Heart disease remains the leading cause of death in the United States. The disease contributes to heart attack and stroke, which can be debilitating or fatal. Due to advances in medicine doctors and patients have more options for diagnosing heart disease. Diagnostic capabilities aid in early detection of heart disease and stroke which helps physicians plan medical treatments or recommend changes in life style. One tool that’s often used in conjunction with other procedures is intravascular ultrasound (IVUS).

How IVUS Works

Intravascular ultrasound is often done in tandem with other cardiac catheterization procedures. The cardiologist inserts a catheter into the artery that runs through the patient’s groin or arm, and threads it through to the coronary arteries. At the end of the catheter is a special ultrasound wand, called a transducer.

Once the transducer is in place, it emits sound waves. Those waves bounce off the walls of the arteries. A computer converts the sound waves into a picture that illustrates the inside of the artery. The image shows any blockages in the arteries, such as plaque buildup, or where possible onset of coronary disease

IVUS is a minimally invasive procedure, requiring only a small incision in the groin area. It is used in combination with a diagnostic heart cath, and doesn’t lengthen the patient’s hospital stay at all.

Applications of IVUS

IVUS may be used as a diagnostic tool and in combination with an intervention. Cardiologists often use IVUS for the following reasons:

• To decide whether a patient needs angioplasty or bypass surgery
• To evaluate whether a stent is necessary after an angioplasty, and to determine stent placement
• To inspect the aorta and arterial walls for signs of heart disease
• To appropriately size the vessel for stent, balloon, or an aortic aneurysm system.

If you have questions about intravascular ultrasound or heart health, please contact us at Central Florida Regional Hospital. Visit us online or call Consult-a-Nurse® at 1-800-445-3392 for answers to your questions and free physician referrals.

The leading cause of missed work, back pain can easily sideline someone from even the simplest daily activities. Because the causes of back pain vary so widely, however, treatment options also vary. Most patients need only rest, over-the-counter anti-inflammatories, and maybe a heating pad. But when back pain is more severe, or persists over time, it may be necessary to seek medical attention. For some patients, the best treatment is minimally invasive spine surgery (MISS).

Obtaining Accurate Diagnosis

Back pain can be caused by multiple medical conditions—some of which have nothing to do with the back muscles or spine. For instance, kidney or gallbladder infection may cause back pain, as could a tumor or an ulcer. Patients who experience sudden, sharp back pain, or dull back pain that doesn’t go away after a few days, need to see a doctor.

The doctor generally conducts multiple tests to determine the cause of each patient’s back pain. These could include diagnostic imaging, such as x-rays, MRI, or CT scans. To rule out other medical conditions, the doctor may also do blood work or other tests. If the pain originates in the bones or musculature of the back and requires more specific treatment, the doctor will often refer the patient to a specialist. Given the complex neurological structures contained within the spine, including the spinal cord and spinal nerves, there are orthopedic and neurological surgery specialists who are trained to perform these spinal procedures.

Surgery Isn’t First Line of Defense

After diagnosis, a specialist usually recommends conservative treatment options first. These may include medication, physical therapy, or visiting a chiropractor. Qualified spine specialists tailor the treatment to address the cause of each patient’s back pain. If these methods don’t work, surgery may be an option. It’s important to remember that not all conditions can be treated surgically. The following conditions can usually be treated effectively with surgery:

• Spinal stenosis
• Scoliosis
• Spondyolisthesis
• Kyphosis
• Ruptured or herniated discs
• Bone spurs

It’s important to remember that surgery is a serious treatment, with definite risks. Some patients may still have pain or suffer from relapse after surgery. However, recent advances in medical technology are improving the outcome for back surgery patients. Minimally invasive spine surgery (MISS) is an excellent option for many patients. MISS allows doctors to address spinal disorders with minimal dissection of the muscles typically resulting in less pain, a shorter hospitalization, and a quicker recovery. That factor means shorter recovery time, less post-operative pain, and reduced risk for complications.

If you have questions about back pain treatment or minimally invasive spine surgery, please contact us at Central Florida Regional Hospital. Visit us online or call our Spine Center at 1-800-445-3392 to schedule a personal evaluation.

