Have you ever heard of computerized axial tomography? Probably not, but if we said “CAT scan” that might ring a bell. CAT Scans are one of the many diagnostic tools available at University Hospital and Medical Center. We have found that the more people know about the high tech equipment that we use to provide medical care, the more comfortable they are when they come in as patients. In that spirit we are going to talk about one of our very useful pieces of technology.

Uses for CAT Scans

CAT Scans are diagnostic tools. That means that we use them to evaluate patients to see what particular medical condition is ailing them. CAT Scans can help physicians to diagnose many medical issues and provide clear pictures of medical conditions such as:

• Fractured Bones
• Internal Bleeding
• Cancer
• Blood Clots
• Heart Disease

A CAT Scan lets doctors see what is going on inside the body without using procedures that involve entering the body with medical equipment. This means that CAT Scans are non-invasive diagnostic procedures. Non-invasive procedures generally allow patients to be more comfortable while still providing doctors the information they need to provide medical care. After a CAT Scan has been performed, doctors have a much better idea about what is bothering a patient and where exactly in the body the condition has developed.

How CAT Scans Work

CAT scans use radiation technology to create pictures of the body. It is the same technology that is used in x-rays, just taken up a level. The x-rays penetrate the body and allow the CAT Scan to create a picture that clearly differentiates bone from tissue and organs. The machine moves across the patient’s body or body part and takes multiple individual pictures by sending out x-rays. The individual pictures, sometimes called slices, are then stored in a computer. After the CAT Scan is complete, the computer assembles all of the individual pieces into one very accurate picture of the interior of the body. The image that is produced is then used to identify medical conditions in the patient.

What to Expect

During a CAT scan, the patient must remain very still. If you move you can throw off the final picture and the assessment may need to be done again. You will most likely lay on a table on your stomach, back or side. The machine will move over you as the assessment is performed.

In some cases the doctor will need you to take a “contrast material” before the scan. Contrast material is a substance that, when inside your body, allows the final image that is produced to be clearer. Contrast materials are taken orally, through an enema or intravenously. There is not a significant amount of discomfort associated with contrast materials so don’t worry if your doctor recommends one.

CAT Scans are used in many situations. They can be used in regular or even emergency medical situations because they provide fast, accurate results. They are great medical tools that help doctors make the right diagnoses.

SOURCES
University Hospital and Medical Center Diagnostics
RadiologyInfo.org
Food and Drug Administration
MedLine Plus – National Institute of Health
MedLine Plus – National Institute of Health

Since you are thinking right now, we know that you understand how important it is to meet your brain’s needs. Your brain is surrounded by a liquid called cerebrospinal fluid, or CSF for short. This liquid is very important as it helps to cushion the brain; supply nutrients and remove waste; and keep the equilibrium in the skull balanced as the amount of blood in the head changes. It also helps the brain communicate with the body because this fluid flows back and forth between your skull and your spine. As you can see, CSF plays an important role in your body.

Your body naturally creates CSF, uses it and then absorbs it back into the bloodstream. Sometimes, complications develop that cause too much CSF fluid to accumulate around your brain. This condition is called hydrocephalus. The problem starts because the body becomes unable to absorb enough of the fluid. The nature of how the condition starts defines which type of hydrocephalus you have.

• Non-communicating Hydrocephalus- This type of the disorder happens when there is some sort of block in the ventricular pathway. Ventricular pathways are the “pipes” in the body through which CSF flows. As with any blocked pipe, there will be a buildup of the liquid that it helps travel. In this case, the buildup is in the cranium.
• Communicating Hydrocephalus- This aspect of the disorder happens after the CSF flows through the ventricular pathways. The fluid ends up accumulating because the body cannot absorb it fast enough.

The human body exhibits different symptoms for hydrocephalus, depending upon age. The condition can affect anyone from an infant to an elderly adult. While we warn that medical professionals should be consulted to diagnose a condition such as hydrocephalus, there are some warning signs that you can look for in adults:

• Severe headaches that result in vomiting
• Lack of coordination and balance
• Blurred vision
• Irritability
• Lack of Energy
• Noticeable changes in one’s temperament or personality

If you or someone you know seems to be exhibiting the above symptoms, we recommend that they be diagnosed by a medical professional. If the doctor does in fact agree that they are suffering from hydrocephalus, they will undergo treatment for the disorder. While there is not a cure at this time, there are medical options which can alleviate the problems that the condition causes.

