Sticks and Stones Break Bones, So Does the Silent Disease Osteoporosis

The World Osteoporosis Day (WOD) 2018 campaign calls for global action to improve bone health and prevent fractures due to osteoporosis, including vertebral (spine) fractures — which often remain undiagnosed and untreated.  The public, healthcare professionals and organizations worldwide are joining together to raise awareness of bone health and call for action on osteoporosis and fracture prevention in their communities.

Facts About Osteoporosis

  • Osteoporosis is ahidden, underlying cause of painful, debilitating and life-threatening fractures
  • The most common of osteoporotic fractures are spine (vertebral) fractures, a major cause of pain, disability and loss of quality of life
  • Up to 70% of spine fractures remain undiagnosed, leaving sufferers unprotected against the high risk of more fractures
  • Back pain, height-loss and stooped back are all possible signs of spine fractures – ask for testing and treatment!
  • A family history of osteoporosis and broken bones is a sign that you too may be at higher risk
  • Osteoporosis is a growing global problem that respects no boundaries: worldwide, fractures affect one in three women and one in five men over the age of 50.

 

What is Osteoporosis

Osteoporosis causes bones to become weak and brittle — so brittle a fall or even mild stresses, such as bending over or coughing, can cause a fracture. Osteoporosis-related fractures most commonly occur in the hip, wrist or spine.

Bone is living tissue that is constantly being broken down and replaced. Osteoporosis occurs when the creation of new bone doesn’t keep up with the removal of old bone.

Osteoporosis affects men and women of all races. But white and Asian women — especially older women who are past menopause — are at highest risk. Medications, healthy diet and weight-bearing exercise can help prevent bone loss or strengthen already weak bones.

 

What are the symptoms of Osteoporosis

There typically are no symptoms in the initial stages of bone loss. But once your bones have been weakened by osteoporosis, you may have signs and symptoms that include:

  • Back pain, caused by a fractured or collapsed vertebra
  • Loss of height over time
  • A stooped posture
  • A bone fracture that occurs much more easily than expected

 

What causes Osteoporosis

Osteoporosis weakens bone.  Your bones are in a constant state of renewal — new bone is made, and old bone is broken down. When you’re young, your body makes new bone faster than it breaks down old bone and your bone mass increases. Most people reach their peak bone mass by their early 20s. As people age, bone mass is lost faster than it’s created.

How likely you are to develop osteoporosis depends partly on how much bone mass you attained in your youth. The higher your peak bone mass, the more bone you have “in the bank” and the less likely you are to develop osteoporosis as you age.

 

What are the risk factors of Osteoporosis?

A number of factors can increase the likelihood that you’ll develop osteoporosis — including your age, race, lifestyle choices, and medical conditions and treatments.

Unchangeable risks

Some risk factors for osteoporosis are out of your control, including:

  • Your sex. Women are much more likely to develop osteoporosis than are men.
  • Age. The older you get, the greater your risk of osteoporosis.
  • Race. You’re at greatest risk of osteoporosis if you’re white or of Asian descent.
  • Family history. Having a parent or sibling with osteoporosis puts you at greater risk, especially if your mother or father experienced a hip fracture.
  • Body frame size. Men and women who have small body frames tend to have a higher risk because they may have less bone mass to draw from as they age.
  • Hormone levels

Osteoporosis is more common in people who have too much or too little of certain hormones in their bodies. Examples include:

  • Sex hormones. Lowered sex hormone levels tend to weaken bone. The reduction of estrogen levels in women at menopause is one of the strongest risk factors for developing osteoporosis. Men experience a gradual reduction in testosterone levels as they age. Treatments for prostate cancer that reduce testosterone levels in men and treatments for breast cancer that reduce estrogen levels in women are likely to accelerate bone loss.
  • Thyroid problems. Too much thyroid hormone can cause bone loss. This can occur if your thyroid is overactive or if you take too much thyroid hormone medication to treat an underactive thyroid.
  • Other glands. Osteoporosis has also been associated with overactive parathyroid and adrenal glands.
  • Dietary factors

Osteoporosis is more likely to occur in people who have:

  • Low calcium intake. A lifelong lack of calcium plays a role in the development of osteoporosis. Low calcium intake contributes to diminished bone density, early bone loss and an increased risk of fractures.
  • Eating disorders. Severely restricting food intake and being underweight weakens bone in both men and women.
  • Gastrointestinal surgery. Surgery to reduce the size of your stomach or to remove part of the intestine limits the amount of surface area available to absorb nutrients, including calcium.
  • Steroids and other medications

Long-term use of oral or injected corticosteroid medications, such as prednisone and cortisone, interferes with the bone-rebuilding process. Osteoporosis has also been associated with medications used to combat or prevent:

  • Seizures
  • Gastric reflux
  • Cancer
  • Transplant rejection
  • Medical conditions

The risk of osteoporosis is higher in people who have certain medical problems, including:

  • Celiac disease
  • Inflammatory bowel disease
  • Kidney or liver disease
  • Cancer
  • Lupus
  • Multiple myeloma
  • Rheumatoid arthritis
  • Lifestyle choices

Some bad habits can increase your risk of osteoporosis. Examples include:

  • Sedentary lifestyle. People who spend a lot of time sitting have a higher risk of osteoporosis than do those who are more active. Any weight-bearing exercise and activities that promote balance and good posture are beneficial for your bones, but walking, running, jumping, dancing and weightlifting seem particularly helpful.
  • Excessive alcohol consumption. Regular consumption of more than two alcoholic drinks a day increases your risk of osteoporosis.
  • Tobacco use. The exact role tobacco plays in osteoporosis isn’t clearly understood, but it has been shown that tobacco use contributes to weak bones.

 

How does osteoporosis cause vertebrae to crumple and collapse?

Bone fractures, particularly in the spine or hip, are the most serious complication of osteoporosis. Hip fractures often are caused by a fall and can result in disability and even an increased risk of death within the first year after the injury.

In some cases, spinal fractures can occur even if you haven’t fallen. The bones that make up your spine (vertebrae) can weaken to the point that they may crumple, which can result in back pain, lost height and a hunched forward posture.

How can you prevent Osteoporosis?

Good nutrition and regular exercise are essential for keeping your bones healthy throughout your life.

Protein

Protein is one of the building blocks of bone. And while most people get plenty of protein in their diets, some do not. Vegetarians and vegans can get enough protein in the diet if they intentionally seek suitable sources, such as soy, nuts, legumes, and dairy and eggs if allowed. Older adults may also eat less protein for assorted reasons. Protein supplementation is an option.

Body weight

Being underweight increases the chance of bone loss and fractures. Excess weight is now known to increase the risk of fractures in your arm and wrist. As such, maintaining an appropriate body weight is good for bones just as it is for health in general.

Calcium

Men and women between the ages of 18 and 50 need 1,000 milligrams of calcium a day. This daily amount increases to 1,200 milligrams when women turn 50 and men turn 70. Reliable sources of calcium include:

  • Low-fat dairy products
  • Dark green leafy vegetables
  • Canned salmon or sardines with bones
  • Soy products, such as tofu
  • Calcium-fortified cereals and orange juice

If you find it difficult to get enough calcium from your diet, consider taking calcium supplements. However, too much calcium has been linked to kidney stones. Although yet unclear, some experts suggest that too much calcium especially in supplements can increase the risk of heart disease. The Institute of Medicine recommends that total calcium intake, from supplements and diet combined, should be no more than 2,000 milligrams daily for people older than 50.

Vitamin D

Vitamin D improves your body’s ability to absorb calcium and improves bone health in other ways. People can get adequate amounts of vitamin D from sunlight, but this may not be a reliable source if you live in a high latitude, if you’re housebound, or if you regularly use sunscreen or avoid the sun entirely because of the risk of skin cancer.

Scientists don’t yet know the optimal daily dose of vitamin D for each person. A good starting point for adults is 600 to 800 international units (IU) a day, through food or supplements. For people without other sources of vitamin D and especially with limited sun exposure, a supplement may be needed. Most multivitamin products contain between 600 and 800 IU of vitamin D. Up to 4,000 IU of vitamin D a day is safe for most people.

Exercise

Exercise can help you build strong bones and slow bone loss. Exercise will benefit your bones no matter when you start, but you’ll gain the most benefits if you start exercising regularly when you’re young and continue to exercise throughout your life.

Combine strength training exercises with weight-bearing and balance exercises. Strength training helps strengthen muscles and bones in your arms and upper spine, and weight-bearing exercises — such as walking, jogging, running, stair climbing, skipping rope, skiing and impact-producing sports — affect mainly the bones in your legs, hips and lower spine. Balance exercises such as tai chi can reduce your risk of falling especially as you get older.

Swimming, cycling and exercising on machines such as elliptical trainers can provide a good cardiovascular workout, but they’re not as helpful for improving bone health.

When to see a doctor

You may want to talk to your doctor about osteoporosis if you went through early menopause or took corticosteroids for several months at a time, or if either of your parents had hip fractures.

You’ll probably first bring your symptoms to the attention of your family doctor, who may refer you to a rheumatologist — a doctor specializing in the treatment of diseases of the joints, muscles and bone. To get the right help, find a rheumatologist or other physician who knows how hard it is to endure bone deteriation.  Go to HealthLynked.com today to build a Free patient profile and begin communicating there with those who will collaborate on your wellness.

Sources adapted from:

mayoclinic.org

 

 

It’s PB&J Day, but It’s Not What You Think

Today is World Pediatric Bone and Joint (PB&J) Day, created by the multi-disciplinary Pediatric Specialty Group of the United States Bone and Joint Initiative (USBJI).  The United States Bone and Joint Initiative Group’s goal is to identify the primary areas of concern with regard to children’s musculoskeletal health, including those that relate to other health issues, and to develop programs and activities through research, education and advocacy to promote improved health and reduce the burden of disease.

  • Nearly 48% of adults have a musculoskeletal condition, many of which began in childhood.
  • Children represent 10% of the population with a disabling musculoskeletal condition.

Since 2012, this day has been set aside to urge doctors and parents to recognize the effects of musculoskeletal issues in children, and take action, so they do not lead to lifelong challenges. While every year has had its own theme, there has been an ongoing focus on obesity.  The percentage of children who are overweight or obese has more than tripled since 1980, rising from 7 percent  to nearly 30 percent today. Obesity can affect bones and joints at an early age.

In addition, a child who is overweight may not consistently eat foods rich in vitamin D, calcium and other important nutrients which contribute to healthy bones and joints. The child’s weight may lead him or her not to want to exercise and build bone mass, critical to maintain and improve their health.  All these may cause undue stress on the musculoskeletal system and can impair growth and contribute to serious childhood or lifelong conditions.

 

10 Tips to Keep Bones and Joints Healthy

 

As the summer comes to an end and the weather starts to cool, we find our kids indoors more often clutching video games or deep in social media. That means less physical activity. Any change in activity makes us more susceptible to joint- and bone-related issues. It is important we guide children in healthy living and activity to prevent damage, reduce pain, and improve their overall quality of life and health.

Following are 10 Tips we can all benefit from:

Exercise to protect and strengthen your joints. Overall, by strengthening muscles and aiding in weight loss, exercise can reduce the strain on joints. Squats and lunges, as well as certain exercises with weights, can help strengthen quadriceps and reduce the pressure on knees. Weight-bearing exercise such as walking also helps maintain bone density, no matter a person’s age. However, note that running and other high-intensity exercise may damage joints and ligaments, leading to inflammation, pain and, eventually, arthritis.

Stretch and warm up prior to exercising. Our bodies need to be warmed up in order to work properly and avoid excess injuries. This allows our tendons to flex and become suppler, helps the muscles to loosen up and work better, and gets the blood flowing through our body. Bodybuilding and weight lifting-related joint pain problems can be caused by tendonitis, an inflammation or irritation of the tendons. This type of joint pain can be reduced or eliminated by stretching and warming up tendons before working them too hard. This makes them more flexible and able to handle the added weight or exercise loads we put on them.

Change exercises. Both avid and novice exercisers should consider changing exercise routines. Impact-style exercising, such as step aerobics or kick boxing, is harder on our joints than exercises such as yoga and water-based workouts.

Don’t over-exercise. Regardless of the type of exercise, or how heavy the workout, our bodies need time to repair. Someone who does hours of intense exercising daily will have more problems with chronic joint pain than someone who allows their body to recuperate. Our muscles, tendons and ligaments all need time to rest and repair after a hard workout. That’s what causes them to strengthen over time.

Lose weight, if advisable. Extra body weight creates strain on our joints, particularly the knee joints. Losing as little as 10 pounds of body weight can help reduce pain and improves breathing and circulation.

Understand the value of omega-3 fatty acids. Omega-3 acids are primarily found in fatty fish and some nuts and seeds, such as flaxseeds. Omega-6 acids are found in many vegetables, such as corn and corn oil. While the anti-inflammatory benefits of omega-3 fatty acids (which include fish oil supplements) is well known, less known is the fact that your intake of these fats can affect both bone formation and the rate at which bone is broken down. It’s important to consume both varieties, though consuming more omega-3 fatty acids improves bone mineral density, particularly important for good hip health. Eating a fatty fish like salmon twice a week is recommended, and many physicians suggest fish oil supplements.

We need Vitamin D. Vitamin D helps our body absorb calcium and maintain enough calcium and phosphate in our blood so it doesn’t get pulled out of bone. It also enables bone growth and the breaking down and building up of bone. Low levels of vitamin D contribute to osteoporosis and a condition called osteomalacia, which produces an aching pain in our bones as the bone weakens. Low vitamin D also causes muscle weakness, which can lead to falls and fractures as we age. The best source of D is sunlight, but it’s nearly impossible to get enough in the fall and winter, or if we’re using sunscreen. That’s why supplements are helpful. The Institute of Medicine (IOM) recommends a daily level of vitamin D to 600 international units (IUs) for anyone up to age 71 years old, including children, and as much as 800 IUs for those 71 and older. As with all medicines or supplements, consult with your physician or nutritionist to ensure the best regimen for your personal wellness needs.

