There are some doctors I choose not to thank but most have helped along the way.
Monthly Archives: March 2018
Issues of Aging
Once again, I’ve changed the focus of this blog. This time to the issues and problems that come with aging.
In January 2018, I managed to do something painful to my thumb. I finally couldn’t take it anymore and went to the ER on February 1. They did x-rays and sent me away with a spica splint (I thought they were calling it a thumb spike), a diagnosis of deteriorating thumb joint plus tendonitis, and a referral to an orthopedic doctor.
Here it is the end of March and I still haven’t been able to get to that new doctor. Maybe soon?
February 6, 2018 we were still living at the Residence Inn due to water damage at our home on November 6, 2017 (more on that in another blog, someday). My mom and I were coming back from WalMart and she fell in the parking lot. Luckily, DH was still in our apartment and he came right down. He couldn’t get her to stand up, so I drove the car over to her. Although she didn’t want to go, we took her to the emergency room.
They did lots of scans there. The first determined that she’d broken her pelvis in 2 places. Thankfully, they don’t do surgery for a broken pelvis. They thought that they would send her to Mount Vernon Hospital for intensive rehab.
Her white blood count was high, so they assumed infection and started 2 IV meds for that. Her blood pressure dropped very low several times, causing her to pass out.
A chest x-ray was clear, so no infection there. Because of the passing out episodes, they sent her for a head scan in case there had been a stroke. Nope.
About 1 am on the 7th, a hospitalist came in to admit her. He asked if she had abdominal pain and she said yes. So, he started palpating various areas and found a tender spot. He called for an abdominal scan, which showed internal bleeding. So, the WBC wasn’t from infection but massive blood loss.
They called an ambulance and sent her to Fairfax Hospital for emergency surgery to stop the bleeding.
At Fairfax, they did a new scan with contrast – missed that she was allergic to that – and found that the bleeding was stopping all by itself. Then, they gave her Benadryl.
She stayed there for 3 nights because Medicare required 3 midnights before going to rehab. <Sheesh!>
From there, she went to Manor Care for rehab. She no longer qualified for Mount Vernon.
She was doing really well…until she started having internal bleeding. Back to Fair Oaks. Same room. AARRGGHH! She was admitted for a few days to stop the bleeding and turned out to have an ulcer. Then, edema.
Finally, she came home and is doing really well with a walker. The pelvis is supposed to heal itself in a couple months.
Mild Cortisol Increases Affect Cardiovascular Changes Linked to Heart Disease in Cushing’s
Increases in cortisol secretion, even if mild, induce early heart and blood vessel changes that may increase the risk for cardiovascular disease, according to Italian researchers.
The findings continue to support the role of the hormone cortisol in heart disease, and demonstrate the need for carefully monitoring cardiovascular risk in patients with high levels of the hormone, including those with Cushing’s disease.
The study, “Cardiovascular features of possible autonomous cortisol secretion in patients with adrenal incidentalomas,” was published in the European Journal of Endocrinology.
While most patients with adrenal incidentalomas don’t have symptoms, nearly half have excess cortisol production. Adrenal incidentalomas are masses in the adrenal glands discovered only when a patient undergoes imaging tests for another unrelated condition.
These asymptomatic, mild cortisol-producing cases are defined as possible autonomous cortisol secretion (pACS), according to the European Society of Endocrinology Guidelines.
Excess production of the hormone, seen in Cushing’s disease patients, is associated with increased mortality, mainly due to heart diseases. Patients with asymptomatic adrenal adenomas and mild cortisol secretion also have more cardiovascular events and generally die sooner than those with normal cortisol levels.
But little is known about the causes behind cardiac and vessel damage in these patients.
To shed light on this matter, a research team at Sapienza University of Rome evaluated the cardiovascular status of patients with pACS. This allowed them to study the impact of cortisol in the heart and blood vessels without the interference of other hormone and metabolic imbalances seen in Cushing’s disease.
The ERGO trial (NCT02611258) included 71 patients. All had been diagnosed with adrenal incidentalomas, 34 of which were pACS with mildly increased levels of the hormone and 37 were defined as nonfunctioning adenoma (NFA) — adrenal masses with normal hormone levels.
The two groups were very similar, with no significant differences in metabolic and cardiovascular risk factors. Adrenal lesions in the pACS group, however, were significantly bigger, which was linked to cortisol levels.
Looking at the heart morphology, researchers found that pACS patients had a significantly higher left ventricular mass index (LVMI), which is a well-established predictive measure of adverse cardiovascular events.
Further analysis revealed that LVMI scores were associated with levels of the hormone, suggesting it has an “independent effect of cortisol on cardiac function,” the researchers wrote.
Slightly more than half of pACS patients (53%) also had a thicker left ventricle, a feature that was seen only in 13.5% of NFA patients. The performance of the left ventricle during diastole (muscle relaxation) was also affected in 82.3% of pACS patients, compared to 35.1% in those with NFA.
Patients with pACS also had less flexible arteries, which may contribute to the development of vascular diseases.
The results show that “mild autonomous cortisol secretion can sustain early cardiac and vascular remodeling” in patients who appear apparently healthy, the researchers said.
“The morphological and functional cardiovascular changes observed in pACS underline the need for further studies to correctly define the long-term management of this relatively common condition,” they added.
