(kena habiskan cuti kat rumah.. macam mana nak jalan-jalan makan angin ni???)
Klik klik
Memaparkan catatan dengan label kesihatan. Papar semua catatan
Memaparkan catatan dengan label kesihatan. Papar semua catatan
Khamis, April 08, 2010
Cuti Sakit lagi...
Baru balik dari berjumpa Pakar Bedah Orthopedik di Hospital Sg. Buloh. Sambung lagi cuti sakit sehingga 29/04/2010 nanti. Balik dari hospital tadi, sempat singgah sebentar di pejabat untuk masukkan cuti dalam HRMIS dan berjumpa dengan teman-teman yang sudah sebulan tidak ditemui.

(kena habiskan cuti kat rumah.. macam mana nak jalan-jalan makan angin ni???)
(kena habiskan cuti kat rumah.. macam mana nak jalan-jalan makan angin ni???)
Isnin, Mac 08, 2010
Doakan..
kakcik akan masuk ke hospital pagi ini untuk rawatan 'slip disc'. Dijadualkan menjalani pembedahan esok pagi. Doakan agar kakcik sembuh dan sihat semula, ya? Terima kasih.
Sabtu, Februari 20, 2010
Gatal Hidung

rimas sungguh! tergaru-garu.. rasa macam nak cabut hidung, letak dalam air panas! Dah dua kali buat rawatan (pembedahan?) membuang folip-folip dalam ruang sinus di pipi yang setiap satunya menelan belanja ribuan RM (itupun atas ihsan Syarikat tempat suami 'cari makan' - kalau tidak, tak akan buat sama sekali!).
Bila tergaru-garu macam ni, rasa comot dan selekeh sangat.. huhuhu....
Rabu, Januari 27, 2010
Hiperhidrosis

Sering berkeringat yang berlebihan di telapak tangan dan kaki merupakan salah satu manifestasi hiperhidrosis (pengeluaran keringat yang berlebihan). Hiperhidrosis yang hanya terjadi secara lokal di telapak tangan dan kaki (juga ketiak), biasanya disebabkan stimulasi emosi dan atau suhu (Stimulasi emosi kadang lebih kuat dibandingkan stimulasi suhu). Hiperhidrosis ini biasanya mulai timbul ketika masa kanak-kanak atau masa dewasa muda. Biasanya hal ini sering muncul ketika kita sedang mengalami stress (karena tekanan pekerjaan atau menjelang ujian). Selain karena pengaruh emosi dan suhu, hiperhidrosis jenis ini dapat ditemukan pada mereka yang mencandu alkohol.
Hiperhidrosis (berkeringat yang berlebihan) yang terjadi secara general (di seluruh tubuh) dapat merupakan manifestasi klinis yang dapat ditemukan pada beberapa penyakit jantung tertentu, namun hiperhidrosis lokal (hanya di tangan dan atau kaki) bukan manifestasi klinis spesifik penyakit jantung dan atau paru. Hiperhidrosis yang terjadi secara general pun bukan petanda adanya penyakit jantung dan atau paru, karena sering hanya berupa manifestasi klinis yang menyertai, bukan manifestasi klinis utama. Keluhan yang sering ditemukan pada pasien dengan penyakit jantung dan atau paru adalah sesak (kesulitan bernafas) dan nyeri dada. Jadi jika hanya keringat yang berlebihan di kedua tangan dan atau di kedua kaki tanpa disertai keluhan sesak, jantung berdebar-debar, nyeri dada, batuk, atau keluhan yang lainnya, InsyaAllah bukan karena tanda penyakit jantung dan atau paru.
kenapa tiba2 pulak aku berbahasa Indonesia ni?? Sebenarnya aku copy paste saja... malas pulak nak terjemahkan... (dari semalam lagi, tapak tanganku tiba-tiba rasa lembab dan melekit...tapiiii.. yang pastinya, ibu-ibu, bapak-bapak sekalian.. aku tidak mengambil alkohol, ya..)
Selasa, Disember 22, 2009
Jumaat, Disember 11, 2009
Bengkung

sejak beberapa hari lepas aku mula memakai bengkung seperti dalam gambar di atas. Bengkung ini bertujuan untuk menyokong tulang belakangku. Jurupulih anggota yang merawatku mengesyorkan aku memakai bengkung. Aku teringat kepada bengkung En. Suami yang ada di rumah.
Jadinya bermula Selasa lepas, aku pun memakai bengkung tersebut semasa di pejabat dan juga semasa tidur! hehehe.. 'lihat pinggangkuuuuuu.... ramping kannnnnnnn' (macam dalam iklan kat TV tu.. tak ingat iklan apa...). Rasanya ada juga kesan dari pemakaian bengkung ini, kakiku tidak lagi merasa sakit sewaktu aku memakainya, dan aku juga lebih mudah untuk bangun dari pembaringan di waktu pagi. (Sepatutnya, aku tak perlu pakai sewaktu tidur.. tapi, aku pakai juga...)
Khamis, Disember 03, 2009
Duduk di wad
bukanlah sesuatu yang menggembirakan seperti duduk di hotel. Sebilik untuk 4 orang. Tak mahu duduk bilik seorang - takut!
Bila ramai, mesti banyak ragam. Aku tak ada pelawat pun.. Cuma Along atau suami datang menjenguk. Itupun sekejap. Iyalah.. masing2 sibuk. Aku tak sedih pun. Wanita di katil berhadapan katilku, disyaki ada tumor dalam kepala (atau otak?). Dia akan dirujukkan ke HKL atas alasan yang aku tak tahu.. nak bertanya, nanti dikatakan penyibuk pulak.. dia bercerita, aku dengarlah. Malam tadi, ramai saudara maranya datang melawat. Riuh rendah dengan anak buahnya (3 orang kanak2 perempuan) siap tidur baring atas katil kosong di sebelah katilku...aduh! sabar jelah. Setakat tidur baring tak apa lagi.. suara hiruk pikuk yang tak tahan tu... :( Jururawat pun tak boleh buat apa-apa... (kalau hospital kerajaan, mahu dah kena tengking agaknya..)
Dua orang pesakit lagi (nenek-nenek) dah discaj. Malam ini, aku mungkin tinggal seorang. Tapi tak apalah, bilikku di hadapan kaunter jururawat.
Hari pertama buat fisio, aku tak merasa pun regangan yang dilakukan, mungkin disebabkan sakit yang kualami mengatasi rasa regangan yang dibuat. Hari kedua (semalam) barulah ada rasa pinggang ke bawah ditarik-tarik.
Doakanlah, mudah2an selepas ini sakit kakiku tidak lagi menjadi satu masalah yang membataskan pergerakan dan aktiviti seharianku. InsyaAllah.