Evaluate shoes. Proper footwear is important for bone and joint health. It is important that all shoes, including tennis and athletic shoes, fit properly. Toes need room and there should be good arch support. Some sort of cushion, especially under the ball and heel areas of feet, also is recommended.

Change positions. Sitting or standing all day, day after day, can cause joint pain. We need to vary our routines to give both our bodies and joints variety and rest periods. Getting up and moving around is helpful to break up a routine and keep our bodies in shape.

Listen to biofeedback. Overdoing it can be costly. Make sure kids are staying bio aware and addressing any aches and pains.

 

Among the signs of strain on the musculoskeletal system:

  • Back pain.
  • Pain in the groin or inside of the thigh and knee, which may signal a significant problem with the growth plate of the hip.
  • Bowed legs (where the knees bend outward). Some bowing of the legs is common in children age 2 and younger; however, an ongoing or worsening spread of the knees are not normal.
  • Knock knees, or knees bending inward or even touching, may cause early arthritis and knee, shin and foot pain.

 

Getting Help

 

If you notice any of these conditions in a child, especially if they worsen over time, please contact your health care provider as soon as possible. After an examination, which may include X-rays or other imaging, a diagnosis and appropriate treatment protocol will be determined.

To find a great health professional, use HealthLynked. It is the first of its kind medical network built as a social ecosystem with a Higher Purpose – Improving HealthCare.  Go to HealthLynked.com to learn more, sign up for free find our additional resources and health information.

 

Adapted From:

usbji.org

prnewswire.com

cbia.com

 

 

In observance of this day, the USBJI is asking you to share your event or your thoughts on Facebook or via Twitter @USBJI.

 

Beware the Fungus Among Us – 10 Questions to Ask

Today marks the end of Fungal Disease Awareness Week, sponsored by the Centers for Disease Control and Prevention.  The CDC organized this week to raise awareness about the importance of recognizing serious fungal diseases early enough in the course of a patient’s illness to provide life-saving treatment.

Fungal Disease Awareness Week highlights the grave reality some fungal diseases go undiagnosed and cause serious infections in people in the United States and around the world, leading to illness and even death. Increased awareness about fungal diseases is one of the most important ways to improve early recognition and reduce delays in diagnosis and treatment. A key clue to when a sick person may have a fungal infection is that he or she is being treated with medications for other types of infection without expected improvement.

Healthcare providers and their patients are encouraged to Think Fungus when symptoms of infection do not get better with treatment.  Fungal diseases range from relatively minor superficial and mucosal infections to severe, life-threatening systemic infections. Delayed diagnosis and treatment can lead to poor patient outcomes and high medical costs. The overall burden of fungal diseases in the United States is challenging to quantify because they are likely substantially underdiagnosed.

 

Facts

It is estimated that fungal diseases cost more than $7.2 billion in 2017, including $4.5 billion from 75,055 hospitalizations and $2.6 billion from 8,993,230 outpatient visits. Hospitalizations for Candida infections (n=26,735, total cost $1.4 billion) and Aspergillus infections (n=14,820, total cost $1.2 billion) accounted for the highest total hospitalization costs of any disease. Over half of outpatient visits were for dermatophyte infections (4,981,444 visits, total cost $802 million), and 3,639,037 visits occurred for non-invasive candidiasis (total cost $1.6 billion).[1]

Fungal diseases are often misdiagnosed as their symptoms sometimes resemble other conditions. For example, Valley fever — an inhaled fungal infection that incites cough, fever and a distinctive rash on the upper body or legs — is often misdiagnosed as bacterial pneumonia. While an estimated 150,000 cases of Valley fever occur every year, only 10,000 cases are diagnosed.

About 46,000 healthcare-associated invasive fungal infections occur in the U.S. annually. Growing drug resistance is also making certain fungal strains more difficult to treat.

 

The fungus is among us.

Fungi are everywhere. There are millions of distinct species of fungi on Earth, but only about 300 of those are known to make people sick. Fungal infections are often caused by microscopic fungi that are common in the environment. Fungi live outdoors in soil and on plants and trees as well as on many indoor surfaces and on human skin.

Mild fungal skin infections can look like a rash and are very common. For example, ringworm is a skin infection that’s caused by a fungus, not a worm! Fungal infections in the lungs can be more serious and often cause symptoms that are similar to other illnesses, such as the flu or tuberculosis.

Fungal meningitis and bloodstream infections are less common than skin and lung infections but can be life-threatening. Because the symptoms of fungal infections can be similar to other illnesses, proper diagnosis and treatment are often delayed. The more you know about fungal infections and your chances of getting one, the better prepared you can be to protect your health.

 

10 questions you can use to understand fungal infections, learn how you can get sick, and know what you need to do to stay healthy.

 

Where do you live and travel? Fungi that can cause serious infections are more common in some parts of the United States and world. For example, the fungus that causes Valley fever (also called coccidioidomycosis) is found mainly in the southwestern United States. Histoplasmosis and blastomycosis occur most often in the eastern United States. These infections usually cause a lung infection that is often mistaken for flu or a bacterial infection.

What types of activities are you doing? Harmful fungi can be found in air, dust, and soil. Histoplasma grows especially well in soil that contains bird or bat droppings. Activities like digging, gardening, cleaning chicken coops, and visiting caves can result in you breathing in fungi that may cause infection.

Do you have a dog or cat? People can get ringworm from their pets. Dogs and cats with ringworm sometimes have circular, hairless patches on their skin or other types of rashes. Adult animals do not always show signs of ringworm infection.

Have you recently taken antibiotics? Antibiotics can make women more likely to get vulvovaginal candidiasis, also known as a vaginal yeast infection. Women who are pregnant and have weakened immune systems also are more likely to get this condition. Men also can get genital candidiasis.

Are you taking any medications that affect your immune system? Medications used to treat conditions like rheumatoid arthritis or lupus may weaken your immune system and increase the chance of getting a fungal infection.

Are you living with HIV/AIDS? People living with HIV/AIDS may be more likely to get fungal infections. Two well-known fungal infections associated with HIV/AIDS in the United States are oral candidiasis (thrush) and Pneumocystis pneumonia. Worldwide, cryptococcal meningitis is a major cause of illness in people living with HIV/AIDS.

Will you be hospitalized? In the United States, one of the most common bloodstream infections in hospitalized patients is caused by a fungus called Candida. Candida normally lives in the gastrointestinal tract and on skin without causing any problems, but it can enter the bloodstream during a hospital stay and cause infection.

Have you recently had a transplant? People who have recently had an organ transplant or a stem cell transplant have a greater chance of developing a fungal infection while their immune systems are weakened. Doctors prescribe antifungal medication for some transplant patients to prevent fungal infections from developing.

Are you receiving chemotherapy or radiation treatments? Cancer treatment, such as chemotherapy and radiation, weakens your immune system and may increase the chance you will get a fungal infection.

Do you have symptoms of pneumonia that are not getting better with antibiotics? Fungal infections, especially lung infections like Valley fever, histoplasmosis, and aspergillosis, can have similar symptoms as bacterial infections. However, antibiotics don’t work for fungal infections. Early testing for fungal infections reduces unnecessary antibiotic use and allows people to start treatment with antifungal medication, if necessary.

 

Conclusions

Anyone can get a fungal infection, and fungal diseases impose a considerable economic burden on the healthcare system. Since they are often under-diagnosed, it is important to learn more about the signs, symptoms, and treatment of fungal infections and get prevention tips by visiting CDC’s fungal diseases website and by talking with your healthcare provider.

To connect quickly with the right healthcare provider in your area, go to HealthLynked.com – the FUTURE OF CONNECTED HEALTHCARE.  There, you will find one comprehensive platform that connects doctors, families and medical data to Improve HealthCare.

 


Adapted from the CDC pages on fungal infections.

 

[1] Estimation of direct healthcare costs of fungal diseases in the United States

Kaitlin Benedict  Brendan R Jackson  Tom Chiller  Karlyn D Beer

Clinical Infectious Diseases, ciy776, https://doi.org/10.1093/cid/ciy776

Published: 10 September 2018

 

The Good, The Bad, The Hela | by Alexandra de Carpio

Today marks the death of the woman in whom the most famous (and infamous) immortal cell line was discovered.  Henrietta Lacks, a hard-working woman and loving mother, passed away from the virulent Cervical cancer that was taking over her body.  In honor of the woman, whose family just recently won the right to determine what happens with HeLa cells, we are sharing an article from a research student who insightfully describes all that has occurred with this incredible cell line – The Good, The Bad and the HeLa.


Ask most people and they’ll say that being first is best: you win medals at races, get best dibs on cookies at a reception, avoid getting scooped on research, and ride shotgun in a car. Sometimes, however, being first has both positive and negative consequences, as anyone familiar with the history of HeLa cells can tell you.

HeLa cells have the distinction of being the first immortal cell line cultured by scientists. Unlike a normal population of human cells, which divide about 40 to 50 times before dying away, HeLa cells have the remarkable ability to divide indefinitely. Coming in first secured their status as one of the most popular cell lines used by scientists for research, making them the cornerstone of some of the most significant biological advances. UC Berkeley researchers are also no stranger to HeLa: an estimated 200 labs on campus have used HeLa cells. Today, Berkeley scientists have a wider array of cell lines to choose from, but HeLa’s familiarity and hardy growth continues to make it a popular choice.

In the early 1950’s, however, scientists had yet to meet HeLa. In fact, the original HeLa cells were still attached to a living, breathing human being; a woman who put her family first in every situation, even when battling an unyielding cancer. This cancer would overcome her, but her cancerous cells would continue to grow in laboratories across the world. As the first immortal human cell line, HeLa cells, along with their involuntary donor’s family, had to deal with the growing pains of a society who could develop the technology for cell and tissue culture faster than the ethical rules needed to regulate it.

Both the good and the bad, this is the story of a woman, her legendary cells, and how they have touched the lives of research scientists at UC Berkeley.

A prominent mother figure: paving the way for breakthrough research

For most scientists, Henrietta Lacks represents the mother of all HeLa cells. As the first and, for many years, only cell line able to divide indefinitely out of the body, their popularity among research scientists flourished, and HeLa cells quickly became workhorses in the laboratory. Their first formidable task? To aid in the development of the polio vaccine in 1953. Jonas Salk, a virologist at the National Foundation for Infantile Paralysis, had created a vaccine from inactivated viruses. It seemed promising, but he needed cells—lots of them—to test his vaccine before human trials. HeLa cells were the perfect tool. Not only did they grow vigorously, making it easy to amass the enormous quantity of cells required for the study, but they also become easily infected by the poliomyelitis virus. Within less than a year, the vaccine was ready for human patients.

From there, the list of HeLa’s accomplishments only continued to grow. Known as the mother of virology, cell and tissue culture, and biotechnology, HeLa cells were used to jumpstart research on how viruses act and reprogram cells, as well as to develop standard lab practices for freezing and culturing cells and tissues. Scientists used them to develop cell cloning, in vitro fertilization, and isolation of stem cells, as well as to research AIDS, cancer, and the effects of radiation and toxic substances. HeLa cells have been infected with an array of diseases, from tuberculosis to salmonella, and have helped scientists understand that a normal human cell has 46 chromosomes, thus making genetic disorders easier to diagnose. It is easy to see why many have also named HeLa the mother of modern medicine. HeLa cells were a welcome development for researchers around the world.

For Lawrence, Elsie, Sonny, Deborah, and Zakariyya Lacks, Henrietta was simply known as mom. Described as a strong but caring woman, Henrietta kept her growing family together while her husband, Day, worked at a steel mill. She was no stranger to hard work after growing up with her grandfather on a tobacco farm in Virginia. For the youngest children in the family, however, much of what they know of their mother would come second hand. Henrietta was diagnosed with cervical cancer a mere four and a half months after giving birth to her fifth child, Zakariyya, and would perish from it less than a year later.

Henrietta’s battle with cancer began when, worried about a knot that she felt in her abdomen, she made the 20-mile trip to Johns Hopkins Hospital. At the time, Johns Hopkins was the only option in the area for African Americans seeking medical treatment. A biopsy of her cervix revealed that she had cervical carcinoma, a type of cancer that grows from the epithelial cells that line and protect the cervix. Extensive treatment ensued, which began by inserting tubes of radium into her cervix to reduce the tumor, followed by daily X-ray therapy. Despite the debilitating treatments, Henrietta’s commitment to her family never wavered, and she was able to keep her condition secret from most family members in order to spare them the worry. In turn, she endured much of it alone while Day was at work. Her cancer proved to be too resilient, however, and began to weaken both body and spirit. Tumors overcame nearly all the organs in her abdomen, and relief from the excruciating pain was the only service available at Johns Hopkins. Henrietta passed away on October 4th, 1951.

Her death left a family without its mother.

The birth of HeLa: an exceptional cell line

HeLa as we know it today was born in the lab of George Gey, the director of the Tissue Culture Laboratory at Johns Hopkins Hospital in the 1950s. Gey’s agenda? Cure cancer. His tactic? Develop an immortal human cell line that could be used for research. Fortunately, his position at Johns Hopkins meant he had plenty of tissue samples from which he could try growing human cells in the lab. Unfortunately, most of these cell samples would die within a few generations. That is, until one of them did not: HeLa. Gey obtained HeLa from the surgeon treating Henrietta’s carcinoma, who had been taking cancerous tissue samples from patients for Gey’s research. As with his other samples, Gey named the cell line using the first two letters of the patient’s first and last name. Henrietta Lacks became HeLa.

