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Monday, May 27, 2013

Diagnosing Arthritis and Other Rheumatic Diseases

Diagnosing arthritis and other rheumatic diseases is often difficult, as many symptoms are similar among the different diseases. To make an accurate diagnosis, a doctor may need to conduct the following:
  • Review the medical history
  • Perform a physical examination
  • Obtain laboratory tests, X-rays, and other imaging tests

Sunday, May 26, 2013

What is involved in reviewing your medical history?

When reviewing your medical history, your doctor may ask the following questions:
  • Where is the pain?
  • How long have you had the pain?
  • When does the pain occur and how long does it last?
  • When did you first notice the pain?
  • What were you doing when you first noticed the pain?
  • How intense is the pain?
  • What tends to relieve the pain?
  • Have you had any illnesses or injuries that may explain the pain?
  • Is there a family history of arthritis or other rheumatic diseases?
  • What medication(s) are you currently taking?

Saturday, May 25, 2013

It's impossible to include all of the best photos of 2013

It's impossible to include all of the best photos of 2013 in one gallery, but these images offer a fantastic glimpse pictures.

What are the symptoms of fibromyalgia?

Pain is the most common and chronic symptom of fibromyalgia. Pain may begin in one area of the body, such as the neck and shoulders, but eventually the entire body may become affected. The pain ranges from mild to severe and may be described as burning, soreness, stiffness, aching, or gnawing pain. Fibromyalgia usually is associated with characteristic tender spots of pain in the muscles. The following are other common symptoms of fibromyalgia. However each individual may experience symptoms differently. Symptoms may include:
  • Moderate to severe fatigue
  • Decreased exercise endurance
  • Sleep problems at night
  • Depressed mood
  • Anxiety
  • Headaches
  • Irritable bowel symptoms, such as abdominal pain and bloating, diarrhea, and constipation 
  • Restless legs
  • Painful menstrual periods
The symptoms of fibromyalgia may resemble other medical conditions or problems. Always consult your doctor for a diagnosis.

Topic Index - Arthritis and Other Rheumatic Diseases Arthritis & Other Rheumatic Diseases Home

  • Arthritis & Other Rheumatic Diseases Home
  • Statistics
  • Anatomy of a Joint
  • About Arthritis and Other Rheumatic Diseases
  • Diagnosing Arthritis and Other Rheumatic Diseases
  • Common Types of Arthritis and Other Rheumatic Diseases
  • Ankylosing Spondylitis
  • Bursitis
  • Carpal Tunnel Syndrome
  • Fibromyalgia
  • Gout
  • Infectious Arthritis
  • Juvenile Rheumatoid Arthritis
  • Lyme Disease
  • Low Back Pain
  • Osteoarthritis
  • Psoriatic Arthritis
  • Raynaud's Phenomenon
  • Reactive Arthritis (Reiter's Syndrome)
  • Rheumatoid Arthritis
  • Scleroderma
  • Systemic Lupus Erythematosus (Lupus)
  • Tendonitis
  • Treatment for Arthritis and Other Rheumatic Diseases
  • Living With a Rheumatic Disease
  • Glossary
  • Online Resources

Gill Heart Institute doctors give viola professor an encore

Gill Heart Institute doctors give viola professor an encore

One minute, Deborah Lander was on her way to a performance at the Lexington Opera House.

The next, she lay dead on the sidewalk.

On that day in February 2012, Lander experienced sudden cardiac arrest, where the heart unexpectedly stops pumping blood to vital organs. About 300,000 Americans have sudden cardiac arrest each year. Only about 10 percent survive.

Lander is one of the survivors.

The swift actions of bystanders and the skilled techniques of trained experts at the UK Gill Heart Institute saved her life.

Two strangers saw Lander lying on the ground and performed CPR until an ambulance arrived about 10 minutes later. That was the first important step to keeping her alive.

Next, the ambulance took Lander to the emergency department at UK Albert B. Chandler Hospital, where a cardiac team was waiting. There, doctors performed therapeutic hypothermia on Lander. That process involves using catheters and ice to cool the body to 90-93 degrees Fahrenheit for about 24 hours.

For patients who experience sudden cardiac arrest, much of the damage happens after the heart starts pumping blood again. The rush of blood returning to the brain can cause inflammation and other complications that often result in neurological damage and a slow, challenging recovery. Cooling the body helps it adapt to the return of blood flow.

Because she received immediate CPR and then therapeutic hypothermia at UK, Lander has fully returned to a normal, healthy life. She’s back working as a viola professor at UK and enjoying the local arts scene.

“The whole series of events had to happen for me to recovery properly like this,” Lander said. “I was extremely lucky. They took care of me.”

No memory of that day

Lander grew up in Sydney, Australia, where she learned viola and joined the Australian Chamber Orchestra at age 17.

She moved to Lexington after falling in love with the rolling hills of horse country and became the first salaried, tenure-track viola professor in the state. After she moved to Kentucky, she gave up her car and walked almost everywhere.

“I haven’t owned a car in 20 years,” Lander said. “I’ve always tried to be a healthy person. I do my exercise program, walk a lot, try to eat right within reason.”

But, as she noted, sudden cardiac arrest has that name for a reason.

