October

Brain Injury Awareness Month

What is a traumatic brain injury?
A traumatic brain injury (TBI) is defined as a blow or jolt to the head or a penetrating head injury that disrupts the function of the brain. Not all blows or jolts to the head result in a TBI. The severity of such an injury may range from "mild," i.e., a brief change in mental status or consciousness to "severe," i.e., an extended period of unconsciousness or amnesia after the injury. A TBI can result in short or long–term problems with independent function.

How many people have TBI?
Of the 1.4 million who sustain a TBI each year in the United States:

The number of people with TBI who are not seen in an emergency department or who receive no care is unknown.

What causes TBI?
The leading causes of TBI are:

Blasts are a leading cause of TBI for active duty military personnel in war zones.

Who is at highest risk for TBI?

What are the costs of TBI?
Direct medical costs and indirect costs such as lost productivity of TBI totaled an estimated $60 billion in the United States in 1995.

What are the long–term consequences of TBI?
The Centers for Disease Control and Prevention estimates that at least 3.17 Million Americans currently have a long–term or lifelong need for help to perform activities of daily living as a result of a TBI.

According to one study, about 40% of those hospitalized with a TBI had at least one unmet need for services one year after their injury. The most frequent unmet needs were:

TBI can cause a wide range of functional changes affecting thinking, language, learning, emotions, behavior, and/or sensation. It can also cause epilepsy and increase the risk for conditions such as Alzheimer’s disease, Parkinson’s disease, and other brain disorders that become more prevalent with age.

Source: Brain Injury Association of America (www.biausa.org)

Breast Cancer Control Month

Breast cancer is the most common cancer in women in the United States, aside from skin cancer. According to the American Cancer Society (ACS), an estimated 192,370 new cases of invasive breast cancer are expected to be diagnosed among women in the United States this year. An estimated 40,170 women are expected to die from the disease in 2009 alone. Today, there are about 2.5 million breast cancer survivors living in the United States.

Breast cancer is a malignant tumor that grows in one or both of the breasts. Breast cancer usually develops in the ducts or lobules, also known as the milk–producing areas of the breast.

Breast cancer is the second leading cause of cancer death in women (after lung cancer). Although African–American women have a slightly lower incidence of breast cancer after age 40 than Caucasian women, they have a slightly higher incidence rate of breast cancer before age 40. However, African–American women are more likely to die from breast cancer at every age. Breast cancer is much less common in males; by comparison, the disease is about 100 times more common among women. According to the American Cancer Society, an estimated 1,910 new cases of invasive breast cancer are expected to be diagnosed among men in the United States in 2009.

Types of breast cancer
There are several different types of breast cancer that can be divided into two main categories — noninvasive cancers and invasive cancers. Noninvasive cancer may also be called "carcinoma in situ." Noninvasive breast cancers are confined to the ducts or lobules and they do not spread to surrounding tissues. The two types of noninvasive breast cancers are ductal carcinoma in situ (referred to as DCIS) and lobular carcinoma in situ (referred to as LCIS).

It is known that hormones in a woman’s body, such as estrogen and progesterone, can play a role in the development of breast cancer. In breast cancer, estrogen causes a doubling of cancer cells every 36 hours. The growing tumor needs to increase its blood supply to provide food and oxygen. Progesterone seems to cause stromal cells (the woman’s own cells to send out signals for more blood supply to feed the tumor.

There are several kinds of invasive breast cancers. The most common type is invasive ductal carcinoma, which appears in the ducts and accounts for about 80 percent of all breast cancer cases. There are differences in the various types of invasive breast cancer, but the treatment options are similar for all of them.

Not all breast cancers are alike
There are different stages of breast cancer based on the size of the tumor and whether the cancer has spread. For healthcare provider and patient, knowing the stage of breast cancer is the most important factor in choosing among treatment options. Healthcare providers use a physical exam, biopsy, and other tests to determine breast cancer stage.

Stages of Breast Cancer
The most common system used to describe the stages of breast cancer is the AJCC/TNM (American Joint Committee on Cancer/Tumor–Nodes–Metastases) system. This system takes into account the tumor size and spread, whether the cancer has spread to lymph nodes, and whether it has spread to distant organs (metastasis).

