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3 Reasons Why Most Wounds Won’t Heal

There are several connected causes for non-healing wounds.

According to figures from the U.S. Centers for Disease Control and Prevention, chronic wounds–injuries that have yet to heal after six weeks–affect some 5.7 American adults. There are many reasons for these non-healing wounds, and understanding each cause is vital to implementing the most effective wound care regimen possible.

 

Here are three of the more frequent explanations for why many wounds just won’t heal:

 

Poor circulation

As Johns Hopkins Medical School pointed out, blood is perhaps the most important component of the entire wound healing process. When an injury occurs, it’s the blood that transports cells to the wound site, which begin rebuilding veins and other important tissue structures.

When you have poor circulation, blood cannot move around as quickly, and as a result, wounds take much longer to begin healing. According to Healthline, there are several medical conditions that cause poor circulation, including varicose veins, obesity and chronic ailments like diabetes, peripheral artery disease and Raynaud’s disease. Fortunately, there are just as many ways to improve circulation, like frequent exercise and elevating wounds or limbs in general.

 

Fluid buildup

According to the Mayo Clinic, edema occurs when fluid leaks from blood vessels, causing these secretions to accumulate in nearby tissue. The result is a large bump or nodule that is painful and sometimes prone to infection. Edema is usually the result of a number of medications, including several drug therapies geared toward diabetes. Edema can also occur due to a reaction to steroids, anti-inflammatory drugs and even estrogen supplements.

Other than being uncomfortable, edema can wreak havoc on the wound-healing process. Due to fluid buildup, the blood vessels and tissue become rigid and immovable, greatly restricting blood flow. This compression cycle can also kill skin patches, which could lead to ulcers.


Infection

As a rule, infections can be quite traumatic to the host. Perhaps the biggest effect–one that might surprise some people–is that infections can all but halt the wound healing process. According to St. Luke’s Clinic, an average infection has a number of methods for preventing healthy tissue regeneration.

For instance, some infections can extend the length of the inflammatory phase, and that can halt the subsequent stages of wound healing. Additionally, there are strains that can interfere with clotting mechanisms, which in turn causes wounds to continue bleeding.

According to a 2010 study from the Journal of Dental Research, the two most damaging strains of bacteria are pseudomonas aeruginosa and staphylococcus.

When it comes to handling chronic wounds, patients need advanced wound care products to prevent infection and create a sustainable healing environment; that’s why so many patients turn to Advanced Tissue when they experience most chronic wounds.

As the nation’s leader in the delivery of specialized wound care supplies, Advanced Tissue ships supplies to individuals at home and in long-term care facilities.

 


Reference: https://advancedtissue.com/2016/02/3-reasons-why-most-wounds-wont-heal/

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Anesthesia, Microcirculation, and Wound Repair in Aging

Abstract

Age-related changes in skin contribute to poor wound healing after surgical procedures. Changes in skin with age include a decline in thickness and composition, a decrease in the number of most cell types, and diminished microcirculation, the process that provides tissue perfusion, fluid homeostasis, and delivery of oxygen and other nutrients. It also controls temperature and the inflammatory response. Surgical incisions cause further disruption of the microvasculature of aged skin; however, perioperative management can be modified to minimize damage to aged tissues. Judicious use of fluids, maintenance of normal body temperature, pain control, and increased tissue oxygen tension are examples of adjustable variables that support microcirculation. Anesthetic agents influence microcirculation in a number of ways, including cardiac output, arterial pressure, and local microvascular changes. The authors examined the role of anesthetic management in optimizing microcirculation and potentially improving postoperative wound repair in older persons.

Aged skin is at increased risk of poor postoperative wound healing. Changes in the cutaneous microcirculation with aging contribute to this risk. This review examines the role of anesthesia management in microcirculatory function.

SURGICAL wound repair is a major problem in the older population, who are at increased risk of wound dehiscence and infection. As a specific example, surgical site infections (SSIs) are common (approximately 500,000 cases annually in the United States), lead to worse patient outcome (patients who develop SSI are twice as likely to die), and are an enormous economic burden (1–10 billion dollars annually). Many factors contribute to age-related changes in skin5 and subsequent vulnerability to impaired wound healing and infection. Changes in skin with age (fig. 1) include a decline in epidermal and dermal thickness and composition, as well as a decrease in the number of most resident cell types. The dermal–epidermal junction is flattened and the microcirculation is diminished. The latter is defined as blood flow through arterioles, capillaries, and venules and is the key system that affects the entire skin surface. In the aging patient, the microcirculation in the skin is reduced by 40% between the ages of 20 and 70 yr. The microcirculation provides tissue perfusion, fluid hemostasis, and delivery of oxygen and other nutrients. It also controls temperature and the inflammatory response. Surgical incisions cause disruption of the microcirculation in the skin as manifested by local edema resulting from vasodilation and increased vascular permeability.

Fig. 1.
Numerous changes in skin with age contribute to impaired wound healing.

 

Perioperative management can be modified to optimize the microcirculation. Measures that support the microcirculation include careful use of fluids, normothermia, pain control, and smoking cessation. Factors that can be influenced by intraoperative management (judicious use of fluids, maintenance of normal body temperature, pain control, and increased tissue oxygen tension) have been suggested to be beneficial as well. Most anesthetic agents also influence the microcirculation: a reduction in cardiac output and arterial pressure decreases flow in the microcirculation, whereas anesthetic-induced local microvascular changes and vasodilatation can increase perfusion. Optimization of these variables plays an important role in enhancing the microcirculation in all patients, but is especially relevant if modifications could improve postoperative wound healing in the older population.

