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   Medical Directory
 

We are in the process of creating an online Medical Directory. If you are a health care provider and are interested in being included, please contact us at info@davidsoncountyonline.com or call us at 704-244-1937.

 
   Health News
 
Understanding And Coping With Painkiller Addiction

Once some people start taking painkillers to alleviate feelings of pain or discomfort, it can be hard for them to stop. Unfortunately, that feeling of dependency can become an addiction, which can cause serious harm and consequences to a persons life and health. Overcoming the addiction is difficult and is a process that many struggle with or dont feel they can attempt. However, breaking the habit is possible with the right treatment.

What Causes Painkiller Addiction?

Becoming addicted to pain medication is serious because the addiction cannot be broken without going through a severe withdrawal. This withdrawal can be terrible for some people because their brain has become dependent on the drug. The following is the physical process of addiction as outlined by Spine-Health.com:

1.Nerve cells start to function abnormally due to the brains increased production of receptors for the painkiller.

2.Endorphins, which are the bodys natural painkillers, stop being produced because the body is now receiving the drugs instead.

3.Because the nerve cells have ceased to function correctly, the brain is now dependent on the painkillers instead.

Aside from the physical aspect, other factors contribute to the addiction of painkillers as well. Genetics may play a part in the addiction along with lifestyle. If a person is raised in an environment where drug usage is acceptable or surrounds themselves with people who encourage drug use, then an addiction could very well develop in that person.

Symptoms Of Painkiller Addiction

When people become addicted to painkillers, they may deny it or try to hide it from others. However, a close examination of their actions will probably give them away. These are the symptoms of an addiction to painkillers:

Using the drug more than needed: If the person is taking an unusually high dose of the drug, or is taking it daily or even several times a day, this is the first sign that he or she is addicted.

Keeping a well-stocked supply: People with addictions will be sure to have an ample supply of the drug on hand.

Spending excessive amounts of money on the drug: Some people with addictions will even go so far as to spend money they dont have on the drug. They may forego other necessary expenses or even steal just so they can afford to feed their addiction.

Failed attempts at quitting: If the person cannot stop using the drug or feels that the drug is needed in order to deal with lifes problems, then that person is definitely addicted.

Treatment Options

Going through a withdrawal can be extremely uncomfortable, and even painful, especially for those who have been addicted to painkillers for a long time. Many people quit detox or dont even start for fear of the unsettling experience of withdrawal symptoms, which include intense cravings, twitching, tremors, vomiting, and severe aches and pains once off the painkillers. The ideal detox process should be:

Done as briefly as possible

Done through a safe method with as few symptoms as possible

Completed with the encouragement and understanding of supportive friends and family

Because detox is a serious and somewhat complicated process, those suffering form painkiller addiction should not attempt to detox on their own. Its best to complete a medically- assisted treatment to ensure the most ease and success throughout the process.

One of the most common methods of detox is known as Rapid Opiate Detoxification or ROD. This method entails going under anesthesia so as not to endure the symptoms of withdrawal. High doses of naltrexone are administered to shorten the withdrawal symptoms and when the patient wakes up, his or her body is free of the drug and did not have to experience any unpleasant symptoms.

Another method is called Accelerated Opiate Neuro- regulation or AON, which is a type of rapid detox. In this process, the patient is also administered anesthesia and basically sleeps off the symptoms of withdrawal. But in this case, the patient will feel slightly ill the next day and may experience nausea, vomiting, diarrhea and have little to no energy. However, the patient should feel better after a few days.

Addiction Prevention

Painkiller addiction is not actually as common as you may think it is. And just because you need to use painkillers doesnt mean that you have an addiction to them or at risk of becoming addicted to them. But if you are taking painkillers and are worried about dependency, follow these tips:

Know the side effects of the medication youre taking and how it can affect you and your health.

Take the proper dosage. If the medication isnt working for you, consult with your doctor.

Check in often with your doctor anyway to make sure the medication is working properly and that youre on the right track to recovery.

Follow the directions closely. Take no more than whats been prescribed for you and never take someone elses medication.

Having an addiction to painkillers can have a serious impact on your physical, mental and even social health. Getting treatment may seem like a tough, scary process but with the right method, recovery can be easier than you think.