True to his ultimate goal of curing cancer, Gey was generous with his newly discovered gem, and gave away samples to a few close colleagues working to eradicate cancer. From its beginning in Baltimore, Maryland, HeLa soon traveled the world as scientists far and wide learned of this remarkable immortal cell line.

So, what makes HeLa special? As cancer cells, HeLa cells are unlike normal human cells, and there is no better proof of this than to take a look at its chromosomes, or karyotype. Normal human cells have 46 chromosomes, while HeLa has 76 to 80 heavily mutated chromosomes. The origin of this deviation from normalcy stems from the human papilloma virus (HPV), the cause of nearly all cervical cancers. HPV inserts its DNA into a host cell, causing it to begin producing a protein that binds to and inactivates the native p53 protein. p53 is known as the guardian of the genome due to its role in preventing mutations and suppressing tumors. Non-functional p53 protein can therefore have disastrous consequences.

Relative to other cancer cells, however, HeLa cells still grow unusually fast. Gey was amazed to see that within 24 hours of culturing his first HeLa sample, the number of cells had doubled. The source of this abnormal vigor lies in HeLa’s telomerase enzyme. During normal cell division, the string of repetitive DNA at the tips of all chromosomes, known as telomeres, are shortened. This leads to cell aging and ultimately to apoptosis, or cell death. Normal cells have a maximum number of divisions before these telomeres are depleted. HeLa cells, meanwhile, have an overactive telomerase enzyme that rebuilds telomerases after cell division, thus circumventing the aging process and skirting death. This internal fountain of youth is what has allowed HeLa cells to divide indefinitely, making them now older than Henrietta was when she died.

The birth of HeLa: at the expense of proper consent

For decades, Henrietta’s side of the story has been largely ignored, but thanks to Rebecca Skloot’s novel, The Immortal Life of Henrietta Lacks, she finally has a voice. When Henrietta stepped into the public ward of Johns Hopkins on January 29th, 1951, she could have had no knowledge of what was to ensue. She hoped that her radium treatments would cure her of cervical carcinoma. She hoped that she would still be capable of having children. She hoped to see her family thrive and grow. Unfortunately, she was let down on many counts; Henrietta’s cancer proved too powerful for the doctors at Johns Hopkins to treat, despite their best efforts.

No effort, however, was made to treat Henrietta herself as a woman capable of making her own medical decisions. Without question, Henrietta would have opted out of treatment had she been informed that it would leave her infertile, a fact that she only discovered once it was too late. She also never discovered that her surgeon had taken tissue samples for Gey’s research. Would she have consented? Would she have appreciated Gey sending her cells to his colleagues? What about having her cells commercialized and sold for profit, as they are commonly done today? Would she mind that strangers would profit from her cells, selling them to researchers making important medical advances, while her own family is unable to pay for health care?

It’s too late for Henrietta to answer these questions, but her story has forced scientists and doctors to make sure that such questions are addressed by patients and research participants. Since 1991, scientists and doctors have been governed by the Common Rule, which requires them to inform people when they are participating in research, and that their participation be completely voluntary. Patients must sign consent forms which clearly state what the research is, how long it will last, what the potential risks are, if there is any compensation, and more. Unfortunately, the Common Rule did not come soon enough to protect Henrietta’s family. After HeLa cells exploded on the scene and became associated with many significant scientific advances, people became curious about the woman behind the cells. Along with consent, anonymity and privacy were not issues that had been properly addressed in the medical arena, and Henrietta’s identity was soon revealed. Having her name so closely related to HeLa probably did not help.

This is how, 22 years after her death, Henrietta’s children learned that pieces of their mother were still alive and thriving. Scientists came knocking, asking for blood samples to supply the genetic information needed to better understand HeLa. Again, no consent was obtained, and with a limited background in biology, the family misunderstood the purpose of these samples; they thought they were being tested for cancer. Marginalized by the media and the medical community, it would take decades for them to uncover the true story of what happened to their mother and to gain an understanding of what HeLa means to the world today.

Life in the lab as a hearty membrane source

When Pengcheng Zhang steps into his lab in Li Ka Shing Center to start another day, he is often met by HeLa. Zhang is a fifth year molecular and cell biology PhD student working in the lab of Professor Randy Schekman. The Schekman lab focuses on understanding how proteins produced in a cell are shuttled out via the secretory pathway, an intricate assembly of membranes and proteins. Schekman’s goal is to decipher this pathway by pinpointing the proteins and biomolecules that make it run and determining just how they do it. So far, he has been successful in yeast.

“[Schekman] started out in yeast because it’s much less complex than tissues and organs,” explains Zhang. “After about 20 years of work they came up with this protein complex called COPII, which is required for the first step into this secretory pathway.”

COPII (coatomer protein complex II) is a set of five proteins that work together to create vesicles, or sacs, that bud from protein-producing subunits in the cell, known as the endoplasmic reticulum. These vesicles are then transported to other membranes in the cell for unloading, including export through the outer membrane. The Schekman lab was able to recreate the process in test tubes with only the cargo, purified yeast membranes, and COPII, thus identifying the key components required for the secretory pathway. “This is a very central concept in biochemistry: that we can reconstitute biological processes in the test tube,” says Zhang. “We look at biological processes as a series of chemical reactions.”

Although cells are composed of a vast amount of material, if the proper proteins or biomolecules required for a given cellular reaction are identified and isolated, that same reaction can be carried out in a cell-free system. This is how the Schekman lab was able to identify and isolate the COPII complex of yeast. More recently, however, they have set their sights on understanding the secretory pathway in higher order organisms such as mammals. “We know for a fact that in mammals COPII does the same thing,” explains Zhang. “But the thing is, from yeast to humans the number of proteins that go through the secretory pathway expands.”

For some of these larger, more complex proteins, the Schekman lab has found that COPII alone is insufficient in their test tube “cell”. Understanding the modifications, such as additional proteins, that are required for mammalian cells is now the goal. Zhang, for instance, is trying to understand the necessary components for shuttling transforming growth factor alpha (TGF-α), a protein that is involved in the development of epithelial tissue such as skin or the lining of the cervix. This is where HeLa comes in. “HeLa cells are the major membrane source for my biochemical reactions,” says Zhang. “They are desirable in our case because it’s a human cell line and it grows relatively fast.”

Faster growth means more membranes for Zhang’s experiments. Zhang also uses another mammalian cell line derived from rat liver cells to harvest its cytosol, which is the cellular fluid containing all the proteins and biomolecules of the cell. Zhang transfects, or introduces, additional TGF-α cargo into these liver cells in order to yield better signals. By combining purified COPII, HeLa’s cell membranes, where the secretory mechanism occurs, and the harvested cytosol containing the TGF-α cargo and Zhang’s mystery proteins, Zhang has all that he needs to recreate the secretory pathway in vitro. The trick, however, is figuring out which protein or proteins in the cytosol are doing the work.

“We fractionate the cytosol, separate the protein content, and analyze where the activity goes,” explains Zhang. When one of the fractions successfully reproduces the secretory pathway, Zhang knows that it contains his desired protein. Unfortunately, it’s usually not the only protein present. “[The fractions are] not pure enough that we can assign the function to a particular protein or couple of proteins with confidence. That’s why we need many fractionation steps to get down to a pure enough fraction to have confidence to say that we think these things are responsible for this secretory function.”

So far, the protein of interest remains a mystery. Once identified, however, the Schekman lab can determine if changes or mutations in the protein are linked to any human diseases, with the ultimate goal being treatment of such a disease.

Zhang is not the only graduate student at Berkeley taking advantage of HeLa’s utility in the lab. Ann Fischer, who has been running the Tissue Culture Facility in Barker Hall since 1989, supplies HeLa cells for many of the labs who use them today. She is no stranger to HeLa: Fischer has been working in tissue culture facilities, first at UCSF, then at UCLA, and finally here at UC Berkeley, since 1971.

Fischer says the use of HeLa cells by UC Berkeley researchers has gone through various phases during her time here. Initially, she would grow hundreds of liters of HeLa cells for researchers in the biochemistry department to extract large quantities of a given protein of interest.

“That was the heyday of just biochemistry: using cells to get proteins out,” explains Fischer. “People [later] started using cells for overexpression.” Overexpression involves inserting a gene of interest into the DNA of HeLa cells and stimulating the cells to express it, thus enabling researchers to obtain larger quantities of protein with fewer cells. Today, overexpression is still a popular application of HeLa cells, but the utility of HeLa has expanded. Zhang, for instance, uses HeLa to harvest its membranes, while others take advantage of HeLa’s large size for imaging. In the end, HeLa’s vigor is what makes it so popular.

“It’s because they grow so well,” explains Fischer. “That’s the reason people use HeLa cells.”

Life in the lab: as a hearty contaminant

When Professor Gertrude Buehring steps into her lab in Koshland Hall, she is never met by HeLa cells. In fact, she makes a point of it. “We never grow them,” she says. “I wouldn’t want to take that risk, actually.”

Buehring, a professor of virology in the School of Public Health, has a reason to be wary of HeLa. Both her PhD and postdoc careers were spent working at UC Berkeley’s Cell Culture Laboratory housed in the Naval Biosciences Laboratory in Oakland, a cell repository funded by the federal government that characterized and maintained cell lines for research scientists. She happened to be working there at a time when Dr. Walter Nelson-Rees, the co-director, was working hard to expose HeLa’s misdeeds. The vigorous cell’s crime? The contamination of other, less hardy cell lines.

Nelson-Rees was not the first to suspect contamination by HeLa cells. In the 1960s, Dr. Stanley Gartler, a research geneticist, released the initial “HeLa bomb”. Gartler had discovered that the 18 different cell lines he had collected for his research all turned out to be genetically identical, with genes only present in people of African descent. HeLa was a suspect, but many scientists refused to accept the implications of his discovery, and chose instead to ignore it. Ten years later, Nelson-Rees picked up where Gartler left off, and discovered several HeLa specific chromosomal markers that could be used to test the identity of cell lines.

“Since this repository had so many cell lines, [Nelson-Rees] was going through all of them and examining them for these markers,” recalls Buehring. “While he was there he came up with 40, which was more than one expected.”

In that instant, any tissue-specific research that used the cell lines identified as HeLa contaminants was suddenly invalid. How can research on breast cancer cells be taken seriously when the cells used were actually cervical cancer cells all along? It has been estimated that over 500 research papers and more than 20 million dollars of funding have been wasted. The problem stems from the adolescent days of cell culture.

“After Dr. Gey established the HeLa line, everybody was so excited and thought they could establish a human cell line, too,” Buehring explains. Unfortunately, most of these labs did not have the knowledge or equipment to properly culture cells. What they did have was plenty of HeLa cells around, and due to HeLa’s hardiness, a single cell could outgrow and overtake all normal human cells in a culture. “Suddenly everybody was able to establish a human cell line,” jokes Buehring. It turned out that many of them were just HeLa.

Even years after being exposed for what they really were, HeLa contaminants continued to be sold by the American Type Culture Collection (ATCC), one of the largest international cell line repositories, and scientists continued to request the cells they had become so familiar with. In fact, many scientists were hostile towards Nelson-Rees, and unable to accept the implications of his work. Over time, however, the ATCC refused to sell HeLa contaminants. This doesn’t mean, however, that they are no longer used in labs today. Since her days working at the Naval Science Laboratory, Buehring kept HeLa in the back of her mind, and was curious about the extent to which HeLa contaminants were still used, as well as how aware researchers were about HeLa’s potency.

“I couldn’t find any research papers where people actually looked at that,” she says. So, in 2004 she decided to look into it herself. With the help of an undergraduate student, Professor Buehring conducted a survey of researchers known to culture cells and asked what kinds of cell lines they worked with, whether it was for tissue-specific work or not, and if they ever tested the identities of their cell lines. The results surprised her.

“There were so many people who used HeLa cells in their laboratory, and only about 50% did any kind of check to see if there was contamination,” she says. Not only that, but about 60% of respondents had acquired at least one cell line from another laboratory rather than from a repository like the ATCC.

“Often times people will think they’re getting a good cell line from a colleague down the hall, but they don’t know it’s already been contaminated,” she explains. “If it isn’t checked, you never know that.” Buehring herself rarely gets cells from other labs, but if she does, she makes sure to check their identity before trusting them.

The survey also revealed that about 10% of respondents still used HeLa contaminants, 30% of which used them for tissue-specific purposes. The original “HeLa bomb” of the 1960s and 70s had lingering effects, it appeared.

The truth is, however, that many researchers today don’t see HeLa as a contamination threat anymore. “Back when cell cultures started, they were using glass. It was so easy to contaminate,” says Fischer. The use of disposables today helps eliminate some of the threat. “Nowadays, I don’t worry about that at all.”

Like Buehring, Fischer also insists on getting cells from reputable sources like the ATCC; otherwise, she suggests verifying their identity. Going back to frozen stocks of cells every week or two is another method of avoiding contamination. Zhang says that he, too, is not concerned. “If it gets contaminated with a different cell line it’s very recognizable because looking under the microscope every cell line has a very distinct shape,” he explains. HeLa cells, for instance, are often very large and triangular.

Not only have cell culturing methods improved, but HeLa’s days as the easiest and fastest growing cell line are over. New cell lines have emerged that work just as well, if not better, for certain applications. Insect cells, for instance, can also be used to overexpress proteins, but can be grown in larger quantities. This makes them ideal little protein factories for when researchers need large quantities of a given protein for study. “People don’t use HeLa cells as much because they’re harder to grow than insect cells,” says Fischer. “Believe it or not! Harder to grow!”

