Heartburn

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Heartburn is a burning pain in your chest, just behind your breastbone. The pain is often worse after eating, in the evening, or when lying down or bending over.

Occasional heartburn is common and no cause for alarm. Most people can manage the discomfort of heartburn on their own with lifestyle changes and over-the-counter medications.

Heartburn that is more frequent or interferes with your daily routine may be a symptom of a more serious condition that requires medical care.

Symptoms

Symptoms of heartburn include:

  • A burning pain in the chest that usually occurs after eating and may occur at night
  • Pain that worsens when lying down or bending over
  • Bitter or acidic taste in the mouth

When to see a doctor

Seek immediate help if you experience severe chest pain or pressure, especially when combined with other signs and symptoms such as pain in the arm or jaw or difficulty breathing. Chest pain may be a symptom of a heart attack.

Make an appointment with your doctor if:

  • Heartburn occurs more than twice a week
  • Symptoms persist despite use of over-the-counter medications
  • You have difficulty swallowing
  • You have persistent nausea or vomiting
  • You have weight loss because of poor appetite or difficulty eating

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In vitro fertilization (IVF)

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Familial hypercholesterolemia affects the way the body processes cholesterol. As a result, people with familial hypercholesterolemia have a higher risk of heart disease and a greater risk of early heart attack.

The gene that causes familial hypercholesterolemia is inherited. The condition is present from birth. Treatments including medications and healthy lifestyle behaviors can help reduce the risks.

Symptoms

High cholesterol is a common medical condition, but it’s often the result of unhealthy lifestyle choices, and thus preventable and treatable. With familial hypercholesterolemia, a person’s risk of high cholesterol is higher because a defect (mutation) in a gene changes how the body processes cholesterol. This mutation prevents the body from removing low-density lipoprotein (LDL) cholesterol, the “bad” cholesterol, from the blood. As a result, plaques can cause your arteries to narrow and harden, increasing the risk of heart disease. Genetic testing can reveal whether you have this mutation.

These gene mutations are passed from parent to child. To have the condition, children need to inherit an altered copy of the gene from one parent. Most people with familial hypercholesterolemia have one affected gene and one normal gene. In rare cases, a person inherits an affected copy from both parents, which can lead to a more severe form of the condition.

Causes

Familial hypercholesterolemia is caused by a gene that’s passed down from one or both parents. People who have this condition are born with it. This defect prevents the body from ridding itself of the type of cholesterol that can build up in your arteries and cause heart disease. This type of cholesterol is called low-density lipoprotein but it’s also commonly known as LDL or bad cholesterol. LDL cholesterol can cause your arteries to get hard and narrow. This increases your risk of a heart attack and heart disease.

Risk factors

The risk of familial hypercholesterolemia is higher if one or both of your parents have the gene defect that causes it. Most people who have the condition got one affected gene. But in rare cases, a child can get the affected gene from both parents. This can cause a more severe form of the condition.

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Achilles tendon rupture

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Achilles (uh-KILL-eez) tendon rupture is an injury that affects the back of your lower leg. It mainly occurs in people playing recreational sports, but it can happen to anyone.

The Achilles tendon is a strong fibrous cord that connects the muscles in the back of your calf to your heel bone. If you overstretch your Achilles tendon, it can tear (rupture) completely or just partially.

If your Achilles tendon ruptures, you might hear a pop, followed by an immediate sharp pain in the back of your ankle and lower leg that is likely to affect your ability to walk properly. Surgery is often performed to repair the rupture. For many people, however, nonsurgical treatment works just as well.

Although it’s possible to have no signs or symptoms with an Achilles tendon rupture, most people have:

  • The feeling of having been kicked in the calf
  • Pain, possibly severe, and swelling near the heel
  • An inability to bend the foot downward or “push off” the injured leg when walking
  • An inability to stand on the toes on the injured leg
  • A popping or snapping sound when the injury occurs

When to see your doctor

Seek medical advice immediately if you hear a pop in your heel, especially if you can’t walk properly afterward.

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Bone marrow transplant

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A bone marrow transplant is a procedure that infuses healthy blood-forming stem cells into your body to replace your damaged or diseased bone marrow. A bone marrow transplant is also called a stem cell transplant.

You might need a bone marrow if your bone marrow stops working and does not produce enough healthy blood cells.

Bone marrow may use cells from your own body (autologous transplant) or from a donor (allogeneic transplant).

What are the characteristics of myelofibrosis?

One characteristic of myelofibrosis is the overproduction of giant cells called megakaryocytes. Megakaryocytes normally release tiny fragments called platelets. Platelets play an important role in the formation of blood clots at the site of an injury.