More Women than Men Have a Stroke

Approximately 55,000 more women than men have a stroke each year. Women are twice as likely to die from stroke than breast cancer annually. African Americans have almost twice the risk of first-ever stroke.

Two million brain cells die every minute during stroke, increasing risk of permanent brain damage, disability or death.

Recognizing symptoms and acting FAST to get medical attention can save a life and limit disabilities.

Memorize these signs of stroke:

 F = FACE Ask the person to smile. Does one side of the face droop?

 A = ARMS Ask the person to raise both arms. Does one arm drift downward?

 S = SPEECH Ask the person to repeat a simple sentence. Does the speech sound slurred or strange?

 T = TIME If you observe any of these signs (independently or together), call 9-1-1immediately.


15 Cancer Symptoms Women Ignore

Women tend to be more vigilant than men about getting recommended health checkups and cancer screenings, according to studies and experts.

They're generally more willing, as well, to get potentially worrisome symptoms checked out, says Mary Daly, MD, oncologist and head of the department of clinical genetics at Fox Chase Cancer Center in Philadelphia.

But not always. Younger women, for instance, tend to ignore symptoms that could point to cancer. "They have this notion that cancer is a problem of older people," Daly tells WebMD. And they're often right, but plenty of young people get cancer, too.

Of course, some women are as skilled as men are at switching to denial mode. "There are people who deliberately ignore their cancer symptoms," says Hannah Linden, MD, a medical oncologist. She is a joint associate member of the Fred Hutchinson Cancer Research Center and associate professor of medicine at the University of Washington School of Medicine, Seattle. It's usually denial, but not always, she says. "For some, there is a cultural belief that cancer is incurable, so why go there."

Talking about worrisome symptoms shouldn't make people overreact, says Ranit Mishori, MD, an assistant professor of family medicine at the Georgetown University School of Medicine in Washington, D.C. "I don't want to give people the impression they should look for every little thing," she says.

With that healthy balance between denial and hypochondria in mind, WebMD asked experts to talk about the symptoms that may not immediately make a woman worry about cancer, but that should be checked out. Read on for 15 possible cancer symptoms women often ignore.

What Is Your Cancer Risk? Take the WebMD Cancer Health Check

No. 1: Unexplained Weight Loss

Many women would be delighted to lose weight without trying. But unexplained weight loss -- say 10 pounds in a month without an increase in exercise or a decrease in food intake -- should be checked out, Mishori says.

"Unexplained weight loss is cancer unless proven not," she says. It could, of course, turn out to be another condition, such as an overactive thyroid.

Expect your doctor to run tests to check the thyroid and perhaps order a CT scan of different organs. The doctor needs to "rule out the possibilities, one by one," Mishori says.

No. 2: Bloating

Bloating is so common that many women just live with it. But it could point to ovarian cancer. Other symptoms of ovarian cancer include abdominal pain or pelvic pain, feeling full quickly -- even when you haven't eaten much -- and urinary problems, such as having an urgent need to go to the bathroom.

If the bloating occurs almost every day and persists for more than a few weeks, you should consult your physician. Expect your doctor to take a careful history and order a CT scan and blood tests, among others.

No. 3: Breast Changes

Most women know their breasts well, even if they don't do regular self-exams, and know to be on the lookout for lumps. But that's not the only breast symptom that could point to cancer. Redness and thickening of the skin on the breast, which could indicate a very rare but aggressive form of breast cancer, inflammatory breast cancer, also needs to be examined, Linden says. "If you have a rash that persists over weeks, you have to get it evaluated," she says.

Likewise, if the look of a nipple changes, or if you notice discharge (and aren’t breastfeeding), see your doctor. "If it's outgoing normally and turns in," she says, that's not a good sign. "If your nipples are inverted chronically, no big deal." It's the change in appearance that could be a worrisome symptom.

If you have breast changes, expect your doctor to take a careful history, examine the breast, and order tests such as a mammogram, ultrasound, MRI, and perhaps a biopsy.

