There are many factors that effect a woman’s body during pregnancy. The sudden change in body function, posture, and morphology creates an effective way for toxins and invaders to lower the body’s ability to protect itself. One of these toxins commonly consumed is caffeine. When a woman is not pregnant, its addictive properties are viewed as tolerable, effecting heart rate, blood pressure, and the function of the nervous system. A woman’s exposure to caffeine during pregnancy is correlated with spontaneous abortion and low infant birth weight. Other life styles associated with high caffeine consumption, including drinking alcohol and smoking while pregnant, have been implicated as the actual cause of these problems.
In an eight-year Danish study, 18,478 pregnant women visiting a department of obstetrics and gynecology provided information about coffee consumption before and 16 weeks into pregnancy. Coffee consumption was classified as 0, 1-3, 4-7 or 8 or more cups per day. Researchers looked for a possible association between coffee consumption and stillbirth (delivery of dead fetus after 28 weeks of gestation) or infant death in the first years.
Pregnant women that consumed 8 or more cups of coffee daily while pregnant (5% of subjects) were three times more likely to experience a stillbirth than women drinking no coffee, before adjusting for smoking and alcohol use. After adjusting for these and other factors, women who drank eight or more cups of coffee daily remained 2.2 times more likely to have a stillbirth child; women drinking 4-7 cups of coffee daily remained 1.4 times more likely.
There was no link observed between coffee consumption and infant death in the first year following birth, after adjusting for other factors. There is no evidence that the effects of caffeine consumed by women from other sources, including tea, chocolate and cola were or showed similar results. The subjects were noted to consume little caffeine from these other sources.
For more information on this study see Wisborg K, Kesmodel U, et al. Maternal Consumption of Coffee During pregnancy and Stillbirth and Infant Death in First Year of Life: Prospective Study. British Medical Journal 2003: 326, pp420-423 or http://bmj.com
Wednesday, August 11, 2010
Saturday, March 27, 2010
Make Checkups Part Of Your Healthcare Plan
Make Checkups Part Of Your Healthcare Plan
This Article is from a staff Writier at Black Doctors.org I thought this was good information to share
The importance of annual physical exams for African American adults cannot be stressed enough. Regular exams can very often help uncover risk factors and problems before they become serious. Plus, if a disease is caught early, treatment is usually much more effective. Ultimately, having regular doctor's visits will help you live a long and healthier, happier life.
Depending on your age, gender and family medical history, a checkup with your doctor may include:
• Blood, urine, vision and hearing tests to evaluate your overall health
• Assessments of your blood pressure, cholesterol level and weight
• A discussion about your diet and exercise habits, and any tobacco, drug and alcohol use
• Immunizations and booster shots
• Screenings to assess your risk of developing certain diseases, including diabetes (if you already have high blood pressure or high cholesterol) and cancer
• Depending on your age and sexual lifestyle, testing for STDs and possibly HIV
• Starting at age 40, screening for colorectal cancer
• A discussion about depression and stress to evaluate your mental health
For men, in addition to checking weight, blood pressure and other basics, your doctor's visit may specifically include:
• Starting at age 40, a rectal exam to check for abnormalities in the prostate and a prostate specific antigen (PSA) blood test to screen for prostate cancer
• Between the ages of 65 and 75, if you have ever smoked cigarettes, an abdominal exam to check for an enlargement in your aorta. An abdominal aortic aneurysm, a weakness in the lining of the aorta (a large blood vessel in your chest and abdomen), can develop with age and become a life-threatening problem.
Women should be checked for the same basics as men, and may also receive the following specific exams during a doctor's visit:
• A test for cervical cancer, called a Pap smear, every one to three years
• A clinical breast exam to check for any unusual lumps in your breasts
• Starting at age 40 (or younger if you have a strong family history for breast cancer), a breast cancer screening with a mammogram every one to two years
• Starting at age 65, a referral for a bone density test to screen for osteoporosis, the disease that causes brittle, fragile bones and typically affects older women; women with more than one risk factor for osteoporosis may start earlier
Be Prepared
It's crucial that you to play an active role in getting the most out of your doctor's visits. Before your exam, review and update your family health history, be prepared to ask if you're due for any general screenings or vaccinations, and come up with a list of questions if you have particular health concerns.
During your appointment, don't be shy about getting your questions answered. Also, if your doctor gives you advice about specific health issues, don't hesitate to take notes. Time is often limited during these exams, but by coming prepared you’re sure to get the most out of your checkup.
Looking for a physician? Click on our Doctor Search tool ... it's free!
By De’Laney Rowland, BDO Staff Writer 26-Mar-2010
This Article is from a staff Writier at Black Doctors.org I thought this was good information to share
The importance of annual physical exams for African American adults cannot be stressed enough. Regular exams can very often help uncover risk factors and problems before they become serious. Plus, if a disease is caught early, treatment is usually much more effective. Ultimately, having regular doctor's visits will help you live a long and healthier, happier life.
Depending on your age, gender and family medical history, a checkup with your doctor may include:
• Blood, urine, vision and hearing tests to evaluate your overall health
• Assessments of your blood pressure, cholesterol level and weight
• A discussion about your diet and exercise habits, and any tobacco, drug and alcohol use
• Immunizations and booster shots
• Screenings to assess your risk of developing certain diseases, including diabetes (if you already have high blood pressure or high cholesterol) and cancer
• Depending on your age and sexual lifestyle, testing for STDs and possibly HIV
• Starting at age 40, screening for colorectal cancer
• A discussion about depression and stress to evaluate your mental health
For men, in addition to checking weight, blood pressure and other basics, your doctor's visit may specifically include:
• Starting at age 40, a rectal exam to check for abnormalities in the prostate and a prostate specific antigen (PSA) blood test to screen for prostate cancer
• Between the ages of 65 and 75, if you have ever smoked cigarettes, an abdominal exam to check for an enlargement in your aorta. An abdominal aortic aneurysm, a weakness in the lining of the aorta (a large blood vessel in your chest and abdomen), can develop with age and become a life-threatening problem.
Women should be checked for the same basics as men, and may also receive the following specific exams during a doctor's visit:
• A test for cervical cancer, called a Pap smear, every one to three years
• A clinical breast exam to check for any unusual lumps in your breasts
• Starting at age 40 (or younger if you have a strong family history for breast cancer), a breast cancer screening with a mammogram every one to two years
• Starting at age 65, a referral for a bone density test to screen for osteoporosis, the disease that causes brittle, fragile bones and typically affects older women; women with more than one risk factor for osteoporosis may start earlier
Be Prepared
It's crucial that you to play an active role in getting the most out of your doctor's visits. Before your exam, review and update your family health history, be prepared to ask if you're due for any general screenings or vaccinations, and come up with a list of questions if you have particular health concerns.
During your appointment, don't be shy about getting your questions answered. Also, if your doctor gives you advice about specific health issues, don't hesitate to take notes. Time is often limited during these exams, but by coming prepared you’re sure to get the most out of your checkup.
Looking for a physician? Click on our Doctor Search tool ... it's free!
By De’Laney Rowland, BDO Staff Writer 26-Mar-2010
Sunday, February 21, 2010
Post Traumatic Headache
Headache is the second most frequently reported symptom in cervical spine trauma patients. Many names have been applied to the headache resulting from cervical trauma: Spondylogenic, vertebrogenic, cervicogenic, cervical migraine, post-traumatic, post-concussive, muscle contraction, occipital-trigeminal syndrome, or occipital neuralgia. Headaches secondary to cervical trauma can be difficult to clinically verify. Cases may vary widely in onset of symptoms as well as distribution of pain.
Sources differ on etiological factors. Cervical trauma can occur as a result of blunt traumas such as vehicle accidents, falls, sports injuries or penetrating trauma such as gun shot wounds, stab wounds, or impalement. The “whipping” action of the neck when the body is held tightly against the seat is suggested as contributing causes. Recent evidence implicates several mechanisms of headache secondary to cervical trauma relate to upper cervical vertebral dysfunction to occipital and/or temporal headache.
The cervical spine is unlike the rest of the axial spine skeleton, in that it exhibits greater ranges of motion. Stability is maintained by bony and ligamentous structures. The primary function of the muscles in the cervical spine is motion. When cervical muscles do act as a stabilizer, it is as a splint to prevent motion after the cervical region has been traumatized. Ligamentous damage can occur when the head exceeds normal ranges of motion, especially forward flexion and extension. Local spine pain with referred head pain and reflex muscle spasm are the results followed by aberrant motion, mechanical stress affecting the vertebrobasiliar system, cervical spine sympathetic nerves, and cervical segmental nerves.
Symptoms associated with cervical trauma including headache, may begin to appear 24 to 72 hours, or may take weeks to manifest. Headache pain is usually unilateral and can be constant to intermittent in frequency that begins in the suboccipital area and radiating toward the orbit (eye), forehead, temporal, or maxillary (cheeks on the face) regions.
The cervical trauma patient may also experience Autonomic Nervous System response, including episodes of dizziness, nausea and vomiting and even earache. Sleep posture in cervical trauma patients should be controlled to protect neck alignment and prevent permanent deformation of ligaments.
Sources differ on etiological factors. Cervical trauma can occur as a result of blunt traumas such as vehicle accidents, falls, sports injuries or penetrating trauma such as gun shot wounds, stab wounds, or impalement. The “whipping” action of the neck when the body is held tightly against the seat is suggested as contributing causes. Recent evidence implicates several mechanisms of headache secondary to cervical trauma relate to upper cervical vertebral dysfunction to occipital and/or temporal headache.
The cervical spine is unlike the rest of the axial spine skeleton, in that it exhibits greater ranges of motion. Stability is maintained by bony and ligamentous structures. The primary function of the muscles in the cervical spine is motion. When cervical muscles do act as a stabilizer, it is as a splint to prevent motion after the cervical region has been traumatized. Ligamentous damage can occur when the head exceeds normal ranges of motion, especially forward flexion and extension. Local spine pain with referred head pain and reflex muscle spasm are the results followed by aberrant motion, mechanical stress affecting the vertebrobasiliar system, cervical spine sympathetic nerves, and cervical segmental nerves.
