Diabetes management can be a difficult task for a patient. When a patient is followed closely with their primary care and endocrinologist, this diagnosis can easily be managed. Diabetes management requires awareness of your blood sugar levels and how to be aware of certain factors that can contribute to your diabetes management.
Exercise
Physical activity is a key aspect of proper Diabetes management. When a patient exercises they are able to use sugar for energy when working their muscles. Regular physical activity has been shown to help the body use insulin more effectively. All of these factors help the patient to regulate their blood sugar levels.
Talk to your doctor about an exercise plan
Keep a regular exercise schedule
Know your blood sugar levels
Check your blood sugar level before and after exercise
Always stay hydrated
Keep a small snack with you at all times
Medication
Store insulin properly
Date all insulin that is opened
Be mindful of new medications that you are prescribed and keep a record of your blood sugar levels
Report any changes to your physician
References
Down, S. (2020). New advice on frailty and type 2 diabetes management: A great start to the year! Journal of Diabetes Nursing, 24(1), 1–3.
Rosenberg, Y. Z. R. S., Verweel, L., Gionfriddo, M. R., MacCallum, L., & Dolovich, L. (2018). Community pharmacists’ perspectives on shared decision‐making in diabetes management. International Journal of Pharmacy Practice, 26(5), 414–422. https://doi.org/10.1111/ijpp.12422
Tazhbenova, S. T., Millere, I., Yermukhanova, L. S., Sultanova, G., Turebaev, M., & Sultanova, B. P. (2019). Effectiveness of diabetes mellitus management program at primary health care level. Electronic Journal of General Medicine, 16(6), 1–6. https://doi.org/10.29333/ejgm/115848
Across the country, many teens partake in ritualistic drinking with their peers. Underage drinking is enriched in American culture, and overflowing in our media. If you watch any television series surrounding the lives of American teenagers, you find these children participating in drinking after football games, or sneaking a flask of liquor into the prom. Television and such, do not show the true dangers of drinking.
Accidents such as motor vehicle accidents, are the leading cause of death for teens aged 16-20. We all know how dangerous it can be when you drive drunk, and can lead to a fatality. 1/3 of all drunk driving deaths occur with drivers aged 16-20. That is an astounding statistic considering it is not even legal for the teen to obtain the alcohol.
Many teenagers don’t seem to think about the effects that alcohol can have on their young developing bodies. Teenagers possess an superiority complex, where they do no believe that anything bad can happen to them. Teens believe they are invincible. When you take a peak at the statistics, the facts of what can happen to a teens body is astounding. Not only does it have an awful effect on the body’s digestive system, the reproductive system, your skin, it has an everlasting damaging effect on a teens developing brain. While teens are partaking in drinking, their young brains are still developing, which can lead to the effects of alcohol lasting a lifetime.
A young brain is still developing, and is not fully formed well into a persons twenties. Alcohol, especially binge drinking, can have a lasting effect on the teens body. Drinking while the brain is still developing, can lead to permanent structural and functional damage to the brain. As you can see, alcohol can have devastating effects to a young persons life. It can lead to brain abnormalities, digestive issues, criminal charges, or even death.
According to the CDC Lyme disease is the most common vector borne illness in the United States and can cause some serious problems for its victims. Unfortunately there are at least a dozen other bacterial infections (some deadly) that can be transmitted as well. The media has discussed tick transmitted illnesses in fictional television shows, educational shows, and the news, but are they reliable?
Source 1: House (fictional television show)
Claims by Show:
Ticks can cause paralysis and it can be instantly cured by removal of the tick
Death can result from cardiac arrest
According to Tick Paralysis by Edlow and Mcgillicuddy tick paralysis is cured by removing the tick. The article researched accounts as far back as 1824 and found 2 recorded deaths out of Washington state. This situation is extremely rare and usually found in livestock were infestations occur. It usually occurs in young girls which the tv show used but unlike the show the heart is not affected. Death occurs from respiratory paralysis. After reading the article, the show clearly did its homework but maybe switched the cause of death to make things more suspenseful.