No. 4: Between-Period Bleeding or Other Unusual Bleeding

'Premenopausal women tend to ignore between-period bleeding," Daly says. They also tend to ignore bleeding from the GI tract, mistakenly thinking it is from their period. But between-period bleeding, especially if you are typically regular, bears checking out, she says. So does bleeding after menopause, as it could be a symptom of endometrial cancer. GI bleeding could be a symptom of colorectal cancer.

Think about what's normal for you, says Debbie Saslow, PhD, director of breast and gynecologic cancer at the American Cancer Society in Atlanta. "If a woman never spots [between periods] and she spots, it's abnormal for her. For someone else, it might not be."

"Endometrial cancer is a common gynecologic cancer," Saslow says. "At least three- quarters who get it have some abnormal bleeding as an early sign."

Your doctor will take a careful history and, depending on the timing of the bleeding and other symptoms, probably order an ultrasound or biopsy.

No. 5: Skin Changes

Most of us know to look for any changes in moles -- a well-known sign of skin cancer. But we should also watch for changes in skin pigmentation, Daly says.

If you suddenly develop bleeding on your skin or excessive scaling, that should be checked, too, she says. It's difficult to say how long is too long to observe skin changes before you go to the doctor, but most experts say not longer than several weeks.

No. 6: Difficulty Swallowing

If you have difficulty swallowing, you may have already changed your diet so chewing isn't so difficult, perhaps turning to soups or liquid foods such as protein shakes.

But that difficulty could be a sign of a GI cancer, such as in the esophagus, says Leonard Lichtenfeld, MD, deputy chief medical officer at the American Cancer Society.

Expect your doctor to take a careful history and order tests such as a chest X-ray or exams of the GI tract.

No. 7: Blood in the Wrong Place

If you notice blood in your urine or your stool, don’t assume it's from a hemorrhoid, says Mishori. "It could be colon cancer."

Expect your doctor to ask questions and perhaps order testing such as a colonoscopy, an exam of the colon to look for cancer.

Seeing blood in the toilet bowl may actually be from the vagina if a woman is menstruating, Mishori says. But if not, it should be checked to rule out bladder or kidney cancer, she says.

Coughing up blood should be evaluated, too. One occasion of blood in the wrong place may not point to anything, Mishori says, but if it happens more than once, go see your doctor.

No. 8: Gnawing Abdominal Pain and Depression

Any woman who's got a pain in the abdomen and is feeling depressed needs a checkup, says Lichtenfeld. Some researchers have found a link between depression and pancreatic cancer, but it's a poorly understood connection.

No. 9: Indigestion

Women who have been pregnant may remember the indigestion that occurred as they gained weight. But indigestion for no apparent reason may be a red flag.

It could be an early clue to cancer of the esophagus, stomach, or throat.

Expect your doctor to take a careful history and ask questions about the indigestion before deciding which tests to order, if any.

No. 10: Mouth Changes

Smokers should be especially alert for any white patches inside the mouth or white spots on the tongue, according to the American Cancer Society. Both can point to a precancerous condition called leukoplakia that can progress to oral cancer.

Ask your dentist or doctor to take a look and decide what should be done next.

No. 11: Pain

As people age they seem to complain more of various aches and pains, but pain, as vague as it may be, can also be an early symptom of some cancers, although most pain complaints are not from cancer.

Pain that persists and is unexplained needs to be checked out. Expect your physician to take a careful history, and based on that information decide what further testing, if any, is needed.

No. 12: Changes in the Lymph Nodes

If you notice a lump or swelling in the lymph nodes under your armpit or in your neck -- or anywhere else -- it could be worrisome, Linden says.

"If you have a lymph node that gets progressively larger, and it's [been] longer than a month, see a doctor," she says. Your doctor will examine you and figure out any associated issues (such as infection) that could explain the lymph node enlargement.If there are none, your doctor will typically order a biopsy.

No. 13: Fever

If you have a fever that isn't explained by influenza or other infection, it could point to cancer. Fevers more often occur after cancer has spread from its original site, but it can also point to early blood cancers such as leukemia or lymphoma, according to the American Cancer Society.

Other cancer symptoms can include jaundice, or a change in the color of your stool.

