Archive for the ‘Men's Health’ Category

DC Hospitals Step It Up During Prostate Cancer Awareness Month – FREE Resources You Need to Know About

Wednesday, September 7th, 2011

September is Prostate Cancer Awareness Month. To raise awareness about prostate cancer, hospitals in Washington, D.C. are stepping-up this September for a good cause indeed.  Did you know that an estimated 240,890 new cases of prostate cancer will be reported this year? About 33,720 men will die this year alone from prostate cancer. About 1 in 6 men will be diagnosed with prostate cancer during their lifetime.

Although prostate cancer is the most common cancer in American men, the good news is that the survival rate is quite high for patients who are diagnosed and treated early.  If you are a man, a key to your survival is to be familiar with the signs and symptoms of prostate cancer and to seek regular screening.

This year, Georgetown University Hospital will recognize Prostate Cancer Awareness Month by offering men free prostate cancer screening.

Who should get screened?

-          Men over the age of 35 – particularly African-American or Hispanic men over the age of 35

-          Men with a family history of prostate cancer

If you meet the above criteria, don’t miss out on this opportunity. Free screening will be offered on Saturday, September 17, 2011 from 8:00a.m. to 12:00p.m. in the Lombardi Comprehensive Cancer Center. Free parking will be available in the Leavey Center garage.  The Georgetown University Hospital is located at 3800 Reservoir Rd. NW, Washington, D.C., 20007. “The screening will consist of blood testing to determine PSA (prostate specific antigen) level, total cholesterol, and a digital rectal exam (DRE) to be performed by physicians.”

If you or someone you know has been diagnosed with prostate cancer, you might want to contact the Providence Hospital prostate cancer support group.  This group is specifically dedicated to helping patients live and cope with prostate cancer. Brothers Prostate Cancer Support Group meets every 4th Tuesday between 6:30p.m. and 8:30 p.m. at Providence Hospital’s Wellness Institute (1150 Varnum St. NE, 3rd Floor, Washington, D.C 20017).  For more information, please call 202-269-7795.

Please share this information with your friends, fans, and readers. For more information about cancer support groups in the D.C. area, please visit DC Cancer Consortium.

Summer Vacation Checklist: Add Vaccination to Your List!

Monday, May 30th, 2011

Photo from guardian.co.uk

Ahhh, summer vacation is coming. Passport? Airline tickets? Three 1oz containers? Zipper-lock bag? Sunblock? Camera? Vaccination status?

Summer is typically the busiest time for vacationers to explore new territories, or even old ones. Granted, the economy has replaced some travelers’ grand plans with much more modest ones, but many are still planning trips to Mexico and other foreign destinations. The summer is also a big time for missionary groups to head to underserved areas to provide assistance and medical care. The events of September 11th have forever changed travel for the United States and countries all over the world. There is now a new concern…..your vaccination status!

According to the Centers for Disease Control, the United States is experiencing its largest outbreak of measles in 15 years! USA Today reported a record 118 cases of confirmed measles in the USA between January 1 and May 20 of this year, mostly acquired abroad by unvaccinated individuals and brought back to the States. Measles was reported to have been “eradicated” from the USA as of the year 2000 due mostly to the efforts of immunization, but measles is still prevalent in other parts of the world.

Over 42,000 cases were diagnosed in an outbreak among young adults in Brazil in 1997! Third-world countries are not the only ones affected; over 7,500 cases have been diagnosed in France between January and March of this year, according to the CDC! And the outbreaks continue across most countries of Europe. Failure to vaccinate and receive periodic “booster shots” to provide immunity allows the virus to infect that individual who then gets sick. Since the virus is spread via respiratory droplets (coughing and sneezing), public modes of transportation allow for contact with infected individuals.

Measles is NOT just a rash!

According to the Associated Press, 2 of every 5 of these 118 patients required hospitalization; none died, but measles can have deadly consequences. Worldwide, measles causes nearly 800,000 deaths annually, mostly in small children. Some of the bad consequences include encephalitis characterized by vomiting, seizures, coma and even death; of those who survive this, approximately one-third are left with permanent neurologic deficits.

Once the spots are gone…

Interestingly, there is a late complication of measles infection, called subacute sclerosing panencephalitis (SSPE), that occurs from 5 to 15 years after the acute infection; the virus causes a slow degeneration of the brain and central nervous system long after the initial infection. Measles can also cause bronchiolitis or bronchopneumonia, and it can be associated with secondary bacterial infections due to the depleted immune system that occurs while fighting the virus.

Measles is NOT the only vaccine-preventable disease available for infection!

There have been recent outbreaks of mumps, another viral disease that has potential complications of pancreatitis, orchitis and even meningitis and encephalitis.

There have been outbreaks of Bordetella pertussis (part of the DPT vaccine), otherwise known as “whooping cough.” Pertussis can severely affect young children under 2 years, but it affects adults as well. Since the vaccine does not impart lifelong immunity, adults become a reservoir for this disease, unless a booster shot is given, and the adults spread the disease to unvaccinated children.

Haemophilus influenza type B, known as HIB, can cause typical cases of upper respiratory infections, sinusitis and otitis media (common ear infection); it can also cause epiglottitis, a potentially fatal infection of the epiglottis. The epiglottis is a flap of tissue that acts like a valve, protecting our airway when we eat and swallow food. This “valve” swells up so large from the infection that it can totally obstruct the airway and prevent a child from breathing; it is a medical emergency that can require emergent tracheostomy! An HIB vaccine has been available for years, and this infectious culprit had nearly been eradicated, as well, in the USA. The anti-vaccine movement has produced many children, adolescents and even young adults who have never received this vaccine  - et voila….there is a resurgence of HIB and Haemophilus epiglottitis.

Hepatitis B is a virus (HBV) for which a vaccine has also been available for over 20 years. It is a 3-shot regimen, but it also requires that titers be drawn after vaccination to prove immunity. HBV can be transmitted through sexual contact or any exchange of body fluids, including contaminated food in rare instances. Although the human body can fight some cases of HBV, other cases become chronic and lead to liver failure and/or liver cancer. Wouldn’t you know it? May is “Hepatitis Awareness Month” for the CDC!

There are plenty more vaccines available for a multitude of viral, bacterial and other infectious agents. Additionally, there are immunoglobulin shots that can address other infectious conditions and act as prophylaxis during your time abroad.

The Moral of the Story

Check your own vaccination status first. If you are not sure, your doctor can do blood tests to determine if you are immune to specific infectious agents…even the chicken pox virus! Secondly, take the time to check the CDC website (www.cdc.gov) for infections endemic to the area to which you are traveling. Follow guidelines offered for disease prevention and possible vaccines, medications or immunoglobulins available.

Be aware and be prepared! Protect yourself and those near and dear to you!