Bila ramai, mesti banyak ragam. Aku tak ada pelawat pun.. Cuma Along atau suami datang menjenguk. Itupun sekejap. Iyalah.. masing2 sibuk. Aku tak sedih pun. Wanita di katil berhadapan katilku, disyaki ada tumor dalam kepala (atau otak?). Dia akan dirujukkan ke HKL atas alasan yang aku tak tahu.. nak bertanya, nanti dikatakan penyibuk pulak.. dia bercerita, aku dengarlah. Malam tadi, ramai saudara maranya datang melawat. Riuh rendah dengan anak buahnya (3 orang kanak2 perempuan) siap tidur baring atas katil kosong di sebelah katilku...aduh! sabar jelah. Setakat tidur baring tak apa lagi.. suara hiruk pikuk yang tak tahan tu... :( Jururawat pun tak boleh buat apa-apa... (kalau hospital kerajaan, mahu dah kena tengking agaknya..)
Dua orang pesakit lagi (nenek-nenek) dah discaj. Malam ini, aku mungkin tinggal seorang. Tapi tak apalah, bilikku di hadapan kaunter jururawat.
Hari pertama buat fisio, aku tak merasa pun regangan yang dilakukan, mungkin disebabkan sakit yang kualami mengatasi rasa regangan yang dibuat. Hari kedua (semalam) barulah ada rasa pinggang ke bawah ditarik-tarik.
Doakanlah, mudah2an selepas ini sakit kakiku tidak lagi menjadi satu masalah yang membataskan pergerakan dan aktiviti seharianku. InsyaAllah.
Rabu, Disember 02, 2009
Slip disc
Beginilah rupa alat yang digunakan untuk merawat tulang belakang kakcik...
saat menaip ni, kakcik 'lari' sekejap dari Hospital Pakar Al Islam (dulunya Kampung Baru Medical Centre). Hehehe... dengan kebenaran Doktor la... Nak ambil pakaian, nak suruh suami atau anak yang bawakan, nanti entah 'kain buruk' mana yang mereka ambil.
Hari Isnin.. balik dari kerja, suami ajak terus ke HPAI.. sakit kakiku bagai tak tertanggung lagi. Doktor pakar yang melihat keadaanku, mengagak yang aku kena 'slip disc'. Dia kata kena buat MRI Scan. Aku bagitahu kat Dr. S yang aku dah pernah buat MRI Scan. Dr. S meminta aku bawa filem itu kepadanya. Dipendekkan kisah, memang sah aku mengalami slip disc. Aku terpaksa menjalani rawatan fisioterapi. Jadinya, andai blog ini sunyi... faham2lah bahawa aku sedang berada di Hospital. Malas nak bawa lappy ni ke wad... Lagipun, lappy ini Along yang punya...

saat menaip ni, kakcik 'lari' sekejap dari Hospital Pakar Al Islam (dulunya Kampung Baru Medical Centre). Hehehe... dengan kebenaran Doktor la... Nak ambil pakaian, nak suruh suami atau anak yang bawakan, nanti entah 'kain buruk' mana yang mereka ambil.
Hari Isnin.. balik dari kerja, suami ajak terus ke HPAI.. sakit kakiku bagai tak tertanggung lagi. Doktor pakar yang melihat keadaanku, mengagak yang aku kena 'slip disc'. Dia kata kena buat MRI Scan. Aku bagitahu kat Dr. S yang aku dah pernah buat MRI Scan. Dr. S meminta aku bawa filem itu kepadanya. Dipendekkan kisah, memang sah aku mengalami slip disc. Aku terpaksa menjalani rawatan fisioterapi. Jadinya, andai blog ini sunyi... faham2lah bahawa aku sedang berada di Hospital. Malas nak bawa lappy ni ke wad... Lagipun, lappy ini Along yang punya...
Rabu, November 11, 2009
Seandainya Mampu, Hulurkanlah Bantuan
(dari blog http://saifulislam.com)

Kesihatan Ahmad Khariri al-Hadi sentiasa terumbang-ambing.
Komplikasi yang dialami kesan daripada pendermaan hati yang dilakukannya dulu, semakin pelbagai.
Terkini Ahmad Khariri disahkan perlu menjalani pembedahan pada 10 November 2009 untuk kes adhesion colic. Beliau memerlukan pembiayaan sejumlah RM12,000 untuk pembedahan ini dilakukan.
Saya dengan penuh rasa rendah diri, merayu kepada para pengunjung blog Saifulislam.Com ini menghulurkan bantuan seikhlas mungkin bagi membantu saudara kita ini. Panjangkanlah juga pesanan ini kepada sesiapa sahaja yang saudara saudari rasakan boleh membantu beliau.
Ahmad Khariri al-Hadi Md Yusop boleh dihubungi di talian 017-6351057 atau email
Sumbangan juga boleh disampaikan terus melalui akaun bank beliau di MAYBANK, 162106646530.

Kesihatan Ahmad Khariri al-Hadi sentiasa terumbang-ambing.
Komplikasi yang dialami kesan daripada pendermaan hati yang dilakukannya dulu, semakin pelbagai.
Terkini Ahmad Khariri disahkan perlu menjalani pembedahan pada 10 November 2009 untuk kes adhesion colic. Beliau memerlukan pembiayaan sejumlah RM12,000 untuk pembedahan ini dilakukan.
Saya dengan penuh rasa rendah diri, merayu kepada para pengunjung blog Saifulislam.Com ini menghulurkan bantuan seikhlas mungkin bagi membantu saudara kita ini. Panjangkanlah juga pesanan ini kepada sesiapa sahaja yang saudara saudari rasakan boleh membantu beliau.
Ahmad Khariri al-Hadi Md Yusop boleh dihubungi di talian 017-6351057 atau email
Sumbangan juga boleh disampaikan terus melalui akaun bank beliau di MAYBANK, 162106646530.
Selasa, November 10, 2009
Ubat Sakit Kaki
Inilah pil @ maajun yang kutelan 2 biji di waktu pagi dan dua biji di waktu petang. Tapi .. sejauh mana keberkesanannya, wallahhuaklam. Yang kutahu, sejak Jumaat lepas, Alhamdulillah, kaki ini kurang sakitnya...


Jumaat, Jun 05, 2009
Fibromialgia
Anda berasa letih dan sakit pada seluruh badan, terutamanya tengkuk, bahu, belakang, pinggul, tangan atau kaki. Ada beberapa bahagian pada badan anda yang dikenali sebagai “bahagian sakit” yang terasa sakit bila disentuh. Namun begitu, apabila anda menjalani ujian di klinik, tidak ada apa yang ditunjukkan.
Sebelum anda mula berfikir bahawa sakit itu hanya dalam otak anda, mungkin anda harus bertanya doktor sama ada anda menghidap fibromialgia.