Expect your doctor to conduct a careful physical exam and take a medical history, and then order tests such as a chest X-ray, CT scan, MRI, or other tests, depending on the findings.

No. 14: Fatigue

Fatigue is another vague symptom that could point to cancer -- as well as a host of other problems. It can set in after the cancer has grown, but it may also occur early in certain cancers, such as leukemia or with some colon or stomach cancers, according to the American Cancer Society.

No. 15: Persistent Cough

Coughs are expected with colds, the flu, allergies, and sometimes are a side effect of medications. But a very prolonged cough -- defined as lasting more than three or four weeks -- should not be ignored, Mishori says.

You would expect your doctor to take a careful history, examine your throat, check out your lung functioning and perhaps order X-rays, especially if you are a smoker.


10 Morning Mood Boosters

Have you ever noticed that what happens during the morning hours often sets the tone for the rest of the day? When things go smoothly, you tend to feel more relaxed and ready to face whatever the day may bring. However, when things get bumpy before youve even managed to get dressed, youre more likely to remain grumpy until bedtime. While some hassles cant be avoided, you can make mood- enhancing decisions during the a.m. hours that will set the stage for the next 16 or so. We spoke with the experts and combed the latest research for 10 pick- me-ups that will have your mood rising like the morning sun. Try one (or all!) of them for a happier and healthier you.

1. Pick one spoil-me task to do.
When you wake up, give yourself 30 seconds to think of at least one nice thing you can do for yourself that day&and then do it. When Alice Domar, PhD, psychologist and coauthor of Live a Little! Breaking the Rules Wont Break Your Health, was in Los Angeles for a book tour one winter, she woke up much earlier than usual. But instead of fretting about lost zzzs, she realized with excitement that she could score some fresh fruit at the nearby farmers market, which wouldve been impossible if she were back home in Boston. That impromptu side trip kept her mood lifted throughout the day.

2. Eat a well-balanced meal. Start your morning with a nutritious mix of complex carbohydrates and proteins that will last you until lunch, such as oatmeal or toast with peanut butter (include a sprinkle of cinnamon, which one study linked to improved mood and alertness, for an extra boost). Other research found that a moderate amount of caffeine (200 mg, or the amount in about two cups of coffee) elevated mood and mental sharpness, so enjoy some joe or black tea with your breakfast.

3. Get some fresh air. Head out for some green exercisephysical activity performed in an outdoor settingeven if you only have a few minutes to spare. Researchers found that people experienced an enhanced mood and higher self-esteem after just five minutes of various types of green exercise, including walking and gardening. The study also found that exercising near water amplified the effects, so if you live near a lake, river or waterfall, even better.

4. Listen to the sounds of nature.
Capture the benefits of the great outdoors, even if you cant get outside, by listening to recorded nature sounds. In a recent study, participants recovered from a stressful situation more quickly when they listened to a recorded combination of running water and bird sounds. Open your window in the morning so you can hear Mother Natures music as you get ready, or invest in an alarm clock that eases you awake with nature sounds.

5. Focus on feeling good. Right after waking up, Robyn McKay, PhD, a psychologist based in Tempe, Arizona, and founder of the Smart Girl-Modern Goddess coaching program, recommends taking five deep breaths and making the decision to feel good for the day. Imagine that, even when you encounter frustrations and surprises, you will remember to breathe and respond mindfullyrather than react mindlesslyto your circumstances, she says. Dr. McKay also suggests that, throughout the day, you take five deep, intentional breaths and remind yourself of your decision to feel good.

6. Drink hot chocolate.
A recent study found that sipping a drink containing cocoa flavonols improved participants moods and levels of alertnesseven as they worked on a series of challenging math problems. So go ahead and savor some hot cocoa made with lowfat or skim milk and dark chocolate. The protein and carbs in the milk will help keep your blood sugar levels stable until lunch, which will help you hold on to your mood momentum.

7. Take a moment to assess yourself.
Dont jump out of bed right when you open your eyes in the morning. Instead, take five minutes to pay attention to your body and notice if you feel any stiffness, then do some light stretching while breathing deeply, suggests Lynn Louise Wonders, LPC, RPT-S, RYT, a psychotherapist and yoga teacher in Marietta, Georgia. She notes, Before racing off to the hundred things on the day's to-do list, it can be tremendously beneficial to claim these five minutes to tune in to your body and your breath. You'll find that you are more present and better equipped to deal with the busyness of the day ahead.

