to maintain homeostasis. The small intestine then becomes to acidic to digest foods properly. The pancreas, gallbladder and liver must then work harder to make up for this deficiency in order to metabolize foods properly. This negatively impacts metabolic enzyme production, resulting in lowered immune function, fatigue, hormonal imbalances and absorption and digestive problems.

The bones begin to leach calcium when pH is too acidic, resulting in bone density problems.

Insulin levels increase and fat is stored rather than being metabolized.

Electrolyte imbalances occur that can negatively impact the nerve, heart and muscle cells.

A hyperalkaline state can cause muscle cramps and weakness.

Amoebas

2007-10-06T17:38:00.001-06:00

Come look at some excellent photographs of the most famous one-celled animal.

Chemical Overuse

2007-09-14T05:04:00.000-06:00

Here is a discussion post that I created for my biology class.

Chemicals can be useful in that they can eradicate disease carrying and crop destroying pests. But there may be ways to do this that do not involve chemicals. In terms of crops, natural predators can be introduced to eat the pests, as long as these predators are native to the areas they are being introduced to and won't disrupt the ecosystem. Praying mantises have long been favored for eating pests such as potato bugs. Ladybugs eat aphids. And dragonflies consume mosquito larvae.
Another problem with chemicals is the fact that they don't discriminate between which bugs are helpful and which are pests. They kill everything. Populations of natural predator insects have been badly damaged by the widespread use of chemicals to control garden pests and weeds. The time may be right to start re-introducing these natural predators and to cut back on the use of chemicals to control pests.
The chemicals used are not healthy for animals either, and this includes humans. If enough of them are introduced into the system of a larger animal such as a human, over time they will begin mutating cells into cancer cells. The lymph system will be overwhelmed, unable to trap and destroy all of these cancer cells, and the affected organism will develop cancer. And, as in the case of DDT, the shells of birds in areas exposed to the pesticide over a long period of time became thin and fragile due to mutations.
According to the Agency for Toxic Substances and Disease Registry
"Exposure to DDT, DDE, and DDD occurs mostly from eating foods containing small amounts of these compounds, particularly meat, fish and poultry. High levels of DDT can affect the nervous system causing excitability, tremors and seizures. In women, DDE can cause a reduction in the duration of lactation and an increased chance of having a premature baby. DDT, DDE, and DDD have been found in at least 441 of the 1,613 National Priorities List sites identified by the Environmental Protection Agency (EPA)."
Cutting back on the use of toxic substances in agriculture will reduce contamination of ground water and may in the long run reduce the incidence of cancer.

Bedbugs

2007-09-10T23:08:00.000-06:00

I was reading where the incidence of bedbug infestation has been on the rise in the United States and it crosses class barriers. It seems to be due to increased international travel and decreased use of certain pesticides. On the upside, these pesticides are carcinogenic, so less is better. Also, bedbugs, though vile, are generally not vectors for disease the way fleas, ticks and mosquitoes are.

I work in an upscale retirement community and we do have folks here who still travel frequently. We have had a few instances of bedbugs. The interesting thing about bedbugs is that they do not hide in mattresses the way many people think. They hide in the cracks of the bed, or in surrounding furniture. There are nontoxic powders containing diatoms that can be sprinkled in the cracks of furniture.

My ex husband rides the bus that comes from the airport when he comes to visit our son on the weekends. A couple of times bedbugs have hitched a ride on his backpack. I've eradicated them using this type of powder a couple of times. But it's kind of like a Stephen King story. They come back. I'll know they're back when I find itchy bites on my arms. Bastards!

For all their persistence, bedbugs are not high on the intelligence scale. At work last night I was doing something on the computer. I turned around to look at my lab book and there, bold as brass, sat a bedbug. Right in the middle of the lab book. Big sucker it was too. (For a bedbug, big is about the size of a pin head.) Had gotten fat and happy feasting off the blood of the elderly and was now coming to see me. I grabbed a Kleenex, plucked it off my book, and squashed it. That will teach it to be cocky!

It's nice to know that there are non-poisonous methods of dealing with these miniature vampires. Perhaps my next book should be titled Night of the Bedbug. Now that's a real vampire, and a real nightmare!

Thumb Dominance Experiment

2007-09-10T00:50:00.000-06:00

DOMINANT THUMB EXPERIMENT

ABSTRACT
The hypothesis of the experiment states that when people clasp their hands, the thumb of the dominant hand may overlap the thumb of the non-dominant hand. The experiment is conducted to determine whether there is a correlation between which thumb is on top when the hands are clasped and hand dominance.

HYPOTHESIS
In theory, the thumb of the dominant hand should be on top when the hands are clasped.

RESEARCH DESIGN AND TESTING
Fifty volunteers were located to participate in the study.

PROCEDURES
The subjects were asked to state which was their dominant hand, then to clasp their hands together and see which thumb ended up on top.

SUMMARY OF DATA
SUBJECTS NUMBER % OF TOTAL SUBJECTS
Right handed with right thumb dominant (7) 14%
Right handed with left thumb dominant (34) 68%
Left handed with right thumb dominant (4) 8%
Left handed with left thumb dominant (5) 10%
Total number of experimental subjects (50) 100
Number of subjects per category divided by total subjects 100

RESULTS
As is shown in the table, 68% of subjects were right hand dominant with left thumb dominant. 14% were right handed with right thumb dominant. 10% were left handed with left thumb dominant and 8% were left handed with right thumb dominant. The majority of people in the world are right handed and that was reflected in this experiment. It is interesting to note that overall, thumb dominance is seen to be the opposite of hand dominance. This is overwhelmingly true with the right handed subjects. However, in the left handed subjects, a small majority had left thumb dominance. It is uncertain why this would be the case.
Overall, the hypothesis that thumb dominance should match hand dominance was disproven. However, the question remains as to why it appears that in left handed persons, thumb dominance generally matches hand dominance.

Alcohol and other teratogens in pregnancy: my experience

2007-06-06T16:32:00.000-06:00

Alcohol is the most common teratogen in developed nation. Children with fetal alcohol syndrome tend to have specific facial deformities including widely spaced eyes and an abnormally thin upper lip. They often have developmental delays, both physically and mentally. They tend to have learning disabilities.
The amount of alcohol consumed in pregnancy has an effect on how badly affected the child will be.
When I became pregnant I had been told that I could not get pregnant. I was drinking fairly heavily at the time. Once I discovered I was pregnant I quit drinking and smoking. However, I was also taking synthyroid and Inderal, which I continued to take throughout the pregnancy. I was somewhat angry when I later discovered that the Inderal was probably unnecessary. It had not been prescribed for high blood pressure but for a mild tremor in my hands, which in monitoring myself I discovered only happens during my period.
My son wasn't technically low birth weight. He was born two weeks early by induced labor and, as it turned out, cesarean section, because I had toxemia. This is fortunate because I had also contracted campylobacter from chicken I had eaten at a restaurant and while a healthy adult can recover from this, it can kill a fetus. It was lucky that he was delivered by c-section because he could have contracted it if he had been delivered normally and could have died from the resulting infection. As it was I became very dehydrated due to the horrific diarrhea caused by this vile microbe, and I am not a small person. For a tiny infant, the loss of fluid and electrolyte imbalance would likely have been deadly.
I am not sure how much effect my drinking and smoking before realizing I was pregnant had on my son's birth weight. He was 5 pounds 12 ounces and there didn't seem to be any fat on his body. I ate well enough but wasn't particularly good about taking my calcium supplements and I think he must have been leeching calcium from my bones because I constantly craved dairy products, particularly chocolate milk and chocolate pudding.
I do know that Inderal can cause low birth weight, which is why I'm angry that the doctors thought I should continue taking it. I haven't read of any detrimental affects from taking synthyroid during pregnancy.

This post brought to you by:

999 Eyes Sideshow

2007-06-03T22:34:00.000-06:00

There are those that will disagree with me, but after hearing the freaks speak out on the Discovery health channel show, I say that they have every right to earn THEIR OWN LIVING showcasing their different physiotypes. I do not use the term "freak" disparagingly. This is what they call themselves, and this term describes anyone who doesn't fit the "norm." Although I look "normal" on the outside, I too am a freak. More on this in a moment.

999 Eyes is a sideshow in the old style tradition. But let me borrow this paragraph from the home page because it says it better than I can.

The 999 EYES Authentic Freakshow explicitly celebrates real genetic diversity by showcasing amazing feats performed by LIVING HUMAN ODDITIES! The freaks share real stories of what it is like to be born truly different from the average 10 fingered and 10 toed genetic blueprint for humanity – giving folks from all corners a chance to realize that what is different in beautiful. We present as guests Human Marvels and Sideshow artists, such as the Leopard Man and the Human Blockhead for their fantastically adorned bodies and wondrous sideshow skills. In this show, one must be born physically and obviously different from the vast majority of humanity to be considered a true freak. The 999 EYES freaks are performers who choose by their own free will to celebrate their medical anomaly on stage. The 999 EYES supports rights for differently-abled people, and we play only in wheelchair accessible venues.

Thank you for doing it! It isn't only the so called "beautiful" people who should be able to excel in this world. Why not the truly different? Why not the "handicapped?" I usually hate P.C. terms, but these people are true illustrations of what it means to be "differently abled." I hate the idea that the world has to be a place enslaved by a very constrained definition of beautiful and those who do not fit this definition should do a favor to those whose eyes and delicate sensibilities would be offended and hide away.

My handicap is not obvious from the outside. I have a mental handicap and I do have a physical handicap which isn't obvious. I have bipolar disorder. Often I can function "normally," whatever that may be. But at other times I wrestle with a mind that seems hell bent on killing me and although I take Lithium to control my mood swings, nothing is perfect and, in the same way that a diabetic's medications sometimes fail them, Lithium sometimes fails to do the job for me. Before diagnosis I was at the mercy of my mood swings. I know that I'm different from other people and there are those who want a "perfect" world who would say that a person like me should keep away from "normal" people. But I have the right to make a living and maybe even make an impact.

I also deal with fibromyalgia, which while it does not in any way distort the limbs can occasionally be, if not crippling, physically compromising. I have a relatively mild case, but sometimes it makes me very tired and I have difficulty concentrating. The muscle soreness is of the low grade variety, but it is from head to toe. It was worse when I was working a job that was very physically demanding. I would be sore and tired for days and missed a lot of work. I was ashamed of how "lazy" I appeared to be.

I am not ashamed of my handicaps but most of my co workers still do not know that I am bipolar. They know about the fibromyalgia and the hypothyroidism. These are "acceptable" diagnoses. Mental illness is still shrouded in shame. Which is why the world needs a freak like me to tell it like it is.

So, far from saying "those poor people" regarding the side show performers, I say "let them speak out! Let them tell it like it is! Let them show off their unique body types, their unique abilities. Right on, Freaks!"

Besides, for fuck's sake, they're a hell of a lot more interesting than Paris Hilton or Lindsay Lohan on their worst day!

This freak is trying to make an extra buck or two with some affiliate marketing. I find programs I think that people really might be interested in and insert them at the bottom of my posts. No, I won't come to your house in the middle of the night with a gun and make you order anything. But I might send Axe Man to your house naked. So...the choice is yours!

This post brought to you by:

KCKmedical.com is America's leading online medical retailer. We deliver non-prescription medications and health related products at substantial savings direct to the consumer. We service thousands of customers nationwide from one location.

Phreequeshow

2007-06-01T00:00:00.000-06:00

I am currently taking Human Growth and Development and we are studying genetics and congenital abnormalities. Phreequeshow is a site which educates about various genetic abnormalities in a way that is at once entertaining, educational and respectful.
I once watched a program about "Freaks" and was struck by the fact that many of the sideshow performers were upset about the people who were trying to protect them from exploitation. As one man said, "these people are trying to take away my means of making a living!"
Many "freaks" stated that they were well treated and respected as performers and that in many ways they called the shots. They were not "owned" by the carnival management, they were contract performers.
As long as we are respectful of others, why not allow them to make their living by capitalizing on their differences? Then instead of a handicap, it can be an asset. They can educate others that one doesn't need to be perfect or even "normal" to be a valid and valuable member of society even as they entertain and amaze. I am often inspired when I see a person with what might seem monumental handicaps triumph. In this world we have to use the abilities that we've been given, and sometimes those abilities are disguised as disabilities.
Besides, I think that Aloa the Alligator Boy would be a far more interesting person than Paris the Attention Whore.
From what I've found, I say let the "Freaks" have their show. They deserve to be in show business as much as the so-called "Beautiful" people!

