Archive for July, 2016



Doctors use diagnostic medical imaging to find out the possible causes of illness, injury or pain, to help provide an accurate diagnosis. These images include X rays, CAT scans, MRIs, and ultrasound.

X-rays were the very first imaging technique and are still the most commonly used today. X-rays use radiation which produces rays that pass through the body. When striking something dense like bone the image appears white and when going through something hollow like the lungs the image appears black. Muscle and fat appear as shades of gray. Sometime a dye can be introduced into the body before the x-ray, to make certain organs stand out.

X-rays used to be developed on a type of photographic film which needed to be developed and stored. Now the x-ray images can be instantly viewed on a computer screen, eliminating the need for the old film technique. This is a landmark feature because not only are the digital images immediately available, but they can be sent instantly to another source, such as a consulting physician.

X-rays are still excellent for evaluating bones, teeth, the chest (including the lungs and heart), and swallowed opaque items such as coins and most pieces of glass. The digestive tract can be visualized using a dye, such as barium.

Computerized Axial tomography ( CAT/CT ) scans use x-rays with computers to produce 360 degree cross sectional views of the body. These views allow the physician to see details of bony structures, chest, heart and lung problems, cancers, and many other internal organs. A typical exam may take 10-30 minutes.

A CAT scanner is much larger and more complex than an x-ray machine. It is a very expensive piece of equipment and therefore more costly to the patient than an x- ray. In spite of the increased cost, CAT scans can provide the physician with much more information and diagnostic ability than can most x-rays.

CAT scans use substantially more radiation than conventional x-rays and therefore should be used only when absolutely necessary. Don’t hesitate to ask the ordering provider if the scan is absolutely necessary.

Magnetic Resonance Imaging ( MRI ) combines a very powerful magnet along with a computer and radio waves ( no radiation exposure ) to provide detailed, accurate images of bones, internal organs, soft tissue, and other internal body parts. Patients must be carefully screened to insure that they have nothing metallic in or on the body such as rings, necklaces, pace makers, metal implants and some tattoos, because of the use of the magnet.

MRIs often take at least 30 minutes or more and, as with the CAT scan, can take cross sectional images of the body area being studied. The patient needs to lie completely still inside of a large tube, which may be very difficult for a person with claustrophobia. While inside the tube, the MRI machine makes a very loud knocking sound, usually necessitating the need for wearing ear plugs. The MRI is the most expensive of all the imaging techniques.

Ultrasound uses high frequency sound waves to produce images of structures within our bodies. Like MRIs, it uses no radiation and is very safe. A small hand held device is pressed against lubricated skin and moves it around to capture the image. This exam can take from 30 minutes to an hour. Unlike the other imaging techniques, this exam can also be used in a doctor’s office or emergency room making it a very useful diagnostic tool in many circumstances.

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There appears to be an outbreak in our community of a benign (non serious) viral infection caused by a virus called Coxsackie. This infection can manifest itself in two ways.

First it may be seen as hand, foot, and mouth disease. The most common manifestation of this disease in children causes symptoms of fever, runny nose, sore throat, and poor appetite, all beginning about 4-5 days after exposure. Several days after these symptoms occur, a blister-like rash forms in the mouth, on the palms of the hands, and on the bottom of the feet. It takes about a week for the rash to clear up.

The other manifestation of this disease is called herpangina, where along with the fever and fussiness, the mouth has painful blisters, but no involvement of the hands or the feet.

This virus usually occurs in children under 10 years of age, but as it is doing now, it can occasionally occur in middle and high school students as well as young adults. It is spread by direct contact with nose and throat secretions, blisters, and feces of infected people.

Contagiousness begins with the onset of the first symptoms and continues for about 5-7 days. The virus may remain in the stool for several weeks.

There is no known cure for this infection. Because it is caused by a virus it just has to run its course. Treatment of the symptoms includes over the counter pain medications such as Tylenol (acetaminophen) or Advil (ibuprofen). Lifetime immunity may occur, but not always. Pregnant women who have been exposed to this illness should consult with their doctor.

Most of us who treat children with this disease feel that they can return to day care or school when the fever is gone and the child feels well. This usually takes about one week from onset of the first symptoms. Thorough hand washing in general, particularly after changing diapers, is important in limiting the spread of this disease.

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Anemia is a condition where blood lacks an adequate number of hemoglobin rich red blood cells, thus decreasing the amount of oxygen which is so vital to the proper functioning of our bodily tissues. Within each red blood cell is a protein called hemoglobin which is rich in iron and gives blood its red color. Hemoglobin is what enables red blood cells to carry oxygen from the lungs to all tissues of the body and carries carbon dioxide from the tissues back to the lungs.

Anemia is the most common of all blood conditions affecting some three and a half million Americans, especially women, children and the chronically ill. It most commonly causes weakness and fatigue.

There are several main causes of anemia, one of which is due to blood loss, which can be slow and happen over a long period of time. Common causes of this would include problems with the gastrointestinal tract, such as colon and stomach cancer, ulcer disease, gastritis (inflammation of the stomach), and hemorrhoids. Heavy menstruation is another common cause. Rapid blood loss from surgery or injury can also cause anemia and usually necessitates immediate blood transfusion as a life saving measure.

Decreased or faulty production of red blood cells can also contribute to anemia. Some of these common conditions include certain vitamin and iron deficiencies, bone marrow diseases (often associated with some cancers), and chronic kidney and thyroid disease.

Destruction of red blood cells faster than the body can produce them also causes anemia. Such conditions can also be due to chronic liver and kidney disease, as well as inherited diseases such as sickle cell anemia and a blood disorder called Thalassemia.

Some of the more common symptoms of anemia are: fatigue, weakness, pale skin, shortness of breath, and dizziness.

Often, the diagnosis of anemia is made on a routine blood test, where the patient had no obvious symptoms. This can occur because the anemia develops over a very long time allowing the body to compensate for the lack of oxygen to its tissues.

Once the diagnosis is made, further tests will be done to help determine the cause and best treatment for the anemia.

Anemia will be treated according to what has been determined to cause it. Iron supplements for iron deficiency anemia or folic acid and vitamin C supplements may be all that’s necessary to cure some types of anemia. In other cases, curing the underlying disease will help to improve the anemia.

Blood transfusion may be necessary for more severe forms of anemia to rapidly increase the number of functioning red blood cells and help to more quickly alleviate the symptoms of the disease.

See your doctor if you have any of the above mentioned symptoms and expect a complete workup and proper treatment plan.

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