Apakah Fibromialgia?
Fibromialgia (FM) ialah penyakit kesakitan kronik yang mana ciri-cirinya adalah lenguh otot di seluruh badan, sakit dan kekejangan, sakit tisu lembut, keletihan dan masalah tidur.
Mereka yang menghidap juga mungkin mempunyai simptom lain seperti sakit kepala, tangan dan kaki yang berdenyut-denyut atau kebas, sengungut dan masalah dengan pemikiran dan ingatan, yang kadang kala dikenali sebagai “fibro fog”.
Sakit dan keletihan kadangkala begitu teruk sehingga mengganggu kehidupan harian seperti bangun daripada tidur dan bekerja. Sakit ini bertambah teruk dalam cuaca sejuk/lembap, tidur yang tidak memulihkan, keletihan fizikal dan mental, aktiviti fizikal berlebihan, tiada aktiviti fizikal, kerisauan dan ketegangan.
Simptom lain termasuk usus dan pundi kencing yang rengsa, sindrom kaki resah (gangguan pergerakan kaki berkala), kulit sensitif dan ruam, mata dan mulut kering, kemurungan, bunyi di dalam telinga, pening, masalah penglihatan, Sindrom Raynaud, simptom neurologi, dan masalah koordinasi. Semua simptom ini akan datang dan pergi.
Sakit otot biasanya dirasakan apabila pesakit melalukan aktiviti ulangan. Oleh itu, ramai pesakit mengehadkan aktiviti mereka termasuk rutin senaman. Ini menjadikan mereka tidak sihat dan akan memburukkan lagi simptom fibromialgia.
Fibromialgia boleh terjadi kepada sesiapa sahaja, yang mana wanita pertengahan umur berada dalam golongan peratusan yang tertinggi. Lebih ramai wanita yang menghidap fibromialgia berbanding lelaki, dengan nisbah kira-kira 20:1.
Mereka dengan reumatoid artritis, spondilitis mengankilosis, lupus eritematosus sistemik (lupus) dan penyakit auto imun yang lain berkemungkinan tinggi akan menghidap fibromialgia.
Walaupun ramai pesakit fibromialgia merasakan sakit apabila mereka berehat, rasa sakit itu amat ketara apabila otot mereka digunakan. Ketidakselesaan ini mungkin amat teruk sekali sehingga mengehadkan kebolehan mereka melakukan kerja-kerja harian mereka.
Apakah penyebab Fibromialgia?
Fibromialgia tidak mempunyai sebab yang diketahui, walaupun saintis dapat mengaitkannya kepada perkara trauma seperti kemalangan kereta, kecederaan berulang dan penyakit. Hubungan genetik juga dikatakan faktor penyebab.
Penyelidik juga mendapati bahawa Fibromialgia berlaku disebabkan keluarbiasaan fisiologi dalam korda spina, kawasan talamus otak dan paksi HPA.
Pemprosesan deria luar biasa dalam sistem saraf pusat meningkatkan pengalaman sakit dalam orang yang menghidap fibromialgia, dan membuatkannya lebih teruk lagi.
Pengurusan Fibromialgia
Cabaran utama untuk pesakit ialah diagnosis yang tepat. Oleh sebab tidak terdapat ujian makmal yang dapat mendiagnosis fibromialgia, doktor perlu bergantung pada pemeriksaan klinikal yang terdiri daripada sejarah perubatan pesakit, keterangan simptom, pemeriksaan fizikal dan pemeriksaan bahagian yang sakit.
Menurut American College of Rheumatology (ACR), kriteria ini mesti meliputi sakit di keempat-empat kuadran badan untuk tempoh minimum tiga bulan dan rasa sakit di sekurang-kurangnya 11 daripada 18 bahagian sakit apabila terdapat tekanan ke atasnya.
Tidak ada ubat untuk fibromialgia, tetapi terdapat beberapa perkara yang dapat melegakan anda. Berikut adalah beberapa tip:
1) Dapatkan seorang doktor yang memahami anda
Apabila ujian darah dan x-ray menunjukkan bahawa tiada masalah, ramai doktor akan memberitahu anda bahawa anda mempunyai masalah psikologi. Dapatkan pendapat kedua atau ketiga sehingga anda berjumpa dengan doktor yang biasa dengan fibromialgia dan yang dapat memahami kesakitan anda.
2) Atasi rasa sakit
Perubatan tahan sakit seperti asetaminofen atau ibuprofen mungkin berkesan dalam mengawal kesakitan yang dialami. Antidepresan dan suntikan pada bahagian sakit mungkin juga dapat membantu. Program tetap yang meliputi senaman ringan dan regangan yang dapat mengekalkan otot dan mengurangkan sakit dan kekejangan juga disyorkan.
3) Dapatkan tidur yang mencukupi
Rejim tidur yang sihat – seperti waktu masuk tidur dan bangun yang sama setiap hari, memastikan bahawa persekitaran tidur adalah sesuai, pengelakan kafeina, gula, alkohol sebelum tidur – akan melegakan keletihan siang hari. Perubatan tidur hanya disyorkan dalam kes kronik apabila pesakit tidak dapat tidur disebabkan sindrom kaki resah atau penyakit penggerakan kaki berkala.
4) Sokongan sosial
Sokongan Psikologi dan emosional adalah penting untuk pesakit fibromialgia. Pesakit perlu kerap berkomunikasi dengan sahabat handai dan ahli keluarga atau menjalani kaunseling apabila mereka mula ingin memencilkan diri.
5) Terapi pelengkap
Terapi merehatkan minda dan badan dapat membantu. Cuba terapi fizikal, urut terapeutik, terapi air, aerobik ringan, acupressure, aplikasi panas atau sejuk, akupunktur, yoga, senaman merehatkan, teknik pernafasan, terapi kognitif atau perkhidmatan kiropraktik.
6) Pemakanan yang baik
Pastikan diet anda seimbang dan berunding dengan doktor sama ada pemakanan tambahan diperlukan. Pemakanan yang baik akan meningkatkan kesejahteraan dan membantu anda menguruskan simptom dengan lebih baik.
7) Ubah gaya hidup anda
Ketahui apa yang menambahkan kesakitan, seperti pergerakan ulangan tertentu dan elakkan diri daripada melakukannya atau lakukan pada kadar yang sesuai agar anda tidak menyakitkan diri anda. Anda mungkin perlu berfikir tentang bertukar pekerjaan atau mengurangkan kadar kerja anda sekiranya simptom agak serius.
Sebelum anda mula berfikir bahawa sakit itu hanya dalam otak anda, mungkin anda harus bertanya doktor sama ada anda menghidap fibromialgia.
Apakah Fibromialgia?
