Auto news on Youtube Nov 14 2018

In this video I will talk about Dupuytren's contracture, what it is, my experience

with it, including some gruesome video of my operation and we're going to talk

about the three treatment options, coming right up!

oh, just kidding about the gruesome video, it's not that bad.

Hey everyone, its Kent and we're talking about Dupuytren's contracture.

Dupuytren's contracture is a common usually

inherited condition in which one or more fingers become permanently bent in a

flexed position. It usually begins as small hard nodules just under the skin

of the palm. It then worsens over time until the fingers can no longer be

straightened. Although the cause is unknown Dupuytren's most often occurs in

males over the age of 50. It mostly affects white people and is rare among

Asians and Africans. Risk factors include; family history, alcoholism, smoking,

thyroid problems, liver disease, diabetes, previous hand trauma, and epilepsy.

My pinky finger on my left hand suffers from Dupuytren's contracture. I noticed I

wasn't able to fully straighten my finger about ten years ago and as time

went by the angle of the bend slowly increased. Right before my operation five

years ago in late 2013 it peaked at about 55 degrees permanent bent. It did

not really hurt, but it was very annoying. For example, it was hard to put on gloves

and get my hands into the pockets of my pants. I also play guitar, so that was

very challenging as well and aesthetically it wasn't very attractive.

My dreams of being a hand model were shot! Although my finger wasn't a hundred

percent straight and back to normal after my operation, the angle went down

to approximately 15 degrees from 55 degrees, which was a huge improvement.

There are three options for treatment Xiaflex injections is one, surgical

Excision is two, and this last one is hard to pronounce,

Percutaneous Needle Aponeurotomy or PNA is the third.

Xiaflex is a drug composed of an enzyme that breaks down the collagen.

This drug is injected around the affected area of the finger over a

period of days. The drugs will start to dissolve the collagen, breaking down the

cord allowing the doctor to straighten the finger at a scheduled one-week

follow up. Xiaflex works 90 to 100 percent of the

time in most cases. The common side effects are skin splitting open, small risks of

infection and scar tenderness. The chance of do patricians reoccurring with the

use of Xiaflex injections is 10 to 30 percent over 3 to 5 years.

Xiaflex drug is expensive, approximately $1300 Canadian or $1000 US

per injection. Some insurance companies will offer 50 to 100 percent coverage though.

Surgical excision is a procedure done in the hospital operating room. An incision

is made to remove the thickened cord in order to straighten your finger as much

as possible. Sutures are put in the skin and a plaster splint is put in place to

be worn at night for three months. After surgery you will be referred to see a

therapist to start an exercise program to help with the risk of stiffness

and/or permanent loss of motion from occurring. Therapy lasts about two to

three months, as well a one-week follow-up is booked for the sutures to

be removed. There are small risks of infection, scar tenderness, and permanent

numbness. The chance of Dupuytren's reoccurring is about 25% over three to

five years

And the last treatment, is the treatment I chose, Percutaneous Needle Aponeurotomy

or PNA. A needle is used to break up the collagen fibers

so that your finger can be made straighter. The patient is able to

proceed with light activities with no restrictions within a week after the

procedure is done. A splint is worn for three months at night time only. There is

a small risk of infection, scar tenderness and numbness that is

permanent. The chance of Dupuytren's reoccurring is about 40% over

three to five years. Now let's get to the video of my operation. The treatment I

chose was PNA and was performed by Dr. Paul A Binhammer at Sunnybrook

Hospital in Toronto Canada. He is amazing, I highly recommend him. I'm not a hundred

percent sure but I think he is one of the few surgeons that do the PNA

treatment. As mentioned, it's been five years since my operation and I noticed

some gradual reoccurring of Dupuytren's. I was originally at 55% Bend, after the

operation it then went down to about 15% and now I think I'm back up to

about 25 maybe approaching 30%. But I have annual checkups with Dr. Binhammer

to assess the rate in which Dupuytren's is reoccurring on my finger.

And if it ever gets to the point where the bend in my finger is too much for me to

handle, I will explore more treatment. Now let's get to the video, roll em!

There's lots of freezing, how you doing? Good, I can feel a little bit but there's no pain

I got pretty good tolerance.

A little more freezing.

okay? Yes.

okay? Yes.

We're all done. No way? Oh, yes way.

Dupuytren's Contracture is a progressive disease of the hand that can affect

patients for a lifetime. There is no available cure and a contracture can

reoccur following all of the treatment options. But as you can see, there are

some really good treatment options to help you deal with this disease. For more

information please check out the links in the video's description. Let me know

in the comments below if you or someone you know has Dupuytren's Contracture

and what your experience was with treatment. If you like this video, please

give it a 'like' and subscribe. Thank you very much for watching!

For more infomation >> Dupuytren's Contracture Treatments & Operation Video - Duration: 10:37.

-------------------------------------------

4-year old latest beneficiary of new Nemours treatment - Duration: 3:46.

For more infomation >> 4-year old latest beneficiary of new Nemours treatment - Duration: 3:46.

-------------------------------------------

Iron Deficiency Treatment - Duration: 5:56.

iron deficiency treatment

Treatment for iron-deficiency anemia will depend on its cause and severity.

Treatments may include iron supplements, procedures, surgery, and dietary changes.

Severe iron-deficiency anemia may require intravenous (IV) iron therapy or a blood transfusion.

Iron supplements Your doctor may recommend that you take iron

supplements, also called iron pills or oral iron, by mouth once or several times a day

to increase the iron in your body.

This is the most common treatment for iron deficiency.

It generally takes three to six months to replenish your iron stores.

Iron supplements are sometimes recommended by your doctor during pregnancy.

If your condition is caused by certain rare genetic conditions, such as a TMRPSS6 gene

mutation, you may not respond to oral iron supplements.

