April 13th, 2015 | The Blog
Cesarean sections represent 1 in 3 births in the US. C-sections are the most common surgery performed in the United States.
Some new moms that have delivered via C-section feel as though they have missed out on a very important moment in their pregnancy and have somehow failed because they could not experience a vaginal delivery. In an effort to personalize and lessen the harshness of a C-section, there is a new trend afoot to create a gentle cesarean experience.
Why Have a C-Section?
There are many reasons that a woman needs to deliver a baby via C-section instead of a vaginal delivery. Some of them include, but are not limited to:
The decision about a C-section versus a vaginal delivery is one that is made with the guidance and expertise of a healthcare professional. The safety and wellness of both the baby and mother are taken into consideration.
Sedation is often administered to the mom, who is actually undergoing major abdominal surgery. Most women doze on and off into a twilight sleep during a traditional C-section.
New C-section moms often feel as if they have missed the birth of their baby due to their more medical entrance into the world.
Traditionally, a sterile drape blocks the mom’s view of the operating field. She does not see the actual birth and then the newborn is whisked away at least one-half hour (30 minutes) for medical care.
The Gentle Cesarean
The changes in cesarean delivery practice are somewhat minor but they are significant for the new mom and baby. The focus is on making a C-section feel more like a birth than a major surgical procedure.
Here are some changes:
The gentle C-section allows moms, if they choose to, to watch the birth. A clear sterile drape is often used so the mom can see the baby being born.
The newborn is then immediately, before the umbilical cord is cut, placed on the mom’s chest for skin-to-skin contact. This helps to stimulate immediate bonding and breast-feeding. This is a standard procedure in most vaginal births.
The newborns often remain on the mom?s chest during the remainder of the C-section, when the wound is being closed. She can talk and bond with the newborn.
Simple changes like moving an EKG monitor from the mom’s chest to the side helps her to visualize the birth. Moms are not strapped onto the operating table. Intravenous lines are specifically placed in the non-dominant hand so the dominant hand is free to hold the baby.
Will It Catch On?
The trend towards gentle cesarean is slowly evolving. Cost is not a factor in its popularity as only minor logistical adjustments are made. The basic procedure remains the same.
Clinical studies and scientific outcomes will be the driving force for the transition from the traditional cesarean to the gentle cesarean.
It is important to note that a gentle cesarean is not a new replacement for a vaginal birth. It is a means by which a traditional and necessary cesarean section birth can be an enhanced surgical experience.
April 6th, 2015 | The Blog
Organ donation is truly the gift of life. This gift bypasses 18 people in the US everyday. These 18 people die while waiting for an available organ.
The Controversial Question
When should organs for donation be removed or harvested from a dying patient? There is an ongoing debate about when it is too soon to remove them versus when it is too late, rendering the organs at risk of being too damaged for successful use.
Brain Death Defined
A group of neurologists, public health clinicians, biochemists, transplant surgeons, a medical historian and an ethicist convened at Harvard University in 1968 to define brain death or a permanently nonfunctioning brain.
These points, according to the Harvard University group, define brain death:
It is important to note that brain death is not synonymous with cardiac arrest.
The group developed criteria for irreversible coma, which later became the new criteria for death. Harvard University’s criteria and definition for death remain the standard in today’s healthcare field.
Dead Donor Rule
The definition of the Dead Donor Rule, which is the standard rule of ethics in the medical world, “forbids organs from being harvested from those who are still living”. Therefore, a patient must be brain dead in order for their organs to be harvested.
Time Limit on Harvesting Organs
Once a heart stops and there is no longer perfusion to the organs. Time is of the essence to remove the organs designated for transplant before irreversible damage is done and they are rendered useless.
A living donor is a healthy person who gives their consent to donate a kidney or a lobe of the liver while they are alive. This is an elective donation. Life, for the donor and recipient, continues forward after the organ donation and transplant.
A donation by a dying patient carries more guidelines and further discussion. A donation by a dying patient is guided by two main principles:
According to multiple studies, there is no uniformity about organ donation from institution to institution. What are some of the differences?
Organ donors, living and dying, absolutely save lives. It is a personal decision about whether or not to partake in this circle of life.
March 30th, 2015 | The Blog
Disappearing body fat is a phenomenon that everyone wants to personally witness. Where does fat actually disappear to when someone “loses” it?
Recent information published in The BMJ, previously called the British Medical Journal, explains what happens to the fat that a person burns off when they lose body fat and, ultimately, weight. The simplest explanation reveals that, when fat is “lost” or “burned off,” it undergoes a complex biochemical process. What exactly does that mean?