Fibromialgia (FM) ialah penyakit kesakitan kronik yang mana ciri-cirinya adalah lenguh otot di seluruh badan, sakit dan kekejangan, sakit tisu lembut, keletihan dan masalah tidur.
Mereka yang menghidap juga mungkin mempunyai simptom lain seperti sakit kepala, tangan dan kaki yang berdenyut-denyut atau kebas, sengungut dan masalah dengan pemikiran dan ingatan, yang kadang kala dikenali sebagai “fibro fog”.
Sakit dan keletihan kadangkala begitu teruk sehingga mengganggu kehidupan harian seperti bangun daripada tidur dan bekerja. Sakit ini bertambah teruk dalam cuaca sejuk/lembap, tidur yang tidak memulihkan, keletihan fizikal dan mental, aktiviti fizikal berlebihan, tiada aktiviti fizikal, kerisauan dan ketegangan.
Simptom lain termasuk usus dan pundi kencing yang rengsa, sindrom kaki resah (gangguan pergerakan kaki berkala), kulit sensitif dan ruam, mata dan mulut kering, kemurungan, bunyi di dalam telinga, pening, masalah penglihatan, Sindrom Raynaud, simptom neurologi, dan masalah koordinasi. Semua simptom ini akan datang dan pergi.
Sakit otot biasanya dirasakan apabila pesakit melalukan aktiviti ulangan. Oleh itu, ramai pesakit mengehadkan aktiviti mereka termasuk rutin senaman. Ini menjadikan mereka tidak sihat dan akan memburukkan lagi simptom fibromialgia.
Fibromialgia boleh terjadi kepada sesiapa sahaja, yang mana wanita pertengahan umur berada dalam golongan peratusan yang tertinggi. Lebih ramai wanita yang menghidap fibromialgia berbanding lelaki, dengan nisbah kira-kira 20:1.
Mereka dengan reumatoid artritis, spondilitis mengankilosis, lupus eritematosus sistemik (lupus) dan penyakit auto imun yang lain berkemungkinan tinggi akan menghidap fibromialgia.
Walaupun ramai pesakit fibromialgia merasakan sakit apabila mereka berehat, rasa sakit itu amat ketara apabila otot mereka digunakan. Ketidakselesaan ini mungkin amat teruk sekali sehingga mengehadkan kebolehan mereka melakukan kerja-kerja harian mereka.
Apakah penyebab Fibromialgia?
Fibromialgia tidak mempunyai sebab yang diketahui, walaupun saintis dapat mengaitkannya kepada perkara trauma seperti kemalangan kereta, kecederaan berulang dan penyakit. Hubungan genetik juga dikatakan faktor penyebab.
Penyelidik juga mendapati bahawa Fibromialgia berlaku disebabkan keluarbiasaan fisiologi dalam korda spina, kawasan talamus otak dan paksi HPA.
Pemprosesan deria luar biasa dalam sistem saraf pusat meningkatkan pengalaman sakit dalam orang yang menghidap fibromialgia, dan membuatkannya lebih teruk lagi.
Pengurusan Fibromialgia
Cabaran utama untuk pesakit ialah diagnosis yang tepat. Oleh sebab tidak terdapat ujian makmal yang dapat mendiagnosis fibromialgia, doktor perlu bergantung pada pemeriksaan klinikal yang terdiri daripada sejarah perubatan pesakit, keterangan simptom, pemeriksaan fizikal dan pemeriksaan bahagian yang sakit.
Menurut American College of Rheumatology (ACR), kriteria ini mesti meliputi sakit di keempat-empat kuadran badan untuk tempoh minimum tiga bulan dan rasa sakit di sekurang-kurangnya 11 daripada 18 bahagian sakit apabila terdapat tekanan ke atasnya.
Tidak ada ubat untuk fibromialgia, tetapi terdapat beberapa perkara yang dapat melegakan anda. Berikut adalah beberapa tip:
1) Dapatkan seorang doktor yang memahami anda
Apabila ujian darah dan x-ray menunjukkan bahawa tiada masalah, ramai doktor akan memberitahu anda bahawa anda mempunyai masalah psikologi. Dapatkan pendapat kedua atau ketiga sehingga anda berjumpa dengan doktor yang biasa dengan fibromialgia dan yang dapat memahami kesakitan anda.
2) Atasi rasa sakit
Perubatan tahan sakit seperti asetaminofen atau ibuprofen mungkin berkesan dalam mengawal kesakitan yang dialami. Antidepresan dan suntikan pada bahagian sakit mungkin juga dapat membantu. Program tetap yang meliputi senaman ringan dan regangan yang dapat mengekalkan otot dan mengurangkan sakit dan kekejangan juga disyorkan.
3) Dapatkan tidur yang mencukupi
Rejim tidur yang sihat – seperti waktu masuk tidur dan bangun yang sama setiap hari, memastikan bahawa persekitaran tidur adalah sesuai, pengelakan kafeina, gula, alkohol sebelum tidur – akan melegakan keletihan siang hari. Perubatan tidur hanya disyorkan dalam kes kronik apabila pesakit tidak dapat tidur disebabkan sindrom kaki resah atau penyakit penggerakan kaki berkala.
4) Sokongan sosial
Sokongan Psikologi dan emosional adalah penting untuk pesakit fibromialgia. Pesakit perlu kerap berkomunikasi dengan sahabat handai dan ahli keluarga atau menjalani kaunseling apabila mereka mula ingin memencilkan diri.
5) Terapi pelengkap
Terapi merehatkan minda dan badan dapat membantu. Cuba terapi fizikal, urut terapeutik, terapi air, aerobik ringan, acupressure, aplikasi panas atau sejuk, akupunktur, yoga, senaman merehatkan, teknik pernafasan, terapi kognitif atau perkhidmatan kiropraktik.
6) Pemakanan yang baik
Pastikan diet anda seimbang dan berunding dengan doktor sama ada pemakanan tambahan diperlukan. Pemakanan yang baik akan meningkatkan kesejahteraan dan membantu anda menguruskan simptom dengan lebih baik.
7) Ubah gaya hidup anda
Ketahui apa yang menambahkan kesakitan, seperti pergerakan ulangan tertentu dan elakkan diri daripada melakukannya atau lakukan pada kadar yang sesuai agar anda tidak menyakitkan diri anda. Anda mungkin perlu berfikir tentang bertukar pekerjaan atau mengurangkan kadar kerja anda sekiranya simptom agak serius.
Sabtu, Mei 09, 2009
kesan pemakaian kasut tumit tinggi
PULAU PINANG 8 Mei - Berkasut tumit tinggi memang kegemaran sebahagian besar wanita kerana selain menjadi sebahagian daripada fesyen, penampilannya akan nampak lebih bergaya dan elegan apabila mengenakan kasut bertumit tinggi.