Bacteria cells are actually the easiest cell type to grow but may not be capable of making some of the more complicated human proteins that often require more intricate modifications before they become fully functional. Yeast cells, which have a more advanced protein assembly system, are the next line of attack, followed by insect cells. Only if these three cell types are unable to produce the human protein of interest do researchers consider human cells such as HeLa.

There are other reasons that HeLa cells are finding themselves at the bottom of the list: as a cancer cell, its DNA is a major liability. “[HeLa cells] have the strangest karyotype,” says Fischer. “They have 3 copies of this, and 2 copies of this, and 5 copies of that. They’re not normal.”

Many researchers today choose to work with cells that more closely resemble normal human cells, thus taking their in vitro systems one step closer to mimicking how a real human functions. IMR-90 cells are one such example. Cultivated from the lungs of a human fetus in the Netherlands, IMR-90s have a normal karyotype with 46 chromosomes. Of course, there are drawbacks to working with “mortal” cells.

“They only go up 60 populations and then they [die],” says Fischer. “We have to thaw those every three weeks.” Not only that, but as the cell line becomes older and older, they show signs of aging and may not be ideal for research anymore. Luckily, Zhang doesn’t have to worry about trying to work with more normal, but finicky, cell lines.

“Since we’re looking at such a fundamental process in the cell, we think that although HeLa cells are very different from normal human cells, the basic processes that keep the cell alive should essentially be unaltered,” reasons Zhang.

Buehring agrees that there is an important distinction between using HeLa to obtain basic cellular material versus using HeLa as a whole cell and expecting all of its cellular processes to be the same. As a “bag to hold the biomolecules of study,” however, they work just fine.   For other purposes, HeLa may not be top dog anymore.

A wealth of information: making research faster and easier

Like a celebrity, the more scientists learn and work with HeLa, the more popular it becomes. It began in the early days of cell culture, when HeLa’s vigor and human origin made it unique. Today, scientists take comfort in HeLa because of its familiarity.

It’s well-characterized because so many labs have been working on it,” explains Zhang. “There are many tools that work with HeLa cells that don’t necessarily work well with obscure cell lines.”

This is because many of these tools or techniques were originally developed using HeLa cells and are thus optimized for them. One example, gene knockdowns, can be used to stop HeLa from expressing a specific protein, thus helping Zhang determine if and how it affects the secretory pathway. HeLa also has good transfection efficiency, ensuring that when Zhang transfects his HeLa cells with a protein, a higher percentage of the population will have his protein of interest.

Not only can HeLa do a lot, we also know a lot about it. As a human cell line, the human genome database becomes an important source of genetic information. Zhang, for instance, uses the database to design his knockdowns and target a specific gene of interest. Though not crucial, HeLa’s specific genome would make things even easier. Luckily, this is now a possibility. Since August of 2013, researchers can submit proposals to gain access to the HeLa genome on the National Institute of Health’s (NIH) database.

“You would know which genes are expressed instead of empirically testing it, which can take a week,” says Zhang. Access to the NIH database would let him see what genes are expressed and to what degree, therefore making it easier to design effective knockdowns.

Simply put, HeLa cells are just plain simple.

 

A wealth of information: crossing the boundaries of privacy

As HeLa’s popularity in the lab grew and the list of medical discoveries reached the ears of non-scientists, public interest sprouted. Articles began to surface that speculated on the identity of this mystery woman. Credit was given to Helen Lane or Helen Larson, until eventually Henrietta’s true identity was revealed.

Researchers, members of the media, and con artists soon hounded the family, all hungry to use them for their genetic information, family history, or as pawns for a fraudulent money-making lawsuit against Johns Hopkins, respectively. No one, however, provided the family with any information in return, and they were often left in the dark about their mother’s final months, the origin of HeLa, and the implications of HeLa in research. The infamous cells became a burden.

This kind of disclosure about a human cell line would be unthinkable today, and rightly so. “Nowadays, if you take their cells, you wouldn’t call them by that patient’s name because of confidentiality,” says Fischer. “What if you found a genetic abnormality that could be traced back to the family?”

Which is, in fact, a very real question posed by members of the Lacks family. In March of 2013, HeLa’s complete genome was published without the family’s knowledge. Researchers like Zhang sit on both sides of the fence on the issue. “It would be helpful to get some genomic information that would be specific to HeLa cells,” he begins, “but there’s this privacy issue, an ethical issue.”

The genome was removed after the family voiced its concerns. A few short months later, however, a compromise was reached, known as the HeLa Genome Data Use Agreement. Researchers can obtain controlled access to the genome after submitting a proposal, and any data obtained from the genome must be openly shared on the NIH database. Access to the genome will be tightly regulated by a committee of six, two of whom are members of the Lacks family.

It may not have been a simple journey, but the family is in the dark no more.

Over the years the family has come to learn about the use and importance of HeLa cells, and the research and medical communities have, in turn, learned to respect them. Credit, in large part, must be given to Rebecca Skloot, whose book, The Immortal Life of Henrietta Lacks, was the first to focus on the story of Henrietta and her family rather than HeLa. Skloot took a different, more constructive, approach than the scientists and members of the media who came before her. She chose to work with the family rather than use them and helped them understand all parts of their mother: from life to death to HeLa. In turn, scientists can now learn about the history of the cells they have become so familiar with in the lab and understand their significance outside of the lab.

“The wealth of information that we’ve learned from her cells is just so overwhelming,” says Zhang. Not only has this information resulted in valuable medical advances, research papers, and PhD theses, but also in crucial laws and policies governing the use of cells and tissues, and a greater awareness of cell line contamination. It may be that with good comes bad, but the key is converting the mistakes of the past into something constructive for the future. Zhang would argue that acknowledging those who deserve the credit is also important: “I think we should all be grateful to her.”

 

This article appears in the print edition of the Berkeley Science Review. All authors and editors are graduate students in the Bay Area.

14 Proven Treatments for Restless Leg Syndrome

Restless legs syndrome (RLS), also called Willis-Ekbom Disease, causes unpleasant or uncomfortable sensations in the legs and an irresistible urge to move them.  Symptoms commonly occur in the late afternoon or evening hours and are often most severe at night when a person is resting, such as sitting or lying in bed.  They also may occur when someone is inactive and sitting for extended periods (for example, when taking a trip by plane or watching a movie).

Since symptoms can increase in severity during the night, it could become difficult to fall asleep or return to sleep after waking up.  Moving the legs or walking typically relieves the discomfort but the sensations often recur once the movement stops.

What is restless legs syndrome?

RLS is classified as a sleep disorder since the symptoms are triggered by resting and attempting to sleep, and as a movement disorder, since people are forced to move their legs in order to relieve symptoms.  It is, however, best characterized as a neurological sensory disorder with symptoms that are produced from within the brain itself.

RLS is one of several disorders that can cause exhaustion and daytime sleepiness, which can strongly affect mood, concentration, job and school performance, and personal relationships.  Many people with RLS report they are often unable to concentrate, have impaired memory, or fail to accomplish daily tasks.  Untreated moderate to severe RLS can lead to about a 20 percent decrease in work productivity and can contribute to depression and anxiety.  It also can make traveling difficult.

It is estimated that up to 7-10 percent of the U.S. population may have RLS.  RLS occurs in both men and women, although women are more likely to have it than men.   It may begin at any age.  Many individuals who are severely affected are middle-aged or older, and the symptoms typically become more frequent and last longer with age.

More than 80 percent of people with RLS also experience periodic limb movement of sleep (PLMS).  PLMS is characterized by involuntary leg (and sometimes arm) twitching or jerking movements during sleep that typically occur every 15 to 40 seconds, sometimes throughout the night.  Although many individuals with RLS also develop PLMS, most people with PLMS do not experience RLS.

Fortunately, most cases of RLS can be treated with non-drug therapies and if necessary, medications.

What are common signs and symptoms of restless legs?

People with RLS feel the irresistible urge to move, which is accompanied by uncomfortable sensations in their lower limbs that are unlike normal sensations experienced by people without the disorder.  The sensations in their legs are often difficult to define but may be described as aching throbbing, pulling, itching, crawling, or creeping.  These sensations less commonly affect the arms, and rarely the chest or head.

Although the sensations can occur on just one side of the body, they most often affect both sides.  They can also alternate between sides. The sensations range in severity from uncomfortable to irritating to painful.

Because moving the legs (or other affected parts of the body) relieves the discomfort, people with RLS often keep their legs in motion to minimize or prevent the sensations.  They may pace the floor, constantly move their legs while sitting, and toss and turn in bed.

A classic feature of RLS is that the symptoms are worse at night with a distinct symptom-free period in the early morning, allowing for more refreshing sleep at that time.  Some people with RLS have difficulty falling asleep and staying asleep.  They may also note a worsening of symptoms if their sleep is further reduced by events or activity.

RLS symptoms may vary from day to day, in severity and frequency, and from person to person.  In moderately severe cases, symptoms occur only once or twice a week but often result in significant delay of sleep onset, with some disruption of daytime function.  In severe cases of RLS, the symptoms occur more than twice a week and result in burdensome interruption of sleep and impairment of daytime function.

People with RLS can sometimes experience remissions — spontaneous improvement over a period of weeks or months before symptoms reappear — usually during the early stages of the disorder.  In general, however, symptoms become more severe over time.

People who have both RLS and an associated medical condition tend to develop more severe symptoms rapidly.  In contrast, those who have RLS that is not related to any other condition show a very slow progression of the disorder, particularly if they experience onset at an early age; many years may pass before symptoms occur regularly.

What causes restless legs syndrome?

In most cases, the cause of RLS is unknown (called primary RLS).  However, RLS has a genetic component and can be found in families where the onset of symptoms is before age 40.  Specific gene variants have been associated with RLS.  Evidence indicates that low levels of iron in the brain also may be responsible for RLS.

Considerable evidence also suggests that RLS is related to a dysfunction in one of the sections of the brain that control movement (called the basal ganglia) that use the brain chemical dopamine.  Dopamine is needed to produce smooth, purposeful muscle activity and movement.  Disruption of these pathways frequently results in involuntary movements.  Individuals with Parkinson’s disease, another disorder of the basal ganglia’s dopamine pathways, have increased chance of developing RLS.

RLS also appears to be related to or accompany the following factors or underlying conditions:

  • end-stage renal disease and hemodialysis
  • iron deficiency
  • certain medications that may aggravate RLS symptoms, such as antinausea drugs (e.g. prochlorperazine or metoclopramide), antipsychotic drugs (e.g., haloperidol or phenothiazine derivatives), antidepressants that increase serotonin (e.g., fluoxetine or sertraline), and some cold and allergy medications that contain older antihistamines (e.g., diphenhydramine)
  • use of alcohol, nicotine, and caffeine
  • pregnancy, especially in the last trimester; in most cases, symptoms usually disappear within 4 weeks after delivery
  • neuropathy (nerve damage).

Sleep deprivation and other sleep conditions like sleep apnea also may aggravate or trigger symptoms in some people.  Reducing or completely eliminating these factors may relieve symptoms.

How is restless legs syndrome diagnosed?

Since there is no specific test for RLS, the condition is diagnosed by a doctor’s evaluation.  The five basic criteria for clinically diagnosing the disorder are:

  • A strong and often overwhelming need or urge to move the legs that is often associated with abnormal, unpleasant, or uncomfortable sensations.
  • The urge to move the legs starts or get worse during rest or inactivity.
  • The urge to move the legs is at least temporarily and partially or totally relieved by movements.
  • The urge to move the legs starts or is aggravated in the evening or night.
  • The above four features are not due to any other medical or behavioral condition.

A physician will focus largely on the individual’s descriptions of symptoms, their triggers and relieving factors, as well as the presence or absence of symptoms throughout the day.  A neurological and physical exam, plus information from the person’s medical and family history and list of current medications, may be helpful.  Individuals may be asked about frequency, duration, and intensity of symptoms; if movement helps to relieve symptoms; how much time it takes to fall asleep; any pain related to symptoms; and any tendency toward daytime sleep patterns and sleepiness, disturbance of sleep, or daytime function.

Laboratory tests may rule out other conditions such as kidney failure, iron deficiency anemia (which is a separate condition related to iron deficiency), or pregnancy that may be causing symptoms of RLS.  Blood tests can identify iron deficiencies as well as other medical disorders associated with RLS.

In some cases, sleep studies such as polysomnography (a test that records the individual’s brain waves, heartbeat, breathing, and leg movements during an entire night) may identify the presence of other causes of sleep disruption (e.g., sleep apnea), which may impact management of the disorder.  Periodic limb movement of sleep during a sleep study can support the diagnosis of RLS but, again, is not exclusively seen in individuals with RLS.

Diagnosing RLS in children may be especially difficult, since it may be hard for children to describe what they are experiencing, when and how often the symptoms occur, and how long symptoms last.  Pediatric RLS can sometimes be misdiagnosed as “growing pains” or attention deficit disorder.

How is restless legs syndrome treated?

RLS can be treated, with care directed toward relieving symptoms.  Moving the affected limb(s) may provide temporary relief.  Sometimes RLS symptoms can be controlled by finding and treating an associated medical condition, such as peripheral neuropathy, diabetes, or iron deficiency anemia.

Iron supplementation or medications are usually helpful, but no single medication effectively manages RLS for all individuals.  Trials of different drugs may be necessary.  In addition, medications taken regularly may lose their effect over time or even make the condition worse, making it necessary to change medications.