 

Week in Review: (May 22 – 28, 2011) The Eye Opener Health, Law and Medicine Blog

Saturday, May 28th, 2011

From the Editor – Brian Nash

Last week’s posts by our blawgers were packed with information about a variety of topics ranging from the medicine you need to know about concussions, living with cancer, cerebral palsy resources and the potential risks of overdosing your child with medications.

On the legal front, we began a series I’m personally excited about. We call it Legal Boot Camp. It will be a series for those in our practice jurisdictions of Maryland and Washington, D.C. Our teacher’s face is on – lesson plans in place. We hope you learn some things about the laws that can affect your lives in the areas of personal injury – particularly medical malpractice law.  Our first class took place with a piece by Sarah Keogh that examines the law in Maryland on the right to claim loss/diminished earning capacity. If you’re wondering if you can have such a claim even if you weren’t working when you were injured, Sarah has some information for you. Check it out. Turn in your class card and have some fun.

We wrapped up the week with a piece by yours truly on a wonderful community outreach program by our local baseball heroes, the Baltimore Orioles. Aptly named – OriolesREACH, this initiative has a number of wonderful events, charities and missions that are worth knowing about. One in particular, Shannon’s Fund, is a great program to help those in need while dealing with the financial burdens while dealing with cancer. It is run by the University of Maryland Medical Center. Read about our challenge to our brethren before the bar in the Greater Baltimore Area.

Without further ado, here are the blogs we posted this past week …. and a sneak peak of the week ahead.

Concussions: The Message of Brian Roberts’ Injury Should Not Go Unheeded

Posted by Brian Nash

Anyone who follows sports is well aware that finally the old school mentality of “gut it out and get back in there” following blows to the head are coming (not too soon) to an end. Committees have been formed, articles written and the national spotlight of the media have finally focused on this issue. Those recommendations, debates and guidelines are beyond the scope of this post. Nevertheless, those involved in sports…Read more >

Children’s Medications: Coming Changes and Tips to Avoid Overdose

Posted by Sarah Keogh

My children are both young; the youngest is now a little past her second birthday. In the last few years, we have had both infant and children medication in the house, liquid and tablets, and I have been very careful to make sure to double-check myself if I ever have to medicate either child to make sure that I am reading the correct dosing matrix for the correct concentration and for the correct child. More often than not, I have found that children need medication when their parents are tired. As parents know – children frequently…Read more >

 

Living With Cancer: What to Expect After the Diagnosis

Posted by Jon Stefanuca

About a million and a half people will be diagnosed with cancer in the U.S. this year. The devastating truth about cancer is that about one-third of these people will die from cancer at some point. For most, the diagnosis is unexpected and completely overwhelming.The cancer does not just affect how one feels, it undermines all sense of security and stability. It changes lifestyles and redefines relationships. So often the emotional trauma is equally shared among family members and loved ones. Read more >

New Blog Series: Legal Boot Camp

Posted by Brian Nash

I’m really pleased to announce a new series we’re starting today. If you’re a reader of our blog, you know that we post numerous times a week on health, safety, medicine and related law topics. That’s what we do in our firm – we represent people who are injured by the negligence of health care providers and those who suffer catastrophic injuries in non-medical settings as well. So, sharing what we believe is some good information about medical, health and safety issues is our mission. We strongly believe that our social networking should be about giving good information, engaging in dialogue about relevant issues – just plain good, old sharing. Read more >

Legal Boot Camp (First Class): The Story of Pam – Maryland’s Law on Loss of Earning Capacity

Posted by Sarah Keogh

A 41-year-old woman, Pam, who was laid off from her job as a swimming instructor and swim coach in December of 2009, has been struggling to find a new position for the last few years. Even though Pam had been working as a swimming instructor full-time for the past 18 years, she felt that she needed to jump into a new career while waiting to find a new position as a swimming instructor and coach. Starting in October of 2010, her father died leaving her a rundown home that he had recently purchased with the intent of renovating it. Pam felt that she could put her physical fitness and knowledge of home aesthetics to work, not to mention the ideas she picked up watching renovations shows while unemployed, by renovating the home her father left… Read more >

Dealing with Cerebral Palsy: A Resource for Parents and Family

Posted by Jason Penn

Today’s society has become increasingly dependent on aggregators. We use a variety of methods to assemble and sort information so that we can easily consume it.  Mint.com and Quicken help with our finances and Google Reader helps to manage our online content. A quick search of the internet suggests that the parents of children withcerebral palsy do not yet have an objective aggregator of information to turn to.  Let’s consider this our attempt to provide parents in the Baltimore and Washington D.C. areas with a place to turn. Read more >

Charity Begins at Home: OriolesREACH Program Hits a Grand Slam with Us!

Posted by Brian Nash

I recently wrote a post about our local area charities and civic organizations who do so much for so many in our community. With that in mind, as I was happily reading the sports page in the warm glow of the Orioles’ 12th inning victory yesterday (5 in a row – Go O’s), I came across a piece about a new initiative for our military personnel by the Birds. While looking at the details of this worthy program, I noticed (ashamedly for the first time, I admit) a host of community programs being run by the Orioles. The team uses the name OriolesREACH for the community programs they sponsor, promote or fund. Read more >

Sneak Peak of the Week Ahead

Here’s a sampling of what’s coming next week on The Eye Opener: Views and Opinions from the Nash Community:

  • As families prepare for the upcoming holidays and summer vacation, Theresa Neumann has some important medical advice about what else needs to be included in your travel plans.
  • Legal Boot Camp: Prepare for our second class – get those pencils, pens, iPads and whatever else you need out and ready – there could be a pop quiz on next week’s primary on law.
  • What rights do babies-before-birth (fetal rights) have in our legal system? Do parents who lose a child just before birth have any rights of recovery? You’ll find out next week.
  • Home births are on the rise. Is that a good or a bad thing? Sarah Keogh weighs in on that issue in the coming edition of The Eye Opener

And….maybe even more to come…you can never tell….

Have a wonderful and safe Memorial Day Weekend. Best to All of You and Your Families and Friends from All of Us at Nash & Associates

Living With Cancer: What to Expect After the Diagnosis

Wednesday, May 25th, 2011

Alicia Staley - Cancer Survivor - Visual (Image from her site - awesomecancersurvivor.com

About a million and a half people will be diagnosed with cancer in the U.S. this year. The devastating truth about cancer is that about one-third of these people will die from cancer at some point. For most, the diagnosis is unexpected and completely overwhelming.The cancer does not just affect how one feels, it undermines all sense of security and stability. It changes lifestyles and redefines relationships. So often the emotional trauma is equally shared among family members and loved ones.