Iron supplements are generally not recommended for people who do not have iron-deficiency

anemia.

This is because too much iron can damage your organs.

Do not stop taking your prescribed iron supplements without first talking to your doctor.

Talk to your doctor if you are experiencing side effects such as a bad metallic taste,

vomiting, diarrhea, constipation, or upset stomach.

Your doctor may be able to recommend options such as taking your supplements with food,

lowering the dose, trying a different type of iron supplement, or receiving intravenous

(IV) iron.

Procedures If iron supplements alone are not able to

replenish the levels of iron in your body, your doctor may recommend a procedure, including:

Iron therapy, or intravenous (IV) iron.

This is sometimes used to deliver iron through a blood vessel to increase iron levels in

the blood.

One benefit of IV iron is that it often takes only one or a few sessions to replenish the

amount of iron in your body.

People with severe iron-deficiency anemia or who have chronic conditions such as kidney

disease or celiac disease may be more likely to receive IV iron.

You may experience vomiting, headache, or other side effects right after the IV iron,

but these usually go away within a day or two.

Red blood cell transfusions.

These may be used for people with severe iron-deficiency anemia to quickly increase the amount of red

blood cells and iron in the blood.

Your doctor may recommend this if you have serious complications of iron-deficiency anemia,

such as chest pain.

Surgery, upper endoscopy or colonoscopy, to stop bleeding.

Healthy lifestyle changes To help you meet your daily recommended iron

levels, your doctor may recommend that you:

Adopt healthy lifestyle changes such as heart-healthy eating patterns.

Increase your daily intake of iron-rich foods to help treat your iron-deficiency anemia.

See Prevention strategies to learn about foods that are high in iron.

It is important to know that increasing your intake of iron may not be enough to replace

the iron your body normally stores but has used up.

Increase your intake of vitamin C to help your body absorb iron.

Avoid drinking black tea, which reduces iron absorption.

Other treatments If you have chronic kidney disease and iron-deficiency

anemia, your doctor may recommend erythropoiesis stimulating agents (esa).

These medicines stimulate the bone marrow to make more red blood cells.

ESAs are usually used with iron therapy or IV iron, or when iron therapy alone is not

enough.

Look for Living With will discuss what your doctor

may recommend, including lifelong lifestyle changes and medical care to prevent your condition

from recurring, getting worse, or causing complications.

Research for Your Health will discuss how we are using current research and advancing

research to treat people with iron-deficiency anemia.

Participate in NHLBI Clinical Trials will highlight our ongoing clinical studies that

are investigating treatments for iron-deficiency anemia.

For more infomation >> Iron Deficiency Treatment - Duration: 5:56.

-------------------------------------------

New Treatment Offers Hope For Those Suffering From Excessive Sweating - Duration: 2:26.

For more infomation >> New Treatment Offers Hope For Those Suffering From Excessive Sweating - Duration: 2:26.

-------------------------------------------

Whiplash Treatment - Petaluma Chiropractor - Duration: 4:33.

Hi, I'm Dr.

Steven Battaglino

with Battaglino Family Chiropractic.

I want to talk a little bit about chiropractic

and whiplash.

Specifically

what whiplash is,

what causes it,

and how chiropractic can help heal

from whiplash.

So, when you're in a car accident

and you get hit from behind.

Let's say you're parked

or at a red light,

someone rear ends you from behind.

What happens.

This is the spine from the side view,

you're looking this way.

You get hit from behind and

you know the headrests that are in most

cars, even that nice fancy cars,

are just not very good.

That's a whole other subject,

but basically the

rest makes contact

with the back of the head.

This is the base of the skull here.

So the heads like this.

The head makes contact

with the headrest

or maybe it doesn't in most cases.

When there's an impact from behind,

the head

goes like this.

And the spine

and the neck kind of gets folded

into that area where there's no

headrest.

So,

basically you're getting

hit from behind.

It's doing this

and then you're getting flung forward

like this

and then you're coming back to neutral.

Technically, whiplash is called a hyperextension-hyperflexion

injury.

So, hyper means you're doing it too much.

You're extending

and then you're whipping forward

and then you're coming back like that.

So, there's a lot of injury that can happen

in that little moment of time.

There's tearing of ligaments

and

muscles around the neck.

But also the discs

get injured.

You can see these are the bones of the spine

and the cervical spine,

the neck.

And then from the front we see some discs.

These are called intervertebral discs,

they're like little shock absorbers in between

each of these bones.

They're soft tissue,

there you know tough

and durable but they're still soft tissue.

And they separate the bones

out to create spaces for

these nerves to come out.

You've got a lot of nerve flow coming out of the neck.

If you think about all the fine

motor skills that you can do

and all the sensitive touch that you

have in your fingers

and hands.

And plus all the muscles

and all the different organs that

get run from this area,

there's a lot of nerve flow that comes out of these

cables.

So, when there's an injury like

a whiplash you're doing injury

to, not only the muscles

and ligaments, but also to

these discs and to these nerves.

So, we want to try

and rehab this injury

so that it heals well.

And so the symptoms go away.

But also so that long term you're

not going to have an injured neck that just

gets worse and worse.

Chiropractic is the solution

for this because you know this is a structural

problem where the

disc. You know when you have

an injury it's

doing this to the disc.

It's stretching it out

and injuring it that way.

So, the disk is supposed to sit like this like

a shock absorber, so it's suppose to do

this.

When it comes like this,

it is,

you know going to injure that disk,

the fibers inside it.

So, it'll start to swell.

That's the body's first reaction.

It will swell into

the cavity where these nerves are coming out.

The nervous swell because it's

been injured.

And the body really

can't fix all of it.

It just, the best that I can do is

to immobilize it

and keep it from getting more

hurt. So, the muscles get really tight

and limit any range of

motion. It gets really stiff.