Treatment options for RLS include:

Lifestyle changes.  Certain lifestyle changes and activities may provide some relief in persons with mild to moderate symptoms of RLS.  These steps include avoiding or decreasing the use of alcohol and tobacco, changing or maintaining a regular sleep pattern, a program of moderate exercise, and massaging the legs, taking a warm bath, or using a heating pad or ice pack.  There are new medical devices that have been cleared by the U.S. Food & Drug Administration (FDA), including a foot wrap that puts pressure underneath the foot and another that is a pad that delivers vibration to the back of the legs.  Aerobic and leg-stretching exercises of moderate intensity also may provide some relief from mild symptoms.

Healthy sleep habits.  Having good sleep habits is advisable for anyone, but perhaps especially for people who have trouble sleeping, such as those with RLS.

While sleeping better may not resolve your RLS symptoms, it could help you offset the sleep loss you suffer from your condition.

Try the following tips to make your sleep as restful and restorative as possible.

  • Go to sleep and wake up at the same times each day.
  • Keep your sleep area cool, quiet, and dark.
  • Keep distractions, such as the TV and phone, to a minimum in your bedroom.
  • Avoid electronic screens for the two to three hours before you go to sleep. Blue light from these screens can throw off your circadian rhythm, which helps you keep a natural sleep cycle

Iron and Vitamin Supplements.  For individuals with low or low-normal blood tests called ferritin and transferrin saturation, a trial of iron supplements is recommended as the first treatment.  Iron supplements are available over-the-counter.  A common side effect is upset stomach, which may improve with use of a different type of iron supplement.  Because iron is not well-absorbed into the body by the gut, it may cause constipation that can be treated with stool softeners such as polyethylene glycol.  In some people, iron supplementation does not improve a person’s iron levels.  Others may require iron given through an IV line in order to boost the iron levels and relieve symptoms.

In addition, vitamin D deficiency could be linked with RLS. A 2014 study found that vitamin D supplements reduced RLS symptoms in people with RLS and vitamin D deficiency.

And for people on hemodialysis, vitamins C and E supplements may help relieve RLS symptoms.

Exercise can help you feel better if you have RLS.  The National Institutes of Health states that moderate exercise may help ease mild RLS symptoms.

And a 2006 study of 23 people with RLS found that aerobic exercise and lower body resistance training, done three times per week for 12 weeks, significantly decreased RLS symptom.

Other studies have also found exercise very effective for RLS, especially in people with ESRD.

Given these studies, plus others showing that activity can help improve sleep, exercise seems a natural fit for people with RLS.

One recommendation from the Restless Legs Foundation — exercise in moderation. Don’t work out to the point of aches and pains, as this could make your RLS symptoms worse.

Yoga and stretching.  Like other types of exercise, yoga and stretching exercises have been shown to have benefits for people with RLS.

A 2013 eight-week study of 10 women found that yoga helped reduce their RLS symptoms. It also helped improve their mood and reduce their stress levels, which could in turn improve their sleep. And a 2012 study showed that yoga improved sleep in 20 women with RLS.

Another study showed that stretching exercises made significant improvements in the RLS symptoms of people on hemodialysis.

It’s not entirely clear to researchers why yoga and stretching works, and more research would be beneficial. But given these results, you might want to add some calf and upper leg stretches to your daily exercise routine.

Massaging your leg muscles could help ease your RLS symptoms. Many health organizations, such as the National Institutes of Health and the National Sleep Foundation, suggest it as an at-home treatment,  Although there’s not a lot of other research that backs up massage as an RLS treatment, a 2007 case study illustrated its benefits.

A 35-year-old woman who had 45-minute leg massages twice a week for three weeks had improved RLS symptoms throughout that time period. Her massages included a range of techniques, including Swedish massage and direct pressure to leg muscles.

Her RLS symptoms eased after two massage treatments and didn’t start to return until two weeks after the massage regimen ended.  The author of that study suggested that the increased release of dopamine caused by massage could be a reason for the benefits. Also, massage has been shown to improve circulation, so that might be a reason for its effects on RLS.

As an added bonus, massage can aid in relaxation, which could help improve your sleep.

Foot wrap (restiffic)A foot wrap has been shown to help relieve RLS symptoms.

Called restiffic, the foot wrap puts pressure on certain points on the bottom of your foot. The pressure sends messages to your brain, which responds by telling the muscles affected by RLS to relax. This helps relieve your RLS symptoms.

A 2013 study of 30 people using the foot wrap for eight weeks found significant improvements in RLS symptoms and sleep quality.

The restiffic foot wrap is available by prescription only, and per the company’s website, it costs about $200. It may or may not be covered by your insurance.

Pneumatic compression.  If you’ve ever stayed overnight in the hospital, you may have had pneumatic compression. This treatment uses a “sleeve” that goes over your leg and inflates and deflates, gently squeezing and releasing your limb.

In the hospital, a pneumatic compression device (PCD) is typically used to improve circulation and prevent blood clots. Improved circulation might also be the reason pneumatic compression has been shown to help relieve RLS symptoms.

Some researchers believe that a cause of RLS is low oxygen levels in the limbs. They think that the body responds to this problem by increasing circulation via the muscle contractions that occur when the person moves their limb.

Whatever the reason, some research has shown that pneumatic compression can help relieve RLS symptoms.

A 2009 study of 35 people who used a PCD for at least an hour every day for a month had markedly improved RLS symptoms, sleep quality, and daytime function. However, other research has not shown the same effects.

Some PCDs are rented, and others can be purchased over the counter or with a prescription. Insurance coverage for a PCD might be easier to acquire for people who can’t tolerate RLS medication

Vibration pad (Relaxis).  A vibrating pad called the Relaxis pad may not relieve your RLS symptoms, but it could help you sleep better.

You use the vibrating pad while you’re at rest or sleeping. You place the pad on the affected area, such as your leg, and set it to the desired vibration intensity. The pad vibrates for 30 minutes and then shuts itself off….

The idea behind the pad is that the vibrations provide “counter stimulation.” That is, they override the uncomfortable sensations caused by RLS making you feel the vibrations instead of your symptoms.

There’s not a lot of research available on the Relaxis pad, and it hasn’t been shown to actually relieve RLS symptoms. However, it has been shown to improve sleep.

In fact, one study found it to be as effective in improving sleep as the four FDA-approved RLS drugs: ropinirole, pramipexole, gabapentin, and rotigotine.

The Relaxis pad is available only by prescription from your doctor. Per the company website, the device is not covered by insurance, and it costs a little over $600.

Near-infrared spectroscopy (NIRS).  A noninvasive treatment that’s not yet in wide use for this purpose could help relieve RLS symptoms.

This painless treatment is called near-infrared spectroscopy (NIRS). With NIRS, light beams with long wavelengths are used to penetrate the skin. The light causes blood vessels to dilate, increasing circulation.

One theory posits that RLS is caused by low oxygen levels in the affected area. It’s thought that the increased circulation caused by NIRS increases that oxygen level, helping to relieve the RLS symptoms.

Several studies have found this treatment effective. One study treated 21 people with RLS with NIRS three times per week for four weeks. Both circulation and RLS symptoms showed significant improvement.

Another showed that people treated with twelve 30-minute treatments of NIRS over four weeks also had significantly reduced symptoms of RLS. Symptoms were improved up to four weeks after treatment ended.

NIRS devices can be purchased online for several hundred dollars to over $1,000.

Anti-seizure drugs.  Anti-seizure drugs are becoming the first-line prescription drugs for those with RLS.  The FDA has approved gabapentin enacarbil for the treatment of moderate to severe RLS, This drug appears to be as effective as dopaminergic treatment (discussed below) and, at least to date, there have been no reports of problems with a progressive worsening of symptoms due to medication (called augmentation).  Other medications may be prescribed “off-label” to relieve some of the symptoms of the disorder.

Other anti-seizure drugs such as the standard form of gabapentin and pregabalin can decrease such sensory disturbances as creeping and crawling as well as nerve pain.  Dizziness, fatigue, and sleepiness are among the possible side effects.  Recent studies have shown that pregabalin is as effective for RLS treatment as the dopaminergic drug pramipexole, suggesting this class of drug offers equivalent benefits.

Dopaminergic agents.  These drugs, which increase dopamine effect, are largely used to treat Parkinson’s disease.  They have been shown to reduce symptoms of RLS when they are taken at nighttime.  The FDA has approved ropinirole, pramipexole, and rotigotine to treat moderate to severe RLS.  These drugs are generally well tolerated but can cause nausea, dizziness, or other short-term side effects.  Levodopa plus carbidopa may be effective when used intermittently, but not daily.

Although dopamine-related medications are effective in managing RLS symptoms, long-term use can lead to worsening of the symptoms in many individuals.  With chronic use, a person may begin to experience symptoms earlier in the evening or even earlier until the symptoms are present around the clock.  Over time, the initial evening or bedtime dose can become less effective, the symptoms at night become more intense, and symptoms could begin to affect the arms or trunk.  Fortunately, this apparent progression can be reversed by removing the person from all dopamine-related medications.

Another important adverse effect of dopamine medications some experience is the development of impulsive or obsessive behaviors such as obsessive gambling or shopping.  Should they occur, these behaviors can be improved or reversed by stopping the medication.

Opioids.  Drugs such as methadone, codeine, hydrocodone, or oxycodone are sometimes prescribed to treat individuals with more severe symptoms of RLS who did not respond well to other medications.  Side effects include constipation, dizziness, nausea, exacerbation of sleep apnea, and the risk of addiction; however, very low doses are often effective in controlling symptoms of RLS.

Benzodiazepines.  These drugs can help individuals obtain a more restful sleep.  However, even if taken only at bedtime they can sometimes cause daytime sleepiness, reduce energy, and affect concentration.  Benzodiazepines such as clonazepam and lorazepam are generally prescribed to treat anxiety, muscle spasms, and insomnia.  Because these drugs also may induce or aggravate sleep apnea in some cases, they should not be used in people with this condition.  These are last-line drugs due to their side effects.

Treatments with less scientific backup

 The above treatments have some research to support their use. Other treatments have less evidence but may still work for some people with RLS.

Hot and cold treatments .  While there’s not a lot of research backing up using heat and cold to relieve RLS symptoms, many healthcare organizations recommend it. They include the National Sleep Foundation and the Restless Legs Syndrome Foundation.

These organizations suggest taking a hot or cold bath before going to bed, or applying hot or cold packs to your legs.

Some people’s RLS symptoms are aggravated by cold, while others have problems with heat. This could explain the benefits of these hot or cold treatments.

Repetitive transcranial magnetic stimulation (rTMS).  A noninvasive procedure that’s typically used to treat depression could be helpful in relieving RLS symptoms. So far, studies have been limited and more research is needed, but the results are promising .

Repetitive transcranial magnetic stimulation (rTMS) sends magnetic impulses to certain areas of the brain.

It’s not entirely clear why rTMS could help relieve RLS symptoms. One theory is that the impulses increase the release of dopamine in the brain. Another suggests that rTMS could help calm the hyperarousal in parts of the brain that are associated with RLS.

In one 2015 study, 14 people with RLS were given 14 sessions of rTMS over 18 days. The sessions significantly improved their RLS symptoms and improved their sleep. The results lasted for at least two months after the treatment ended.

Transcutaneous electrical nerve stimulation (TENS).  With transcutaneous electrical nerve stimulation (TENS), a device sends small electrical currents to parts of your body to help relieve pain.

There’s not a lot of research on the use of TENS to treat RLS, but it could work.

The idea is that like the Relaxis vibrating pad, it uses counter stimulation. One study showed that regular use of TENS along with a vibration treatment completely relieved one man’s RLS symptoms.

Acupuncture can be helpful in the treatment of many health conditions, and RLS might be one of them.

A 2015 study of 38 people with RLS who were treated with acupuncture for six weeks showed that their abnormal leg activity from RLS was greatly reduced.

However, more research is needed to confirm acupuncture as a reliable treatment for RLS.

Surgery for varicose veins.  For people with certain circulatory issues, surgery could be the most effective treatment for their RLS.

Varicose veins are enlarged blood vessels, often in the legs, that overfill with blood. This increased amount of blood can lead to superficial venous insufficiency (SVI), which means your body can’t properly circulate blood. As a result, the blood pools in your legs.

In a 2008 study, 35 people with SVI and RLS had a procedure called endovenous laser ablation to treat their varicose veins. Of the 35 people, 84 percent of them had their RLS symptoms significantly improved or completely eliminated by the surgery.

Again, more research is needed on this surgery as a treatment for RLS.

What is the prognosis for people with restless legs syndrome?

RLS is generally a lifelong condition for which there is no cure.  However, current therapies can control the disorder, minimize symptoms, and increase periods of restful sleep.  Symptoms may gradually worsen with age, although the decline may be somewhat faster for individuals who also suffer from an associated medical condition.  A diagnosis of RLS does not indicate the onset of another neurological disease, such as Parkinson’s disease.  In addition, some individuals have remissions—periods in which symptoms decrease or disappear for days, weeks, months, or years—although symptoms often eventually reappear.  If RLS symptoms are mild, do not produce significant daytime discomfort, or do not affect an individual’s ability to fall asleep, the condition does not have to be treated.

What research is being done?

The mission of the National Institute of Neurological Disorders and Stroke (NINDS) is to seek fundamental knowledge about the brain and nervous system and to use that knowledge to reduce the burden of neurological disease.  The NINDS is a component of the National Institutes of Health (NIH), the leading supporter of biomedical research in the world.

While the direct cause of RLS is often unknown, changes in the brain’s signaling pathways are likely to contribute to the disease.  In particular, researchers suspect that impaired transmission of dopamine signals in the brain’s basal ganglia may play a role.  There is a relationship between genetics and RLS.  However, currently there is no genetic testing.  NINDS-supported research is ongoing to help discover genetic relationships and to better understand what causes the disease.