What is Fat?
Fat is, scientifically, called adipose tissue. The main component of human body fat is triglycerides.
When a molecule of triglyceride is burned, this is what the chemical formula looks like: C55H104O6+78O2—>55CO2+52H2O+energy.
What does this complex and perplexing chemical formula mean? Simply stated, it means that when fat is metabolized, the end result in the human body is carbon dioxide, water and energy.
CO2 versus H2O?
So, what percentage of the disappearing fat mass turns to CO2 (carbon dioxide) and what percentage turns to H2O (water)? According to the authoring scientists, Ruben Meerman (a physicist from Australia) and Andrew Brown (a researcher from the University of New South Wales), here are the estimated results:
Oxidizing 10 kilos of human fat requires a person to inhale 29 kilos of oxygen. The end result produces 28 kilos of CO2 and 11 kilos of water. So, in real terms, 84% of lost fat ends up as carbon dioxide and 16% of lost fat ends up as water.
Lost fat is exhaled. Since carbon dioxide is the most common gas in the air that we breathe, the person who is losing the weight actually exhales all that fat.
As a result, once exhaled, the CO2 helps the photosynthesis of plants and, conversely, adds to the global warming of the Earth.
Speed it Up
How can you lose more weight faster? If you exhale more CO2, you will lose more weight. That simple fact equates to the simple explanation that running will make you lose weight faster than sauntering along on a leisurely walk. This is true because you exhale more carbon dioxide when you run than when you walk.
The human body, in several ways, disposes of, the water that is produced by fat metabolism:
In the End
Some people theorize that fat metabolites turn to muscle or are evacuated in solid waste or feces. Meerman and Brown dispute this as incorrect information. According to their research, fat is just breathed away…ahhhh.
March 23rd, 2015 | The Blog
Staphylococcus aureus or staph is a common bacteria, which 1 in every 3 people carry on their skin or in their nose. Usually, it does not cause medical issues for those who have staph on their skin surface. But, that said, staph does have the potential to cause serious skin infections, pneumonia or/or a blood infection in some patients.
If a patient develops a staph infection, it is most commonly and effectively treated with antibiotics. Unfortunately, some staph bacteria cannot be eradicated with a typical course of antibiotics. If this is the case, it becomes known as Methicillin-resistant Staphylococcus aureus or MRSA.
Who Gets MRSA?
Patients who are most likely to get a MRSA infection especially include:
How is MRSA Spread?
There are several ways that a patient can become infected with MRSA, which include:
There are less common and stronger than traditional antibiotics that can be used to treat MRSA. Some patients have had active MRSA abscesses surgically drained, followed by a full course of antibiotics.
Once discharged from an acute care setting in which an infection occurred, it is important for a MRSA patient to do the following:
The greatest prevention, as for all bacteria, is hand washing with soap and water or an alcohol-based hand rub before and after caring for every patient. This is important in a hospital, clinic, office or home setting.
Scrupulous cleaning of all medical equipment, according to the facility policies and procedures, is imperative.
Contact precautions should be initiated for those patients with MRSA. Some of these precautions include:
Patients should be proactive and feel comfortable asking a healthcare provider, at any level of care-giving, to wash their hands if the patient has not seen them do so upon entry into an examination of hospital room.
March 16th, 2015 | The Blog
Let’s look at some nutrition information, especially that of healthy foods. So what constitutes a healthy food choice?
It is interesting to note that, according to the US Department of Agriculture (USDA), 43% of all store-bought food items have at least one health claim in print on the packaging.
What Does It All Mean?
Here are a few of the most common health claims on the food packages found in supermarkets in the US:
Some products contain a mere 32 milligrams of healthy fat per serving. This is 1/10 the amount found in one ounce of salmon.
The better option, according to the American Heart Association (AHA) is to eat at least two servings, 3.5 ounces, cooked, per week of fatty, omega-3-rich fish like trout or salmon.
Good Source of Antioxidants
What constitutes a “good source?” According to the FDA, if a packaged food contains 10% of the recommended daily intake of vitamins A, C and E, it is a good source of antioxidants.
The better option is to consume antioxidants from natural food sources like fruits and vegetables. One small carrot contains twice as much vitamin A than a full serving of an antioxidant-enriched breakfast cereal.
Eat four servings of fruit and five servings of vegetables per day to meet the suggested requirements. Make note that the more colorful the vegetables, the higher the antioxidant content.
High in Fiber
A high fiber diet, specifically natural fiber, might reduce the risk of heart disease. Some bread, energy bars and other man-made items can deliver up to 35% of the daily fiber requirement.