It's just like a cast.

So instead of putting like a plaster

of paris cast around the neck,

the body is using those muscles to splint

the area.

So, the muscles get really sore

and tight as well over time.

What we want to do is reverse this

problem

and create better

alignment in those areas that have been injured

so that they can heal properly.

Take pressure off the discs

and nerves

and the pain goes away

and then the muscles relax

and so everything starts to heal up.

And you know the pain goes away,

which is the main

complaint that patients typically have

after an injury like this.

But again these nerves are going to run really

important things,

we want to make sure that nerve flow going to these

nerves is, you know,

turned up.

I'm Dr.

Steve Battaglino with Battaglino Family Chiropractic

and this has been your health minute.

For more infomation >> Whiplash Treatment - Petaluma Chiropractor - Duration: 4:33.

-------------------------------------------

Treatment after overdoses - Duration: 2:18.

For more infomation >> Treatment after overdoses - Duration: 2:18.

-------------------------------------------

Ankylosing Spondylitis Symptoms, Causes and Treatment - Duration: 4:13.

Before We begin..

Don't forget to Subscribe and hit the Notification button.

So you won't miss the next great videos from us!

Ankylosing spondylitis is a form of arthritis that primarily affects your spine.

It causes severe inflammation of the vertebrae that might eventually lead to chronic pain

and disability.

In more advanced cases, the inflammation can cause new bone to form on the spine.

This may lead to deformity.

Ankylosing spondylitis can also cause pain and stiffness in other parts of your body.

Other large joints, such as the shoulders, hips, and knees, can be involved as well.

What are the symptoms of ankylosing spondylitis?

The symptoms of ankylosing spondylitis vary.

It's often characterized by mild to moderate flare-ups of inflammation that alternate with

periods of almost no symptoms.

The most common symptom is back pain in the morning and at night.

You may also experience pain in the large joints, such as the hips and shoulders.

Other symptoms may include: • early morning stiffness

• poor posture or stooped shoulders • loss of appetite

• low-grade fever • weight loss

• fatigue • anemia or low iron

• reduced lung function Because ankylosing spondylitis involves inflammation,

other parts of your body can be affected as well.

People with ankylosing spondylitis may also experience:

• inflammation of the bowels • mild eye inflammation

• heart valve inflammation • Achilles tendonitis

While ankylosing spondylitis is primarily a condition of the spine, it can impact other

parts of the body, too.

What causes ankylosing spondylitis?

The cause of ankylosing spondylitis is currently unknown.

The disorder does tend to run in families, so genetics probably play a role.

If your parents or siblings have ankylosing spondylitis, research estimates you're 10

to 20 times more likely to have it than someone with no family history.

How is ankylosing spondylitis diagnosed?

A rheumatologist is often consulted to help diagnose ankylosing spondylitis.

This is a doctor who specializes in arthritis.

The first step will be a thorough physical exam.

Your doctor will ask you for details about your pain and your history of symptoms.

Your doctor will then use an X-ray to check for erosion on your spine and any painful

joints.

Erosion may not be detected if the disease is in its early stages.

An MRI study may also be done.

However, MRI results are often difficult to interpret.

A blood test called an erythrocyte sedimentation rate may be done to gauge the presence of

any inflammation.

A blood test for the protein HLA-B27 may be done.

However, the HLA-B27 test doesn't mean that you have ankylosing spondylitis.

It only that you have the gene that produces this protein.

Diagnosing this type of arthritis can take some time.

What are the complications of ankylosing spondylitis?

If ankylosing spondylitis is left untreated, some complications are possible.

These include: • vertebrae may fuse together because of

chronic inflammation • inflammation can spread to nearby joints,

including hips and shoulders • inflammation may spread to ligaments and

tendons, which may make flexibility worse • difficulty breathing

• eye irritation • heart, lung, or bowel damage

• compression fractures of the spine It's important to seek treatment for lower

back pain or chronic joint stiffness.

For more infomation >> Ankylosing Spondylitis Symptoms, Causes and Treatment - Duration: 4:13.

-------------------------------------------

Autism Holistic Treatment - Is Healing Autism Naturally the Key? When Mainstream has Little to Offer - Duration: 5:18.

Hi this is the Autism Journey Video Series, and this is roadblock number 5.

Mainstream medicine seems to offer so little for autism so the question

becomes does a mind/body/spirit approach makes sense in autism?

well first I'm going to take you to a very unusual story about a shaman in

Vermont that I went to go see. I took my whole family up there was several years

ago and I had just read The Horse Boy which was a documentary and a book about

a man who's very into horses took his son and his family on a trek across

Mongolia in search of shamans that would heal their son so of course I wanted a

shaman as well so I found one in Vermont and it was a very very eye-opening

experience you know fast forward through the office work that we did with her in

terms of you know laying on the table and different modalities that she was

using you know drumming and herbs and burning of incense but she came to our

house in the evening because she wanted to get an assessment for my son while he

was sleeping so she came over at like 10 o'clock one night went in the room with

him and just did all of this stuff shaman stuff with him and she comes out

to the table a little bit later and we're sitting at the kitchen table in

this house that we rented in Vermont and she says your son is in a constant state

