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It’s About Time for Sepsis.

Sepsis Awareness Month:  September.

Sepsis Quick Facts:

  • Sepsis is a public health crisis.
  • Every 20 seconds someone is diagnosed with sepsis.
  • Every 2 minutes sepsis takes a life.
  • Each year in the U.S., sepsis takes more lives than:
    • Opioids (47,600)
    • Breast cancer (41,000)
    • Prostate cancer (30,000)
    • Combined these are 118,600 deaths per year.
  • Sepsis deaths alone – 270,000 per year.

What Is Sepsis?

  • The body’s overwhelming and life-threatening response to infection, which can lead to tissue damage, organ failure, and death.
  • Sepsis is the #1:
    • leading cause of death in hospitals.
    • leading cause of hospital readmissions.
    • single biggest cost to hospitals.
  • Sepsis is about TIME watch for:
    • Temperature higher or lower than normal.
    • Infection – there may be signs and symptoms of infection.
    • Mental decline – confused, sleepy, difficult to rouse.
    • Extremely ill – “I feel like I may die!”  Severe pain and/or discomfort.
  • It is not contagious.
  • There is no simple test or cure for sepsis.
  • Sepsis can be prevented by preventing infections.
  • Sepsis can be treated (successfully in most cases) with early recognition and fast treatment.

More Steps for Sepsis Prevention:

Sepsis can be caused by any type of infection:  bacterial, viral, fungal, or even parasitic.

  • Get your vaccinations!
  • Care for open wounds!
  • If prescribed antibiotics, take them correctly!
  • Wash your hands!!

Who Can Get Sepsis?

Sepsis is more likely to affect:

  • Very young children.
  • Older adults.
  • People with chronic illnesses.
  • People with weakened immune systems.

It can affect:

  • People of any age.
  • People at all levels of health.

The Causes of Sepsis:

  • An infection…
    • viral
    • bacterial
    • fungal
    • parasitic
  • Infections started from something as simple as…
    • paper cuts
    • bug bites
  • Larger infections…
    • pneumonia
    • meningitis
  • Sometimes doctors never learn what the infection was or where it came from.

Septic Symptoms:

  • Higher or lower temperature than usual.
  • Signs of infection.
  • Confused, sleepy, difficult to rouse (mental decline).
  • Extremely ill – feeling like they may  die, severe pain/discomfort.

** The sepsis symptoms spell TIME.  Sepsis is about recognizing it quickly and starting treatment. **

 

Visit www.sepsis.org for more information.

 

Men’s Health – Prostate Cancer.

Prostate Cancer Awareness Month:  September.

Prostate Cancer Quick Facts:

  • This year more than 174,600 men will be diagnosed with prostate cancer.
  • More than 31,600 die from the disease.
  • Most prostate cancer is diagnosed in men over age 65.
  • Most common cancer type among men in the United States, other than skin cancer.

For localized or regional prostate cancers, the survival rate is nearly 100%.

Risk Factors:

Prostate cancer risk factors can include:

  • Age – the older a man is, the greater his risk.
  • Family history – certain genes inherited may increase risk.  A man with a father, brother, or son who has had prostate cancer is 2-3 x more likely to develop the disease himself.
  • Race – prostate cancer is more common in African American men.  It tends to start at younger ages and grow faster than in other racial or ethnic groups.

Symptoms:

There are usually no symptoms in the early stages.  Some men will have no symptoms at all.  Symptoms could include:

  • Difficulty starting urination.
  • Weak or interrupted urine flow.
  • Frequent urination, especially at night.
  • Difficulty emptying the bladder completely.
  • Pain or burning during urination.
  • Blood in the urine or semen.
  • Pain in the back, hips, pelvis that doesn’t go away.
  • Painful ejaculation.

If you have symptoms that worry you, see a doctor right away.  Keep in mind that these symptoms may be caused by conditions other than prostate cancer.