This post about Interesting People aka Freaks is brought to you by:

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Hypochondriac

2007-03-24T23:23:00.001-06:00

You Are 43% Hypochondriac

You can deal well with being sick - even if your symptoms are a little scary.
You're occasionally prone to worry about your health, but only when you have pretty strange symptoms.

Are You a Hypochondriac?
Make a Quiz

Ear Wax

2007-03-19T01:34:00.000-06:00

Who would have thought a little ear wax could cause so many problems?

At the end of December, I ended up in the emergency room. I felt dizzy and was walking like I was drunk. My blood pressure was 180/100. I was nauseated. I thought that I was having a neurological problem.

I had hardened wax jammed against the ear drum.

When the wax was removed with a jet of water (a very uncomfortable sensation!) by the ER nurse, my blood pressure came back down to an acceptable 140/80.

Some people produce more ear wax than others. If ear wax were a commodity, I'd be in high demand!

Sometimes people think they're losing their hearing, but their ears just have too much wax. When the wax is removed, they can hear just fine.

Here is a page all about ear wax.

And now you know more than you ever wanted to?

Glucophage and PCOS

2007-01-22T23:26:00.000-07:00

I have just started taking glucophage, not for diabetes but to combat the symptoms of polycystic ovarian syndrome. It is a last-ditch effort to try and help me lose weight. I have cut back on chowing down, doing things that most people would have responded to such as no longer snacking on candy from the vending machine at night and watching how many calories I consume at meals. I do exercise, not anything over the top but yoga three times a week, walking at least an hour a day plus extra walking on the treadmill twice a week. I wouldn't expect to be skinny because I do like to eat and sometimes I don't eat as well as I should, but I also wouldn't expect to weigh 240 pounds.

Stubborn weight gain is but one of the joys of PCOS. Many women who suffer from this condition have irregular periods. I have regular periods but they are extremely heavy. I have very thick hair on my head, which I'm glad of because some women who suffer from PCOS start losing their hair due to elevated androgen levels. However, I also have extremely thick hair on my arms and legs. I have to shave my arms as well as my legs and the hair is so thick that I go through a razor every time I shave, if I let the hair grow at all. The hair is extremely dark. Not very becoming, to say the least. I also have some trouble with facial hair growth but fortunately it is easily controlled with one of those small ladies' razors (Finishing Touch) and doesn't grow back as quickly as a man's beard would. My mother told me about one of my great aunts who had to shave daily or she would grow a beard like a man. I'm sure this poor woman must have had PCOS. My great grandmother was five feet tall and weighed 300 pounds. I'm 5'5" tall and currently weigh 240. I don't want to follow in her footsteps.

My mother has PCOS, as does my aunt. It does run in families.

I did have trouble with infertility and for all I know I still might if I tried to conceive a child again. My (now ex) husband and I were together for six years and never used any kind of birth control before my son was conceived. Interestingly enough, we had been planning to try adopting. My son was a surprise for us.

Ladies, if you are trying to conceive a child and having trouble, and if you are also experiencing any of the above symptoms, have your doctor check you out for PCOS.

Read this informative Article from IVF.com

I hope that the glucophage therapy works for me. So far the only side effects I've experienced were a very mild headache within ten minutes of taking it that went away on its own, and mild dry mouth. I would be thrilled if my weight loss efforts finally started working. I have been frustrated by a weight gain of 5-10 pounds every year and as I currently need to lose 90 pounds to get to a weight I find acceptable, I certainly don't need to gain more!

Keeping my fingers crossed...

What happens to a baby at birth

2006-12-07T17:32:00.000-07:00

Before birth, oxygenated blood from the placenta flows into the child’s inferior vena cava and mixes with blood returning from the lower part of the body. The atria are, in effect, one chamber due to the open foramen ovale; however, laminar blood flow tends to supply the left atrium and ventricle (and hence the upper body) with more placental (oxygenated) blood than the right atrium receives. The ventricles also act as one and pump blood around the body. Blood from the right ventricle bypasses the lungs, flowing through the ductus arteriosus and joining blood from the left ventricle in the descending aorta. A large portion of this blood flow goes to the placenta through the umbilical arteries.

Although the pulmonary vessels are fully developed in the fetus, only a tiny amount of blood (about 5% of cardiac output) flows through them due to intense vasoconstriction of the pulmonary arterioles. The nutritive blood supply to the lungs is from the bronchial arteries that arise from the aorta. The collapsed alveoli (air sacs) are filled with amniotic fluid.

Oxygenated blood is red, de-oxygenated blood is blue, and at the moment of birth, a normal newborn is circulating a mixture of blue and red blood. The color (lips and tongue) of a healthy newborn at birth is a pinkish purple; the child has been this color for nine months and normal placental function (cord pulsating) will maintain this color until the lungs function.

When the lungs are functioning, the umbilical vessels close, the ductus venosis closes, the hepatic portal vein is open, the foramen ovale closes, the heart is two sided, the cardiac output from the right ventricle (blue blood) goes through the lungs and is oxygenated, the left ventricular output (red blood) goes through the body, the ductus arteriosus closes, the pulmonary arterioles are open, the alveoli are full of air and the child turns from purple to pink. All of this complicated process is coordinated and controlled by the child’s reflexes; it usually happens within three or four minutes of birth. What makes it happen?

All babies are born soaking wet, and on meeting the atmosphere, the skin cools; this triggers two reflexes:

The cold crying reflex - cold, wet diapers produce the same result, crying.
The cold pressor reflex - cold skin raises blood pressure.
In order to cry, the child must first take a deep breath, and an inspiratory "gasp" is often the first sign, triggered by cold, that a child is going to cry or breathe. Contraction of the diaphragm and intercostal muscles increase thoracic volume and create negative intra-thoracic pressure. Once air is in the lungs, another reflex is triggered that relaxes the pulmonary arterioles; this causes an enormous increase in pulmonary blood flow.

The cold pressor reflex increases the blood pressure in the aorta, and this may be sufficient to reverse blood flow through the ductus arteriosus causing more blood to flow through the lungs.

The cord is also cooling, and the cord is a well-designed self-refrigerator. It has no skin and blubber to keep it warm like the child. It contains only the cord vessels surrounded by a watery gel, Wharton’s jelly, covered by a single layer of cells, the amnion. Water evaporation cools it rapidly, causing the vessels, especially the muscular arteries, to constrict; this further helps to raise systemic blood pressure and to reverse ductus arteriosus flow.

At the same time, a large transfusion of placental blood is being forced into the child by gravity and/or by uterine contraction, greatly increasing cardiac output and pulmonary blood flow. The net result of these changes is a large amount of blood flowing into the left atrium from the lungs, which raises left atrial pressure and closes the foramen ovale - the heart changes from one-sided to two-sided. The lungs are now oxygenating blood that is pumped round the body by the left ventricle - the child turns pink.

If the child has not taken the first breath, or is depressed and cannot breathe, the massive increase in pulmonary blood flow generated by the placental transfusion may, of itself, initiate ventilation. Jaykka [1,2] showed that the fetal lungs are erectile tissues; by injecting serum through the pulmonary artery of excised animal fetal lungs, the engorged capillaries around the alveoli erected them and caused air to enter through the trachea. With establishment of pulmonary blood flow, the high colloid osmotic pressure of blood causes absorption of amniotic fluid from the alveoli and "dries out" the lungs, filling the "erected" alveoli with air.

Cold will eventually cause the cord vessels to close; however, a high arterial blood oxygen concentration is probably a key factor in umbilical artery closure - they close before the umbilical vein closes; it may also cause ductus arteriosus closure. After umbilical artery closure, the placental transfusion may continue through the cord vein in a very measured and controlled manner.

Information found at: http://whale.to/a/morley4.html

Powerful Picture

2006-12-06T16:06:00.000-07:00

Click the title link to view the photo in a larger scale at its original location. This is a five-week-old embryo found in the case of an ectopic pregnancy. Ectopic pregnancies cannot survive and present great danger to the mother's health. The embryo was removed shortly after the photo was taken. The details in the photograph are amazing. At this stage it is difficult to distinguish a human fetus from the fetuses of other animals. Apologies as I reveal the horror movie lover in me, but we do look a bit like alien chestbursters during our earliest stages of development.

Ovarian Follicles

2006-12-06T12:52:00.000-07:00

An ovarian follicle consists of a developing oocyte surrounded by one or more layers of cells called follicular cells. At the same time that the oocyte is progressing through meiosis, corresponding changes are taking place in the follicular cells. Primordial follicles, which consist of a primary oocyte surrounded by a single layer of flattened cells, develop in the fetus and are the stage that is present in the ovaries at birth and throughout childhood.
Beginning at puberty follicle-stimulating hormone stimulates changes in the primordial follicles. The follicular cells become cuboidal, the primary oocyte enlarges, and it is now a primary follicle. The follicles continue to grow under the influence of follicle-stimulating hormone, and the follicular cells proliferate to form several layers of granulose cells around the primary oocyte. Most of these primary follicles degenerate along with the primary oocytes within them, but usually one continues to develop each month. The granulosa cells start secreting estrogen and a cavity, or antrum, forms within the follicle. When the antrum starts to develop, the follicle becomes a secondary follicle. The granulose cells also secrete a glycoprotein substance that forms a clear membrane, the zona pellucida, around the oocyte. After about 10 days of growth the follicle is a mature vesicular (graafian) follicle, which forms a "blister" on the surface of the ovary and contains a secondary oocyte ready for ovulation.

Ovulation
Ovulation, prompted by luteinizing hormone from the anterior pituitary, occurs when the mature follicle at the surface of the ovary ruptures and releases the secondary oocyte into the peritoneal cavity. The ovulated secondary oocyte, ready for fertilization is still surrounded by the zona pellucida and a few layers of cells called the corona radiata. If it is not fertilized, the secondary oocyte degenerates in a couple of days. If a sperm passes through the corona radiata and zona pellucida and enters the cytoplasm of the secondary oocyte, the second meiotic division resumes to form a polar body and a mature ovum

After ovulation and in response to luteinizing hormone, the portion of the follicle that remains in the ovary enlarges and is transformed into a corpus luteum. The corpus luteum is a glandular structure that secretes progesterone and some estrogens. Its fate depends on whether fertilization occurs. If fertilization does not take place, the corpus luteum remains functional for about 10 days then it begins to degenerate into a corpus albicans, which is primarily scar tissue, and its hormone output ceases. If fertilization occurs, the corpus luteum persists and continues its hormone functions until the placenta develops sufficiently to secrete the necessary hormones. Again, the corpus luteum ultimately degenerates into corpus albicans, but it remains functional for a longer period of time.

http://training.seer.cancer.gov/module_anatomy/unit12_3_repdt_female1_ovaries.html

Meiosis

2006-12-06T12:49:00.000-07:00

Normally, meiosis causes a halving of chromosome material, so that each parent gives 23 chromosomes to a pregnancy

A cool site about meiosis for you to enjoy:
http://www.sciencecases.org/mitosis_meiosis/mitosis_meiosis2.asp

Testes! One, two...three???

2006-12-06T12:47:00.000-07:00

We are currently studying the reproductive system in class. Here is some fun trivia about the testes. The information was gathered from Wikipedia.

In land mammals, with the exception of the elephant the testes are located outside of the body, as they are suspended by the spermatic cord and within the scrotum. This is due to the fact that The cremasteric muscle is part of the spermatic cord. When this muscle contracts, the cord is shortened and the testicle is moved closer up toward the body, which provides slightly more warmth to maintain optimal testicular temperature. When cooling is required, the cremasteric muscle relaxes and the testicle is lowered away from the warm body and are able to cool. This phenomenon is known as the cremasteric reflex. It also occurs in response to stress (the testicles rise up toward the body in an effort to protect them in a fight), and there are persistent reports that relaxation indicates approach of orgasm. There is a noticeable tendency to also retract during orgasm.

The testicles can also be lifted voluntarily using the pubococcygeus muscle, which partially activates related muscles. This can sometimes be triggered by tightening or sucking in the stomach or abdomen.

Animals other than mammals do not have externalized testicles. Birds, despite having very high core body temperatures have internal testes: it was once theorized that birds used their air sacs to cool the testes internally, but later studies revealed that birds' testes function at core body temperature.[1] Marine mammals also have internal testes, but it has recently been shown (eg, for dolphins) that they use elaborate vascular networks to provide the necessary temperature lowering for proper operation.

The seminiferous tubules of the testes are the starting point for the process of spermatogenesis, where stem cells adjacent to the inner tubule wall divide in a centripetal direction - beginning at the walls and proceeding into the lumen to produce immature sperm.

What is meant by "my food went down the wrong tube"?