SOURCES
Ivanhoe Medical Breakthroughs
Spine Universe
Providence Health Services

At one time or another, most of us have experienced back pain. The leading cause of missed work, back pain contributes to over $50 billion a year in lost productivity. Most of the time, these injuries heal themselves. However, some back pain requires medical attention, and sometimes surgery. But how can you tell the difference?

Knowing Those Normal Aches and Pains

The most prevalent back injuries include muscle strains and spasms. These generally occur due to overexertion, for instance lifting something extremely heavy or twisting the body into an unnatural position. These kinds of injuries can generally be remedied with over-the-counter anti-inflammatories and proper rest. Applying mild heat to the injured muscles also works. For muscle tightness, medical massage can relieve tension and pain.

Avoiding back pain due to overexertion requires preventative care. Appropriate preparation for physical activity is critical, and not only stretching before exercise. Maintaining optimum muscle condition through strength building exercise is also important. Protecting the back by using the right lifting, twisting, and bending postures also helps.

When Pain Requires Immediate Attention

Sometimes back pain starts without any discernible exertion, or as the result of a sudden injury. In those cases, or if pain persists, it’s important to see a doctor. The following symptoms require attention from a physician:

• Pain accompanied by numbness in the arms or legs could be a sign of a herniated disc or spinal stenosis.
• Sharp pain that occurs with any movement, especially after a fall or other trauma, could be caused by a spinal fracture.
• Consistent achiness or “creakiness” of the joints often indicates some form of arthritis, especially if the pain isn’t fully alleviated by over-the-counter anti-inflammatories.
• Any back pain accompanied by fever, burning during urination, or blood in the urine requires immediate medical attention, because it signals an infection or stones in the kidneys.
• Moderate back pain that lasts more than a few days or interferes with daily activities is worth a doctor’s visit.

The doctor usually does x-rays and other diagnostic exams to diagnose the cause of back pain. Treatment may require follow-up with an orthopedist. Since the spine contains the central nerve for the body inside the spinal column, it’s important to see an orthopedic doctor who has specialized experience with back injuries and spinal treatment.

Treatment varies, depending on the condition. While arthritis may be treated with prescription medications or other conservative options, physical therapy may be the answer for another condition. In limited cases, back surgery is the most appropriate option.

If you have questions about back pain or back surgery, please contact us at Central Florida Regional Hospital. The physicians and staff at our Spine Center are skilled at diagnosing, treating, and preventing back pain. Visit us online or call Consult-a-Nurse® 1-800-445-3392.

Ouch, that has to hurt. You’ve seen school kids carrying their overloaded backpacks, and it’s just painful to watch. Usually, they’re leaning to one side, huge bags hoisted onto single shoulders. If you think that isn’t healthy, you’re right.

Studies have shown that students suffer back pain and injury when their backpacks are too heavy or fit improperly. These super-loads can effect kids’ balance, distort their spines, and make their shoulders round over. But there are steps you can take to help your children be ready for school—and be safe, too.

• Use the right bag. Make sure your child uses a backpack with these features:        

                 Lightweight material, such as canvas—not something heavy like leather
                 Two padded straps
                 Padded back
                 Separate compartments
                 Hip strap or waist belt

• Pack well. Place the heavy objects in the bag first, so they are lower and closer to the body. Then fill the smaller compartments so the load is even. If there are bulky or sharp materials, make sure they aren’t packed so they rub against your child’s back.
• Lift carefully. Make sure your child uses his or her leg muscles when putting on the backpack. Pulling with just the arms is bad for the back.
• Wear it right. Have your child use both straps and places them over both shoulders. The pack needs to be evenly distributed. Fasten the waist belt or hip strap to keep the bag from moving too much.
• Ride high. Help your child adjust the straps so the backpack is snug and rides a few inches above the waist. When packs are too low, they put pressure on the shoulders.
• Stay straight. If you see that your child has to lean forward when carrying the backpack, it’s too heavy. Stop and reconsider all the objects inside. Is everything really necessary?
• Weight it. According to the American Chiropractic Association, your child’s backpack should not weigh more than 5 to 10 percent of his or her body weight. Speak with your child’s teacher if you have concerns about all the books or other materials being carried.

