If you live with chronic sinus infections or inflammation, sinusitis, you’ve likely tried many treatments or therapies to get relief. Sometimes, the only option is surgery though and this is proving to be quite a boon for many people who need it. In fact, according to a new study, over 3/4 of patients who needed endoscopic sinus surgery had good results.

Endoscopic surgery involves using very small instruments that reach into the sinuses, allowing surgeons to operate without having to make incisions. These types of surgeries are called minimally invasive surgeries.

Chronic sinusitis or rhinosinusitis (CRS) is defined as a condition where symptoms persist for more than three months, despite medical treatment. Statistics show that it affects about 14% to 16% of the American population. According to the American Academy of Allergy, Asthma & Immunology, CRS is a problem that is the most common chronic illness seen in Americans.

Symptoms of CRS include:

• stuffy nose,
• sinus pain and pressure
• headache
• sneezing

On top of being uncomfortable, CRS can affect the bottom line economically. There is not only the amount of money spent on treatments and therapies, but lost work and productivity.

People who live with CRS often have, believe it or not, more overall body pain than and less social contact than people who live with more serious health issues, such as heart failure, COPD (chronic obstructive pulmonary disease) or back pain.

To understand how effective surgery can be on patients with CRS, researchers examined 302 patients and followed them for about 18 months after. The results of the study were published in the most recent issue of the journal Otolaryngology – Head and Neck Surgery.

What the results showed was that a majority of the patients, between 72% and 76%, showed significant improvements in their quality of life after having the surgery.

Of course, not all patients are candidates for surgery and not all patients can be helped with this type of surgery, but the results are promising for many, particularly patients who are suffering with CRS and who are trying to decide if they should go ahead and have the procedure done.

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Image: MorgueFile.com

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Sinus Surgery Improves Quality of Life

The researchers didn’t, however, find the same results that American researchers found two years earlier, which suggested that Avandia also increased the risk of heart attacks. The Canadian researchers found no difference between patients who took Avandia and another type of medication, Actos (pioglitazone), and the rate of heart attacks among them

The researchers studied 40,000 patients over the age of 65 who took Avandia or Actos. For every 93 patients, there was one more heart “event” or death each year among those who took Avandia.

This being said, this doesn’t mean that Avandia shouldn’t be used to treat type 2 diabetes. The results show that perhaps it shouldn’t be prescribed for people who are in high risk groups or who have heart disease already.

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Photo: StockXchng.com

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Avandia, Diabetes Drug, May Cause Problems

But several research studies not only talk about the benefits of omega-3 fatty acids for prevention of heart disease, they also talk about how beneficial they are in treating it. That’s huge. One study says that omegas “help in therapy for a number of conditions, such as atrial fibrillation, heart attack, atherosclerosis and heart failure.”

When you think about the damage done to your body during heart disease, this news is truly fabulous. It means that it’s never too late to be better heart healthy.

Image: sxc.hu.

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Omega-3 Fatty Acids for Cardiac Treatment

There isn’t one particular issue that helped drop the death rate, but a combination. People are taking the healthy life message more seriously, exercising and eating well. New medications, such as those that lower cholesterol, and treatments immediately after heart attacks and strokes have also helped decrease the death rate.

This study appears in the most recent edition of the Canadian Medical Association Journal .

• The death rate for people hospitalized after suffering a cardiovascular incident showed more modest declines. Post-stroke mortality fell only 8.9 per cent, while heart disease deaths dropped 8.1 per cent.
• Heart attacks dropped 38.1%
• Heart attack deaths dropped 33%
• Strokes dropped 28.2%
• Deaths from heart failure dropped 23.5%
• 4,000 few deaths from heart disease between 1994 and 2004, despite a 14% increase in population

The researchers caution, however, that any gains in heart health may be wiped out by the growing problem of obesity and type 2 diabetes – another major health issue to affect North Americans in general.

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Image: Courtesy of PhotoXpress.com

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Canadian Heart/Stroke Deaths Down

Carradine died in Thailand while working on a movie. This complicates matters in that it has been difficult to get the exact details of what happened. A maid apparently found the actor with a “rope tied around his neck and one around his genitals.”

“It is unclear whether he committed suicide or not, or he died of suffocation or heart failure,” said police Lt. Gen. Worapong Chewprecha.”

I can certainly understand a family wanting to know if their loved one killed himself or died by accident. The family also wants to know if anyone else might have been involved. To make matters worse, a photo of the dead actor was apparently published in a Thai tabloid.