All of this information is then combined in a process called stage grouping. The stage is expressed as a Roman numeral. After stage 0 (carcinoma in situ), the other stages are I through IV (1–4). Some of the stages are further sub–divided using the letters A, B, and C. In general, the lower the number, the less the cancer has spread. A higher number, such as stage IV (4), means a more advanced cancer.

These are the stages of breast cancer:
Stage 0 – Stage 0 is carcinoma in situ, early stage cancer that is confined to the ducts or the lobules, depending on where it started. It has not gone into the tissues in the breast nor spread to other organs in the body. Stage I – Stage I is an early stage of invasive breast cancer. In Stage I, cancer cells have not spread beyond the breast and the tumor is no more than 2 centimeters (three–quarters of an inch) across.

Stage II – Stage II is one of the following:

Stage III – Stage III may be a large tumor, but the cancer has not spread beyond the breast and nearby lymph nodes. It is locally advanced cancer. Stage IV – Stage IV is distant metastatic cancer. The cancer has spread to other parts of the body.

Recurrent cancer – Recurrent cancer is cancer that has come back (recurred) after a period of time when it could not be detected. It may recur locally in the breast or chest wall as another primary cancer, or it may recur in any other part of the body, such as the bone, liver, or lungs, which is generally referred to as metastatic cancer.

Source: National Breast Cancer Awareness Month (www.nbcam.org)

Depression & Mental Health Month

Clinical Depression is a common, real and treatable illness.

Basic Facts About Clinical Depression:

Treatments for Clinical Depression:
Clinical depression is very treatable, with more than 80% of those who seek treatment showing improvement. The most commonly used treatments are antidepressant medication, psychotherapy or a combination of the two. The choice of treatment depends on the pattern, severity, persistence of depressive symptoms and the history of the illness. As with many illnesses, early treatment is more effective and helps prevent the likelihood of serious recurrences. Depression must be treated by a physician or qualified mental health professional.

Symptoms of Clinical Depression:

If you have five or more of these symptoms for two weeks or more, you could have clinical depression and should see your healthcare provider or a qualified mental health professional for help.

Causes of Clinical Depression:
Many things can contribute to clinical depression. For some people, a number of factors seem to be involved, while for others a single factor can cause the illness. Oftentimes, people become depressed for no apparent reason.
Source: Mental Health America (www.nmha.org)

Halloween Safety Month

Safety Tips to Keep Your Children Safe this Halloween.
  1. Wear makeup instead of masks. Use Mom’s hypo–allergenic makeup if possible or purchase hypo–allergenic formulas. Have an adult apply the makeup and remove it with cold cream instead of soap and water.
  2. Avoid costumes with masks, wigs, floppy hats or eye patches that block vision.
  3. Avoid pointed props such as spears, swords or wands that endanger other children’s eyes.
  4. Wear bright, reflective clothing or have reflective patches somewhere on the costume if you are going out at night in your costume.
  5. Carry a bright flashlight to illuminate sidewalks, steps and paths.
  6. No one should drive while wearing a mask.
  7. Obey all traffic signals, both as a pedestrian and a driver.
  8. Younger children should be accompanied by an adult while traveling about the neighborhood. Older children should trick–or–treat in groups.
  9. Use common sense. Never dart out from between parked cars or hidden corners such as alleys. Avoid streets under construction. Don’t trick–or–treat in busy commercial areas or where there is heavy traffic.
  10. Grownups should inspect all trick–or–treat items before allowing children to have them.
  11. Be sure the path and stairs to your front door are well illuminated and clear of obstacles.
  12. Daylight trick or treating is safer than going out after dark.
  13. Halloween parties are safer than trick–or–treating at any time.


Source: Prevent Blindness America (www.preventblindness.org)

Let’s Talk Month

When parents talk to and affirm the value of their children, young people are more likely to develop positive, healthy attitudes about themselves. This is also true when the subject is sex. Research shows that positive communication between parents and their children can help young people establish individual values and make healthy decisions.