This video talked about people getting tick bites, Lyme disease infection, and prevention. It was informative and interesting as it utilized interviews from first hand accounts. The video was extremely informative and is backed by the research of Prevention of Tick-Bourne Illness by Gutiérrez & Decker and Lyme Disease by E Sharpio including:
Symptoms such as fatigue, headache, arthralgia, myalgia, and less often, fever
Prevention
Deet
Permethrin
Clothing
Source 3: CBS News (Informational)
CBS used everything from the CDC website. They were correct on all their statements which Prevention of Tick-Bourne Illness by Gutiérrez & Decker and Lyme Disease by E Sharpio confirm:
Pulling ticks off with tweezers is best by removal
Ticks carry many serious diseases, not just Lyme.
To help prevent tick bites:
Wear deet repellant
Mice are reservoirs
Tuck pants into boots or socks
Avoiding tall grass and performing tick checks
CBS failed to portray were ticks are distributed as well as other species of ticks which cause harm to humans and their pets. However, this could be overlooked by their main message of ticks being located were you live and that you should take preventative measures to protect your loved ones and yourself.
Bottom Line:
Aside from the tv show House not putting out the proper information on a symptom, the main message from all three media sources is clear: ticks can be a very serious threat to our health. However, with easy preventative measures, nobody should be afraid of going outside!
References
CDC, NCEZID (2019, November 4). Ticks. Retrieved February 19, 2020, from https://www.cdc.gov/ticks/
Edlow, J., & Mcgillicuddy, D. (2008). Tick Paralysis. Infectious Disease Clinics of NorthAmerica, 22(3), 397-413.
Gutiérrez, R., & Decker, C. (2012). Prevention of Tick-Borne Illness. Disease-a-Month, 58(6), 377-387.
Shapiro, E. (2014). Lyme Disease. The New England Journal of Medicine, 370(18), 1724-1731.
Have you heard of people making the switch to a vegan diet? Even NFL players such as Andre Patton and Griff Whalen have made the switch from an omnivore diet to a vegan diet!
Suddenly, being vegan is more than a “hipster” diet, it could actually be beneficial to anyone. Becoming vegan can be for multiple reasons such as improving your health or supporting animal rights. For those who want to improve their health, this blog will explain the positive effects a vegan diet can have on you. Before getting into the positive effects of this diet, let’s discuss what veganism is about.
What is Veganism?
Veganism is a diet omitting animal products and animal by-products. Examples of omitted foods are
chicken
beef
veal
fish
milk
cheese
eggs
Taking away all of these foods?! What could one possibly eat without them!
Foods you could eat when following a vegan diet are:
Following a vegan diet can have numerous benefits on your health. A plant-based diet can reduce the risk of heart disease, stroke, obesity, and some types of cancers (“Academy of Nutrition”, 2017). Studies have shown a vegan diet decreased participants saturated fat intake, resulting in a decreased risk of cardiovascular diseases, diabetes, and cancer. The study also determined there was a component of dairy products which increased the risk of prostate cancer (Mengels, 2008). Another study showed participants following a vegan diet reported fewer feelings of anxiety and depression than those who did not follow a vegan diet (Beezhold, Radnits, Rinne & DiMatteo, 2015). View the clip below to learn more about how a vegan diet will benefit your health!
Are you convinced yet? Are you ready to make the switch? Below is a video on a “starter pack” providing you with the necessary information to transition into a vegan diet.
How easy will it be for you to make the change and take control of your diet?
References
Academy of Nutrition and Dietetics Weighs In Vegan Diets Are Good for Health. (2017). Good Medicine, 26(1), 9.
Beezhold, B., Radnitz, C., Rinne, A., & DiMatteo, J. (2015). Vegans report less stress and anxiety than omnivores. Nutritional Neuroscience, 18(7), 289–296. https://doi.org/10.1179/1476830514Y.0000000164
Mangels R. (2008). Vegan diet offers health benefits. Vegetarian Journal, 27(4), 20.
A lot of controversy these days has stemmed around whether or not to vaccinate and if vaccines actually work. To understand how vaccines work, it is important to know how exactly your body fights illness and disease.