All this makes the grieving process that much more difficult. Until answers are found, it will be difficult for the family to come to terms with this death.

Image: Zuma Press

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Carradine Family Searches for Details

According to the warning issued by Health Canada earlier today:

The use of sibutramine may cause serious side-effects, including cardiovascular reactions, such as increased blood pressure, chest pain, and stroke, in addition to dry mouth, difficulty sleeping and constipation. Sibutramine should only be used under the supervision of a healthcare practitioner.

Sibutramine should not be taken by people who have had a heart attack, coronary artery disease, heart-related chest pain, irregular heart beats, congestive heart failure, a stroke or symptoms of a stroke, in individuals with controlled or poorly controlled high blood pressure, or in patients who are depressed or have a pyschiatric illness. Sibutramine is not recommended for women who are pregnant, breastfeeding or planning to become pregnant.

You may go to the Health Canada website to read more and for contact information should you have any questions or anything to report.

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Photo: iStock

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Canadian Warning: Slim Magic Herbal product

Jeffery Steers, MD, is one such transplant surgeon. After graduating from the University of Kansas Medical Center, School of Medicine with his MD, he went on to do a residency in general surgery, followed by a fellowship at the Mayo Graduate School of Medicine in surgery. His interest in transplantation, specifically liver transplantation, happened when he was looking after people with severe liver disease. “Watching them die, it made me feel helpless that they would die without replacing the organ,” he said. And, once Dr. Steers began participating in liver transplants, he said the changes in the patients were close to miraculous. “Where you had a patient who was dying, who had no hope, and you end up seeing him six or seven months after the transplantation, I don’t even recognize them sometimes. That was when I knew I wanted to do a fellowship in transplantation.

“That’s one of the other exciting things about this: seeing patients who went on to do something amazing things, knowing that you were able to play a small part in helping them get there.”

Dr. Steers is now head of the abdominal transplant program for Aurora Health Care. He’s based at Aurora St. Luke’s Medical Center in Milwaukee. Aurora Health Care is the largest not-for-profit health system in Wisconsin, with 13 hospitals and more than 100 clinics.

Being part of this process of giving back life has been part of Dr. Steers’ life for 20 years now and the changes in the field are making his job easier as patients are able to live better and longer with the care they are receiving. “The general medical care of patients before and after their transplants has dramatically improved – taking care of complications and preventing them from being a fatal problem, especially if we look at heart and lung transplants,” he explained.

With the heart, before there were ventricular assist devices – machines that help the heart to pump or take the place of the heart’s pumping action – it was difficult to manage people who had severe heart disease. Dr. Steers says, “I had one lady in her thirties who had heart failure. In a period of three months’ time, I admitted her four times. Now, there are some medical therapies that made a difference in how their heart works, so we can keep their heart working much better and if it fails, we can move on to ventricular assist devices, which are basically mechanical pumps to help blood through. And, as a last resort, we can do a heart transplant.”

The care has also improved to the point that the doctors and nurses don’t see some of the complications after transplantation that they used to. “We don’t even see the rejections for kidneys, or kidney and pancreas, or liver as we did 15 years ago.”

Who Can/Can’t Donate?

Believe it or not, not many people can’t donate anything at all. Age is definitely not a factor either in many cases. According to Dr. Steers, “I would say that it’s rare for someone not to be able to donate any organ, unless they have a disease that could be transmitted into the recipient. So the common situations are like cancer, that is active. There are several kinds of cancer that are easily passed from donor to recipient so we have to be careful about avoiding those.” Infections, like HIV, may rule out some donors, but not all infections. For instance, recipients who are hepatitis C positive can receive organs from donors who also had hepatitis C.

“Anyone who has seen the before and after would never doubt the value of transplantation.”

Dr. Steers also points out something that many people don’t think about. Donations and transplantations aren’t always about major organs, but also about tissues. Someone might not meet the requirements for organ donations, but their tissues may be usable. Body tissues can be used to repair injuries, heal burn patients, and even provide skin for someone who need breast reconstruction following mastectomies.

Memories

There are stories and patients you never forget in just about any field of medicine and maybe no more so in transplantation. When asked, Dr. Steers’ memory was about a child. “Before I came to Wisconsin, I practiced in Florida. We had several children who had died at amusement parks in Orlando. One particular one, I’ll never forget was a girl, 7 or 8 years old. She and her family were going to one of the amusement parks and it was her first trip there. She was so excited. They were standing at the spot to meet the trolley to take them to the park when she pulled on her moms hand and said, ‘I have a horrible headache’ and she just collapsed. Those are stories you just never forget. You carry those with you forever.”