Parent/Child communication about sexuality Messages Worth Repeating

Communication Tips

Door Openers Door Slammers
"What do you think?" "You’re too young."
"That’s a good question." "Where did you hear that?"
"I don’t know, but I’ll find out." If you say that word again, I’ll ...
"I’m trying to understand what you’re feeling." That’s none of your business.
"Do you know that word means?" I don’t care what your friends are doing.
"I’m glad you told me about that." That’s just for boys (girls).
"We’ll talk about that when you need to know."

What Young People Ask?
Parents may worry about the types of questions their young people may ask and what conclusions they can or should draw from those questions.

Questions often asked by preschoolers (ages 3 to 5) include: Questions often asked by preteens include: Questions often asked by teens include: When parents are aware of the questions young people ask (or want to ask), they can see that "Am I normal?" underlies many of these questions. Children seek reassurance as well as information. Understanding this may ease parental discomfort. Parents’ uneasiness can be further alleviated by knowing how experts recommend talking with young people about sexuality. The experts say, be prepared to:
Why Is It So Hard to Talk About Sex?
Some parents:
Source: Advocates for Youth (www.advocatesforyouth.org)

National Celiac Disease Awareness Month

What is Celiac Disease?
Celiac disease (CD) is a genetically linked disease with an environmental trigger. In people with CD, eating certain types of protein fractions, commonly called gluten, set off an autoimmune response that causes damage to the small intestine. This, in turn, causes the small intestine to lose the ability to absorb the nutrients found in food, leading to malnutrition and a variety of other complications.

The offending protein, gluten, is found in wheat, barley, rye, and to a lesser extent, and oats. Related proteins are found in triticale, spelt, kamut.

Celiac Disease is: Celiac Disease is NOT:

The Damaging Proteins
The term "gluten" is, in a sense, a generic term for the storage proteins that are found in grains. In reality, each type of protein is slightly different from the others. The "gluten" in wheat, rye, barley, and in a much lower amount, oats, contains particular amino acid sequences that are harmful to persons with celiac disease. The damaging proteins are particularly rich in proline and glutamine (especially the amino acid sequences which are in the following orders: Pro–Ser–Gln–Gln and Gln–Gln–Gln–Pro). As peptides, some such as 33–MER, cannot be broken down any further. In people with celiac disease, 33–MER stimulates T–cells to produce antibodies. The antibodies, in turn, attack the villi in the small intestine, reducing their ability to absorb nutrients. It is important to note that these sequences are NOT found in the proteins of corn and rice.

The Nature of the Injury
The damage to the small intestine (the jejunum) caused by this disease is very slow to develop and is insidious. It is: How Does One "Catch" Celiac Disease?
Celiac disease cannot be "caught," but rather the potential for CD may be in the body from birth. Its onset is not confined to a particular age range or gender, although more women are diagnosed than men. It is not known exactly what activates the disease, however three things are required for a person to develop CD:

Summary
Celiac disease is life–long and currently incurable. The only known treatment at this time is strict adherence to a gluten–free lifestyle, free of WBRO. Oats are not a risk free choice for those with celiac disease and not recommended during the first year. There is no way to determine in advance whether or not a person will be able to tolerate uncontaminated oats.

What are the symptoms of Celiac Disease?
The symptoms of celiac disease (CD) vary so widely among patients that there is no such thing as a "typical celiac." The amount of intestinal damage that has occurred and the length of time nutrient absorption has been abnormal seem to be the factors that determine the type and severity of symptoms experienced. It is interesting to note that some people with CD report no symptoms at all.

A. The Patient’s Physical State
What are the symptoms? How long have they been present? How often do they occur?

• Abdominal cramping/bloating • Feet (Reduced fat padding)
• Abdominal distention • Flatus (Passing gas)
• Acidosis • Gluten ataxia
• Appetite (Increased to the point of craving) • Mouth sores or cracks in the corners
• Back pain (Such as a result of collapsed lumbar vertebrae) • Muscle cramping (Especially in the hands and legs)
• Constipation • Night blindness
• Decreased ability to clot blood • Skin (Very dry)
• Dehydration • Stools (Loose? Hard? Small? Large? Foul smelling? Floating? Clay, Light tan or Gray-colored? Highly rancid? Frothy?)
• Diarrhea • Tongue (Smooth or geographic - looks like different continents)
• Edema • Tooth enamel defects
• Electrolyte depletion • Weakness
• Energy loss • Weight loss
• Fatigue