2006-11-26T05:30:00.000-07:00

When food is swallowed, it travels down the throat, which is the common conduit for food, drink and air. Midway down the neck, the throat branches. The front branch, the trachea, channels air towards the lungs. At the top of this branch is the larynx. Just behind the larynx is esophagus, which is the tube that directs food to the stomach. As a person swallows, the soft palate closes off the nasal passages so that food doesn't get pushed up into the nose. As the throat squeezes food towards the esophagus, the larynx tips forward to allow the food to pass through, and the epiglottis seals off the airway to prevent food from going down into the trachea. Eating while talking or laughing can sometimes cause the larynx to be slow in sealing off the trachea, allowing a bit of food or drink to head towards the lungs. This triggers a strong coughing reflex to prevent aspiration.

Way Crappy!

2006-11-17T05:32:00.000-07:00

For those of you who have never been exposed to the glory of The Poop Report, click the title link to read one of the top funniest stories ever to appear there. They're all funny, but this one's a classic!

A Refreshing Glass...Of Whiz???

2006-11-12T04:20:00.000-07:00

There's nothing like being able to take a proper piss. If you can't, your life is made far more difficult. This simple function brings relief several times a day, although as we get older it can be a nuisance at times because it becomes harder to hold your water. For my own part, I'd rather resign myself to wearing Depends than to not be able to go and having to rely on dialysis, which is a wearying and time-consuming procedure.

Much though I enjoy the relief provided by a good leak, I feel no desire to re-consume my pee once it leaves my body. I might do it to save my own life in a situation such as being lost in the desert. However, some folks drink a hearty glass of nature's own "lemonade" by choice. Read all about it here. And fellows, I know this will break your hearts, but you need to know this. Lips that touch piss will never touch mine!

Kidney Anatomy and Physiology

2006-11-12T03:03:00.000-07:00

My complete 26-page kidney anatomy and physiology report is available for the asking. It is a good study aid for basic anatomy and physiology from junior high level on up. Just post your request in the comments section along with your email and I will gladly send it to you. I will also be posting it a piece at a time on this site as I get around to it.

And now the irritating disclaimer.

This is intended as a resource for your own studies, not as a tool for plagarism. I enjoy sharing the knowledge I've learned through my studies and if it can make another person's learning process less frustrating, that pleases me. It's ok to take a shortcut to knowledge, but cheating only screws up your karma. Thanks!

Kidney Komponents

2006-11-05T04:43:00.000-07:00

More information about kidneys than you ever wanted to know!
Or if you did want to know it, here it is. This is copied from my lab report on the renal system. Click the title link to see some excellent slides of various parts of the kidney along with an in-depth tutorial from the University of Texas cellular biology graduate student program.

Renal Cortex
The renal cortex is the outer portion of the kidney between the renal capsule and the renal medulla. The renal cortex forms a shell around the medulla. Its tissues dip into the medulla between adjacent renal pyramids to form renal columns. It contains renal corpuscles and renal tubules, except for those portions of the loop of Henle which descend into the renal medulla. It also contains blood vessels and cortical collecting ducts. The granular appearance of the cortex is due to the random arrangement of tiny tubules associated with nephrons. The renal cortex is the part of the kidney where ultrafiltration occurs.

Renal Medulla
The renal medulla is the innermost part of the kidney. It is split up into cone-shaped masses of tissue called renal pyramids, whose bases are directed toward the convex surface of the kidney, and the apices of which form the renal papillae. Each pyramid together with the associated overlying cortex forms a renal lobe. The tip of each pyramid, called a papilla, empties into a calyx, and the calices empty into the renal pelvis.
The renal medulla also contains blood vessels. Blood enters into the kidney via the renal artery, which then splits to form the arcuate arterioles. The arcuate arterioles in turn branch into interlobar arterioles, which finally reach the glomeruli.

Renal Pyramids
Renal pyramids, also known as malpighian pyramids, are the cone-shaped masses contained in the renal medulla. The renal medulla is made up of 8 to 18 renal pyramids. The broad base of each pyramid faces the renal cortex. Its apex, or papilla, points internally. The pyramids appear striped because they are formed by straight parallel segments of nephrons.

Bases of Pyramids
The broad outer portion of a renal pyramid that lies next to the cortex. Also known as basis pyramidis renis.

Renal Papilla
The papillae are small conical projections along the wall of the renal sinus. They have openings through which urine passes into the calyces.

Renal Columns
Tissue between the renal pyramids that allows for support of the renal cortex. The columns consist of blood vessels, urinary tubes, and fibrous material.

Renal pelvis
The renal pelvis is the funnel-shaped proximal part of the ureter, located approximately in the center of the kidney. It is the point of convergence of two or three major calyces. Each renal papilla is surrounded by a branch of the renal pelvis called a calyx. The major function of the renal pelvis is to act as a funnel for urine flowing to the ureter.

Calyces
The calyces surround the apex of the renal pyramids. There are minor and major calyces. Urine passes through a papilla at the apex into a minor calyx, then travels into a major calyx before passing through the renal pelvis into the ureter. Peristalsis of the smooth muscle of pace-maker cells in the walls of the calyces propels urine through the renal pelvis.

Glomerulus and Bowman's capsule
The glomerulus is the main filter of the nephron. It is a semipermeable, twisted mass of tiny tubes through which blood passes, allowing water and soluble wastes to pass through and be excreted out of the Bowman's capsule as urine. The filtered blood passes out of the glomerulus into the efferent arteriole to be returned through the medullary plexus to the intralobular vein.
The Bowman's capsule contains the primary glomerulus. Blood is transported into the Bowman's capsule from the afferent arteriole, which branches off of the interlobular artery. Within the capsule, the blood is filtered through the glomerulus and exits via the efferent arteriole. Meanwhile, the filtered water and aqueous wastes are passed from the Bowman's capsule into the proximal convoluted tubule.
Here is the best drawing I've seen of the inside of a glomerulus.

Filtration membrane
The filtration membrane is formed from the endothelial cells of the capillaries, basement membrane, and visceral epithelium of the Bowman’s capsule. It is composed of three layers:
Fenestrated endothelium of the glomerular capillaries
Visceral membrane of the glomerular capsule (podocytes)
Basement membrane composed of fused basal laminae of the other layers

Podocytes
Podocytes are cells of the visceral epithelium in the kidneys. They form a crucial component of the glomerular filtration barrier. Structural features of podocytes indicate a high rate of vesicular traffic. Many coated vesicles and pits can be seen along the basolateral domain of podocytes. Within their cell bodies, podocytes have a well-developed endoplasmic reticulum and a large Golgi apparatus, indicative of a high capacity for protein synthesis and post-translational modifications. There are also a large number of multivesicular bodies and other lysosomal components within the podocytes, indicating high endocytic activity.
Adjacent podocytes interlock to cover the basal lamina of the glomerular capillaries. There are thin filtration slits left between the podocytes. The slits are covered by diaphragms, which are composed of numerous cell-surface proteins, including nephrin, podocalyxin, and P-cadherin. These proteins ensure that large macromolecules such as serum albumin and gamma globulin remain in the bloodstream. Small molecules such as water, glucose, and ionic salts pass through the slit diaphragms and form an ultrafiltrate, which is further processed by the nephron to produce urine.
Disruption of the slit diaphragms or destruction of the podocytes can lead to massive proteinuria, whereby large amounts of protein are lost from the blood. An example of this occurs in Finnish-type Nephrosis, a congenital disorder caused by a mutation in the nephrin gene. This defect causes neonatal proteinuria leading to end-stage renal failure.
Information gathered primarily from http://en.wikipedia.org/wiki/Podocyte

Juxtaglomerular Apparatus
The juxtaglomerular apparatus is a structure consisting of the macula densa, mesangial cells, and juxtaglomerular cells. Juxtaglomerular cells, also known as JG cells, or granular cells, are the site of renin secretion.
JG cells are found in the afferent arterioles of the glomerulus and act as an intra-renal pressure sensor. Lowered pressure leads to secretion of rennin, which increases systemic blood pressure via the renin-angiotensin system.
The macula densa senses fluid flow rate and sodium chloride concentration in the distal tubule of the kidney and secretes paracrine vasopressor, which acts on the adjacent afferent arteriole to decrease glomerular filtration rate.
Mesangial cells regulate blood flow in the glomerulus and monitor sodium and chloride levels in the distal convoluted tubules. These cells communicate with the afferent arteriole and can cause vasoconstriction, decreasing the blood flow and GFR if necessary.

Peritubular Capillaries
Peritubular capillaries are the tiny blood vessels beside the nephrons, allowing reabsorption and secretion between blood and the inner lumen of the nephron. Ions and minerals to remain in the body are reabsorbed into the peritubular capillaries through active transport, secondary active transport, or transcytosis. Ions to be excreted as waste are secreted from the capillaries into the nephron and sent to the bladder. The majority of exchange through the peritublar capillaries occurs because of chemical gradients, osmosis, and Na+ pumps.

Distal Convoluted Tubule
The distal convoluted tubule is the portion of a nephron between the loop of Henle and the collecting duct system. It is partly responsible for the regulation of potassium, sodium, calcium, and pH.
The DCT regulates pH by absorbing bicarbonate and secreting H+ protons into the filtrate. Sodium and potassium levels are controlled by secreting K+ and absorbing Na+.
Sodium absorption by the distal tubule is mediated by the hormone aldosterone. Aldosterone increases sodium reabsorption. Sodium and chlorine reabsorption are also mediated by a group of four kinases called WNK kinases.
The distal convoluted tubule also participates in calcium regulation by absorbing Ca2+ in response to parathyroid hormone.
Histologically, cells of the DCT can be differentiated from cells of the proximal convoluted tubule by looking for these features:
DCT cells do not have an apical brush border
DCT cells are less eosinophilic than proximal cells
DCT cells have less cytoplasm
DCT cells are more likely to have visible nuclei
Information primarily gathered from http://en.wikipedia.org/wiki/Distal_convoluted_tubule

Proximal Convoluted Tubule
The proximal convoluted tubule is the longest (14mm) and widest (60µm) part of the nephron. It is lined with epithelial cells containing microvilli and numerous mitochondria. The most distinctive characteristic of the proximal tubule is its brush border. In the PCT, over 80% of the filtrate is reabsorbed into the tissue fluid and returned to the blood. This ensures that all necessary materials that were filtered out of the blood, such as glucose and amino acids, are now returned.

Thin (descending) Loop of Henle
The descending limb of the Loop of Henle has low permeability to ions and urea, while being highly permeable to water. The ascending limb of the LOH is impermeable to water. The net effect is for sodium chloride to leave the ascending limb and to enter the descending limb, having first passed through the renal medullary interstitium. Water is readily reabsorbed from the descending limb by osmosis, increasing the concentration of the urine. Osmolality can reach up to 1200 mOsmol/kg by the end of the descending limb.

Vasa Recta Capillary
The Vasa recta, or straight vessels, are bundles of thin vessels which carry blood into and out of the medulla. The Vasa recta eventually return blood to arcuate veins.