The NINDS also supports research on why the use of dopamine agents to treat RLS, Parkinson’s disease, and other movement disorders can lead to impulse control disorders, with aims to develop new or improved treatments that avoid this adverse effect.

The brain arousal systems appear to be overactive in RLS and may produce both the need to move when trying to rest and the inability to maintain sleep.  NINDS-funded researchers are using advanced magnetic resonance imaging (MRI) to measure brain chemical changes in individuals with RLS and evaluate their relation to the disorder’s symptoms in hopes of developing new research models and ways to correct the overactive arousal process.  Since scientists currently don’t fully understand the mechanisms by which iron gets into the brain and how those mechanisms are regulated, NINDS-funded researchers are studying the role of endothelial cells—part of the protective lining called the blood-brain barrier that separates circulating blood from the fluid surrounding brain tissue—in the regulation of cerebral iron metabolism.  Results may offer new insights to treating the cognitive and movement symptoms associated with these disorders.

The takeaway

RLS can cause significant discomfort, sleep issues, and problems with daily functioning, so treatment should be a priority. Your first step should be to try the at-home options on this list. But if they don’t help you, be sure to talk to your doctor.

Your doctor can provide more information about each of these treatments and which one — or ones — might be a good choice for you.

Keep in mind that what works for one person may not work for another, and you may need to try several different drugs or treatments. Keep trying until you find the treatment plan that works for you.

Whatever health concerns you have today, making sure you are connected to the right physicians and they have all of your most up to date information is what HealthLynked is all about.  It is the first of its kind social ecosystem designed to “Lynk” patients with their healthcare team in new ways to ensure they receive the best possible care and are restored to the best health possible.

Ready to get “Lynked”?  Go to HealthLynked.com, right now, and get signed up for free.

 

Sources:

ninds.nih.gov

healthline.com

 

 

 

 

 

What is Idiopathic Thrombocytopenic Purpura ?

Our six year old came in from playing on a warm summer’s day.  She seemed her normal, happy and carefree self, but when she jumped into my lap, I noticed dime sized bruises all over her legs, evenly spaced.  It looked odd to say the least, and she couldn’t say anything had happened, so we called the clinic to discuss with the on duty nurse.

“So, you have an active 6 year old with bruises on her legs; doesn’t seem like a big deal to me,” was her response.  After sharing with the nurse I didn’t think she quite understood, which she agreed – at least she couldn’t understand the worry in my voice – she asked we bring her in….

We found out she had Henoch-Schonlein purpura (HEN-awk SHURN-line PUR-pu-ruh) – a disorder that causes inflammation and bleeding in the small blood vessels in your skin, joints, intestines and kidneys.  While this is not ITP, it was our introduction to the words purpura, platelets and thrombocytopenia.

September is National ITP Awareness Month

Chronic ITP and platelet function disorders are perhaps the most common bleeding disorder. It affects both sexes and all ages and races. While we don’t know for sure, there are an estimated 120,000 persons with ITP in the United States. That’s more than 10 times the number of people with Hemophilia!

The purpose of ITP awareness month is to increase the public’s awareness and understanding of ITP and to let patients and families know that there are resources and support available to help them have the best possible outcomes. Patients and families are not alone.

What is ITP?

Platelets are relatively small, irregularly shaped components of our blood. They are required to support the integrity of our blood vessel walls and for blood to clot. Without enough platelets, a person is subject to spontaneous bleeding or bruising.

Idiopathic thrombocytopenic purpura (ITP) is a disorder that can lead to easy or excessive bruising and bleeding. The bleeding results from unusually low levels of platelets — the cells that help blood clot.

Idiopathic thrombocytopenic purpura, which is also called immune thrombocytopenia, affects children and adults. Children often develop ITP after a viral infection and usually recover fully without treatment. In adults, the disorder is often long term.

If you don’t have signs of bleeding and your platelet count isn’t too low, you may not need any treatment. In rare cases, the number of platelets may be so low that dangerous internal bleeding occurs. Treatment options are available.

Symptoms

Idiopathic thrombocytopenic purpura (ITP) may have no signs and symptoms. When they do occur, they may include:

  • Easy or excessive bruising (purpura)
  • Superficial bleeding into the skin that appears as a rash of pinpoint-sized reddish-purple spots (petechiae), usually on the lower legs
  • Bleeding from the gums or nose
  • Blood in urine or stools
  • Unusually heavy menstrual flow

Causes

In some people thrombocytopenia is caused by the immune system mistakenly attacking and destroying platelets. If the cause of this immune reaction is unknown, the condition is called idiopathic thrombocytopenic purpura. Idiopathic means “of unknown cause.”

In most children with ITP, the disorder follows a viral illness, such as the mumps or the flu. It may be that the infection triggers the immune system malfunction.

Increased breakdown of platelets

In people with ITP, antibodies produced by the immune system attach themselves to the platelets, marking the platelets for destruction. The spleen, which helps your body fight infection, recognizes the antibodies and removes the platelets from your system. The result of this case of mistaken identity is a lower number of circulating platelets than is normal.

A normal platelet count is generally between 150,000 and 450,000 platelets per microliter of circulating blood. People with ITP often have platelet counts below 20,000. Because platelets help the blood clot, as their number decreases, your risk of bleeding increases. The greatest risk is when your platelet count falls very low — below 10,000 platelets per microliter. At this point, internal bleeding may occur even without any injury.

Risk factors

Idiopathic thrombocytopenic purpura can occur in anyone at almost any age, but these factors increase the risk:

  • Your sex. Women are two to three times more likely to develop ITP than men are.
  • Recent viral infection. Many children with ITP develop the disorder after a viral illness, such as mumps, measles or a respiratory infection.

Complications

Spontaneous bleeding can also occur in mucous membranes inside the mouth or in the gastrointestinal tract. ITP is often accompanied by fatigue and sometimes depression.

A rare complication of idiopathic thrombocytopenic purpura is bleeding into the brain, or disruptive bleeding into internal organs, which can be fatal.

Pregnancy

In pregnant women with ITP, the condition doesn’t usually affect the baby. But the baby’s platelet count should be tested soon after birth.

If you’re pregnant and your platelet count is very low, or you have bleeding, you have a greater risk of heavy bleeding during delivery. In such cases, you and your doctor may discuss treatment to maintain a stable platelet count, taking into account the effects on your baby.

When to see a doctor

Make an appointment with your doctor if you or your child develop symptoms that worry you.

Bleeding that won’t stop is a medical emergency. Seek immediate help if you or your child experiences bleeding that can’t be controlled by the usual first-aid techniques, such as applying pressure to the area.

The best way to find a physician to talk to you about abnormal bleeding or bruising is to search online through the large data base at HealthLynked.  We are connecting physicians and patients in new ways so they can more closely collaborate on care and wellness.

Ready to get Lynked?  Go to HealthLynked.com to get started, today, for free!

 

 

How to Safely Handle Food and Why It Matters

September is National Food Safety Education Month. It provides an opportunity to raise awareness about the steps you can take to prevent food poisoning.

Every year, an estimated 1 in 6 Americans (or 48 million people) get sick, 128,000 are hospitalized, and 3,000 die from eating contaminated food. Some people are more susceptible to contracting a foodborne illness (also called food poisoning) or to become seriously ill.

Why Food Safety Matters

Food safety means knowing how to avoid the spread of bacteria when you’re buying, preparing, and storing food. Food that hasn’t been prepared safely may contain bacteria like E. coli. Unsafe food can also spread foodborne illnesses like salmonellosis and Campylobacter (pronounced: kam-pye-low-BAK-tur) infection.

The good news: you can keep on top of bacteria and foodborne illness by playing it safe when buying, preparing, and storing food.

Start at the Supermarket

You have your shopping list in one hand and a squeaky shopping cart with the bad wheel in the other. Now, where should you start and how do you know which foods are safe?  Follow these tips:

  • Make sure you put refrigerated foods in your cart last. For example, meat, fish, eggs, and milk should hit your cart after cereals, produce, and chips.
  • When buying packaged meat, poultry (chicken or turkey), or fish, check the expiration date on the label (the date may be printed on the front, side, or bottom, depending on the food). Don’t buy a food if it has expired or if it will expire before you plan to use it.
  • Don’t buy or use fish or meat that has a strong or strange odor or appears discolored. Follow your nose and eyes — even if the expiration date is OK, pass on any fresh food that has a strange smell or looks unusual.
  • We applaud you bringing in your own market bags.  Still, place meats in plastic bags so any juices do not leak onto other foods in your cart or in your car.
  • Separate any raw meat, fish, or poultry from vegetables, fruit, and other foods you’ll eat uncooked.
  • Check eggs before buying them. Make sure that none of the eggs are cracked and they are all clean. Eggs should be grade A or AA.

Cart surf by these bad-news foods:

  • fruit with broken skin (bacteria can enter through the skin and contaminate the fruit)
  • unpasteurized milk, ciders, or juices (they can contain harmful bacteria)
  • pre-stuffed fresh turkeys or chickens

In the Kitchen

After a trip to the market, the first things you should put away are those that belong in the refrigerator and freezer. Keep eggs in the original carton on a shelf in the fridge – most refrigerator doors don’t keep eggs cold enough.

Ready to cook but not sure how quickly things should be used, how long they should cook, or what should be washed? Here are some important guidelines:

  • Most raw meat, poultry, or fish should be cooked or frozen within 2 days. Steaks, chops, and roasts can stay in the refrigerator 3-5 days.
  • Unopened packages of hot dogs and deli meats can be kept in the refrigerator for 2 weeks. Opened packages of hot dogs should be eaten within 1 week and deli meats within 3-5 days.
  • Thaw frozen meat, poultry, and fish in the refrigerator or microwave, never at room temperature.
  • For best results, use a food thermometer when cooking meat and poultry.
  • Cook thawed meat, poultry, and fish immediately; don’t let it hang around for hours.
  • Never wash raw chicken. Washing raw meat and poultry can spread germs around the kitchen. Germs are killed during cooking when chicken is cooked to an internal temperature of 165°F (74°C). So washing doesn’t help.
  • Cook roasts, steaks, chops, and other solid cuts of meat (beef, veal, pork, and lamb) until the juices run clear or until the meat has an internal temperature of at least 145°F (63°C). After the meat finishes cooking, let it rest for 3 minutes at room temperature before eating it.
  • Cook ground beef, veal, pork, or lamb until it’s no longer pink or until it has an internal temperature of at least 160°F (71°C). Cook ground chicken or turkey to 165°F (74°C).
  • Cook chicken and other turkey until it’s no longer pink or has an internal temperature of at least 165°F (74°C). Check chicken and turkey in several places — breast meat and leg meat — to be sure it’s cooked.
  • Cook fish until it is opaque and flaky when separated with a fork or until it has an internal temperature of 145°F (63°C).
  • Scrub all fruits and veggies with plain water to remove any pesticides, dirt, or bacterial contamination.
  • Remove the outer leaves of leafy greens, such as spinach or lettuce.
  • Don’t let eggs stay at room temperature for more than 2 hours.
  • Make sure you cook eggs thoroughly so yokes or whites are firm. Scrambled eggs should not be runny.

Clean Up

Even though the kitchen might look clean, your hands, the countertops, and the utensils you use could still contain lots of bacteria that you can’t even see. To prevent the spread of bacteria while you’re preparing food:

  • Always wash your hands with warm water and soap before preparing any food.
  • Wash your hands after handling raw meat, poultry, fish, or egg products.
  • Keep raw meats and their juices away from other foods in the refrigerator and on countertops.
  • Never put cooked food on a dish that was holding raw meat, poultry, or fish.
  • If you use knives and other utensils on raw meat, poultry, or fish, you need to wash them before using them to cut or handle something else.
  • If you touch raw meat, poultry, or fish, wash your hands. Don’t wipe them on a dish towel — this can contaminate the towel with bacteria, which may be spread to someone else’s hands.
  • Use one cutting board for raw meat, poultry, and fish, and another board for everything else.
  • When you’re done preparing food, wipe down the countertops with hot soapy water or a commercial or homemade cleaning solution. Consider using paper towels to clean surfaces. Don’t forget to wash the dishes, utensils, and cutting board in hot, soapy water.
  • Wash cutting boards — which can become a breeding ground for bacteria if they aren’t cleaned carefully — separately from other dishes and utensils in hot, soapy water. Cutting boards can be sanitized with a homemade cleaning solution (1 tablespoon of chlorine bleach in 1 gallon of water). After washing and disinfecting the cutting board, rinse it thoroughly with plain water and pat with paper towels or leave it to air dry.
  • Wash dirty dish towels in hot water.

Storing Leftovers Safely

Your dinner was a success and you’re lucky to have some to enjoy later. Here are some tips on handling leftovers:

  • Put leftovers in the fridge as soon as possible, within 2 hours. If you leave leftovers out for too long at room temperature, bacteria can quickly multiply, turning your delightful dish into a food poisoning disaster.
  • Store leftovers in containers with lids that can be snapped tightly shut. Bowls are OK for storing leftovers, but be sure to cover them tightly with plastic wrap or aluminum foil to keep the food from drying out, and avoid storing the food deeper than two inches.
  • Eat any leftovers within 3 to 4 days or freeze them. Don’t freeze any dishes that contain uncooked fruit or veggies, hard-cooked eggs, or mayonnaise.
  • If you’re freezing leftovers, freeze them in one- or two-portion servings, so they’ll be easy to take out of the freezer, pop in the microwave, and eat.
  • Store leftovers in plastic containers, plastic bags, or aluminum foil. Don’t fill bowls all the way to the top; when food is frozen, it expands. Leave a little extra space — about ½ inch (about 13 millimeters) should do it.
  • For best quality, eat frozen leftovers within 2 months.

Do I have Food Poisoning?