B. The Patient’s Emotional State
What is the patient’s emotional state? Is it consistent throughout the day? When and for how long do the symptoms occur? C. Additional Conditions
What else is involved? Other diseases? Other organs? D. Symptoms in Children
How is the child developing? Under age three:
Older children:

How is Celiac Disease Diagnosed?
When working with a healthcare provider to diagnose and/or confirm celiac disease (CD), three major steps are taken. First, a thorough physical examination is conducted, including a series of blood tests, sometimes referred to as the Celiac Blood Panel. Second, a duodenal biopsy is performed with multiple samples from multiple locations in the small intestine. And third, the gluten–free diet is implemented. When the patient shows a positive response to the diet – symptoms subside and the small intestine returns to its normal, healthy state – the diagnosis of CD is confirmed.

(NOTE: To ensure the most accurate and timely diagnosis, the gluten–free diet should be implemented only after the first two steps have been completed.)

Source: Celiac Sprue Association (www.csaceliacs.org)

National Down Syndrome Awareness Month

Down syndrome is a genetic condition that occurs in one in every 733 births. It is the most frequently occurring chromosomal condition and is found in people of all races and economic levels. More than 400,000 people in the United States have Down syndrome.

A few of the common physical traits of Down syndrome are low muscle tone, small stature, an upward slant to the eyes, and a single deep crease across the center of the palm. Every person with Down syndrome is a unique individual and may possess these characteristics to different degrees or not at all.

People with Down syndrome have an increased risk for certain medical conditions such as congenital heart defects, respiratory and hearing problems, Alzheimer’s disease, childhood leukemia, and thyroid conditions. However, many of these conditions are now treatable, so most people with Down syndrome lead healthy lives. Life expectancy for people with Down syndrome has increased dramatically in recent decades – from 25 in 1983 to 60 today.

People with Down syndrome experience cognitive delays, but the effect is usually mild to moderate and is not indicative of the many strengths and talents that each individual possesses. Children with Down syndrome learn to sit, walk, talk, play, and do most other activities; only somewhat later than their peers without Down syndrome.

Quality educational programs, a stimulating home environment, good health care, and positive support from family, friends and the community enable people with Down syndrome to develop their full potential and lead fulfilling lives. People with Down syndrome attend school and work, and participate in decisions that concern them, and contribute to society in many wonderful ways.

What is the cause of Down syndrome?
The additional copy of the 21st chromosome which causes Down syndrome can originate from either the father or the mother. Approximately five percent of the cases have been traced to the father.

Who has the highest risk of having a child with Down syndrome?
Down syndrome can occur in people of all races and economic levels. Older women have an increased chance of having a child with Down syndrome. A 35–year–old woman has about a one in 400 chance of conceiving a child with Down syndrome, and this chance increases gradually to one in 110 by age 40. At age 45 the incidence becomes approximately one in 35.

Since many couples are postponing parenting until later in life, the incidence of Down syndrome conceptions is expected to increase. Therefore, genetic counseling for parents is becoming increasingly important. Still, many healthcare providers are not fully informed about advising their patients about the incidences of Down syndrome, advancements in diagnosis, and the protocols for care and treatment of babies born with Down syndrome.

Why are medical researchers today so keenly interested in Down syndrome?
Down syndrome is a developmental condition. As researchers learn more about the molecular genetics and other aspects of Down syndrome, they also obtain valuable information about human development and can advance the study of many biological processes.

In addition, individuals with Down syndrome have a higher incidence of certain medical conditions, and the study of Down syndrome may yield important breakthroughs in those areas. Research in Down syndrome provides a way for looking at many important problems: Source: National Down Syndrome Society (www.ndss.org)

National Family Health Month

What You Can Do to Maintain Your Health
Don’t Smoke or Use Tobacco
Smoking and using tobacco are very dangerous habits. Smoking causes 440,000 deaths in the United States every year. More preventable illnesses (such as emphysema, mouth, throat and lung cancer and heart disease) are caused by tobacco use than by anything else. The sooner you quit, the better.