When myelofibrosis occurs, the bone marrow produces too many megakaryocytes, accompanied by the release of proteins called cytokines. Cytokines are the same substances that make you feel ill when you have the flu. The cytokines in myelofibrosis cause inflammation and buildup of more fibrous tissue in the bone marrow.

Why it’s done

A bone marrow may be used to:

  • Safely allow treatment of your condition with high doses of chemotherapy or radiation by replacing or rescuing the bone marrow damaged by treatment
  • Replace diseased or damaged marrow with new stem cells
  • Provide new stem cells, which can help kill cancer cells directly

Bone marrow transplants can benefit people with a variety of both cancerous (malignant) and noncancerous (benign) diseases, including:

  • Acute leukemia
  • Adrenoleukodystrophy
  • Aplastic anemia
  • Bone marrow failure syndromes
  • Chronic leukemia
  • Hemoglobinopathies
  • Hodgkin’s lymphoma
  • Immune deficiencies
  • Inborn errors of metabolism
  • Multiple myeloma
  • Myelodysplastic syndromes
  • Neuroblastoma
  • Non-Hodgkin’s lymphoma
  • Plasma cell disorders
  • POEMS syndrome
  • Primary amyloidosis

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Risks Peritoneal dialysis

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Complications of peritoneal dialysis can include: Risks Peritoneal dialysis

  • Infections. An infection of the abdominal lining (peritonitis) is a common complication of peritoneal dialysis. An infection can also develop at the site where the catheter is inserted to carry the cleansing fluid (dialysate) into and out of your abdomen. The risk of infection is greater if the person doing the dialysis isn’t adequately trained.
  • Weight gain. The dialysate contains sugar (dextrose). Absorbing some of the dialysate might cause you to take in hundreds of extra calories daily, leading to weight gain. The extra calories can also cause high blood sugar, especially if you have diabetes.
  • Hernia. Holding fluid in your abdomen for long periods may strain your muscles.
  • Inadequate dialysis. Peritoneal dialysis can become ineffective after several years. You might need to switch to hemodialysis.

If you have peritoneal dialysis, you’ll need to avoid:

  • Certain prescription and over-the-counter medications that can damage your kidneys, including nonsteroidal anti-inflammatory drugs.
  • Soaking in a bath or hot tub, or swimming in a lake, pond, river or nonchlorinated pool — which increases the risk of infection. Showers and swimming in a chlorinated pool are generally acceptable.

How you prepare

You’ll need an operation to insert the catheter that carries the dialysate in and out of your abdomen. The insertion might be done under local or general anesthesia. The tube is usually inserted near your bellybutton.

After the tube is inserted, your doctor will probably recommend waiting up to a month before starting peritoneal dialysis treatments to give the catheter site time to heal.

You’ll also receive training on how to use the peritoneal dialysis equipment.

What you can expect

During peritoneal dialysis:

  • The dialysate flows into your abdomen and stays there for a prescribed period of time (dwell time) — usually four to six hours
  • Dextrose in the dialysate helps filter waste, chemicals and extra fluid in your blood from tiny blood vessels in the lining of your abdominal cavity
  • When the dwell time is over, the solution — along with waste products drawn from your blood — drains into a sterile collection bag

The process of filling and then draining your abdomen is called an exchange. Different methods of peritoneal dialysis have different schedules of exchange. The two main schedules are:

  • Continuous ambulatory peritoneal dialysis (CAPD)
  • Continuous cycling peritoneal dialysis (CCPD)

Continuous ambulatory peritoneal dialysis (CAPD)

You fill your abdomen with dialysate, let it remain there for a prescribed dwell time, then drain the fluid. Gravity moves the fluid through the catheter and into and out of your abdomen.

With CAPD:

  • You may need three to five exchanges during the day and one with a longer dwell time while you sleep
  • You can do the exchanges at home, work or any clean place
  • You’re free to go about your normal activities while the dialysate dwells in your abdomen

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Blood pressure test

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A blood pressure measures the pressure in your arteries as your heart pumps. You might have a blood pressure as a part of a routine doctor’s appointment or as a screening for high blood pressure (hypertension). Some people use a blood pressure test at home to better track their heart health.

Why it’s done

A blood pressure is a routine part of most doctor appointments. Blood pressure screening is an important part of your general health. Find out when you should have a blood pressure test.

  • People age 18 and older with normal blood pressure and no heart disease risk factors should have a blood pressure test at least once every two to five years.
  • People age 40 and older — or younger with an increased risk of high blood pressure — should have a blood pressure test every year. Risk factors for high blood pressure include obesity and being Black.
  • People who have chronic health conditions, such as high or low blood pressure or heart disease, may need to have blood pressure tests more often.