In this review, we will use skin as a representative organ to describe age-related changes that negatively affect the microcirculation and have subsequent impacts on wound healing and the incidence of postoperative infection. We will then examine the role of anesthesia management in minimizing detrimental effects on the microcirculation. A greater understanding of these variables could promote improvements that lead to better outcomes with respect to wound repair in older patients.

Summary of Wound Repair and Aging

It has been nearly a century since it was noted that the rate of cutaneous scar formation after a wound is inversely related to the age of the patient. Four decades ago, it was observed that older age was associated with an increased risk of postoperative disruption of the surgical wound, leading to higher mortality. Recent data suggest that in patients older than 65 yr, development of SSI is associated with a two-fold increase in cost and a staggering four-fold increase in mortality.

Wound healing ensues via a sequential chain of events (with variable overlap) that includes inflammation, tissue formation, and remodeling (fig. 2). Circulating factors have a pivotal role in each of these phases. Accordingly, as we will discuss below, immediate changes in the microcirculation influence each stages of the wound-healing response in aging. As human data is lacking, we have taken data from established animal models of aging. Although animal models are not uniformly predictive of responses in human tissues, several animal models of wound healing are generally accepted.

Fig. 2.

The stages of wound healing are a sequential chain of events that include: (A) inflammation, (B) proliferation and granulation tissue formation, and (C) extracellular matrix (ECM) deposition and tissue remodeling. PDGF = platelet-derived growth factor; TGF-β1 = transforming growth factor-β1; TNF-α = tumor necrosis factor-α; VEGF = vascular endothelial growth factor.

 

Summary

Nearly every anesthesiologist who provides care to adults will participate in the care of geriatric patients. A growing older population is undergoing surgical procedures that are increasing in number and complexity. Poor healing of surgical wounds is a major cause of morbidity, mortality, and substantial economic burden. Wound healing is dependent on the microcirculation that supplies the incision area. Measures that support the microcirculation during the perioperative period have a profound effect on wound healing. Some measures such as maintenance of normal body temperature and control of postoperative pain are supported by ample evidence and have been implemented in routine clinical care. Other measures, for example, the choice of anesthesia technique and use of opioids are supported by basic research but need further clinical studies. A better understanding of the effect of aging and anesthesia on the microcirculation can potentially assist in improving postoperative wound repair, thereby benefiting a growing older population.

 

The Surgical Context of Wound Repair and Aging

Measures that support the microcirculation improve wound repair, thereby reducing the risk of postoperative dehiscence and infection.52General preoperative measures such as smoking cessation and optimal management of comorbid medical conditions have been reviewed in other contexts.53,54 For the purpose of this review, we will focus on interventions in the perioperative setting.

Oxygen Administration

Wound healing is dependent upon adequate levels of oxygen.55 Oxygen interacts with growth factor signaling and regulates numerous transduction pathways necessary for cell proliferation and migration.56 It is also an indispensable factor for oxidative killing of microbes.57 Consequently, the effects of oxygen tension on the outcome of surgical wounds have been best studied in the context of postoperative infection. Resistance to surgical wound infection is presumed to be oxygen dependent—with low oxygen tension viewed as a predictor of the development of infection,56 particularly when subcutaneous tissue oxygenation (measured by a polarographic electrode) decreases to less than 40 mmHg.58

In two recent meta-analyses, one found that perioperative supplemental oxygen therapy exerts a significant beneficial effect on the prevention of SSIs,59 whereas the other suggested a benefit only for specific subpopulations.60 Although most authors suggest that supplemental oxygen during surgery is associated with a reduction in infection risk,61,62 others propose it may be associated with an increased incidence of postoperative wound infection.63Notably, in the latter report, the sample size was small and there was a difference in the baseline characteristics of the groups. A prospective trial randomizing patients to either 30 or 80% supplemental oxygen during and 2 h after surgery did not find any difference in several outcome measures including death, pulmonary complications, and wound healing.64 Of note, the administration of oxygen to aged subjects may be limited by the finding that although arterial oxygen tension did not decrease with age, there was reduced steady-state transfer of carbon monoxide in the lungs.65 This indicates that oxygen transport could be diffusion-limited in older subjects, especially when oxygen consumption is increased. Furthermore, longitudinal studies of five healthy men over 3 decades showed impaired efficiency of maximal peripheral oxygen extraction,66 suggesting that tissue oxygen uptake is reduced in the aged subjects.67 This likely reflects a decrease in the number of capillaries as well as a reduction in mitochondrial enzyme activity.68 Animal models (rabbit69 and mouse69,70 ) have suggested that aging and ischemia have an additive effect on disruption of wound healing. Consequently, the potential benefit of increasing tissue oxygen tension during surgical wound repair in older patients should be further evaluated.

 

 

Reference: http://anesthesiology.pubs.asahq.org/article.aspx?articleid=1917910

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Blood, Oxygen & Wound Healing: How It Works

Most of us take our natural wound-healing abilities for granted. You scrape your knee, clean it and wait for it to heal on its own. It seems pretty simple, right? Not exactly. The truth is, what goes on underneath that Band-Aid is a complex process that requires healthy blood flow to deliver the oxygen and nutrients necessary to heal, and if this process is interrupted, it can slow or prevent healing entirely.