“It can happen to anybody,” Lander said. “There is no warning.”

She doesn’t remember much about the day it happened, which her doctors at the Gill Heart Institute say is fairly normal. Her first memory after waking up at the hospital was seeing her sister who had flown in from London, England, and her mother, who had come from Sydney.

“Coming back to consciousness was a strange thing,” Lander said. “Everybody is crying and happy you’re awake. But you have no memory of what has happened.”

Lander spent 10 days in Chandler Hospital before returning home.

Important clinical advancement

That memory loss appears to be the only lasting effect from her sudden cardiac arrest. Without the use of therapeutic hypothermia at UK, her prognosis could have been much worse.

Patients who are treated swiftly with hypothermia often are able to recover complete brain function, said Alison Bailey, MD, an assistant professor at UK and one of Lander’s physicians at the Gill Heart Institute.

Susan Smyth, MD, PhD, chief of cardiovascular medicine at the Gill Heart Institute, said therapeutic hypothermia has been heralded as one of the most important clinical advances in the science of resuscitation. But despite receiving the highest endorsement from the American Heart Association and other societies, it is still not routinely used in many hospitals. It’s one of the many ways UK HealthCare offers the most advanced treatments to patients.

UK treats about two patients a week with therapeutic hypothermia, which has helped save dozens of lives, Smyth said.

Teamwork at Gill

John Gurley, MD, an interventional cardiologist at Gill implanted a defibrillator in Lander in hopes that another sudden cardiac arrest can be prevented. If the device senses an abnormal heart rhythm, it will send an electric shock to return the heart to its normal rhythm.

She will meet with Navin Rajagopalan, MD, her primary Gill cardiologist, every six months to make sure her heart is healthy.

“The doctors at Gill work together extremely well,” she said. “They really work hard to have the best outcome for the patient. I was very impressed by the teamwork at UK.” 
“They really work hard to have  the best outcome for the patient.  
 I was very impressed by the teamwork at UK.” 

Lander also praised the nurses who cared for her during her hospital stay.

“They are willing to go above and beyond for anything you could reasonably ask of them,” she said. “Apart from the quality of medical care they give you, which is extremely good, all the nurses as people have been extraordinary.”


Looking ahead

Lander is now an advocate for learning CPR. She has returned to teaching viola and exercises regularly.

“I’ve been given an excellent prognosis,” she said. “I’m as active today as the day before this event happened to me. I’ve been told to go out and have a normal life and do what I do.”

Autopsy: How Understanding Death Helps the Living

Helping the living understand death
The death of a loved one is one of the most devastating events in a person's life. Whether death is expected because of disease or illness or happens suddenly, the bereaved are often left with unanswered questions about the exact cause of death. Shock and grief may cloud the decision as to whether to request an autopsy. Factors such as cost, pending funeral arrangements, religious beliefs, perceived social stigma and misunderstanding may stand in the way of a family member's willingness to request an autopsy.

Advances in medical technology, sophisticated imaging techniques and new laboratory methods have led to the perception by many that autopsies are not as necessary as they once were. Yet, as genetics play a deeper role in a wide range of medical conditions, autopsies may provide valuable information about medical conditions, allowing surviving family members to make necessary lifestyle changes and get critical medical tests to increase the quality of and prolong their lives.

What is an autopsy?
The word autopsy literally means "to look for oneself." An autopsy involves a complete medical examination of the body, both external and internal. Performed by a pathologist - a physician specially trained in the procedure who is able to recognize the effects of disease on the body - the initial procedure generally takes four hours to complete. Synthesizing data from microscopic examination (small biopsies of tissue taken during examination) and specialized consultations result in a final report.

This report is usually issued within a month of the procedure, which allows the pathologist time to review medical records, discuss the decedent's clinical course with clinical physicians, study tissue sections and perform additional studies as needed. In rare instances, the report may be finalized after two months. The report is made available to the deceased's attending physician, and if desired, to the legal next-of-kin.

An autopsy can answer specific questions about illness, the cause of death and whether other co-existing conditions may have contributed to the person's death. The autopsy can also provide specific information on inherited diseases that may be useful to family members.

How an autopsy is performed
The autopsy room is regarded as an important place for gathering medical knowledge. The body is treated with respect and dignity. The family's wishes are observed at all times.

An autopsy begins with the pathologist gathering as much information as possible about the person who died and the events leading to death. This includes reviewing medical records and consulting with the deceased person's physicians about previous medical problems. Information may also be gathered from family members.

A surgical incision opens the body cavity to allow examination of organs and tissues. Small samples of each organ are taken for microscopic examination to look for malignancies, infections or other disorders. Other tests may be performed to study genes and check for drugs, chemicals or other toxic substances.

Once the autopsy is completed, the incisions are closed. The body is then prepared for family viewing, should that be the family's wish. An autopsy does not disfigure the body and does not preclude viewing. Pathologists perform autopsies in a way that does not interfere with burial or cremation.

Other facts about autopsies
For patients who die in a hospital, autopsies are generally performed at the hospital's expense; however, when death occurs elsewhere, the expense must often be incurred by the family. Private autopsy is not covered by insurance or Medicare at this time.

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