Symptoms associated with cervical trauma including headache, may begin to appear 24 to 72 hours, or may take weeks to manifest. Headache pain is usually unilateral and can be constant to intermittent in frequency that begins in the suboccipital area and radiating toward the orbit (eye), forehead, temporal, or maxillary (cheeks on the face) regions.
The cervical trauma patient may also experience Autonomic Nervous System response, including episodes of dizziness, nausea and vomiting and even earache. Sleep posture in cervical trauma patients should be controlled to protect neck alignment and prevent permanent deformation of ligaments.
Monday, December 28, 2009
The Not-So-Hidden Cost of Back Pain
An abstract from the article:
The cost of medically treating back pain is not new to the health care industry. This cost may be new to individuals dealing with the ongoing costs to feel better. The research findings are well documented, and your clinical experiences undoubtedly verify it: Back pain affects nearly everyone. An estimated 80 percent of adults experience one or more episodes of back pain in their lifetime, and the one-year prevalence rate is approximately 15%-20% with some estimates as high as 40%. However some “experts” ironically, those outside the chiropractic profession, have attempted to describe back pain as harmless, self-limiting condition that requires only rest and time for resolution, despite the evidence to the contrary.
A study published in the January 1, 2004 issue of Spine “Estimates and Patterns of Direct health Care Expenditures Among Individuals With Back Pain in the United States” analyzed data from the 1998 medical Expenditures Panel Survey, (MEPS), a national survey on health care utilization and expenditures. Researchers utilize the data from the MEPS for two specific purposes: to estimate U.S. health care expenditures for back pain in 1998 and to describe health care expenditures patterns among individuals with back pain during that time period. The results of the study are as followed: Estimated total health care expenditures for back pain sufferers were a staggering $90.7 billion in 1998. In-patient care accounted for $27.9 billion in total expenditures while out-patient/office-based visits accounted for $23.6 billion. Prescription drugs account for more than 15% of the total health care expenditures ($14.1 billion) incurred by back pain sufferers. This service has increased more than any other service expenditure. The average health care costs incurred by individuals with back pain were approximately 60% higher than without back pain. The 25% most expensive individuals accounted for >75% of the service expenditures. If these data are not troublesome enough, the authors note that their estimates maybe understated, as they did not include cost associated with nursing home care, which accounted for approximately 20% of total health care cost for back pain in previous studies.
The bottom line is health care costs attributable to back pain in 1998 were “substantial,” and demonstrate “wide variation among back pain individuals with different clinical, demographic, and socioeconomic characteristics.” One can only assume that in 2004, these figures are notably higher, both in terms of the number of people suffering from back pain and the associated health care cost. For doctors of chiropractic, this study reinforces what has been said in the past. Back pain affects a significant number of the population, and when not treated appropriately it can account for substantial health care cost. In terms of prescription and hospital visits.
Crownfield, Peter; Dynamic Chiropractic; Feb. 12, 2004, Vol. 22, Number 4, cover/pg 49
The cost of medically treating back pain is not new to the health care industry. This cost may be new to individuals dealing with the ongoing costs to feel better. The research findings are well documented, and your clinical experiences undoubtedly verify it: Back pain affects nearly everyone. An estimated 80 percent of adults experience one or more episodes of back pain in their lifetime, and the one-year prevalence rate is approximately 15%-20% with some estimates as high as 40%. However some “experts” ironically, those outside the chiropractic profession, have attempted to describe back pain as harmless, self-limiting condition that requires only rest and time for resolution, despite the evidence to the contrary.
A study published in the January 1, 2004 issue of Spine “Estimates and Patterns of Direct health Care Expenditures Among Individuals With Back Pain in the United States” analyzed data from the 1998 medical Expenditures Panel Survey, (MEPS), a national survey on health care utilization and expenditures. Researchers utilize the data from the MEPS for two specific purposes: to estimate U.S. health care expenditures for back pain in 1998 and to describe health care expenditures patterns among individuals with back pain during that time period. The results of the study are as followed: Estimated total health care expenditures for back pain sufferers were a staggering $90.7 billion in 1998. In-patient care accounted for $27.9 billion in total expenditures while out-patient/office-based visits accounted for $23.6 billion. Prescription drugs account for more than 15% of the total health care expenditures ($14.1 billion) incurred by back pain sufferers. This service has increased more than any other service expenditure. The average health care costs incurred by individuals with back pain were approximately 60% higher than without back pain. The 25% most expensive individuals accounted for >75% of the service expenditures. If these data are not troublesome enough, the authors note that their estimates maybe understated, as they did not include cost associated with nursing home care, which accounted for approximately 20% of total health care cost for back pain in previous studies.
The bottom line is health care costs attributable to back pain in 1998 were “substantial,” and demonstrate “wide variation among back pain individuals with different clinical, demographic, and socioeconomic characteristics.” One can only assume that in 2004, these figures are notably higher, both in terms of the number of people suffering from back pain and the associated health care cost. For doctors of chiropractic, this study reinforces what has been said in the past. Back pain affects a significant number of the population, and when not treated appropriately it can account for substantial health care cost. In terms of prescription and hospital visits.
Crownfield, Peter; Dynamic Chiropractic; Feb. 12, 2004, Vol. 22, Number 4, cover/pg 49
Sunday, November 29, 2009
Prostate Warning Signs
Prostate Problem Warning Signs
The prostate is a small organ about the size of a walnut. It is found below the bladder (where urine is stored) and surrounds the tube that carries urine away from the bladder (urethra). The prostate makes a fluid that becomes part of semen. Semen is the white fluid that contains sperm. Prostate problems are common in men age 50 and older. Sometimes men feel symptoms themselves, or sometimes their doctors find prostate problems during routine exams. Doctors who are experts in diseases of the urinary tract (urologists) diagnose and treat prostate problems. There are many different kinds of prostate problems. Many don't involve cancer, but some do. Treatments vary but prostate problems can often be treated without affecting sexual function
Overall Signs of Prostate Problems
· Frequent urge to urinate
· Blood in urine or semen
· Painful or burning urination
· Difficulty in urinating
· Difficulty in having an erection
· Painful ejaculation
· Frequent pain or stiffness in lower back, hips, or upper thighs
· Inability to urinate, or
· Dribbling of urine
Yearly PSA Testing
Some doctors think men age 50 and older should have yearly PSA tests; others do not. We know that this test can help detect cancer before it causes symptoms, but we aren’t sure that PSA tests save lives. The PSA test can find small cancers that may not grow or spread. Not all prostate cancers are life-threatening, and treatments can cause side effects. That’s why doctors sometimes prefer “watchful waiting” until there are signs that treatment is needed. Researchers are studying ways to improve the PSA test so that it detects only cancers that need treatment. Medicare will pay for a PSA test every year for men age 50 and older.
There are several types of prostate problems including:
Prostatitis:
a disease of the prostate gland, can cause pain in the groin, painful urination, difficulty urinating and related symptoms.It isn't a single condition but a group of disorders with related symptoms It isn't a single condition but a group of disorders with related symptoms
·Acute prostatitis is an infection of the prostate caused by bacteria. It usually starts fast and can cause fever, chills, or pain in the lower back and between the legs. It also can cause pain when you urinate. If you have these symptoms, see your doctor right away. Antibiotic drugs usually help heal the infection and relieve the symptoms. Your doctor also may suggest that you drink more liquids.
· High fever
· Chills
· Nausea
· Vomiting
· General feeling of being unwell
·Chronic prostatitis is a prostate infection that keeps coming back time after time. Symptoms may be milder than in acute prostatitis, but they can last longer. Chronic prostatitis can be hard to treat. Antibiotics may work if bacteria are causing the infection. But if bacteria are not the cause, antibiotics won't work. Massaging the prostate sometimes helps to release fluids. Warm baths also may bring relief. Often chronic prostatitis clears up by itself.
Possible causes of chronic prostatitis/chronic pelvic pain may include:
· Immune system disorder
· Nervous system disorder
· Psychological stress
· Infection
· Pressure on prostate from other diseased tissue
· Traumatic injury
Signs or symptoms
· Pain or burning sensation when urinating (dysuria)
· Difficulty urinating, such as dribbling or hesitant urination
· Frequent urination, particularly at night (nocturia)
· Urgent need to urinate
· Pain in the abdomen, groin or lower back
· Pain in the area between the penis and rectum (perineum)
· Pain or discomfort of the penis or testicles
· Painful ejaculations
Untreated complications:
Acute bacterial prostatitis
Complications of acute bacterial prostatitis may include:
· Chronic bacterial prostatitis
· Bacterial infection of the blood (bacteremia)
· Inflammation of the coiled tube at the back of the testicle that stores and carries sperm (epididymitis)
· Pus-filled cavity in the prostate (prostatic abscess)
Chronic prostatitis
Complications due to chronic bacterial prostatitis and chronic prostatitis/chronic pelvic pain may include:
· Abnormalities in semen and infertility
· Generally poor quality of life
Cancer:
About Prostate Cancer
Prostate cancer is a disease in which malignant (cancer) cells form in the tissues of the prostate. The prostate is a gland in the male reproductive system located just below the bladder and in front of the rectum. It is about the size of a walnut and surrounds the urethra (the tube that empties urine from the bladder). The prostate gland produces fluid that is one of the components of semen.
Prostate cancer is the most common non-skin malignancy in men
Prostate cancer is responsible for more deaths than any other cancer, except for lung cancer. However, microscopic evidence of (prostate?) cancer is found at autopsy in many if not most men. The American Cancer Society (ACS) estimated that about 218,890 new cases of prostate cancer were diagnosed in the United States during 2007. About 1 man in 6 will be diagnosed with prostate cancer during his lifetime, but only 1 man in 34 will die of it. A little over 1.8 million men in the United States are survivors of prostate cancer.
Prognosis & Treatment
Treatment options and prognosis depend on the stage of the cancer, the Gleason score4, and the patient’s age and general health. With greater public awareness, early detection is on the rise and mortality rates are declining. Additionally, new advances in medical technology are enabling cancer patients to return to active and productive lives after their treatment.