of trying to return to the ecstasy of death now from the vantage point that I

was at that time that sounded horrible like I felt sick to my stomach

I felt I felt like it was a literal thing like you know like he wanted to

die now that wasn't in fact what she was trying to tell me but the problem with

that is it took me about a year to get through the process of understanding

what she was really trying to tell me and the reason I'm sharing this story is

because what that visit with the shaman did all those years ago

was it opened my mind up to a possibility of a bigger picture it

opened my mind up to get beyond just the physical healing of our bodies and you

know in those days I was very fixated on fixing autism now I totally understand

that autism is a differently wired brain and I actually embrace that because all

of my son's strengths come from that but you know restoring the unwellness and

fixing the physical issues it was certainly an issue that I continued to

strive for but anyway what the shaman did for me was really open up my mind to

the possibility that there is more than meets the eye about what's going on with

autism and if you fast forward through that year when I started discovering

what it really meant to be a spiritual being or have a spiritual experience you

know Jill Bolte Taylor I don't know if you guys have heard of her she's a

neuroanatomist that had a stroke and she has a wonderful TEDx about it and I

wrote a book called my stroke of insight really amazing testimony about the

really unbelievable unfathomable energetic existence of everything that's

around us and the unity and connection between all that is so Jill Bolte Taylor

reading about experiences by different autistic people really opened my eyes to

the fact that it wasn't just a physicality here that we were dealing

with you know yes my son was was sick and there were issues with his physical

immune system neurologic system digestive system but there was also this

emotional and spiritual aspect to him and to me that really couldn't be

ignored if I really wanted all of the answers to

you know what was going on why me what did it all mean so I just want you

guys to keep an open mind about mind body spirit medicine

about holistic healing modalities it's never what you see in front of you is

never all there is there's a whole different realm of other things going on

here so think about exploring holistic healing modalities think about looking

at your children and your life with a bigger picture context and I hope this

helps I hope this gives you some insights into some alternative ways of

thinking about autism other than just the mainstream approach which we all

have sort of in front of us on a regular basis so I am dr. Andrea labuda

you can jump over to my website AndreaLibutti.com, join a tribe, a growing

community of people that are supporting each other and really shifting the

autism paradigm from what's not possible to what is possible. Thanks for listening

For more infomation >> Autism Holistic Treatment - Is Healing Autism Naturally the Key? When Mainstream has Little to Offer - Duration: 5:18.

-------------------------------------------

Being Well 1109: Stroke Awareness and Latest Treatment Options - Duration: 27:45.

[music playing] Male Voice: Carle combines clinical care,

health insurance, and research in a way that solves problems today, with an eye toward

the future.

Supported by a deep philanthropic spirit, and dedicated to making life better, for as

many as possible.

Rameen: Meeting the ever changing in healthcare needs

of our communities.

Paris Community Hospital/Family Medical Center is now Horizon Health, with the same ownership,

management, providers and employees.

Horizon Health provides patient care and promotes wellness to the communities of East Central

Illinois.

Jeff: At HSHS St. Anthony's Memorial Hospital we

are at work transforming heart care, rebuilding knees and hips, delivering new generations,

and focused on providing healthcare to you.

We are HSHS St. Anthony's Memorial Hospital.

Lori: Sarah Bush Lincoln Health System supporting

healthy lifestyles, eating heart-healthy diet, staying active, managing stress, and regular

checkups are ways of reducing your health risks.

Proper health is important to all at Sarah Bush Lincoln Health System.

Ke'an: Hi.

Thank you so much for joining us on this episode of Being Well.

I'm your host, Ke'an Armstrong.

And today, we are going to be talking about stroke awareness and the latest treatment

options with stroke.

Ke'an: And joining me today are two physicians.

I have Dr. Amrendra Miranpuri, from Carle.

And I have Dr. Joseph Burton, with Sarah Bush.

So, thank you so much, both of you, for joining me today.

Joseph: Thanks for having us.

Ke'an: Yeah.

Amrendra: Thanks for having us, yeah.

Ke'an: So, this is an amazing topic to talk about.

I think a lot of people are interested in this, and learning about stroke, and know

when and how to take a loved one, or what to do if they're suffering themselves.

So, let's just start off with some basics here, like: what is a stroke?

How do we explain it to folks?

Amrendra: Most strokes come in as a blockage in a blood vessel.

So, you'll have a patient come in where they may have a drooping of their face, they may

not be able to get words out.

They might have a weak arm.

And generally, when you see somebody who comes in with an acute, abrupt onset of something

like that, stroke kind of makes it to the top of the list, because if that's not identified

and treated, if possible, patients can have long-term complications from that.

Amrendra: And so, 80% of the strokes that we see present like that, where it's a blockage

of a blood vessel.

A part of the brain is not getting blood flow to it, and so they'll have these types of

manifestations, the facial droop, arm weakness, speech difficulties, problems with their vision

potentially.

Amrendra: The other 20% are bleeding strokes.

So, it's a blood vessel that may have bled into the brain itself.

And those patients will oftentimes present with headaches, nausea, vomiting.

Because of the bleed, they're having some elevated pressure in the brain, and so those

patients require a different treatment course.

Ke'an: So, you're a neurosurgeon with Carle, and you are the medical director of acute

care medicine at Sarah Bush.

So you both work hand-in-hand when it comes to dealing with patients with stroke.

So, we're going to have you talking a little bit more about that portion, what causes a

stroke, what is a stroke.

And then, I want you to talk a little bit about who is at risk, and is it only older

people?

Joseph: Usually, it is.

And it's patients that have underlying comorbidities, or risk factors, such as hypertension, diabetes.

And depending on how well-controlled those disease entities are, that's sometimes what

puts people at higher risk for having strokes.

Joseph: People who have underlying coronary artery disease, or heart disease, are also

at increased risk, because you can have a stroke by a ruptured vessel, or a vessel that

has compromised blood flow.

Or you can have what we call "global hypoperfusion."

So, if your heart doesn't work well, and if you have low blood pressure, or if you go

into shock because of blood loss, or because of an infection, or a heart attack that's

massive, those things can also put you at risk to have a stroke, because of just generalized

decreased blood flow to your brain.

Joseph: And depending upon what part of the brain is affected, that's what determines

how severe the stroke is.