 

Wound-Healing Process

Every wound goes through a continuous repair and healing process, which typically takes a few weeks to complete. For a wound to heal properly, the four wound-healing stages must be completed:

Stage 1: Hemostasis

Hemostasis happens immediately after an injury to skin causes bleeding. Your blood vessels constrict and reduce the flow of the blood to the injury site. Blood clots form within the injured blood vessels to prevent further blood loss.

Stage 2: Inflammation

Once a blood clot has closed the wound, the surrounding blood vessels are able to open up to deliver fresh nutrients and oxygen into the wound for healing. This process triggers macrophage, a white blood cell, to enter the wound, fight infection, oversee the repair process and send messengers, called growth factors, needed to heal the wound. Macrophage is the clear fluid you may see in or around the wound.

Stage 3: Proliferation

Proliferation is the growth and rebuilding phase, where blood cells arrive to help build new tissue to replace the tissue and cellular elements that were damaged during the process of wounding the skin. At this point, your body’s cells will produce a protein called collagen, which acts like scaffolding, to support the repair process.

Stage 4: Remodeling

The last wound-healing stage is remodeling, whereby the inflammation is gradually resolved and the collagen is deposited. New tissue takes the form of the original tissue and fills the area of the wound. We call this scar tissue, and while the wound may appear to have healed, it does not have the same strength as the normal tissue previously had. It may take several months to a year for the healed wound to gain full strength.

 

When Wound Healing Is Interrupted

For healthy adults, the four wound-healing stages progress naturally. For others, however, certain factors – especially poor circulation – can interrupt the body’s natural healing process, causing a wound to heal much more slowly, if at all. These wounds are called chronic wounds (wounds that do not heal in six to eight weeks despite normal treatment) and are most common in people with diabetes, high blood pressure, obesity and other vascular diseases. If not cared for or treated by a doctor, chronic wounds can lead to pain, infection, disability and possibly amputation of the affected limb.

 

Tips for Improving Circulation

The oxygen and nutrients that new blood carries to the wound are crucial to the healing process. By improving circulation and blood flow, more healing nutrients and oxygen reach the cells.

 

Eat a healthy diet.

A healthy diet promotes proper blood flow and can even speed up the wound-healing process. Eat the following power foods to make sure you are getting the right nutrients for optimal circulation and wound healing:

Protein: Lean meats, low-sodium beans, low-fat milk and yogurt, tofu, soy nuts and soy products

Vitamin C: Citrus fruits and juices, strawberries, tomatoes, spinach, potatoes, peppers and cruciferous vegetables

Vitamin A: Dark green, leafy vegetables; orange or yellow vegetables; cantaloupe and fortified cereals or dairy products

Zinc: Red meats, seafood and fortified cereals

 

Quit smoking.

There are a number of reasons to quit smoking and better your health. Beyond increasing risk for cancer and heart disease, tobacco can cause poor circulation and delayed wound healing. If you smoke, consult your doctor to devise a smoking cessation plan.

 

Stay hydrated.

Dehydration and poor hydration can greatly reduce circulation of blood and body fluids. Dehydration can also lead to poor oxygen perfusion, a failure to deliver essential nutrients to the wound surface and draining inefficiency. Drink eight 8-ounce glasses of water each day to improve blood flow and wound-healing abilities.

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10 Things You Should Know About DVT

One of the most important things to talk about in relation to DVT, is varicose veins.

Deep Vein Thrombosis (DVT) is the result of blood clotting whilst it is still inside the blood vessel. In the majority of cases, painful swelling in the leg will be experienced as a ‘warning sign’ however, this is not always the case and, in some instances, no obvious symptoms will be presented.

In short, a DVT is a clot in the deep vein

Despite the fact that many people could be at risk of developing DVT, there is still much uncertainty as to how to prevent the condition from occurring, and a general lack of awareness around the importance of speaking medical treatment if you think you are suffering from the condition.

Here, to help provide some clarity on the condition, leading vascular specialist Professor Mark Whiteley of The Whiteley Clinic, shares the ten key things everyone should know:

 

DVT CAN OCCUR FOR NO APPARENT REASON

Professor Whiteley says: “Although there are some recognised risk factors for DVT, the condition can also effect people for no apparent reason. If there is a clear reason why DVT has occurred, we call it “provoked” DVT. If there is no known reason for DVT then we call it an “unprovoked” case.

Studies have shown that over 80% of hospital patients will experience a minor DVT. One in 12 people who fly long haul, over 7 hours, will also experience a minor case. However, in most cases these cases will resolve themselves and will not cause the individual any lasting problems. In fact, many people may not even know they’ve had a problem.

However, we must be careful not to trivialise DVT as some individuals will experience much more serious symptoms – such as aching/pain and swelling, clots to the lung (called pulmonary embolism) , and/or scarring of the deep vein with long-term deterioration of the leg post thrombotic syndrome (PTS).”

 

DVT PRESENTS A NUMBER OF SYMPTOMS

Professor Whiteley says: “Although in some cases there will be no symptoms associated with DVT, in others there will be some distinct warning signs. These can include: pain/swelling/tenderness in the leg (usually in the calf), a heavy aching feeling, warm skin around the affected area, or a redness to the skin. If anyone is concerned that they may be experiencing any of these symptoms, and they become breathless or experience chest pain, then they should seek medical attention immediately.”

 

PREGNANCY INCREASES YOUR RISK OF A DVT

Professor Whiteley says: “Pregnancy can increase the risks of DVT, particularly at the time of delivery. A normal adult has approximately 5L of blood. However, pregnant women increase their blood volume to 7L at the end of pregnancy. This is because women lose blood whilst giving birth and so the body produces more to keep at a safe level. Not only do women have extra blood, their body also adapts to clot blood quicker after they have given birth to stop haemorrhages.