Prostate Cancer Treatment Options:
Before choosing a treatment option, it is important for a patient to discuss their options with their physician based on his individual case. Upon diagnosis with prostate cancer, a man has the following primary treatment options:
· Remove the cancerous prostate (surgery)
· Radiate the cancerous prostate (external beam or radioactive seed implants)
· Watchful Waiting
Other treatments
Radiation:
Radiation therapy uses high-energy x-rays, either beamed from a machine or emitted by radioactive seeds implanted in the prostate, to kill cancer cells. When prostate cancer is localized, radiation therapy serves as an alternative to surgery. External beam radiation therapy is also commonly used to treat men with regional disease, whose cancers have spread too widely in the pelvis to be removed surgically, but who have no evidence of spreading to the lymph nodes. In men with advanced disease, radiation therapy can help to shrink tumors and relieve pain.
It is important to be aware that radiation can cause long-term damage to the nerves and important structures involved in sexual function. Many patients undergoing brachytherapy or external beam radiation treatment develop erectile dysfunction (as many as 50% in several studies.) 12, 13 Many radiation patients are also placed on hormone therapy, which has an immediate negative impact on sexual function.
Freezing the Cancer Prostate (Cryotherapy):
Cryosurgery uses liquid nitrogen to freeze and kill prostate cancer cells. The doctor places needles in preselected locations in the prostate gland. The needle tracks are dilated for the thin metal cryo probes to be inserted through the skin of the perineum into the prostate. Liquid nitrogen in the cryo probes forms an ice ball that freezes the prostate cancer cells; as the cells thaw, they rupture. The procedure takes about 2 hours, requires anesthesia (either general or spinal), and requires 1 or 2 days in the hospital.
Hormonal Therapy:
Hormonal therapy combats prostate cancer by cutting off the supply of male hormones (androgens) such as testosterone that encourage prostate cancer growth. Hormonal control can be achieved by surgery to remove the testicles (the main source of testosterone) or by drugs.
Hormonal therapy targets cancer that has spread beyond the prostate gland and is thus beyond the reach of local treatments such as surgery or radiation therapy. Hormonal therapy is also helpful in alleviating the painful and distressing symptoms of advanced disease. Further, it is being investigated as a way to arrest cancer before it has a chance to metastasize. Although hormonal therapy cannot cure, it will usually shrink or halt the advance of disease, often for years.
Watchful Waiting:
Watchful waiting refers to closely monitoring a patient's condition without giving any treatment until symptoms appear or change. This is usually used in older men with other medical problems and early-stage disease. Watchful waiting is based on the premise that localized prostate cancers may advance so slowly that they are unlikely to cause men—especially older men—any problems during their lifetimes. 17 Some men who opt for watchful waiting, also known as "observation" or "surveillance," have no active treatment unless symptoms appear. They are often asked to schedule regular medical checkups and to report any new symptoms to the doctor immediately.
Experimental / Out-of-Country Treatments:
When faced with serious illness, many people explore alternative or experimental treatment options with the goal of easing their symptoms and controlling or eliminating the disease.
A treatment option for prostate cancer currently available outside the United States is High-Intensity Focused Ultrasound (HIFU). HIFU treatment uses the principle of ultrasound energy to destroy cancer cells. To treat prostate cancer, t he energy is delivered to the patient using a transrectal probe under general or regional anaesthesia. Current studies show HIFU has significant complication rates and failure rates in effectively treating cancer in both initial and recurrent prostate cancer cases. As a result, some leading urologists have suspended their use of HIFU pending further evidence of its safety and effectiveness.
BPH (Benign Prostatic Hyperplasia):
What is BPH?
After the age of 40, the prostate may begin to enlarge. As its size increases, the prostate squeezes the urethra, potentially stopping or slowing the flow of urine and semen. Most of the symptoms associated with BPH are related to obstruction of the urethra and loss of bladder function. Read more about BPH.
Is BPH a sign of cancer?
No. While it is possible to have both BPH and prostate cancer, having BPH does not increase your risk of having prostate cancer. However, because early symptoms of both conditions are similar, it is important to see your doctor if you are experiencing any symptoms associated with a urinary condition. Read more about the signs and symptoms of BPH.
Is BPH a serious disease?
If your symptoms are not bothering you, BPH may not be a serious disease for you at this time. However, BPH can lead to serious problems, including infections and the inability to urinate. In rare cases, BPH can lead to kidney damage.
What tests will my doctor order?
Multiple tests are available to help your doctor diagnose your condition. Discuss each test with your doctor, including any concerns you may have and what he or she expects to learn from the results.
Digital rectal exam
This is usually the first test your doctor will order. During the DRE, the doctor inserts a gloved and lubricated finger into the rectum to feel the size of the prostate.
Urinalysis. The urine test is used to rule out the presence of infection or conditions that may produce similar symptoms as BPH.
Blood test [prostate-specific antigen (PSA)]
Your doctor may order a blood test to measure your prostate-specific antigen (PSA) level and rule out prostate cancer as a cause of your symptoms.
Imaging tests
Ultrasound may be performed to estimate the size of your prostate and may also detect a prostate stone, kidney stone, or obstruction, or a tumor.
Urinary flow test. Urinary flow study. You may be asked to urinate into a special device that monitors the strength and amount of your urinary flow. A reduced urine flow may indicate BPH.
Cystoscopy
A cystoscope is a thin tube with a magnifying lens that is inserted into the bladder through the urethra.
What treatments are available for BPH?
Several treatments are available. You should discuss all of your treatment options with your doctor.
Watchful waiting. If your symptoms are not bothering you, your doctor may suggest monitoring your disease and postponing treatment.
Medicines. Multiple medications are available to relieve your symptoms with or without reduction in the size of the prostate.
Nonsurgical procedures. Several minimally invasive thermal therapies are available that allow your doctor to access your prostate through your urethra and reduce the size of the prostate or decrease obstruction of the urethra.
Surgical treatment. Surgery may be used to remove part or all of the prostate.
Signs & Symptoms of BPH
Before visiting your doctor, write down a list of what you are experiencing as listed here. While BPH symptoms range from mild to severe, the size of the prostate does not necessarily correlate with the severity of the symptoms. As the prostate grows, it can cause two primary sets of problems:
Obstruction:
Feeling of incomplete bladder emptying
Delay and difficulty in initiating an urinary stream
Stopping and starting urination several times during voiding
Weak urinary stream
Dribbling at the end of urination
Pushing or straining while urinating
Irritation symptoms:
Feeling of little warning when the urge of urination develops
Frequent urination with short intervals
Need to urinate during the night
Inability to hold back urine
Onset and risk factors:
Additionally, there are four theories as to what may cause BPH:
1 BPH does not occur in men who had their testes removed before puberty. It is believed that BPH may be triggered by factors related to the aging of the testes.
2 Healthy males produce testosterone (a male hormone) and a small amount of estrogen (a female hormone). As men age, they naturally produce less testosterone, which changes the balance in the body between the two hormones. Some animal studies suggest that a higher proportion of estrogen may increase the activity of other substances within the body that promote BPH.
3 Males naturally turn testosterone into a chemical called dihydrotestosterone (DHT). Research shows that older men continue to produce large amounts of DHT. DHT which may promote growth of the prostate.
4 Some scientists believe that certain cells in the prostate are programmed to "reawaken" later in life. As these cells begin to multiply and become more active, they may trigger growth in other cells found in the prostate.
It’s only natural to have concerns about how sexual function might be affected by BPH. That’s why it’s important to talk to your doctor about all of your concerns—as treatment may also cause sexual side effects.
Common sexual concerns:
Impotence – Some medications or surgical procedures may cause impotence, or the inability to have an erection. Surgery for BPH rarely causes long-term impotence. If a man was able to maintain an erection shortly before surgery, he will probably be able to have erections afterward.
Ejaculation – Both surgery and medications may cause a condition known as Retrograde
Ejaculation. When this occurs, semen exits into the bladder instead of out of the penis during orgasm and later leaves the body during urination.
Decreased libido – Some medications may reduce the sex drive.
Other Conditions (Related to prostate Function):
Bladder neck Obstruction
Hypertension
Obesity
Urinary Retention
Prevention:
What you can do:
Make a list ahead of time that you can share with your doctor. Your list should include:
· Symptoms you're experiencing, including any that may seem unrelated to pelvic pain
· Key personal information, including any major stresses or recent life changes
· Medications that you're taking, including any vitamins or supplements
· Questions to ask your doctor
Other typical questions are as follows:
· Over the past month or so, how often have you had to urinate again in less than 2 hours?
· Over the past month, from the time you went to bed at night until the time you got up in the morning, how many times a night did you typically get up to urinate?
· Over the past month or so, how often have you had a sensation of not emptying your bladder completely after you finished urinating?
· Over the past month or so, how often have you had a weak urinary stream?
· Over the past month or so, how often have you had to push or strain to begin urinating?
Preparing for the Exam
The common tests your doctor or nurse will perform first require no special preparation. Digital rectal exams (DRE) and blood tests for prostate-specific antigen (PSA) are often included in routine physical examinations for men over 50. For African-American men and men with a family history of prostate cancer, it is recommended that tests be given starting at age 40. Some organizations even recommend that these tests be given to all men starting at age 40.
If you have urination problems or if the DRE or PSA test indicates that you might have a problem, you will probably be given additional tests that may require some preparation. Ask your doctor or nurse whether you should change your diet or fluid intake or stop taking any medications. If the tests involve inserting instruments into the urethra or rectum, you may be given antibiotics before and after the test to prevent infection.
PSA Blood Test
To rule out cancer, your doctor may recommend a PSA blood test. The amount of PSA, a protein produced by prostate cells, is often higher in the blood of men who have prostate cancer. However, an elevated level of PSA does not necessarily mean you have cancer. The Food and Drug Administration has approved a PSA test for use in conjunction with a DRE to help detect prostate cancer in men age 50 or older and for monitoring men with prostate cancer after treatment. However, much remains unknown about how to interpret the PSA test, its ability to discriminate between cancer and benign prostate conditions, and the best course of action if the PSA is high.