Needless to say, the original cancer diagnosis marks the beginning of a difficult, frightening and frustrating experience. For this reason, it is critical not to despair. One must always remain hopeful, adjust, and prepare for the way to recovery. A fundamental step in this process is gaining an understanding and familiarity with the impending medical treatment and associated lifestyle changes. A good deal of stress can be avoided by simply understanding what to expect. While cancer treatment varies depending on the type of cancer and the individual characteristics of the patient, the patient should generally be aware of the following:

Chemotherapy

The vast majority of cancer patients will receive some degree of chemotherapy. This may consist of one or more chemotherapy cycles.  Each cycle can be as long as 3-6 months. Chemotherapy involves the administration of various chemical agents called antineoplastic drugs in order to stop cancerous cells from dividing. Antineoplastic drugs are designed to attack and kill cells that divide in an uncontrolled or rapid matter. Antineoplastic drugs, however, are not able to discriminate between cancerous cells and normal cells. Therefore, cells that divide rapidly as part of their normal life cycle are also attacked. Chemotherapy may cure the cancer entirely or control its growth. Many times, chemotherapy is used in conjunction with other treatments. Some associated complications of chemotherapy include:

  • Anemia
  • Hair Loss
  • Lethargy
  • Nausea and loss of appetite
  • Kidney damage
  • Liver damage
  • Heart damage
  • Deterioration of pre-existing medical conditions such as osteoarthritis, among other things.

Radiation Therapy

In addition to chemotherapy, a patient may also receive radiation therapy. Radiation therapy involves exposing cancerous tissue to ionizing radiation (electromagnetic waves), which tends to destabilize the molecular structure of cancerous cells. In essence, the electromagnetic waves will ionize the atoms of the cancerous cells, by displacing electrons within the inherent structure of the atom. In turn, this process destabilizes the molecules of the cancerous cells, causing them to die.

Surgery

In a number of instances, cancer patients will also require surgery to treat their cancer. Often times, the malignant tumor is identifiable and localized (as opposed to metastasized). In such instances, timely surgery is preferred. Chemotherapy of radiation therapy may follow the surgery. The type of surgery  will vary depending on the type of cancer and how advanced it is. For example, a woman with ovarian cancer will likely undergo a total hysterectomy, including the removal of the ovaries. A patient with intestinal cancer may undergo a laparotomy with dissection of the cancerous tissue. Generally speaking, the sooner the cancer is identified, the less extensive the surgery.

Monitoring

After surgery and chemotherapy/radiation therapy, each cancer patient/cancer survivor should establish a systematic and well developed course of monitoring and supportive care with his/her physician. This will often involve a number of other health care providers such as physicians, nurses, and physical therapists. For example, a patient who has undergone treatment for ovarian cancer may require monitoring by an oncologist, a surgical oncologist, an internist (primary care physician), a gynecologist, and even a urologist. One must then factor in the extent to which the cancer treatment resulted in additional complications or the extent to which pre-existing medical conditions deteriorated as a result of the cancer treatment. As such, the patient may require the involvement of additional specialists to address and monitor the side effects of the cancer treatment. It is very important that the patient maintain a healthy nutrition and exercise regimen, if and as prescribed by the physician.

The bottom line is that cancer patients will invariably have a long and difficult road to recovery, which may take months or even years. Drastic lifestyle changes may be necessary, and patience as well as perseverance are essential. A cancer patient must know what to expect and be proactive to create support structures involving health care providers and family members/loved ones.

Helping Others in Need

If you or someone you know is a cancer patient/survivor, I encourage you to share your story with our readers. What helped you most to cope and persevere on your way to recovery?

Related Posts:

Ovarian Cancer: Five Tips to Get the Medical Care You Need

Ovarian Cancer: Early Intervention is Key – What You Must Know…

Breast Cancer: What You Need to Know About Digital vs. Film Mammograms

Warning to Women of Menopausal Age: HRT Linked to Increase in Death From Breast Cancer

Concussions: The Message of Orioles’ Brian Roberts’ Injury Should Not Go Unheeded!

Sunday, May 22nd, 2011

Brian Roberts - NBC Sports photo (modified)

As I was reading the sports page this morning, after working my way past yesterday’s Preakness news, I was motivated to write this post by the report of Jeff Zrebieck in the Baltimore Sun’s Notebook section. Earlier this week, Brian Roberts of the Orioles was removed from the lineup due to headaches. At the time, I thought back over the games that preceded this news report but couldn’t remember any incident when Roberts could have sustained an injury that led to his headaches. For a guy like Brian Roberts, whose recent career has been marred by injuries, it was hard to believe that as tough and gritty as he is, that something like a sinus problem, allergies or the like had felled this guy. Then within a day or so, following examination and testing, we learned that Brian had sustained a concussion.

Once again, I thought through the games leading up to his line-up departure and still couldn’t remember any play or at-bat that would, in my mind, cause a concussion. There was no high and tight, back-him-off-the-plate pitch, no knee to the head by a middle infielder when he was sliding into second on an attempted steal, not even a take-out at second base while he was turning a double play. As we learned later, he sustained his current injury while sliding into first base headfirst trying to beat out a single. He never struck his head on anyone or anything. So how in the world did Brian Roberts wind-up on the disabled list with a concussion?

Last year’s injury set the stage for a recurrence

While no one knows for sure, the speculation during the 2010 season, which was also marred for Roberts by a back injury, was that Roberts had caused the concussion when, out of sheer frustration from a bad plate appearance, he struck himself in the helmet with his bat on the return to the dugout. We’re not talking a violent collision between a defensive back and an unprotected wide receiver, a car crash or a vicious criminal assault. Nevertheless, Roberts’ head injury lingered on well past the end of the season, which ended for him six games early due to dizziness and headache following this incident.

When he reported to spring training, the Orioles faithful were hoping that the past season’s injuries (back, strained abdominal muscle, concussion), which caused him to miss a total of 103 games in 2010, were a thing of the past. Then on Wednesday, February 23, 2011, the report came out that Brian had left spring training that morning due to a stiff neck. What was this all about? Then came the news last week – a slide felled this mighty warrior.

Concussions: a mild traumatic brain injury

Just what is a concussion? Brainline.org, a great resource for those seeking more information about traumatic brain injuries, gives this description:

In a nutshell, a concussion is a blow or jolt to the head that can change the way your brain normally works. Also called amild traumatic brain injury, a concussion can result from a car crash, a sports injury, or from a seemingly innocuous fall.Concussion recovery times can vary greatly.

Most people who sustain a concussion or mild TBI are back to normal by three months or sooner. But others . . . have long-term problems remembering things and concentrating. Accidents can be so minor that neither doctor nor patient makes the connection.

The Days of Yore – “Gut It Out” – are thankfully coming to an end

Anyone who follows sports is well aware that finally the old school mentality of “gut it out and get back in there” following blows to the head are coming (not too soon) to an end. Committees have been formed, articles written and the national spotlight of the media have finally focused on this issue. Those recommendations, debates and guidelines are beyond the scope of this post. Nevertheless, those involved in sports, particularly at the scholastic levels, should constantly be aware of this ever-expanding information, which is available through multiple resources and media channels.