Unfortunately, the downside of this is that it increases the risk of DVT. If a woman is pregnant and has varicose veins, then the risk is increased even more so.

 

COMPRESSION STOCKINGS ARE KEY FOR PREVENTION

Professor Whiteley says: “Wear properly measured and fitted graduated compression stockings if you are ever in a position where you cannot move easily such as on a long flight, long car journey, long coach journey etc.

 

VARICOSE VEINS ARE A SERIOUS FACTOR

Professor Whiteley says: “One of the most important things to talk about in relation to DVT, is varicose veins. Varicose veins occur when the flow of blood within a vein changes. Blood can fall backwards down your veins with gravity if the valves are not working properly – stretching the vein walls as a result. With the flow of blood changing, and the vein wall changing, this is serious potential for clots forming in the veins.

When a clot forms in a varicose vein, it is called “phlebitis”. Since 2012, it has been known that everyone with phlebitis should have a duplex scan for the following reason. If the clot is small and in a varicose vein a long way from the deep veins, then it can be treated safely with aspirin and support stockings. However, if it is within 5 cm of a deep vein, there is a risk of it causing a clot on the lung (pulmonary embolism). Of course, having varicose veins treated properly by the new endovenous techniques will stop the risks of phlebitis and any other associated problems.”

 

POOR LIFESTYLE CAN INCREASE YOUR RISK

Professor Whiteley says: “Other known factors for developing DVT are malignancy, immobility, major surgery, dehydration, smoking (particularly if combined with oral contraceptive pill) and a family history of getting DVTs (called thrombophilia).”

 

A SLOW BLOOD FLOW IS CRITICAL

Professor Whiteley says: “In short, a DVT is a clot in the deep vein. Clots form because of one or more of three main reasons – changes in the composition of the blood, changes in the flow of blood, or changes in the vein wall. Any one of these, or combination of these, can increase the risk of a deep vein thrombosis.”

 

DVT CAN BE FATAL

Professor Whiteley says: “Deep vein thrombosis (DVT) is a diagnosis that will cause huge concern for many patients. However, as with many medical conditions, DVT can affect people in different ways. DVTs can be tiny, and of no significance, or can be huge and can be life threatening. Of course between these two extremes, there is also a whole scale. A duplex ultrasound scan will be able to diagnose a DVT and also assess how severe it is.

The risks associated with DVT are reduced both in the short term (clots to the lung) and in the long term (post thrombotic syndrome-swollen and discoloured leg with or without leg ulceration) if the DVT is diagnosed early and treated aggressively with anticoagulation.”

If DVT is not treated, around one in 10 people will develop a pulmonary embolism. This is a serious condition which can cause chest pain, sudden collapse and/or either gradual or sudden breathlessness.

 

EXERCISE IS KEY FOR RECOVERY

Professor Whiteley says: “People undergoing major surgery nowadays get blood thinners and support stockings to try and reduce the risk of DVT. Physiotherapists also try to mobilise patient as soon as possible after such operations. Many Surgeons today also prefer local anaesthetic procedures so that their patients can “walk in, walk out”, and keep mobile. This new “ambulatory” surgery performed in local anaesthetic clinics dramatically reduces risks of deep vein thrombosis.

Anything that increases the flow of blood in the veins will reduce the risk of clots, and therefore reduce the risk of DVT. Exercise and movement, particularly walking, is so important. Compression stockings, particularly if properly fitted, have been shown to reduce the risk of DVT but this is markedly enhanced by movement of walking. Those who cannot walk or move often require anticoagulation injections or tablets.”

 

THERE ARE MANY WAYS TO PREVENT A DVT

Professor Whiteley says: “Keep hydrated, keep active and mobile – particularly through lots of walking. Treat varicose veins as quickly as possible with an endovenous technique, under local anaesthetic, to reduce risk of DVTs occurring.”

 

Reference: https://www.femalefirst.co.uk/health/10-things-you-should-know-about-dvt-1146974.html

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Being mindful of symptoms

LEWISTOWN–Dr. Maya Lichtenstein, neurologist at Geisinger-Lewistown Hospital, said that there are a myriad of potential symptoms that could be signs of a stroke. “Any sudden changes,” said Lichtenstein, “go the E.R.”

A stroke, according to Liechtenstein, is either the result of not enough blood flow to the brain, plaque in the blood vessels or heart, each resulting in a clot, or a hemorragic bleed, resulting in a bursted blood vessel in the brain. Classic symptoms of a stroke include numbness, tingling, weakness on one side of the body and changes in speech, but other sudden changes in in understanding language, vision, vertigo or clumsiness can also be symptomatic.

“It depends on what part of the brain is damaged,” said Lichtenstein.

Treatment options for a stroke vary, depending on the type of stroke.

“If you get seen fast enough,” said Lichtenstein, for a clot, a “clot-busting medication, a form of blood thinner” can be administered via I.V. A thrombectomy, a procedure, not an operation, said Lichtenstein, is another treatment option, similar to a cardiac catheterization. A bleeding stroke often leads to lowering the patient’s blood pressure and surgically relieving pressure on the brain. Taking aspirin can also treat a stroke.

Post-stroke, Liechtenstein said that rehabilitation is important, including physical, occupational, speech, and cognitive therapies. “Aggressive therapy can continue to improve people’s symptoms,” said Lichtenstein. “Everyone thinks they’re better if they can move their arms and legs.” Lichtenstein also encourages stroke patients to be aware of their mood and possible depression, encouraging them to accept all the help available.