Because so many questions are unanswered, the relative magnitude of the test’s potential risks and benefits is unknown. When added to DRE screening, PSA enhances detection, but PSA tests are known to have relatively high false-positive rates, and they also may identify a greater number of medically insignificant tumors.
The PSA test first became available in the 1980s, and its use led to an increase in the detection of prostate cancer between 1986 and 1991. In the mid-1990s, deaths from prostate cancer began to decrease, and some observers credit PSA testing for this trend. Others, however, point out that statistical trends do not necessarily prove a cause-and-effect relationship. The benefits of prostate cancer screening are still being studied. The National Cancer Institute is conducting the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, or PLCO Trial, to determine whether certain screening tests reduce the number of deaths from these cancers. DRE and PSA exams are being studied to see whether yearly screening will decrease the risk of dying from prostate cancer.
Until a definitive answer is found, doctors and patients should weigh the benefits of PSA testing against the risks of followup diagnostic tests and cancer treatments. The procedures used to diagnose prostate cancer may cause significant side effects, including bleeding and infection. Treatment for prostate cancer often causes erectile dysfunction, or impotence, and may cause urinary incontinence.
Urinalysis
Your doctor or nurse may ask for a urine sample to test with a dipstick or to examine with a microscope. A chemically treated dipstick will change color if the urine contains nitrite, a byproduct of bacterial infection. Traces of blood in the urine may indicate that a kidney stone or infection is present, or the sample might reveal bacteria or infection-fighting white blood cells. You might be asked to urinate into two or three containers to help locate the infection site. If signs of infection appear in the first container but not in the others, the infection is likely to be in the urethra. Your doctor or nurse might ask you to urinate into the first container, then stop the stream for a prostate massage before completing the test. If urine taken after prostate massage or the prostate fluid itself contains significantly more bacteria, it is a strong sign that you have bacterial prostatitis.
Transrectal Ultrasound and Prostate Biopsy
If prostate cancer is suspected, your doctor may recommend a transrectal ultrasound. In this procedure, the doctor or technician inserts a probe slightly larger than a pen into the rectum. The probe directs high-frequency sound waves at the prostate, and the echo patterns form an image of the gland on a television monitor. The image shows how big the prostate is and whether there are any irregularities, but it cannot unequivocally identify tumors.
To determine whether an abnormal-looking area is indeed a tumor, the doctor can use the probe and the ultrasound images to guide a biopsy needle to the suspected tumor. The needle collects a few pieces of prostate tissue for examination with a microscope.
Transrectal ultrasound and prostate biopsy.
Magnetic Resonance Imaging (MRI) and Computerized Tomography (CT) Scans
MRI and CT scans both use computers to create three-dimensional or cross-sectional images of internal organs. These tests can help identify abnormal structures, but they cannot distinguish between cancerous tumors and noncancerous prostate enlargement. Once a biopsy has confirmed cancer, a doctor might use these imaging techniques to determine how far the cancer has spread. Experts caution, however, that MRI and CT scans are very expensive and rarely add useful information. They recommend using these techniques only when the PSA score is very high or the DRE suggests an extensive cancer, or both.
Urodynamic Tests
If your problem appears to be related to blockage, your doctor or nurse may recommend tests that measure bladder pressure and urine flow rate. You may be asked to urinate into a special device that measures how quickly the urine is flowing and records how many seconds it takes for the peak flow rate to be reached. Another test measures postvoid residual, the amount of urine left in your bladder when you have finished urinating. A weak stream and difficulty emptying the bladder completely may be signs of urine blockage caused by an enlarged prostate that is squeezing the urethra.
Abdominal Ultrasound
For an abdominal ultrasound exam, a technician will apply gel to your lower abdomen and sweep a handheld transducer across the area to receive a picture of your entire urinary tract. An abdominal ultrasound can show damage in the upper urinary tract that results from urine blockage at the prostate.
The prostate is a small organ about the size of a walnut. It is found below the bladder (where urine is stored) and surrounds the tube that carries urine away from the bladder (urethra). The prostate makes a fluid that becomes part of semen. Semen is the white fluid that contains sperm. Prostate problems are common in men age 50 and older. Sometimes men feel symptoms themselves, or sometimes their doctors find prostate problems during routine exams. Doctors who are experts in diseases of the urinary tract (urologists) diagnose and treat prostate problems. There are many different kinds of prostate problems. Many don't involve cancer, but some do. Treatments vary but prostate problems can often be treated without affecting sexual function
Overall Signs of Prostate Problems
· Frequent urge to urinate
· Blood in urine or semen
· Painful or burning urination
· Difficulty in urinating
· Difficulty in having an erection
· Painful ejaculation
· Frequent pain or stiffness in lower back, hips, or upper thighs
· Inability to urinate, or
· Dribbling of urine
Yearly PSA Testing
Some doctors think men age 50 and older should have yearly PSA tests; others do not. We know that this test can help detect cancer before it causes symptoms, but we aren’t sure that PSA tests save lives. The PSA test can find small cancers that may not grow or spread. Not all prostate cancers are life-threatening, and treatments can cause side effects. That’s why doctors sometimes prefer “watchful waiting” until there are signs that treatment is needed. Researchers are studying ways to improve the PSA test so that it detects only cancers that need treatment. Medicare will pay for a PSA test every year for men age 50 and older.
There are several types of prostate problems including:
Prostatitis:
a disease of the prostate gland, can cause pain in the groin, painful urination, difficulty urinating and related symptoms.It isn't a single condition but a group of disorders with related symptoms It isn't a single condition but a group of disorders with related symptoms
·Acute prostatitis is an infection of the prostate caused by bacteria. It usually starts fast and can cause fever, chills, or pain in the lower back and between the legs. It also can cause pain when you urinate. If you have these symptoms, see your doctor right away. Antibiotic drugs usually help heal the infection and relieve the symptoms. Your doctor also may suggest that you drink more liquids.
· High fever
· Chills
· Nausea
· Vomiting
· General feeling of being unwell
·Chronic prostatitis is a prostate infection that keeps coming back time after time. Symptoms may be milder than in acute prostatitis, but they can last longer. Chronic prostatitis can be hard to treat. Antibiotics may work if bacteria are causing the infection. But if bacteria are not the cause, antibiotics won't work. Massaging the prostate sometimes helps to release fluids. Warm baths also may bring relief. Often chronic prostatitis clears up by itself.
Possible causes of chronic prostatitis/chronic pelvic pain may include:
· Immune system disorder
· Nervous system disorder
· Psychological stress
· Infection
· Pressure on prostate from other diseased tissue
· Traumatic injury
Signs or symptoms
· Pain or burning sensation when urinating (dysuria)
· Difficulty urinating, such as dribbling or hesitant urination
· Frequent urination, particularly at night (nocturia)
· Urgent need to urinate
· Pain in the abdomen, groin or lower back
· Pain in the area between the penis and rectum (perineum)
· Pain or discomfort of the penis or testicles
· Painful ejaculations
Untreated complications:
Acute bacterial prostatitis
Complications of acute bacterial prostatitis may include:
· Chronic bacterial prostatitis
· Bacterial infection of the blood (bacteremia)
· Inflammation of the coiled tube at the back of the testicle that stores and carries sperm (epididymitis)
· Pus-filled cavity in the prostate (prostatic abscess)
Chronic prostatitis
Complications due to chronic bacterial prostatitis and chronic prostatitis/chronic pelvic pain may include:
· Abnormalities in semen and infertility
· Generally poor quality of life
Cancer:
About Prostate Cancer
Prostate cancer is a disease in which malignant (cancer) cells form in the tissues of the prostate. The prostate is a gland in the male reproductive system located just below the bladder and in front of the rectum. It is about the size of a walnut and surrounds the urethra (the tube that empties urine from the bladder). The prostate gland produces fluid that is one of the components of semen.
Prostate cancer is the most common non-skin malignancy in men
Prostate cancer is responsible for more deaths than any other cancer, except for lung cancer. However, microscopic evidence of (prostate?) cancer is found at autopsy in many if not most men. The American Cancer Society (ACS) estimated that about 218,890 new cases of prostate cancer were diagnosed in the United States during 2007. About 1 man in 6 will be diagnosed with prostate cancer during his lifetime, but only 1 man in 34 will die of it. A little over 1.8 million men in the United States are survivors of prostate cancer.
Prognosis & Treatment
Treatment options and prognosis depend on the stage of the cancer, the Gleason score4, and the patient’s age and general health. With greater public awareness, early detection is on the rise and mortality rates are declining. Additionally, new advances in medical technology are enabling cancer patients to return to active and productive lives after their treatment.
Prostate Cancer Treatment Options:
Before choosing a treatment option, it is important for a patient to discuss their options with their physician based on his individual case. Upon diagnosis with prostate cancer, a man has the following primary treatment options:
· Remove the cancerous prostate (surgery)
· Radiate the cancerous prostate (external beam or radioactive seed implants)
· Watchful Waiting
Other treatments
Radiation:
Radiation therapy uses high-energy x-rays, either beamed from a machine or emitted by radioactive seeds implanted in the prostate, to kill cancer cells. When prostate cancer is localized, radiation therapy serves as an alternative to surgery. External beam radiation therapy is also commonly used to treat men with regional disease, whose cancers have spread too widely in the pelvis to be removed surgically, but who have no evidence of spreading to the lymph nodes. In men with advanced disease, radiation therapy can help to shrink tumors and relieve pain.
It is important to be aware that radiation can cause long-term damage to the nerves and important structures involved in sexual function. Many patients undergoing brachytherapy or external beam radiation treatment develop erectile dysfunction (as many as 50% in several studies.) 12, 13 Many radiation patients are also placed on hormone therapy, which has an immediate negative impact on sexual function.
Freezing the Cancer Prostate (Cryotherapy):
Cryosurgery uses liquid nitrogen to freeze and kill prostate cancer cells. The doctor places needles in preselected locations in the prostate gland. The needle tracks are dilated for the thin metal cryo probes to be inserted through the skin of the perineum into the prostate. Liquid nitrogen in the cryo probes forms an ice ball that freezes the prostate cancer cells; as the cells thaw, they rupture. The procedure takes about 2 hours, requires anesthesia (either general or spinal), and requires 1 or 2 days in the hospital.