What are the signs and symptoms of a concussion?

While there is apparently no universally accepted definition of concussion despite hundreds of studies and years of research, according to one source, there is some unanimity in what are the worrisome signs and symptoms, which can include:

  • Headaches
  • Weakness
  • Numbness
  • Decreased coordination or balance
  • Confusion
  • Slurred speech
  • Nausea
  • Vomiting

If you or someone in your family has sustained any type of head injury, no matter how minor and they show these signs or symptoms, get to the doctor or an emergency room immediately.

CT Scans, MRI’s and other diagnostic test after head injuries

TBI’s or traumatic brain injuries are reported to be “a major cause of death and disability worldwide, especially in children and young adults.” In cases of obvious severe head trauma, it’s a “no-brainer” that diagnostic testing should be done. But what about cases of mild to moderate head trauma? Who defines what is “minor” and “moderate” when it comes to TBI’s? What testing is necessary; when is it unnecessary?

While these judgments are made by the medical professionals, you need to be your own advocate at times in making this decision-making process. Brian Roberts was tested and submitted to radiographic tests for a host of reasons – probably not the least of which is the fact that he is a very valuable member of a professional sports team. What about the ordinary guy in the street?

Well, the short answer is – the recommendations vary when it comes to mild and moderate head injuries. In fact, the very definition of what constitutes a moderate TBI can also vary depending on whom you read. Nevertheless, certain signs, symptoms and history are not disputed indications for a radiographic study to rule in or rule out a potential brain injury. For example, one need only read the indications for the use of radiographic studies published by MedicineWorld.org or a host of other organizations on this topic.

In a recent case, I personally came across someone whom I believe to be a leader in the field of traumatic brain injuries (TBI), Dr. Andy Jagoda, an emergency medicine specialist in New York. He has done extensive research, writing and lecturing on this topic. I’ll save you the effort, here are the search results for his body of work.

A Lesson – Hopefully – Learned

I started this piece with the story of Brian Roberts. I didn’t simply do this because I am a long-suffering fan of the Orioles (which I am) and an admirer of Brian Roberts (which I also am) but because of the message his story tells us. A self-inflicted bat to the helmet because of a strikeout? A slide into first base with no blow to the head? A concussion none the less – apparently!

Brian Roberts may have a team of medical specialists watching and monitoring his every grimace, complaint and move; you probably won’t have that luxury. If you have a head injury – minor or otherwise – and have any of the known signs, symptoms or risk factors for a traumatic brain injury, be vigilant and pro-active for your own health and well-being.

If you are in an emergency room and the discussion of whether or not you should undergo radiographic testing takes place, get involved – ask questions. If you are discharged from the emergency room, whether you had a CT or an MRI or not, pay very careful attention to the head injury discharge instructions you are given. It is a well known phenomenon that there can be a delay in symptoms and signs of a TBI days if not weeks later. If you are suffering any ill-effects during this post-discharge period, get to a healthcare provider immediately.

The stories of how lives are altered forever more as a result of TBI are legion. Don’t become yet another statistic.

Your time to share

Have you ever had a TBI? Know someone who has? What happened in that situation? Was a test done? Do you think CT scans are overused, particularly in children? Are they underused? How did your “experience” turn out? Any advice for others? Share, Good People, share!

Good luck, Brian – and speed recovery!

 

 

 

Week in Review (May 2 – 6, 2011): The Eye Opener Health, Law and Just Interesting Stuff Blog

Saturday, May 7th, 2011

From Brian Nash (Editor)

We appreciate your stopping by to see what this past week’s posts covered in the world of law, medicine, health and safety – and then some.

You’ve been told you need to undergo treatment. The doctor tells you (hopefully) the risks and benefits of what’s being proposed. You’re wondering – “Is this my only choice?” In a non-emergency situation you usually have a choice you may not have considered – a second opinion. Theresa Neumann’s piece this past week addresses this usually available but very under-utilized resource for patient’s facing this situation.

Sarah Keogh writes about a topic that makes a lot of sense – when you stop and think about it. Who are the people on a hospital’s medical team that are with you more than anyone else? Your nurses, of course. Just how does a nurse’s working conditions not only affect him or her – how does it affect your health? Read Sarah’s piece and find out.

Asthma affects the lives of 20 million people in America. It does not discriminate since it affects the young, the old and all in between. This past week, Jon Stefanuca, who has been immersed in a case involving a young man who tragically died as a result of asthma shortly after being discharged from a local hospital, shared his “4 tips” to make sure you get the health care you need when you have an asthma problem. If you or someone close to you has asthma, take the time to consider Jon’s suggestions. As always, if there are some suggestions you could share with others, please do in the comments section.

Recently our firm started using QR Codes on our business cards. I’d heard about them but wasn’t quite sure what they were all about. After a little bit of study and discussion, I was amazed at what they can do – you will be too. So many now use their phones and mobile devices as their primary means for connecting with the world via the internet. Just download a free mobile application, snap a picture using the app and the QR Code will whisk (at a blazingly fast speed) you away to more information than you can imagine. Jason Penn, who was the first to get his QR Code business card, was apparently fascinated by this new technology, so he wrote a post this week about it and shares with you some interesting information about some others who have been using it for some time now.

Our Posts of the Past Week

Medical Second Opinions: An Under-utilized Option for Patients

By: Theresa Neumann

Today’s medical world is vast with various technologies, treatments and options.  So, if a patient is diagnosed with a medical condition, and doctor A recommends treatment A, what keeps the patient from seeking a second opinion? This is an interesting phenomenon.  After performing intake summaries and client interviews for quite a while now, it still amazes me how many people have bad outcomes from surgery simply because they never requested a second opinion. Second opinions are not simply reserved for surgery, though; cancer treatment options, medical therapies for chronic conditions like rheumatoid arthritis or inflammatory bowel disease….read more

 

Working Conditions for Nurses Impact Patient Health

By: Sarah Keogh

I suspect that anyone who has spent even as much as one day or night in a hospital knows just how critical the nursing staff is in the , health, care and comfort of a patient. A compassionate and personable nurse can put a patient at ease and help them feel better in ways that go beyond just medicine.

Recently, I wrote about how different schedules impact nurses’ lives and how they cope with shifting from day to night schedules. This week, I was drawn to write about nurses again after seeing an article on medicalnewstoday.com that spoke about a study done by the University of Maryland School of Nursing.  Read more

Having an Asthma Problem: 4 Tips for you to use to get the medical care you need

By: Jon Stefanuca

Did you know that approximately 20 million Americans suffer from asthma?  Every day, about 40,000 of them miss school or work because of this condition. Each day, approximately 30, 000 experience an asthma attack.  About 5000 patients end up in the emergency room. Asthma is also the most common chronic condition among children. Can there by any doubt it is a very serious and potentially deadly medical condition that needs equally serious understanding and attention? The good news is that with proper education and treatment, most asthmatics have active and productive lives.