8. Envision the negative. Youve probably heard that gratitude is a mood elevator, but heres a surprising twist to that tactic: Think about a positive event from your lifehow you got your dream job or met your ideal partner, for instanceand then imagine what your life would be like if the event hadnt happened. Though it seems like this would have the opposite effect, it actually improved the mood of one studys participants more so than simply thinking of the positive event itself.

9. Breathe in some mint.
Researchers found that sniffing peppermint enhanced mood and attention while also fighting fatigue. Try keeping a bottle of peppermint essential oil or bag of peppermint tea on your nightstand so you can inhale the positive scents right as you wake up. Another happiness helper is chewing gum, which elevated the moods, alertness and attention spans of another study's participants. Pop a piece of peppermint gum after breakfast for a double- duty perk-up.

10. Smile.
Theres one thing you can do just about anywhere:
Smile. Remember, says Dr. McKay, smiling is a simple way to change your moodand the mood of those around you, too. So spread your good-mood wealth by baring those pearly whites as often as possible in the morning as well as throughout the day.


The Benefits of Donating Your Blood

We all know that Blood Donation is a beneficial social act; we help other people who need blood in a way that is not really troublesome, and we can do it in regular basis if we are eligible and have healthy conditions. Besides that, Blood Donation means that we are participating in public screening program, which helps local health officials to review the general health trends and supports easier monitoring activities concerning disease trends or epidemics in your area. However, do you know that there are other more personal benefits related to donating your blood? They prove that donating blood is not only beneficial for other people, but also you.

The most obvious benefit of donating blood is the free health screening process. Before donating your blood, you will be tested for possible health problems or infectious disease, and officers will tell you if they make you ineligible for Blood Donation. By this screening test, you will get free, basic health information consists of your blood pressure, cholesterol level, hemoglobin level, and possible infectious disease if you really have them. This is of course cannot replace personal health screening process, but at least you will get the information if there is something wrong with your health.

Other health benefits related to Blood Donation is the reduction of cardiovascular disease. High level of iron in the blood has been related to cardiovascular disease, which explains why men and post menopausal women have higher risks in cardiovascular disease than pre-menopausal women (whose menstruations help them cleanse excess iron from their blood). Therefore, regular blood donors have fewer risks of getting cardiovascular disease. However, a person should make sure that the iron level in his or her body is not too low before he or she donates blood, to make sure that the recuperation process after the Blood Donation is smooth.


Should Blood Pressure Be Taken in Both Arms?
Differences in Blood Pressure Between Arms May Signal Blood Vessel Problems

Differences in blood pressure readings taken from the left and right arms may be a sign of heart and blood vessel disease and death risk, according to a new review of recent research.

Researchers found that a difference of 15 points or more in the readings between the left and right arms raised the risk of peripheral vascular disease, a narrowing or blockage of the arteries, by two-and-a-half times.

That same 15 point-difference in systolic readings (the top number in a blood pressure reading) also increased the risk of cerebrovascular disease by 60%. Cerebrovascular disease is associated with thinking problems, such as dementia, and an increased risk of stroke.

Researchers say the results suggest that doctors should routinely compare blood pressure readings from both arms to prevent unnecessary deaths.

Although the practice of taking blood pressure from both arms as a part of heart disease screening has been adopted in Europe, and some guidelines in the U.S. recommend it, American Heart Association spokesman Richard Stein, MD, says it’s not routinely done in the U.S.


Do You Know Which Symptoms Signal a Heart Attack in Women?

Women’s heart attacks can be different than men’s. Learn the warning signs.

Most women know the symptoms of a heart attack -- squeezing chest pain, shortness of breath, nausea. But as it turns out, these symptoms are more typical for males.
Female heart attacks can be quite different -- and it’s important for all women to learn the warning signs.