• Shunt- By far the most common treatment is the surgical implantation of a shunt. A shunt is a medical device that is implanted in the head that allows the CSF to be drained to another area of the body where it can be absorbed. A shunt is comprised of :
  • A catheter that serves to drain the CSF
  • A tube that carries the CSF from the cranium to another part of the body, usually in the abdomen.
  • A valve that makes sure that the CSF flow through the catheter, down the tube away from the brain and not in the opposite direction.
• Third Ventriculostomy- This treatment is only available for a small number of hydrocephalus patients. This procedure involves surgeons using a very small camera to get a better look at the third ventricle. (one of the passageways that CSF flows through in the cranium) Once the surgeons have a good look at the third ventricle, they actually create a small hole in it. This hole allows the CSF to drain out.

Medical advances come about every day. In the future there will likely be more treatments for hydrocephalus. In the meantime it is best to take the advice of an expert as to how the condition should best be treated.

If you would like more information On University Hospital and Medical Center or hydrocephalus, feel free to visit us online. If you have other medical questions, we encourage you to call our Consult-A-Nurse® hotline at 1-866-442-2362.

SOURCES

http://www.hydrocephalus.org/facts.htm
https://health.google.com/health/ref/Hydrocephalus
http://www.medicinenet.com/hydrocephalus/page3.htm
http://www.ninds.nih.gov/disorders/hydrocephalus/detail_hydrocephalus.htm
http://uhmchealth.com/

While the human body is a wonder, sometimes medical science can help improve it. Injuries, birth defects, arthritis and wear and tear are all reasons that the body sometimes needs the help of medical science. Artificial joints can be the answer to all of these problems.

Joints are parts of our skeletal structure that help us to move and function. They allow our limbs to bend and are designed to hold the weight our body naturally carries. As they wear out, the body becomes less mobile and often experiences pain. A joint replacement procedure can often combat both problems. Some of the more commonly replaced joints include:

• Hip
• Knee
• Wrist
• Ankle
• Finger
• Elbow

But what exactly are these artificial joints made of? Many patients are concerned with the new “body parts” that they are about to receive and want to know more about the artificial joints. The truth is, every artificial joint is a little different. It depends upon which joint is being replaced and the needs of that particular joint. An artificial knee has to be sturdy because it supports body weight, while fingers and elbows need to be capable of bending regularly. If an artificial joint is not designed for function, then there is no point in incorporating it into medical care. The materials used to make the prosthetic joints are key to both durability and function.

Metal- Metal is one of the most commonly used materials. It is strong, durable and can be shaped to match the human form. Metal portions of the artificial joint are generally the part of the joint that provides stability or helps the body carry weight. Some common types of metal used are:

• stainless steel
• titanium
• chrome
• cobalt alloys.

Plastic- Plastic is another common material. Plastic can also be formed into any shape. In addition to that, many types of plastic are strong yet less dense than metal, providing the artificial joint with flexibility. Plastic parts allow artificial joints to restore mobility because they are more giving than metal. Joints that require lots of movement (fingers, knees and elbows) generally have plastic parts. Another benefit of plastic is that it can be used in combination with metal in a manner that restores mobility but does not create the grinding that two metal parts working together would create.

Ceramic- Ceramics are becoming more popular in some joint replacement procedures, especially hip replacements. Ceramic is strong yet has a smooth finish. This provides durability and reduces the friction caused by different pieces of the joint rubbing together as the body uses the joint for daily activities. Excessive friction can cause complications with artificial joints and sometimes another surgical procedure must be done down the road to fix these problems.

Bone Cement- Some artificial joints are built so that the organic body parts they come into contact with–most often bone– grow into and around them. This holds the artificial joint in place. In other cases artificial joints can be attached to bones with screws or metal pins. When these two options are not employed, a product called bone cement is. Bone cement is a synthetic product made mostly of a chemical called polymethylmetacrylate. It is used to help attach the artificial joint to the surrounding bone. It works more like grout than glue. Bone cement fills in gaps in between the artificial joint and bone and helps to connect the two.

