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Monday, September 11, 2017

Non-surgical weight management program at Mayo Clinic

From: Mayo Clinic https://www.youtube.com/watch?v=hj_sZVQpYhk

What’s up with hiccups?

Follow me on Twitter @RobShmerling

If you do an Internet search on “hiccups” you’ll find lots of supposed cures for this annoying but usually fast-passing condition — one site lists 250 of them! One thing you won’t find, though, is a good reason for why we hiccup.

Hiccupping is a more complex reflex than it might seem: a sudden contraction or spasm of the diaphragm and the muscles between the ribs makes you inhale quickly and involuntarily. It ends with “glottic closure” — the space in the throat near the vocal cords snaps shut, producing the typical hiccup sound. The technical term for hiccups (singultus) comes from a Latin word (singult) that means catching your breath while crying, which seems like a pretty good description of the sound of hiccupping.

In most cases hiccups seem to serve no purpose and go away on their own, usually after 30 or more hiccups. Any of the following may cause a short bout of hiccups:

an overly full stomach, due to too much food, too much alcohol, or too much air in the stomach
sudden changes in temperature, either outside your body or internally
smoking cigarettes
excitement, stress, or other heightened emotions.

Making hiccups go away

Of the many, many ways to get rid of hiccups, here are a few you can try that are logical, considering the muscles and tissues involved:

Stimulating the nasopharynx, or the uppermost region of the throat, by pulling on your tongue, swallowing granulated sugar, gargling with water, sipping ice water, drinking from the far side of a glass, or biting on a lemon (not all at once, of course)
Stimulating the skin that covers the spinal nerves near the neck by tapping or rubbing the back of the neck
Stimulating the pharynx, or back of the throat, by gently poking it with a long cotton swab
Interrupting your normal respiratory cycle by holding your breath, breathing into a paper bag (which increases the amount of carbon dioxide you inhale), gasping in fright, or pulling your knees up to your chest and leaning forward
Distracting your mind from the fact that you have the hiccups.

And when hiccups won’t go away…

Occasionally, hiccups just won’t go away. A farmer in Iowa reportedly had hiccups for 60-plus years. Imagine that annoying, interrupting gasp for air coming every few seconds for 60 years! Luckily, even long-lasting hiccups don’t usually signal a medical problem. Very rarely, though, persistent hiccups may be a sign of disease, usually something that causes irritation of one of the nerves in the chest. Examples include laryngitis, goiters (enlargement of the thyroid gland), tumors in the neck, infections near the diaphragm, and hiatal hernia (usually accompanied by heartburn). Hiccups can also be triggered by excess alcohol use, kidney failure, and infections (especially ear infections). Rarer causes are aortic aneurysms and multiple sclerosis.

Persistent hiccups can also cause problems of their own. Think about it — hiccupping can make it difficult to eat, drink, and sleep, all things you need to do to keep healthy.

If you have hiccups that won’t go away on their own, your doctor will look for problems that may be causing them, and then try to fix that problem. Your doctor may also prescribe a medication (there are some that can reduce hiccups) — or tell you to stop taking a particular drug, because there are medications that can set off the hiccups.

Surgery for persistent hiccups is also an option, though one that’s exercised rarely. Two examples are a “nerve block” that stops the phrenic nerve (the major nerve supply for the diaphragm) from sending signals so that the diaphragm stops contracting, and implantation of a pacemaker to make the diaphragm contract in a more rhythmic pattern.

The bottom line

So, to review: we don’t know why we hiccup and we don’t know how to reliably get rid of them. They are as mysterious as they are universal. And it seems that just about everyone has a cure. Here’s my favorite: waiting a few minutes.

The post What’s up with hiccups? appeared first on Harvard Health Blog.

From: Robert H. Shmerling, MD https://www.health.harvard.edu/blog/whats-up-with-hiccups-2017090512150

CRNAs on Why Choose Mayo Clinic

From: Mayo Clinic https://www.youtube.com/watch?v=ayIHZA_Po_M

CRNAs on Growing your career at Mayo

From: Mayo Clinic https://www.youtube.com/watch?v=mCwgh8lV75w

CRNA Career at Mayo Clinic Health System – Laraine Klunder

From: Mayo Clinic https://www.youtube.com/watch?v=FLMgWCUkiTg

CRNA Career at Mayo Clinic – Cara Mann

From: Mayo Clinic https://www.youtube.com/watch?v=_svwhKSdNx0

10 things parents should know about flu shots

Follow me on Twitter @drClaire

We started giving flu shots at our practice last week, and it made me not just happy, but relieved. I know how bad influenza can be and I always feel better when we can start preventing it.