To avoid a stroke, Liechtenstein said patients should see their doctors regularly for preventive care and that leading a healthy lifestyle is the key, including regular exercise to keep up the heart rate and eating a diet rich in fresh fruit and vegetables, lean proteins and whole grains. Lichtenstein also encourages patients to keep control of their vascular issues, such as high blood pressure and diabetes, as well as to quit smoking, if they smoke.

 

Reference: http://www.lewistownsentinel.com/news/local-news/2018/05/being-mindful-of-symptoms/

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8 Warning Signs of Poor Blood Circulation

Poor blood circulation is the start of numerous other ailments.

What causes poor blood circulation?

Low blood circulation is caused by different underlying conditions. The most common ones are atherosclerosis (“hardening of the arteries) and peripheral artery disease (PAD).

If you experience symptoms of blood circulation problems, consult your physician right away. Poor circulation can lead to heart attack, stroke and even death.

What are the signs of poor blood circulation?

Symptoms of poor blood circulation mostly occur in the hands, feet, arms, and legs. Here are 8 signs to look out for…

  1. Leg Pain While Walking

A common symptom of poor blood circulation is pain or cramping of your leg or hip muscles. This is felt while walking, climbing stairs or another similar physical activity. This is a condition called intermittent claudication, which is a sign of PAD.

  1. Numbness and Weakness

Your arms or legs may feel weak or numb. This can happen while you are moving, or even sitting still.

If these symptoms in your arms and legs come about suddenly and are accompanied by impaired or slurred speech and drooping facial muscles, you may have low blood circulation to your brain due to atherosclerosis.

Poor circulation in the arteries which supply blood to the brain can cause a stroke.

  1. Coldness and Swelling

If your feet, hands or lower legs feel cold all the time for no apparent reason – it is a sign of poor blood circulation.

Low blood circulation due to PAD or atherosclerosis tends to produce coldness in one foot, hand or leg more than the other. You could also notice swelling in your extremities due to poor circulation, particularly in your legs and feet.

  1. Non-healing Sores

Sores on your feet or legs that don’t seem to heal are a common sign. You may also notice that ulcers or infections in your legs and feet heal very slowly.

You may also notice that you’re losing hair on your legs and feet or that your hair is growing slower than normal. Your toenails may grow slowly as well.

  1. Changes in Skin Colour

Poor circulation can cause your skin in your arms, hands, legs and feet to change colour. You may notice that your skin looks “shiny”.

Your legs and feet may turn pale or bluish in colour, due to the poor blood and oxygen delivery to your extremities.

  1. Weak Pulse in Your Legs

Poor blood circulation due to atherosclerosis or PAD can cause your pulse to become weak in your feet or legs.

When the pulse in your limbs is weak or absent, this means that there is little or no blood circulation to these areas.

The most common method that doctors use to determine blood flow problems is to check your pulse in the leg and groin areas.

  1. Chest Pain

Chest pain or angina, and other symptoms of a heart attack are signs of poor blood circulation in the arteries to your heart.

This may be a sign of atherosclerosis in these arteries. If you have chest pain, you should see your doctor right away to prevent a potentially life-threatening medical problem.

  1. Erectile Dysfunction

If you’re a man, experiencing erectile dysfunction can be a sign of low blood circulation.

Erectile problems can indicate poor blood flow to your groin and lower extremities due to one or more blocked, clogged, or narrowed arteries.

D’OXYVA (deoxyhemoglobin vasodilator) delivers the highest possible concentration of CO2 and has been clinically studied to SIGNIFICANTLY INCREASE BLOOD FLOW volume in the microcirculatory system.

In short, based on current leading neurology, immunology, microvascular, and cellular oxygenation science, D’OXYVA is leading the field by quickly targeting to:

Significantly lower the risk of diabetes and cardiovascular complications

Provide complete healing of difficult wounds together with major pain relief and improved quality of life:

  • Detoxify the skin and body
  • Improve sleep
  • Stamina and skin health
  • Reduce inflammation
  • And much more for all kinds of people
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Diabetes – Understanding a Debilitating Disease and Its Complications

by Dr. James O.

Honors in Epidemiology, Ophthalmology Electives and Albert Einstein College of Medicine

A Sad Case Struggling with Diabetes – Most people remember the popular movie Animal House and would recognize the popular character Flounder, who was played by the actor Stephen Furst. A recent article in “PeopleCelebrity” (people.com) is useful, for it describes Furst’s lackadaisical attitude toward diabetes, which eventually killed him at the age of 63.

According to the article, both of Furst’s parents died from diabetes-related complications when he was only 16 years old. Several weeks later, Furst himself was diagnosed with diabetes, but he basically ignored his condition, stating: “I went into denial…I didn’t realize the long-term effects.”

Unfortunately, after many years spent battling obesity and diabetes, Furst died on June 16, 2017 from “complications of diabetes.”

What Is Diabetes Mellitus – Diabetes mellitus is a devastating chronic illness that can have horrific and debilitating consequences. This condition, if left untreated, can lead to amputations of multiple limbs, blindness, kidney failure, heart attacks, strokes, hypertension, dental disease, poor wound healing, impotence, loss of sensation in limbs, and many other serious health conditions.

Definition – There are three general types of diabetes. Diabetes mellitus type one, which is also called juvenile diabetes, is usually diagnosed in childhood and accounts for approximately 5% of cases of diabetes. This type of diabetes is usually caused by the body’s inability to produce insulin. Diabetes mellitus type 2 is the most common type of diabetes; it involves an elevation of blood-glucose levels in adults.