Hormonal Therapy:
Hormonal therapy combats prostate cancer by cutting off the supply of male hormones (androgens) such as testosterone that encourage prostate cancer growth. Hormonal control can be achieved by surgery to remove the testicles (the main source of testosterone) or by drugs.
Hormonal therapy targets cancer that has spread beyond the prostate gland and is thus beyond the reach of local treatments such as surgery or radiation therapy. Hormonal therapy is also helpful in alleviating the painful and distressing symptoms of advanced disease. Further, it is being investigated as a way to arrest cancer before it has a chance to metastasize. Although hormonal therapy cannot cure, it will usually shrink or halt the advance of disease, often for years.
Watchful Waiting:
Watchful waiting refers to closely monitoring a patient's condition without giving any treatment until symptoms appear or change. This is usually used in older men with other medical problems and early-stage disease. Watchful waiting is based on the premise that localized prostate cancers may advance so slowly that they are unlikely to cause men—especially older men—any problems during their lifetimes. 17 Some men who opt for watchful waiting, also known as "observation" or "surveillance," have no active treatment unless symptoms appear. They are often asked to schedule regular medical checkups and to report any new symptoms to the doctor immediately.
Experimental / Out-of-Country Treatments:
When faced with serious illness, many people explore alternative or experimental treatment options with the goal of easing their symptoms and controlling or eliminating the disease.
A treatment option for prostate cancer currently available outside the United States is High-Intensity Focused Ultrasound (HIFU). HIFU treatment uses the principle of ultrasound energy to destroy cancer cells. To treat prostate cancer, t he energy is delivered to the patient using a transrectal probe under general or regional anaesthesia. Current studies show HIFU has significant complication rates and failure rates in effectively treating cancer in both initial and recurrent prostate cancer cases. As a result, some leading urologists have suspended their use of HIFU pending further evidence of its safety and effectiveness.
BPH (Benign Prostatic Hyperplasia):
What is BPH?
After the age of 40, the prostate may begin to enlarge. As its size increases, the prostate squeezes the urethra, potentially stopping or slowing the flow of urine and semen. Most of the symptoms associated with BPH are related to obstruction of the urethra and loss of bladder function. Read more about BPH.
Is BPH a sign of cancer?
No. While it is possible to have both BPH and prostate cancer, having BPH does not increase your risk of having prostate cancer. However, because early symptoms of both conditions are similar, it is important to see your doctor if you are experiencing any symptoms associated with a urinary condition. Read more about the signs and symptoms of BPH.
Is BPH a serious disease?
If your symptoms are not bothering you, BPH may not be a serious disease for you at this time. However, BPH can lead to serious problems, including infections and the inability to urinate. In rare cases, BPH can lead to kidney damage.
What tests will my doctor order?
Multiple tests are available to help your doctor diagnose your condition. Discuss each test with your doctor, including any concerns you may have and what he or she expects to learn from the results.
Digital rectal exam
This is usually the first test your doctor will order. During the DRE, the doctor inserts a gloved and lubricated finger into the rectum to feel the size of the prostate.
Urinalysis. The urine test is used to rule out the presence of infection or conditions that may produce similar symptoms as BPH.
Blood test [prostate-specific antigen (PSA)]
Your doctor may order a blood test to measure your prostate-specific antigen (PSA) level and rule out prostate cancer as a cause of your symptoms.
Imaging tests
Ultrasound may be performed to estimate the size of your prostate and may also detect a prostate stone, kidney stone, or obstruction, or a tumor.
Urinary flow test. Urinary flow study. You may be asked to urinate into a special device that monitors the strength and amount of your urinary flow. A reduced urine flow may indicate BPH.
Cystoscopy
A cystoscope is a thin tube with a magnifying lens that is inserted into the bladder through the urethra.
What treatments are available for BPH?
Several treatments are available. You should discuss all of your treatment options with your doctor.
Watchful waiting. If your symptoms are not bothering you, your doctor may suggest monitoring your disease and postponing treatment.
Medicines. Multiple medications are available to relieve your symptoms with or without reduction in the size of the prostate.
Nonsurgical procedures. Several minimally invasive thermal therapies are available that allow your doctor to access your prostate through your urethra and reduce the size of the prostate or decrease obstruction of the urethra.
Surgical treatment. Surgery may be used to remove part or all of the prostate.
Signs & Symptoms of BPH
Before visiting your doctor, write down a list of what you are experiencing as listed here. While BPH symptoms range from mild to severe, the size of the prostate does not necessarily correlate with the severity of the symptoms. As the prostate grows, it can cause two primary sets of problems:
Obstruction:
Feeling of incomplete bladder emptying
Delay and difficulty in initiating an urinary stream
Stopping and starting urination several times during voiding
Weak urinary stream
Dribbling at the end of urination
Pushing or straining while urinating
Irritation symptoms:
Feeling of little warning when the urge of urination develops
Frequent urination with short intervals
Need to urinate during the night
Inability to hold back urine
Onset and risk factors:
Additionally, there are four theories as to what may cause BPH:
1 BPH does not occur in men who had their testes removed before puberty. It is believed that BPH may be triggered by factors related to the aging of the testes.
2 Healthy males produce testosterone (a male hormone) and a small amount of estrogen (a female hormone). As men age, they naturally produce less testosterone, which changes the balance in the body between the two hormones. Some animal studies suggest that a higher proportion of estrogen may increase the activity of other substances within the body that promote BPH.
3 Males naturally turn testosterone into a chemical called dihydrotestosterone (DHT). Research shows that older men continue to produce large amounts of DHT. DHT which may promote growth of the prostate.
4 Some scientists believe that certain cells in the prostate are programmed to "reawaken" later in life. As these cells begin to multiply and become more active, they may trigger growth in other cells found in the prostate.
It’s only natural to have concerns about how sexual function might be affected by BPH. That’s why it’s important to talk to your doctor about all of your concerns—as treatment may also cause sexual side effects.
Common sexual concerns:
Impotence – Some medications or surgical procedures may cause impotence, or the inability to have an erection. Surgery for BPH rarely causes long-term impotence. If a man was able to maintain an erection shortly before surgery, he will probably be able to have erections afterward.
Ejaculation – Both surgery and medications may cause a condition known as Retrograde
Ejaculation. When this occurs, semen exits into the bladder instead of out of the penis during orgasm and later leaves the body during urination.
Decreased libido – Some medications may reduce the sex drive.
Other Conditions (Related to prostate Function):
Bladder neck Obstruction
Hypertension
Obesity
Urinary Retention
Prevention:
What you can do:
Make a list ahead of time that you can share with your doctor. Your list should include:
· Symptoms you're experiencing, including any that may seem unrelated to pelvic pain
· Key personal information, including any major stresses or recent life changes
· Medications that you're taking, including any vitamins or supplements
· Questions to ask your doctor
Other typical questions are as follows:
· Over the past month or so, how often have you had to urinate again in less than 2 hours?
· Over the past month, from the time you went to bed at night until the time you got up in the morning, how many times a night did you typically get up to urinate?
· Over the past month or so, how often have you had a sensation of not emptying your bladder completely after you finished urinating?
· Over the past month or so, how often have you had a weak urinary stream?
· Over the past month or so, how often have you had to push or strain to begin urinating?
Preparing for the Exam
The common tests your doctor or nurse will perform first require no special preparation. Digital rectal exams (DRE) and blood tests for prostate-specific antigen (PSA) are often included in routine physical examinations for men over 50. For African-American men and men with a family history of prostate cancer, it is recommended that tests be given starting at age 40. Some organizations even recommend that these tests be given to all men starting at age 40.
If you have urination problems or if the DRE or PSA test indicates that you might have a problem, you will probably be given additional tests that may require some preparation. Ask your doctor or nurse whether you should change your diet or fluid intake or stop taking any medications. If the tests involve inserting instruments into the urethra or rectum, you may be given antibiotics before and after the test to prevent infection.
PSA Blood Test
To rule out cancer, your doctor may recommend a PSA blood test. The amount of PSA, a protein produced by prostate cells, is often higher in the blood of men who have prostate cancer. However, an elevated level of PSA does not necessarily mean you have cancer. The Food and Drug Administration has approved a PSA test for use in conjunction with a DRE to help detect prostate cancer in men age 50 or older and for monitoring men with prostate cancer after treatment. However, much remains unknown about how to interpret the PSA test, its ability to discriminate between cancer and benign prostate conditions, and the best course of action if the PSA is high.
Because so many questions are unanswered, the relative magnitude of the test’s potential risks and benefits is unknown. When added to DRE screening, PSA enhances detection, but PSA tests are known to have relatively high false-positive rates, and they also may identify a greater number of medically insignificant tumors.
The PSA test first became available in the 1980s, and its use led to an increase in the detection of prostate cancer between 1986 and 1991. In the mid-1990s, deaths from prostate cancer began to decrease, and some observers credit PSA testing for this trend. Others, however, point out that statistical trends do not necessarily prove a cause-and-effect relationship. The benefits of prostate cancer screening are still being studied. The National Cancer Institute is conducting the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, or PLCO Trial, to determine whether certain screening tests reduce the number of deaths from these cancers. DRE and PSA exams are being studied to see whether yearly screening will decrease the risk of dying from prostate cancer.
Until a definitive answer is found, doctors and patients should weigh the benefits of PSA testing against the risks of followup diagnostic tests and cancer treatments. The procedures used to diagnose prostate cancer may cause significant side effects, including bleeding and infection. Treatment for prostate cancer often causes erectile dysfunction, or impotence, and may cause urinary incontinence.
Urinalysis
Your doctor or nurse may ask for a urine sample to test with a dipstick or to examine with a microscope. A chemically treated dipstick will change color if the urine contains nitrite, a byproduct of bacterial infection. Traces of blood in the urine may indicate that a kidney stone or infection is present, or the sample might reveal bacteria or infection-fighting white blood cells. You might be asked to urinate into two or three containers to help locate the infection site. If signs of infection appear in the first container but not in the others, the infection is likely to be in the urethra. Your doctor or nurse might ask you to urinate into the first container, then stop the stream for a prostate massage before completing the test. If urine taken after prostate massage or the prostate fluid itself contains significantly more bacteria, it is a strong sign that you have bacterial prostatitis.