Thick (ascending) Loop of Henle
The ascending limb of the LOH is impermeable to water. As the fluid passes through the ascending limb, it becomes increasingly dilute as the sodium chloride is removed. Thus, the fluid entering the distal convoluted tubule is hypotonic (150 mmol/l).
Sodium, potassium (K+) and chloride (Cl-) ions are reabsorbed by active transport. K+ is passively transported along its concentration gradient through a K+ channel in the basolateral aspect of the cells, back into the lumen of the ascending limb. This K+ "leak" generates a positive electrochemical potential difference in the lumen. The electrical gradient causes more reabsorption of Na+, as well as other cations such as magnesium (Mg2+) and calcium Ca2+.
Information primarily gathered from http://en.wikipedia.org/wiki/Loop_of_Henle

Collecting Ducts
There are several components of the collecting duct system, which includes the connecting tubules and cortical and medullary collecting ducts. With respect to the renal corpuscle, the connecting tubule is the most proximal part of the collecting duct system. It is adjacent to the distal convoluted tubule, which is the most distal segment of the renal tubule. Connecting tubules from several adjacent nephrons merge to form cortical collecting tubules, and these may join to form cortical collecting ducts. Connecting tubules of some juxtamedullary nephrons may arch upward, forming an arcade.
The cortical collecting ducts receive filtrate from multiple connecting tubules and descend into the renal medulla to form medullary collecting ducts. Medullary collecting ducts are divided into outer and inner segments, the latter reaching deeply into the medulla. The terminal portions of these ducts are the papillary ducts, which end at the renal papilla and empty into a minor calyx.
Each component of the collecting duct system contains two cell types: intercalated cells and a segment-specific cell type. For the connecting tubules, this specific cell type is the connecting tubule cell; for the collecting ducts, it is the principal cell. The inner medullary collecting ducts contain an additional cell type, the inner medullary collecting duct cell.
The principal cell mediates the collecting duct's influence on sodium and potassium balance via sodium and potassium channels located on the cell's apical membrane. Intercalated cells come α and β varieties and participate in acid-base homeostasis. The α-intercalated cells secrete acid via an apical H+-ATPase and H+/K+ exchanger in the form of hydrogen ions and reabsorb bicarbonate via a basolateral Cl-/HCO3- exchanger. Damage to the α-intercalated cell's ability to secrete acid can result in distal renal tubular acidosis.
Similarly, β-intercalated cells secrete bicarbonate via an apical Cl-/HCO3- and reabsorb acid via a basal H+-ATPase. Because of their contribution to acid-base homeostasis, the intercalated cells play important roles in the kidney's response to acidosis and alkalosis.
The collecting duct system plays a role in electrolyte and fluid balance through reabsorption and excretion, which are regulated by the hormones aldosterone and antidiuretic hormone. The collecting duct system is the last component of the kidney to influence the body's electrolyte and fluid balance. It accounts for 4-5% of the kidney's reabsorption of sodium and 5% of reabsorption of water. During extreme dehydration, over 24% of the filtered water may be reabsorbed in the collecting duct system.
The collecting duct system regulates electrolytes, including chloride, potassium, hydrogen ions, and bicarbonate. The variable reabsorption of water and, depending on fluid balances and hormonal influences, the reabsorption or secretion of sodium, potassium, hydrogen, and bicarbonate ion continues here.
The wide variation in water reabsorption levels of the collecting duct system reveals its dependence on hormonal activation. The collecting ducts, particularly the outer medullary and cortical collecting ducts, are largely impermeable to water without the presence of ADH, or vasopressin. In the absence of ADH, excess water in the renal filtrate is allowed to enter the urine, promoting diuresis. When ADH is present, aquaporins allow for the reabsorption of water, inhibiting diuresis.
Information (and copying of unusual alpha-numeric characters) found at http://en.wikipedia.org/wiki/Collecting_duct_system

Kidney Failure and Dialysis

2006-10-31T21:01:00.000-07:00

If a person's kidneys fail to function properly, the only way to prevent toxic buildup in the body is to undergo dialysis.
There are two types of dialysis: hemodialysis and peritoneal dialysis. The most commonly recognized form of dialysis is hemodialysis. About 90 percent of dialysis patients receive hemodialysis. In this procedure, the blood is circulated from the body into a machine before being returned to the patient.
In order for hemodialysis to be performed, a doctor must make an access into the patient's blood vessels. This is done by minor surgery in the leg, arm or sometimes neck. The best access for most patients is called a fistula, wherein minor surgery is performed to join an artery to a vein under the skin to make a larger vessel.
If no vessels are suitable for a fistula, the doctor uses a soft plastic tube called a vascular graft to join the artery and vein.
Once the access is made and healed, two needles are inserted in the fistula or graft, one on the artery side and one on the vein side.
For temporary dialysis in the hospital, a patient might require a catheter implanted into a large vein in the neck.
A dialysis machine is composed of two parts: one side for blood and one for a fluid called dialysate. A thin, semipermeable membrane separates the two sides. Particles of waste from the blood pass through microscopic holes in the membrane and are washed away in the dialysate. Blood cells are too large to go through the membrane and are returned to the body.
The benefits of hemodialysis are that the patient requires no special training, and he or she is monitored regularly by someone trained in providing dialysis.
The other type of treatment, Continuous Ambulatory Peritoneal Dialysis (CAPD) uses the patient's own peritoneal membrane as a filter. This membrane, like the membrane in the dialysis machine, is semipermeable. Waste particles can pass through it, but larger blood cells cannot.
The patient has a peritoneal catheter surgically implanted into the belly. He or she slowly empties about two quarts of dialysate fluid through the catheter into the abdomen. As the patient's blood is exposed to the dialysate through the peritoneal membrane, impurities are drawn through the membrane walls into the dialysate. The patient drains out the dialysate after three or four hours and pours in fresh fluid. The draining takes about half an hour and must be repeated about five times a day.
The main benefit of CAPD is freedom. The patient doesn't have to be at a dialysis clinic for several hours a day, three times a week. The dialysate can be exchanged in any well-lit, clean place, and the process is not painful. The drawback to this treatment is that there is a risk of infection of the peritoneal lining, and the process may not work well on very large people.
Pediatric patients often do a similar type of dialysis called Continuous Cycling Peritoneal Dialysis (CCPD). Their treatments can be done at night while they sleep. A machine warms and meters dialysate in and out of their abdomens for 10 hours continuously. In this way, they are free from treatments during the day.
This information was gathered from http://www.fda.gov/fdac/features/1998/198_dial.html

The toll on a person who must endure dialysis can be quite high both physically and mentally. Persons with kidney failure often feel ill and tired in spite of dialysis. Hemodialysis is time-consuming and leaves the patient with little freedom to enjoy other activities. Often the patient with kidney failure doesn't feel well enough to consider other activities, even if hemodialysis weren't so time consuming. In spite of the blood-cleaning function of dialysis, the body's toxins still have an effect. People with kidney failure are often flushed or sweating.
I knew a young man in high school whose father had been undergoing dialysis for a number of years. He was in constant pain and eventually committed suicide to escape from the pain and hopelessness of his situation.
A gentleman who was a patient in a long-term care facility where I worked had himself admitted so that we could perform hospice care on him. He had voluntarily ceased his dialysis treatments and knew that he was going to die. His blood pressure was often so high that it was impossible to measure. His appetite was very poor and his skin was usually clammy. He was constantly nauseated and sometimes in terrible pain. He died within a week. I have always remembered him for his gentle personality and friendly attitude in the face of his illness and impending death.
A man in another long-term care facility where I worked had been dialysis for many years. His skin eventually began breaking down and in spite of our best efforts, he developed severe bed sores because he was constantly oozing B.M. and the acidic quality of the stool ate away at his skin. He had been a doctor and my mother, who was a nurse at the facility, conferred with him. Between his medical knowledge and their frank discussion, he made the decision to discontinue his dialysis treatments. After two days he slipped into a coma and was dead within five days.
There are several causes for kidney failure. This website sums them up with simple, easily understandable terminology.
http://www.kidneypatientguide.org.uk/site/fail.php

The Nasal Conchae

2006-10-29T20:08:00.000-07:00

What is the purpose of the conchae? How do they increase turbulance of air flow and why would this be useful?
The conchae, or turbinates, are long curled bones protruding into the nasal passages. They divide the nasal airway into three groove-like air passages –and are responsible for forcing inhaled air to flow in a steady, regular pattern around the largest possible surface of cilia and climate controlling tissue. They are lined with pseudo-stratified columnar ciliated respiratory epithelium. The turbinates comprise most of the mucosal tissue of the nose. They contain many airflow pressure and temperature sensing nerve receptors, which are linked to the trigeminal, or fifth cranial nerve.
As a whole, the turbinates are responsible for filtration, heating and humidification of air inhaled through the nose. As air passes over the turbinate tissues it is heated to body temperature, humidified (up to 98% water saturation) and filtered.
There are three turbinates. The inferior turbinates are the largest. They are responsible for airflow direction, humidification, heating, and filtering of air inhaled through the nose.
The smaller middle turbinates project downwards over the openings of the maxillary and ethmoid sinuses, and act as buffers to protect the sinuses from coming in direct contact with pressurized nasal airflow. Some areas of the middle turbinates are also innervated by the olfactory bulb. Most inhaled airflow travels between the inferior turbinate and middle turbinate.
The superior turbinates are smaller still. They are connected to the middle turbinates by nerve endings, and serve to protect the olfactory bulb. The superior turbinates also protect the nerve axons which come through the cribriform plate into the nose.
The respiratory epithelium which covers the Lamina propria of the turbinates is part of the body’s first line of immunological defense. The respiratory epithelium is partially comprised of mucus producing goblet cells. This secreted mucus covers the nasal cavities, and serves as a filter, by trapping air-borne particles larger than 2 to 3 micrometers. The respiratory epithelium also serves as a means of access for the lymphatic system which protects the body from being infected by viruses or bacteria.
The turbinates provide necessary humidity to the delicate olfactory epithelium. If this epithelial layer becomes too dry or irritated, its function will be impaired. By directing and deflecting airflow across the mucosal surface of the inner nose, the turbinates are able to propel the inspired air. This, coupled with the humidity and filtration provided by the turbinates, helps to carry more scent molecules towards the high, narrow regions of the nasal airways, where olfaction nerve receptors are located.
If the turbinates become swollen, it leads to blockage of nasal breathing. Allergies, exposure to environmental irritants, persistent inflammation within the sinuses, or deformity or deviation of the nasal septum can lead to turbinate swelling.
Most information gathered from http://en.wikipedia.org/wiki/Turbinate

Cool Site

2006-10-29T05:03:00.000-07:00

Click the title link to see some images of the respiratory system. Contains concise descriptions.

Damn shame...

2006-10-29T04:14:00.000-07:00

That they couldn't get funding for the website you'll find if you click the title link.

My Respiratory Anatomy Paper

2006-10-29T03:46:00.000-07:00

I know you will be just thrilled to read my descriptions of the respiratory anatomy!

1. Pharynx

a. Nasopharynx

The external nares, or nostrils, lead to the nasopharynx. The nasopharynx lies between the internal nares, or choanae, and the soft palate. On the lateral walls of the nasopharynx are the triangular pharyngeal ostia of the auditory tubes. These are bounded behind by the torus or cushion, a firm prominence formed by the medial end of the cartilage of the tube which elevates the mucous membrane. A vertical fold of mucous membrane, the salpingopharyngeal fold, stretches from the lower part of the torus; it contains the Salpingopharyngeus muscle. A second and smaller fold, the salpingopalatine fold, stretches from the upper part of the torus to the palate. Behind the ostium of the auditory tube is the pharyngeal recess, or fossa of Rosenmüller. The pharyngeal tonsils, or adenoids, are found on the posterior wall. Above the pharyngeal tonsil, the pharyngeal bursa forms an irregular flask-shaped depression which sometimes extends up as far as the basilar process of the occipital bone. The surface of the nasopharynx is covered by pseudostratified columnar epithelium. Goblet cells secrete mucus, which cleans, warms and moistens incoming air before it moved deeper into the respiratory tract. Blood vessels are seen at the base of the epithelium.

b. Oropharynx

The Oropharynx reaches from the soft palate to the epiglottis and hyoid bone. It opens anteriorly, through the isthmus faucium, into the mouth. In its lateral wall, between the two palatine arches, is the palatine tonsil.

c. Laryngopharynx
The Laryngopharynx, or hypopharynx, is the bottom part of the pharynx. It extends from the epiglottis to the cricoid cartilage of the larynx.
Along the oropharynx and the laryngopharynx, the epithelium changes to nonkeritinizing stratified squamous epithelium. The basement membrane varies in thickness and contains blood vessels as well.

2. Larynx
The larynx is a 1.5 inch long tube that is located in the throat below the base of the hyoid bone and tongue and anterior to the esophagus. Its walls are made up of nine rings of supportive cartilages supported by interconnecting ligaments, intrinsic and extrinsic muscles, and lined with mucosa. At the front is the thyroid cartilage, which creates the Adam's apple. The inferior horns of the thyroid cartilage rest on the ring-shaped cricoid cartilage which connects the larynx to the trachea. The cricoid cartilage is narrow in front and broader in back. The arytenoid cartilages are pyramid shaped. They sit on top of the back plate of the cricoid cartilage. At the superior tip of each arytenoid cartilage is a corniculate cartilage. They are shaped like small triangles. The cuneiform cartilages support the soft tissues of the aryepiglottic folds, which connect the arytenoid cartilages to the epiglottis. During swallowing, the cartilages close the entrance to the larynx so food and liquids cannot enter. The larynx also houses the vocal folds and ligaments. The vocal folds consist of connective tissues, muscles, and the vocal ligament which vibrates to produce the vocal sounds. The surfaces of the vocal folds are covered by stratified squamous epithelium. Directly above the vocal folds are the vestibular, or false folds. They are formed by a thick layer of respiratory mucosa and a vestibular ligament. The vestibular folds lubricate and protect the vocal folds. The glottis forms the entryway to the vocal folds. It opens to allow for sounds.

