A Quick Guide: Understanding Rheumatoid Arthritis

adc-ra

Learn the signs of rheumatoid arthritis, which affects millions of Americans.

Rheumatoid Arthritis is the most common form of autoimmune arthritis, affecting more than 1.3 million Americans. Of these, about 75 percent are women. In fact, 1–3 percent of women may get rheumatoid arthritis in their lifetime. The disease most often begins between the fourth and sixth decades of life. However, RA can start at any age.

RA is a chronic (long-term) disease that causes pain, stiffness, swelling and limited motion and function of many joints. While RA can affect any joint, the small joints in the hands and feet tend to be involved most often. Inflammation sometimes can affect organs as well, for instance, the eyes or lungs.

Signs of Rheumatoid Arthritis

  • Tender, warm, swollen joints
  • Symmetrical pattern of affected joints
  • Joint inflammation often affecting the wrist and finger joints closest to the hand
  • Joint inflammation sometimes affecting other joints, including the neck, shoulders, elbows, hips, knees, ankles and feet
  • Fatigue, occasional fevers, a loss of energy
  • Pain and stiffness lasting for more than 30 minutes in the morning or after a long rest
  • Symptoms that last for many years
  • Variability of symptoms among people with the disease.

Who has Rheumatoid Arthritis?

Scientists estimate that about 1.5 million people, or about 0.6 percent of the U.S. adult population, have RA. Interestingly, some recent studies have suggested that although the number of new cases of RA for older people is increasing, the overall number of new cases may actually be going down.

RA occurs in all races and ethnic groups. Although the disease often begins in middle age and occurs with increased frequency in older people, older teenagers and young adults may also be diagnosed with the disease. Children and younger teenagers may be diagnosed with juvenile idiopathic arthritis (a condition related to RA). Like some other forms of arthritis, RA occurs much more frequently in women than in men. About two to three times as many women as men have the disease.

How does Rheumatoid Arthritis Affect People’s Lives?

RA affects people differently. Some people have mild or moderate forms of the disease, with periods of worsening symptoms, called flares, and periods in which they feel better, called remissions. Others have a severe form of the disease that is active most of the time, lasts fro many years or a lifetime and leads to serious joint damage and disability.

Although RA is primarily a disease of the joints, its effects are not just physical. Many people with RA also experience issues related to:

  • Depression
  • feelings of helplessness
  • low self-esteem

RA can affect virtually every part of a person’s life, from work life to family life. It can also interfere with the joys and responsibilities of family life and may affect the decision to have children.

Finally…

The rheumatologists at Amarillo Diagnostic Clinic specialize in treating patients with arthritis, gout, lupus and related diseases.  Knowledge of these diseases continues to expand through research efforts.  Our major goal is to limit any arthritic damage, especially in rheumatoid arthritis.  Our services include bone density testing, joint injections and an IV infusion clinic for new medications.  Our rheumatologists are armed with the latest information regarding your disease and treatment options to improve your quality of life. Contact us for more information or to schedule an appointment.

(Some information provided by the American College of Rheumatology).

Taking Blood Clots Seriously

Emergency Victim

Courtesy of UrbanHospital.org

Know the Signs of Blood Clots Before They Become Medical Emergencies

Blood clots, also known as deep vein thrombosis, are serious business. They can lead to a pulmonary embolism which is a medical emergency that results in death in about one of every three people diagnosed. It is important to know the signs and get treated right away.

Blood clots usually occur in people who can’t move around well or who have had recent surgery or an injury. You may also get a blood clot if you:

  • Have had recent surgery.
  • Are 65 or older.
  • Take hormones, especially for birth control. (Ask your doctor about this).
  • Have had cancer or are being treated for it.
  • Are obese.
  • Are confined to bed or a chair much of the time.
  • Have had a stroke or are paralyzed.
  • Have varicose (VAR­e­kos) or bad veins.
  • Have heart trouble.
  • Have taken a long trip (more than an hour) in a car, airplane, bus,
    or train.

Symptoms and Signs of a Blood Clot

You may have a blood clot if you see or feel:

  • New swelling in your arm or leg.
  • Soreness or pain in your arm or leg.
  • A warm spot on your leg

Blood Clots Affecting the Lungs

A blood clot may have gone to your lungs if you suddenly have:

  • A hard time breathing.
  • Chest pain.
  • A fast heartbeat.
  • Fainting spells.
  • A mild fever.
  • A cough, with or without blood.