This can be due either to the lack of production of the hormone insulin by the pancreas or to the development of a condition called insulin resistance, in which the body’s cells no longer react normally to insulin, thereby preventing insulin from transporting glucose from the blood into the cells. The third type of diabetes is gestational diabetes, which refers to the development of high blood-sugar levels during pregnancy.

Statistics – According to Healthline (healthline.com), 29.1 million people in the United States have been diagnosed with diabetes at a cost of 245 billion dollars per year in health expenses (in 2012), with an estimated 8.1 million more people unaware that they too have the condition. Furthermore, in the United States, approximately 1.4 million new cases of diabetes are diagnosed every year. Worldwide, “[d]iabetes kills 1.5 million people every year” (healthline.com).

Risk Factors – Risk factors for diabetes mellitus include obesity, smoking, (advanced) age, sedentary lifestyle, positive family history, poor diet, elevated cholesterol and triglycerides, and hypertension. Also, African Americans, Native Americans, Asian Americans, Pacific Americans and Hispanic Americans all have an increased risk of developing diabetes.

Warning Signs of Diabetes – Common symptoms of diabetes include severe thirst, frequent urination, dry mouth, intense hunger, blurred vision, poor healing of wounds, dry and itchy skin, and yeast infections.

Complications – One of the major complications of diabetes is damage to what is called the body’s “microcirculation.” This term refers to the circulation of blood in the smallest blood vessels, which are composed of terminal arterioles, capillaries, and venules.

The arterioles (tiny arteries) carry oxygenated blood to the capillaries, where oxygen is then transported to the tissues. The venules (tiny veins) carry deoxygenated blood and C02 from the capillaries to the larger veins.

It is critical for microcirculation to work optimally because its function is critical to the regulation of blood flow, tissue perfusion, normal blood pressure, and normal oxygen delivery and cellular-waste removal.

Studies have shown that early in the course of diabetes, changes begin to occur, namely damaging and thickening the “basement membranes” of microcirculation. This causes alterations in blood-flow properties, alterations in oxygen transport, and changes in homeostasis.

These changes in blood supply, tissue perfusion, and oxygen delivery eventually lead to a progressive loss of nerve-fiber function, causing neuropathy, chronic pain, and numbness.

The damage to microcirculation also causes peripheral vascular disease, which can lead to tissue necrosis, nonhealing ulcers, gangrene, and eventual limb amputation. It is estimated that 2 to 6% of patients with diabetes will develop a diabetic foot ulcer (DFU) that eventually becomes infected. Infected DFUs, in turn, can lead to foot or leg amputation, with 50% of those with amputations dying within 5 years.

Diagnosis – Diabetes can be diagnosed using several common blood tests or urinalysis revealing elevated levels of glucose. A fasting blood sugar over 125 mg/dl (for reference, the normal value is less than 100 mg/dl) may indicate diabetes; a Hgb A1C blood test with a value over 5.7%, which measures average blood-sugar levels over a 3-month period, may also indicate diabetes. Another valuable diagnostic test is the glucose tolerance test used to measure blood-sugar levels 3 hours after oral administration of a sugary syrup.

Traditional Treatments – First-line traditional treatment of diabetes usually involves weight loss, a healthy diet low in carbohydrates and high in fruits and vegetables, and increased exercise for at least 20 minutes 3 times a week.
If diet and exercise are not sufficient to lower blood sugar to normal levels, then medication may be necessary. The first medication usually administered is metformin. Metformin, also known as Glucophage, is an oral medication usually taken twice per day; it works by decreasing the level of sugar produced by the liver and by increasing cells’ sensitivity to insulin. It also lowers the amount of glucose absorbed by the intestines.

Since metformin is metabolized by the liver, if someone has decreased liver function caused by liver disease, this may lead to a buildup of metformin, in turn inducing lactic acidosis, which can cause severe medical conditions and even death.

In the same way, since Metformin is excreted from the body by the kidneys, those with kidney disease and/or lowered kidney function are also at risk of lactic acidosis when taking metformin.

Other types of oral medications are also available to treat diabetes. If these medications fail, daily insulin administration can be given either through injections, inhalation, or an insulin pump.

Traditional treatments of diabetic vascular disease causing impaired circulation include revascularization surgery and angioplasties. Treatment of the tingling, numbness, and sharp pain from diabetic neuropathy include medications such as gabapentin (Neurontin), pregablin (Lyrica), and the antiseizure medicine Tegretol.

Alternative treatments for diabetic neuropathy include Chinese medicine, acupuncture, aromatherapy, massage therapy, reflexology, homeopathy, and biofeedback.

Another treatment that has shown great promise both for the treatment of diabetic neuropathy and diabetic microvascular disease is D’OXYVA. This is a noninvasive, nonopioid transdermal delivery system of medical carbon dioxide (C02) and water vapor that boosts microcirculation, balances the sympathetic and parasympathetic nervous systems, lowers blood pressure, decreases chronic pain, promotes healing of wounds and ulcers, and helps prevent amputations.

D’OXYVA improves blood circulation by means of a transdermal transfer of C02 using a transmission device placed over the thumb for a 5-minute period.
Numerous studies have shown “sustained, remote vasodilation and decreased systolic blood pressure” with the use of D’OXYVA. This is because bathing the tissues in C02 stimulates vasodilation in the periphery of the body, thereby improving circulation, blood flow, and oxygenation levels.