Bronchospasm and inflammation: the key features of asthma

This chronic airway disease has two primary features: bronchospasm and inflammation. Bronchospasm refers to the mechanism by which airways become narrower. In asthmatic patients, the muscle within the wall of the airway contracts, thus narrowing the lumen (a cavity or channel within a tubular structure) of the airway and causing respiratory obstruction. Inflammation refers to the process by which the wall of the airway becomes thicker in response to inflammation, which also causes the lumen to narrow and produce respiratory obstruction. Bronchospasm is usually treated with….read more

Bar Codes, QR Codes and More: The Intersection of Life and Technology

By: Jason Penn

The business cards I ordered arrived yesterday.  I tore into the package to do the usual inspection.  Is my name spelled correctly?  Is the card stock heavy enough?  Did they use the desired typeface?  Yes. Yes. And Yes.  But I needed to ask one additional question: Does the QR code link correctly?   I know what you are thinking:  What is a QR Code and why is it on your business card?  Let’s try an experiment. Read more…

Don’t forget, however – you can learn about Jason but just using your QR Code reader right now….

Sneak Peak of the Week Ahead

That was it for last week. What’s coming in the week ahead? Here you go -

  • Mike Sanders has a piece about our wonderful canine friends and how they are being used for those with special needs.
  • Sarah Keogh will be investigate the role and responsibility of our schools to warn parents about potential health problems involving their children
  • Jon Stefanuca will be taking a look at ovarian cancer and suggesting some key issues to discuss with your physician
  • Jason Penn will be telling us more about stroke and a very interesting problem that his research has revealed
  • I will be writing about a brand new project we are starting to take our social networking to a whole new level – stay tuned.

Again – many thanks to all who stopped by. Take a few minutes, read our posts and maybe have some interesting topics for discussion this weekend after reading last week’s Eye Opener.

Have a great weekend, Everyone!



Week in Review (April 23 – 29, 2011): The Eye Opener Health and Law Blog

Saturday, April 30th, 2011

From the Editor:

Last week was a busy but productive week for our firm’s blawgers – 6 posts – and we actually practiced law a lot! My personal thanks to our writers for taking the time to post some important pieces on health, safety, medicine and law. To our readers, my continued and sincere thanks as well. While it’s great to pull-out our soapbox and write about stuff we do and are passionate about, it’s incredibly rewarding to have you, our readers, take the time to read what we write. To those who left comments, a special thanks. We really enjoy interacting with you!

Now on to the business at hand. What did we write about that you may find interesting? Here you go.

My Pet Peeves About the New Age Mediation Process

Having been inspired by a fellow blawger from New York, Scott Greenfield, who chided legal bloggers (thus the name “blawgers”) for simply rehashing news and not taking a stand on issues, I wrote a piece called Mediation of Lawsuits: The 5 Top Things that Tick Me Off!

Having recently been through a number of mediations that were enough to pull your hair out because of the silliness that people engage in when they claim they are mediating to get cases resolved, I decided that it was time to take a stand and post a personal rant. While perhaps best understood by lawyers, claims adjusters and mediators, this blawg was not intended just for them. I’ve seen what impact foolish approaches and conduct by the participants to mediation can have on my clients, the injured parties. It was time to sound-off; so that’s what I did. I once again invite anyone who has been a party to a lawsuit mediation to do your own personal sound-off and tell us what it was like for you. It’s your turn to tell us just how much you enjoyed the process and what can be done to make it better. Read the horror story told in our Comments section by one of our Canada readers when she went through a domestic mediation process. Share your thoughts and stories as well.

Health Care: Who’s “Voiceless” When It Comes to Being Heard on Capitol Hill

Guess I had too much time on my hands at the beginning of this week (not really!). I couldn’t help but be inspired by a piece Jason Penn had done last week about how families were so adversely affected by the budget cuts that were made when the government shutdown was looming a few weeks ago. As I was going through my Google Reader early this past week, I came across an Op Ed by a doctor, who was complaining or at least suggesting that the president and congress need to hear more what doctors had to say about health care reform. Having read that, Jason’s piece jumped into my mind and the result was my blawg entitled Health Reform: What voice does the patient have in the debate.

The post brings to light the amount of money being spent by the healthcare industry in its lobbying efforts on health care reform. ObamaCare‘s raison d’etre is explored as well since it is ironic, if not sad, how the story behind all this money, lobbying and legislation seems to have been lost in the rhetoric. More affordable, better and available health care for our citizens? Then why were the most needy among us the victims of back room wheeling and dealing when the time came for budget cuts to save the federal government from closing its doors? I ask the question – who’s voice is being heard – but more important – who’s is not?

FDA approves use of “meningitis drug,” Menactra, for younger children

Hopefully you’ll never need to use this information, but if you do, Jason Penn reported on a condition – meningitis – that can affect not only adults and older children, but infants and toddlers as well. Meningitis is generally defined as an inflammation of the protective membranes covering the brain and spinal cord. Prior to a recent change in position by the FDA, there wasn’t a vaccine available for children under the age of 2. Now, with the FDA’s recent approval, Menactra can be used to vaccinate children from the age of 9 months to age 2.

In addition to this news release, Jason tells parents about the signs and symptoms they should be aware of to spot this condition.

The classic symptoms of meningitis are a high fever, headache and stiff neck. Detection of these symptoms, particularly headache and stiff neck are certainly difficult to detect in infants and toddlers. According to the Centers for Disease Control and Prevention, infants with meningitis may appear slow or inactive, have vomiting, be irritable, or be feeding poorly. Seizures are also a possibility.

To learn more about this important topic, read his piece Meningitis & Your Baby: Three Things to Think About.

Why are children still dying because of venetian blinds?

Sarah Keogh wrote what I believe is a very important piece for parents, grandparents or anyone who has a baby in the house. Years ago we all heard about the horror of parents finding their babies dead from strangulation when their necks became entangled in venetian blinds. Years have passed since those stories made the front page. Well, an update on just how well manufacturers and parents have been doing to avoid such tragedies was recently posted in The New York Times.

In her blawg entitled Window Blinds: Why are Children Still Dying, Sarah tells us the sad truth that these deaths and injuries still continue in our country. Find out what you as a caregiver of a young child need to realize about this product. Maybe you’ve put the cords up high and out-of-reach for your baby. Maybe you’ve taken other steps to avoid such a nightmarish event ever happening in your home and in your life. Unfortunately, many who have done so have still suffered this tragedy. Why? What is being done by manufacturers and the government to prevent these injuries and deaths ? Read Sarah’s piece for the answers and some practical advice you can take to make your home safer for your child.