World Kidney Day
Chronic kidney disease affects more women than men, but most people with this condition don’t know they have it. This World Kidney Day, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health, joins organizations around the world in urging women to take action to prevent kidney disease — for themselves and their loved ones.
Healthy lifestyle changes can help prevent and manage kidney disease and its main causes — diabetes and high blood pressure. One in seven Americans has chronic kidney disease, or CKD, a condition that can lead to kidney failure and means your kidneys are damaged and can’t filter blood the way they should. CKD affects 16 percent of women and 13 percent of men. Approximately 700,000 people in the United States have kidney failure treated with dialysis or a kidney transplant.
Given the impact of kidney disease on women, the NIDDK encourages all women to learn about risk factors and talk with health care professionals. Taking action now can help protect your kidneys. Here are ways to reduce your risk:
- Choose healthier foods, such as fresh fruits, fresh or frozen vegetables, whole grains, and low-fat or fat-free dairy products.
- Be physically active for 30 minutes or more on most days.
- Reduce screen time, and aim for 7 to 8 hours of sleep each night.
- Join family, friends, or coworkers in encouraging each other to stick to a healthy routine.
- Use the NIH Body Weight Planner to help achieve and stay at a healthy weight.
NIDDK-funded research continues to examine how lifestyle changes affect kidney disease, diabetes, and more. The Chronic Renal Insufficiency Cohort(link is external) is an ongoing observational study looking at a wide spectrum of kidney disease topics, such as the risk factors for loss of kidney function and the link between kidney and heart disease. The Sit Less, Interact, Move More Intervention for Sedentary Behavior in Chronic Kidney Disease clinical trial is recruiting participants with CKD to find out whether decreasing time spent sitting and increasing walking time will result in less belly fat and improved physical function and quality of life.
The NIDDK conducts and supports research on diabetes and other endocrine and metabolic diseases; digestive diseases, nutrition, and obesity; and kidney, urologic, and hematologic diseases. Spanning the full spectrum of medicine and afflicting people of all ages and ethnic groups, these diseases encompass some of the most common, severe, and disabling conditions affecting Americans. For more information about the NIDDK and its programs, visit www.niddk.nih.gov.
About the National Institutes of Health (NIH): NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.
From https://www.nih.gov/news-events/news-releases/world-kidney-day-shine-spotlight-womens-health
March is Kidney Cancer Awareness Month
Kidney Cancer awareness is very important to me, because I learned I had it in 2006.
I’m pretty sure I had it before 2006 but in that year I picked up my husband for a biopsy and took him to an outpatient surgical center. While I was there waiting for the biopsy to be completed, I started noticing blood in my urine and major abdominal cramps. I left messages for several of my doctors on what I should do. I finally decided to see my PCP after I got my husband home.
When Tom was done with his testing, his doctor took one look at me and asked if I wanted an ambulance. I said no, that I thought I could make it to the emergency room ok – Tom couldn’t drive because of the anesthetic they had given him. I barely made it to the ER and left the car with Tom to park. Tom’s doctor followed us to the ER and became my new doctor.
When I was diagnosed in the ER with kidney cancer, Tom’s doctor said that he could do the surgery but that he would recommend someone even more experienced, Dr. Amir Al-Juburi.
Dr. Amir Al-Juburi has been so kind to me, almost like a kindly grandfather might be, and he got rid of all 10 pounds of my cancer in addition to my kidney.
More than 12,000 people in the UK are diagnosed with kidney cancer each year, according to 2014 statistics.
And although 42% of cases are deemed “preventable”, only 50% of patients survive kidney disease for 10 or more years. I will celebrate 12 years next month, on May 9!
It’s the seventh most common cancer in the UK and is much more prevalent in males.
But do you know the warning signs of the potentially deadly disease?
Here we reveal the 12 main symptoms of kidney cancer:
1. Blood in your pee Not until the day I was diagnosed.
You may notice your pee is darker than normal or reddish in color. This could also be a sign of chronic kidney disease and bladder cancer.
2. A persistent pain in your lower back or side, just below your ribs No
3. A lump or swelling in your side (although kidney cancer is often too small to feel) No
4. Extreme tiredness (fatigue) Possibly, although I assumed it was from Cushing’s
5. Loss of appetite and weight loss No
6. Persistent high blood pressure Yes
7. A high temperature of 38C (100.4F) or above No
8. Night sweats No
9. In men, swelling of the veins in the testicles Nope
10. Swollen glands in your neck No
11. Bone pain No
12. Coughing up blood No
If you are concerned about any of these symptoms you should see you GP, they will carry out a series of tests, including urine and blood tests, in order to get an accurate diagnosis.
What are the treatment options?
The treatment will depend on the size and severity of the cancer and whether it has spread to other parts of the body.
These are the five main treatments:
1. Surgery to remove part or all of the affected kidney Yes, all plus some other stuff
This the main treatment for most people
2. Ablation therapies No
Where the cancerous cells are destroyed by freezing or heating them
3. Biological therapies No
Medications that help stop the cancer growing or spreading
4. Embolisation No
A procedure to cut off the blood supply to the cancer
5. Radiotherapy No
Where high-energy radiation is used to target cancer cells and relieve symptoms
For more information go to nhs.uk/Conditions/Cancer-of-the-kidney
Adapted from http://www.dailystar.co.uk/health/605586/Kidney-cancer-symptoms-treatment-males-females-early-warning-signs
MaryO'Medical 