Artificial joints can be a great treatment option for the right patients. They allow problems to be addressed with the body that likely affect the patients’ lives on a daily basis. The technology is still evolving but do not worry, it is established. Artificial joints have been in use for over fifty years and have changed the lives of thousands of patients.

If you would like more information on joint care, visit the University Hospital and Medical Center’s Orthopedic Department online. If you have other medical questions, we encourage you to call our Consult-A-Nurse® hotline at 1-866-442-2362.

We all seem to take having mobility with ease for granted until we do not have it any more. The knee is one of the most important joints in the body when it comes to mobility. Without healthy knees, it is difficult if not impossible to walk. Once your knee begins to deteriorate, you will likely know in a short amount of time. Pain and difficulty moving will be sure fire signs that you have a knee problem. You are not alone, over a half a million knee arthroplastys (knee replacements) are performed each year. Medical advances have made it possible for the procedure to be done in a minimally invasive manner.

What might require you to need a knee replacement?

• A misaligned knee cap
• Arthritis in the knee
• Torn meniscus
• Torn or otherwise damaged knee cartilage

As you can see, multiple issues may cause your knee to need to be replaced. Whether the damage occurred in a sports accident or over time from walking, knee replacement surgery may be the answer to your pain and mobility problems. The procedure only takes between 1 and 3 hours and the new minimally invasive techniques require an incision that is just 6 inches long or less. (compare that to the 10 inch incision that older techniques require) Other benefits of the new style of knee replacement include shorter recovery times and hospital stays.

Before you have the procedure, it is helpful to understand it a little better. Keep in mind that it is a very common procedure and there is nothing to worry about as long as you follow your physician’s instructions.

Steps involved in Knee Arthroscopy

• A local anesthesia will be administered to dull pain.
• A 4 to 6 inch incision will be made.
• A tiny camera is inserted in the leg behind the knee cap which lets the surgeon see what they are working on.
• Saline is pumped into the incision to help limit bleeding and increase the size of the area the surgeon has to work in.
• Once the surgeon knows what they must do, other smaller incisions are made.
• Depending upon the patient, different tools are used to scrape and remove dead or damaged cartilage.
• Synthetic parts made of metal, plastic or ceramic are then inserted to replace removed cartilage or bone.
• The saline is drained and the incisions are stitched

Knee replacements can reduce your pain and increase your range of motion. They have the ability to make walking a lot easier and can get you back into the swing of things. Recovery is relatively easy compared to other procedures as long as you follow your doctor’s orders. Some patients even return to work in as little as a week after surgery.

If you would like more information On University Hospital and Medical Centers Orthopedics Department, feel free to visit us online. If you have other medical questions, we encourage you to call our Consult-A-Nurse® hotline at 1-866-442-2362.

If you have diabetes, you probably know that it’s caused by too much sugar in your bloodstream. What you may not be aware of is that nearly 24 million adults and children in the U.S. have diabetes.

Type 1 diabetes, the less common form of the disease, occurs when your body does not produce the insulin needed to break down glucose in your blood for the cells. It usually is discovered in children and young adults, who must receive insulin shots.

On the other hand, Type 2 diabetes develops when the body needs more insulin than normal to break down the sugar in the blood. This form of diabetes is managed by various means, including medication and lifestyle changes.

Diabetic complications

People with diabetes are at higher risk of heart attack, stroke and high blood pressure than the average person. In addition, diabetes can damage blood vessels and nerves, which can affect circulation in a diabetic’s legs and feet and cause either numbness or a complete lack of feeling.

If a diabetic loses sensation in his legs or feet, he may not notice wounds that form on his legs or feet. Left unattended, these wounds can grow and become infected.

Continued lack of treatment may lead to severe pain, loss of function, and eventually, amputation of the legs or feet. The Amputee Coalition of America reports that over half of all amputations in the U.S. are due to diabetes or related complications. Most diabetic amputations were to the lower limbs.

In 2004, the most current year data was available, approximately 71,000 non-traumatic lower-limb amputations were performed in people with diabetes, according to the American Diabetes Association.

Treating diabetic wounds

Paying close attention to their limbs can help diabetics minimize these complications, especially amputations. If discovered early, diabetic wounds can be treated successfully. Here are some of the treatment options:

• Hyperbaric oxygen therapy: The patient is placed in a hyperbaric oxygen chamber. Wounds are bathed in 100% oxygen, which speeds growth of new tissue and blood vessels.
• Nutrition therapy: Some diabetics do not get proper nutrition, and have vitamin and mineral deficiencies, which can slow healing.
• Compression therapy: This treatment option is appropriate when the patient has ulceration and swelling in the extremities.