Transrectal Ultrasound and Prostate Biopsy
If prostate cancer is suspected, your doctor may recommend a transrectal ultrasound. In this procedure, the doctor or technician inserts a probe slightly larger than a pen into the rectum. The probe directs high-frequency sound waves at the prostate, and the echo patterns form an image of the gland on a television monitor. The image shows how big the prostate is and whether there are any irregularities, but it cannot unequivocally identify tumors.
To determine whether an abnormal-looking area is indeed a tumor, the doctor can use the probe and the ultrasound images to guide a biopsy needle to the suspected tumor. The needle collects a few pieces of prostate tissue for examination with a microscope.
Transrectal ultrasound and prostate biopsy.
Magnetic Resonance Imaging (MRI) and Computerized Tomography (CT) Scans
MRI and CT scans both use computers to create three-dimensional or cross-sectional images of internal organs. These tests can help identify abnormal structures, but they cannot distinguish between cancerous tumors and noncancerous prostate enlargement. Once a biopsy has confirmed cancer, a doctor might use these imaging techniques to determine how far the cancer has spread. Experts caution, however, that MRI and CT scans are very expensive and rarely add useful information. They recommend using these techniques only when the PSA score is very high or the DRE suggests an extensive cancer, or both.
Urodynamic Tests
If your problem appears to be related to blockage, your doctor or nurse may recommend tests that measure bladder pressure and urine flow rate. You may be asked to urinate into a special device that measures how quickly the urine is flowing and records how many seconds it takes for the peak flow rate to be reached. Another test measures postvoid residual, the amount of urine left in your bladder when you have finished urinating. A weak stream and difficulty emptying the bladder completely may be signs of urine blockage caused by an enlarged prostate that is squeezing the urethra.
Abdominal Ultrasound
For an abdominal ultrasound exam, a technician will apply gel to your lower abdomen and sweep a handheld transducer across the area to receive a picture of your entire urinary tract. An abdominal ultrasound can show damage in the upper urinary tract that results from urine blockage at the prostate.
Exercises and Exercise Theory
Every year thousands of people turn to chiropractic for treatment of chronic and acute musculoskeletal disorders. They find relief I professional adjustments- but many patients require additional therapy to achieve full recovery, especially from joint injuries. Prescribed exercise helps to develop strength and endurance, and work with the adjustment to help attain full and proper healing of the injured area.
Muscles are joints’ primary stabilizer. When injury or illness interferes with muscle function, joint integrity declines. The chiropractic professional must address this interrelationship of bone and soft tissue to effectively treat musculoskeletal complaint.
A comprehensive rehabilitation program combine the chiropractor’s skill and the patient’s cooperation with exercise. A well-devised, scientifically-based exercise program can produce:
Enhance muscle performance
Decrease risk of injury
Decrease the severity of injury
Accelerated rehabilitation and return to activity.
Why Movement Helps
Before reviewing biomechanical principles of exercise, consider the effects of immobilization on musculoskeletal structures. Historically, accepted procedure was to immobilize the injured joint and to allow pain and swelling to subside. But such as course did not address the cause of that pain. nor did it offer hope for regaining maximal joint integrity.
Soft tissue follows the use disuse principle: when used, it remains strong; it weakens, Immobilized muscle atrophy at an approximate rate of 1.5 percent per day. Studies show that muscle atrophy begins within six hours of immobilization.
Detrimental effects of immobilization have also been noted in the synovial joint, connective tissue and tendon structure, which loses tensile loading capacity. Seriously irreversible damage to the articular cartilage can also occur.
In addition to soft tissue, vascular and neurological structures suffer from extended immobilization of injured joints. Significant changes in the impulse patterns of motor neurons weakening the immobilized muscle have been noted.
Adhesion formation is another risk of immobilization, causing more pain and loss of range of motion. Uncontrolled fibroblasts and scar formation make rehabilitation more difficult.
Exercise Theory
The goal of chiropractic management of musculoskeletal conditions is to develop the strength, endurance, and joint stability required for activities of daily living. Rehabilitation of soft tissue through exercise can accelerate recovery. The cornerstone of the therapeutic exercise is known as Davis’ Law, which states that the soft tissue will model according to imposed demand. This principle was demonstrated by Frost, who revealed how collagen fibers adapt to mechanical demands. He found that intermittent tension loads stimulate cells to produce additional collagen. Stearns drew a similar conclusion from his study some 50 years ago of fibroblastic activity and healing of connective tissue. He discovered that the movement was responsible for developing an orderly arrangement of fibrils. This results in a small flexible scar that facilitates recovery from musculoskeletal injury.
Types Of Exercise
One of the most important requirements for effective chiropractic treatment is knowledge of various training methods and exercise techniques. Exercise not only shortens recovery, it can help prevent injuries and reduce the risk of rein jury, as well.
With the popularity of fitness clubs and today’s heightened awareness of exercise programs. Activities applicable to chiropractic care can be categorized in three groups:
Isometric exercise is static. It produces no joint movement and affected muscle hold a fixed length. Speed and resistance is fixed.
Isotonic exercise produces joint movement. It too, utilizes fixed resistance, but speed varies.
Isokinetic exercise also involves joint movement. It is performed at a fixed speed, but resistance will vary to match the applied force.
This viable resistance means that isokinetic exercise will accommodate pain and fatigue. Patients benefit form movement and soft tissue modeling while they achieve pain-free maximal muscle loading.
Benefits Of Isokinetics
The nature of is kinetic exercise offers the greatest benefit is cases of musculoskeletal complaints. We have already seen movement encourages formation of a flexible scar. Other physiological principle of exercise demonstrate the value of isokinetics.
Velocity spectrum
Most functional activities occur at very fast contractile velocities. Walking, for example, generates movement of 233 degrees per second in the knee joint. Cross country skiing over flat terrain moves the hip 469 degrees per second Successful rehabilitation helps prepared a patient to resume activities at normal contractile velocities. The advantage of isokinetic is that it allows a patient to rehabilitate at a speed which is comparable to functional daily activities.
Crossover
Any isokinetic exercise program should involve both the affected joint and its anatomical opposite. Exercise routines should begin with the unaffected area and progress to the site of injury.
Facilitate
Joint injury disrupts normal neuron pathway to the involved muscles. The law of facilitation states that when an impulse passes through a certain set of neurons to the exclusion of others, it will traverse this path in the future. Each time the impulse follows this course, resistance in the pathway lessens.
Overflow
When patients experience pain through a part of the affected joint’s range of motion, it is unlikely they will comply with a prescribed exercise program. The overflow principle of isokinetic enable a patient to exercise without pain yet still benefit from the activity.
Clinical Protocols For Applying Isokinetics
The Thera-Ciser exercise utilize a flexible tubing to create resistance in affected muscles. Resistance builds gradually as the patient progresses through four activity phases:
PHASE I
Features short range slow-paced movements.
PHASE II
Continues short range movements but at a faster pace. This level encourages neurological reeducation for enhanced muscle tonus and facilitates collagen healing.
PHASE III
Exercises are performed at a slow pace and full range of motion to begin duplicating normal functional movements. The patient performs Phase 3 muscle contraction only on alternate days to avoid fiber deterioration.
PHASE IV
Introduces the patient to fast paced, full- range movement. Emphasis is on developing strength and endurance lost through muscle atrophy.
In Summary
Isokinetic exercise has broad application in chiropractic management of musculoskeletal disorders. It is especially well suited to conditions involving pain with range of motion. A chiropractor’s efforts to treat musculoskeletal complaints will be enhanced by instructing patients in proper joint exercises , with emphasis on isokinetic range of motion therapy.
*references can be made available upon request.
Muscles are joints’ primary stabilizer. When injury or illness interferes with muscle function, joint integrity declines. The chiropractic professional must address this interrelationship of bone and soft tissue to effectively treat musculoskeletal complaint.
A comprehensive rehabilitation program combine the chiropractor’s skill and the patient’s cooperation with exercise. A well-devised, scientifically-based exercise program can produce:
Enhance muscle performance
Decrease risk of injury
Decrease the severity of injury
Accelerated rehabilitation and return to activity.
Why Movement Helps
Before reviewing biomechanical principles of exercise, consider the effects of immobilization on musculoskeletal structures. Historically, accepted procedure was to immobilize the injured joint and to allow pain and swelling to subside. But such as course did not address the cause of that pain. nor did it offer hope for regaining maximal joint integrity.
Soft tissue follows the use disuse principle: when used, it remains strong; it weakens, Immobilized muscle atrophy at an approximate rate of 1.5 percent per day. Studies show that muscle atrophy begins within six hours of immobilization.
Detrimental effects of immobilization have also been noted in the synovial joint, connective tissue and tendon structure, which loses tensile loading capacity. Seriously irreversible damage to the articular cartilage can also occur.
In addition to soft tissue, vascular and neurological structures suffer from extended immobilization of injured joints. Significant changes in the impulse patterns of motor neurons weakening the immobilized muscle have been noted.
Adhesion formation is another risk of immobilization, causing more pain and loss of range of motion. Uncontrolled fibroblasts and scar formation make rehabilitation more difficult.
Exercise Theory
The goal of chiropractic management of musculoskeletal conditions is to develop the strength, endurance, and joint stability required for activities of daily living. Rehabilitation of soft tissue through exercise can accelerate recovery. The cornerstone of the therapeutic exercise is known as Davis’ Law, which states that the soft tissue will model according to imposed demand. This principle was demonstrated by Frost, who revealed how collagen fibers adapt to mechanical demands. He found that intermittent tension loads stimulate cells to produce additional collagen. Stearns drew a similar conclusion from his study some 50 years ago of fibroblastic activity and healing of connective tissue. He discovered that the movement was responsible for developing an orderly arrangement of fibrils. This results in a small flexible scar that facilitates recovery from musculoskeletal injury.
Types Of Exercise
One of the most important requirements for effective chiropractic treatment is knowledge of various training methods and exercise techniques. Exercise not only shortens recovery, it can help prevent injuries and reduce the risk of rein jury, as well.