Our pulmonary specialists at Amarillo Diagnostic Clinic specialize in treating patients with lung and respiratory disorders. We use ventilation/perfusion nuclear lung scanning, CT, and other tests to evaluate pulmonary diseases.

Enjoying Paradise – Tips to Avoid Travel Illness

As you plan your exotic summer vacation, the excitement of what lies ahead begins to really grow. But, have you asked yourself the question, “What if, among the once-in-a-lifetime paradise I am visiting, I do something to leave me stuck inside my hotel room sick?” Let us offer you some tips to keep you in tip-top shape while you’re in paradise.

Because really, wouldn’t you rather be enjoying this:

Palm Beach

Instead of this:

Sick in a Hotel

Vaccinations

  • You should get vaccinated against any diseases that may be endemic to the region you’re headed to at least four weeks before a trip out of the country.
  • Visit the Centers for Disease Control and Prevention site to learn more about diseases you could come in contact with during your trip.

To Reduce Contamination in your Food and Water

In countries with poor sanitation:

  • Don’t drink tap water or use it to brush your teeth. Use filtered or bottled water instead.
  • Ice in your drinks could spell disaster, so avoid it altogether. Bottled drinks with a seal are usually safe, and so are boiled water and hot drinks made with boiled water.
  • If food has been kept at room temperature in warm locations, it could have been exposed to flies. Try only eating food that is served hot.
  • Don’t eat salads, uncooked fruits and vegetables unless you’ve washed and peeled them yourself.

Staying Away from Bug Bites

  • If you are visiting an area where mosquitos are common, sleep under a mosquito net to avoid being bitten at night. Extra tip: Carry a small sewing kit with you to repair any holes in the net.
  • Malaria mosquitoes bite between dusk and dawn, so being indoors during these hours can reduce the number of bites.
  • Using products with DEET are the most effective insect repellents, but be sure to read the directions for their proper use.
  • Avoid tight clothing, which mosquitos can bite through. Wear loose-fitting clothing in malaria hotspots.

Don’t let Jet Lag Ruin your Vacation/Treat it Early

  • Jet lag can throw off your biological clock, which weakens your immune system. Try adjusting to your new schedule at least a week before you travel, if possible. Go to sleep and wake up earlier/later depending on which direction you’re heading.
  • Don’t try to cure jet lag with caffeine or alcohol. This will give you an inefficient amount of sleep and possibly make conditions worse.

Follow these tips, and plan for your safety on upcoming trips. Proper planning will allow you to make the most of your vacation and come back with great stories to tell your friends and family.

— — —

If you are traveling out the country, set up a consultation with our travel medicine specialist, J. Taylor Carlisle, M.D. at 358-0200.

Planning for Your Healthy Baby: Pregnancy and Diabetes (Amarillo Diagnostic Clinic)

By Rachel Pessah Pollack, MD

Do you have diabetes? Are you thinking about getting pregnant?

If so, there are things you need to do for the health of you and your baby during pregnancy. Your blood sugar control is very important.

Diabetes during pregnancy is on the rise.

healthy pregnancy with diabetes

More and more people are getting diabetes. There are about 1.5 million new cases per year. As a result, many more women with type 2 diabetes are becoming pregnant.

Elevated blood sugar (glucose) levels during pregnancy are bad. They can cause a higher risk of birth defects, miscarriage, birth injury, preterm delivery and certain complications such as pre-eclampsia. By being careful with blood sugar levels before becoming pregnant and during the early weeks of pregnancy, these potential problems can be prevented.

Here is what you can do to optimize your care and ensure a successful outcome.