3. Trachea
The trachea is 4 to 5 inches long. It runs through the lower neck and chest. It lies just anterior to the esophagus. It conducts air between the larynx and the primary bronchi. It is composed of 16-20 hyaline cartilage rings.
The tracheal wall is composed of four layers of tissue. The luminal surface is lined by respiratory mucosa. Its epithelium contains goblet cells to produce mucus which warms, moistens and removes foreign particles from air flowing to the trachea.
The submucosa consists mostly of loose connective tissue. It contains seromucous glands, which secrete water and mucus to the luminal surface of the trachea through narrow ducts.
The cartilage rings compose the next layer of the trachea. The outermost layer is the adventitia. It is a band of loose connective tissue which holds the trachea in place in the chest cavity.

4. Bronchi
The primary bronchi split off from the trachea and one enters each lung. The secondary bronchi, also known as lobular bronchi, each enter one lobe of the lungs. The tertiary bronchi branch off from the secondary bronchi. They conduct air to and from the ten bronchopulmonary segments in the right lung and eight in the left lung. The bronchi also have a layer of respiratory mucosa on their luminal surface with mucus-secreting goblet cells. The next layer is a broken ring of smooth muscle fibers which contract during exhalation and relax during inhalation. There are plates of hyaline cartilage which supports the tissue. In the micrograph of the bronchus wall, the alveoli can be seen. The mucosa of the bronchus wall is stained deep pink. The cartilage plates are light blue.

5. Lungs
The lungs are relatively cone-shaped sacs. They lie behind the rib cage. The lungs of mammals have a spongy texture and are honeycombed with epithelium having a much larger surface area in total than the outer surface area of the lung itself. A healthy lung is pink. The base of the lungs rests on the diaphragm muscle. The right lung is slightly larger and has three lobes while the left has only two. The lungs contain the bronchi and alveoli. The lungs are enveloped by plurae. The visceral pleura adheres to the outer surface of the lung. The parietal pleura is an extension of the visceral pleura. The pleurae are serous membranes. They secrete a thin layer of pleural fluid into the cavity that separates them.

6. Bronchial Tree
The bronchial tree is composed of the branches from the main bronchi that penetrate the lungs to deliver air to the alveoli. It is called the bronchial tree because it has the appearance of an inverted tree with the trachea as the trunk, branching into the primary bronchi, which then branch into the secondary bronchi, which branch into the tertiary bronchi, which terminate in the alveoli. The alveoli are the “leaves” of the tree.

7. Alveoli
The alveoli are the spherical outcroppings of the respiratory bronchioles. They resemble clusters of grapes in their appearance. They have radii of about 0.1 mm and wall thicknesses of about 0.2 µm. They are the primary sites of gas exchange in the lungs. Alveoli have an epithelial layer and an extracellular matrix surrounded by capillaries. In some alveolar walls, there are pores between alveoli. There are two major pneumocytes in the alveolar wall: Type I cells that form the structure of an alveolar wall and type II cells that secrete surfactant to lower the surface tension of water The alveoli have an innate tendency to collapse because of their spherical shape, small size, and surface tension due to water vapor. Phospholipids and pores help to equalize pressures and prevent collapse.
Bordering the lumen of the alveoli are wandering cells called alveolar phagocytes, or macrophages. These cells engulf dust, bacteria and other inhaled particles that are trapped in the pulmonary surfactant. After they become filled with debris, the macrophages migrate to the bronchioles, where they then get carried by ciliary action to the pharynx where they get swallowed. Alternatively, they may also migrate into the interstitium where they are then removed via the lymphatic vessels.
Information gathered from http://en.wikipedia.org/wiki/Alveoli and http://www.bioeng.auckland.ac.nz/physiome/ontologies/respiratory/cells.php

8. Type I and II alveolar cells
Type I alveolar cells cover about 95% of the alveolar surface. Type I alveolar cells are extremely thin. They occupy most of the alveolar surface area. Their external surfaces are covered with capillaries. Both their thinness and the capillaries surrounding them make these ideal cells for the diffusion of gases. They form a thin barrier through which gas exchange occurs. The basement membranes of the alveolar I cells and the capillary endothelium are actually fused together. Thus the exchange surface consists of the alveolar I cell membrane, the endothelial cell membrane, and the fused basement membranes. Type I alveolar cells do not divide.
Type II alveolar cells are cuboidal in shape with short microvilli along their apical surface. Their primary function is the secretion of surfactant.
Information primarily found at http://www.mededsys.com/courses_online/302/index.html

Intake this!

2006-10-16T05:48:00.000-06:00

A few fun breathing facts from my current biology lab.

1. What are the structural adaptations of the nasal cavity that allow it to carry out its functions?
Nasal hairs act as a filter to keep dust and dirt out of the nasal passages. Loss of nasal hair due to alopecia areata has been linked to increased severity of asthma, seasonal allergy and atopic dermatitis.
In humans, as with most mammals, the nose is the primary organ for smelling. The air flows over structures called turbinates in the nasal cavity. The turbulence caused by this disruption slows the air and directs it toward the olfactory epithelium. At the surface of the olfactory epithelium, odor molecules carried by the air contact olfactory receptor neurons which translate the features of the odor molecule into electrical impulses in the brain.
The shape of the nose is determined by the ethmoid bone and the nasal septum. The septum consists mostly of cartilage. It separates the nostrils.
The ethmoid bone is a cubical bone in the skull that separates the nasal cavity from the brain. It is located at the roof of the nose, between the two orbits. It is lightweight due to its spongy construction. The ethmoid bone consists of four parts: the horizontal Cribriform plate or lamina cribrosa, the vertical Perpendicular plate or lamina perpendicularis, which is part of the nasal septum, and the two lateral masses or labyrinths.
The ethmoid bone is very delicate and is easily injured by a sharp upward blow to the nose. The force of such a blow can drive bone fragments through the cribiform plate into the meninges or brain tissue. Such injuries cause leakage of cerebrospinal fluid into the nasal cavity and the brain. Blows to the head can also shear off the olfactory nerves that pass though the ethmoid bone and cause anosmia, an irreversible loss of the sense of smell. This not only eliminates certain aesthetic pleasures, but can also be dangerous. A person who cannot smell would be unable to detect smoke, gas, or spoiled food.
The nasal septum separates the left and right airways in the nose, dividing the two nostrils. It is composed of the ethmoid bone, vomer bone and the quadrangular.
A turbinate, or nasal conchae, is a long, narrow and curled bone shelf shaped like an elongated sea-shell which protrudes into the breathing passage of the nose. Turbinate bone refers to any of the scrolled spongy bones of the nasal passages in humans and other vertebrates. The turbinates divide the nasal airway into three groove-like air passages, and are responsible for forcing inhaled air to flow in a steady, regular pattern around the largest possible surface of cilia and climate controlling tissue.
The turbinates are located laterally in the nasal cavities. They curl medially and downwards into the nasal airway. Each pair is comprised of one turbinate in either side of the nasal cavity, divided by the septum.
The inferior turbinates are the largest turbinates. They are approximately three inches long, and are responsible for the majority of airflow direction, humidification, heating, and filtering of air inhaled through the nose.

The middle turbinates are usually around 2.5 inches long. They project downwards over the openings of the maxillary and ethmoid sinuses, and act as buffers to protect the sinuses from coming in direct contact with pressurized nasal airflow. Most inhaled air travels between the inferior turbinate and the middle turbinate.
The superior turbinates are smaller structures, connected to the middle turbinates by nerve endings. They protect the olfactory bulb.
The turbinates comprise most of the mucosal tissue of the nose. They are enriched with airflow pressure and temperature sensing nerve receptors linked to the trigeminal nerve route. They are responsible for filtration, heating and humidification of air inhaled through the nose. As air passes over the turbinate tissues it is heated to body temperature, humidified by up to 98% water saturation, and filtered.
The respiratory epithelium which covers the Lamina propria of the turbinates is part of the body’s first line of immunological defense. The respiratory epithelium is partially comprised of mucus producing goblet cells. This secreted mucus covers the nasal cavities and traps air-borne particles larger than 2 to 3 micrometers. The respiratory epithelium also serves as a means of access to the lymphatic system.
Information primarily gathered from http://www.wikipedia.org
2. What are the structural adaptations of the larynx that allow it to carry out its functions?
The larynx is mainly composed of cartilage bound by ligaments and muscle. At the front is the thyroid cartilage. This cartilage forms the Adam's apple. The inferior horns of the thyroid cartilage rest on the ring-shaped cricoid cartilage which connects the larynx to the trachea. Above the larynx is the hyoid bone, by which the larynx is connected to the jaw and skull. These muscles move the larynx during swallowing. The epiglottis consists of cartilage extending upwards behind the back of the tongue and projects down through the hyoid bone. It connects to the thyroid cartilage just beneath the thyroid notch. The space defined by these main cartilages is divided into the supraglottis and the glottis.
The glottis is defined as the space between the vocal cords, which are located at the upper rim of the cricoid cartilage. They attach to the thyroid cartilage at the front, and to the Arytenoid cartilages at the back. These are two roughly tetrahedral cartilages responsible for adduction and abduction of the vocal cords. The vocal cords are muscular masses coated with a mucous membrane which protects much of the respiratory tract from foreign particles. Their inner edges contain the vocal ligament.
The supraglottis is the portion of the pharynx above the glottis. It contains the ventricle of the larynx or laryngeal sinus, the ventricular folds or false vocal cords, the epiglottis, and the aryepiglottal folds. These are two folds of connective tissue that connect the epiglottis to the arytenoid cartilages. Muscles in the aryepiglottal folds have the ability to pull the epiglottis down, sealing the larynx and protecting the trachea below from foreign objects.
3. What are the structural adaptations of the trachea that allow it to carry out its functions?
The trachea, or windpipe, is a tube extending from the larynx to the bronchi, carrying air to the lungs. It is lined with ciliated cells which push particles out, and cartilage rings which reinforce the trachea and prevent it from collapsing on itself during breathing. These numerous cartilaginous half-rings, located one above the other along the trachea, have open ends adjacent to the esophagus. The rings are connected by muscular and fibrous tissue, and they are lined inside with a ciliated mucous membrane.
4. What are the structural adaptations of the alveoli that allow it to carry out its functions?
The alveoli consist of an epithelial layer and extracellular matrix surrounded by capillaries. In some alveolar walls, there are pores between alveoli. The alveoli are composed of Type I cells that form the structure of an alveolar wall, and Type II cells that secrete surfactant to lower the surface tension of water. The lungs contain about 300 million alveoli, each wrapped in a fine mesh of capillaries.
5. Compare the function of the conducting and respiratory zones.
The Conducting zone consists of the mouth, nose, pharynx, larynx, trachea, bronchi
The Respiratory zone consists of the respiratory bronchioles and alveoli.
The conducting zone warms the incoming air and removes pathogens and debris from it before it enters the respiratory zone. In the respiratory zone, oxygen is uploaded into the erythrocytes from the alveoli and transported throughout the body. Erythrocytes which have traveled through the body return to download carbon dioxide, which is then expelled from the body via the conducting zones.

Cystic Fibrosis

2006-10-12T20:19:00.000-06:00

This information about cystic fibrosis is an answer to a question that was posed on an upcoming lab for my biology class.

What is Cystic Fibrosis and what specific tissues in the lung does it affect?