Some kids opt for backpacks that have wheels, but they aren’t always practical and some schools have banned them. Talk to your child and figure out what works.

If you have questions about spine and back health, contact Central Florida Regional Hospital. Visit us online or call Consult-A-Nurse® at 1-800-445-3392. Your kids—and their backs—will thank you.

Sources:
http://www.spine-health.com/conditions/back-pain/backpacks-and-back-pain-children
http://www.spine-health.com/conditions/back-pain/tips-prevent-back-pain-kids-backpacks
http://www.acatoday.org/content_css.cfm?CID=65

Heart disease is the top killer in the United States, and stroke follows close behind as the third most deadly condition. Both heart disease and stroke are also leading causes for disability in this country. Yet patients can also prevent both through their lifestyle choices; after all, the first step in protecting your mind and body from the ravages of stroke is protecting your heart from damage and disease.

The Heart-Mind Connection

Heart disease and stroke are inextricably linked, since the cardiovascular system plays a pivotal role in all the body’s functions, including the brain. The heart pumps blood to all the areas of the body, delivering oxygen and other nutrients that keep the body functioning properly. Heart disease makes this system function less efficiently.

High blood pressure almost always accompanies heart disease. Over time, the extra pressure wears on the arteries and blood vessels throughout the body. This is especially dangerous in the brain, where tiny blood vessels can stretch thin over time. Eventually the blood vessel can protrude and form a sort of pouch, called an aneurysm. This aneurysm can eventually rupture, causing a hemorrhagic stroke. It is possible to catch an aneurysm and intervene before it ruptures, so hemorrhagic stroke accounts for only a small portion of strokes.

However, the greater danger lies in the formation of blood clots. As the heart pumps less efficiently, and plaque builds up in the arteries, blood can begin to pool. When that happens, clots may form, then be pumped to other places in the body. If a clot reaches the brain and blocks blood flow, the patient suffers an ischemic stroke. Ischemic strokes account for 85 to 90% of stroke cases.

Stroke deprives brain cells of necessary oxygen, and they die as the stroke is left untreated. The type and extent of brain damage depends on where the stroke occurs, and how long the patient waits before getting treatment. Common side effects of stroke include loss of motion (usually in one side of the body), aphasia (inability to speak), and memory loss. Some of these can be reversed with rehabilitation, but others are permanent.

Preventing Heart Disease and Stroke

Even patients who have already been diagnosed with heart disease can decrease their risk for stroke and other complications. Talk to a doctor and a nutritionist before making any significant lifestyle changes, and ask how you can work to improve your heart health.

• Be brutally honest about what’s in the pantry. A healthy diet—low in salt, fat, and cholesterol—goes a long way toward keeping your heart healthy. Over time, fat and cholesterol build up in the arteries, while salt contributes to the development of high blood pressure. Opt for less meat, and more veggies!
• Take it to the street. Even moderate exercise like a daily walk around the neighborhood can improve heart health. Put together an exercise regimen that fits your schedule and makes you want to get active. A trainer can help you tailor a program to your current fitness level and choose activities that interest you.
• Quit putting off that checkup. The doctor has many diagnostic tools available, to help you catch heart disease before it causes irreversible damage. Heed the doc’s advice on getting tests like AngioScreens® or stress tests done. These simple steps can save your life.
• Work on getting rid of bad habits. Both drinking and smoking diminish overall health, including your heart’s ability to function properly. Cut down on drinking, and quit smoking entirely. The local hospital or other community organization may have smoking cessation programs to help you quit permanently.

If you have questions about stroke, heart disease, or other medical conditions please contact us at Central Florida Regional Hospital. Visit us online or call Consult-a-Nurse® at 1-800-445-3392 for answers to your questions and free physician referrals.

The recent outbreak of pertussis (whooping cough) in California raises an important health issue: adult vaccinations. Often we equate immunizations with babies and school children, but adults need them, too. Not only are unimmunized adults risking their own health, but they can also act as carriers for infectious diseases.