Early Detection Is Important:

Two tests are commonly used to screen for prostate cancer –

  • Digital rectal exam (DRE):  physical exam
  • Prostate specific antigen (PSA) test:  a blood test
    • As a rule, the higher the PSA level in the blood, the more likely a prostate problem is present.
  • Many factors can affect PSA levels:
    • Some prostates make more PSA than others.
    • Age
    • Race
    • Certain medical procedures.
    • Some medications
    • Enlarged prostate
    • Prostate infection

Remember, ONLY A BIOPSY can diagnose prostate cancer for sure.

Treatment Options for Prostate Cancer:

  • Active surveillance – close monitoring.
  • Surgery – prostatectomy or radical prostatectomy.
  • Radiation therapy – external or internal.
  • Hormone therapy

Treatment therapies for prostate cancer that are still under investigation include:

  • Cryotherapy – freezing cancer cells.
  • Chemotherapy – using pill/IV form drugs.
  • Biological therapy – works wit the body’s immune system.
  • High-intensity focused ultrasound – high-energy sound waves directed to kill cancer cells.

More information can be found at www.cancer.org/cancer/prostate-cancer.html

Cholesterol Check.

National Cholesterol Education Month:  September.

What Is Cholesterol?

  • A waxy, fat-like substance found in your body and in many foods.
  • Your body needs cholesterol to function normally and makes all you need.
  • Too much cholesterol can build up in your arteries.
  • In time, these deposits narrow your arteries – putting you at risk for heart disease and stroke.

How Many Americans Have High Cholesterol?

  • More than 102 million American adults (20 years or older) have total cholesterol levels at or above 200 mg/dL – above healthy levels.
  • More than 35 million of these people have levels of 240 mg/dL or higher – which puts them at risk for heart disease.

How Do You Know if Your Cholesterol Is High?

  • High cholesterol usually has no symptoms.
  • Doctors can do a blood test to check your levels
    • A lipoprotein (blood test) can measure total cholesterol levels including LDL (low-density lipoprotein – “bad” cholesterol), HDL (high-density lipoprotein – “good” cholesterol), and triglycerides.
  • High cholesterol can be controlled through lifestyle changes, or by medication, if necessary.

How Often Should Cholesterol Be Checked?

  • It is recommended that adults aged 20 and older have their cholesterol checked every 5 years.
  • Preventive guidelines for cholesterol screening among young adults differ, but experts agree on the need to screen young adults who have other risk factors for coronary heart disease:
    • Obesity
    • Smoking
    • High blood pressure
    • Diabetes
    • Family history
    • *Less than 1/2 of young adults who have these risk factors get cholesterol screening, even though up to 1/4 of them have elevated cholesterol.

Optimal Lipid Levels for Adults:

Desirable cholesterol levels are:

  • Total cholesterol:  Less than 170 mg/dL
  • Low LDL (“bad”) cholesterol:  Less than 110 mg/dL
  • High HL (“good”) cholesterol:  35 mg/dL
  • Triglycerides:  Less than 150 mg/dL

Can Children & Adolescents Have High Cholesterol?

  • High cholesterol can develop in early childhood and adolescence – with risk increasing as weight increases.
  • In the U.S., more than 1/5 (20%) of youth aged 12-19 years have at least one abnormal lipid level.
  • It is important for children over 2 years old to have their cholesterol checked if:
    • they are overweight/obese.
    • they have a family history of high cholesterol.
    • they have family history of heard disease and high blood pressure.
    • they have certain chronic conditions:
      • chronic kidney disease (CKD)
      • chronic inflammatory diseases
      • congenital heart disease (CHD)
      • Childhood cancer survivorship.
  • Specific recommendations about cholesterol treatment have been developed by the National Cholesterol Education program for people at increased risk (those with family history of high cholesterol and heart disease.

If You Have High Cholesterol, How Can You Lower It?