CF is caused by a mutation in a gene called the cystic fibrosis transmembrane conductance regulator (CFTR). This gene helps create sweat, digestive juices, and mucus. Although most people without CF have two working copies of the CFTR gene, only one is needed to prevent cystic fibrosis. CF develops when neither gene works normally. Therefore, CF is considered an autosomal recessive disease. The name cystic fibrosis refers to the characteristic scarring (fibrosis) and cyst formation within the pancreas.
The symptoms of cystic fibrosis depend on the age of the individual, the extent to which the disease affects specific organs, and the types of infections experienced. Cystic fibrosis affects the entire body and impacts growth, breathing, digestion, and reproduction. The newborn period may be marked by poor weight gain and intestinal blockage caused by thick feces. Other symptoms of CF appear during growth and early adulthood. These include continued problems with growth, the onset of lung disease, and increasing difficulties with poor absorption of vitamins and nutrients by the gastrointestinal tract.
Lung disease results from clogging of the smaller airways with thick mucus. Inflammation and infection damage the lungs and the resulting damage leads to a variety of symptoms. In the early stages, incessant coughing, copious phlegm production, and decreased tolerance of exertion are common. Sometimes bacteria that normally inhabit the thick mucus grow out of control and cause pneumonia. In later stages of CF, changes in the architecture of the lung further exacerbate chronic respiratory difficulties. Other symptoms include coughing up blood, changes in the major airways in the lungs, known as bronchiectasis, pulmonary hypertension, heart failure, hypoxia, and respiratory failure requiring support with breathing masks such as bilevel positive airway pressure machines or ventilators.
In addition to typical bacterial infections, people with CF more commonly develop other types of lung disease. The lungs of individuals with cystic fibrosis are colonized and infected by bacteria from an early age. These bacteria, which often spread amongst individuals with CF, thrive in the altered mucus, which collects in the small airways of the lungs. This mucus encourages the development of bacterial microenvironments (biofilms) that are difficult for immune cells and antibiotics to penetrate. The lungs respond to repeated damage by thick secretions and chronic infections by gradually remodeling the lower airways (bronchiectasis), making infection even more difficult to eradicate.
Over time, both the types of bacteria and their individual characteristics change in individuals with CF. Initially, common bacteria such as Staphylococcus aureus and Hemophilus influenzae colonize and infect the lungs. Eventually, however, Pseudomonas aeruginosa and sometimes Burkholderia cepacia dominate. Once within the lungs, these bacteria adapt to the environment and develop resistance to commonly used antibiotics. Pseudomonas can develop special characteristics which allows the formation of large colonies. These strains are known as "mucoid" Pseudomonas and are rarely seen in people who do not have CF. Among these are allergic bronchopulmonary aspergillosis, in which the body's response to the common fungus Aspergillus fumigatus causes worsening of breathing problems. Another is infection with mycobacterium avium complex (MAC), a group of bacteria related to tuberculosis which can cause further lung damage. MAC does not respond to common antibiotics.
Mucus in the paranasal sinuses is equally thick and may cause blockage of the sinus passages, leading to infection. This may cause facial pain, fever, nasal drainage, and headaches. Individuals with CF may develop nasal polyps due to inflammation from chronic sinus infections. Such polyps can block the nasal passages and increase breathing difficulties.
Most information gathered from Wikipedia at http://www.wikipedia.org/wiki/Cystic_Fibrosis

Many people with cystic fibrosis do not live beyond their early 20's. Norma far surpassed that. She is 45 years old and has created a website with extensive information on the disease. Click the title link to visit this interesting and informative resource.

Antibodies

2006-10-10T04:27:00.000-06:00

In mammals there are five types of antibody: IgA, IgD, IgE, IgG, and IgM, with 4 IgG and 2 IgA subtypes present in humans. (Ig stands for immunoglobulin, which is another name for antibody). These are classified according to differences in their heavy chain constant domains (see below for more information regarding the structural features of antibodies). Each immunoglobulin class differs in its biological properties and has evolved to deal with different antigens. IgA can be found in areas containing mucus (e.g. in the gut, in the respiratory tract or in the urinogenital tract) and prevents the colonization of mucosal areas by pathogens. IgD functions mainly as an antigen receptor on B cells. IgE binds to allergens and triggers histamine release from mast cells (the underlying mechanism of allergy) and also provides protection against helminths (worms). IgG (in its four forms) provides the majority of antibody-based immunity against invading pathogens. IgM is expressed on the surface of B cells and also in a secreted form with very high affinity for eliminating pathogens in the early stages of B cell mediated immunity (i.e. before there is sufficient IgG to do the job).
Immature B cells express only IgM on their cell surface (this is the surface bound form not the secreted form of immunoglobulin). Once the naive B cell reaches maturity, it can express both IgM and IgD on its surface - it is the co-expression of both these immunoglobulin isotypes that renders the B cell 'mature' and ready to respond to antigen. Following an engagement of the immunoglobulin molecule with an antigen, the B cell becomes activated, and begins to divide and differentiate into an antibody producing cell (sometimes called a plasma cell). In this activated form, the B cell will produce its immunoglobulin in a secreted form rather than a membrane-bound form. Some of the daughter cells of the activated B cells will undergo isotype switching, a mechanism by which the B cell begins to express the other heavy chains and thus produce IgD, IgA or (more commonly) IgG.

Influenza

2006-10-07T05:07:00.000-06:00

This is a mini-report that I wrote for my biology course.

From the Stanford Website:
"Microbes, bacteria in particular, are the oldest and most abundant form of life — predating humans by about 3.5 billion years. Most microbes are benign or beneficial to humans, but the portion of the microbial world that is pathogenic (capable of producing disease) has periodically wreaked havoc on human populations. Epidemics (localized outbreaks of disease) and pandemics (global outbreaks) have occurred throughout human history."

In 1918, the influenza pandemic killed between 20 and 40 million people worldwide. The virus followed the paths of shipping lines to affect global population. This particular strain was most deadly for people ages 20 to 40. This pattern of morbidity was unusual for influenza, which is usually a killer of the very young and the elderly. This influenza strain had a profound virulence, with a mortality rate at 2.5% compared to the previous influenza epidemics, which were less than 0.1%. The death rate for 15 to 34-year-olds of influenza and pneumonia were 20 times higher in 1918 than in previous years. People who contracted the illness died rapidly.
One physician writes that patients with seemingly ordinary influenza would rapidly "develop the most viscous type of pneumonia that has ever been seen" and later when cyanosis appeared in the patients, "it is simply a struggle for air until they suffocate." Another physician recalls that the influenza patients "died struggling to clear their airways of a blood-tinged froth that sometimes gushed from their nose and mouth.
The origins of this influenza variant is not precisely known. It is thought to have originated in China in a rare genetic shift of the influenza virus. Recently the virus has been reconstructed from the tissue of a dead soldier and is now being genetically characterized.
The loss of life from even a particularly virulent strain of influenza would likely not be as great in modern times due to the ability to vaccinate readily. However, if the population were taken unawares by a drastic infectious agent of this nature, there could very likely be a shortage of the vaccine. Persons living in underprivileged circumstances would likely be deprived of the vaccine and of medical techniques that might save their lives. Persons in positions that involved high public contact, such as health care workers, would have a high degree of exposure to the disease.
Although scientists understand much more than they once did about influenza, the virus mutates and a highly virulent strain could still take a number of lives globally in spite of our more advanced medical technologies. Viruses are still the most difficult of all the infectious agents to combat. Unlike bacteria or parasites, they do not specifically "live." They are not subject to the effects of antibiotics. The only force that can combat them is an organism's immune system, possibly with the help of vaccines.

Phuck Fibromyalgia

2006-09-29T00:38:00.000-06:00

I suffer from fibromyalgia. I have a fairly mild case, but sometimes it gets the better of me. I can no longer do heavy physical activity, which is why even though I'm a licensed EMT I don't work on an ambulance. I have also suffered from several lower back injuries and this pain is exacerbated by the fibromyalgia.
There are days when I'm fairly well asymptomatic, especially since I switched to working in a department where the physical demands are far less. Chiropractic treatments tend to help as realigning the muscles and spine means less stress on the muscles and joints. (The type of chiropractic I receive involves manipulation of the muscles which leads to eventual reposition of the vertebrae as opposed to "cracking" the bones. It's far more effective in the long term.) However if I overdo things, whether physically or simply through being under too much stress, my muscles start to ache. Often it radiates down my arms, so that even if I haven't been doing any heavy lifting they feel like I've overdone things at the gym. Currently the pain is mostly in my lower back and my ankles, although there is some pain all over. I consider myself fortunate that I'm not one of those people that has such bad fibromyalgia that I can't bear to be touched. However, experiencing pain all over the body tends to exacerbate the fatigue that I'm already experiencing, and it becomes a vicious cycle. Due to suffering from bipolar disorder as well, the fatigue and resulting frustration can trigger a depressive spiral.
I wonder how closely problems like chronic fatigue or fibromyalgia are tied in with mood disorders.
Here are some basic Fibromyalgia facts:
Fibromyalgia (FM or FMS) is a debilitating chronic syndrome (constellation of signs and symptoms) characterized by diffuse or specific muscle, joint, or bone pain, fatigue, and a wide range of other symptoms. It is not contagious. It affects more females than males, with a ratio of 9:1 by ACR (American College of Rheumatology) criteria[2]. Fibromyalgia is seen in 3% to 6% of the general population, and is most commonly diagnosed in individuals between the ages of 20 and 50. The nature of fibromyalgia is not well understood. There are few, if any, treatments available[3], and there is no cure, but the disease is not life-threatening.
The primary symptom of fibromyalgia is widespread, diffuse pain, often including heightened sensitivity of the skin (Allodynia), tingling of the skin (often needlelike), achiness in the muscle tissues, weakness in the limbs, and nerve pain. Chronic sleep disturbances are also characteristic of fibromyalgia, and some studies suggest that these sleep disturbances are the result of a sleep disorder called alpha wave interrupted sleep pattern, a condition in which deep sleep is frequently interrupted by bursts of brain activity similar to wakefulness.

Many patients experience "brain fog", also known as "fibrofog", which is objectively proven abnormally slow brain waves and objectively proven cognitive deficits[5]. Many experts suspect that "brain fog" is directly related to the sleep disturbances experienced by sufferers of fibromyalgia.

Other symptoms often attributed to fibromyalgia (possibly due to another comorbid disorder) are chronic paresthesia, physical fatigue, irritable bowel syndrome, genitourinary symptoms such as those associated with the chronic bladder condition interstitial cystitis, dermatological disorders, headaches, myoclonic twitches, and symptomatic hypoglycemia. Although it is common in people with fibromyalgia for pain to be widespread, it may also be localized in areas such as the shoulders, neck, back, hips, or other areas. Not all patients have all symptoms.

Fibromyalgia can start as a result of some trauma (such as a traffic accident) or illness, but there is currently no known strong correlation between any specific type of trigger and the subsequent initiation of fibromyalgia. Symptoms can have a slow onset, and many patients have mild symptoms beginning in childhood, such as growing pains. Symptoms are often aggravated by unrelated illness or changes in the weather. They can become more tolerable or less tolerable throughout daily or yearly cycles; however, many people with fibromyalgia find that, at least some of the time, the condition prevents them from performing normal activities such as driving a car or walking up stairs. The syndrome does not cause inflammation as is presented in arthritis, but anti-inflammatory treatments, such as Ibuprofen and Iontophoresis, are known to temporarily reduce pain symptoms.

Variability of Symptoms
The following factors are said to temporarily increase the suffering of patients:
Cold weather, especially when damp
Malnutrition, hunger, or starvation
Physical activity of any kind, including minor tasks such as writing
Lack of deep sleep
Increase of stress
The consumption of alcohol
Some patients have reported a near-complete remission of their symptoms within several weeks of traveling to a warm, or tropical climate, especially with rest and relaxation, and the complete renewal of symptoms upon returning.

Diagnosis
When making a diagnosis of fibromyalgia, a practitioner would take into consideration the patient's case history and the exclusion of other conditions such as endocrine disorders, arthritis, and polymyalgia rheumatica. There are also two criteria established by the American College of Rheumatology for diagnosis:
A history of widespread pain lasting more than three months — widespread as in all four quadrants of the body, i.e., both sides, and above and below the waist.
Tender points — there are 18 designated possible tender points (although a person with the syndrome may feel pain in other areas as well). During diagnosis, four kilograms-force (40 Newtons) of force[3] is exerted at each of the 18 points; the patient must feel pain at 11 or more of these points for fibromyalgia to be considered. Four kilograms of force is about the amount of pressure required to turn fingernails white or to feel pain sensations on the forehead. This technique was developed by the American College of Rheumatology as a means of confirming the diagnosis for clinical studies. It is also used in the United Kingdom. Pressure on nearby areas rarely elicits any reaction. Fibromyalgia patients also have elevated levels of Substance P in the body, which increases the levels of pain and intensity.

Differentials
A number of other disorders can produce essentially the same symptoms as fibromyalgia. Other disorders known to produce similar symptoms are:
Myofascial pain syndrome
Chronic fatigue syndrome
Tendinitis
Gulf War syndrome
Depression
Influenza
Thyroid disease
Vitamin B12 deficiency
Lyme disease
Celiac disease
Mercury toxicity
Lead poisoning
Lupus erythematosus (SLE)
Whiplash-associated disorder

Treatment
As with many other soft tissue and rheumatolgical organic disorders, there is no cure for fibromyalgia, but some treatment options are available. A patient may try many routes of treatment under the guidance of a physician to find relief. Treatments range from symptomatic prescription medication to alternative and complementary medicine.

One experimental treatment is the use of the Guaifenesin Protocol, developed by Dr. R. Paul St. Amand. Because of the large number of patients improving on Guaifenesin, there are now several doctors throughout the U.S. who are using the Guaifenesin protocol in their practices[6].

Conventional analgesics rarely reduce the pain, and even strong narcotics are often not sufficient to entirely eliminate the pain.