How does the body fight off illness and disease:
When a bacteria or virus enters the body, it immediately begins to multiply, this invasion is what causes illness. Your bodies immune system uses white blood cells (WBC) to fight off infection (CDC, 2018). The WBC responsible for fighting off infection include:
Macrophages: Involved in phagocytosis (or cell eating of bacteria or dead cells)
B-lymphocytes: Produce antibodies to attack antigens
T-lymphocytes: Attack cells in the body that have already been infected
After an infection subsides, your immune system’s T-lymphocytes (or memory cells) remembers what is learned about how to protect your body from that disease. This allows the body to respond quicker once it comes in contact with the disease again (CDC, 2018).
Now that you know more of how the body fights illness and disease, its time to learn how exactly vaccines work:
Vaccines work by establishing an immune response that recognizes a pathogen when it enters the body. To do this the pathogen is introduced into the body in a form in which it imitates an infection. This allows you body to build up immune defenses to combat the virus or bacteria. This immune response builds up your bodies memory T-lymphocytes and B-lymphocyte antibodies to help your body fight infection and disease when it arises again (CDC, 2018).
Types of vaccines available:
Live attenuated: Contain a version of the virus or bacteria that has been weakened, most similar to natural infection without causing serious disease. Examples include- MMR and Varicella
Inactive vaccines: bacteria or virus is killed or inactivated, can require multiple doses. Examples- Polio vaccine
Toxoid vaccines: toxins are weakened so they cannot cause illness. Examples- DTaP and Tetanus
Subunit vaccines: include only part of the virus or bacteria instead or entire germ. Examples- whooping cough vaccine
Conjugate vaccine: have antigens with outer sugar coating, which help to link this coating in the immune system to an antigen to develop an immune response. This is used in young children with immature immune responses. Example: Hib vaccine
All Vaccines have their side effects, but these tend to be mild, making the benefits of vaccinating better then the possible negative effects that could occur (CDC, 2018).
Benefits of vaccines
Vaccinating helps prevent, preventable disease that could cause death
Help reduce the risk of infection
Builds up your bodies immune response
Decreases health care related costs and visits
(CDC, 2018)
3 Common Myths Associated with Vaccines:
There is a link between autism and vaccinations.
Many parents believe that vaccines can cause health risks to their children and also they tend to have negative views of pharmaceutical companies. The doctors in this article “Vaccines do not cause autism: Pediatricians fight back against anti-science by Knopf”, go on to defend vaccinations, specifically MMR, stating that not vaccinating your child can lead them to contract the disease and die. The doctors state that the vaccination works with the body’s natural defenses to help it safely develop immunity to the measles (Knopf, 2017). Also, when more people are vaccinated, there are fewer opportunities for the disease to spread (Knopf,2017). The article then goes on to provide evidence by the CDC, stating how there is no evidence linking vaccines to autism. The main point of this article was to debunk rumors posed against vaccines, because not vaccinating is always worse and it can also be deadly.
2. Children have adverse reactions to vaccinations, specifically MMR because they are given to many at once.
The article of the tale of shifting hypotheses on vaccines and autism does a great job in debunking this myth. The article gives various reasons throughout on why it would not be possible to link autism and to many vaccines given to children too soon. The article states that first, vaccines do not overwhelm the immune system of an infant. The article explains that an infant’s immune system is capable of generating protective responses and can detect the capacity to respond to vaccines simultaneously (Gerber, 2009). The article then goes on to explain that multiple vaccines do not weaken the immune system and that autism in fact is not even an immune-mediated disease (Gerber, 2009). The article explains that there is no scientific evidence supporting the facts that there is immune activation of inflammatory lesions in the CNS of people with autism (Gerber, 2009). Thus the speculations posed against vaccinations in single or multiple doses, is highly inappropriate and not true, based on the findings of this article.
3.The CDC has known all along there was a risk for autism with vaccines.