In one particular case, a male patient suffering severe diabetic neuropathy and intractable ulcers and open sores on his legs, along with hypertension and an inability to sleep due to severe pain, was placed on D’OXYVA via his thumb for 5 minutes twice a day for 6 weeks.

By the end of the 6-week period, the patient reported a significant decrease in pain; he reported being able to sleep through the night for the first time in years and reported that most of his leg wounds had healed. In addition, his blood pressure dropped from 188/130 to 135/95 within 30 minutes of each application.

Summary – Diabetes is an insidious chronic condition that devastates both patients and families. Increased awareness and preventive measures, such as controlling diet and increasing regular exercise, can encourage weight loss and hopefully prevent the development or worsening of diabetes and the need for oral medications or treatment with insulin. In addition, new advances in therapy such as D’OXYVA offer a noninvasive, transdermal, low-cost, and very effective alternative to help stop the intractable chronic pain of diabetic neuropathy and to help prevent limb amputations.

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Are You Ready to Visit Your Doctor Online?

Dallas marketing executive Susan Thompson knew exactly where her cold was headed when she began feeling under the weather one day a few years ago. Her symptoms follow a pattern, often leading to a chest infection that requires antibiotics to clear up. “After living in this body for 74 years, I know what I’m getting,” Thompson says.

Instead of waiting a few days to get an appointment with her doctor to confirm her diagnosis, Thompson called Teladoc, a telemedicine service offered by her employer. Within 10 minutes she had a doctor on the line, and by the end of the day she had a prescription for the infection.

She’s used the service three times since, always with the same results.

Thompson is part of a growing trend toward telemedicine, which uses technology to connect doctors and patients via apps, phones and videoconferencing. Telemedicine revenue is expected to grow around 40 percent a year over the next five years, from its current $645 million to more than $3.5 billion in 2020, according to a report by IBISWorld.

Telemedicine has been rapidly changing the way health care is delivered in the United States, giving doctors the ability to communicate with their patients through text and video messages from thousands of miles away in the event that an in-person consultation is either unnecessary or unattainable.

“At this point it feels like health care is lagging daily life, with the advent of smartphones and the Internet,” says Shana Alex Charles, an assistant professor in the Health Services Department at California State University, Fullerton. “Why do we still need to go to a doctor’s office and sit in a waiting room for something that can be done, especially something like daily monitoring, better and faster online?”

When it comes to serving consumers, the industry is growing in two distinct areas: non-urgent diagnosis and treatment of minor ailments like strep throat or an ear infection, and ongoing monitoring of high-risk patients or those recently released from the hospital.

In the first instance, a person experiencing flu-like symptoms would log on to an app or Web portal directly administered by a health system, an insurer or their employer and video conference with a doctor who would assess the patient and write a prescription, all from potentially hundreds of miles away. Some pharmacies have installed self-service kiosks that patients can use to video conference with a doctor who could potentially call in a prescription while the consumer is still in the store.

In the second scenario, a patient might go home with Internet-connected devices that would monitor their blood pressure, temperature and other vitals and remotely send reports to a doctor or hospital who would analyze the results for any potential problems.

“There’s been a push to lower hospital readmission rates along with health care reform,” says Sarah Turk, a health care sector analyst with IBISWorld. “You can use telehealth to examine and monitor fluctuations in their system and then address it before it becomes a costly complication.”

 

The Savings

Telemedicine gives the patient the convenience of staying home (and not spreading or catching germs in a doctor’s office) for a fraction of the price of a traditional appointment or a visit to an ER or urgent care clinic. The cost of a telemedicine call is usually around $25 to $30.

Whether insurance will cover the service, however, varies. Twenty-nine states require insurance companies to reimburse telehealth treatment, but in other states it’s up to your insurer. Another 15 states are considering similar laws. Either way, you can pay for services using a health savings account or flexible savings account.

Insurers and some medical service providers have been at the forefront of the trend toward telemedicine and now employers are starting to take notice, particularly as they realize that they need to drastically reduce costs before the Obamacare “Cadillac tax” kicks in in 2018. They’re increasingly working with insurers to implement telemedicine programs as part of their benefit package. Some insurers are throwing the service in for free to large companies as a way to keep their business.

 

Companies Get on Board

Employers offering telemedicine increased by a third in 2015, according to Towers Watson, and more than 80 percent of employers are considering implementing programs by 2018. Even so, use by employees is still relatively small. Just one in 10 eligible members accessed such services last year. Increased adoption could save the health care industry more than $6 billion a year, the benefits consultant found, by reducing office and ER visits by 15 percent and urgent care visits by 37 percent.

The hesitation on the part of patients may have to do with age and general comfort with technology. A recent report by TechnologyAdvice Research found that less than half of those over age 65 would trust a virtual diagnosis, compared to 83 percent of 18-to-24 year olds.

While many in the medical field support the trend toward telemedicine and its inevitable expansion, many have also expressed concerns that patients who need in-patient care might elect for telemedicine in an effort to save money, or that doctors administering care might miss a diagnosis because they’re missing some key information in the patient’s medical history or because the patient read her vitals incorrectly.

“We think that these services should allow you to extend your existing relationship with your doctor, not to replace them with a doc of the day,” says Steve Ommen, a cardiologist and associate dean for the Center for Connected Care at Mayo Clinic.

An adoption of telemedicine by existing health care providers could help alleviate some concerns. The TechnologyAdvice report found that about 63 percent of consumers would be more likely to schedule a virtual appointment if they had previously seen the doctor in person.