And it also, in determining which vessels are injured, that's what drives the treatment

therapies that we look at in the emergency department, or in any acute setting.

Ke'an: And what's the typical thing that you see?

Does someone bring themselves to the doctor, curious about this and what's happening to

them?

A loved one maybe calls?

What takes place, so the people who are watching this will know maybe what to look for, or

how to notice if something is happening with themselves?

Amrendra: It's variable.

Sometimes, there are witnesses to this happening.

And so, the key with stroke is that it's abrupt.

It's not something that gradually takes time for it to manifest.

So, you might be sitting there at dinner with someone, and all of a sudden, they can't talk,

or they have a facial droop.

And so, that is a red flag that somebody could be having a stroke.

Amrendra: The other situation is where it's unwitnessed, and those are terrifying because

you don't know how long that patient's been sitting on the floor.

Ke'an: Yeah, scary.

Amrendra: Maybe they had a weak leg, weak arm, and they fall to the ground.

And somebody comes upon them, maybe a family member, several hours, or in some cases where

we've seen, a day or two later.

You show up to the apartment, and you see somebody lying there.

So, those patients are obviously much different than the patient where you see it happen before

you.

Ke'an: When they come into the emergency department, time is of the essence, because someone has

really taken heart to seeing, "Hey, something is very wrong here, this may be a stroke."

So, you would be one of the first people who would see that patient coming in?

Joseph: To Dr. Miranpuri's point, there's a group of strokes that occur while people

are sleeping.

Ke'an: Oh, okay.

Joseph: And so, they go to bed, they're normal, they're acting normal, they're talking normal.

And then they wake up and then they have these deficits, and they can't speak, or they can't,

sometimes, get out of bed, or they're having difficulties.

And so, the sentinel indicator is that a family member either finds them still in bed, or

hears them fall in the morning.

Numerous times, we have patients' husbands or wives say, "I got up first, I was fixing

breakfast, and then I heard a thud."

Joseph: And so, currently, and we can talk in more detail about some of this, is that

these patients typically, when they woke up with those symptoms, we considered them out

of the treatment window for certain options in terms of how we treat stroke.

We now have studies that are letting us know that we perhaps have more time than that,

now, and we can actually potentially treat some of these patients that have had these

types of strokes.

Ke'an: Oh, that's good to know.

Joseph: And so, that's probably one of the best pieces of news that we've had in terms

of treatment of stroke.

And those studies have been around for a while longer, but the two studies that came out

at the beginning of, January, February, of this year, are the ones that have brought

more attention to all of this.

Joseph: Dr. Miranpuri has known for quite some time that this treatment option was likely

going to work, but these studies, which he can speak to, are the exciting part of the

treatment.

Ke'an: Oh, okay.

Do you want to expand on that?

Amrendra: Yeah.

So, one of the things that people probably know about a loved one or a friend in the

community is the clot-busting drug TPA.

So, this is a drug that, when patients come into an emergency room, we have in some patients

up to three hours from when they were last known normal, and then in other patients,

up to four and a half hours.

But four and a half hours is the max.

Amrendra: So, if somebody woke up with a stroke, and they went to bed at 11:00 at night, and

it's 7:00 in the morning, they show up to an emergency department.

They are likely not going to be eligible for that clot-busting drug, unless they woke up

in the middle of the night and the family member said, "Yeah, he woke up at 3:00 in

the morning, and they went back to sleep.

And when I saw them at 3:00 in the morning, they were perfectly normal.

But then they went back to bed, and now at 5:00, I saw them not normal."

Amrendra: So, that history is the key to stroke care.

We rely on the witness, because oftentimes the patient can't tell us reliably what's

going on.

And this medication, if you give it outside the time window, you're putting the patient

at risk of having bleeding in the brain.

And it's a clot-busting drug, so it's basically given through an IV, and it finds its way

up to the level of where that blockage is in the blood vessel, and it lyses the clot.

Not in all patients, but in enough to know that that is the standard of care.

So, patients who can get that, it's a wonderful option.

Amrendra: The other patients that, as a neurosurgeon, I get involved with, are the patients that

come in with very severe strokes.

These are the patients who are basically paralyzed on one side, they have a ... They can't speak,

they're looking off to one side.

And these patients, when we study their blood vessels through a scan that we obtain in the

emergency department, we will see that there's a blockage in the largest blood vessel that

supplies the whole half of brain.

And what we know is that that clot-busting drug, because you're giving it through an

IV, it doesn't work as effectively in lysing that clot.

Amrendra: And so, what we've found is that these patients benefit from an intervention,

a procedure, where we take a small catheter, wires, balloons, stents, and we take it through

an artery in the leg, and we navigate it up through the arteries using X-ray and dye,

and then we actually physically remove the clot.

Because it's such a large clot that the clot-busting drug may not work.

Amrendra: Now, that being said, everybody who is eligible for the clot-busting drug

needs to get the drug.

And anybody who is eligible for the procedure to remove the clot physically, with the mechanical

device, needs to get that procedure done.

Amrendra: And what we don't want patients to do is, we don't want patients to sit at

home, thinking that, "Maybe this thing will get better over time."

If it came on suddenly, it's not something that you've ever had before, you've got to

get medical attention right away.

Because now, we do have data that shows that we can go up with catheters and wires, beyond

the four and a half hours that the clot-busting drug can be used for.

We can go up to 24 hours, "last known normal."

That's a phrase that we use in the stroke world.

Amrendra: But again, we don't want somebody at home, sitting there for 24 hours, getting

the message, "Well, I can wait up to 24 hours, because the doctors say that they have this

new procedure, and they can do it that many hours out."

No, we want you to come in, because the sooner, the better.

Ke'an: The sooner the better.

Time is always of the essence, it sounds like, when it's coming to dealing with a stroke.