Bagaimanapun, kecenderungan ini boleh mengundang bahaya dan masalah kesihatan lebih-lebih lagi bagi wanita hamil.
Presiden Persatuan Pengguna Pulau Pinang (CAP) S. M. Mohamed Idris berkata, kasut tumit tinggi direka untuk menolak dada ke depan dan punggung ke belakang sehingga spina dan pinggul terkeluar daripada kedudukan asalnya dan menimbulkan masalah kesihatan bukan sahaja kepada kaki tetapi keseluruhan badan.
Katanya, CAP juga mendapati kasut tumit tinggi jika dipakai terlalu lama boleh menyebabkan kencing tidak lawas, masalah belakang dan tulang pinggul.''Selain itu ia juga boleh menyebabkan kesakitan pada bahagian rahang, leher dan kepala, gangguan kitaran haid malah membawa kepada masalah kesuburan,'' katanya pada sidang akhbar di pejabatnya di sini hari ini.
Menurut beliau, berkasut tumit tinggi selama bertahun-tahun akan menyebabkan tendon Achhilles menjadi pendek hingga menyebabkan sakit tumit.
Tambahnya, memakai kasut tumit tinggi mengubah cara jalan seseorang dengan mengenakan pusat graviti ke atas bebola kaki dan meletakkan tekanan berlebihan sehingga 26 peratus pada lutut iaitu kes biasa osteoprosis.
''Hasil kajian pakar pembedahan ortopedik dari Kolej Perubatan Baylor, Houston, Profesor Madya Dr. John Marymont, seseorang yang memakai kasut bertumit 2.5 inci memberi 50 peratus manakala kasut bertumit 3 inci memberi 76 peratus tekanan pada kaki.''
Masalah lebih menyakitkan berkaitan pemakaian kasut tumit tinggi ialah neuroma iaitu kaki dipaksa masuk ke dalam kasut tumit tinggi yang ketat dan runcing di depan,'' katanya.
Jelasnya, ia kemudian akan menekan saraf dan tisu mula terbentuk di sekitar saraf yang menyebabkan kesakitan sehingga pembedahan mungkin perlu dilakukan untuk memulihkannya.
Kecacatan Haglunds juga, katanya, sering dialami wanita berkasut tumit tinggi yang mana berlaku pembesaran tulang bahagian belakang kaki sehingga kaki bengkak, merah dan menyakitkan.''Masalah yang biasa berlaku ialah pergelangan kaki terseliuh kerana sukar mengimbang badan kerana memakai kasut tumit tinggi.''
Sehubungan itu CAP menasihati kaum wanita agar berhenti menyeksa tubuh mereka dengan mengelak kasut tumit tinggi yang boleh menyelamatkan diri daripada mengalami pelbagai masalah kesihatan,'' jelasnya.
Bagaimanapun, kecenderungan ini boleh mengundang bahaya dan masalah kesihatan lebih-lebih lagi bagi wanita hamil.
Presiden Persatuan Pengguna Pulau Pinang (CAP) S. M. Mohamed Idris berkata, kasut tumit tinggi direka untuk menolak dada ke depan dan punggung ke belakang sehingga spina dan pinggul terkeluar daripada kedudukan asalnya dan menimbulkan masalah kesihatan bukan sahaja kepada kaki tetapi keseluruhan badan.
Katanya, CAP juga mendapati kasut tumit tinggi jika dipakai terlalu lama boleh menyebabkan kencing tidak lawas, masalah belakang dan tulang pinggul.''Selain itu ia juga boleh menyebabkan kesakitan pada bahagian rahang, leher dan kepala, gangguan kitaran haid malah membawa kepada masalah kesuburan,'' katanya pada sidang akhbar di pejabatnya di sini hari ini.
Menurut beliau, berkasut tumit tinggi selama bertahun-tahun akan menyebabkan tendon Achhilles menjadi pendek hingga menyebabkan sakit tumit.
Tambahnya, memakai kasut tumit tinggi mengubah cara jalan seseorang dengan mengenakan pusat graviti ke atas bebola kaki dan meletakkan tekanan berlebihan sehingga 26 peratus pada lutut iaitu kes biasa osteoprosis.
''Hasil kajian pakar pembedahan ortopedik dari Kolej Perubatan Baylor, Houston, Profesor Madya Dr. John Marymont, seseorang yang memakai kasut bertumit 2.5 inci memberi 50 peratus manakala kasut bertumit 3 inci memberi 76 peratus tekanan pada kaki.''
Masalah lebih menyakitkan berkaitan pemakaian kasut tumit tinggi ialah neuroma iaitu kaki dipaksa masuk ke dalam kasut tumit tinggi yang ketat dan runcing di depan,'' katanya.
Jelasnya, ia kemudian akan menekan saraf dan tisu mula terbentuk di sekitar saraf yang menyebabkan kesakitan sehingga pembedahan mungkin perlu dilakukan untuk memulihkannya.
Kecacatan Haglunds juga, katanya, sering dialami wanita berkasut tumit tinggi yang mana berlaku pembesaran tulang bahagian belakang kaki sehingga kaki bengkak, merah dan menyakitkan.''Masalah yang biasa berlaku ialah pergelangan kaki terseliuh kerana sukar mengimbang badan kerana memakai kasut tumit tinggi.''
Sehubungan itu CAP menasihati kaum wanita agar berhenti menyeksa tubuh mereka dengan mengelak kasut tumit tinggi yang boleh menyelamatkan diri daripada mengalami pelbagai masalah kesihatan,'' jelasnya.
kanser prostat

1) Epidemiologi:
Kanser jenis yang kedua yang paling banyak dijangkiti oleh kaum lelaki. Di Amerika Syarikat orang keturunan Afrika menghidap 25% dari seluruh barah prostat di sana. Di Asia manakala hanya di antara 3-5%. Penduduk di California dijangkit kanser ini 100 kali lebih banyak dari penduduk Cina di Shanghai. Oleh sebab itu ada unsur-unsur genetik dan suasana kemastautinan yang perlu di selidik. Kes-kes kanser ini sedang menurun, 180 000 kes dalam setahun, tetapi tahapnya dua kali ganda 10 tahun yang lepas. Terdapat 40 000 kematian setahun. Kanser prostat mengambil jangka masa yang agak lama untuk merebak, oleh sebab itu kanser ini digelar penyakit orang tua. Isipadu ketumbuhan ini berlipat ganda setiap 4 tahun.
2) Ketumbuhan kanser prostat :
Kanser ini memrebak dari kelanjar; dari beberapa punca didalam kelenjar, ianya bermula didalam lapisan lemak prostat. Dari situ ianya merebak ke pundi kencing, saliran kelenjar seminal dan kelenjar limfa berdekatan. 90% dari sel kanser ini merebak ke tulang.
