Liver Transplants

This is typically done in patients suffering from end-stage liver disease and acute liver failure. As in other major surgeries, there is a substantial amount of risk during the procedure.

If a patient has end-stage liver disease or acute liver failure they don’t automatically qualify for liver transplant.

They must also be avoid of other competing medical issues that typical result in poor outcomes such as: uncontrolled metastatic cancer – when it is outside of the liver, active drug abuse, active alcohol abuse, active infections. HIV used to be on the list but this has recently changed.

Age, serious heart conditions, and other medical issues need to be reviewed in each patient before transplant would be approved.

Recently, several doctors and a recent study is trying to indicate that a patient shouldn’t have to prove that they are sober for six months to qualify for a transplant.

A small study in France indicates that they had several patients that were given a new liver and became sober years later. Only 26 people were in the study where 77% were alive after six months and only three began drinking within the next three years. All 26 had very stable and supportive group of family and friends.

It is to be noted that the study looked at individuals who were suffering from hepatitis related liver failure from alcohol abuse.

There has been an ongoing and difficult, often bitter debate over whether this is ethical and appropriate. Liver’s for transplant are already in high demand. Many point to George Best, a British soccer player who received a liver transplant in 2002, only to start drinking again and he eventually died three years later.

Excess alcohol abuse can cause liver damage including cirrhosis and hepatitis. Just under 20% of current transplants go to current or former heavy abuse drinkers. Patients must give up heavy drinking for six months before a transplant center will approve them to be placed on the list.

The French study suggests dropping the ban only for patients with hepatitis related to excess alcohol abuse. Arguments are that obesity and drug abuse causing liver failure patients are a large majority of patients receiving liver transplants and these are lifestyle choices as well.

Last year alone, over 6,000 liver transplants were performed in the United States. It has been reported that around 1,400 individuals died waiting for a transplant. This data is given by United Network for Organ Sharing.

Remember that alcohol alone is no the only way to have liver damage. Some patients with no history of alcohol, drug use or obesity are currently waiting for a transplant. Approving the drop in six months free of alcohol will affect them as well.

Controversy has been seen on this topic before and it appears that this new study will again draw in the sand lines of opposition. Some state that the lines are becoming increasingly clear, while others states that facts just blur them into confusion.

Please comment as too where you stand. One way or another, lives are at stake. Please be mindful of that in the comment section.

The research is taking place in Chicago at the Rush University Medical Center. Initial research was intriguing though additional studies are required before anything is certain.

Antibodies, found on the surface of ovarian cancer cells, were found in the blood of most of the women with ovarian cancer. These antibodies were also found with women who had previously known ovarian problems – but not necessarily cancer. Women with normal ovarian function and no ovarian cancer were found to not have this antibody.

Typical treatment of ovarian cancer is to removed the uterus completely. This is usually done because the cancer is in an advanced stage. Single ovary removal along with the fallopian tubes can also be seen. Following surgery chemotherapy is a possibility. Radiation is rarely used as a treatment.

If the cancer is diagnosed early – the fiver year survival is very high. If not, the survival rate is far lower.

When you finally awake you are unable to speak. It is almost impossible to swallow. Your throat is so sore that it feels as if someone is pouring razorblades into your mouth. You can’t breath, you tense up your fist and want to scream, but you can not make a sound. Finally you hear a voice, “Calm down, you are okay. Take several deep breaths. You are being mechanically ventilated to help you breath.”

Surgery may have gone as planned with a complete success. The problem that occurred my have been what is called Aspiration Pneumonia. This can be a potentially serious condition. It is also known as bronchopneumonia and occurs when foreign material, such as oral or gastric contents, enter the lungs. Such foreign material can be from food, saliva, gastric juices, nasal secretions and more. When this happens during surgery, often the cause is eating something before surgery. But of course, this is not always the case. Vomiting during surgery can happen and gastric juices can then slide into the lungs.

Aspiration pneumonia does not just occur during surgery. Can also be seen after strokes, seizures, and other conditions where the swallowing reflux is changed or altered. Respiratory patients with asthma, COPD, respiratory distress and any number of other diseases or conditions can have a similar outcome.

Bacterial infections may result as part of the aspiration and the result could be pneumonia. Hospital stay and antibiotics are often necessary to get through this difficult experience. Sometimes, doing everything perfectly still results in an incident of Aspiration Pneumonia.