Every year, influenza sickens millions, hospitalizes hundreds of thousands, and kills tens of thousands. This is not your average common cold. While it is especially dangerous for anyone who already has a health problem (such as a weakened immune system, or heart or lung problems), it can be dangerous for healthy people, too.

Even if you don’t get that sick from the flu, aside from missing school or work there is the very real problem that influenza is very contagious — and you can be contagious before you realize that you have the flu. That means you can spread it to others, some of whom may get very sick. Getting immunized helps keep everyone safe: it’s not just about you, it’s about everyone around you. This is especially true for children, who aren’t always great about washing their hands and tend to touch lots of things and people around them.

Here are a few things all parents should know about the flu vaccine:

1. It’s the best way to prevent the flu. Hand washing is crucial, and staying away from sick people helps, but we can’t wash our hands every second, and we can’t always know who is sick. It’s true that the vaccine isn’t 100% effective (the effectiveness varies by year) but it’s your best bet if you don’t want to get sick.

2. You and your children should get it early. The flu season runs from roughly September to March. The sooner you get it, the sooner you are protected. It’s best to get it done before the end of October. This is especially true if your child is young and hasn’t had it before, because…

3. Children who are less than nine years old and getting it for the first time need two doses, a month apart. So getting started early is even more important for them. If your child is younger than nine and only got one dose last season, they will need two doses this season.

4. People with egg allergy can get the flu shot. If the allergy is severe you should talk to your doctor, as in those cases it’s recommended that people be monitored and have medications to treat an allergic reaction at the ready, but it’s unlikely that that anything will happen.

5. There are very few people who shouldn’t get a flu shot. Children less than six months old or who had a definite allergic reaction to the flu shot are the only ones who can’t. Those with a history of Guillain-Barre Syndrome should talk to their doctor, but that’s rare. If a child is significantly ill we will sometimes postpone the shot, but children with a minor illness like a cold can get it.

6. There are some people who really need a flu shot. That includes babies, who are at higher risk of complications, as well as children with asthma, other lung diseases, heart problems, weakened immune systems, or other chronic illnesses. You should call your doctor right away about getting vaccinated if your child falls into one of these groups.

7. There’s no more nasal spray version. Sorry. It didn’t work very well. That means a needle for everyone. But there are lots of ways to ease the pain of the needle, so talk to your doctor.

8. You don’t need to worry about thimerosal. Thimerosal is a preservative that has been used to prevent contamination in vaccines. Some people have worried that it could be linked to autism, but it has been studied carefully and there is no actual evidence that this is true. There is no thimerosal in the vaccines we routinely give to children. There are some formulations of the flu vaccine that contain a tiny amount of thimerosal, but there are also preservative-free formulations available. Either way, your child is safe. Talk to your doctor if you have questions about this.

9. You can’t catch the flu from the flu vaccine. The virus in the vaccine is inactivated. As with any vaccine, there can be side effects; the most common ones are pain at the injection site or fever. But it cannot give you the flu.

10. In many states, older children can get the flu shot at their local pharmacy. We pediatricians like you to get shots at our office, so that we have a record of it and can answer any questions. But we mostly want your child to be vaccinated, and we understand that getting to the office isn’t always easy. Check with your local public health department to see what your options are. If your child does get the flu shot at a pharmacy or flu clinic, please bring documentation to your doctor so that they can put it in their medical record.

If you have any questions about the flu or the flu shot, check out flu.gov.

The post 10 things parents should know about flu shots appeared first on Harvard Health Blog.

From: Claire McCarthy, MD https://www.health.harvard.edu/blog/10-things-parents-should-know-about-flu-shots-2017090412363

Sunday, September 10, 2017

As Hurricane Irma looms, don’t forget senior citizens

Experts offer practical tips to help ensure the safety of this vulnerable population

From: http://www.cbsnews.com/news/hurricane-irma-florida-senior-citizens-safety-tips/

Guinea pigs can harbor a hidden health hazard

Doctors in Europe report three people were hospitalized due to infections from these pets

From: http://www.cbsnews.com/news/guinea-pigs-hidden-health-hazard-chlamydia-caviae-bacteria/

Hurricane Irma poses major challenges for medical care

As Hurricane Irma approaches southeast Florida, the state's health system is mobilizing for a surge in demand for medical care. At least 11 medical facilities in the Florida area are being evacuated and health officials are warning residents to take action now to avoid an emergency. Dr. David Agus joins "CBS This Morning" to offer advice for patients in Irma's path.

From: http://www.cbsnews.com/videos/hurricane-irma-poses-major-challenges-for-medical-care/