The better option is to eat natural fiber sources like beans, oats, berries and broccoli.
Made With Whole Grains
What is whole grain? Whole grain denotes foods that are higher in fiber, vitamins and mineral than their refined equivalent. There are many crackers, breads and cereals, which list on the package that they are “made with whole grains.”
There is no minimum content required in order to list “made with whole grains” on the packaging. Some products contain as little as 1/16th of the recommended daily intake.
The better option is to purchase only foods, which list that they are “100% whole grain.” This statement ensures that the product contains no refined flours.
Other Food Package Statements
There are some food items that list “shelf life” and “expiration dates” on the packaging. When should the consumer pay extra heed to these dates?
The “sell by” date on an egg carton does not guarantee freshness. Eggs should be kept in refrigerator for 3 to 5 weeks, no longer.
The “best by” date on cereals is an estimate of the duration for quality. Cereals will stay fresh and crisp for 3 months after opening, if the inner package is tightly sealed.
The best way to store red apples is by placing them in a plastic bag with a few holes poked to allow air circulation. The bag should be stored in the refrigerator. The apples should last for up to 3 weeks.
Unopened packages of deli meat will safely last in the refrigerator for 2 weeks, even if the “sell by” date has passed.
The “best by” date on bread is not significant. Storing a loaf of bread in the refrigerator extends bread freshness by 2 weeks.
So, there you have it, a few tips and tricks about food labeling content. The wording on food packaging is important but leaves room for consumer translation.
March 9th, 2015 | The Blog
Seizures and epilepsy are serious conditions. These medical symptoms and issues are often difficult to track, especially in pediatric patients.
The Concerns About Children and Seizures
Everyone worries about the long-term effects of seizures. These are especially difficult thoughts for many parents:
New Wristband Sensor System
Boston Children?s Hospital (BCH) is on the cutting edge of medical innovations in many specialties. Recently, the Epilepsy Program, in conjunction with a Massachusetts Institute of Technology (MIT), has been conducting trials of a wristband sensor system called Embrace to track seizure activity and provide an alarm for quick medical intervention.
How it Works
The wristband is Bluetooth-enabled and contains two sensors:
The combination of the data will sound an alarm when a pre-programmed symptom threshold is reached.
Not only is there an audible alarm worn by the patient, there is also a companion Embrace. This wristband is worn by a parent, caregiver or roommate. It vibrates if there is a patient alert so the patient?s parent, caregiver or roommate can quickly intervene with potentially lifesaving care.
During the research and trial phase, the data collected from the wristband sensor system is cross-referenced with information collected from electroencephalogram (EEG) data. The EEG data is collected and assimilated repeatedly for up to a week of data.
Thus far, according to the BCH data collected from a base of 80 patients, tracking EEGs documented 16 grand mal seizures in 7 patients during one trial phase. The wristband sensor detected 15 of those 16 documented grand mal seizures.
Over 3,500 monitoring hours, there were 102 false alarms detected, which represented one in about one-third of the trial subjects.
There is a high risk of death for children during a severe epileptic seizure. This innovative sensor will, hopefully, help intercept and treat a seizure disorder and save lives.
The Future of Embrace
The hope is that, eventually, the wristband sensor data can be wirelessly transmitted to the patient?s physician.
A sensor is being developed that can be positioned under the ear and be wirelessly connected to electrodes on the scalp or those implanted in the brain. This form of sensor use is in the development stage.
The device is headed for final product validation tests and then onto the US Food and Drug Administration (FDA) for approval.
March 2nd, 2015 | The Blog
Look around the over-the-counter analgesic and fever aisle. There are so many different forms of medication available. There are tablets, caplets, softgels, gelcaps, liquids, powders, quick-dissolve tablets and chewables. While they are all effective, which one works the fastest?
The Absorption of Medication
After swallowing, traditional tablet forms are broken down into smaller particles, dissolved in the stomach and absorbed by the intestinal tract into the blood. Other forms of medications are absorbed faster because they do not need to be broken down as much as a solid tablet.
Pros and Cons
Here are a few of the pros and cons of the different forms of medications, which are readily available on the market:
Solid tablet or pill form
Patients and their healthcare providers choose different medication delivery forms based upon individual needs and preferences. There are a few factors that influence the decision:
The delivery choice does not significantly, although it does minimally in some cases, affect the absorption of any medication. The delivery form is a personal choice for personal reasons.