So don't wait, that's the biggest thing that you want to get across to people: you need

to get treatment right away.

Joseph: The death rate for strokes in third-world countries is much higher than in the United

States, and part of that reason is linked to the fact that people have not been educated

and made aware that you need to hurry up and get to a definitive place for treatment, for

stroke.

And so, those types of patients typically just either stay at home, or don't go see

anybody.

They don't know what's wrong with them.

And then, unfortunately, in those cases, those patients die.

Joseph: So, we still have an uphill battle to fight, in terms of patient awareness, even

within our communities here, because more often than not, we still have patients that

show up, and they basically ... We say, "When did your symptoms start?"

And they say, "Well, it started sometime day before yesterday."

Or, "It started sometime yesterday, in the morning, but I just put it off."

And then we do an exam, and we find out, "Oh my goodness, you've been having a stroke.

But it's too late, you've passed the window for treatment with TPA."

Joseph: What the new studies have done now is opened up the window for treatment for

certain types of strokes.

It's not for all the strokes, and it's only for a small portion of those types of strokes.

But roughly, the literature I was reading was saying maybe somewhere between 10-20%

of the ischemic strokes, perhaps involve large-vessel strokes, that potentially could be treated

by the endovascular intervention that Dr. Miranpuri does.

Ke'an: Okay.

So, lots of different types of strokes, but just be aware of some of the signs and symptoms

that you've mentioned up to this point.

And don't sit around and wait.

If you're not feeling well, or if someone recognizes this, just go to the doctor, don't

wait.

Ke'an: So, let's talk about how you work together, through the treatment, with Carle and Sarah

Bush.

And the stroke rehabilitation, and how you work together for the patient's care.

Either one of you can- Joseph: Let me start.

Ke'an: Okay.

Joseph: Because, when the studies first came out, in January, February, we were, in the

emergency medicine community, we were very excited because the TPA administration for

the treatment of stroke has been controversial.

There has been a group of ED physicians that felt that the studies initially didn't support

giving TPA for strokes.

Then there was groups of physicians that obviously supported it.

And that has gone back and forth.

It used to be, you were at higher risk from a malpractice standpoint, to be sued if you

gave TPA in the treatment of a patient.

Ke'an: Interesting.

Joseph: Currently, fast-forwarding to within the past two, three years, that trend has

reversed: you are now more apt to be litigated against if you did not give TPA for stroke.

But there's still almost a ... I think the study I read was a 17% chance of you being

sued if you gave the TPA, and there was a bad outcome.

Joseph: And so, it is a sensitive area.

And so, when the emergency medicine community read these papers, and we found out that there

was a treatment for stroke that extended the treatment time window, and that potentially

helped stroke patients, even if they didn't qualify for TPA, that was really good news

for us, and also for the patients, obviously.

Joseph: The other thing that I would emphasize is that Sarah Bush emergency department at

hospital is, we have always worked very closely with all the specialists and medical staff

up at Carle.

Because they are the trauma tertiary care center, they are now the tertiary stroke center.

And so, the things that they have offered and we have enjoyed for the past multiple

decades, now, has been immense.

And it's been a good thing for the community, it's been a good thing for the hospital.

Joseph: So, Dr. Miranpuri was actually asked to come down and speak with our medical staff.

How many months ago, two?

Amrendra: It's probably three or four, yeah, three months.

Joseph: Three or four months ago.

Joseph: And so, he presented the information to our entire medical staff, to just make

people cognizant of what the treatment options were for this, and how it's developing.

So, it's getting exciting, because as all of this starts to develop, the standard of

care is also going to change to some degree.

Joseph: So, we've actually even begun to prepare, pre-hospital-wise, how we're going to direct

patients.

Because, when you have a limited resource of treatment, which the neuroendovascular

intervention is currently ... Because I think the only, the next closest neuroendovascular

will be Springfield, currently?

Amrendra: Springfield, yeah.

Joseph: So, obviously, we have to be careful of ... We don't want to send too many cases

that may be false positives to these tertiary centers.

At the same time, we want to get patients there as quickly as possible, and what's best

for the patient.

So, we're trying to now figure out what that balance is.

Joseph: And then I can ... I've been taking over.

Amrendra: And Dr. Burton, he calls me in the middle of the night about a potential case,

we have those images that are being produced at Sarah Bush sent over to Carle immediately.

I open up my laptop, I look at the case.

He and I talk about the patient.

And so, we have a conversation.

Because like he said, we don't want somebody coming from here unless they're going to end

up potentially getting something done.

Amrendra: There are some patients, their stroke is so devastating that we may not be able

to reverse the stroke.

That is always our goal.

Ke'an: To reverse the stroke.

Amrendra: To make them look the way they did before they started having these issues.

Ke'an: Okay.

Amrendra: Okay?

Those are the patients that we really get excited about.

Unfortunately, there are some patients who have very devastating strokes, large hemorrhages

in the brain, a blood clot that's been plugging a blood vessel for so long, that we will not

be able to undo that stroke.

Amrendra: And we still have to care for those patients.

We have to have conversations with patients' families, be able to explain to them what

the next several days, weeks, months, will look like.

And we always want to respect those patients' wishes, using the voice of the family.

Amrendra: It's a very tough thing that we have to deal with on a day-to-day basis, because

there's the joys of reversing the stroke, and then there's the sadness of not being

able to reverse it.

But because some patients, knowing their wishes, would like everything done, we want to get

them through that.

And they know they're going to have some deficits.

Amrendra: And then, being able to try to get them to a rehabilitation facility, to get

them as better as they can get, and still being able to interact with their families.

That's always our goal.

And so, if they come to Carle, we really want to get them back to their community as quick

as possible, so they can be close to their loved ones.

Ke'an: Yeah, absolutely.