Food poisoning, also called foodborne illness, is illness caused by eating contaminated food. Infectious organisms — including bacteria, viruses and parasites — or their toxins are the most common causes of food poisoning.

Infectious organisms or their toxins can contaminate food at any point of processing or production. Contamination can also occur at home if food is incorrectly handled or cooked.

Food poisoning symptoms, which can start within hours of eating contaminated food, often include nausea, vomiting or diarrhea. Most often, food poisoning is mild and resolves without treatment. But some people need to go to the hospital.

Anyone can get sick from eating spoiled food. Some people are more likely to get sick from food illnesses.

  • Pregnant women
  • Older Adults
  • People with certain health conditions like cancer, HIV/AIDS, diabetes, autoimmune disorders and kidney disease

Some foods are riskier for these people. Talk to your doctor or other health provider about which foods are safe for you to eat.

Symptoms

Food poisoning symptoms vary with the source of contamination. Most types of food poisoning cause one or more of the following signs and symptoms:

  • Nausea
  • Vomiting
  • Watery or bloody diarrhea
  • Abdominal pain and cramps
  • Fever

Signs and symptoms may start within hours after eating the contaminated food, or they may begin days or even weeks later. Sickness caused by food poisoning generally lasts from a few hours to several days.

When to see a doctor

If you experience any of the following signs or symptoms, seek medical attention.

  • Frequent episodes of vomiting and inability to keep liquids down
  • Bloody vomit or stools
  • Diarrhea for more than three days
  • Extreme pain or severe abdominal cramping
  • An oral temperature higher than 100.4 F (38 C)
  • Signs or symptoms of dehydration — excessive thirst, dry mouth, little or no urination, severe weakness, dizziness, or lightheadedness
  • Neurological symptoms such as blurry vision, muscle weakness and tingling in the arms

4 Basic Food Safety Tips for Review

Clean

Always wash your food, hands, counters and cooking tools. 

  • Wash hands in warm soapy water for at least 20 seconds. Do this before and after touching food.
  • Wash your cutting boards, dishes, forks, spoons, knives and counter tops with hot soapy water. Do this after working with each food item.
  • Scrub fruits and veggies in fresh water.
  • Clean the lids on canned goods before opening.

Separate (Keep Apart)

Keep raw foods to themselves. Germs can spread from one food to another.

  • Keep raw meat, poultry, seafood, and eggs away from other foods.
  • Do this in your shopping cart, bags, and fridge.
  • Do not reuse marinades used on raw foods unless you bring them to a boil first.
  • Use a special cutting board or plate for raw foods only.

Cook

Foods need to get hot and stay hot. Heat kills germs.

  • Cook to safe temperatures:
    • Beef, Pork, Lamb 145 °F
    • Fish 145 °F
    • Ground Beef, Pork, Lamb 160 °F
    • Turkey, Chicken, Duck 165 °F
  • Use a food thermometer to make sure that food is done. You can’t always tell by looking.

Chill

Put food in the fridge right away. 

  • 2-Hour Rule: Put foods in the fridge or freezer within 2 hours after cooking or buying from the store. Do this within 1 hour if it is 90 degrees or hotter outside.
  • Never thaw food by simply taking it out of the fridge.
  • Thaw food:
    • In the fridge
    • Under cold water
    • In the microwave
  • Marinate foods in the fridge.

Think you have a food illness?

Call your doctor and get medical care right away if you think you have a food illness. Save the food package, can or carton. Then report the problem. Call USDA at 1-888-674-6854 if you think the illness was caused by meat, poultry or eggs. Call FDA at 1-866-300-4374 for all other foods.

Call your local health department if you think you got sick from food you ate in a restaurant or another food seller.

Feeling a little less than well?  Something you ate?  Find a physician in the first of its kind social ecosystem designed to connect medical providers with their patients to more closely collaborate on wellness.

Ready to get Lynked?  Go to HealthLynked.com to sign up for Free and begin safely taking charge of your health today!

 

Adapted from:

kidshealth.org

cdc.gov

foodsafetyfocus.com

 

 

Help is Needed to Tackle Childhood Cancers and Improve Survivorship

Each year, over 15,000 kids and young adults are diagnosed with cancer—that’s about 42 per day.

Though the 5-year-survival rate for childhood cancers has reached over 80 percent, nearly 2,000 kids under age 19 are taken from us each year – this makes cancer the leading killer of children by disease.

And that’s just in the United States. In 2016, over 300,000 kids and young adults were diagnosed worldwide.

Today is National Tackle Kids Cancer Day, originally established by the Children’s Cancer Institute at Hackensack University Medical Center as a day to raise awareness about the challenges and make it possible for everyone to be part of the cure by raising funds for pediatric cancer research.  National Tackle Kids Cancer Day supports the innovative research and patient care programs at CCI and its efforts to pioneer over a dozen clinical trials to treat aggressive types of pediatric cancer.  Additionally, Tackle Kids Cancer funds the Cure and Beyond Program – one of the handful survivorship programs for pediatric cancer survivors in the country.

Cancer in Little Ones is a BIG problem:

Children’s cancer cannot be treated exactly like adult cancers, where most of federal research funding goes.  Current treatments are devastatingly toxic, affect a child’s development and are often decades old.

  • To treat childhood cancer in the best way possible, we need to create specialized treatments just for kids, yet only 4% of all federal cancer funds go to pediatric care and research.
  • The causes of childhood cancer are largely unknown. We need to study what causes childhood cancer to understand what treatments work best.
  • Many childhood cancer survivors in the U.S. suffer from lifelong damage to their organs, mental health and more. We must understand how treatments affect kids long-term and discover methods to prevent late effects.

Post-Treatment and Survivorship Research

Childhood cancer leaves a lasting impact on children and their families. Even after treatment ends, ongoing effects of cancer treatment may pose challenges for survivors. Children and young adults, along with their families, may experience significant changes to their lifestyle.

As researchers continuously work to increase the survivorship rates for childhood cancer, they’re also studying ways to improve the health and well-being of survivors after the cancer has been treated.

Today, there are an estimated 15.5 million childhood cancer survivors in the U.S. and survivorship research is more important than ever.

Late and Lasting Effects

Toxic cancer treatments often cause lasting effects on a child’s body. These effects can last months or years after treatment ends.

Effects will vary depending on the type of cancer and form of treatment a child receives.  A few common late effects may include:

  • Memory or hearing loss
  • Learning disabilities
  • Nerve damage, pain and weakness
  • Stunted bone growth
  • Secondary cancers
  • More cavities or loss of teeth
  • Heart damage
  • Delayed or early puberty and infertility
  • Depression and anxiety

Health Care After Cancer

Survivors should create a plan with their care team to help them practice a healthy lifestyle and cope with any possible late effects that they may experience. Regular follow up appointments with a care team are critical to monitoring late effects and the long-term health of childhood cancer survivors. Maintaining a healthy lifestyle is especially important for survivors.

Children’s Cancer Research Fund supports ongoing research to help understand survivorship. Each year, they help to underwrite the Survivorship Conference, held by the Masonic Cancer Center, University of Minnesota. This initiative gets cancer survivors together to talk about common experiences they face. Panel discussions, researcher presentations and keynote speakers are just a few elements offered at the Survivorship Conference.

About Tackle Kids Cancer

Tackle Kids Cancer is a philanthropic initiative of the Children’s Cancer Institute at the Joseph M. Sanzari Children’s Hospital at Hackensack Meridian Health Hackensack University Medical Center dedicated to finding a cure for pediatric cancer.  Funds raised support pediatric cancer research and innovative patient services.

Pediatric cancer is the number one cause of death by disease in children. The Children’s Cancer Institute is the only center conducting bone marrow transplants and the only site for the new immunotherapy CAR-T treatment in New Jersey. The Children’s Cancer Institute provides a growing research program, including pioneering work in neuro-oncology, and is home to Cure and Beyond, a pediatric cancer survivorship program, providing services and medical support for pediatric cancer survivors.

Community supporters and corporate partners are dedicated to supporting the essential work toward a cure for pediatric cancer. To date, Tackle Kids Cancer has raised more than $5 million to support its mission. For additional information, please visit TackleKidsCancer.org

Get Connected

Everyday, you can find physicians in your area who are looking for new and unique ways to connect and collaborate with you on your care and the wellness of your family.  You might find them in HealthLynked – the first of its kind social ecosystem designed to truly allow patients and physicians to engage online in ways never before possible.

If you are enduring the challenges of Childhood Cancer, or any other disease, find strength and real connectedness by getting Lynked.  Go to HealthLynked.com to sign up for free and start taking control of your family’s health.

Adapted from:

childrenscancer.org

tacklekidscancer.org

What Are the Signs and Symptoms of Ovarian Cancer?

Each year, the first Friday in September is designated as Wear Teal Day.  On this day, organizations unite in an effort to encourage you to dress in teal and educate yourself and those around you about the symptoms and risk factors of Ovarian Cancer.

What is Ovarian Cancer?

Ovarian cancer is a disease in which, depending on the type and stage, malignant (cancerous) cells are found inside, near, or on the outer layer of the ovaries. An ovary is one of two small, almond-shaped organs located on each side of the uterus that store eggs, or germ cells, and produce female hormones estrogen and progesterone.

Cancer Basics

Cancer develops when abnormal cells in a part of the body (in this case, the ovary) begin to grow uncontrollably. This abnormal cell growth is common among all cancer types.

Normally, cells in your body divide and form new cells to replace worn out or dying cells, and to repair injuries. Because cancer cells continue to grow and divide, they are different from normal cells. Instead of dying, they outlive normal cells and continue to create new abnormal cells, forming a tumor. Tumors can put pressure on other organs near the ovaries.

Cancer cells can sometimes travel to other parts of the body, where they begin to grow and replace normal tissue. This process, called metastasis, occurs as the cancer cells move into the bloodstream or lymph system of the body. Cancer cells that spread from other organ sites (such as breast or colon) to the ovary are not considered ovarian cancer. Cancer type is determined by the original site of the malignancy.

What is the general outlook for women diagnosed with ovarian cancer?

In women ages 35-74, ovarian cancer is the fifth leading cause of cancer-related deaths. An estimated one woman in 75 will develop ovarian cancer during her lifetime. The American Cancer Society estimates that there will be over 22,280 new cases of ovarian cancer diagnosed this year and that more than 14,240 women will die from ovarian cancer this year.

When one is diagnosed and treated in the earliest stages, the five-year survival rate is over 90 percent. Due to ovarian cancer’s non-specific symptoms and lack of early detection tests, about 20 percent of all cases are found early, meaning in stage I or II.

If caught in stage III or higher, the survival rate can be as low as 28 percent. Due to the nature of the disease, each woman diagnosed with ovarian cancer has a different profile and it is impossible to provide a general prognosis. With almost 80% of women diagnosed in advanced stages of ovarian cancer, when prognosis is poor, we know that more needs to be done to spread awareness of this horrible disease that will take the lives of more than 14,000 women this year.

What are the Signs & Symptoms of Ovarian Cancer?

Ovarian cancer is difficult to detect, especially in the early stages. This is partly due to the fact that the ovaries – two small, almond-shaped organs on either side of the uterus – are deep within the abdominal cavity. The following are often identified by women as some of the signs and symptoms of ovarian cancer:

  • Bloating
  • Pelvic or abdominal pain
  • Trouble eating or feeling full quickly
  • Feeling the need to urinate urgently or often

Other symptoms of ovarian cancer can include:

  • Fatigue
  • Upset stomach or heartburn
  • Back pain
  • Pain during sex
  • Constipation or menstrual changes

If symptoms are new and persist for more than two weeks, it is recommended that a woman see her doctor, and a gynecologic oncologist before surgery if cancer is suspected.

Persistence of Symptoms

When the symptoms are persistent, when they do not resolve with normal interventions (like diet change, exercise, laxatives, rest) it is imperative for a woman to see her doctor. Persistence of symptoms is key. Because these signs and symptoms of ovarian cancer have been described as vague or silent, only approximately 19 percent of ovarian cancer is diagnosed in the early stages. Symptoms typically occur in advanced stages when tumor growth creates pressure on the bladder and rectum, and fluid begins to form.

Treatment Options

Surgery

Surgery to remove the cancerous growth is the most common method of diagnosis and therapy for ovarian cancer. It is best performed by a qualified gynecologic oncologist.

Most women with ovarian cancer will have surgery at some point during the course of their disease, and each surgery has different goals.

Chemotherapy

Before treatment begins, it is important to understand how chemotherapy works. Chemotherapy is the treatment of cancer using chemicals designed to destroy cancer cells or stop them from growing. The goal of chemotherapy is to cure cancer, shrink tumors prior to surgery or radiation therapy, destroy cells that might have spread, or control tumor growth.

Radiation

Radiation therapy uses high-­energy X­-rays to kill cancer cells and shrink tumors. Please note that this therapy is rarely used in the treatment of ovarian cancer in the United States. It is more often used in other parts of the body where cancer has spread.

Complementary Therapies

Some women with ovarian cancer turn toward the whole ­body approach of complementary therapy to enhance their fight against the disease, as well as to relieve stress and lessen side effects, such as fatigue, pain, and nausea.

Complementary therapies are diverse practices and products that are used along with conventional medicine. Many women have tried and benefited from the complementary therapies listed below. Speaking with other women, in addition to the healthcare team, can suggest the therapies that may be most helpful and appropriate for each woman’s lifestyle.

Clinical Trials

Clinical trials are research studies designed to find ways to improve health and cancer care. Each study tries to answer scientific questions and to find better ways to prevent, diagnose, or treat cancer. Many women undergoing treatment for ovarian cancer choose to participate in clinical trials. Through participation in these trials, patients may receive access to new therapy options that are not available to women outside the clinical trial setting.