With the popularity of fitness clubs and today’s heightened awareness of exercise programs. Activities applicable to chiropractic care can be categorized in three groups:
Isometric exercise is static. It produces no joint movement and affected muscle hold a fixed length. Speed and resistance is fixed.
Isotonic exercise produces joint movement. It too, utilizes fixed resistance, but speed varies.
Isokinetic exercise also involves joint movement. It is performed at a fixed speed, but resistance will vary to match the applied force.
This viable resistance means that isokinetic exercise will accommodate pain and fatigue. Patients benefit form movement and soft tissue modeling while they achieve pain-free maximal muscle loading.
Benefits Of Isokinetics
The nature of is kinetic exercise offers the greatest benefit is cases of musculoskeletal complaints. We have already seen movement encourages formation of a flexible scar. Other physiological principle of exercise demonstrate the value of isokinetics.
Velocity spectrum
Most functional activities occur at very fast contractile velocities. Walking, for example, generates movement of 233 degrees per second in the knee joint. Cross country skiing over flat terrain moves the hip 469 degrees per second Successful rehabilitation helps prepared a patient to resume activities at normal contractile velocities. The advantage of isokinetic is that it allows a patient to rehabilitate at a speed which is comparable to functional daily activities.
Crossover
Any isokinetic exercise program should involve both the affected joint and its anatomical opposite. Exercise routines should begin with the unaffected area and progress to the site of injury.
Facilitate
Joint injury disrupts normal neuron pathway to the involved muscles. The law of facilitation states that when an impulse passes through a certain set of neurons to the exclusion of others, it will traverse this path in the future. Each time the impulse follows this course, resistance in the pathway lessens.
Overflow
When patients experience pain through a part of the affected joint’s range of motion, it is unlikely they will comply with a prescribed exercise program. The overflow principle of isokinetic enable a patient to exercise without pain yet still benefit from the activity.
Clinical Protocols For Applying Isokinetics
The Thera-Ciser exercise utilize a flexible tubing to create resistance in affected muscles. Resistance builds gradually as the patient progresses through four activity phases:
PHASE I
Features short range slow-paced movements.
PHASE II
Continues short range movements but at a faster pace. This level encourages neurological reeducation for enhanced muscle tonus and facilitates collagen healing.
PHASE III
Exercises are performed at a slow pace and full range of motion to begin duplicating normal functional movements. The patient performs Phase 3 muscle contraction only on alternate days to avoid fiber deterioration.
PHASE IV
Introduces the patient to fast paced, full- range movement. Emphasis is on developing strength and endurance lost through muscle atrophy.
In Summary
Isokinetic exercise has broad application in chiropractic management of musculoskeletal disorders. It is especially well suited to conditions involving pain with range of motion. A chiropractor’s efforts to treat musculoskeletal complaints will be enhanced by instructing patients in proper joint exercises , with emphasis on isokinetic range of motion therapy.
*references can be made available upon request.
Tuesday, November 3, 2009
The Ultimate Guide To Controlling Diabetes
Diabetes is having an obscene affect in our community. Based on in-depth research, it has been found that African Americans are more likely to contract and suffer from diabetes than any other ethnic group in the world. Why? We don’t exactly know why, but we do know that we don’t want to be victims anymore. That’s why we are providing you with the ultimate guide to treating and controlling diabetes.
These principles, or steps, will help you manage your diabetes and live a long and active life. Every person who has diabetes has different needs. Talk to your healthcare team about a treatment plan that is best for you. Diabetes affects almost every part of the body and good diabetes care requires a team of healthcare providers. They include doctors, diabetes educators, nurses, dietitians, pharmacists, mental health providers, eye specialists, foot specialists, dentists and social workers.
It is vitally important to control diabetes. Plus, taking good care of yourself will make you feel better and can lower your chances of getting:
• Heart disease
• Stroke
• Eye disease that can lead to a loss of vision or even blindness
• Nerve damage that may cause a loss of feeling or pain in the hands, feet, legs, or other parts of the body and lead to problems such as lower limb amputation or erectile dysfunction
• Kidney failure
• Gum disease and loss of teeth
Look for ways to empower yourself and that can help you take action to control your diabetes:
Principle 1: Learn as Much as You Can About Diabetes
The more you know about diabetes, the better you can work with your healthcare team to manage your disease and reduce your risk for problems. You should know what type of diabetes you have. If you do not know, ask your doctor whether you have type 1 or type 2 diabetes.
Type 1 diabetes. Those with type 1 diabetes must take insulin every day. This type of diabetes is less common and used to be called juvenile diabetes. Type 2 diabetes. Diet and daily physical activity help to control type 2 diabetes. Most people also need to take diabetes medication and/or insulin. Type 2 diabetes is very common and used to be called adult onset diabetes. Diabetes is always a serious disease. Terms that suggest that diabetes is not serious, such as “a touch of diabetes,” “mild diabetes,” and “sugar’s a little high,” are not correct and should no longer be used. Becoming diagnosed and treating diabetes early can prevent health problems later on. Many people with type 2 diabetes have no symptoms and do not know they have diabetes. Some people are at higher risk for diabetes than others. People at high risk include those who:
• are older than 45• are overweight
• have a close family member such as a parent or sibling who has or has had diabetes
• had diabetes during pregnancy
• had a baby that weighed more than 9 pounds
• are African American, Hispanic or Latino, Asian American or Pacific Islander, or American Indian
• have high blood pressure
• have high cholesterol or other abnormal blood fats• are inactive
If you know someone who has any of the risk factors for diabetes, suggest they talk to their doctor about getting tested.
Principle 2: Get Regular Care for Your Diabetes
If you have diabetes, it is important to:
• see your healthcare team regularly
• make sure your treatment plan is working. If it is not, consult with your healthcare team to help you change it.
• ask your family, friends and co-workers for help and support when you need it
• work with your healthcare team to get the best help to control your diabetes
• ask your healthcare team how often you need to see them for check-ups
• always know the date and time for your next visit with your healthcare team and make a list of questions and concerns you want to talk about then
Ask your doctor, clinic or office staff, or pharmacist to help you find resources if you have problems paying for food, medicines or medical supplies. You should be able to get Medicare or other insurance to help you pay for diabetes supplies.
Principle 3: Learn How to Control Your Diabetes
Diabetes affects many parts of the body. To stay healthy, it is important to know how to eat the right foods, be physically active and look after yourself. Understanding the following checklist will help you learn how to control your diabetes.
How Active Are You in Controlling Your Diabetes? I talk to my healthcare team about:
• my special needs to help control my diabetes
• ways to improve my ABC numbers: A1C,* blood pressure and cholesterol
• aspirin therapy to prevent heart problems
• getting regular physical activity
• quitting smoking, if needed
• I learn from my doctor, diabetes educator, podiatrist, pharmacist, or dietitian how to follow a meal plan to control my diabetes
• check my feet every day
• take my medicines as prescribed
• check my blood glucose levels* A1C (pronounced A-one-C) is a measure of your average blood glucose over the last three months. You should get this test at least twice a year.I visit my:
• general doctor at least twice a year• eye doctor each year and report any changes in vision
• dentist twice a year• specialists as my general doctor advises
Principle 4: Take Care of Your Diabetes ABCs
A major goal of treatment is to control the ABCs of diabetes: A1C (blood glucose average), blood pressure and cholesterol. You can do this in many ways.
• Follow a meal plan that was made for you.
• Be active every day.
• Take your medicine as prescribed.
• Before taking any nonprescription medicines, vitamins or herbal products, ask your pharmacist how they may affect your diabetes or prescription medicines.
• Test your blood glucose on a routine basis.
• Talk to your healthcare team about the best ways to control your A1C, blood pressure and cholesterol and know your target numbers.
• Get involved in setting goals and making a treatment plan for your diabetes.
Principle 5: Monitor Your Diabetes ABCs
To reduce your risk for diabetes problems such as blindness, kidney disease, losing a foot or leg, and early death from heart attack or stroke, you and your healthcare team need to monitor the diabetes ABCs: A1C, blood pressure and cholesterol. Talk to your healthcare team about how to reach your target numbers. Get the A1C Test. The A1C test is usually performed by your doctor. It measures how well your blood glucose has been controlled over the last three months. This test is very important because it tells how well you are taking care of your diabetes over the long term. It should be done at least twice a year. You may need to check your own blood glucose on a regular basis to help control your diabetes. It will tell you what your blood glucose is at the time you test. Keep a record of your results and show it to your healthcare team. Some meters and test strips report blood glucose results as plasma glucose values which are 10% to 15% higher than whole blood glucose values. Ask your doctor or pharmacist whether your meter and strips provide whole blood or plasma results. The target glucose range for most people using whole blood is 80 to 120 before meals and 100 to 140 at bedtime. The target glucose range for most people using plasma is 90 to 130 before meals and 110 to 150 at bedtime. Talk to your healthcare team about the best ways to check your own blood glucose.
Know Your Blood Pressure. High blood pressure makes your heart work too hard. This can lead to stroke and other problems such as kidney disease. Your blood pressure should be checked at every visit. You may need to check it yourself in between visits. The target blood pressure for most people with diabetes is less than 130/80. Ask your healthcare team what your blood pressure is and keep a dated record of the results. Discuss your blood pressure target with your healthcare team and write it down and determine what you need to do to reach your target.
Know Your Cholesterol. LDL is the "bad" cholesterol that builds up in your blood vessels. It causes the vessels to narrow and harden, which can lead to a heart attack. Your doctor should check your LDL at least once a year. The target LDL cholesterol for most people with diabetes is less than 100. Discuss your LDL cholesterol target with your healthcare team and keep a record of the results. Discuss what you need to do to reach your target and keep a record of your results. This will help you know when you and your healthcare team need to take extra action.
Principle 6: Prevent Long-Term Diabetes Problems
People with diabetes must control their blood glucose, blood pressure and cholesterol to prevent the problems of diabetes: heart attack, stroke, eye and kidney problems, nerve damage, impotence, foot or leg amputation, gum disease and loss of teeth. Here are the key self-care activities to help you manage your diabetes and live a long and healthy life.