Rhonda Monroe's story is a cautionary tale. She was mystified when strong pain struck her left breast and left arm. Monroe, who was a 36-year-old mother of three, didn’t know it at the time, but she was having early symptoms of a heart attack. “I certainly wasn’t thinking about my heart because I was young and healthy and had been skinny,” she says.

As the pain moved into her shoulder and back, Monroe took pain relievers and showered for relief. But the next day, she was overwhelmed with nausea, sweating, vomiting, and chest pain. An ambulance rushed her to the emergency room.

Her next hurdle: getting the doctors to believe her. “They didn’t take me seriously,” Monroe says. She didn’t fit the profile of a heart attack patient. The doctors told her she was too young, she was not overweight, and there was no family history of heart disease.

Bedeviled by worsening pain and weakness and convinced she was dying, Monroe returned to the hospital several times over the days that followed, only to come home with no answers. “I was angry and frustrated,” the West Virginia resident says.

Monroe turned to her primary care doctor about her situation and went through more tests at the hospital. Finally, she got her diagnosis -- a week after the initial breast and arm pain. As Monroe recalls, a cardiologist who had previously dismissed her complaints made the diagnosis. “The doctor told me, ‘Well, it’s a good thing you’re persistent because you’re having a heart attack.’”

Heart experts say Monroe’s situation is all too common. Women who have “atypical” symptoms, such as arm or back pain or nausea, might not realize at first that they’re having a heart attack. Then when they do seek emergency care, doctors sometimes misdiagnose them.

Female heart attack symptoms

“Typical” heart attack symptoms include chest pressure or squeezing or stabbing sensations in the center or left side of the chest, says Myung H. Park, MD, FACC, who is director of the Pulmonary Vascular Diseases Program at the University of Maryland Medical Center. “It’s very typical for people to make a fist when they’re describing their symptoms,” she says. “Some people describe it as feeling like a vise encasing their whole chest area.”

But in women, symptoms can be less typical. Although women can experience chest pain or discomfort, many don’t. In a 2003 Circulation study of female heart attack patients, scientists found that during an attack, 43% of the 515 women studied had no “acute chest pain, a ‘hallmark symptom in men.’”

The study noted some common female heart attack symptoms:

• shortness of breath (57.9%)

• weakness (54.8%)

• unusual fatigue (42.9%)

Women had other atypical heart attack symptoms, too:
nausea, dizziness, lower chest discomfort, upper abdominal pressure or discomfort that feels like indigestion, and upper back pain.

Often, women are unaware that these symptoms can be a sign of a heart problem, and blame them on heartburn or indigestion, arthritis, or stress, experts say. If women become short of breath with little exertion, they tell themselves they are out of shape, overworked, or fatigued.

Pay attention to heart attack symptoms

Experts urge women to learn the various heart attack symptoms and to call 911 promptly at the appearance of these signs.

Though most women feel indigestion once in a while, experiencing a cluster of unusual symptoms or a persistent sensation in the chest, back, or stomach never felt before is reason to seek emergency care. Park has seen too many patients wait too long. Because women have lots of competing demands -- jobs, families, and sometimes caregiving duties -- “taking care of themselves, even if they don’t feel well, usually doesn’t make it to the top of the list,” she says.

That can be dangerous, experts say.

“The longer a woman waits before getting treatment to open the blocked blood vessel to the heart, the more damage is done to the heart muscle. If a large amount of the heart muscle is damaged, the woman will be at risk for heart failure,” says Teresa Caulin-Glaser, MD, co-author of The Woman’s Heart: An Owner’s Guide and director of preventive cardiology and research at McConnell Heart Health Center in Columbus, Ohio.

Assert yourself if you have heart attack symptoms

Unfortunately, doctors may also be unfamiliar with atypical symptoms and may overlook a woman’s heart attack, experts tell WebMD. In fact, according to the Circulation study, women have more unrecognized heart attacks than men and are more likely to be “mistakenly diagnosed and discharged from emergency departments.”

Be direct with doctors and other medical staff, Caulin- Glaser says: “Women arriving at the emergency room should state clearly that they think they are having a heart attack and need to be evaluated.”

At a minimum, an immediate evaluation should include being placed on oxygen, being given an aspirin, having blood drawn, having an electrocardiogram performed, and receiving a cardiac monitor within minutes of arrival, she says.