Who Needs Adult Immunizations

Although adults don’t need the numerous boosters and shots that children do, they do need some vaccines on a regular basis. Certain factors like overall health, certain medical conditions, occupation, and travel plans may influence a patient’s vaccination schedule, so it’s important to discuss them with your healthcare provider. The CDC also recommends immunizations based on patient age:

Ages 18-49

• Influenza vaccine before the start of every flu season reduces risk and prevents the spread of flu to people whose immune systems are more vulnerable.
• One to two doses of pneumonia immunization for smokers is highly recommended.
• A TdaP, which protects against tetanus, diphtheria, and pertussis (whooping cough) is necessary at least three times during a patient’s life, with boosters of Td every ten years.
• For women 26 and under, an HPV vaccination is recommended. Men under 26 can also take the Gardasil brand of HPV immunization.
• Any young adult who will be staying in a college dorm must be immunized against meningitis.

Ages 50-64

• Get a flu shot before the season gets into gear, usually in the late fall or early winter.
• Smokers may need another dose of the pneumonia immunization.
• Whether patients need another TdaP depends on immunization history. Most patients will need another dose during this time. At the very least, patients still need that Td every ten years.
• Patients who have never had chickenpox (varicella) will want to discuss this vaccination option with a doctor.
• Patients born in 1957 or earlier will need another dose of the measles/mumps/rubella (MMR) vaccine.

Ages 65 and up

• For older adults, an influenza vaccination every flu season is extremely important.
• Adults who reach age 65 and have never been vaccinated against pneumonia should get the immunization. It sometimes requires two doses.
• Whether a patient needs another TdaP depends on medical history.
• Any patient in this age bracket who hasn’t had chickenpox should discuss the vaccine with a healthcare provider.
• Everyone 65 and older should get immunized for Zoster, commonly known as shingles.

Some patients may also need immunization against Hepatitis A and Hepatitis B, depending on medical history, risk for contracting the diseases, and other factors.

Get Your Immunizations in August

August is National Adult Immunization Month, so now is the perfect time to schedule a doctor’s visit. Ask your healthcare provider if you need any vaccinations, and get answers to any questions you may have about how vaccinations work, what they’re made of, and how they protect you and your family from preventable illnesses.

If you have questions about immunizations, please contact us at Central Florida Regional Hospital. Visit us online or call Consult-a-Nurse® at 1-800-445-3392 for free physician referrals and answers to your health questions.

Even before a woman realizes that she is pregnant, her body has begun preparation for nurturing a new life. From the moment of conception, both mother and child begin an incredible journey together. During the first trimester, the changes that take place can seem imperceptible, but they are critical nonetheless.

Physical Changes for Expectant Mothers

Although a woman may not look visibly pregnant during the first trimester, her body is rapidly changing to accommodate a growing body. Levels of progesterone, estrogen, and other hormones fluctuate rapidly, turning off the woman’s normal menstrual cycle. Those hormonal differences lead to many of the changes associated with early pregnancy:

• Breasts grow more tender, and they may feel heavier and fuller. Many women find that wearing a more supportive bra can ease some of that discomfort as their breasts get larger and more sensitive.
• Rapid changes in hormonal balance can cause nausea. Since this symptom is most common early in the day, it’s been nicknamed morning sickness. But nausea can happen at any time of day. Eating small, frequent meals can help.
• By the seventh week, the uterus is the size of a tennis ball. It can press on the bladder, increasing frequency of urination. Skip the caffeine, which can induce more frequent urination.
• The lining of the vagina gets thicker and less sensitive. A whitish discharge is normal, as is some spotting. Immediately contact your medical provider if you experience any heavy bleeding.

During the first trimester the body also increases circulation, as the mother’s blood must circulate for mother and child. Veins may become more prominent, since the volume of blood increases. Meanwhile new moms may feel extremely tired or suffer bouts of dizziness. These symptoms are associated with circulation changes, but they can also occur due to stress or hunger. It’s important to get plenty of rest and pay attention to nutrition during pregnancy.

Emotional Changes during the First Trimester

Just as hormonal changes affect the body, they also affect the emotions. The drastic increases in hormones generally cause some emotional changes, most frequently weepiness or mood swings. These usually subside as hormone levels become more stable later in pregnancy.

But the state of being pregnant itself can lead women on an emotional rollercoaster. Feeling joy, anticipation, fear, and anxiety in turn—or at once—is completely normal; after all, these next months will completely change a woman’s life. Talking about changing emotions with a trusted friend or family member can help an expectant mom cope with these emotions.