3) Simptom: -
Kerap kencing dan arus kencing yang perlahan, selalunya pada waktu malam. Kencing tak puas, darah atau sperma dalam air kencing adalah sebahagian dari simptomnya. - Kalau terdapat sakit-sakit tulang, pinggul atau tulang belakang, kemungkinan kanser telah melarat.
4) Diagnosa: -
Pemeriksaan rektum dengan menggunakan jari oleh doktor pakar ; - Petanda tumor iaitu PSA, had maksima yang boleh dicapai ialah 4.0ng/ml. Kalau dari lingkungan 4.0 ke 10 ng/ml, bengkak prostat biasa boleh disyaki. Tetapi untuk membezakan kanser prostat dari bengkak prostat biasa, menghitung FPSA( Free PSA) dan nisbah FPSA/PSA boleh menolong, untuk kajian yang normal nisbah ini mesti lebih tinggi dari 0.25. Kalau nisbah ini rendah kebarangkalian risiko kanser tinggi. - Menggunakan kaedah skan melalui dubur dan cebisan biopsi untuk mengenalpasti kedudukan dan saiz tumor. Oleh kerana mengambil biopsi ada risikonya, ianya boleh dielakkan dengan mengambil hitungan FPSA.
5) Rawatan:
Ianya bergantung kepada tahap tumor, adakahnya dah melarat dan membesar. Dalam kes-kes yang biasa ulangan dengan pakar dah memadai, tetapi memerlukan rawatan perubataan seperti terapi hormon. - Pembedahan : mengeluarkan keseluruhan atau sebahagian prostat; - Pancaran radiasi : Perkembangan yang pesat dalam mesin dan cara-cara perubatan; - Hormon terapi: Khasnya digunakan untuk mengurangkan tahap hormon testosteron, boleh mengakibatkan impotensi dan badan rasa panas ; - Kemoterapi jarang digunakan.
6) Rawatan susulan: -
Pemeriksaan klinikal; - ultrasound; - Skan dan kajian PSA dan FPSA. Selepas pembedahan prostat, tahap PSA akan turun ke kosong. Jikalau ada peningkatan tahap PSA ini menunjukan kewujudan kembali kanser prostat.
7) Pencegahan:
Ini di atas keperihatinan diri sendiri dan bermakna berjumpa doktor untuk pemeriksaan prostat melalui rektum dan kajian darah untuk PSA/FPSA.AWAS : Jikalau anda sedang mengambil apa-apa rawatan anti-penuaan yang mengandungi "DHEA", anda MESTI PASTIKAN anda tidak dijangkit kanser prostat. "DHEA mesti dimakan atas nasihat doktor, di mana doktor akan membuat kajian darah untuk steroid, lemak, glukos dan memeriksa kesihatan prostat." kata Dr. John Nestle, MD, profesor endokrin dan metabolisma di Universiti Virginia Commonwealth. Dialah orang yang membuat kajian mengenai kesan DHEA ke atas penyakit kencing manis dan pembekuan darah.
Petanda tumor adalah sebahagian daripada ujian Biomarkers C12; anda dinasihatkan menjalani ujian ini sekali setiap tahunKanser dapat dikesan : lakukannya SEKARANG.
Khamis, Mei 07, 2009
What is transposition of the great arteries(TGA)?

Transposition of the great arteries is a congenital (present at birth) heart defect. Due to abnormal development of the fetal heart during the first 8 weeks of pregnancy, the large vessels that take blood away from the heart to the lungs, or to the body, are improperly connected.
Normally, oxygen-poor (blue) blood returns to the right atrium from the body, travels to the right ventricle, then is pumped through the pulmonary artery into the lungs where it receives oxygen. Oxygen-rich (red) blood returns to the left atrium from the lungs, passes into the left ventricle, and then is pumped through the aorta out to the body.
In transposition of the great arteries, the aorta is connected to the right ventricle, and the pulmonary artery is connected to the left ventricle - the exact opposite of a normal heart's anatomy.
Oxygen-poor (blue) blood returns to the right atrium from the body, passes through the right atrium and ventricle, then goes into the misconnected aorta back to the body.
Oxygen-rich (red) blood returns to the left atrium from the lungs, passes through the left atrium and ventricle, then goes into the pulmonary artery and back to the lungs.
Two separate circuits are formed - one that circulates oxygen-poor (blue) blood from the body back to the body, and another that recirculates oxygen-rich (red) blood from the lungs back to the lungs.
Other heart defects are often associated with TGA, and they actually may be necessary in order for an infant with transposition of the great arteries to live. An opening in the atrial or ventricular septum will allow blood from one side to mix with blood from another, creating "purple" blood with an oxygen level somewhere in-between that of the oxygen-poor (blue) and the oxygen-rich (red) blood. Patent ductus arteriosus (another type of congenital heart defect) will also allow mixing of oxygen-poor (blue) and oxygen-rich (red) blood through the connection between the aorta and pulmonary artery. The "purple" blood that results from this mixing is beneficial, providing at least smaller amounts of oxygen to the body, if not a normal amount of oxygen.
Because of the low amount of oxygen provided to the body, TGA is a heart problem that is labeled "blue-baby syndrome."
Transposition of the great arteries is the second most common congenital heart defect that causes problems in early infancy. TGA occurs in 5 to 7 percent of all congenital heart defects. Sixty to 70 percent of the infants born with the defect are boys.
What causes transposition of the great arteries?
The heart is forming during the first 8 weeks of fetal development. The problem occurs in the middle of these weeks, allowing the aorta and pulmonary artery to be attached to the incorrect chamber.
Some congenital heart defects may have a genetic link, either occurring due to a defect in a gene, a chromosome abnormality, or environmental exposure, causing heart problems to occur more often in certain families. Most of the time this heart defect occurs sporadically (by chance), with no clear reason for its development.
Why is transposition of the great arteries a concern?
Babies with TGA have two separate circuits - one that circulates oxygen-poor (blue) blood from the body back to the body, and another that recirculates oxygen-rich (red) blood from the lungs back to the lungs. Without an additional heart defect that allows mixing of oxygen-poor (blue) and oxygen-rich (red) blood, such as an atrial or ventricular septal defect, infants with TGA will have oxygen-poor (blue) blood circulating through the body - a situation that is fatal. Even with an additional defect present that allows mixing, babies with transposition of the great arteries will not have enough oxygen in the bloodstream to meet the body's demands.
Even when a good bit of mixing of oxygen-poor (blue) and oxygen-rich (red) blood can occur, other problems are present. The left ventricle, which in TGA is connected to the pulmonary artery, is the stronger of the two ventricles since it normally has to generate a lot of force to pump blood to the body. The right ventricle, connected to the aorta in TGA, is the weaker of the two ventricles. Because the right ventricle is weaker, it may not be able to pump blood efficiently to the body, and it will enlarge under the strain of the job. The left ventricle may pump blood into the lungs more vigorously than needed, leading to strain in the blood vessels in the lungs.