How am I Diagnosed with Ovarian Cancer?

Most women with ovarian cancer are diagnosed with advanced-stage disease (Stage III or IV). This is because the symptoms of ovarian cancer, particularly in its early stages, often are not acute or intense, and present vaguely. In most cases, ovarian cancer is not detected during routine pelvic exams, unless the doctor notes that the ovary is enlarged. The sooner ovarian cancer is found and treated, the better a woman’s chance for survival. It is important to know that early stage symptoms can be difficult to detect, though are not always silent. As a result, it is important that women listen to their bodies and watch for early symptoms that may present.

Did You Know?

The Pap test does not detect ovarian cancer. It aids in evaluating cells for the detection of cervical cancer.

Screening Tests

Although there is no consistently-reliable screening test to detect ovarian cancer, the following tests are available and should be offered to women, especially those women at high risk for the disease:

  • Pelvic Exam: Women age 18 and older should have a mandatory annual vaginal exam. Women age 35 and older should receive an annual rectovaginal exam (physician inserts fingers in the rectum and vagina simultaneously to feel for abnormal swelling and to detect tenderness).
  • Transvaginal Sonography: This ultrasound, performed with a small instrument placed in the vagina, is appropriate, especially for women at high risk for ovarian cancer, or for those with an abnormal pelvic exam.
  • CA-125 Test: This blood test determines if the level of CA-125, a protein produced by ovarian cancer cells, has increased in the blood of a woman at high risk for ovarian cancer, or a woman with an abnormal pelvic examination.

While CA-125 is an important test, it is not always a key marker for the disease. Some non-cancerous diseases of the ovaries can also increase CA-125 levels, and some ovarian cancers may not produce enough CA-125 levels to cause a positive test. For these reasons the CA-125 test is not routinely used as a screening test for those at average risk for ovarian cancer.

Positive Tests

If any of these tests are positive, a woman should consult with a gynecologic oncologist, who may conduct a CT scan and evaluate the test results. However, the only way to more accurately confirm an ovarian cancer diagnosis is with a biopsy, a procedure in which the doctor takes a sample of the tumor and examines it under a microscope.

Research into new ovarian cancer screening tests is ongoing, and new diagnostic tests may be on the horizon. The National Ovarian Cancer Coalition monitors the latest scientific developments. Please visit their Research page for additional information.

Getting Help

To locate a physician in your area who can help with the symptoms you are suffering and aid in treatment, if necessary, please find one today using HealthLynked.com.  We are the first of its kind social ecosystem designed to connect physicians and patients for the efficient exchange of information in a secure platform designed for communication and collaboration.

Ready to get Lynked?  Go to HealthLynked.com, right now, to start getting the help you need, for free.

 

Source:

Ovarian.org

10 Facts about A [little] Fib that May Surprise You

Atrial fibrillation, also called AF or AFib, is the most common type of heart rhythm disorder. People with this condition are at higher risk for serious medical complications, such as dementia, heart failure, stroke, or even death. Too many of those affected by the condition don’t realize that they have it, and many who have it don’t realize the seriousness of the affliction. All too often, healthcare providers may also minimize the effects of the condition.

September is Atrial Fibrillation Awareness Month, designated to help patients and healthcare providers learn more about this complex condition. In addition to stroke prevention, additional know-how can improve the overall wellness of those suffering from AFib. Often, those with AFib have a lower quality of life than those who have suffered a heart attack. And, unfortunately, some healthcare providers may not know about treatment options that can essentially put a stop to the condition.

For those who have AFib, seeking information about the ailment and  finding early treatment are imperative. The longer someone has AFib, the more likely they will convert from intermittent AFib to enduring it all the time, making it much more difficult to stop or cure.

What is atrial fibrillation?

Atrial fibrillation (also called AFib or AF) is a quivering or irregular heartbeat (arrhythmia) that can lead to blood clots, stroke, heart failure and other heart-related complications.  A racing, pounding heartbeat that happens for no apparent reason should not be ignored, especially when other symptoms are also present — like shortness of breath with light physical activity or lightheadedness, dizziness, or unusual fatigue. AFib occurs when the heart muscles fail to contract in a strong, rhythmic way. When a heart is in AFib, it may not be pumping enough oxygen-rich blood out to the body.

Why is AFib associated with a five-times-greater risk for stroke?

When the heart is in AFib, the blood can become static and can be left pooling inside the heart. When blood pools, a clot can form. When a clot is pumped out of the heart, it can get lodged in the arteries which may cause a stroke. Blocked arteries prevent the tissue on the other side from getting oxygen-rich blood, and without oxygen the tissue dies.

Any person who has AFib needs to evaluate stroke risks and determine with a healthcare provider what must be done to lower the risks. Studies show that many people with AFib who need risk-lowering treatments are not getting them. Learn more about stroke risks with the CHA2DS2–VASc tool.

If I don’t have these symptoms, should I be concerned?

There are people who have atrial fibrillation that do not experience noticeable symptoms. These people may be diagnosed at a regular check-up or their AFib may be discovered when a healthcare provider listens to their heart for some other reason.

However, people who have AFib with no symptoms still have a five-times-greater risk of stroke. Everyone needs to receive regular medical check-ups to help keep risks low and live a long and healthy life.  Many may experience one or more of the following symptoms:

  • General fatigue
  • Rapid and irregular heartbeat
  • Fluttering or “thumping” in the chest
  • Dizziness
  • Shortness of breath and anxiety
  • Weakness
  • Faintness or confusion
  • Fatigue when exercising
  • Sweating
  • Chest pain or pressure

Are there different types of AFib?

The symptoms are generally the same; however, the duration of the AFib and underlying reasons for the condition help medical practitioners classify the type of AFib problems.

  • Paroxysmal fibrillation is when the heart returns to a normal rhythm on its own, or with intervention, within 7 days of its start. People who have this type of AFib may have episodes only a few times a year or their symptoms may occur every day. These symptoms are very unpredictable and often can turn into a permanent form of atrial fibrillation.
  • Persistent AFib is defined as an irregular rhythm that lasts for longer than 7 days. This type of atrial fibrillation will not return to normal sinus rhythm on its own and will require some form of treatment.
  • Long-standing AFib is when the heart is consistently in an irregular rhythm that lasts longer than 12 months.
  • Permanent AFib occurs when the condition lasts indefinitely and the patient and doctor have decided not to continue further attempts to restore normal rhythm.
  • Nonvalvular AFib is atrial fibrillation not caused by a heart valve issue.

Over a period of time, paroxysmal fibrillation may become more frequent and longer lasting, sometimes leading to permanent or chronic AFib. All types of AFib can increase your risk of stroke. Even if you have no symptoms at all, you are nearly 5 times more likely to have a stroke than someone who doesn’t have atrial fibrillation.

How are heart attack symptoms different from AFib symptoms?

Fluttering and palpitations are key symptoms of AFib and are the key differences, but many heart problems have similar warning signs. If you think you may be having a heart attack, DON’T DELAY. Get emergency help by calling 9-1-1 immediately. A heart attack is a blockage of blood flow to the heart, often caused by a clot or build-up of plaque lodging in the coronary artery (a blood vessel that carries blood to part of the heart muscle). A heart attack can damage or destroy part of your heart muscle. Some heart attacks are sudden and intense — where no one doubts what’s happening. But most heart attacks start slowly, with mild pain or discomfort. Often people affected aren’t sure what’s wrong and wait too long before getting help.

People living with AFib should know the Warning Sings

As stated earlier, having atrial fibrillation can put you at an increased risk for stroke. Here are the warning signs that you should be aware of:

Heart Attack Warning Signs

Chest Discomfort

Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.

Discomfort in Other Areas of the Upper Body

Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.

Shortness of Breath

With or without chest discomfort.

Other Signs

May include breaking out in a cold sweat, nausea or lightheadedness.

Stroke Warning Signs

Spot a stroke F.A.S.T.:

  • Face Drooping: Does one side of the face droop or is it numb? Ask the person to smile.
  • Arm Weakness : Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
  • Speech Difficulty: Is speech slurred, are they unable to speak, or are they hard to understand? Ask the person to repeat a simple sentence, like “the sky is blue.” Is the sentence repeated correctly?
  • Time to call 9-1-1: If the person shows any of these symptoms, even if the symptoms go away, call 9-1-1 and get them to the hospital immediately.

Call 9-1-1 immediately if you notice one or more of these symptoms, even if they are temporary or seem to disappear.

10 ATRIAL FIBRILLATION FACTS THAT MAY SURPRISE YOU

  1. AFib affects lots of people.  Currently as many as 5.1 million people are affected by AFib — and that’s just in America. By 2050, the number of people in the United States with AFib may increase to as many as 15.9 million. About 350,000 hospitalizations a year in the U.S. are attributed to AFib.  In addition, people over the age of 40 have a one in four chance of developing AFib in their lifetime.
  2. AFib is a leading cause of strokes.  Nearly 35 percent of all AFib patients will have a stroke at some time. In addition to leaving sufferers feeling weak, tired or even incapacitated, AFib can allow blood to pool in the atria, creating blood clots, which may move throughout the body, causing a stroke. To make matters worse, AFib strokes are fatal nearly three times as often as other strokes within the first 30 days. And according to a recent American Heart Association survey, only half of AFib patients understand that they have an increased risk of stroke.
  3. The U.S. Congress recognizes the need for more AFib awareness. StopAfib.org, along with several other professional and patient organizations, asked Congress to make September AFib Month. On September 11, 2009, the U.S. Senate declared it National Atrial Fibrillation Awareness Month.
  4. Barry Manilow has AFib. In 2011, Manilow spoke to Congress about AFib, urging the House of Representatives to pass House Resolution 295, which seeks to raise the priority of AFib in the existing research and education funding allocation process. The resolution does not seek any new funding. Other celebs with AFib include NBA legends Larry Bird and Jerry West, politicians George H. W. Bush and Joe Biden, Astronaut Deke Slayton, Billie Jean King, music mogul Gene Simmons and Helmut Huber, the husband of daytime TV star Susan Lucci.
  5. Healthcare professionals often minimize the impact of AFib on patients.  According to recent research in the Journal of Cardiovascular Nursing, “Compared with coronary artery disease and heart failure, AFib is not typically seen by clinicians as a complex cardiac condition that adversely affects quality of life. Therefore, clinicians may minimize the significance of AFib to the patient and may fail to provide the level of support and information needed for self-management of recurrent symptomatic AFib.”
  6. AFib patients may go untreated.  AFib can fly under the radar as some patients don’t have symptoms and some may only have symptoms once in a while. Thus, patients may go for a year or two undiagnosed, and sometimes not be diagnosed until after they have a stroke or two. Because some health care professionals perceive that AFib doesn’t affect patients’ everyday lives, a common approach is to just allow patients to live with the condition. But…
  7. The quicker the treatment, the greater the chance AFib can be stopped.  For those who have AFib, information about the ailment and treatment options are imperative. The longer someone has AFib, the more likely they will convert from intermittent to constant AFib, which means it’s more difficult to stop or cure.
  8. AFib changes the heart.  Over time, AFib changes the shape and size of the heart, altering the heart’s structure and electrical system. Research at the University of Utah shows that this scarring (fibrosis) from long-term remodeling is correlated with strokes.
  9. Treatments continue to rapidly evolve.  For years, the standard treatment for AFib patients was to send them home with medications, some of which caused harm. Now there are additional options for stopping AFib, including minimally invasive ablation procedures performed inside and outside the heart. For stubborn and long-lasting AFib, open-heart surgery may provide a cure.
  10. You can make a difference in an AFib patient’s life.  This month, forward a link to someone you may know who could have the condition. Attend an AFib awareness raising event or webinar. Or share StopAfib.org siteand ALittleFib.org with patients and friends.  Something as simple as that can help someone become free of AFib.

Prevention and Risk Reduction

Although no one is able to absolutely guarantee a stroke or a clot is preventable, there are ways to reduce risks for developing these problems.

After a patient is diagnosed with atrial fibrillation, the ideal goals may include:

  • Restoring the heart to a normal rhythm (called rhythm control)
  • Reducing an overly high heart rate (called rate control)
  • Preventing blood clots (called prevention of thromboembolism)
  • Managing risk factors for stroke
  • Preventing additional heart rhythm problems
  • Preventing heart failure

Getting Back on Beat

Avoiding atrial fibrillation and subsequently lowering your stroke risk can be as simple as foregoing your morning cup of coffee. In other words, some AFib cases are only as strong as their underlying cause. If hyperthyroidism is the cause of AFib, treating the thyroid condition may be enough to make AFib go away.

Doctors can use a variety of different medications to help control the heart rate during atrial fibrillation.

“These medications, such as beta blockers and calcium channel blockers, work on the AV node,” says Dr. Andrea Russo of University of Pennsylvania Health System. “They slow the heart rate and may help improve symptoms. However, they do not ‘cure’ the rhythm abnormality, and patients still require medication to prevent strokes while remaining in atrial fibrillation.”

AFib Treatment Saves Lives & Lowers Risks

If you or someone you love has atrial fibrillation, learn more about what AFib is, why treatment can save lives, and what you can do to reach your goals, lower your risks and live a healthy life.

If you think you may have atrial fibrillation, here are your most important steps:

  1. Know the symptoms
  2. Get the right treatment 
  3. Reduce risks for stroke and heart failure

Finding the right physician who gets your AFib, understands all the options for treatment, and will openly collaborate with you in your care is key.  Use our first of its kind healthcare ecosystem to find one near you.

As a patient, you can take control of your healthcare.  Go to HealthLynked.com, right now, to sign up for Free!

 

Sources:

Heart.org

Aug 29, 2012 | ArticlesDoctor’s Voice | 12  |