February 23rd, 2015 | The Blog
Long, lush eyelashes are the envy of the runway and the everyday woman. The current beauty trend is for bold eyebrows and stunningly full eyelashes. If you were not born with naturally long and thick eyelashes, you are now in luck. There is a new product available on the market.
SmartLash is a non-prescription, dermatologist recommended, eyelash enhancer. It is an affordable option for many patients.?Many healthcare providers suggest that patients seek the professional opinion of a qualified dermatologist before starting to use this product.
How It Works
Patients who use this product state that 4 weeks of regular use leads to fuller and longer eyelashes. SmartLash can also be used on the eyebrows to make them more shapely.
Most eyelash enhancers are made with prostaglandin, a hormone, which can cause darkened irises (the color around the pupil of the eye) and blurred vision. The darkened irises are an irreversible side effect of some of the more popular prescription enhancers like Latisse. SmartLash does not contain any hormones or parabens.
So what does this product contain??SmartLash contains a blend of polypeptides, amino acids and conditioning agents, which enhance lashes and help to prevent eyelash breakage.
The Mechanics of the Product
SmartLash is easy to use. Here is a simple explanation of how to use it:
Who Can Use SmartLash?
The product is user-friendly. Most people who have used SmartLash have not experienced any eye irritation or eyelid discoloration. Most patients with eye sensitivity can safely use it. It is also safe for most contact lens wearers.
The Effectiveness of the Product
The numbers collected through user studies tell the tale about SmartLash:
The Cost of Eyelash Enhancement
The cost is reasonable and the product is dermatologist recommended. SmartLash Eyelash Enhancer costs about $29.95 for a 0.16 ounce container.
The price (literally) of cosmetic enhancements must be weighed against the effectiveness of a product and the potential side effects with regular use.
SmartLash is not FDA approved but neither are many other cosmetic products regularly used in the US.?It is important to note that Latisse, a prescription product, is the only US Food and Drug Administration (FDA) approved eyelash enhancer. Latisse actually stimulates growth of eyelashes but does have some common side effect like darkening of the eyelids.
In The End
There needs to be a frank discussion between the patient and a qualified dermatologist about which eyelash enhancing product is the safest and most effective that individual’s use.
February 20th, 2015 | The Blog
People are living longer and this very fact impacts the number of joint replacements done in the US every year. This discussion focuses specifically on hip replacements in the US.
Hip Replacement Statistics
According to the US Centers for Disease Control and Prevention (CDC), over 332,000 total hip replacements are performed annually. The need to replace a hip joint can be a direct result of wear-and-tear or the result of a fall and subsequent hip fracture. Certainly, there are many individual reasons why a patient, with the guidance of their physician, chooses to undergo hip replacement surgery.
How Things Have Changed
The traditional or posterior hip replacement is performed by:
The updated anterior hip replacement:
Ideal Patients for the Surgery
The best candidate for an anterior hip replacement is:
It is important to note that patients with a more complex medical history and hip injury are best treated with the more traditional posterior approach to hip replacement.
Anterior Hip Replacement Recovery
The very remarkable and positive post-surgery changes with the anterior hip replacement technique is:
What about exercise after an anterior hip replacement? Patients can usually start:
Anterior Hip Replacement Popularity
The orthopedic surgeons who are trained in this approach are about 30% of all US orthopedic surgeons. The procedure takes intense training and a great deal of time to perfect. It is a more difficult procedure to perform than the posterior approach.
Of those limited number, who are trained in anterior hip replacement surgery techniques, the orthopedic surgeons report that up to 75% of their hip replacement patient population are undergoing this surgical approach. The percentage of patients with the anterior replacement is rising.
This is truly cutting edge surgery in the field of orthopedics. The bottom line for the patient is less pain after surgery and better mobility.
February 17th, 2015 | The Blog
With the recent measles outbreak in California, it is appropriate to have a discussion about adult immunizations. This discussion is best done in list form to keep the information concise.
It is important to note that many immunization-preventable diseases are far more serious when contracted by an adult than a child. Adults need updated immunizations for several main reasons, including:
Adult patient need to discuss their individual immunization needs with their primary care physician at their regular visits.
The following information has been condensed in order to briefly touch upon each important immunization. The US Centers for Disease Control and Prevention (CDC) is an outstanding source for further information.
Tetanus or lockjaw
Pertussis or whooping cough
Flu or Influenza
Pneumococcal disease or pneumonia
Varicella or chickenpox
Childhood immunizations are important for the health of the greater population as well as the individual child. Adult immunizations are important to maintain the health of the individual and their community.
It is important for every individual to discuss a plan for immunization with a primary care physician.