Limit How Much Alcohol You Drink
This means no more than 2 drinks a day for men and 1 drink a day for women. One drink is equal to 1 can of beer (12 ounces), a 4–ounce glass of wine or a jigger (1 ounce) of liquor.

Too much alcohol can damage the liver and contribute to some cancers, such as throat and liver cancer. Alcohol also contributes to deaths from car wrecks, murders and suicides.

Eat Healthy
A healthy diet has many health benefits. Heart disease, certain cancers, stroke, diabetes and damage to your arteries can be linked to what you eat. By making healthier food choices, you can also lower your cholesterol and lose weight.

Lose Weight if You’re Overweight
Many Americans are overweight. Carrying too much weight increases your risk for high blood pressure, high cholesterol, diabetes, heart disease, stroke, certain cancers, gallbladder disease and arthritis in the weight–bearing joints (such as the spine, hips or knees). A high–fiber, low–fat diet and regular exercise can help you lose weight and keep it off.

Exercise
Exercise can help prevent heart disease, high blood pressure, diabetes, osteoporosis and depression. It can also help prevent colon cancer, stroke and back injury. You’ll feel better and keep your weight under control if you exercise regularly. Try to exercise for 30 to 60 minutes, 4 to 6 times a week, but remember that any amount of exercise is better than none.

Don’t Sunbathe or Use Tanning Booths
Sun exposure is linked to skin cancer, which is the most common type of cancer in the United States. It’s best to limit sun exposure and wear protective clothing and hats when you are outside. Sunscreen is also very important. It protects your skin and will help prevent skin cancer. Make sure you use sunscreen year round on exposed skin (such as your face and hands). Choose a broad–spectrum sunscreen with at least an SPF of 15 and one that blocks both UVA and UVB light.

Practice Safe Sex
The safest sex is between 2 people who are only having sex with each other and who don’t have a sexually transmitted infection (STI) or share needles to inject drugs.

Use latex condoms and a spermicide (a product that kills sperm) gel or cream. Talk with your healthcare provider about being tested year for STIs.

Control Your Cholesterol Level
If your cholesterol level is high, keep it down by eating right and by exercising. You can also decrease your cholesterol level by limiting how much cholesterol you eat and by quitting smoking.

Control High Blood Pressure
High blood pressure increases your risk for heart disease, stroke and kidney disease. To control it, lose weight, exercise, eat less sodium, drink less alcohol, don’t smoke and take medicine if your healthcare provider prescribes it.

Keep Your Shots Up to Date
Adults need a tetanus–diphtheria booster every 10 years. Your healthcare provider may substitute one Td booster with Tdap, which protects you against pertussis (whooping cough). You should also get a flu shot each year. Ask your healthcare provider if you need other shots or vaccines.

Check Your Breasts
Breast cancer is the second most common cause of death for women. Have your healthcare provider check your breasts every 1 to 2 years until you’re 40. After age 40, you should have a yearly clinical exam and a mammogram.

Get Regular Pap Smears
Cancer of the cervix in women can be detected by regular Pap smears. Start having them when you begin having sex or by age 18. You’ll need them once a year at first, until you’ve had at least 3 normal Pap tests. After this, you should have them at least every 3 years.

Ask Your Healthcare Provider About Other Cancer Screenings
Adults over age 50 should ask their healthcare provider about being checked for colorectal cancer. Men over age 50 should discuss with their healthcare provider the risks and benefits of being screened for prostate cancer.

Yearly Physicals
Health screenings are replacing the yearly physical. Instead of every person getting the same exams and tests, only the appropriate ones are given. Talk to your family healthcare provider about your risk factors and what tests and exams are right for you.

Healthy Living: How Common Behaviors Affect Your Health
What comes to mind when you think of taking risks with your health—driving recklessly, or maybe abusing alcohol or illegal drugs? Those behaviors are certainly risky. However, many people have less dramatic behaviors that are just as dangerous in the long run. Tobacco use, unbalanced nutrition (too many calories and/or too much of one food group and not enough of the others) and a lack of physical activity are some of the key risk factors for the most common causes of death.