Mechanical Ventilation is a method that assists or can replace breathing where a machine takes control of the breathing. When a machine is used, it is more of a long term use. A very short term use can be when a breathing bag is manipulated by nursing or medical staff to provide the acute breathing of someone who otherwise can’t breath on their own.

After a patient awakes and can breath on their own, especially in cases of Aspiration Pneumonia, the breathing tube can be removed and the patient will then breath on his own.

After so much attention have we become numb to the actual message. Breast Cancer is a difficult and terrible diagnosis. Often we hear about the success stories of those who have made it through this disease. We often aren’t told about those who don’t. Though, the memories of those lost to breast cancer are always close to the family members of those who lost their battle.

Additionally there has been some discussion about being to aware and fear overtaking the mass. Are we over checking for breast cancer. Are young women much too worried about the possible diagnosis of breast cancer. Many argue that screening mammograms are out of control. Everyone from the twenty year old to the forty year old is now waiting to get a mammogram. Is this the best option is pivotal for discussion.

Screening Mammogram vs. Diagnostic Mammogram

There is a large difference. Screening mammograms are done without any symptoms or findings. Diagnostic mammograms are done after a lump is found or another concerning symptom has been found. The difference is who will be getting the mammogram. Screening mammograms are very controversial and much has been written and studied. Diagnostic mammograms have very little controversy.

Are you worried?

There are several things to think about as a women of any age.

1.) Are you at risk?

2.) Do you have symptoms?

3.) Is there a family history?

4.) Have you spoken with your Physician or Mid-level Provider?

Essentially the idea of Breast Cancer Awareness month was something of a good thing. Now we are so used to seeing and hearing about it that it may actually push some people away from doing what they need to do. The person who needs the message may not be the one getting it. Those who need to see their provider may not be the one who can actually get an appointment.

What to do?

Be reasonable about your risk and the risk of your family. Be honest with yourself if you find something concerning such as a lump. Don’t be afraid to speak with someone, especially a family member and your provider. Don’t get overworked and try not to get desensitized by the public push for an entire month of pink ribbons. Understand that this topic is important and should not be overlooked.

That expense has been researched and it has been reported that cancer is more expensive than malaria, AIDs, the flu, and other conditions.

Other chronic conditions also increase the medical cost. This includes: heart disease and diabetes. Heart disease has been the number one cause of death for the last several years. But, it has been forecasted over the last decade or more that cancer would eventually surpass heart disease and it appears that it has.

Another apparent concern is the actual money that is set aside or provided by both the public and private funding for cancer. The belief is that a relatively small amount of money is used to improve cancer prevention and management. A large amount of money is spent on behalf of treatment and management. The two sides are not proportional to each other.

Other diseases such as flu, AIDs and malaria have a much larger amount set aside for them. The reasoning is that the fear that these conditions cause urges public opinion and public spending. These types of conditions are transmitted or acquired through a host or another person. This raises the fear and brings in a larger portion of the economic dollar.

Cancer’s economic toll was $895 billion in 2008 and this is equivalent to approximately 1.5 percent of the world’s gross domestic product. This dollar amount represents the disability and years of life lost. This specific report does not account for the cost of treating the disease.

But, how can we make strides in this category? Certain medical conditions can be preventable, lung cancers, cardiac heart disease ,and others. Some can be detected earlier but than often, the cost would increase dramatically as well. It is estimated that lung cancer alone accounts for almost $200 billion of the $900 billion. This large amount is very interesting and an important topic to many researches on cancer.

Heart disease is not a distant second in terms of deaths and financial obligations. It is estimated that heart disease accounts for some $750 billion per year worldwide.

What is a statin you ask?  It is one of the main or primary medications to treat cholesterol medications.

This in effect, signals that you can enjoy your hamburgers, fries, coke and swallow a cholesterol medications at the same time. In hopes of preventing the effects caused by excessive cholesterol intake.

Wow, what an idea. Some may argue that this is the complete opposite of prevention medicine.  What do you think?  Let us know in our comment section.

There are others that have concluded that this may be the new preventive medicine.

Often quoted or referred to is a study that was published in the American Journal of Cardiology. Researchers and Scientists from the National Heart and Lung Institute in London tested and formed an opinion that the reduction of risk in cardiac heart disease may be reduced by a statin, a type of cholesterol lowering drug. They also believed that this risk could offset the consequence of eating a cheeseburger and a milkshake.