UHMC can help

In the Wound Healing Center at UHMC, specially trained physicians, nurses and support staff treat patients with wounds caused by diabetes or related conditions. Our team will work with you to ensure the best possible results.

To learn more about the UHMC wound care program, call Alix Needham, our Wound Care Coordinator, at (954) 724-6474. If you would like a physician referral, contact Consult-A-Nurse^® at 1-866-442-2362, or visit University Hospital and Medical Center online.

External wounds can happen to people of all ages. Often, a wound results from a cut, a fall, or an illness. Sometimes, however, there may not be an obvious reason why someone develops a wound.

A wound is a tear in the skin. Depending on how the person received it, a wound can cause significant blood loss, infection, and loss of use of a limb or organ. Treating an external wound quickly can help speed up the healing process and help prevent complications.

According to the Association for the Advancement of Wound Care, the elderly, people in wheelchairs, anyone with mental or sensory impairment, and those with delicate skin run a higher risk of acquiring external wounds.

Types of external wounds

You are probably familiar with the following bodily wounds:

• Abrasion: This wound is caused by friction, like sliding into home plate during a baseball game.
• Bruise: These are most often caused when a part of the body is bumped or struck. Blood pools underneath the skin, giving it a blue, black or even greenish appearance.
• Cut: Normally straight edged, this kind of wound comes in all sizes. A cut with jagged edges is called a laceration.
• Puncture: This type of wound is caused by a sharp object like a nail, a thorn or a knife. It pierces the skin and creates a hole in the body.

Caring for external wounds

Use common sense when treating wounds. If a wound is minor, clean it, wrap it and put an antibiotic ointment on it to help prevent infection. You should seek medical help if a cut or puncture wound won’t stop bleeding despite applying pressure, if muscle or bone is visible, or if the wound was made by a rusty or unclean object.

If you go to the hospital, you will be asked questions about how you acquired the wound, any health conditions you have, including allergies, and any drugs you are taking.

After pain medication is administered to numb the area, the wound will be examined and cleaned to prevent infection. If the wound is on your hands or feet, the physician will ask you to move them, to see if your fingers or toes flex and respond normally. If not, there may be a lack of circulation or other damage.

The physician could order an x-ray if there is the possibility of a broken bone or some kind of object in the wound. Otherwise, if the wound is deep enough, it will be closed with stitches, and an antiseptic dressing or bandage applied.

The Wound Healing Center at UHMC can treat these types of injuries and many more, including animal and insect bites and diabetic ulcers. If you have questions, contact our Wound Care Coordinator at (954) 724-6454; call Consult-A-Nurse^® at 1-866-442-2362, or visit University Hospital and Medical Center online.

A wound is a break in the skin. For many adults and children, this happens in the form of a dog bite, a fall from a bicycle, or a slip of a kitchen knife.

On the other hand, the elderly can develop wounds as a result of having illnesses like diabetes and peripheral vascular disease (PAD), mobility issues, and being confined to a bed for a long time.

As people age, their skin becomes less supple due to a lack of moisture, and therefore, more vulnerable to outside forces. Elderly people are more susceptible to wounds because their skin becomes thinner, as does the layer of fat underneath. In addition, poor nutrition can slow the healing of an elderly person’s wounds.

Life cycle of a wound

There are generally four stages of a wound, no matter how it is acquired:

• Inflammation: This follows the actual creation of the wound. There is damage to the skin surface, blood vessels and, if serious enough, deep tissue and muscle.
• Proliferation: New cells and blood vessels are forming, which is why many wounds have a pink appearance. Collagen begins to form.
• Remodeling: The skin is renewing itself and strengthening. Collagen production continues.
• Maturation: Epithelial cells, which form the exterior layer of the skin, form and re-create the layer of protection that existed prior to the wound.

Common wounds in the elderly

One type of wound, pressure ulcers, is also referred to as bedsores. These are caused by unrelieved pressure on the skin by a hard object, such as a bone protrusion or a bed. The NCBI says that 70% of all pressure ulcers occur in geriatric patients. A pressure ulcer can be aggravated by incontinence of the bowels or bladder, if the wound has contact with feces and urine.