Decisions

You learn a lot about people when you’re a doctor. In transplantation, people who agree to allow their loved one’s organs to be donated may be asked some tough questions about their loved one’s health, even drug use. Dr. Steers explained, “When they’re donating their loved ones organs, we have to – of course – ask about drug use (IV drugs, cocaine, or anything else). It’s shocking the number of times we’ve asked this and they adamantly deny it, that this would never happen. And, we find their blood is positive for two or three different drugs.”

These situations are worrisome because the transplant doctors must try to ensure the health and viability of the donated organs. It’s not as if they have time to run lengthy tests, so they have to depend on the information they have on hand or can get from family members. “The hardest part is we’re expected to make a perfect decision based on imperfect information a lot of the times.”

The Gift of Donation

Dr. Steers has signed his donor card, as he wishes many others would as well. He said, “Donation is probably, short of sacrificing your own life for someone, the greatest sign of compassion and love that anyone could ever express. At a time when you’re experiencing a tremendous loss, to think of other peoples’ needs and what they can do for someone else, I think that there’s probably not a greater thing. It’s not easy.”

“I wanted to be a doctor since I was 6 years old. There are days when it’s tiring and frustrating, but I don’t regret it for a minute.”

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A transplant surgeon shares his story

1- When was the first successful organ transplant done?

On December 23, 1954, Dr. Joseph E. Murray performed the first successful solid organ transplant at Peter Bent Brigham Hospital in Boston, MA. The kidney was given by Ronald Herrick and transplanted into his identical twin, Richard Herrick.

2- When was the first successful heart transplant?

In 1967, Dr. Christiaan Barnard, in South Africa, performed the first successful heart transplant. That same year, the first successful liver transplant was performed by Dr. Thomas Starzl, of the University of Colorado, Denver, CO. It would take many more years when a heart/lung transplant was successfully completed in 1981, by Dr. Norman Shumway of Standford University Medical Center, in Palo Alto, CA.

3- Has an animal to human ever been done and has it been successful?

In 1992, a baboon’s liver transplanted into man dying of liver failure, at the University of Pittsburgh. He died  70 days after the transplant.

4- Do people waiting for organs really carry around beepers? Wouldn’t they be too sick to go anywhere?

Yes, in most cases, people who are waiting for a transplant carry around a tool that can ensure they are reachable at all times. Usually a beeper, it can go off at any time of the day or night.

While these people are extremely ill, they may be able to get out to get some fresh air, visit friends and family, and so on. In one particular case, in Montreal, there was a college student who carried around an artificial heart of sorts that kept him alive while he was waiting for a transplant.

5- what happens if I’m on a waiting list and an organ is available, but I’ve got a bad cold?

These decisions are made by the transplant team. It isn’t unusual though for surgeons to not go ahead with surgery if the patient is ill. Recovery from surgery in general is tough enough, but add to it the complexity and issues surrounding a transplant and a cold, this could be a very bad combination.

6- If my family donates, are we ever told what happens to the recipients?

Most programs have in place a method for you to communicate with the recipient families. Letters can be exchanged but the letters are reviewed by the coordinators to be sure that the relationship you’re forming with the recipients is a healthy one for both you and the recipient. In many cases, the families have met somewhere down the line when the program coordinators feel that this is a good thing for both parties.

7- If I donate a kidney to someone, can I get money for lost wages and such?

Organs can’t be bought or sold. Specific details about what costs are incurred should be discussed with the transplant coordination or procurement team.

8- Can I designate who would get my loved ones’ organs?

Not usually. The organ donation list is long and people are rated according to how sick they are and how badly they need the transplant. There are other issues as well. The person you may want to receive the organ may not be able to take it because the blood and tissue types may not match, the organs may not be the right size, or there may be other issues that come up, making the transplant impossible.

9- Can I leave my whole body instead of just a few organs?

Absolutely! There is more to donation and transplantation than just the “glamorous” parts (the heart, lungs, etc). Doctors can use the heart valves, body tissues, bones, skin, many parts of your body to help save or improve the lives up between 40 to 50 different people.

10- Where should I go to learn more about organ donation?

You can go to Donate Life to learn more.