  • Your doctor may prescribe medications to treat your high cholesterol if they feel it is necessary.
  • You can lower your cholesterol through lifestyle changes:
    • Low-fat/high-fiber food (fresh fruits, veggies, whole grains).
    • For adults, getting 2 hours 30 minutes of moderate or 1 hour 15 minutes of vigorous activity a week can help.
    • For those aged 6-17, getting 1 hour or more of physical activity each day will help.
    • Maintain a healthy weight.
    • Don’t smoke.  If you do smoke, quit.

Increase Your Cholesterol Knowledge:

  • Be aware of how important it is to know how much cholesterol and fat is in the food you eat.
  • Understand that changing your eating and cooking habits will lower the amount of cholesterol and fat in the foods you eat.
  • Know that the foods highest in cholesterol and fat come from animal and organ meats, full fat dairy products, and desserts.
  • Learn how to read nutrition food labels to choose foods with lower cholesterol and fat.
  • Eat a variety of fruits, vegetables, and 100% whole grain products and eat fewer fatty foods.
  • Aim for a healthy weight.
  • Quit smoking.
  • Be physically active.
  • Stay away from packaged foods with palm and coconut oils that are high in saturated fat.
  • Get your cholesterol levels checked.

When Your Spine Isn’t Fine.

Neurosurgery Awareness Month:  August.  2019 Focus:  The Spine.

THREE COMMON SPINAL CONDITIONS

Herniated Disc:

  • A herniated disc (also known as bulged, slipped, ruptured) is a fragment of the disc that is pushed out into the spinal canal through a tear or a rupture.
  • The disc presses on spinal nerves due to this displacement, and can produce pain which may be severe.
  • A single excessive strain or injury may cause a herniated disc.
  • Certain individuals may be more vulnerable to disc problems.

SYMPTOMS OF HERNIATED DISC:

  • Typically a herniated disc is preceded by an episode of low back pain or a long history of intermittent episodes of low back pain.
  • Lumbar spine (lower back) sciatica/radiculopathy frequently results from a herniated disc in the lower back.
  • If a herniated disc is not pressing on a nerve, there may be a low backache or no pain at all.
  • If it is pressing on a nerve there may be pain, numbness, or weakness in the area of the body to which that nerve travels.

Low Back Pain:

  • It is not unique.
  • 75-85% of Americans experience some from in their life.
  • In approximately 90% of cases, though painful, it is temporary and pain improves without surgery.
  • 50% who suffer low back pain will have recurrent episodes within 1 year.
  • Low back pain is considered chronic when it persists more than 12 weeks.

COMMON CAUSES OF LOW BACK PAIN:

  • Sprains & strains
  • Traumatic injury
  • Fracture
  • Herniated Disc
  • Sciatica
  • Lumbar spinal stenosis
  • Osteoarthritis
  • Scoliosis

SYMPTOMS OF LOW BACK PAIN:

  • Shows up as pain in the low back that can include pain into the glutes, hips, or legs.
  • Pain can be sharp, dull, aching, burning, or a combination.
  • Pain can be constant, intermittent, or activity-related.

Osteoarthritis:

  • The most common type of arthritis.
  • Affects the middle-aged and older adults most frequently.
  • Caused by the break down of cartilage in joints.
  • When osteoarthritis affects the spine it is known ass spondylosis.
    • A degenerative disorder that can cause loss of normal spinal structure and function.
  • Spondylosis can affect cervical, thoracic, and/or the lumbar regions of the spine.
    • Can lead to disc degeneration and bone spurs.
    • Can cause spinal stenosis as it worsens.

INCIDENCE & PREVALENCE OF OSTEOARTHRITIS:

  • More than 54 million people in the U.S. are affected.
  • By 2040, about 78 million will be affected.
  • 50% of people age 65 and older exhibit evidence of osteoarthritis in at least one joint.
  • Osteoarthritis is more prevalent in men 45 and younger, but in women age 50 and older.