Tips for Diabetics During Pregnancy

  • Schedule your doctors’ visits.
    • Your doctor may send you to a specialist before you get pregnant to help you with your diabetes control.
    • Obstetrical [ob-steh-trih-kal] care – some patients with diabetes may see obstetricians [ob-steh-TRIH-shen] who specialize in high-risk pregnancies. Your doctor will help you make this decision based on how long you have had diabetes and how well your diabetes is controlled.
    • Eye disease – every woman with diabetes should see an eye doctor for an eye examination before getting pregnant. You may be counseled on the risk of getting diabetic eye disease (retinopathy [reh-tin-AH-pah-thee]). Eye exams are also recommended in the first trimester, during pregnancy, and after birth. Sometimes the eye disease may become worse with pregnancy; however, this risk can be prevented with laser surgery.
    • Kidney disease – all women with diabetes who want to get pregnant should be checked for diabetic kidney disease (nephropathy [neh-FRA-pah-thee]). A urine test is used for this test.
    • High blood pressure – your doctor will want to make sure that your blood pressure is under good control before you get pregnant. You may have to switch or add blood pressure medications.
    • Nerve disease – your doctor may suggest you see a foot specialist (podiatrist [poe-DYE-ah-trist]) to determine if you have diabetic nerve disease. This is also known as peripheral neuropathy [per-IH-fer-al noor-AH-puh-thee]. It is important to take good care of your feet before and during pregnancy and to check your feet each day to keep infections at bay.
  • Focus on healthy eating now
    • Before pregnancy, it is a good time to pay close attention to what you eat. Eating properly is important to achieve and maintain normal sugar levels throughout pregnancy. You are hopefully already following a healthy diabetes diet, including fruits, vegetables, and fiber. You can continue to eat the same foods as you plan for pregnancy. However, be aware that, during pregnancy, how many carbohydrates there are in each meal is the most important factor affecting your blood sugar control, both before and after your meals. It may be useful to meet with a registered dietician or diabetes educator before you get pregnant. This will help you learn how to count calories and choose healthy foods. In addition to watching your diet, all women who want to become pregnant should take a daily prenatal multivitamin containing at least 400 micrograms of folic acid. Folic acid prevents neural tube defects, such as spina bifida [spine-a BIH-fid-a] in babies.
  • Target normal blood sugar levels
    • Studies have shown that poor blood sugar control during pregnancy can lead to poor pregnancy outcomes and risk for birth defects. During the first trimester, the baby’s organs are forming and normal sugar levels can decrease the risk of any problems during this period. For this reason, it is very important to wait to conceive until blood sugars are under excellent control.
    • Hemoglobin A1C, which is a measurement of your blood glucose control over the prior two to three months, should be checked before you get pregnant to help with your overall diabetes treatment plan. Talk with your health care provider about what your blood sugar range and A1C level should be both before pregnancy and during pregnancy to reach your goal of a normal blood sugar. Blood glucose self-monitoring is recommended by many different diabetes organizations (each has different target levels). During pregnancy you will be asked to check blood sugar levels one to two hours after the first bite of your meal. This is different from when you weren’t pregnant.
  • Review your medications for safety
    • Before you get pregnant, have your doctor review your medications and determine if you need to switch them to ones that are safe in pregnancy. Some examples are listed below:
      • Diabetes medications – Many of the diabetes pills that are taken when not pregnant cannot be taken when pregnant. Before you get pregnant discuss with your doctor whether you may need to start insulin before or during pregnancy. Or, you might find out that diet and carbohydrate monitoring are all you need. In general, if insulin is needed, you will likely need to use more insulin the further you get into your pregnancy, especially during the third trimester. Although there is some good data with certain pills for diabetes, it is not known how safe and effective they are, and insulin is often recommended to control blood sugar.
      • Blood pressure medications: ACE inhibitors and ARBs used for blood pressure control and kidney disease are not advised during pregnancy, since they are likely to harm the baby. Before you get pregnant, consult your health care team about changing your blood pressure medications.
      • High-cholesterol medications: “Statins,” a class of medication used for its cholesterol-lowering effects, should be stopped before you get pregnant.
  • Evaluate your pre-pregnancy weight
    • Women with diabetes who are overweight or obese have a higher chance of having problems during pregnancy. These problems include higher rates of cesarean section, high blood pressure, birth defects, and premature infants. The good news is that if you are overweight and are able to reduce or normalize your body weight before you get pregnant, you can prevent many of these poor outcomes from occurring. Losing just a few pounds can help you maintain better control of your sugars and lower your blood pressure.
  • Plan to exercise
    • Once your doctor has decided that you are healthy for physical activity, add exercise to your daily regimen. Choose activities that you enjoy and are most likely to continue with and have a goal of 30 minutes of aerobic exercise most days of the week. Keeping fit will help with both weight loss and control of your blood sugar. Check your sugar level before and after exercising because you may need to eat a snack to prevent low blood sugar during physical activity. Continue your exercise routine during pregnancy unless your doctor advises against it.
  • Avoid bad habits
    • It is very important to get counseling from your doctor before you become pregnant so that you have a healthy pregnancy. Women with diabetes should be screened for depression, tobacco and alcohol use, drug abuse, weight management, and exercise.
    • If you are a smoker or are still drinking alcohol, the perfect time to stop is before you get pregnant.
    • If you are abusing drugs (prescription/non-prescription), now is the time to stop and get help if necessary.
    • If you have missed doses of insulin or if you don’t take your medications as prescribed, focus on taking the best care of your body as you prepare for pregnancy and avoid missing doses.
  • Know when you need to wait
  • It is important for each woman with diabetes to know when a pregnancy is not safe. If your diabetes is not under good control, you should wait to become pregnant. By working with your health care team and making adjustments to your treatment, you can improve control of your blood sugar and ensure a healthy outcome for you and your baby.