I think this is great, that we're talking about putting the patient's wellbeing, their

health, above anything else.

And you're working together.

Is this something that is unique, because we're in a rural area?

Or is this just the way things are merging these days?

Joseph: I'd say probably a little bit of both.

But I'd say the fact that we are a rural community medicine scenario, that leads to several challenges

that, if you're in an urban area, you don't have to worry about.

There's more limited resources.

The distance to definitive treatment is longer, and depending on what the weather is like.

We've had snowstorms where we've had critical patients that we couldn't even get out of

Sarah Bush's emergency department sometimes, because of that.

And so, again, you have special circumstances that other places don't face, because they're

not in a rural area.

Joseph: But again, having a good working relationship, and good lines of communication, information.

Now, going to Carle for CT scan results, and things like this.

When I first started at Sarah Bush, if I did a CAT scan at Sarah Bush, that study wasn't

accessible by the Carle docs.

Ke'an: How closely related are heart disease and stroke?

Joseph: First off, they're related because of, like I spoke to earlier, if you have a

bad heart attack or if you have poor cardiac function, that can lead to low blood pressure

states, which can then put you at higher risk for strokes just because your perfusion of

your brain is not as good as a normal person, with normal blood pressure.

Joseph: Secondarily, if you have certain types of cardiac dysfunction, such as atrial fibrillation,

that can set you up to form clots in the chambers of your heart.

And if you have those clots, sometimes those clots can break off, and embolize, and cause

embolic strokes.

And so, that's a subset of ischemic stroke.

Joseph: Whenever someone has heart disease, it de increases your chances for stroke.

And so, in terms of preventive medicine, and preventive things, if you eat right, if you

control your blood pressure well, your diabetes well, those things all decreases your chance

for heart disease, and thereby also decreases your chances for stroke.

Ke'an: All right.

Would you like to follow up with that?

Amrendra: There's just a lot of corollaries between heart disease and strokes, like Dr.

Burton highlighted: high blood pressure, cholesterol, diabetes, smoking.

And we see, even patients who have blockages in blood vessels in their legs, and there's

kind of this trifecta, where you have patients who may be at risk for stroke, be at risk

for heart attack, be at risk for having blood clots in their leg arteries, where they're

having pain when they're walking.

So, this is all in a spectrum that's common between these, what we call "vascular diseases."

Ke'an: It is very important to get this education and awareness out.

It's critical to let people know the timeliness of what is important.

And so, to wrap up the program here, we've got a couple of minutes left.

What would you like to let people know, on what's most critical here?

Joseph: I would emphasize the need that, if you think that you're having a stroke, if

you're a family member or if you're the patient -- it's difficult if you're the patient, but

-- you need to get to see a physician as soon as possible.

That would be the number one message that I would deliver.

Ke'an: Okay.

Amrendra: We just had stroke awareness month, and the thing that we were blasting out into

the community was this acronym that a lot of people now know, actually, is FAST.

It's very simple.

FAST is F-A-S-T.

Amrendra: F is for Face: so, if you see somebody, or yourself, having asymmetry in your face

that comes on all of a sudden.

A is Arm: the arm gets weak all of a sudden.

S is Speech: you're not able to get your words out.

And T is Time to get help.

So, if you have those three things, or any one of those three things happening, and that's

not normal for you, you need to get attention.

Amrendra: And that T is, they'll show an ambulance on there.

But the key there is, you're not calling your primary care doctor at 5:00 at night, hoping

they're still there.

You're not ... If you can't move your right side, you're not trying to get through, get

into the car, and try to struggle into the ED.

You want to call 911.

And if you see somebody having these problems, you want to focus on that person, and you

really want to help get them to definitive care, and not second-guess yourself.

Ke'an: So, don't drive them, call 911?

Amrendra: Yep.

Ke'an: All right.

It's been great, listening to all this education, the new updates.

Great information for our viewers out there.

So thank you so much for being a part of Being Well, today.

Joseph: You're welcome.

Amrendra: Thanks for having us.

Ke'an: Thank you.

And thank you so much for watching this episode of Being Well.

We hope you have learned about stroke awareness.

So, don't wait, make that call, and get yourself treatment.

If you need more information about this program, visit our website, WEIU.net, and click on

Being Well.

Thanks for watching.

Lori: Sarah Bush Lincoln Health System supporting

healthy lifestyles, eating heart-healthy diet, staying active, managing stress, and regular

checkups are ways of reducing your health risks.

Proper health is important to all at Sarah Bush Lincoln Health System.

Rameen: Meeting the ever changing in healthcare needs

of our communities.

Paris Community Hospital/Family Medical Center is now Horizon Health, with the same ownership,

management, providers and employees.

Horizon Health provides patient care and promotes wellness to the communities of East Central

Illinois.

Jeff: At HSHS St. Anthony's Memorial Hospital we

are at work transforming heart care, rebuilding knees and hips, delivering new generations,

and focused on providing healthcare to you.

We are HSHS St. Anthony's Memorial Hospital.

Male Voice: Carle combines clinical care, health insurance, and research in a way that

solves problems today, with an eye toward the future.

Supported by a deep philanthropic spirit, and dedicated to making life better, for as

many as possible.

[music playing]

For more infomation >> Being Well 1109: Stroke Awareness and Latest Treatment Options - Duration: 27:45.

-------------------------------------------

Long Walk to Treatment - Duration: 0:34.

I will move that this house: 1.

Notes that each year more than 200,000 Australians are unable to access Alcohol and Other Drug

(AOD) treatment and that drug-induced deaths in Australia are at the highest levels in

20 years; 2.

Congratulates Uniting and all those involved in The Long Walk to Treatment, a campaign

that highlights the desperate need for alcohol and drug services in regional NSW;

3.