The Most Common Causes of Death
Heart disease, cancer and stroke are the most common causes of death in the United States. Nearly 1.5 million people in the United States die each year from one of these diseases, or from complications of these diseases. That’s more than the number of American soldiers who died in the Civil War, the Korean War and the Vietnam War combined, and it happens every year.

Top 10 Causes of Death (in order)
  1. Heart Disease
  2. Cancer
  3. Stroke
  4. Chronic lower respiratory disease
  5. Accidents (many are alcohol–related)
  6. Diabetes
  7. Flu and pneumonia
  8. Alzheimer’s disease
  9. Kidney disease
  10. Infection

Don’t these diseases run in families? How much control do I really have?
It’s true that heart disease, stroke and some kinds of cancer tend to occur more often in people who have a family history of the disease. However, your genes are only part of your risk for these diseases. In many cases, your behavior is at least as important to your health as your family history. If you choose unhealthy behaviors, you are at greater risk of having a serious health problem.

Reduce Risk
The following are three of the most important ways to reduce your risk of the top three causes of death:

  1. Quit smoking, or don’t start.
  2. Eat fewer high–fat foods and more fruits and vegetables.
  3. Be more physically active.

Even by doing just one of these things, you will improve your health and reduce your risk of heart disease, cancer and stroke.

Eat More Fruits and Vegetables
Fruits and vegetables are important sources of vitamins, minerals and fiber. To improve your eating habits, you’ll want to cut down on foods that are high in fat and calories, such as soda pop and hamburgers. By replacing those foods with healthier choices, such as fruits and vegetables, you’ll get better nutritional quality from the foods you eat. Also, adding fruits and vegetables—and learning new ways to prepare them—can keep you from getting bored with a more healthy diet.

Is it better to have an exercise plan instead of just trying to be more physically active throughout the day?
Ideally, we would all get enough exercise in our daily lives to burn the energy that we get from eating food. Unfortunately, many things about modern life let people avoid being physically active. For example, many people drive almost everywhere they go, and many jobs require people to sit at a desk for much of the day.

One obvious way to burn more energy is to participate in structured exercise, such as aerobics or basketball. However, you can also burn energy by adding more movement to your everyday activities. For example, try walking in place or riding a stationary bicycle while you watch TV. Take the stairs instead of the elevator or squeeze in a couple of 15–minute walking breaks during the day.

How can I make good habits this time?
Unhealthy behaviors become habits, so changing them can be very hard. You’re more likely to make changes in your habits if you set a specific goal for yourself. The kind of goal you choose and how you think about it is very important. If you set a goal that focuses on an outcome—for example, losing 20 pounds—it can be hard to know where to start or what to do. Instead, set a goal that focuses on a specific behavior. For example, choose one specific thing to change about the way you eat, such as adding a piece of fruit to one meal each day. This type of goal is easier to think about and plan for. Once your new healthy behavior becomes a habit, you can move on to another goal.

If you set a goal to be more physically active, you can improve your chances of success by exercising with other people. For example, set up a walking group at work or in your neighborhood, or ask a friend to be your exercise buddy. This will provide you with support and make physical activity more enjoyable.

Source: American Academy of Family Physicians (www.aafp.org)

National Liver Awareness Month

The liver is a vital organ – no one can survive without it, but it is a silent organ because it can be damaged without sending any signals or symptoms. Hence, many people live with liver disease for a long time without ever knowing it.

Many forms of liver disease are preventable, and many more if detected early can be treated effectively.

Get the Facts
The statistics on the prevalence of liver disease in the United States are startling. Follow These Ten Simple Liver Health Tips
Take care of your liver so your liver can take care of you.

The Progression of Liver Disease
There are many different types of liver disease. But no matter what type you have, the damage to your liver is likely to progress in a similar way.

Whether your liver is infected with a virus, injured by chemicals, or under attack from your own immune system, the basic danger is the same – that your liver will become so damaged that it can no longer work to keep you alive.

Anything that keeps your liver from doing its job may put your life in danger.

The Healthy Liver
Your liver helps fight infections and cleans your blood. It also helps digest food and stores energy for when you need it. A healthy liver has the amazing ability to grow back, or regenerate, when it is damaged. Anything that keeps your liver from doing its job – or from growing back after injury – may put your life in danger.