Being bold can save women’s lives, Caulin-Glaser adds. “If the triage nurse or emergency room physician does not take their concerns seriously and begin the immediate evaluation for a heart attack, then all women should tell the emergency room physician they want to be seen by a cardiologist.”

Shortly after Monroe’s heart attack was finally diagnosed, she underwent emergency quadruple bypass surgery. She reports that she didn’t know all the right questions to ask when she first felt symptoms, “but I definitely knew that something was wrong.”

Now she urges other women who believe they might be having a heart attack to advocate for themselves. “Persist. No one knows your body the way you do,” Monroe says. “I really believe the only reason I’m alive today is that I wouldn’t give up, and I wouldn’t relent.”

Learn about your local heart attack resources

One of the most important ways you can advocate for yourself is doing research. “Take action before you ever have a heart attack,” Caulin-Glaser says.

“It’s important for women to do their homework regarding the hospitals in their neighborhoods. Find out which hospitals specialize in heart disease,” she says. Some questions for women to ask: Does the hospital have a cardiac catheterization lab that performs procedures such as angioplasties and stents? Is this “cath lab” available 24 hours, seven days a week? Is there a coronary bypass surgery program? Once a woman arrives in the emergency room with a heart attack, how quickly is she sent to the cath lab? Can doctors open a blocked blood vessel within the acceptable range of 90 minutes?
Are all of the doctors in the emergency department board- certified in emergency medicine


Muscle Spasms, Cramps, and Charley Horse

You could be out for a run or drifting off to sleep when it happens: The muscles of your calf or foot suddenly become hard, tight, and extremely painful. You are having a muscle cramp.

Sometimes called charley horses -- particularly when they are in the calf muscles - - cramps are caused by muscle spasms, involuntary contractions of one or more muscles. In addition to the foot and calf muscles, other muscles prone to spasms include the front and back of the thigh, the hands, arms, abdomen, and muscles along the rib cage.

Almost everyone experiences muscle cramps, which come without warning. What causes them, and what can you do to relieve them?

Possible Causes of Muscle Cramps

Muscle cramps can have many possible causes. They include:
Poor blood circulation in the legs
Overexertion of the calf muscles while exercising
Insufficient stretching before exercise
Exercising in the heat
Muscle fatigue
Dehydration
Magnesium and/or potassium deficiency
Calcium deficiency in pregnant women
Malfunctioning nerves, which could be caused by a problem such as a spinal cord injury or pinched nerve in the neck or back

Muscle cramps can also occur as a side effect of some drugs. Medications that can cause muscle cramps include:
Lasix (furosemide), Microzide (hydrochlorothiazide), and other diuretics ("water pills") used to remove fluid from the body Aricept (donepezil), used to treat Alzheimer's disease Prostigmine (neostigmine), used for myasthenia gravis Procardia (nifedipine), a treatment for angina and high blood pressure Evista (raloxifene), an osteoporosis treatment Brethine (terbutaline), Proventil and Ventolin (albuterol), asthma medications Tasmar (tolcapone), a medication used to treat Parkinson's disease Statin medications for cholesterol such as Crestor (rosuvastatin), Lescol (fluvastatin), Lipitor (atorvastatin), Mevacor (lovastatin), Pravachol (pravastatin), or Zocor (simvastatin).

Treatment of a Muscle Spasm

When muscle cramps occur, there are several things you can do to help ease them, such as massaging, stretching, or icing the muscle, warming the muscle, or taking a bath with Epsom salt.

For a charley horse in the calf or a cramp in the back of the thigh (hamstring), try putting your weight on the affected leg and bending your knee slightly, or sit or lie down with your leg out straight and pull the top of your foot toward your head. For a cramp in the front of the thigh (quadriceps), hold onto a chair to steady yourself and pull your foot back toward your buttock.

To help reduce the risk of cramps in the future, try the following:
Eat more foods high in vitamins and calcium.
Stay well hydrated.
Stretch properly before exercise.

In most cases, self-care measures are sufficient for dealing with muscle cramps, which typically go away within minutes. But if you experience them frequently or for no apparent reason, you should speak to your doctor. They could signal a medical problem that requires treatment.