What are the symptoms of transposition of the great arteries?
The obvious indication of TGA is a newborn who becomes cyanotic (blue) in the transitional first day of life when the maternal source of oxygen (from the placenta) is removed. Cyanosis is noted in the first hours of life in about half of the infants with TGA, and within the first days of life in 90 percent of them. The degree of cyanosis is related to the presence of other defects that allow blood to mix, including a patent ductus arteriosus - a fetal connection between the aorta and the pulmonary artery present in the newborn, which usually closes in the first few days after birth.
The following are the other most common symptoms of TGA. However, each child may experience symptoms differently. Symptoms may include:
rapid breathing
labored breathing
rapid heart rate
cool, clammy skin
The symptoms of TGA may resemble other medical conditions or heart problems. Always consult your child's physician for a diagnosis.
How is transposition of the great arteries diagnosed?
A pediatric cardiologist and/or a neonatologist may be involved in your child's care. A pediatric cardiologist specializes in the diagnosis and medical management of congenital heart defects, as well as heart problems that may develop later in childhood. A neonatologist specializes in illnesses affecting newborns, both premature and full-term.
Cyanosis is the major indication that there is a problem with your newborn. Your child's physician may have also heard a heart murmur during a physical examination. A heart murmur is simply a noise caused by the turbulence of blood flowing through the openings that allow the blood to mix.
Other diagnostic tests are needed to help with the diagnosis, and may include the following:
chest x-ray - a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
electrocardiogram (ECG or EKG) - a test that records the electrical activity of the heart, shows abnormal rhythms (arrhythmias or dysrhythmias), and detects heart muscle stress.
echocardiogram (echo) - a procedure that evaluates the structure and function of the heart by using sound waves recorded on an electronic sensor that produce a moving picture of the heart and heart valves.
cardiac catheterization - a cardiac catheterization is an invasive procedure that gives very detailed information about the structures inside the heart. Under sedation, a small, thin, flexible tube (catheter) is inserted into a blood vessel in the groin, and guided to the inside of the heart. Blood pressure and oxygen measurements are taken in the four chambers of the heart, as well as the pulmonary artery and aorta. Contrast dye is also injected to more clearly visualize the structures inside the heart.
Treatment for transposition of the great arteries:
Specific treatment for transposition of the great arteries will be determined by your child's physician based on:
your child's age, overall health, and medical history
extent of the disease
your child's tolerance for specific medications, procedures, or therapies
expectations for the course of the disease
your opinion or preference
Your child will most likely be admitted to the intensive care unit (ICU) or special care nursery once symptoms are noted. Initially, your child may be placed on oxygen, and possibly even on a ventilator, to assist his/her breathing. Intravenous (IV) medications may be given to help the heart and lungs function more efficiently.
Other important aspects of initial treatment include the following:
A cardiac catheterization procedure can be used as a diagnostic procedure, as well as initial treatment procedure for some heart defects. A cardiac catheterization procedure will usually be performed to evaluate the defect(s) and the amount of blood that is mixing.
As part of the cardiac catheterization, a procedure called a balloon atrial septostomy may be performed to improve mixing of oxygen-rich (red) and oxygen-poor (blue) blood.
A special catheter with a balloon in the tip is used to create an opening in the atrial septum (wall between the left and right atria).
The catheter is guided through the foramen ovale (a small opening present in the atrial septum that closes shortly after birth) and into the left atrium.
The balloon is inflated.
The catheter is quickly pulled back through the hole, into the right atrium, enlarging the hole, allowing blood to mix between the atria.
An intravenous medication called prostaglandin E1 is given to keep the ductus arteriosus from closing.
Within the first 1 to 2 weeks of age, transposition of the great arteries is surgically repaired. The procedure that accomplishes this is called a "switch," which roughly describes the surgical process.
The operation is performed under general anesthesia, and involves the following:
The aorta is moved from the right ventricle to its normal position over the left ventricle.
The pulmonary artery is moved from the left ventricle to its normal position over the right ventricle.
The coronary arteries are moved so they will originate from the aorta and take oxygen-rich (red) blood to the heart muscle.
Other defects, such as atrial or ventricular septal defects or a patent ductus arteriosus, are commonly closed.
Postoperative care for your child:
After surgery, infants will return to the intensive care unit (ICU) for a few days to be closely monitored during recovery.
While your child is in the ICU, special equipment will be used to help him/her recover, and may include the following:
ventilator - a machine that helps your child breathe while he/she is under anesthesia during the operation. A small, plastic tube is guided into the windpipe and attached to the ventilator, which breathes for your child while he/she is too sleepy to breathe effectively on his/her own. After a transposition of the great arteries, children will benefit from remaining on the ventilator overnight or even longer so they can rest.
intravenous (IV) catheters - small, plastic tubes inserted through the skin into blood vessels to provide IV fluids and important medicines that help your child recover from the operation.
arterial line - a specialized IV line is placed in the wrist or other area of the body where a pulse can be felt, that measures blood pressure continuously during surgery and while your child is in the ICU.
nasogastric (NG) tube - a small, flexible tube that keeps the stomach drained of acid and gas bubbles that may build up during surgery.
urinary catheter - a small, flexible tube that allows urine to drain out of the bladder and accurately measures how much urine the body makes, which helps determine how well the heart is functioning. After surgery, the heart will be a little weaker than it was before, and, therefore, the body may start to hold onto fluid, causing swelling and puffiness.
Diuretics may be given to help the kidneys to remove excess fluid from the body.
chest tube - a drainage tube may be inserted to keep the chest free of blood that would otherwise accumulate after the incision is closed. Bleeding may occur for several hours, or even a few days after surgery.
heart monitor - a machine that constantly displays a picture of your child's heart rhythm, and monitors heart rate, arterial blood pressure, and other values.
Your child may need other equipment not mentioned here to provide support while in the ICU, or afterwards. The hospital staff will explain all of the necessary equipment to you.
Your child will be kept as comfortable as possible with several different medications; some which relieve pain, and some which relieve anxiety. The staff will also be asking for your input as to how best to soothe and comfort your child.
After discharged from the ICU, your child will recuperate on another hospital unit for a few days before going home. You will learn how to care for your child at home before your child is discharged. Your child may need to take medications for a while, and these will be explained to you. The staff will give you written instructions regarding medications, activity limitations, and follow-up appointments before your child is discharged.