Hospitals Reporting Methods for “Adverse Events”

We all know by now that if you want to look good to the public, all you have to do is “play with the numbers.” Well, it seems like hospitals have a penchant for doing just that. One of the key “numbers” that advocates of patient health and safety look at is how many “adverse events” take place in any given hospital. An “adverse event,” as you may already know, is – simply put – any harm to a patient as a result of medical care.

In his post this past week, Jason Penn compares some interesting adverse event bookkeeping by hospitals throughout our country. His blawg, The New Enron? Are Hospitals Cooking the Books?, brings to light serious flaws in the way that our medical institutions “count” the number of so-called adverse events taking place within their walls. His research for this piece reveals…

[M]edical errors occur 10 times more than previously thought.Maybe that wasn’t hard hitting enough. Let me try again. How about this: mistakes occur in one out of every three hospital admissions!

Frankly, that strikes me as an astounding and very concerning number. Are the numbers being reported reflecting this? The simple answer is no. Why not? Read Jason’s post and see what reporting systems are in place – or not in place as the case may be. We all remember Enron. Is this the medical version of “making the numbers look good” when they simply are not!

Surgeons and Booze – an Obvious Bad Combination – Who’s Protecting Us?

It doesn’t take a genius to realize that surgeons should not be under the influence when we as patients are “under the knife” What’s not so obvious is just how prevalent this may be in the operating rooms of our country (and throughout the world).

Wondering what the studies have been done by the medical profession to examine this problem? Have any idea what regulations are in place by hospitals to guard against the problem of “hungover surgeons”?

Wonder no more. Jon Stefanuca’s blog this past week, Hungover Surgeons: Watch Out! There’s Nothing Between You and Their Scalpel!,will tell you all you need to know. Jon queries: “Should hospitals regulate for patient safety?” What do you think? Share your comments.

A “Sneak Peak” of the week ahead

Some more good advice is on the way for parents of special needs children. We all know about what a wonderful aide dogs are for the blind. Mike Sanders will share what he’s learned how these canine wonders are being used for kids in need. Suffering from asthma or know someone who is? Jon Stefanuca will be sharing with  you some valuable information on this topic next week. A number of our clients or their now-deceased family members have suffered from this condition. Jon will share a story or two (without revealing protected confidential information) to bring to light just how this medical condition needs to be better recognized and treated by our health care providers before its too late. We all know what a difficult job nursing can be. That being said, Sarah Keogh will be telling us about some very concerning “trends” that are coming to light in this wonderful profession. Stay tuned for this important piece.

We’ll start next week off with a new blawg by our in-house medical specialist, Theresa Neumann. Her post on how important it can be to get a second opinion before you sign-up for a surgery, procedure or test is sitting in the queue just waiting to hit the pages of The Eye Opener – Views and Opinions from the Nash Community.

One Final Note: I wrote in last weekend’s Week In Review that we intended to post a new White Paper by Marian Hogan on a very important topic relating to Patient Controlled Analgesia (PCA). It didn’t happen – because of “my Bad.” I fouled-up and sent the wrong draft of Marian’ s piece to our graphic designer. He did a wonderful job – as usual – of getting it ready – it just wasn’t the right version. The problem is fixed, but my mistake will delay the posting of this important White Paper for another week. Public apology: Sorry, Marian! We’ll make it right soon.


Health Reform: What voice does the patient have in the debate?

Tuesday, April 26th, 2011

Recently, I came across an Op Ed entitled Health Reform Requires Listening to Doctors. The very title suggests that  physicians and the health care system in general don’t have much of a voice in the discussion of health care legislation.

The question struck me – can that really be true? If the medical profession and health care industry are crying “poor us,” as the Op Ed author would suggest, that’s rather disingenuous at best. It’s well-known in today’s world of American politics that one sure way to have a voice is to hire a lobbyist. According to the Center for Responsive Politicsover $1 billion was spent on lobbying related to health care in 2009 and 2010. Who were the big players and payers in the hiring of lobbyists?

CNN Money tells the tale of the tape:

[L]obbyists for 1,251 organizations disclosed that they worked on health care reform in 2009 and 2010, according to the center and an analysis by the Sunlight Foundation. The number of individual lobbyists who reported working on health related legislation last year hit 3,154 in 2010.

Big Pharma topped the list. The Pharmaceutical Research and Manufacturers of America spent $22 million and deployed an army of no fewer than 52 lobbyists, according to the center.

Blue Cross Blue Shield, which used 43 lobbyists, spent $21 million. The biotech company Amgen (AMGNFortune 500) employed 33 lobbyists and spent $10.2 million.

Yet another source, iWatchnews.org, reports the following:

A Center for Public Integrity analysis of Senate lobbying disclosure forms shows that more than 1,750 companies and organizations hired about 4,525 lobbyists — eight for each member of Congress — to influence health reform bills in 2009.

Among industries, 207 hospitals lined up to lobby, followed by 105 insurance companies and 85 manufacturing companies. Trade, advocacy, and professional organizations trumped them all with 745 registered groups that lobbied on health reform bills, illustrating the common Washington strategy of special interests banding together to pool money and increase their influence.

Seems like a whole lot of money was spent by the health care industry to have a voice.

This blog, however, is not intended to address issues relating to the Obama Health Care Reform (or as it is referred to in some circles as ObamaCare). I don’t claim to understand the in’s and out’s of that political football. I’ll leave that for the so-called pundits to address. What does strike me, however, is the travesty that recently played out in the setting of a threatened federal government shutdown.

Health Care Reform – the goal of the President’s Plan

What was the stated purpose and goals of the President’s health care reform? Look no further than the online posting by the White House for the answer:

Health reform makes health care more affordable, holds insurers more accountable, expands coverage to all Americans and makes our health system sustainable.

Sounds good in principle, right? Putting aside all the politics, rancor and ranting surrounding the debate over the specifics of health care reform, don’t you find it rather ironic that when recent budget cuts to avoid a government shutdown were the topic du jour, those who had very little, if any, voice were the people who desperately need can’t afford health care?

Recent Budget Cuts and Who Paid the Price

As I learned last week, when the back room deals were struck, those without a voice were the victims of political expediency.

As our own Jason Penn reported in his blog post, Budget Crisis Avoided, But What About the Babies? Can They Live With $504 Million Less in Funding?:

At the 11th hour, cuts were made, backroom deals were struck, and Washington spoke:  there will be $38 billion dollars trimmed from the federal budget.  On a positive note, federal agencies will remain operational until the end of September. Reason to cheer? Maybe. Before we break out the party hats and noise makers, let’s take a look at how healthcare fared.  The following areas are among those cut:

-         Special Supplemental Nutrition Program for Women, Infants and Children (WIC):  $504 million

-         Community Health Centers:  $600 million

-         Substance Abuse & Mental Health Services Administration:  $45 million

-         Infectious Disease prevention:  $277 million

Total:  $1.426 Billion.  Yes, billion, with a “B”!