Your doctor may also suggest checking your blood pressure at home. Automated home blood pressure monitors are available and easy to use. Ask your doctor if this is an option for you.

It’s a good idea to keep a blood pressure log at home and have your doctor check your monitor once a year to make sure you are getting accurate readings.

Home blood pressure monitoring isn’t a substitute for visits to your doctor.

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After the cortisone shot

Pain Myth #3: A Cortisone Shot

a cortisone shots might temporarily increase your blood sugar levels. Some people have redness and a feeling of warmth of the chest and face after a cortisone shot. If you have diabetes,

After your cortisone shot, your doctor might ask that you:

  • Protect the injection area for a day or two. For instance, if you received a cortisone shot in your shoulder, avoid heavy lifting. If you received a cortisone shot in your knee, stay off your feet when you can.
  • Apply ice to the injection site as needed to relieve pain. Don’t use heating pads.
  • Not use a bathtub, hot tub or whirlpool for two days. It’s OK to shower.
  • Watch for signs of infection, including increasing pain, redness and swelling that last more than 48 hours.

Results

Results of cortisone shots typically depend on the reason for the treatment. Cortisone shots commonly cause a temporary flare in pain and inflammation for up to 48 hours after the injection. After that, your pain and inflammation of the affected joint should decrease, and can last up to several months.

Some people have redness and a feeling of warmth of the chest and face after a cortisone shot. If you have diabetes, a cortisone shot might temporarily increase your blood sugar levels.

After your cortisone shot, your doctor might ask that you:

  • Protect the injection area for a day or two. For instance, if you received a cortisone shot in your shoulder, avoid heavy lifting. If you received a cortisone shot in your knee, stay off your feet when you can.
  • Apply ice to the injection site as needed to relieve pain. Don’t use heating pads.
  • Not use a bathtub, hot tub or whirlpool for two days. It’s OK to shower.
  • Watch for signs of infection, including increasing pain, redness and swelling that last more than 48 hours.

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Risk factors Amnesia

Dissociative Amnesia Facts and Statistics

Head injuries that cause a concussion, whether from a car accident or sports, can lead to confusion and problems remembering new information. This is especially common in the early stages of recovery. Mild head injuries typically do not cause lasting amnesia, but more-severe head injuries may cause permanent amnesia.

Another rare type of amnesia, called dissociative (psychogenic) amnesia, stems from emotional shock or trauma, such as being the victim of a violent crime. In this disorder, a person may lose personal memories and autobiographical information, but usually only briefly.

The chance of developing amnesia might increase if you’ve experienced:

Brain surgery, head injury or trauma
Stroke
Alcohol abuse
Seizures
Complications
Amnesia varies in severity and scope, but even mild amnesia takes a toll on daily activities and quality of life. The syndrome can cause problems at work, at school and in social settings.

It may not be possible to recover lost memories. Some people with severe memory problems need to live in a supervised situation or extended-care facility.

Prevention developing amnesia
Because damage to the brain can be a root cause of amnesia, it’s important to take steps to minimize your chance of a brain injury. For example:

Avoid excessive alcohol use.
Wear a helmet when bicycling and a seat belt when driving.
Treat any infection quickly so that it doesn’t have a chance to spread to the brain.
Seek immediate medical treatment if you have any symptoms that suggest a stroke or brain aneurysm, such as a severe headache or one-sided numbness or paralysis.

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Irritable bowel syndrome

Irritable bowel syndrome

Irritable bowel syndrome (IBS) is a common disorder that affects the large intestine. Signs and symptoms include cramping, abdominal pain, bloating, gas, and diarrhea or constipation, or both. IBS is a chronic condition that you’ll need to manage long term.

Only a small number of people with IBS have severe signs and symptoms. Some people can control their symptoms by managing diet, lifestyle and stress. More-severe symptoms can be treated with medication and counseling.

IBS doesn’t cause changes in bowel tissue or increase your risk of colorectal cancer.

Symptoms

The signs and symptoms of IBS vary but are usually present for a long time. The most common include:

  • Abdominal pain, cramping or bloating that is related to passing a bowel movement
  • Changes in appearance of bowel movement
  • Changes in how often you are having a bowel movement

Other symptoms that are often related include bloating, increased gas or mucus in the stool.

When to see a doctor

See your doctor if you have a persistent change in bowel habits or other signs or symptoms of IBS. They may indicate a more serious condition, such as colon cancer. More-serious signs and symptoms include:

  • Weight loss
  • Diarrhea at night
  • Rectal bleeding
  • Iron deficiency anemia
  • Unexplained vomiting
  • Difficulty swallowing
  • Persistent pain that isn’t relieved by passing gas or a bowel movement

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