The third article I chose was all about the MMR vaccine, which was the particular target for these autism assumptions. The article explains how the vaccine is given, it states that the vaccine is given in 2 doses, the first dose at the age of 12-15 months, and the second dose at preschool age (MAHMIĆ-KAKNJO, 2017). These are the most prevalent years to be seeing signs of the disease, which is why allegations could be made. The article then explains how the vaccine is 92% effective in the prevention of measles (MAHMIĆ-KAKNJO, 2017). Most importantly that there is no drug on the market without side effects, and specifically this vaccine does not even have a side effect of autism or anything to do with it.Therefore theMMR vaccine is safe, effective and the most inexpensive prevention of the 3 viral diseases and parents should trust their doctors and vaccinate their children.
Vaccines are a great medical advancement in preventing the spread disease and possible death. Now that you know all the contributing factors on how vaccines exactly work and why myths that link vaccines to be the causation of autism in children are just not true, I hope you decide to vaccinate today!
References:
“Understanding How Vaccines Work.” CDC.gov, Cdc, 1 July 2018, www.cdc.gov/vaccines/hcp/conversations/downloads/vacsafe-understand-color-office.pdf.
Knopf, A. (2017). Vaccines do not cause autism: Pediatricians fight back against anti-science. Brown University Child & Adolescent Behavior Letter, 33, 1–2. https://doi.org/10.1002/cbl.30195
Gerber, J. S., & Offit, P. A. (2009). Vaccines and autism: a tale of shifting hypotheses. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 48(4), 456–461. doi:10.1086/596476
MAHMIĆ-KAKNJO, M., RUSTEMPAŠIĆ, E., & HADŽIĆ, E. (2017). Measles-Mumps-Rubella (Mmr) Vaccine – Benefits and Risks Revisited. Pedijatrija Danas: Pediatrics Today, 13(1), 42–45. https://doi.org/10.5457/p2005-114.168
You’ve recently been diagnosed with congestive heart failure (CHF) or have had multiple admissions to the hospital, so now what? I’m going to tell you some of the basics, so you’ll be more informed and know what to do to prevent having to go back to the hospital.
Let’s get started…
CHF means your heart can’t pump enough blood to meet the demands of your body. This may cause you to be short of breath, tired, or even have some swelling in your legs called edema. Never fear, a video with a good explanation is here.
How do you prevent these symptoms?
1. Take your meds! You may have been prescribed a diuretic. This takes out some of the extra fluid from your body making it easier for your heart to pump. You may also be on blood pressure medications. Make sure to take these every day.
2. Know the importance of exercise! Slowly work your way up to walking a mile. Moderate exercise is great for the heart.
3. Watch your salt! The more salt you eat, the more fluid your body will hold on to. The dietician in this video does a great job of describing this. Also, eat a low-fat low cholesterol diet.
4. Monitor your progress! Weigh every day, preferably in the morning after you’ve gone to the bathroom. If you start to see an increase in your weight over a few days, let your doctor know.
Carpometacarpal (CMC) arthritis/ basal joint arthritis is the most common form of osteoarthritis of the hand. Osteoarthritis is a degenerative joint disease that affects the base of your thumb, causing functional disability and pain, particularly with “pinching” actions.
As a health professional (COTA/L) working in an outpatient orthopedic hand therapy practice, I would say this is one of the most common conditions seen.
Below is a video describing CMC arthritis/ basal joint arthritis.
Who gets it?
CMC arthritis/ basal joint arthritis can affect both men and women, but according to Dias et al. (2006), this condition is seen predominately in postmenopausal women >50 years of age, with a female to male ratio of 6:1. This correlation between osteoarthritis and menopause is a cause of concern for women undergoing postmenopausal hormonal changes.
The International Menopause Society has identified the significant impact of osteoarthritis on women. Data collected from a multidisciplinary hand clinic in London found that 80% of the patients were predominately women who had either developed their symptoms within four years of entering menopause or opted to discontinue their menopause hormone therapy (MHT) (Fenton & Panay, 2010).
CMC arthritis/ basal joint arthritis can occur as a result of normal wear and tear of the joint cartilage due to natural signs of aging. Other causes can arise due to trauma or injury to the thumb joint. Hormonal changes may also result in laxity (loose) and unstable ligaments. According to Anakwe & Middleton (2011), it is unclear why this site is mostly affected but appears to be related to the large forces created at the thumb joint with pinching and grasping activities.
What are the signs and symptoms?