Isn’t the answer of who does and who does not have a voice in the bigger picture of health care legislation and so-called fiscal reform self-evident. Who was there in the back rooms of our hallowed halls of Congress protecting those in need of good primary care programs? I suspect that when it’s crunch time, political expedience wins the day. Need cuts to keep a bloated beast alive and floundering? Snatch it from the ones who will be heard the least – the ones who don’t have the ability to spend over $500,000,000 a year for lobbyists so they can have their voice heard.

As Written in the Book of Isaiah the Prophet…

Apparently it’s just “politics as usual.” For all the rhetoric about making primary health care available to all Americans and improving and sustaining programs to deliver critical healthcare to those who need it the most, the voice crying in the wilderness was not loud enough. Maybe, as the Op Ed author claims, everything the medical profession and health care industry has to say is not being heard or at least being accepted. Nevertheless, they have a voice, which is more than can be said for those they claim they want to protect. How many of the enormous lobbying dollars did the medical community and health care industry spend to protect primary care programs from the budget-cutting ax? I suspect we all know the answer.

 

Image source: fromtheleft.wordpress

 

Week in Review (April 18 – 22, 2011) The Eye Opener Health and Law Blog

Saturday, April 23rd, 2011

From the Editor:

This past week, our blawgers (guess I’ll use this term now since we are legal bloggers) were busy on their keyboards once again. They covered a number of topics relating to law, medicine, health and patient safety. This week we posted a primer on aortic aneurysms and how they can present as back pain, a blog about “robot” anesthesiology, a disturbing post about how the recent threat of a federal government shutdown was averted but at a cost to those who are in dire need of healthcare, an interesting piece about laughing gas making its way back into the American medical scene for labor and delivery and finally, and a highly read piece on a not-to-often discussed topic but one of potential grave concern – shift switching by nurses and how this might impact patient safety.

Here’s our usual “quick summaries” for you to peruse, click on, read and comment:

Aneurysms – a deadly condition you need to know about!

Our in-house medical specialist, Theresa Neumann, wrote another highly educational and need-to-know piece about a condition that can present as back pain but which has deadly consequences for those who have this condition.

As Theresa’s research made us aware – “1 in every 50 males over the age of 55 have an abdominal aneurysm, this is a more common pathologic diagnosis than some others.  Men also corner the market at an 8-to-1 ratio as compared to women with abdominal aneurysms.”

As is the case with all of Theresa’s writings, we offer through her valuable information from someone who’s “been there” and “done that” in the clinical setting. Don’t miss her post entitled Aneurysms: A Potential Deadly Condition That May Present as Back Pain.

Who’s using remote control and a joy stick to put a breathing tube down your throat?

Mike Sanders brought to our attention a new practice of anesthesiologists – in Canada – that may soon be part of anesthesia management in the United States as well – using robotics to intubate patients. While you can certainly learn about the concept of intubation by reading Mike’s blog, basically, this is placing a small tube down a patient’s airway so that the anesthesiologist can control the airway and provide ventilation to a patient undergoing surgery.

Here’s an except -

Medical News Today is reporting that Dr. Thomas Hemmerling of McGill University and his team have developed a robotic system for intubation that can be operated via remote control.

For more on this fascinating new project by Dr. Hammerling and his team, read Mike’s post entitled Robot Anesthesiologists?

Government Shutdown Avoided – but who will pay the price for the “deals” that were cut?

The newest member of our blogging team, Jason Penn (fast approaching veteran blawger status) did a fascinating piece of the story-behind-the-story of the recent crisis our country faced when the federal government was on the verge of a shutdown. We all know about deals being cut in the back rooms of congress. We all know that the government avoided a shutdown this time around when the senate and house worked out a compromise that resulted in millions of dollars being earmarked for cuts in the budget.

Jason tells us what programs relating to healthcare will suffer as a result of these negotiated cuts. As some wise person once said, “why is it always those who are least represented who bear the burden of budget cuts?” Maybe it’s because they can’t afford lobbyists to protect them like those who need protection the least can.

Read Jason’s eye opening and no-punches-pulled report on just who will be the victims of the deals in his post of this past week Budget Crisis Avoided, But What About the Babies? Can They Live With $504 Million Less in Funding?

Will moms-to-be now be “laughing” their way through labor and delivery?

One of our seasoned blawgers, who every now and then is driven to report on the off-beat issues of law, medicine and healthcare, Jon Stefanuca, stepped up to the plate once again and took a swing at the return of an old-timer to the arsenal of pain relief for mothers-to-be undergoing labor and delivery – laughing gas!

As Jon’s piece in Eye Opener this past week tells us -

It appears that a number of hospitals are now considering making laughing gas available as a pain relief measure for women in labor. A hospital in San Francisco and another in Seattle have been using laughing gas in their labor and delivery units for a while. Hospitals like Dartmouth-Hitchcock Medical Center plan to offer laughing gas to laboring mothers in the immediate future.

For more about this return of laughing gas to our obstetrical units, read Jon’s piece Laughing Gas Making Its Way Back Into the Labor and Delivery Department.

Nursing and Sleep Deprivation: Is it a risk factor for patient safety?

I suspect somewhere along the line you have done “an all-nighter” – whether it was getting ready for a big test, a social event, or for some other reason. Remember how you felt as you made it through that night or the next day? Have you ever done it several nights in the same week? How about doing it a few times one week and then do the same thing the next week and the next…. Well you no doubt get the idea. You’ve been exhausted, right? Well what about nurses, who have to do this for a living?

Nurses have lives too. They have children, home responsibilities and obligations, and some form of social life. What happens when they swap shifts or are asked to do “a double”?

Sarah Keogh was back blogging this past week and wrote a fascinating (and concerning) post entitled Nurses Switching Shifts: Does a Lack of Sleep Put Patients at Risk? We invite you to read Sarah’s piece and share your comments. Are you a nurse who lives this lifestyle? What are your thoughts about nurses being allowed to work multiple shifts or back-to-back shifts in terms of patient safety? Should there be restrictions on nurses’ shifts just as there (finally) are work restrictions on doctors-in-training?

A “Sneak Peak” of the week ahead

As part of our continuing effort to “get the word out there” on issues relating to health, medicine, patient safety and the law, we post from time to time more extensive research pieces called White Papers. Well, the time has arrived for another White Paper to be posted on our website. Marian Hogan has completed her piece on a very important topic – Patient Controlled Analgesia in today’s hospital environment. She examines how some hospitals are now heavily marketing a spa-like environment so you choose them over the competition. Yet lurking in the shadows of these facilities which promote flat screen TV’s, valet parking, in-room safes and the like is a very dangerous practice: placing patients on patient-controlled-analgesia (for pain relief) without vital monitoring devices and patient safety practices. It’s at the “printer” now; we hope to have it online this week.