There is a lot of planning to be done. However, you must remember that the patience and additional work is worth the end result: your healthy baby!

Dr. Rachel Pessah Pollack has a special interest in pregnancy-related endocrine disorders. She has published articles and given presentations on gestational diabetes, Cushing’s disease during pregnancy, and iodine deficiency during pregnancy.

5 Primary Ways to Keep Your Bones Strong as You Age

A bone density test is the only test that can diagnose osteoporosis before a broken bone occurs. This test helps to estimate the density of your bones and your chance of breaking a bone. Our Diagnostic Imaging Department is equipped to provide a variety of radiology services including BD testing. All studies are interpreted by independent radiologists who are board-certified by the American Board of Radiology.

Knowing Your Family History

A key to understanding your bone health is by knowing your family history. Having a parent or sibling who has osteoporosis puts you at greater risk — especially if you also have a family history of fractures. Additionally, hormone levels also play an important role. Too much thyroid hormone can cause bone loss. In women, bone loss increases dramatically at menopause due to dropping estrogen levels. The prolonged absence of menstruation (amenorrhea) before menopause also increases the risk of osteoporosis. In men, low testosterone levels can cause a loss of bone mass.

Additionally, hormone levels also play an important role. Too much thyroid hormone can cause bone loss. In women, bone loss increases dramatically at menopause due to dropping estrogen levels. The prolonged absence of menstruation (amenorrhea) before menopause also increases the risk of osteoporosis. In men, low testosterone levels can cause a loss of bone mass.

How to Increase Bone Health

Include Calcium in Your Diet

For adults ages 19 to 50 and men ages 51 to 70, the recommended dietary allowance (RDA) is 1,000 milligrams (mg) of calcium a day. The recommendation increases to 1,200 mg a day for women after age 50 and for men after age 70. Good sources of calcium include dairy products, almonds, broccoli, kale, canned salmon with bones, sardines and soy products, such as tofu. If you find it difficult to get enough calcium from your diet, ask your doctor about supplements.

Get More Vitamin D

Your body needs vitamin D to absorb calcium. For adults ages 19 to 70, the RDA of vitamin D is 600 international units (IUs) a day. The recommendation increases to 800 IUs a day for adults age 71 and older. Good sources of vitamin D include oily fish, such as tuna and sardines, egg yolks, and fortified milk. Sunlight also contributes to the body’s production of vitamin D. If you’re worried about getting enough vitamin D, ask your doctor about supplements.

Include Physical Activity in Your Daily Routine

Weight-bearing exercises, such as walking, jogging, tennis and climbing stairs, can help you build strong bones and slow bone loss.

Avoid Substance Abuse

Research suggests that tobacco use contributes to weak bones. Similarly, regularly having more than two alcoholic drinks a day increases the risk of osteoporosis, possibly because alcohol can interfere with the body’s ability to absorb calcium. Don’t smoke. Avoid drinking more than two alcoholic drinks a day.

Bone Density Test

Women ages 65 and up should get tested, the same applies for men 70 and up. You may want to talk with us about the risks and benefits before deciding. Younger women and men ages 50 to 69 should consider the test if they have risk factors for serious bone loss or have a family history of osteoporosis.

We Are Here For You

It’s important to pay attention to your signs and symptoms. Stay updated on which adult health warning signs promote medical attention. Regular physical exams and adult health screening tests are an important part of preventive adult health care. Know which screening tests you need and how often to have them done. Contact us if you have any questions or to schedule an appointment.

(Some information provided by the Mayo Clinic).