Calls on the Government to work with the Opposition and cross-benches to establish a comprehensive

drug summit, led by experts, that addresses shortfalls in treatment services and the evidence

behind harm minimisation approaches to illicit drug use.

For more infomation >> Long Walk to Treatment - Duration: 0:34.

-------------------------------------------

Viveve Treatment - Duration: 4:08.

For more infomation >> Viveve Treatment - Duration: 4:08.

-------------------------------------------

Veterans Treatment Court celebrates five years in Cascade County - Duration: 1:52.

For more infomation >> Veterans Treatment Court celebrates five years in Cascade County - Duration: 1:52.

-------------------------------------------

Man Utd REVELATION: Jose Mourinho's treatment of Eric Bailly finally explained amid battle - Duration: 2:51.

 Manchester United boss Mourinho appears not to fancy Bailly, with the Ivory Coast international making just five Premier League appearances this season

 The 24-year-old signed from Villarreal in the summer of 2016 and, at the time, drew comparisons with Red Devils legends Rio Ferdinand and Nemanja Matic

 His Manchester United career has, though, stagnated. Jose Mourinho is reportedly happy to sell him when the transfer window reopens in January to fund a move for a centre-back better-suited to his demands

 Bailly is popular among the fans and, with Chris Smalling and Victor Lindelof battling for consistency, his absence has been a mystery

 But the Daily Mail claim Mourinho's brutal treatment of the defender stems from an issue last season

 Back in April, United faced West Brom at Old Trafford. The week before, they had denied Manchester City the Premier League title with a massive 3-2 win at the Etihad

 Bailly impressed that game, despite the club shipping two goals, and was in line to face the Baggies the following week

 However, he withdrew from the match through injury. United lost 1-0, giving the title to City in the process in a defeat that left Mourinho fuming

 Bailly then reported to training the following day. And the Daily Mail suggest Mourinho has been at loggerheads with him ever since amid doubts over his ability

 Bailly's form, this season, has left much to be desired.  The Ivorian powerhouse started the season alongside Smalling in defence but, after the 3-2 defeat to Brighton, has rarely got a look-in

 Meanwhile, ESPN FC pundit Alejandro Moreno believes Bailly should leave the club regardless of whether Mourinho stays in charge

 "Regardless of whether Jose Mourinho is there or not, it feels like it's best for him to go elsewhere," he said

 "It's an open-ended question, to leave United? It's a hit."

For more infomation >> Man Utd REVELATION: Jose Mourinho's treatment of Eric Bailly finally explained amid battle - Duration: 2:51.

-------------------------------------------

Tendinitis Treatment - How To Cure Your Tendinitis in 5 Steps - Duration: 4:01.

Hello everybody so my name is Ray Jones and I had chronic tendinitis for 5 years and I

eventually got rid of it.

During all those 5 years of suffering from chronic wrist ache, I've literally tried everything

possible to relieve the pain and cure it once and for all.

So here's a list of 5 things I've found to be the most effective when it comes to healing

tendinitis.

- Applying water therapy to your wrist to relieve the pain

- Doing yoga or practicing the Alexander Technique to reduce overall stress levels on your body

- Fixing your breathing to relax your muscles and nerves

- Using soothing gels and creams to temporarily ease the pain

- And using dietary supplements to speed up the healing process of your injured tendons

Now let me break this down for you

Water Therapy is by far the most effective home remedy you

can use with practically no cost.

All you need is access to hot and cold water.

So every day after you take a hot shower wash your entire arm, until or even above the elbow

with cold water.

Once you feel that your arm has cooled off, warm it again with hot water for a couple

of minutes, and cool it off with cold water again.

By doing this, you'll feel a sweet relief of pain and relaxation.

But what's even better, is that by applying water therapy to your arm, you're actually

stimulating blood flow to the injured area, and faster blood flow means faster delivery

of healing nutrients to your injured tendons.

You can also do this by filing buckets with water but that is not very practical and those

buckets happen to be very heavy which is not good for your tendinitis.

Yoga Now, yoga is very good for reducing overall

stress levels on your body, and it's a very powerful tool to relieve your muscles and

joints so it's a wonderful way to physically feel better, which will help ease your wrist pain.

But you gotta be careful not to put too much stress on your wrist as well, since some yoga

movements might be harmful for your already injured tendons.

The Alexander Technique is a very specific educational process that might just be the

way to heal not only tendinitis, but any health condition related to the overuse or misuse

of muscles and joints.

Alexander Technique practitioners believe that many health problems are caused by wrong

posture and they aim to heal them by correcting your posture and the way you do basic physical

tasks such as sitting, walking or squatting.

You can find plenty of videos and articles about the Alexander Technique online.

Fixing your breathing is especially important if you're not doing sports regularly and have

a stressful life.

Unhealthy breathing habits evolve from psychological and physical traumas and they're very harmful

to your body.

Improving your breathing pattern can help reduce overall physical stress and ease your

muscles resulting in less tendinitis pain.

Always keep some mint gels and anti-inflammation creams laying around in case you really can't

stand the pain.

Although pain is your friend and tells you what not to do, when the pain is too strong

and you can't even consentrate on your work or study, you need to have these creams laying

around for emergency.

Plus, some products even have healing nutrients in them.

When you apply water therapy, you accelerate the rate at which nutrients are supplied to

your injured tendons in your wrist.

But if you also want to increase the nutrient intake, you can consider using some dietary

supplements which your tendons could benefit from.

Use some Glucosamine or MSM dietary supplement to speed up your healing process.

Alright so that's it, and if you want to learn more about the ways of curing tendinitis and

tendinosis, you can check my website tendinitistreatment.com where I explain everything you need to know

about tendinitis and how to get rid of it.

Links and description below, please upvote and subscribe if you think this was helpful.