From our blawgers you can expect reports on a disturbing fight between manufacturers and child safety experts over – blinds! After decades of controversy, you’ll find out where the battle lines are now drawn, who’s winning and who the real losers are in this war. Wonder how healthcare safety is doing since the report To Err is Human was published by the Institute of Medicine over a decade ago? Jason Penn will be providing an updated report card, which you should not miss. Alcohol and surgery – not a good combination! Jon Stefanuca plans on posting a piece that looks deeper in the obvious problems with this potentially deadly combination.

This is just a taste of what’s to come. I better wrap-up now. I’m working on finishing the third installment on Medical Technology and Patient Safety. Oh yeah, if time permits, I might even get to post a piece I’ve been working on this past week – a lawyer’s rant about our modern day love affair with mediation practices and trends.

As always, don’t forget - subscribe to the Eye Opener and tell your friends about us too! …and… don’t forget to join our social networking communities on Facebook and Twitter.

Hope you have a great weekend!

Aneurysms – A Potentially Deadly Condition That May Present as Back Pain

Monday, April 18th, 2011

I have been writing a series of blogs devoted to common and not-so-common causes of back pain, some of which cause devastating and catastrophic injury.  Aneurysms of the aorta, either in the chest or abdominal cavity, can present as back pain, and these can often be fatal if not diagnosed or treated in a short period of time.

Considering that 1 in every 50 males over the age of 55 have an abdominal aneurysm, this is a more common pathologic diagnosis than some others.  Men also corner the market at an 8-to-1 ratio as compared to women with abdominal aneurysms. Thoracic aneurysms make up only 10% of the total number of aneurysms of the aorta, but these have a much poorer prognosis.

What is an aneurysm?

An aneurysm is a localized dilatation (i.e. the widening or stretching of an opening or a hollow structure in the body) of a blood vessel or even the heart, itself, due to some induced weakness in the wall of the vessel. The aorta is the largest blood vessel leaving the heart and transporting blood, oxygen and nutrition to every cell in the human body. It has the highest pressures and the thickest walls.

Should the weakness in the wall of the vessel rupture, blood will be released in such quantities and at such high pressures that the rapid blood loss causes a rapid death in most patients. There are a few exceptions, depending on which side of the blood vessel ruptures. If the rupture occurs on the side facing the abdominal cavity, the blood loss tends to be rapid since no opposing structures obstruct the flow. If the rupture occurs on the side facing the spinal column, structures in the near vicinity can actually slow the flow of blood allowing for a small time frame for diagnosis and intervention to occur. Sometimes, there is a slow “leak” of blood prior to a massive rupture, and this blood causes irritation and pain, allowing for a “window-of-opportunity” for a diagnosis to be made and intervention to occur.

I’ve provided a link at the end of this article to a well done video explaining aneurysms.

Real Case Scenario:

Patient M was a 62-year-old, moderately obese female, who came to the ER when I was working one day, complained of some vague low back pain and several episodes where she briefly lost consciousness that morning while trying to get up and move around. No injuries were sustained, but she felt very weak and light-headed. Her blood pressure was 109/68 while lying flat with a heart rate of 96. An attempt was made to obtain a blood pressure while sitting, but Patient M became near-syncopal and sweaty. A quick examination of her abdomen revealed a pulsatile aneurysm in her abdomen measuring 6cm (almost 2 1/2 inches wide). I was able to contact the vascular surgeon, have nurses place appropriate IV lines and obtain labs, and I notified the nursing supervisor regarding the need for an operating room. Patient M actually went for a CT scan on her way to the OR; the CT verified a “leaking” abdominal aortic aneurysm. Patient M was in the OR within 20 minutes of my evaluation. Upon opening the abdomen, the bleeding worsened, but the surgical team was prepared. They did have to resuscitate Patient M once, but a repair of the aorta was effective, and she went home within one week of her life-saving operation!

How is an aortic aneurysm diagnosed?

Most are actually diagnosed incidentally when patients undergo various diagnostic studies for other, unrelated complaints.These are the luckiest patients, because aneurysms can be detected early, monitored and then the patient can be offered elective intervention before an acute rupture occurs. It seems that 5cm (about 2 inches) is the “magic number” when it comes to an indication for repair since an aneurysm larger than that significantly increases the risk of rupture. Now, with endovascular (i.e. procedures in which a catheter is placed inside the blood vessel) repair options (“stenting procedures”), some of these aneurysm repairs can be done in a minimally invasive manner, offered even earlier, and have very good outcomes with only 2-to-3 day hospital stays.

Routine but thorough physical exams by a conscientious practitioner can ofter detect aneurysms in the abdomen simply by feeling the abdomen by hand. The chest cavity is more difficult for obvious reasons. Chest x-rays can sometimes suggest a problem if calcifications are present in the vessel wall (high-lighting the vessel contour) or if abnormalities are detected in the mid-line structures that overlap in this 2-dimensional picture. These patients can then undergo subsequent imaging studies to determine the existence and extent of the aneurysm.

When aneurysms go undetected, the acute presentation can also vary depending on the location of the aneurysm both in relation to the distance from the heart and the side of the vessel. Because of the position of the aorta anatomically (close to the spine), patients often experience back pain due to impingement of the spine and spinal nerves. If the aneurysm is in the chest cavity (thoracic), one often will feel upper to mid-back pain that can range from dull and aching to searing and excruciating; this may or may not accompany chest pain and other symptoms. If the aneurysm is in the abdomen (most often below the arteries that supply the kidneys), a patient will often complain of low back pain that could extend into the groin, and again, this pain can be dull and aching or sharp and excruciating.

What causes aortic aneurysms to occur?

The most common cause of aortic aneurysms is atherosclerotic vascular disease, commonly called cholesterol-plaqueing of the arteries. There are a multitude of other causes such as genetic conditions, fungal infections, bacterial infections, and other collagen-vascular diseases. Those individuals who have abnormal cholesterol panels, high blood pressure, perhaps a history of coronary artery disease or peripheral vascular disease, and diabetes are at risk for aortic aneurysms as they age.

Bottom line?

So, a person who is a little older with perhaps some of these notable risk factors who develops unusual back pain with no apparent precipitating cause (excessive physical activity/labor, fall, etc.) should be evaluated for a possible aneurysm. If present and detected, it is often a treatable condition; left untreated, it will ultimately lead to death, which is often sudden. Medical technology even offers minimally invasive procedures that are quite effective if treated early enough and located in an accessible region. Keep in mind that thoracic aneuryms do have a worse prognosis than abdominal aneurysms.

Here’s the link to the video explaining aneurysms.

Image from aorticstents.com