Probiotic Powerhouse: How Good Bacteria Can Benefit Your Body

adc-probiotics

Probiotics are live microorganisms that are intended to have health benefits. Products sold as probiotics include foods (such as yogurt), dietary supplements, and products that aren’t used orally, such as skin creams.

Although people often think of bacteria and other microorganisms as harmful “germs,” many microorganisms help our bodies function properly. For example, bacteria that are normally present in our intestines help digest food, destroy disease-causing microorganisms, and produce vitamins. Large numbers of microorganisms live on and in our bodies. In fact, microorganisms in the human body outnumber human cells by 10 to 1. Many of the microorganisms in probiotic products are the same as or similar to microorganisms that naturally live in our bodies.

Why Should You Be Taking Probiotics?

Researchers have studied probiotics to find out whether they might help prevent or treat a variety of health problems, including:

  • Prevent and treat antibiotic-associated diarrhea
  • Promote healthy cholesterol
  • Help aid depression and anxiety
  • Immune system support
  • Soothe symptoms of irritable bowel syndrome
  • Eradicate ulcers
  • Helps melt belly fat

Are all probiotics the same?

There’s preliminary evidence that some probiotics are helpful in preventing diarrhea caused by infections and antibiotics and in improving symptoms of irritable bowel syndrome, but more needs to be learned.

Probiotics are not all alike. For example, if a specific kind of Lactobacillus helps prevent an illness, that doesn’t necessarily mean that another kind of Lactobacillus would have the same effect or that any of the Bifidobacterium probiotics would do the same thing.

When Is It Time to Visit a Gastroenterologist?

A gastroenterologist is specially trained to manage diseases of the digestive tract from the esophagus to the anus.In many cases, people who are diagnosed with a chronic digestive condition are under the long-term care of a gastroenterologist. If you are experiencing a recurrence or a flare-up of an existing condition, you should contact the gastroenterologist who has been managing your treatment. If you are experiencing new symptoms, patients are usually referred to a gastroenterologist by their primary care physician. Your physician may recommend you see a gastroenterologist if you are experiencing any of the following symptoms of GI disorders:

  • Rectal bleeding
  • Leakage/underwear stains
  • Bowel movement urges that are hard to control
  • Diarrhea
  • Change in bowel habits
  • Pale-colored stools
  • Dark urine
  • Heartburn (acid reflux)
  • Abdominal pain or bloating
  • Excessive gas or belching
  • Esophageal pain
  • Vomiting
  • Loss of appetite or weight
  • Lethargy

Finally…

The gastroenterologists at Amarillo Diagnostic Clinic have some of the latest tools to diagnose and treat diseases of the esophagus, stomach, small and large intestines, liver and pancreas.  Your gastroenterologist will manage the most simple to the most complex gastrointestinal diseases. Contact us if you have any questions or to schedule an appointment.

(Some information provided by the National Canter for complementary and Integrative Health).

Precipitating Factors For Each Common Headache Type

sw-factors-for-headaches

Almost everyone has had a headache. Headaches are the most common form of pain and a major reason people miss days at work, school or take a visit to the doctor. The most common type of headache is a tension headache. Tension headaches are due to tight muscles in your shoulders, neck, scalp and jaw. They are often related to stress, depression or anxiety. You are more likely to get tension headaches if you work too much, don’t get enough sleep, miss meals, or use alcohol.

Other common types of headaches include:

 Sinus Headaches

Sinus headaches include gnawing pain over the nasal area and often increase in severity throughout the day. Pain is caused by acute infection, usually with fever, producing blockage of sinus ducts and preventing normal drainage. Fortunately, sinus headaches are rare…however, migraine and cluster headaches are often misdiagnosed as sinus in origin.

Precipitating Factors: Infection, nasal polyps, anatomical deformities, such as deviated septum that blocks the sinus ducts

Treatment: Treat with antibiotics, decongestants, surgical drainage, if necessary

Prevention: None

Arthritis Headaches

You can point out an arthritis headache by the pain at the back of head or neck which intensifies on movement. It is caused by inflammation of the blood vessels of the head or bony changes in the structures of the neck.

Precipitating Factors: Cause of pain is unknown

Treatment: Anti-inflammatory drugs, muscle relaxants

Prevention: None

Caffeine-Withdrawal Headaches

Skip your morning coffee? Caffeine withdrawal headaches include a throbbing headache caused by rebound dilation of the blood vessels, occurring multiple days after consumption of large quantities of caffeine.