CAUSE OF OSTEOARTHRITIS:

The cause is unknown, but the following factors may increase risk of development:

  • Age
  • Heredity
  • Being overweight
  • Joint injury
  • Nerve injury
  • Repeated overuse of joints
  • Lack of physical activity

SYMPTOMS OF OSTEOARTHRITIS:

  • Pain and stiffness in neck and lower back.
  • Pain that radiates to the shoulder or down the arm.
  • Weakness or numbness in one or both arms.
  • Pain/morning stiffness lasting about 30 minutes due to inactivity.
  • Pain that worsens throughout the day due to inactivity.
  • Limited motion.

Spine On Our Mind.

Neurosurgery Awareness Month:  August.

2019 Focus:  The Human Spine

  • According to the American Association of Neurological Surgeons, 450,000 people in the United States are living with a spinal cord injury (SCI).
    • Other organizations conservatively estimate the figure to be about 250,000 people.
  • MVAs (motor vehicle accidents) are the leading cause of SCI in the U.S. in younger individuals.
  • Falls are the leading cause of SCI for people over 65.
  • Acts of violence and sports/recreation activities are other common causes of SCIs.
  • Over 1/2 of all SCIs occur in persons age 16-30…
    • Most are males (80%).
    • Males represent nearly all (90%) of sports-related SCIs.

Spinal & Peripheral Nervous System Anatomy:

  • The spinal cord is an extension of the central nervous system (CNS) – consisting of the brain and the spinal cord.
  • The spinal cord begins at the bottom of the brain stem and ends in the lower back – tapering to form a cone (conus medullaris).
  • The spinal cord is about 18 inches (45 cm) in length.
  • Cerebrospinal fluid (CSF) surrounds the spinal cord along with 3 layers of protection.
  • The spinal cord is within the spinal column (made up of 33 bones called vertebrae).
    • 5 vertebrae are fused together forming the sacrum (part of pelvis).
    • 4 are fused together and form the coccyx (tailbone).
  • The actual spine itself has 4 sections (not including the tailbone):
    • Cervical vertebrae (C1-C7) in the neck.
    • Thoracic vertebrae (T1-T12) in the upper back and attached to the ribcage.
    • Lumbar vertebrae (L1-L5) in the lower back.
    • Sacral vertebrae (S1-S5) in the pelvis.
  • Discs serve as a supportive structure for the spine.
    • Oval-shaped with tough outer layer.
    • Act as shock absorbers for the spinal bones.
    • Are between the vertebral bodies (except C1 & C2)
  • 31 pairs of spinal nerves and roots –
    • Nerves conduct messages from the brain and spinal cord to all other parts of the body.
  • The Peripheral Nervous System (PNS)
    • complex nerve system
    • travel all over the body
    • nerve impulses travel to and from the brain to specific body locations

Any interruption of spinal cord function by disease or injury at any level may result in a loss of sensation and motor function below the level injured.

Depending on severity, the loss of function may be permanent.

Spinal Cord Injury (SCI):

  • Every year an estimated 17,000 SCIs occur in the U.S.
  • Most are caused by trauma to the vertebral column.
  • Affects the spinal cord’s ability to send and receive messages from the brain to the body’s systems that control sensory, motor, and autonomic function below the level of injury.
  • According to the CDC, SCI costs the nation an estimated $9.7 billion each year.

Symptoms of SCI:

COMPLETE SCI

  • Produces total loss of all motor and sensory function below the level of injury.
  • Both sides of body are equally affected.
  • The spinal cord is rarely cut or transected.
  • Loss of function usually caused by a contusion or bruise to the spinal cord, or by compromised blood flow to the injured area of the cord.

INCOMPLETE SCI

  • Some function remains below the primary level of injury.
  • A person with an incomplete injury may have movement abilities in one arm or leg more than in the other – or more functioning on one side of the body than the other.

SCI GRADING

  • Describes the severity of injury.
  • ASIA A:  injury is complete with no sensory or motor function preserved.
  • ASIA B:  a sensory incomplete injury with complete motor function loss.
  • ASIA C:  A motor incomplete injury – some movement, but less than 1/2 the muscle groups are anti-gravity (can lift up against the force of gravity with full range of motion.
  • ASIA D:  a motor incomplete injury with more than 1/2 the muscle groups anti-gravity.
  • ASIA E:  normal.