Low doses of antidepressants like amitriptyline and trazodone may be used to reduce the sleep disturbances sometimes associated with fibromyalgia and are believed by some practitioners to help correct sleep problems that may exacerbate the symptoms of the condition. Because depression often accompanies chronic illness, these antidepressants have additional psychological benefits for patients suffering from depression. Amitriptyline is often favoured as it can also have the effect of providing relief from neuralgenic or neuropathic pain. Some doctors advise against using narcotic sleep aids ("hypnotics"), since these can actually disrupt deep sleep.

New drugs showing significant efficacy on fibromyalgia pain and other symptoms include milnacipran, gabapentin, meloxicam and possibly pregabalin. Milnacipran belongs to a new series of drugs known as serotonin-norepinephrine reuptake inhibitors (SNRIs), and is currently available in parts of Europe where it has been safely prescribed for other disorders. As of August 2005, Milnacipran is the subject of a Phase III study, and, if ultimately approved by the FDA, will be distributed in the United States.

Muscle relaxants such as Cyclobenzaprine (Flexeril) and Orphenadrine Citrate (Norflex) have also been studied in the treatment of fibromyalgia. Cyclobenzaprine has a tricyclic chemical structure similar to Amitriptyline, yet its anti-depressant effects are minimal. It is used only as a short-term muscle relaxant. In a study of 120 fibromyalgia patients, those receiving Cyclobenzaprine (10 to 40 mg) over a 12 week period had significantly improved quality of sleep and pain score. There was a trend towards improvement in fatigue symptoms but not in duration of morning stiffness. Interestingly, there was also a reduction in the total number of tender points and muscle tightness.

Studies have found gentle exercise, such as warm-water pool therapy, improves fitness and sleep and may reduce pain and fatigue in people with fibromyalgia. Stretching is recommended to allay muscle stiffness and fatigue, as is mild aerobic exercise. Because strenuous activity can exacerbate the muscle pain and fatigue already present, patients are advised to begin slowly and build their activity level gradually to avoid inducing additional pain. Exercise may be poorly tolerated in more severe cases with abnormal post-exertional fatigue.

Cognitive behavioral therapy has been shown to improve quality of life and coping in fibromyalgia patients and other sufferers of chronic pain.

EEG Biofeedback has also shown to provide temporary and long term relief, and as it gains more widespread coverage.

Many patients find temporary relief by applying heat to painful areas. Those with access to physical therapy and/or massage may find them beneficial. Chiropractic care can also help relieve pain due to fibromyalgia.

Treatment for the "brain fog" has not yet been developed, however biofeedback and self-management techniques such as pacing and stress management may be helpful for some patients.

A number of practitioners are attracted to the treatment of fibromyalgia, especially because its cause has yet to be identified, and due to its permanent nature, ongoing treatments can be very profitable. While this interest may promote legitimate medical research, patients should be wary: treatments of dubious validity exist in the meantime.

Living with fibromyalgia
Fibromyalgia can affect every aspect of a person's life. While neither degenerative nor fatal, the chronic pain associated with fibromyalgia is pervasive and persistent. FMS can severely curtail social activity and recreation, and as many as 30% of those diagnosed with fibromyalgia are unable to maintain full-time employment. Like others with disabilities, individuals with FMS often need accommodations to fully participate in their education or remain active in their careers.

In the United States, those who are unable to maintain a full-time job due to the condition may apply for Social Security Disability benefits. Although fibromyalgia has been recognized as a condition, along with chronic fatigue syndrome, by the government, applicants are often denied benefits. However, most are awarded benefits at the state judicial level; the entire process often takes two to four years.

In the United Kingdom, the Department for Work and Pensions recognizes fibromyalgia as a condition for the purpose of claiming benefits and assistance[7].

In India, the position with reference to this condition is unclear. However, where the person is rendered incapable of maintaining a regular life due to any disability, he/she can claim disability benefits. Indian laws guarantee that discrimination against people with disabilities is a violation of their individual rights.

Fibromyalgia is often referred to as an "invisible" illness or disability due to the fact that generally there are no outward indications of the illness or its resulting disabilities. The invisible nature of the illness, as well as its relative rarity and the lack of understanding about its pathology, often has psychosocial complications for those that have the syndrome. Individuals suffering from invisible illnesses in general often face disbelief or accusations of malingering or laziness from others that are unfamiliar with the syndrome.

There are a variety of support groups on the Web that cater to fibromyalgia sufferers. Some are offered at the bottom of this article.

Theories on the cause of fibromyalgia
The cause of fibromyalgia is currently unknown. Over the past few decades, many theories have been presented, and the understanding of the disorder has changed dramatically. Most current theories explain only a few symptoms of the disorder and are thus incomplete.

Sleep disturbance
The sleep disturbance theory postulates that fibromyalgia is related to sleep quality. Electroencephalography (EEG) studies have shown that people with fibromyalgia lose deep sleep[8]. Circumstances that interfere with "stage 4" deep sleep (such as drug use, pain, or anxiety) appear to be able to cause or worsen the condition.

According to the sleep disturbance theory, an event such as a trauma or illness causes sleep disturbance and, possibly, some sort of initial chronic pain. These initiate the disorder. The theory supposes that "stage 4" sleep is critical to the function of the nervous system, as it is during that stage that certain neurochemical processes in the body reset. In particular, pain causes the release of the neuropeptide substance P in the spinal cord, and substance P has the effect of amplifying pain and causing nerves near the initiating ones to become more sensitive to pain. Under normal circumstances, this just causes the area around a wound to become more sensitive to pain, but, if pain becomes chronic and body-wide, then this process can run out of control. The sleep disturbance theory holds that deep sleep is critical in order to reset the substance P mechanism and prevent this out-of-control effect.

An interesting aspect of the sleep disturbance/substance P theory is that it explains "tender points" that are characteristic of fibromyalgia but which are otherwise enigmatic, since their positions don't correspond to any particular set of nerve junctions or other obvious body structures. The theory posits that these locations are more sensitive because the sensory nerves that serve them are positioned in the spinal cord to be most strongly affected by substance P. The theory also explains some of more general neurological features of fibromyalgia, since substance P is active in many other areas of the nervous system.

Critics of the theory argue that it does not explain slow-onset fibromyalgia, fibromyalgia present without tender points, or patients without heightened pain symptoms, and a number of the non-pain symptoms present in the disorder.

Also of interest is a possible connection between this theory and the theory that chronic fatigue syndrome and post-polio syndrome are due, at least in part to damage to the ascending reticular activating system of the reticular formation. This area of the brain, in addition to apparently controlling the sensation of fatigue, is known to control sleep behaviors and is also believed to produce some neuropeptides, and thus injury or imbalance in this area could cause both CFS and sleep-related fibromyalgia, explaining why the two disorders so often occur together.

Deposition disease
Another theory involves phosphate and calcium accumulation in cells that eventually reaches a level to impede the ATP process, possibly caused by a kidney defect or missing enzyme that prevents the removal of excess phosphates from the blood stream. This theory posits that fibromyalgia is an inherited disorder, and that phosphate buildup in cells is gradual (but can be accelerated by trauma or illness). Calcium is required for the excess phosphate to enter the cells. The additional phosphate slows down the ATP process; however the excess calcium prods the cell to continue producing ATP[9].

Diagnosis is made with a specialized technique called mapping, a gentle palpitation of the muscles to detect lumps and areas of spasm that are thought to be caused by an excess of calcium in the cytosol of the cells. This mapping approach is specific to deposition theory, and is not related to the trigger points of myofascial pain syndrome.

While this theory does not identify the causative mechanism in the kidneys, it proposes a treatment known as guaifenesin therapy. This treatment involves administering the drug guaifenesin to a patient's individual dosage, avoiding salicylic acid in medications or on the skin, and, if the patient is also hypoglyemic, a diet designed to keep insulin levels low.

The phosphate build-up theory explains many of the symptoms present in fibromyalgia and proposes an underlying cause. The guaifenesin treatment, based on this theory, has received mixed reviews, with some practitioners claiming many near-universal success and others reporting no success. Only one controlled clinical trial has been conducted to date, and it showed no evidence of the efficacy of this treatment protocol. This study was criticized for not limiting the salicylic acid exposure in patients, and for studying the effectiveness of only guaifenesin, not the entire treatment method. As of 2005, further studies to test the protocol's effectiveness are in the planning stages, with funding for independent studies largely collected from groups which advocate the theory.

Fibromyalgia as severe TMS
Another theory is that fibromyalgia is a severe form of Tension myositis syndrome (TMS) which is a mindbody disorder popularized in the books on healing back, neck, and other limb pain by Dr. John E. Sarno of the Howard A. Rusk Institute of Rehabilitation Medicine. Briefly the theory is that in many cases chronic pain is the result of physical changes (primarily mild oxygen deprivation) caused by the brain through the autonomic nervous system as a strategy for distracting you from painful or dangerous unconscious emotions such as repressed anger. Treatment is through a program of education and attitude change which stops the brain from using that chronic pain strategy. Psychotherapy is suggested in the minority of cases where education alone is not sufficient.

Other theories
Other theories relate to various toxins from the patient's environment, viral causes such as the Epstein-Barr Virus, growth hormone deficiencies, an aberrant immune response to intestinal bacteria,[10][11] neurotransmitter disruptions in the central nervous system, and erosion of the protective chemical coating around sensory nerves. Due to the multi-systemic nature of illnesses such as fibromyalgia and chronic fatigue syndrome (CFS/ME), an emerging branch of medical science called psychoneuroimmunology (PNI) is looking into how the various theories fit together.

Comorbid diseases
Cutting across several of the above theories is a theory that proposes that fibromyalgia is almost always a comorbid disorder, occurring in combination with some other disorder that likely served to "trigger" the fibromyalgia in the first place. This concept fits especially well with the sleep disturbance theory.

By this theory, some other disorder (or trauma) occurs first, and fibromyalgia follows as a result. In some cases, the original disorder abates on its own or is separately treated and cured, but the fibromyalgia remains. In other cases the two disorders coexist. This theory would explain why such a wide variety of symptoms are often ascribed to fibromyalgia, since there are potentially a wide variety of comorbid disorders. It also helps explain why fibromyalgia is so hard to treat, since the fibromyalgia is unlikely to abate while the comorbid condition is untreated.

Commonly proposed comorbid/trigger disorders are:

Spinal disorders
Physical trauma, as from a traffic accident
Post-surgical pain
Chronic fatigue syndrome
Irritable Bowel Syndrome
Myofascial Pain Syndrome
Thyroid disease - for example Hashimoto's thyroiditis; thyroid hormone substitution can be helpful in some cases
Lyme disease
Post-polio syndrome
Hypermobility (including Ehlers-Danlos syndrome)
Restless Leg Syndrome
Clinical depression
Lupus erythematosus (SLE)

Skepticism
Some physicians believe that fibromyalgia is not an actual symptom complex. They claim that the symptoms of fibromyalgia are manifestations of depression, along with symptoms of unrelated diseases such as chronic fatigue syndrome, Epstein-Barr syndrome, interstitial cystitis, irritable bowel syndrome, bacterial infection, and others.

Skeptics point to the following list - some of which is no longer true - to support their skeptical positions:

lack of objective evidence to support patient's claims of suffering (no longer true)
divergent or unrelated symptoms ("syndrome")
the different rates of illness among members of different cultures
a relative lack of evidence-based treatments
a correspondingly large number of "quack" healers providing unproven, incorrect, or ineffective diagnosis and treatment
Some medical authorities who are unaware of the current objective physiological indicators revealed by recent research (such as substance P abnormalities) still believe that depression and psychological factors are the root cause of the syndrome, similar to hypochondria[4][5], despite the fact that as of 2006, there are no known specialist fibromyalgia researchers who agree.

"This isn't a disease, it's merely a description of symptoms... We've taken stress, psychosocial distress and pain and the ordinary life experiences some people have and turned them into something they're not -- a physical illness"
-- Dr. Fred Wolfe, a skeptical Rheumatologist who ironically helped define the disease earlier in his career[12].
However, depression should be expected to accompany any debilitating illness. In other words, depression is not a special trait of fibromyalgia. Interestingly, many victims of fibromyalgia either do not suffer from depression at all, or they did not suffer from it until after its onset.

References
^ Information from the National Fibromyalgia Association
^ Fibromyalgia from WebMD
^ [1] Cough syrup found by University of Florida to reduce fibromaylgia pain "moderately" but not recommended for personal self treatment
^ Fibromyalgia, published by BUPA insurance
^ Fibrofog, Fibromyalgia and Dissociation
^ Recommended Guaifenesin protocol practitioners
^ The Fibromyalgia Association of the UK
^ [2]
^ Are phosphates the hidden enemy? (76.7kb pdf)
^ Kendall SN (May 2004). "Remission of rosacea induced by reduction of gut transit time.". Clin Exp dermatol. 29 (3): 297-9. PMID 15115515.
^ Pimental M, Wallace D, Hallegua D et .al (April 2004). "A link between irritable bowel syndrome and fibromyalgia may be related to findings on lactulose breath testing.". Ann Rheum Dis. 63 (4): 450-2. PMID 15020342.
^ Article from Immune Support
Retrieved from "http://en.wikipedia.org/wiki/Fibromyalgia"

Missing Body Parts

2006-08-10T00:09:00.000-06:00

Click the title link. Fun for medical personnel and other sick fucks!