“Sign me up!!” could be the chant of thousands. Though fatty foods such as hamburgers and fries have other problems than just increased cholesterol. Fatty lipids, obesity, risk of Diabetes, and many other consequences would not be helped by the statin gift at mealtime.

Dr. Darrel Francis, who led the research team said the following: “When people engage in risky behaviors like driving or smoking, they’re encouraged to take measures that minimize their risk, like wearing a seat belt or choosing cigarettes with filters. Taking a statin is a rational way of lowering some of the risks of eating a fatty meal.“

Statins are a great medication and in essence are used to help treat our unhealthy lifestyles. We are consuming an increased amount of processed sugars, fats, cholesterol, and others. In addition to statins several other cholesterol and lipid medications are available.

But remember, cholesterol is formed in the liver on a natural level. Our problem, with elevated cholesterol occurs when either our body produces to much and/or we consume excess cholesterol. Therefore many individuals who eat unhealthy many never need a statin and conversely someone who eats healthy and exercises may need a statin or other cholesterol medication.

The rule of thumb should remain, attempt to exercise and eat healthy. This doesn’t mean that you necessarily need to completely abstain from Fast foods, but moderation should always apply.

More than 30 people were arrested in conjunction with this recent . Among the suspected were nurses, doctors, and others.

The total amount that has been allegedly scams sits currently at $251 million.

Some of the breakdown of the scams include:

1.) Unnecessary equipment
2.) False patients
3.) Physical Therapy that was never received
4.) HIV treatment that were never received

One such incident in New York found that a fraud was discovered that brought in $70 million dollars alone for physical therapy. The clinic apparently would pay off patients for their Medicare numbers and would provide bonuses for each additional patients. Undercover agents were sent in and they were paid off as well, as part of the sting operation.

Medicare and Medicaid are a serious industries and a potentially lucrative areas for scams and frauds. Recent health care changes by Obama and overalls to the health care industry may be afforded as the government begins cracking down on fraud that may be costing this country over 60 billion dollars a year.

Health Care Spending is an interesting and concerning area our national budget. Many changes may need to be put into place.

Fraud of the medicare systems is happening all the time and from very small scams to quite extensive and elaborate plans.

Federal authorities have been cracking down on many frauds over the past few years. In this most recent raid, over 360 agents were used across the five states. Federal officials have promised more time, money, resources, and manpower to fight fraud. In addition, they have set up strike forces in several cities. It is believed that Miami is the central base for many fraudulent scams over the past few years. This most recent raid found that almost $150 million dollars was from various scams and frauds in that city.

One must ask, is fraud worsening?

The answer is an alarming yes. Criminals are finding easier ways to attempt fraudulent activity. Medicare Scams are often an easy, yet profitable way to bring in large amount of money. One woman’s medicare number had over 3,500 claims on it.

What can you do to keep safe?

1.) Understand the Medicare program

2.) Be familiar with your number

3.) Keep your Medicare number safe

4.) Call your Medicare claim service to see if your number is being falsely used.

Medicare is not the only affected medical area. Medicaid has also been affected. Take a look at the following blog article about Medicaid in Utah

Fast food, schools, and parents are improving their views of the importance of nutritional meals. Take a look at several foods that need to be given in moderation. None of the following foods needs to be completely avoided but closely monitored.

1.) Chips – Potato chips are easy and accessible and are often a lunch time option.

2.) Soda – Parents who drink soda often have children who ask – sometimes it is hard to say no.

3.) Sugar Cereals – This is an empty calorie landslide with little nutritional value – some mandated vitamins are placed within, this only helps minimally.

4.) French Fries – Whether at a restaurant or going through a drive-through, some parents are choicing other options – but fries still are one of the most common foods for children [and adults].

5.) Toaster Pastries – Fruit is largely lacking in these processed foods with large amount of fats.

6.) Doughnuts – Often convenience is a parent’s goal and little is more convenient than a doughnut either pre-packaged or bought from a bakery. A high calorie breakfast with little nutritional value is the only thing found.

7.) Greasy foods – Unfortunately this could be a list in of itself; hamburgers, chicken, chicken nuggets, fish, all fried or packaged around grease to improve the taste and limit the nutritional value

8.) Candy – Often overlooked as a food group, but for children and some parents it often can be #1. Holidays, birthdays, parties, and any other excuse to allow candy is almost never missed.