Precipitating Factors: Caffeine

Treatment: Treat by terminating caffeine consumption in extreme cases.

Prevention: Avoiding excess use of caffeine.

Chronic Daily Headaches

This refers to a broad range of headache disorders occurring more than 15 days a month; two categories are determined by duration of the headache (less than four hours and more than four hours).

Precipitating Factors: Typically evolve from transformed migraine. Although not related to chronic tension-type headache, they can evolve from episodic tension-type headache. Can be associated with medication overuse.

Treatment: Depending on the type of CHD, different treatment options exist. It is important to limit analgesic use.

Prevention: Based on diagnosis of headache, how long they last, and the number experienced per month.

Depression and Headaches

Depression seems to be especially closely linked to certain kinds of chronic pain in the body, including migraine headaches, severe non-migraine headaches, and lower back pain.

Precipitating Factors: Causes can originate from a wide variety of complaints that can be categorized as physical, emotional, and psychic.

Treatment: The presence of depression is often subtle and the diagnosis is frequently missed. Depression is a wide spread affliction that can be treated, but first it must be unmasked.

Prevention: Physicians can prescribe tricyclic antidepressants, selective serotonin re-uptake inhibitors, or monoamine oxidize inhibitors in the treatment of headaches associated with depression.

 Exertional Headaches

Symptoms of exertional headaches include generalized head pain of short duration (minutes to an hour) during or following physical exertion (running, jumping, or sexual intercourse), or passive exertion (sneezing, coughing, moving one’s bowels, etc.)

Precipitating Factors: Ten percent caused by organic diseases (aneurysms, tumors, or blood vessel malformation). Ninety percent are related to migraine or cluster headaches.

Treatment: Cause must be accurately determined. Most commonly treated with aspiring, indomethacin, or propranolol. Extensive testing is necessary to determine the headache cause. Surgery is occasionally indicated to correct the organic disease.

Prevention: Alternative forms of exercise; avoid jarring exercises

Fever Headaches

Fever headaches include generalized head pain that develops with fever and is caused by the swelling of the blood vessels of the head.

Precipitating Factors: Caused by infection

Treatment: Aspirin; acetaminophen; NSAIDs; antibiotics

Prevention: None

Hangover Headaches

Migraine-like symptoms of throbbing pain and nausea, but it is not localized to one side. Hangovers can last up to 72 hours after drinking, but most are shorter in duration. Again it depends on how much was consumed, how dehydrated you became, nutritional status, ethnicity, gender, the state of your liver, medications, etc.

Precipitating Factors: Alcohol, which causes dilation and irritation of the blood vessels of the brain and surrounding tissue.

Treatment: Liquids (including broth); consumption of fructose (honey, tomato juice are a good source)

Prevention: Drink alcohol only in moderation

Hunger Headaches

Have you ever experienced pain that strikes just before mealtime? Chances are it’s a hunger headache, and it is caused by muscle tension, low blood sugar, and rebound dilation of the blood vessels, oversleeping, or missing a meal.

Precipitating Factors: Strenuous dieting or skipping meals

Treatment: Regular, nourishing meals containing adequate protein and complex carbohydrates

Prevention: Regular, nourishing meals containing adequate protein and complex carbohydrates

Hypertension Headaches

Generalized or “hair band” type pain that is most severe in the morning. It diminishes throughout the day. Very high blood pressure can trigger an event known as malignant hypertension. Malignant hypertension is also referred to as a hypertensive crisis. … In addition to a headache, malignant hypertension usually is also associated with blurred vision, chest pain, and nausea.

Precipitating Factors: Severe hypertension: over 200 systolic and 110 diastolic

Treatment: Treat with appropriate blood pressure medication

Prevention: Keep blood pressure under control

Menstrual Headaches

For some women, Migraine-type pain that occurs shortly before, during, or immediately after menstruation or at mid-cycle (at the time of ovulation). The cause or trigger is thought to be the fall of the level of estrogen. The blood level of this chemical (hormone) falls just before a period. It is not a low level of estrogen that is thought to be the trigger.

Precipitating Factors: Variances in estrogen levels

Treatment: Taking a magnesium supplement might make your headaches shorter and your periods easier. But talk to your doctor before you start using it. It’s also a good idea to limit how much salt you eat before your period starts so your body doesn’t hang on to water in your tissues, which could create extra pressure.