Stem Cell Research

2006-07-27T23:54:00.000-06:00

Click the title link. I really need to do more research on this topic myself. As it stands I don't feel qualified to comment. But I'm very interested in learning more.

Online Histology Slides

2006-07-15T02:37:00.000-06:00

Study microscopic images of various tissues by clicking the title link!

The Third Degree

2006-07-11T04:16:00.000-06:00

Here is a copy of my most recent assignment for my Anatomy and Physiology class. The text is entirely mine. If anyone wishes to quote from it or use the information for their own assignment, or to use the entire essay for teaching purposes, feel free.

COMPLICATIONS AND TREATMENT OF THIRD DEGREE BURNS
The severity of the potential complications posed by third degree burns depends on which part of the body was burned and on the amount of tissue that was damaged. The percentage of damage is calculated using the Rule of Nines. The following is the Rule of Nines measures for an adult: each arm has 9% of the body’s total skin, the head 9%, each leg 18% (two 9’s), the front of the torso 18%, the back of the torso 18%, and the neck 1%. Generally speaking, as the percent of the surface burned increases, morbidity and the probability of mortality increases sharply. Burns which cover 20% or more of the body surface can be fatal without treatment.
The most urgent complication posed by third degree burns is death due to loss of blood plasma, leading to circulatory shock and cardiac arrest. This happens because of fluid being transferred from the bloodstream to replace the fluid lost from the damaged tissue. The result is a decrease in the volume of circulating bloodstream. Another pressing complication comes from the potential for infection in the burned, dead tissue known as eschar. A secondary concern is contracture, or abnormal connective tissue fibrosis as the result of a third degree burn being left to heal on its own without medical intervention. Severe deformities can result from this.
Treatment for third degree burn victims starts with administering intravenous fluid to replace that which has been lost from the damaged tissue. The burn victim must also consume a very high number of calories to make up for protein loss and assist in tissue repair. They will receive supplemental nutrition intravenously or through a gastric tube. They will also receive powerful antibiotics.
The patient is kept in a sterile environment and will receive debridement treatments. The most commonly used method for many years has been mechanical debridement, in which a moist dressing is applied then manually removed. This can be excruciatingly painful for the patient. However, there have been advances in burn treatment and alternative types of debridement such as autolytic debridement are being used in certain cases. Autolytic debridement uses occlusive or semi-occlusive dressings to maintain wound fluid contact with the necrotic tissue. This encourages the body's enzymes and fluids to re-hydrate, soften and finally liquefy hard eschar and slough. Only necrotic tissue is liquefied. This debridement method is virtually painless for the patient but cannot be used in all cases.
After the initial treatment, the patient is likely to require a skin graft. Doctors generally perform an autograft, where skin is taken from another location on the person’s own body, usually the thigh or buttock, and is grafted to the burned area. However, in patients with more extensive burns, surgeons will use an isograft which employs skin from the patient’s close relative, preferably an identical twin. Skin banks also provide skin from cadavers to utilize in homografts. The rejection percentage for homografts is high. Surgeons generally use this measure as a temporary covering for the burned area until the patient is healthy enough to undergo an autograft. Pig skin can also be used in the same way. This method is known as a xenograft. Scientists are also working on developing artificial skin which will provide great advancement in the field of reconstructive treatment for burn patients.
C. Hartley
July 11, 2006

The following text is copied from this website which I utilized in part of my research:
http://www.medicaledu.com/debridhp.htm
Types of Wound Debridement
Autolytic Debridement:
Description:
Autolysis uses the body's own enzymes and moisture to re-hydrate, soften and finally liquefy hard eschar and slough. Autolytic debridement is selective; only necrotic tissue is liquefied. It is also virtually painless for the patient. Autolytic debridement can be achieved with the use of occlusive or semi-occlusive dressings which maintain wound fluid in contact with the necrotic tissue. Autolytic debridement can be achieved with hydrocolloids, hydrogels and transparent films.
Best Uses:
In stage III or IV wounds with light to moderate exudate
Advantages:
Very selective, with no damage to surrounding skin.
The process is safe, using the body's own defense mechanisms to clean the wound of necrotic debris.
Effective, versatile and easy to perform
Little to no pain for the patient
Disadvantages:
Not as rapid as surgical debridement
Wound must be monitored closely for signs of infection
May promote anaerobic growth if an occlusive hydrocolloid is used

Enzymatic Debridement:
Description:
Chemical enzymes are fast acting products that produce slough of necrotic tissue. Some enzymatic debriders are selective, while some are not.
Best Uses:
On any wound with a large amount of necrotic debris.
Eschar formation
Advantages:
Fast acting
Minimal or no damage to healthy tissue with proper application.
Disadvantages:
Expensive
Requires a prescription
Application must be performed carefully only to the necrotic tissue.
May require a specific secondary dressing
Inflammation or discomfort may occur

Mechanical Debridement:
Description:
This technique has been used for decades in wound care. Allowing a dressing to proceed from moist to wet, then manually removing the dressing causes a form of non-selective debridement.
Hydrotherapy is also a type of mechanical debridement. It's benefits vs. risks are of issue.
Best Uses:
Wounds with moderate amounts of necrotic debris
Advantages:
Cost of the actual material (ie. gauze) is low
Disadvantages:
Non-selective and may traumatize healthy or healing tissue
Time consuming
Can be painful to patient
Hydrotherapy can cause tissue maceration. Also, waterborne pathogens may cause contamination or infection. Disinfecting additives may be cytotoxic.

Surgical Debridement:
Description:
Sharp surgical debridement and laser debridement under anesthesia are the fastest methods of debridement.
They are very selective, meaning that the person performing the debridement has complete control over which tissue is removed and which is left behind
Surgical debridement can be performed in the operating room or at bedside, depending on the extent of the necrotic material.
Best Uses:
Wounds with a large amount of necrotic tissue.
In conjunction with infected tissue.
Advantages:
Fast and Selective
Can be extremely effective
Disadvantages:
Painful to patient
Costly, especially if an operating room is required
Requires transport of patient if operating room is required.

Maggots
Click here and scroll down to see the nasty pictures.
These images were supplied by David Janssen, M.D.
Dr. Janssen used to have a very detailed website, but now it's gone.
Other web resources, click here.

Folks, as a trained medical person my stomach is made of fairly strong stuff. During my EMT training we would eat our dinner while viewing slides of gruesome trauma and none of us were fazed. But maggots in a wound, and me knowing they were there? That makes my stomach turn in ways I didn't know it could! Sorry, arm/leg/whatever, but there wouldn't be any saving you if there were maggots involved! Excuse me while I go lose my lunch.

Hopefully the advancements in burn care and reconstruction will continue--without maggots, thanks!

Cie

Marfan Syndrome

2006-07-11T00:50:00.000-06:00

What do a former U.S. president and a Swedish heavy metal singer have in common?
Possibly Marfan syndrome.
Marfan syndrome is an autosomal dominant disorder that has been linked to the FBN1 gene on chromosome 15. FBN1 codes for a protein called fibrillin-1, which is essential for the formation of elastic fibers found in connective tissue. Marfan syndrome is also an example of a dominant negative mutation. Marfan syndrome is associated with incomplete penetrance, therefore not all persons carrying the mutation develop the disease.
Without the structural support provided by fibrillin, many connective tissues are weakened, which can have severe consequences on support and stability. The most serious conditions associated with Marfan syndrome primarily involve the cardiovascular system. Marfan syndrome may cause leakage of the mitral or aortic valves that control the flow of blood through the heart. This may produce shortness of breath, an irregular pulse, and undue tiredness. Another complication is aortic aneurysm.
Curvature of the spine (scoliosis) is a common problem, as is abnormal indentation (pectus excavatum) or protrusion (pectus carinatum) of the sternum. These symptoms may in turn cause unusual pressure on the heart and lungs. Other symptoms include; abnormal joint flexibility, high palates, flat feet, stooped shoulders, and dislocation of the optic lens.
Nearsightedness or myopia is a common condition associated with Marfan syndrome. In addition, the weakening of connective tissue often causes detachment of the retina and/or displacement of the lens in one or both eyes.
Quoted from Wikipedia

Marfan syndrome sufferers may grow to larger than normal height, and typically have long, slender limbs and fingers. Their arm span usually exceeds their height. (For instance a person of 6'6" tall would normally have a 6'6" arm span. A person with Marfan Syndrome at this height would likely have a 7' arm span.) Their arms and legs are strikingly long in comparison with the torso.

Abraham Lincoln was 6'4" tall and weighed around 180 pounds.

Per Ohlin was 6'4" or 6'5" tall. His weight was likely comparable to that of President Lincoln.

Persons with Marfan Syndrome sometimes have fingers with a long, thin, spidery appearance known as arachnodactyly.

These photos show the markedly angular facial features in both subjects. Both men have a prominent, angular nose with a strikingly broad bridge.

Of course not all tall, slender individuals have Marfan Syndrome. Basketball star Michael Jordan is 6'6" tall and weighs 215 pounds. He exhibits none of the characteristics of Marfan's.

For more information on my models:
Abraham Lincoln (February 12, 1809-April 15, 1865)
Per Ohlin (January 16, 1969-April 8, 1991)

A personal note:
Although not a trait associated with Marfan Syndrome, I find it interesting that both Lincoln and Ohlin suffered from mood disorders, either major depression or possibly Bipolar Type II as both had periods when they described moments of elation or high energy uncharacteristic to their normally melancholy personalities. Lincoln once described himself as being the most miserable man alive. Ohlin committed suicide at the age of 21.
Both of these individuals possessed remarkable qualities far beyond being interesting subjects for scientific observation. They were both highly intelligent. Lincoln was a noble humanitarian and Ohlin a gifted poet and musician. I mention these aspects because I believe in the importance of focusing on a person's soul before their physiology.

Skin Repair

2006-07-03T05:13:00.000-06:00

I never realized all the cool stuff that goes on beneath the surface of a scab! Click the title link, then follow the steps below to see it for yourself.
Go to the top left sidebar where it says Click Here to Choose a Unit
Choose Levels of Organization
Click on Tissues
Click on Membranes
Click on the "filmstrip" icon and then click on Next in the picture at the top of the page to follow the slide show!

Just Thinking!

2006-07-03T00:37:00.000-06:00

Click the title link to read a fine speculative article from respected sci-fi author Orson Scott Card regarding the new scientific attitude towards genetics and what it may mean for future generations.

Angelman Syndrome

2006-06-26T03:50:00.000-06:00

This neurological disorder is caused by a deletion or mutation on the mother's contribution to the 15th chromosome. People with this condition have developmental delays but are generally happy and friendly. They enjoy certain sounds such as flowing water and crackling paper. They have a tendency to make big flapping motions with their hands. They are sensitive to high temperatures. Many of them can learn to perform simple tasks on their own.
Here is an excellent site about Angelman Syndrome.
If the deletion or mutation were on the paternal contribution to the 15th chromosome, Prader-Willi syndrome would result. People with this condition tend to be small in stature and suffer from polyphagia. They also suffer from developmental disabilities.

Fitting In Your Genes

2006-06-26T03:34:00.000-06:00

In my A&P class, we are currently studying genetics. I'm fascinated by anything to do with genetics although the intricacies of DNA are a bit overwhelming. I enjoy seeing if I can tell what a person's ancestry is by looking at them and may delve into this a bit. I'm also interested in genetic abnormalities. I know that I have a couple. Bipolar disorder is caused by a mutation, I believe on the 15th chromosome. I also have a mild nonspecific neurological disorder that may or may not be related and when I'm very tired will lead to facial tics and muscle jerking. I have a blog all about abnormal psych issues and will tend to stick to physical issues here, and sometimes the two will overlap. I'm hoping that this will be a fun and interesting if somewhat sporadic project!

Medical Hodgepodge Blog

2006-05-24T02:50:00.000-06:00

I work in the medical field. I've always been fascinated by stuff that people shouldn't be fascinated by such as diseases and decay. Not fascinated as in "turned on," simply wondering how and why this stuff happens. Kinda like the way one doesn't want to look at a horrific accident but can't help but peek through their fingers. So many strange and interesting things can happen to the human body. I'll share some of these things along the way.