Often the best person to provide support may be feeling a little left out by the pregnancy. A woman’s partner may feel excluded from the exciting changes, especially as the pregnant mom draws more attention. Pregnancy certainly changes a relationship, so it’s important for both mother and partner to remain open, supportive, and loving during the process.

If you have questions about what to expect during pregnancy, contact us at Central Florida Regional Hospital. Moms who register with us can attend our prenatal education classes. Or call Consult-a-Nurse® at 1-800-445-3392 for answers and free physician referrals.

By Marijune Feick, RD,LD, CNSD

Mom was right when she said to eat your fruits and vegetables. We all know they are “good” for us, but most of us don’t eat enough because we either don’t like them or take the time to include them in our diets. Of course they provide necessary vitamins and minerals, but they also provide substances that your body needs that aren’t found in vitamin pills. They provide fiber and antioxidants that “just say no” to chronic diseases such as cancer, stroke and heart disease.

Most people need about 5 servings of vegetables and 2 to 4 servings of fruits a day. That may sound like a lot, but check out what a serving size is and you may realize you eat more than you thought. For example, 6-7 baby carrots are considered a serving of vegetables and 17 grapes is considered a serving of fruit. Here are some easy ways to eat more fruits and vegetables every day:

• Top your cold cereal, yogurt, oatmeal, or pancakes with banana or berries.
• Add green pepper, broccoli, spinach or mushrooms to your scrambled eggs or egg white omelet.
• Encourage your children to choose their own favorite fresh fruit when shopping.
• Make a fruit smoothie with low fat milk, banana and frozen strawberries.
• Instead of French Fries when eating out ask for a green side salad, steamed vegetables or corn on the cob.
• Besides lettuce, add green pepper, onion, cucumbers or tomato to a sandwich.
• Add vegetable toppings to pizza.
• Stock your desk or lunch box with mini boxes of raisins, dried cranberries or apricots, or single-serve canned fruit.
• Add mandarin oranges or sliced apples to your tossed green salad.

Visit MyPyramid.gov to find more information on healthy eating and calculate your fruit and vegetable recommendations based on your age, sex and activity level.

Pregnancy brings many changes to a mother’s body, lifestyles, and even relationships. One of the best ways to maintain health and happiness throughout all these changes is with exercise. Although women who are pregnant may have to alter their regular workout routines, it is usually safe to exercise right through delivery day.

Why Exercise?

We all know that exercise keeps your body healthy and fit, and during pregnancy exercise confers even more benefits. Exercise helps to prepare the body for labor and delivery, so mothers who exercise often recover faster—and lose that baby weight sooner—than mothers who don’t exercise during pregnancy. Meanwhile exercise can minimize the risk of varicose veins (which may pop up in the second and third trimesters), decrease problems with constipation, and make it easier to sleep at night.

Women of average weight should gain 25 to 35 pounds during pregnancy, so exercise can help keep weight gain in check. Even women who had no exercise routine before pregnancy can get started and enjoy the benefits, so long as they start out slowly and avoid overexertion. If you’re unsure about where to begin, consult your physician for recommendations about beginning a fitness routine.

Work-Out Tips for Pregnant Women

Pregnancy changes a woman’s body in significant ways, and it’s important to keep these changes in mind during any workout. For instance, release of certain hormones causes a loosening of the joints, which can make pregnant women more prone to joint injuries like sprains and strains. The body’s weight is also distributed differently, so balance can become an issue, especially in the last trimester. To ensure safe and healthy work-outs, pregnant women can follow the following guidelines:

• Choose physical activities that minimize the risk for injury. Swimming, walking, and cycling on a recumbent or stationary bike are great options because they place less impact on the joints and involve lower risk of injury due to falls or loss of balance. Contact sports should be avoided during all stages of pregnancy.
• Prepare your body for exercise by stretching thoroughly. Talk to a trainer or your doctor about appropriate stretches for different phases of your pregnancy, especially when weight gain and a protruding belly can make stretching more difficult.
• Avoid overexertion, including working out until you’re out of breath. Being breathless deprives you—and therefore the baby—of necessary oxygen. How do you know if you’re at the right intensity? You should be able to carry on a conversation with someone during your workout.
• Skip workouts during extreme heat, which can cause fatigue and dehydration. Be sure to drink plenty of fluids, even when working out indoors or in cold weather, as the body can get dehydrated easily in any condition.
• Lifting weights is safe, so long as you don’t lift them overhead or strain the lower back. Focus on maintaining muscle tone, rather than building muscle mass. Use lighter weights, and avoid overworking the abdominal muscles, especially in the later stages of pregnancy, when these muscles begin to separate in preparation for labor.
• Lying flat on your back during the second and third trimesters can cut off blood circulation to the womb. Avoid any exercises or stretches that call for that position. Expectant mothers will also want to change postures during sleeping, so they don’t sleep on their backs.

If you have questions about exercise during pregnancy or other prenatal health concerns, please contact us at Central Florida Regional Hospital. Visit us online or call 407- 321-4500 ext. 5613 for information about registering to deliver in the Baby Suites at Central Florida Regional Hospital, signing up for prepared childbirth classes, and other educational opportunities.

Breastfeeding could save new families up to $3,900 a year in formula alone! Meanwhile, breastfed infants need fewer trips to the doctor and enjoy decreased risk of many long-term health conditions. That translates into fewer trips to the doctor over a lifetime. But the baby isn’t the only one who stays healthier thanks to breastfeeding—so does Mom. Breastfeeding has advantages for both mother and baby.

Benefits for Mothers

Although being the sole provider for your baby’s nutritional needs can certainly be stressful, breastfeeding offers new mothers significant health benefits. Some of these extend far beyond the postpartum phase.

• Mothers who breastfeed tend to lose their baby weight more quickly, since milk production burns so many calories.
• Breastfeeding reduces the time it takes for the uterus to return to pre-pregnancy size, and it reduces postpartum bleeding.
• Breastfeeding has been linked to lowered risk of developing Type II diabetes, although experts haven’t identified the exact causes of that mechanism.
• Mothers who breastfeed enjoy decreased risk of pre-menopausal breast and ovarian cancers.
• Since feeding time promotes mother-baby bonding, mothers who breastfeed have lowered incidence of postpartum depression and increased self-confidence.

Perhaps the greatest benefit is the peace of mind that comes with breastfeeding; it’s the healthiest choice for a new baby, so mothers know that they are supporting their baby’s growth and development.

Benefits for Babies

Breast milk is filled with antibodies and nutrients that are tailored precisely for a baby’s needs. Over time its composition changes, so it always provides the optimal balance of protein, fats, sugars, and water. From the first few days, when the mother produces special milk called colostrum, up through the time a mother weans her child, breast milk offers health benefits that affect a child for a lifetime.

• Because breast milk is easier for babies to digest, breastfed babies have lower incidence of gastrointestinal problems, including diarrhea and stomach viruses.
• The added boost to their immune system means that babies who are breastfed have less ear infections, respiratory infections, and other minor illnesses.
• The unique composition of breast milk promotes healthy brain development; some studies have even shown a link between breastfeeding and increased IQ.
• Premature babies who are breastfed have fewer complications and re-hospitalizations, compared to premature babies who are bottle-fed.
• Over time, breastfed children have lowered risk of both Type I and Type II diabetes, along with lowered incidence of asthma and obesity.
• Baby also benefits from the increased bonding time with mom, feeling more secure and attached.

How long should mothers breastfeed? To enjoy most of these benefits, mothers must breastfeed for at least three months. However, the US Surgeon General recommends breastfeeding for at least six months, when the baby usually starts eating some solid foods. Yet solid foods lack many of the nutritional elements of breast milk, so it’s advisable to continue for the first year.

If you have questions about breastfeeding or other maternity health issues, please contact us at Central Florida Regional Hospital. We offer classes to expectant mothers who register to deliver at our Baby Suites. Visit us online, or call Consult-a-Nurse® at 1-800-445-3392 to find out about our prenatal education programs, get answers to your health questions, or get a free physician referral.

Sources:

http://www.womenshealth.gov/breastfeeding/benefits/#a

http://www.physorg.com/news189331326.html

http://www.centralfloridaregional.com/healthcontent.asp?page=/hic/pregnancy/preg/pregindex