Prevention: Biofeedback; beta blockers (propranolol, timolol); anti-convulsant (divalproex sodium); calcium blockers; and NSAIDs

For many people, finding out what triggers a headache or migraine can help them avoid or lessen the effects of their headache symptoms. Fortunately, we can help. Contact us if you have any questions or to schedule an appointment.

(Some information provided by the National Headache Foundation).

Learn How You May Help Break the Routine of Coping with RLS

adc-rls

You may think you’re managing to cope with your Restless Legs Syndrome (RLS). You may even be getting treatment or taking medication for it. But the truth is, if you’re dealing with RLS  symptoms over and over, you’re stuck in a coping routine that’s affecting your life and changing your behavior.

RLS Isn’t Just About Your Legs

Studies have shown that RLS is actually a neurological condition that causes those unusual sensations in your legs. People with RLS describe the urge to move their legs in many different ways. Two common descriptions are a tingly-tightening sensation in the legs or a creepy-crawly feeling under the skin.

If you’ve ever experienced these symptoms, you know how frustrating RLS can be. Just when you’re about to relax, you feel uncomfortable sensations that give you the urge to move your legs. The symptoms can appear any time but most often occur in the evening or at night when you’re trying to rest. If you recognize these symptoms, discuss them with your doctor:

  • An urge to move the legs, usually accompanied or caused by uncomfortable and unpleasant leg sensations
  • Symptoms begin or worsen during periods of rest or inactivity such as lying or sitting
  • Symptoms are partially or totally relieved by movement, such as walking or stretching, at least as long as the activity continues.
  • Symptoms are worse or occur only in the evening or at night

Talk To Us

Only your doctor can diagnose RLS, so if you are experiencing the symptoms discussed above, we can help you find out for sure. It’s important for your doctor to know as much as possible when it comes to making a diagnosis, so be sure to:

  • Discuss the symptoms you’re having
  • Tell your doctor about your medical history, and if anyone in your family has RLS
  • Tell your doctor about any medications you’re taking, including over-the-counter and prescription, as well as any herbal or vitamin supplements.

Treatment Options

There are two types of RLS: primary RLS, a chronic condition that can be hereditary, and secondary RLS, which is caused by another condition (such as pregnancy or iron-deficiency) and may resolve once the underlying condition no longer exists. Only your doctor can diagnose the type of RLS you may have and provide appropriate treatment options.

Now that you know that RLS is a neurological condition, you should also know that there are treatment options that can help, including medications and non-medication options. Contact us if you have any questions or to set up an appointment.

Sleep Hygiene Rules You Actually Want To Know

adc-sleep-center-3

Sleep isn’t just “time out” from daily life. It is an active state important for renewing our mental and physical health each day. More than 100 million Americans of all ages, however, regularly fail to get a good night’s sleep.

At least 84 disorders of sleeping and walking lead to a lowered quality of life and reduced personal health. They endanger public safety by contributing to traffic and industrial accidents. These disorders can lead to problems falling asleep and staying asleep, difficulties staying awake or staying with a regular sleep/wake cycle, sleepwalking, bedwetting, nightmares, and other problems that interfere with sleep. Some sleep disorders can be life-threatening.

Sleep Hygiene Rules

These guidelines can be used for many different sleep disorders. They will help most people sleep better. For more specific guidelines for your particular sleep disorder, consult your healthcare professional.

  • Keep a regular time to get up in the morning, even on days off work and on weekends.
  • Go to bed only when you’re drowsy.
  • Leave your bedroom and engage in a quiet activity elsewhere if you are unable to fall asleep within 20 minutes. Do not permit yourself to fall asleep outside the bedroom. Return to bed when, and only when, you are sleepy. Repeat this process as often as necessary throughout the night.
  • Use your bedroom only for sleep, sex, and times sickness.
  • Avoid napping during the daytime. If you nap, try to do so at the same time every day and for no more than 40 minutes. Mid-afternoon (no later than 3:00 pm) is best for most people.
  • Establish relaxing pre-sleep rituals such as a warm bath, light bedtime snacks, or 10 minutes of reading.
  • Exercise regularly. Do not exercise vigorously any later than 6 hours before bedtime, and do mild exercises at least 4 hours prior to bedtime.
  • Keep a regular schedule. Regular times for meals, medications, chores and other activities help keep the inner clock running smoothly.
  • Avoid large meals before bedtime. A light snack before bedtime can help you sleep soundly. A large meal before bedtime can cause difficulty sleeping.
  • Avoid drinks with caffeine within 6 hours of bedtime.
  • Do not drink alcohol when sleepy. Even a small dose of alcohol can have a potent effect when combined with tiredness.
  • Use sleeping pills carefully. Most doctors avoid prescribing sleeping pills for longer than 3 weeks.
  • Do not drink alcohol while taking sleeping pills or other medications.