The more severe the injury, the less likely recovery will occur.

SPINAL CONCUSSIONS

  • Complete or incomplete.
  • Spinal cord dysfunction is transient – generally resolving in 1-2 days.
  • Football players are especially susceptible to spinal concussions and spinal cord contusions.
    • Spinal cord contusions can cause neurological symptoms – numbness, tingling, electric shock-like sensations, and burning in the extremities.

When to Seek Medical Care for Spinal Issues:

Following trauma, seek immediate medical attention for any of the following:

  • Extreme pain or pressure in the head, neck, or back.
  • Tingling or loss of sensation in the hands, fingers, feet, or toes.
  • Partial or complete loss of control over any part of the body.
  • Urinary or bowel urgency, incontinence, or retention.
  • Abnormal band-like sensations in the thorax (pain, pressure).
  • Impaired breathing after injury.
  • Unusual lumps on the head or spine.

Dealing With Psoriasis.

Psoriasis Awareness Month:  August.

How Can Psoriasis Be Managed?

The Mayo Foundation for Medical Education and Research (MFMER) suggests a diet rich in:

  • Fruits
  • Vegetables
  • Whole Grains
  • Low-fat dairy products
  • Lean meats and fish

**Fish oil may improve psoriasis symptoms**

  • Provides polysaturated fatty acids needed to maintain healthy skin.

The American Academy of Dermatology suggests the following:

  • Learn about treatment options – This helps you make informed decisions.
  • Take care of yourself – Eat a healthy diet, exercise, don’t smoke, and drink little alcohol.
  • Be aware of your joints – Stiff or sore joints can be the first sign of psoriatic arthritis when you already suffer from psoriasis.
  • Notice your nails – Nails pulling away from the nailbed, developing pitting or ridges, or a yellowish-orange color are signs of psoriatic arthritis.
  • Pay attention to your mood – watch for signs of depression.
  • Talk to your dermatologist before discontinuing medications – Stopping psoriasis medicine cold turkey can have serious consequences.

Managing Psoriasis ITCH:

  • “Psoriasis” comes from the Greek word “psora” that means “to itch”.
  • Itch is present in 70-90% of psoriasis cases.
  • Psoriatic itch is different than that of other skin conditions.
    • Described by some as a burning sensation.
    • Others say it feels like being bitten by fire ants.
  • Psoriasis can have both itch and pain.
    • Itch and pain signals travel different pathways in the spinal cord.
  • Psoriasis itch can occur in areas that do not have psoriasis lesions.
  • Psoriasis itch often follows an itch-scratch cycle.
    • Scratching can trigger the Koebner phenomenon, in which skin injuries trigger a psoriasis flare.
    • Scratching can cause breaks in the skin, flaking, and bleeding that can worsen symptoms.
    • The worsening of psoriasis symptoms can then trigger the itch again.

Home Remedies to Reduce Psoriasis Itch:

  • Keep skin moisturized.
  • Reduce scaling and flaking – exfoliate gently.
  • Cold showers and cooling products
    • cold packs
    • compresses
    • refrigerated lotions
    • warm to cool (not hot) showers
    • cold can help relieve the itch

Prescription Treatments to Reduce Psoriasis Itch:

Effective treatment of psoriasis can reduce lesions, stop itch-scratch cycle symptoms, and reduce irritation and pain.

  • Biologics are found to be more effective than topical treatments because they are able to reduce itch signals to the brain.
  • Other prescription treatments specifically help with itch:
    • topical or oral antihistamines
    • phototherapy
    • topical corticosteroids (steroids)
    • topical anesthetics

Stress and Psoriasis Itch:

Stress is known as a common trigger of psoriasis and can worsen symptoms of itch.

  • Take part in enjoyable hobbies and activities.
  • Change unhealthy lifestyle habits.
  • Say “no” to new responsibilities that may cause stress.
  • Try meditation, mindfulness, or relaxation methods.
  • Consider adding stress-reduction exercises to your routine.