Other wounds common to older people are vascular ulcers and arterial ulcers, both of which are caused by lack of blood flow (circulation). And if an elderly person has diabetes, he or she is at risk for diabetic ulcers, which can lead to amputation of the lower legs and feet. The NCBI says that 60% of amputations of lower limbs in non-trauma situations are the result of diabetes.

Wound prevention and treatment

There are a number of steps that caregivers and healthcare professionals can take to help reduce wounds in the elderly. These include the following:

• Turn the patient in bed at least once every two hours[KM2] .
• Keep the skin moistened.
• Ensure the patient is receiving proper nutrition.
• Keep pressure off areas in danger of skin breakdown.

Wounds are treated using the following techniques and equipment:

• Cleansing
• Irrigation with saline
• Debridement (removal of dead tissue and/or foreign matter)
• Antibiotics
• Local anesthetic
• Sutures
• Dressings

A growing trend 

As the U.S. population ages, the need for wound care[KM4] will increase, according to the National Center for Biotechnology Information (NCBI).

At the Wound Healing Center, we care for people of all ages who have wounds resulting from animal and insect bites, trauma and illness.

Many wounds common to the elderly are successfully treated. Sometimes they can be healed; in other cases, they can be managed to help the patient improve their quality of life .

If you have questions, please call our Wound Care Coordinator at (954) 724-6474. If you would like a doctor referral, contact Consult-A-Nurse^® at 1-888-256-7723, or visit University Hospital and Medical Center online.

Americans are living longer, and many are staying active well into their later years. As a result, an increasing number of men and women are experiencing bone and joint health issues during their lifetimes.

But it’s not just older folks with arthritis who need orthopedic care. Children can fall and suffer fractures, or have difficulty with walking, balance and coordination due to illness or disease; while teens and younger adults can be seriously injured playing sports or in automobile accidents.

UHMC meeting orthopedic needs

The Orthopedic and Spine Institute at University Hospital and Medical Center can assist people of all ages who have musculoskeletal illnesses or injuries.

Our team includes board-certified orthopedic surgeons and neurosurgeons, orthopedic certified/trained professional nurses, physical therapists and technicians, all of whom strive to help patients achieve the best possible outcomes, whether the patients are undergoing diagnosis, surgery or rehabilitation.

Among the musculoskeletal conditions seen in the Orthopedic and Spine Institute are:

• Joint injuries and disorders
• Joint discomfort
• Fractures
• Back pain
• Neck pain
• Ligament and tendon damage
• Arthritis
• Sports injuries

Fast facts

A lot of people visit orthopedic specialists. Here are some statistics from the American Academy of Orthopedic Surgeons. These are based on 2006 data, the most current available.

• Almost 7 1/2 million physician visits were made because of shoulder ailments.
• Approximately 21 million visits were made to doctor’s offices because of back problems. (This includes more than 8 million visits for lower back problems.)
• Knee problems prompted about 12 million visits to physicians’ offices.

A family feeling

Late last year, the Orthopedic and Spine Institute was given an extensive renovation to make it more inviting and comfortable for patients. The result is that it feels very much like a luxury hotel.

There are private suites with space for a visitor or relative to stay overnight with the patient. There is also a private rehabilitation area for orthopedic and spine patients who are undergoing physical therapy and occupational therapy. And the décor was changed to a more neutral tone, to give the facility a more homelike atmosphere.

If you or a loved one has a musculoskeletal injury or condition, don’t wait to seek treatment. Contact Consult-A-Nurse^® at 1-866-4-HCA-DOCS if you have questions or would like a physician referral, or visit University Hospital and Medical Center online.

When it comes to treating stroke, every moment is precious. A patient’s chances of survival and recovery are best when they receive care within the first three hours after a stroke, because during that time, they can be given treatments that can greatly reduce their chances of brain damage and permanent disability.

Stroke is the third most common form of death in the U.S. Every year in this country, about 700,000 people suffer a stroke. Of these, 500,000 are first strokes and 20,000 are recurrent strokes.

University Hospital and Medical Center is committed to providing patients with the very best possible stroke care, which is why the American Stroke Association recently recognized UHMC with its “Get With The Guidelines” Bronze Performance Achievement Award.