Some symptoms of a sleep disorder can include:

  • Insomnia
  • Daytime sleepiness
  • Morning headaches
  • Constant leg movement
  • Gasping episodes at night
  • Overweight/obesity
  • Hypertension
  • Loud snoring
  • Dry mouth, sore throat
  • Forgetfulness
  • Loss of energy

Good sleep hygiene and medications are aimed at improving the soundness of a person’s sleep. Contact us if you have any questions or to schedule and appointment.

 

Flexible Sigmoidoscopy: Why It Might Be For You

adc-round-2

A flexible Sigmoidoscopy is a procedure in which a physician looks at the anus, rectum and lower part of the large intestine through a small scope or tube called an endoscope. This test helps find abnormal growths such as tumors or polyps, hemorrhoids, areas of inflammation or bleeding and other conditions.

Why Should I Have a Flexible Sigmoidoscopy?
This procedure can help find abnormal growths such as tumors or polyps, hemorrhoids, areas of inflammation or bleeding and other conditions.

WHAT INDICATORS DO I NEED TO CONSIDER?

WHAT DISEASES OR ILLNESSES CAN BE FOUND?

  • Diarrhea
  • Rectal bleeding
  • Rectal pain
  • Hemorrhoids
  • Infectious diarrhea

Endoscope
A thin flexible instrument used to visualize the inside of your rectum and colon. It can be used to collect a biopsy (small growths and tissue samples) and contains a small camera with a light on the end to videotape and capture images.

Preparation
Your physician or nurse will give you instructions on preparing for this procedure.

You may receive sedation, which will require that you have someone available to drive you home after the procedure. There are some instances in which sedation is not given.

IMPORTANT: Please tell your nurse if you are allergic to: Fentanyl, Versed, Demerol or Phenergan. We ask that you also inform us in advance if your health history has changed in any way since you last saw your GI physician.

Upon Admission

  • Your nurse will take your blood pressure, temperature and other vital signs
  • You will be asked about pain of any kind
  • Your nurse will go over all of the forms that will need to be filled out
  • Your medications and allergies to medications will be reviewed
  • An IV will be started
  • An assessment will be completed

The Procedure

  • Monitors will be placed on you in order that we may monitor your blood pressure, heart rate and oxygen saturation.
  • You will be placed on a small amount of oxygen through a nasal cannula.
  • Medications will be given by physicians orders throughout the procedure (medications most commonly used are Demerol; Versed; Fentanyl; and Phenergan). Please notify your nurse if you are allergic to any of these medications.
  • Your physician may take biopsies, remove polyps or perform treatment during the procedure (specimens will be sent for testing and your physicians office will call you with the results).
  • The procedure will usually take an average of 30-45 minutes.

We require that the person accompanying you remain at the Center during your procedure and to drive you home after your procedure. If you have any valuables with you, we will ask that you give them to the person accompanying you. Remember to ask any questions that you may have at any time.

Recovery
You will remain in recovery for at least 30 minutes. The nurse will take your temperature, vital signs and do an assessment and the physician will talk to you about your procedure. If appropriate, you will then be given fluids to drink.

Discharge
Discharge instructions will be reviewed with you and the person accompanying you and will include all of the following:

  • Do not operate machinery or heavy equipment for 24 hours
  • Do not drink alcohol for 24 hours
  • Drink plenty of other fluids
  • Avoid any foods that are greasy or spicy for the first meal
  • Call your physician if you experience severe abdominal pain, nausea, vomiting or bleeding.

You may be very sleepy at the time of discharge. You are encouraged to go home and rest for the rest of the day. Any special instructions from your physician will be written on the discharge sheet. Your physician will determine if follow-up is needed. Contact us if you have any questions or to schedule an appointment.