 

An Answer to the Doctor Shortage


In addition to helping consumers access medical care in a more convenient and cost-efficient manner, telemedicine technology is also helping to address a doctor shortage, particularly in rural areas. The Association of American Medical Colleges projects that the country could be short more than 50,000 doctors by 2025, including primary care physicians, surgeons and specialists. The shortage will be felt even more acutely as an aging population increases the demand for health services.

Patients in places affected by the shortage can use telehealth to see doctors if local physicians are spread too thin, and some hospitals are using Skype for specialists to see patients who need a second opinion.

 

 

Reference: http://www.thefiscaltimes.com/2015/10/21/Are-You-Ready-Visit-Your-Doctor-Online-Telemedicine-Has-Arrived

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Did you know that you can have a 20 year old brain At 80?

Stats are greatly against us. On average, by the age of 70 our brain will be 15% lighter than it was in our 20s, beginning to deteriorate with aging damage in our 30s. Fifty is considered the new 30 in modern anti-aging circles. But when brain cell power yields way to younger ones as a result of age-related oxidation, cell death, plaque buildup, impaired blood flow, energy loss and other environmental and biochemical assaults, 50 becomes, well, just plain old. And depressing.

Brain cells don’t divide unlike those of the skin and other tissues. Generally, when cells divide and are in prime health, repair genes can actually make the next division healthier. The progenitor cells die off, too, leaving only the healthier nuclei of new cells behind. The cerebral cells simply have no second chance; they can’t improve their lot through the usual method. Damage control is more difficult and much more necessary.

Especially in older populations, dementia occurs in tandem with depression, leading scientists to surmise midlife blues are a form of brain damage.

The co-occurrence of depression and cognitive impairment doubles every five years after age 70, and by the time one is 85, the chances are 25% that one will be afflicted with depression and cognitive impairment that will adversely impact one’s life, say Guy G. Potter, PhD of the Duke University School of Medicine in Durham, North Carolina and David C. Steffens, MD, of the University of Connecticut Health Center, Farmington. “Depression is primarily a mood disorder, but it can also be viewed as a cognitive disorder for many older adults, they add.

Reference: http://www.healthylivingmagazine.us/Articles/539/

HOW D’OXYVA CAN HELP?

D’OXYVA is the only fully noninvasive, completely painless transdermal (over-the-skin) microcirculatory solution that has been clinically tested to significantly improve microcirculation.


The improvement of microcirculation, i.e., blood flow to the smallest blood vessels, benefits one’s health, immune system and overall sense of well-being in a variety of ways.

What our customers are saying?

I did not expect these results at all but I am happy I did give this product a shot. D’Oxyva makes me sleep better at night and increased my sex drive. I can accomplish more things during the day with my energy up. Great product.
E. Mason
U.S.A.
I show clear change in my skin with D’OXYVA. I feel rejuvenated and energized throughout the day. Thanks to the blog that suggested me to start D’OXYVA.
Brittany
U.S.A.
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Speed up your blood flow to boost your health

Crush fatigue

Slow flow Your blood platelet flow is like the M25: a never-ending motorway. And sugar is the number one cause of congestion. When red blood cells clump together, oxygen delivery is reduced, resulting in fatigue, says nutritionist David Parker.

Speed up The European FSA found fruit and vegetable juice helps blood cells float freer. Go for Sirco juice (sircoheart.com).

Deepen sleep

Slow flow For healthy deep sleep, too many carbs are a bad thing. During 12-3am your body cleanses, rejuvenates and repairs,says Tailor. If your bloodstream is loaded with carbs, your sleep suffers.

Speed up Reach for a loaf packed with alkaline pumpkin flax and sunflower seeds to balance carbs. Do not pass go, do not collect insomnia.

Beat stress

Slow flow when stressed, your body produces the acidic hormone cortisol. A surge of this is useful for short-term crisis management, but continued release means blood becomes gluey, causing further stress, says blood analyst Geeta Tailor.

Speed up Get the chocs out. Cocoa flavonoids help your body process nitric oxide critical for healthy blood flow. Make it 75% cocoa.

Strengthen bones

Slow flow Food digestion creates minerals or waste. If your body needs more acid to break down waste, this hangs around in the middle of your motorway, attacking the central reservation (bones). One of the biggest culprits is excessive milk.

Speed up

Reduce your dairy intake not all calcium has to come from a cow. Chickpeas, parsley and spinach all pack a punch.

Bulk up

Don’t default to protein shakes for your entire tank of muscle fuel too many will restrict your flow. Multiple protein shakes generate acid ash, says Tailor. Too much ash slows blood flow.

Speed up When soaked in water overnight, two handfuls of macadamia nuts are an excellent source of clean protein. It increases their alkalinity, leading to better absorption.

Improve sex

Slow flow Excessive alcohol consumption makes blood clot, creating blockages in the capillaries of your sex organs  resulting in sperm which is tired, slow and less than it once was. Much like you after a heavy Friday night.

Speed up Combine your beer with a carbbased salad for dinner. Grains like quinoa are great sources of sperm-building B vitamins.

 

Reference: http://www.menshealth.co.uk/healthy/heart/speed-up-your-blood-flow-to-boost-your-health

HOW D’OXYVA CAN HELP?

D’OXYVA is the only fully noninvasive, completely painless transdermal (over-the-skin) microcirculatory solution that has been clinically tested to significantly improve microcirculation.


The improvement of microcirculation, i.e., blood flow to the smallest blood vessels, benefits one’s health, immune system and overall sense of well-being in a variety of ways.