Inflammation
In the early stage of any liver disease, your liver may become inflamed. It may become tender and enlarged. Inflammation shows that your body is trying to fight an infection or heal an injury. But if the inflammation continues over time, it can start to hurt your liver permanently.

When most other parts of your body become inflamed, you can feel it – the area becomes hot and painful. But an inflamed liver may cause you no discomfort at all.

If your liver disease is diagnosed and treated successfully at this stage, the inflammation may go away.

Fibrosis
If left untreated, the inflamed liver will start to scar. As excess scar tissue grows, it replaces healthy liver tissue. This process is called fibrosis. (Scar tissue is a kind of fibrous tissue.)

Scar tissue cannot do the work that healthy liver tissue can. Moreover, scar tissue can keep blood from flowing through your liver. As more scar tissue builds up, your liver may not work as well as it once did. Or, the healthy part of your liver has to work harder to make up for the scarred part.

If your liver disease is diagnosed and treated successfully at this stage, there’s still a chance that your liver can heal itself over time.

Cirrhosis
But if left untreated, your liver may become so seriously scarred that it can no longer heal itself. This stage – when the damage cannot be reversed – is called cirrhosis. Cirrhosis can lead to a number of complications, including liver cancer. In some people, the symptoms of cirrhosis may be the first signs of liver disease.

Once you’ve been diagnosed with cirrhosis, treatment will focus on keeping your condition from getting worse. It may be possible to stop or slow the liver damage. It is important to protect the healthy liver tissue you have left.

Liver Failure
Liver failure means that your liver is losing or has lost all of its function. It is a life–threatening condition that demands urgent medical care.

The first symptoms of liver failure are often nausea, loss of appetite, fatigue, and diarrhea. Because these symptoms can have any number of causes, it may be hard to tell that the liver is failing.

Liver failure is a life–threatening condition that demands urgent medical care.

But as liver failure progresses, the symptoms become more serious. The patient may become confused and disoriented, and extremely sleepy. There is a risk of coma and death. Immediate treatment is needed. The medical team will try to save whatever part of the liver that still works. If this is not possible, the only option may be a liver transplant.

When liver failure occurs as a result of cirrhosis, it usually means that the liver has been failing gradually for some time, possibly for years. This is called chronic liver failure.

Chronic liver failure can also be caused by malnutrition. More rarely, liver failure can occur suddenly, in as little as 48 hours. This is called acute liver failure and is usually a reaction to poisoning or a medication overdose.

Cirrhosis, liver cancer, and liver failure are serious conditions that can threaten your life. Once you have reached these stages of liver disease, your treatment options may be very limited.

That’s why it’s important to catch liver disease early, in the inflammation and fibrosis stages. If you are treated successfully at these stages, your liver may have a chance to heal itself and recover.

Talk to your healthcare provider about liver disease. Find out if you are at risk or if you should undergo any tests or vaccinations.

Source: American Liver Foundation (www.liverfoundation.org)

National Lupus Awareness Month

Lupus is a chronic, autoimmune disease that can damage any part of the body (skin, joints, and/or organs inside the body). Chronic means that the signs and symptoms tend to last longer than six weeks and often for many years. In lupus, something goes wrong with your immune system, which is the part of the body that fights off viruses, bacteria, and germs ("foreign invaders," like the flu). Normally our immune system produces proteins called antibodies that protect the body from these invaders. Autoimmune means your immune system cannot tell the difference between these foreign invaders and your body’s healthy tissues and creates autoantibodies that attack and destroy healthy tissue. These autoantibodies cause inflammation, pain, and damage in various parts of the body.

What Causes Lupus
Genes
No gene or group of genes has been proven to cause lupus. Lupus does, however, appear in certain families, and when one of two identical twins has lupus, there is an increased chance that the other twin will also develop the disease. These findings, as well as others, strongly suggest that genes are involved in the development of lupus. Although lupus can develop in people with no family history of lupus, there are likely to be other autoimmune diseases in some family members. Certain ethnic groups, people of African, Asian, Hispanic/Latino, Native American, Native Hawaiian, or Pacific Island descent, have a greater risk of developing lupus, which may be related to genes they have in common.