Localized pain and swelling at the base of the thumb, aggravated by repetitive forceful pinching.
Tenderness to the touch.
Daily activities requiring grip and pinch, such as opening jars, bottle tops, turning doorknobs, and writing can become limited due to pain, weakness, and joint instability.
Symptoms can occur in both thumbs.
This video below describes the joint structure in a little more detail.
How is it diagnosed and treated?
Most patients who are experiencing localized pain at the base of their thumb will seek out care from their medical providers, which includes primary care doctors, rheumatologists, or orthopedic hand surgeons. The medical providers will begin by making a diagnosis based on history, clinical assessment, and plain radiographs (X-rays). Radiographs help to stage the progression of the disease.
*Note: Other possible causes of pain at the base of the thumb include carpal tunnel syndrome, scaphoid arthritis, and de Quervain’s tenosynovitis.
Once your medical provider has confirmed a diagnosis, the next step is treatment, typically that would involve conservative (non-operative) treatment.
The process consists of:
A referral to a hand therapist or occupational therapist (these therapists specialize in hand disorders). The therapists will perform an initial evaluation to establish a care plan that consists of client-centered goals and treatment approaches specific to your care.
Activity modifications: (these are simple modifications by the patient that can effectively reduce pain such as the use of less forceful pinching, alternate hand use and switching to a larger diameter writing instrument)
Splinting:(to rest and immobilize the base of the thumb to help with pain relief and daily functional hand use)
*Note: There are different types of splints commonly used in the treatment of CMC arthritis/ basal joint arthritis. These include:
• Custom fabricated splints: These splints are molded for each patient by the hand or occupational therapist using thermoplastic material that has been heated in a splint pan.
• Prefabricated splints:These splints can be purchased from a pharmacy, medical supply company, or online. Sometimes your medical provider will issue you the splint.
Non-steroidal anti-inflammatory drugs: (for pain and symptom management)
Exercise: (to improve thenar muscle strength and thumb stability, and range of motion of the joint)
Patient education: (to learn ways to manage your symptoms)
Indications for surgery:
When conservative (non-operative) treatments fail, and the pain becomes persistent and functionally disabling, that is an indication to seek a prompt referral to a hand surgeon.
The goals of surgery are to decrease pain, improve functional use of the affected hand, and defer the degenerative disease progression. There are different surgical procedures performed for this type of arthritis. One of the most preferred procedures by hand surgeons is called Thumb CMC arthroplasty, which involves removing the small wrist bone that is part of the CMC joint and replacing it with a wrist flexor tendon.
The video below provides more detail regarding conservative and operative treatment.
Benefits of treatment:
There are many benefits to having conservative (non-operative) treatment such as reducing pain, improving function, although these treatment approaches are not curative, they can help to delay surgery in most patients. For many patients, the idea of not having to undergo surgery makes conservative treatment all worthwhile.
One designed prospective study reported on 33 patients treated with hand therapy, splinting, and anti-inflammatory medication while awaiting surgery. The symptoms were greatly improved in 70% of the patients causing them to refuse surgery after seven months of treatment (Anakwe & Middleton).
So, going back to the question of whether conservative treatments help manage thumb pain. I would have to say yes. I have seen first-hand the benefits of conservative treatment with my patients in the outpatient orthopedic hand therapy practice. Surgery is not the only option and should be used solely as a last resort, as stated above, but it is always important to discuss appropriate treatment options with your medical provider.
References
Anakwe, R. E. & Middletown, S. D. (2011). Osteoarthritis at the base of the thumb. British Medical Journal, 343, 1160-1166.
Dias, R., Chandrasenan, J., Rajaratnam, V. & Burke, F. D. (2007). Basal thumb arthritis.Postgraduate Medical Journal, 83, 40-43.
Fenton, A. & Panay, N. (2016). Estrogen, menopause and joints. Climacteric, 19(2), 107-108.
From medical shows, to series about teachers-turned-drug-dealers, to movies about sarcastic superheroes who love chimichangas, one thing comes to mind of how a person first learns they have cancer- they faint. Television of course needs dramatic visualizations for dramatic events, but is really how people first find out they have cancer?