9.) Ice Cream and Cake – Goes hand in hand for birthday parties or otherwise. Low sugar, low fat, and small portions can help curb these problems

10.) Fruit Juices – Very low nutritional value but often mistaken for a good choice other than cool-aid or soda. The trick is many have very little natural fruit, but this can be deceiving.

Causes:

   -    Dental Cavity is the number one reason for dental pain.
   -    The second most common is gum disease.
   -    Dental Abscess
   -    Dental Decay
   -    Sinus infection
   -    Temporomandibular Joint Disorder (TMJ)
   -    Muscle spasms
   -    Exposed roots

Pain can be encountered when chewing, or sleeping, with hot and/or cold contact.

Other symptoms include: swelling, bleeding, ear pain, neck pain, facial pain, redness of gums, discharge

Diagnosis

Often an appointment with a Dentist is essential to determine cause of pain.

X-rays are often essential

Treatment

   -    Ibu
   -    Tylenol
   -    Topical ointment placed on tooth
   -    Antibiotics
   -    Fillings

Prevention

   -    Daily brushing of teeth
   -    Flossing of teeth
   -    Fluoride
   -    Limit smoking
   -    Teeth cleaning [every six months]

Separated Shoulder

This deals with what is referred to as the AC joint of the shoulder or the acromioclavicular joint. The AC joint is located at the far end of the clavicle. It can be seen in the picture above. When an AC joint is “separated” it means that it has been injured to some severity.

Types of AC joint injuries:

Are all separated shoulders the same?

No…. Separated shoulders are graded according to the severity of the injury and the position of the displaced bones.

Shoulder separations are graded from type I to IV though some grade it up to VI:

Type I Shoulder Separation:
-    Is an injury to the capsule that surrounds the AC joint.
-    The bones are not out of position
-    The primary symptom is pain.
-    Ligaments damage is minimal if any.

Type II Shoulder Separation:
-    Injury to the AC joint capsule
-    Additional injury to the important ligaments that stabilizes the clavicle.
-    This ligament, the coracoclavicular ligament is often partially torn.
-    Symptoms include pain, decrease motion, and a possible small bump over the injury.

Type III Shoulder Separation:
-    Involves the same type of injury as a type II separated shoulder
-    In addition the injury is more severe and damaged.
-    Ligament tearing is more severe.
-    Symptoms include pain, decrease motion, and a possible small bump over the injury.

Type IV Shoulder Separation:
-    Involves the same type of injury as a type II and type III separated shoulder
-    In addition the injury is more severe and damaged.
-    Ligament tearing is more severe and can be complete.
-    Symptoms include pain, decrease motion, and a possible small bump over the injury.
-    In some rare cases the clavicle is pushed behind the AC joint.
-    Other times the clavicle is pushed downward

Treatment -

-    Types I and II often require ice, pain medication, shoulder sling, and time.
-    Types II and III include those for the other types. In addition, surgery, PT and other treatments may be necessary.

Shoulder Dislocation

The joint of the shoulder consists of three bones that come together at one place. The arm bone (humerus), the shoulder-blade (scapula), and the collarbone (clavicle) all meet up at the top of the shoulder.

The joint between the humerus and scapula, also called the glenohumeral joint, is a ball-and-socket joint.  The ball is on the top of the humerus, and this fits into a socket of the shoulder-blade called the glenoid. This joint is effective and multidimensional as it allows the movement of shoulder though a large arc of motion.

There is no other joint in the body that allows more motion than the glenohumeral joint. Unfortunately, by allowing this wide range of motion, the shoulder is not as stable as other joints. Because of this, shoulder dislocations are not uncommon injuries.

Types

1.) Anterior

95% of all shoulder dislocations are anterior or forward.

2.) Posterior

Posterior dislocations are behind the shoulder.  They are possibly due to strength imbalance of the rotator cuff muscles.  Other causes include falls, sports injuries, and other.  Can occur and go unnoticed in elderly patients.

3.) Inferior

Are the least likely to occur with less than 1%.  This can turn into a situation with large amount of complications.  Blood vessels, nerves, tendons, and ligaments can be affected.

Treatment

Reduction – a process to return the shoulder back into the correct joint.

Sling, ICE, Pain Management following Reduction

Post Reduction X-ray to ensure in the right spot

Surgery is necessary in the more severe cases or is considered when chronic shoulder dislocations occur.