What Is Restless Legs Syndrome?

Restless legs syndrome (RLS) is a disorder of the part of the nervous system that affects the legs and causes an urge to move them. Because it usually interferes with sleep, it also is considered a sleep disorder.

Symptoms of Restless Legs Syndrome

People with restless legs syndrome have uncomfortable sensations in their legs (and sometimes arms or other parts of the body) and an irresistible urge to move their legs to relieve the sensations. The sensations are difficult to describe: they are an uncomfortable, "itchy," "pins and needles," or "creepy crawly" feeling in the legs. The sensations are usually worse at rest, especially when lying or sitting. The sensations can lead to sleep deprivation and stress.

The severity of RLS symptoms ranges from mild to intolerable. Symptoms can come and go and severity can also vary. The symptoms are generally worse in the evening and at night and less severe in the morning. For some people, symptoms may cause severe nightly sleep disruption that can significantly impair a person's quality of life.

Who Gets Restless Legs Syndrome?

Restless legs syndrome may affect up to 10% of the U.S. population. It affects both sexes but is more common in women and may begin at any age, even in young children. Most people who are affected severely are middle-aged or older.

RLS is often unrecognized or misdiagnosed. In many people it is not diagnosed until 10 to 20 years after symptoms begin. Once correctly diagnosed, RLS can often be treated successfully.

Causes of Restless Legs Syndrome

In most cases, doctors do not know the cause of restless leg syndrome; however, they suspect that genes play a role. About half of people with RLS also have a family member with the condition.

Other factors associated with the development or worsening of restless legs syndrome include:

Chronic diseases. Certain chronic diseases and medical conditions, including iron deficiency, Parkinsons disease, kidney failure, diabetes, and peripheral neuropathy often include symptoms of RLS. Treating these conditions often gives some relief from restless legs symptoms.

Medications. Some types of medications, including antinausea drugs, antipsychotic drugs, some antidepressants, and cold and allergy medications containing antihistamines may worsen symptoms.

Pregnancy. Some women experience RLS during pregnancy, especially in the last trimester. Symptoms usually go away within a month after delivery.

Other factors, including alcohol use and sleep deprivation, may trigger symptoms or make them worse. Improving sleep or eliminating alcohol use in these cases may relieve symptoms.

Diagnosis of Restless Legs Syndrome

There is no medical test to diagnose restless legs syndrome; however, doctors may use blood tests and other exams to rule out other conditions. The diagnosis of restless legs syndrome is based on a patients symptoms and answers to questions concerning family history of similar symptoms, medication use, the presence of other symptoms or medical conditions, or problems with daytime sleepiness.

Treatment for Restless Legs Syndrome

Treatment for RLS is targeted at easing symptoms. In people with mild to moderate restless legs syndrome, lifestyle changes, such as beginning a regular exercise program, establishing regular sleep patterns, and eliminating or decreasing the use of caffeine, alcohol, and tobacco, may be helpful. Treatment of an RLS- associated condition also provides relief of symptoms.

Other non-drug restless legs treatments may include:
Leg massages
Hot baths or heating pads or ice packs applied to the legs Good sleep habits

Medications may be helpful as RLS treatments, but the same drugs are not helpful for everyone. In fact, a drug that relieves symptoms in one person may worsen them in another. In other cases, a drug that works for a while may lose its effectiveness over time.

Drugs used to treat RLS include:
Dopaminergic drugs, which act on the neurotransmitter dopamine in the brain. Pramipexole (Mirapex), rotigotine (Neupro), and ropinirole (Requip) are FDA approved for treatment of moderate to severe RLS. Others, such as levodopa (Larodopa, Dopar) and pergolide (Permax) may also be prescribed. Benzodiazepines, a class of sedative medications, may be used to help with sleep, but they can cause daytime drowsiness.
Narcotic pain relievers may be used for severe pain. Anticonvulsants, or antiseizure drugs, such as carbamazepine (Tegretol) and gabapentin (Neurontin, Horizant).

Although there is no cure for restless legs syndrome, current treatments can help control the condition, decrease symptoms, and improve sleep.