Jiang, X., Zhao, J., Bai, C., Xu, E., Chen, Z., & Han, Y. (2016). Small-cell lung cancer with recurrent syncope as the initial symptom: A case report and literature review. Molecular and clinical oncology, 5(5), 545–549. https://doi.org/10.3892/mco.2016.1032
Kauffmann, H, 2019. Mechanisms, causes, and evaluation of orthostatic hypotension. In M. Aminoff & J. Wilterdink (Ed.), UpToDate. Retrieved from: https://www.uptodate.com/contents/mechanisms-causes-and-evaluation-of-orthostatic-hypotension
Scheel, B. I., & Holtedahl, K. (2015). Symptoms, signs, and tests: The general practitioner’s comprehensive approach towards a cancer diagnosis. Scandinavian journal of primary health care, 33(3), 170–177. https://doi.org/10.3109/02813432.2015.1067512
Stone, C. A., Kenny, R. A., Nolan, B., & Lawlor, P. G. (2012). Autonomic dysfunction in patients with advanced cancer; prevalence, clinical correlates and challenges in assessment. BMC palliative care, 11, 3. https://doi.org/10.1186/1472-684X-11-3
A numbness and tingling in the hand and arm caused by a pinched nerve in the wrist.
Wrist anatomy, underlying health conditions, and patterns of hand use can contribute to carpal tunnel syndrome
Symptoms
Pain areas: in the hands, wrist, or forearm
Also common: hand numbness, sensation of pins and needles, hand clumsiness, hand pain at night, hand weakness, or wrist weakness
Surgery
During open carpal tunnel release surgery, the transverse carpal ligament is cut, which releases pressure on the median nerve and relieves the symptoms of carpal tunnel syndrome. An incision is made at the base of the palm of the hand. … After the ligament is cut, the skin is closed with stitches.
Wheeler, T. (2019, March 14). Symptoms of Carpal Tunnel Syndrome: What It Feels Like. Retrieved from https://www.webmd.com/pain-management/carpal-tunnel/symptoms-of-carpal-tunnel-syndrome
Sensory processing dysfunction can affect a child or individual in a variety of ways. Normal functioning children can experience symptoms associated with sensory processing disorder(SPD), also known as sensory integration dysfunction (Sweet, 2010). In this disorder, the individual is not able to process sensory information that they receive in their senses (Sweet, 2010). This can correlate to difficulty with learning, developing behaviors, or decrease functional performance in their daily lives (Sweet, 2010). SPD is linked with Autism Spectrum Disorder, Attention Deficit Hyperactivity Disorder, Fragile X Syndrome, Down Syndrome, and other developmental or neurological disorders (Sweet, 2010).
Types of Sensory Dysfunction
Over Responsive:
high energy
impulsive
aggressive
overstimulated
Under Responsive:
fearful
anxious
calm
lazy
Sensory Avoidant:
flat affect
passive
anti-social
Sensory Seeking:
overexcited with stimuli
impulsive
risk taker
loud
The videos below provides useful information regarding the specific signs and symptoms a child with sensory processing disorder or dysfunction may present with.
Treatment:
Professionals that can help children that are negatively affected by sensory processing issues include Psychologists, Occupational Therapists, Pediatricians, and School evaluators.
Treatment interventions include:
Adapting the individuals environment to allow for child to focus or have an area where they can decompress.
Utilize compensatory strategies to decrease negative behaviors and help the child cope with difficulties they have related to sensory processing.
Educate caregiver and child about sensory strategies to help child compensate.
Learn triggers and effective strategies child and family can use to address individual sensory issues.
Resources:
Dunstan E, & Griffiths S. (2008). Sensory strategies: practical support to empower families. New Zealand Journal of Occupational Therapy, 55(1), 5–13. Retrieved from http://search.ebscohost.com/login.aspx?direct=true &db=ccm&AN=105760656&site=ehost-live
Resources for Families. (n.d.). Retrieved January 25, 2020, from https://childmind.org/audience/for-families/
Sweet, M. (2010). Helping Children with Sensory Processing Disorders: The Role of Occupational Therapy. Odyssey: New Directions in Deaf Education, 11(1), 20–22.