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Images: Stock.chnge

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10 FAQs on donation and transplantation

So, what does a pro golfer do if he finds that he’s not quite so strong anymore, he can’t walk as far and he can’t hit the ball as hard – and he’s only 28 years old? This is what happened to Erik Compton, former University of Georgia and Nationwide Tour golfer. He’s not only a heart transplant recipient – he has had two heart transplants. Erik had his first heart transplant when he was 12 years old. He went on to become a pro golfer and dominated the Canadian Tour in 2004.

Now, in 2009, he’s back again, 11 months after he received his second transplant -  his third heart. His most recent competition was last week at the Arnold Palmer Invitation, won by Tiger Woods. Erik will be in Augusta, GA, next week at the Masters Tournament, to receive the Ben Hogan Award. This award is given each year to a golfer who has overcome or is overcoming a physical problem to continue to golf.

But what happened to Erik and why did he need two heart transplants? That’s a good question.

When Erik was 9 years old, he was told that he had an illness called viral cardiomyopathy. Cardiomyopathy is a condition where the heart muscle is inflamed and unable to pump as hard as it should. There are three types of cardiomyopathy, but all three lead to the same thing. Treatment depends on the type of cardiomyopathy, but one in particular can only be helped through a heart transplant.

Erik was fortunate to receive the needed heart when he was 12 and it allowed him to keep living a normal life. Of course, someone who has a new heart has to take many medications to keep the body from rejecting it – the immune system can’t tell that the heart is there because we want it to be, it just sees the heart tissue as something foreign. When asked if he felt different as a teen, Erik responded, “The side effects of the immunosuppressive medication were severe. I was twice my size for the first year post transplant.” That being said, Erik also received the support he needed. “My peers at school were very supportive as the school rallied around my transplant, and the doctors and nurses came to school and explained the side effects. Other kids were sometimes brutally honest and stared.”

The funny thing is, we now know of Erik, the pro golfer with a transplanted heart, but he was also Erik, the advocate, long before. “I have taken an active role with the Transplant Foundation since I was 9 year old,” he explained. “I have been speaking in front of audiences as a “living prop” ever since. I have done appearances in elementary, middle, high school, colleges and clubs, as well as numerous TV appearances and interviews.”

Many people aren’t as lucky as Erik. They wait for years for a heart that never comes.  Why people don’t sign organ donor cards or speak to family members is an important question. Some people are afraid to because of misconceptions or myths. Just three nights ago, on the popular TV show, House, the patient was someone who had been in a cycling accident. The show was shot from the patient’s point of view and his thoughts. We see the patient looking the treating doctor but he’s unable to speak or move. He can hear what the doctor is saying – the doctor says, believing the patient is brain dead, that his heart is great for transplant. And you hear the patient panicking.

Luckily for him, Dr. Gregory House happens to be in the same ER because he’d crashed his motorcycle, so we know that it all ends well. But what struck me as important is that the show has just fed into the fear of people who are scared that they will be considered dead if they’re not.

In real life, it’s not the treating doctor who makes these decisions. Treating doctors are not that callous – they don’t want to lose patients, that’s not what they’re trained to do. A death is often looked at like a failure. Erik suggests that people who are listening to these myths and misconceptions visit Transplant Foundation Inc, United Network for Organ Sharing, and/or Donate Life, among others. Education is knowledge. To make an informed decision, you have to know what you’re facing.

In the end, Erik’s message is a simple one: “I would urge people to sign up to become organ donors. There are over 100,000 Americans currently awaiting a life saving transplant. You can make a difference. One donor can save or enhance the lives of up to 50 individuals.”

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Click here to read more in this organ donation series.

Images courtesy of Transplant Foundation, Miami, FL

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2 heart transplants: 1 Golfer, Erik Compton

When my father came home from the hospital he changed his life style and diet to include more fruits and vegetables very little fat if any and more exercise. Along with all of this he cut his alcohol consumption. Needless to say he lived 25 years longer than expected.

When the heart cannot pump enough blood to the other organs, it is called congestive heart failure. When the blood flow slows going out of the heart, the returning blood through the veins backs up. This change in the flow causes congestion in your tissues.

Some of the symptoms of congestive heart failure are, shortness of breath, swelling of ankles and legs usually, but swelling can take place in other parts of the body as well. Congestive heart failure changes the ability of your kidneys’  to dispose of the fluids and sodium, thus causing the edema.

To find more information on Congestive Heart Failure.

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Congestive Heart Failure