“I am extremely proud of the efforts made by the entire staff here at UHMC, and their dedication to providing the highest standard of care in the treatment of acute stroke and acute coronary syndrome,” says Dr. Kenneth Greenberg, Medical Director of the hospital’s Emergency Department.

“The community should know that the Joint Commission has recognized and certified that UHMC has exceeded the benchmarks in these areas.”

Consistency counts

The award acknowledges the success of University Hospital and Medical Center in implementing a stroke care program that provides patients with treatment that meets nationally-accepted standards and recommendations.

To earn the award, UHMC did the following:

• Consistently followed the “Get With The Guidelines” stroke program for 90 days
• Used medications including the clot-buster tPA, antithrombotics, DVT prophylaxis and cholesterol-reducing drugs
• Employed strategies such as smoking cessation and anticoagulation therapy
• Reached the required 85% compliance level during the 90-day evaluation period

Learn and live

Education is a key element of “Get With The Guidelines”. Patients are taught how to manage their risk factors during the time right after they have had a stroke – when they are most likely to listen to and follow the directions of healthcare professionals.

UHMC provides informative materials to stroke patients when they are discharged from the hospital, customized to their risk profiles. The information is printed in English and Spanish.

Education is an important part of this program because the risk of a second stroke decreases for patients who receive patient information materials while still in the hospital.

Here to help

Should you need it, you can count on University Hospital and Medical Center’s doctors, nurses and technicians for the best possible emergency care. Check out our Stroke Center for information on types of stroke and warning signs.

If you have questions about stroke, or would like a physician referral, contact Consult-A-Nurse^® at 1-866-4-HCA-DOCS, or visit UHMC online.

They may sound similar, but occupational therapy and physical therapy are in fact two very different disciplines.

The role of the occupational therapist is to engage the patient in the important activities of everyday life, such as personal care, interaction with others, work, and education – particularly when such engagement encourages the patient to participate in these activities despite being impaired or limited physically and/or mentally.

On the other hand, physical therapy is the treatment of disease by physical and mechanical means.

Bouncing back

As explained in Medline Plus, recovering from a serious injury, illness or surgery can take some time and require rehabilitation, which often includes:

• Physical therapy to help your strength, mobility and fitness
• Occupational therapy to help you with your daily activities

Where the jobs are

According to the federal Bureau of Labor Statistics, employment of occupational therapists is expected to increase by 26% between now and 2018, much faster than the average for all occupations.

By comparison, BLS predicts employment of physical therapists is expected to increase during the same period by 30%.

Growing need for therapists

Both professions will add more workers to meet the demands of the nation’s growing elderly population, according to BLS. As baby boomers age, they become more likely to suffer serious health conditions such as heart attacks and stroke, and benefit from some type of recuperative therapy.

Also, medical and technological developments will permit a greater percentage of trauma victims and newborns with birth defects to survive, creating an additional demand for rehabilitative care.

Furthermore, growth may result from advances in medical technology and the use of evidence-base practices, which could permit the treatment of an increasing number of disabling conditions that were untreatable in the past, BLS notes.

Then there’s the fact that the federally-mandated Individuals with Disabilities Education Act guarantees that students have access to services from physical therapists and other therapeutic and rehabilitative services.

Therapy Services

Here at University Hospital and Medical Center, we help patients achieve the highest level of physical mobility and functioning possible.

Therapists in our Rehabilitation Center carefully evaluate patients and devise treatment plans to meet their specific needs, whether they are for physical, occupational or speech therapy. The rehab team specializes in the treatment of stroke, arthritis, orthopedic conditions, cardiac disease, swallowing disorders and neurological impairment.

Please note that we require a doctor’s prescription prior to the start of Rehabilitation Center therapy.

Not sure if you could benefit from physical or occupational therapy? Contact Consult-A-Nurse^® at 1-866-4-HCA-DOCS, or visit us online.

Sources:

http://www.nlm.nih.gov/medlineplus/rehabilitation.html

http://www.bls.gov/oco/ocos078.htm

http://www.uhmchealth.com/CustomPage.asp?guidCustomContentID=10322AB6-A8F9-4CAC-9394-59DFACADD9D3

http://www.uhmchealth.com/