Environment
While a person’s genes may increase the chance that he or she will develop lupus, it takes some kind of environmental trigger to set off the illness or to bring on a flare. Examples include: Although many seemingly unrelated factors can trigger the onset of lupus in a susceptible person, scientists have noted some common features among many people who have lupus, including:

However, many people cannot remember or identify any specific factor that occurred before they were diagnosed with lupus.

Hormones
Hormones are the body’s messengers and they regulate many of the body’s functions. In particular, the sex hormone estrogen plays a role in lupus. Men and women both produce estrogen, but estrogen production is much greater in females. Many women have more lupus symptoms before menstrual periods and/or during pregnancy, when estrogen production is high. This may indicate that estrogen somehow regulates the severity of lupus. However, it does not mean that estrogen, or any other hormone for that matter, causes lupus.

Source: Lupus Foundation of America (www.lupus.org)

National Physical Therapy Month

Please join Haskell County Healthcare System in recognition of our physical therapy professionals.

Move Forward... Physical Therapy Brings Motion to Life

Source: American Physical Therapy Association (www.apta.org)

National Spina Bifida Awareness Month

Spina Bifida literally means "split spine." Spina Bifida happens when a baby is in the womb and the spinal column does not close all of the way. Spina Bifida is the most common birth defect that disables people for life. Every day, about eight babies born in the United States have Spina Bifida or a similar birth defect of the brain and spine.

Children and young adults with Spina Bifida can have mental and social problems. They also can have problems with walking and getting around or going to the bathroom, latex allergy, obesity, skin breakdown, gastrointestinal disorders, learning disabilities, depression, tendonitis and sexual issues.

Birth defects like Spina Bifida occur in 7 out of every 10,000 live births in the United States. Birth defects can happen in any family. In fact, 95 percent of neural tube defects (NTDs) occur in women with no personal or family history of NTDs. However, according to the CDC, some risk factors are known:

There are three types of Spina Bifida:
Occulta
Often called hidden Spina Bifida, the spinal cord and the nerves are usually normal and there is no opening on the back. In this relatively harmless form of Spina Bifida, there is a small defect or gap in a few of the small bones (vertebrae) that make up the spine.

There may be no motor or sensory impairments evident at birth. Subtle, progressive neurologic deterioration often becomes evident in later childhood or adulthood.

In many instances, Spina Bifida Occulta is so mild that there is no disturbance of spinal function at all. Occulta can be diagnosed at any age.

Meningocele
The protective coatings (meninges) come through the open part of the spine like a sac that is pushed out. Cerebrospinal fluid is in the sac and there is usually no nerve damage. Individuals may suffer minor disabilities. Additional problems can develop later in life.

Myelomeningocele
This form of Spina Bifida occurs when the meninges (protective covering of the spinal cord) and spinal nerves come through the open part of the spine. This is the most serious type of Spina Bifida, which causes nerve damage and more severe disabilities.

Treatment
A child with meningomyelocele usually is operated on within two to three days of birth. This prevents infections and helps save the spinal cord from more damage.

A child with meningocele usually has it treated with surgery, and more often than not, the child is not paralyzed. Most children with this condition grow up fine, but they should be checked by a healthcare provider because they could have other serious problems, too.

A child with OSD should see a surgeon. Most experts think that surgery is needed early to keep nerves and the brain from becoming more damaged as the child grows.

Spina Bifida occulta does not need to be treated.

Prevention
Women who are old enough to have babies should take folic acid before and during the first three months of pregnancy. Because half of the pregnancies in the United States are unplanned, the Spina Bifida Association asks women to take a vitamin with 400 mcg (0.4 mg) of folic acid each day during the years of their lives when they are possibly able to have children. Women who have a child or sibling with Spina Bifida, have had an affected pregnancy or have Spina Bifida themselves should take 4000 mcg (4.0 mg) of folic acid for one to three months before and during the first three months of pregnancy.

Living with Spina Bifida
With help, children with Spina Bifida can lead full lives. Most do well in school, and many play in sports. Because of today’s medicine, about 90 percent of babies born with Spina Bifida now live to be adults, about 80 percent have normal intelligence and about 75 percent play sports and do other fun activities.

Source: Spina Bifida Association (www.sbaa.org)