Daily:
• Follow your diabetes meal plan with the correct portion sizes. Eat a variety of foods that are high in fiber and low in fat and salt.
• Be active every day.
• Take medicines as prescribed. If you have questions, talk to your pharmacist or doctor about your medicines.
• Get to know your feet, and wash and dry them well each day. Tell your podiatrist or healthcare team about any changes with your feet.
• Check your mouth daily for gum or tooth problems. Call your dentist right away if you have problems with your teeth or gums.
As needed:
• Test your blood glucose as prescribed by your doctor.
• Check your blood pressure as prescribed by your doctor.• Reach and stay at a healthy weight.• Stop smoking.
• Make sure your eyeglasses or contact lens prescription is up-to-date so you can see clearly. Report any changes in your vision to your healthcare team.
Principle 7: Get Checked for Long-Term Problems and Treat Them
See your healthcare team regularly to check for problems that diabetes can cause. Regular check-ups help to prevent problems or find them early when they can be treated and managed well. Along with the checks of your A1C, blood pressure and cholesterol (see Principle 5), here are some tests that you may need:
• Triglycerides (a type of blood fat)—Get yearly
• Dilated eye exam to check for eye problems—Get yearly
• Foot check—Get every visit
• Complete foot exam to check for circulation, loss of feeling, sores or changes in shape—Get yearly
• Urine test to check for kidney problems—Get yearly
• Dental exams to prevent gum disease and loss of teeth—Get twice a year
Ask your doctor about these and other tests you may need to have
Article written by Nicole Smith, BDO Staff Writer for Blackdoctors.Org, http://www.blackdoctor.org/articles1.aspx?counter=28437
These principles, or steps, will help you manage your diabetes and live a long and active life. Every person who has diabetes has different needs. Talk to your healthcare team about a treatment plan that is best for you. Diabetes affects almost every part of the body and good diabetes care requires a team of healthcare providers. They include doctors, diabetes educators, nurses, dietitians, pharmacists, mental health providers, eye specialists, foot specialists, dentists and social workers.
It is vitally important to control diabetes. Plus, taking good care of yourself will make you feel better and can lower your chances of getting:
• Heart disease
• Stroke
• Eye disease that can lead to a loss of vision or even blindness
• Nerve damage that may cause a loss of feeling or pain in the hands, feet, legs, or other parts of the body and lead to problems such as lower limb amputation or erectile dysfunction
• Kidney failure
• Gum disease and loss of teeth
Look for ways to empower yourself and that can help you take action to control your diabetes:
Principle 1: Learn as Much as You Can About Diabetes
The more you know about diabetes, the better you can work with your healthcare team to manage your disease and reduce your risk for problems. You should know what type of diabetes you have. If you do not know, ask your doctor whether you have type 1 or type 2 diabetes.
Type 1 diabetes. Those with type 1 diabetes must take insulin every day. This type of diabetes is less common and used to be called juvenile diabetes. Type 2 diabetes. Diet and daily physical activity help to control type 2 diabetes. Most people also need to take diabetes medication and/or insulin. Type 2 diabetes is very common and used to be called adult onset diabetes. Diabetes is always a serious disease. Terms that suggest that diabetes is not serious, such as “a touch of diabetes,” “mild diabetes,” and “sugar’s a little high,” are not correct and should no longer be used. Becoming diagnosed and treating diabetes early can prevent health problems later on. Many people with type 2 diabetes have no symptoms and do not know they have diabetes. Some people are at higher risk for diabetes than others. People at high risk include those who:
• are older than 45• are overweight
• have a close family member such as a parent or sibling who has or has had diabetes
• had diabetes during pregnancy
• had a baby that weighed more than 9 pounds
• are African American, Hispanic or Latino, Asian American or Pacific Islander, or American Indian
• have high blood pressure
• have high cholesterol or other abnormal blood fats• are inactive
If you know someone who has any of the risk factors for diabetes, suggest they talk to their doctor about getting tested.
Principle 2: Get Regular Care for Your Diabetes
If you have diabetes, it is important to:
• see your healthcare team regularly
• make sure your treatment plan is working. If it is not, consult with your healthcare team to help you change it.
• ask your family, friends and co-workers for help and support when you need it
• work with your healthcare team to get the best help to control your diabetes
• ask your healthcare team how often you need to see them for check-ups
• always know the date and time for your next visit with your healthcare team and make a list of questions and concerns you want to talk about then
Ask your doctor, clinic or office staff, or pharmacist to help you find resources if you have problems paying for food, medicines or medical supplies. You should be able to get Medicare or other insurance to help you pay for diabetes supplies.
Principle 3: Learn How to Control Your Diabetes
Diabetes affects many parts of the body. To stay healthy, it is important to know how to eat the right foods, be physically active and look after yourself. Understanding the following checklist will help you learn how to control your diabetes.
How Active Are You in Controlling Your Diabetes? I talk to my healthcare team about:
• my special needs to help control my diabetes
• ways to improve my ABC numbers: A1C,* blood pressure and cholesterol
• aspirin therapy to prevent heart problems
• getting regular physical activity
• quitting smoking, if needed
• I learn from my doctor, diabetes educator, podiatrist, pharmacist, or dietitian how to follow a meal plan to control my diabetes
• check my feet every day
• take my medicines as prescribed
• check my blood glucose levels* A1C (pronounced A-one-C) is a measure of your average blood glucose over the last three months. You should get this test at least twice a year.I visit my:
• general doctor at least twice a year• eye doctor each year and report any changes in vision
• dentist twice a year• specialists as my general doctor advises
Principle 4: Take Care of Your Diabetes ABCs
A major goal of treatment is to control the ABCs of diabetes: A1C (blood glucose average), blood pressure and cholesterol. You can do this in many ways.
• Follow a meal plan that was made for you.
• Be active every day.
• Take your medicine as prescribed.
• Before taking any nonprescription medicines, vitamins or herbal products, ask your pharmacist how they may affect your diabetes or prescription medicines.
• Test your blood glucose on a routine basis.
• Talk to your healthcare team about the best ways to control your A1C, blood pressure and cholesterol and know your target numbers.
• Get involved in setting goals and making a treatment plan for your diabetes.
Principle 5: Monitor Your Diabetes ABCs
To reduce your risk for diabetes problems such as blindness, kidney disease, losing a foot or leg, and early death from heart attack or stroke, you and your healthcare team need to monitor the diabetes ABCs: A1C, blood pressure and cholesterol. Talk to your healthcare team about how to reach your target numbers. Get the A1C Test. The A1C test is usually performed by your doctor. It measures how well your blood glucose has been controlled over the last three months. This test is very important because it tells how well you are taking care of your diabetes over the long term. It should be done at least twice a year. You may need to check your own blood glucose on a regular basis to help control your diabetes. It will tell you what your blood glucose is at the time you test. Keep a record of your results and show it to your healthcare team. Some meters and test strips report blood glucose results as plasma glucose values which are 10% to 15% higher than whole blood glucose values. Ask your doctor or pharmacist whether your meter and strips provide whole blood or plasma results. The target glucose range for most people using whole blood is 80 to 120 before meals and 100 to 140 at bedtime. The target glucose range for most people using plasma is 90 to 130 before meals and 110 to 150 at bedtime. Talk to your healthcare team about the best ways to check your own blood glucose.
Know Your Blood Pressure. High blood pressure makes your heart work too hard. This can lead to stroke and other problems such as kidney disease. Your blood pressure should be checked at every visit. You may need to check it yourself in between visits. The target blood pressure for most people with diabetes is less than 130/80. Ask your healthcare team what your blood pressure is and keep a dated record of the results. Discuss your blood pressure target with your healthcare team and write it down and determine what you need to do to reach your target.
Know Your Cholesterol. LDL is the "bad" cholesterol that builds up in your blood vessels. It causes the vessels to narrow and harden, which can lead to a heart attack. Your doctor should check your LDL at least once a year. The target LDL cholesterol for most people with diabetes is less than 100. Discuss your LDL cholesterol target with your healthcare team and keep a record of the results. Discuss what you need to do to reach your target and keep a record of your results. This will help you know when you and your healthcare team need to take extra action.
Principle 6: Prevent Long-Term Diabetes Problems
People with diabetes must control their blood glucose, blood pressure and cholesterol to prevent the problems of diabetes: heart attack, stroke, eye and kidney problems, nerve damage, impotence, foot or leg amputation, gum disease and loss of teeth. Here are the key self-care activities to help you manage your diabetes and live a long and healthy life.
Daily:
• Follow your diabetes meal plan with the correct portion sizes. Eat a variety of foods that are high in fiber and low in fat and salt.
• Be active every day.
• Take medicines as prescribed. If you have questions, talk to your pharmacist or doctor about your medicines.
• Get to know your feet, and wash and dry them well each day. Tell your podiatrist or healthcare team about any changes with your feet.
• Check your mouth daily for gum or tooth problems. Call your dentist right away if you have problems with your teeth or gums.
As needed:
• Test your blood glucose as prescribed by your doctor.
• Check your blood pressure as prescribed by your doctor.• Reach and stay at a healthy weight.• Stop smoking.
• Make sure your eyeglasses or contact lens prescription is up-to-date so you can see clearly. Report any changes in your vision to your healthcare team.
Principle 7: Get Checked for Long-Term Problems and Treat Them
See your healthcare team regularly to check for problems that diabetes can cause. Regular check-ups help to prevent problems or find them early when they can be treated and managed well. Along with the checks of your A1C, blood pressure and cholesterol (see Principle 5), here are some tests that you may need:
• Triglycerides (a type of blood fat)—Get yearly
• Dilated eye exam to check for eye problems—Get yearly
• Foot check—Get every visit
• Complete foot exam to check for circulation, loss of feeling, sores or changes in shape—Get yearly
• Urine test to check for kidney problems—Get yearly
• Dental exams to prevent gum disease and loss of teeth—Get twice a year
Ask your doctor about these and other tests you may need to have
Article written by Nicole Smith, BDO Staff Writer for Blackdoctors.Org, http://www.blackdoctor.org/articles1.aspx?counter=28437
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