Infants who spent a lot of time on a ventilator, or who were fairly ill while in the ICU, may have trouble feeding initially. These babies may have an oral aversion; they might equate something placed in the mouth, such as a pacifier or bottle, with a less pleasant sensation such as being on the ventilator. Some infants are just tired, and need to build their strength up before they will be able to learn to bottle feed. Strategies used to help infants with nutrition include the following:
high-calorie formula or breast milkSpecial nutritional supplements may be added to formula or pumped breast milk that increase the number of calories in each ounce, thereby allowing your baby to drink less and still consume enough calories to grow properly.
supplemental tube feedingsFeedings given through a small, flexible tube that passes through the nose, down the esophagus, and into the stomach, that can either supplement or take the place of bottle-feedings. Infants who can drink part of their bottle, but not all, may be fed the remainder through the feeding tube. Infants who are too tired to bottle-feed at all may receive their formula or breast milk through the feeding tube alone.
Caring for your child at home following a TGA surgical repair:
Pain medications, such as acetaminophen or ibuprofen, may be recommended to keep your child comfortable at home. Your child's physician will discuss pain control before your child is discharged from the hospital.
If any special treatments are to be given at home, the nursing staff will ensure that you are able to provide them, or a home health agency may assist you.
You may receive additional instructions from your child's physicians and the hospital staff.
Long-term outlook after TGA surgical repair:
Many infants who undergo TGA surgical repair will grow and develop normally. However, after TGA repair, your infant will need to be followed periodically by a pediatric cardiologist who will make assessments to check for any heart-related problems, which can include the following:
fast, slow, or irregular heart rhythms
leaky heart valves
narrowing of one or both of the great arteries at the switch connection site(s)
narrowing of the coronary arteries at their switch connection site
Prior to the early 1990’s, TGA was generally treated surgically with a Mustard procedure or a Senning procedure. These procedures created a tunnel, or baffle, in the atria to correct blood flow. In the late 1980’s, the arterial switch procedure was introduced. This procedure “switches” the aorta and pulmonary artery to the proper locations. However, the arterial switch procedure may not be indicated in certain situations.
For individuals whose TGA was repaired using a Mustard or Senning procedure, complications such as heart failure and dysrhythmias may develop in the second or third decade of life. There is also a risk for sudden death. Thus, these individuals should receive regular follow-up care at a center offering pediatric or adult congenital cardiac care throughout the individual’s lifespan.
Consult your child's physician regarding the specific outlook for your child.
Normally, oxygen-poor (blue) blood returns to the right atrium from the body, travels to the right ventricle, then is pumped through the pulmonary artery into the lungs where it receives oxygen. Oxygen-rich (red) blood returns to the left atrium from the lungs, passes into the left ventricle, and then is pumped through the aorta out to the body.
In transposition of the great arteries, the aorta is connected to the right ventricle, and the pulmonary artery is connected to the left ventricle - the exact opposite of a normal heart's anatomy.
Oxygen-poor (blue) blood returns to the right atrium from the body, passes through the right atrium and ventricle, then goes into the misconnected aorta back to the body.
Oxygen-rich (red) blood returns to the left atrium from the lungs, passes through the left atrium and ventricle, then goes into the pulmonary artery and back to the lungs.
Two separate circuits are formed - one that circulates oxygen-poor (blue) blood from the body back to the body, and another that recirculates oxygen-rich (red) blood from the lungs back to the lungs.
Other heart defects are often associated with TGA, and they actually may be necessary in order for an infant with transposition of the great arteries to live. An opening in the atrial or ventricular septum will allow blood from one side to mix with blood from another, creating "purple" blood with an oxygen level somewhere in-between that of the oxygen-poor (blue) and the oxygen-rich (red) blood. Patent ductus arteriosus (another type of congenital heart defect) will also allow mixing of oxygen-poor (blue) and oxygen-rich (red) blood through the connection between the aorta and pulmonary artery. The "purple" blood that results from this mixing is beneficial, providing at least smaller amounts of oxygen to the body, if not a normal amount of oxygen.
Because of the low amount of oxygen provided to the body, TGA is a heart problem that is labeled "blue-baby syndrome."
Transposition of the great arteries is the second most common congenital heart defect that causes problems in early infancy. TGA occurs in 5 to 7 percent of all congenital heart defects. Sixty to 70 percent of the infants born with the defect are boys.
What causes transposition of the great arteries?
The heart is forming during the first 8 weeks of fetal development. The problem occurs in the middle of these weeks, allowing the aorta and pulmonary artery to be attached to the incorrect chamber.
Some congenital heart defects may have a genetic link, either occurring due to a defect in a gene, a chromosome abnormality, or environmental exposure, causing heart problems to occur more often in certain families. Most of the time this heart defect occurs sporadically (by chance), with no clear reason for its development.
Why is transposition of the great arteries a concern?
Babies with TGA have two separate circuits - one that circulates oxygen-poor (blue) blood from the body back to the body, and another that recirculates oxygen-rich (red) blood from the lungs back to the lungs. Without an additional heart defect that allows mixing of oxygen-poor (blue) and oxygen-rich (red) blood, such as an atrial or ventricular septal defect, infants with TGA will have oxygen-poor (blue) blood circulating through the body - a situation that is fatal. Even with an additional defect present that allows mixing, babies with transposition of the great arteries will not have enough oxygen in the bloodstream to meet the body's demands.
Even when a good bit of mixing of oxygen-poor (blue) and oxygen-rich (red) blood can occur, other problems are present. The left ventricle, which in TGA is connected to the pulmonary artery, is the stronger of the two ventricles since it normally has to generate a lot of force to pump blood to the body. The right ventricle, connected to the aorta in TGA, is the weaker of the two ventricles. Because the right ventricle is weaker, it may not be able to pump blood efficiently to the body, and it will enlarge under the strain of the job. The left ventricle may pump blood into the lungs more vigorously than needed, leading to strain in the blood vessels in the lungs.
What are the symptoms of transposition of the great arteries?
The obvious indication of TGA is a newborn who becomes cyanotic (blue) in the transitional first day of life when the maternal source of oxygen (from the placenta) is removed. Cyanosis is noted in the first hours of life in about half of the infants with TGA, and within the first days of life in 90 percent of them. The degree of cyanosis is related to the presence of other defects that allow blood to mix, including a patent ductus arteriosus - a fetal connection between the aorta and the pulmonary artery present in the newborn, which usually closes in the first few days after birth.
The following are the other most common symptoms of TGA. However, each child may experience symptoms differently. Symptoms may include:
rapid breathing
labored breathing
rapid heart rate
cool, clammy skin
The symptoms of TGA may resemble other medical conditions or heart problems. Always consult your child's physician for a diagnosis.
How is transposition of the great arteries diagnosed?
A pediatric cardiologist and/or a neonatologist may be involved in your child's care. A pediatric cardiologist specializes in the diagnosis and medical management of congenital heart defects, as well as heart problems that may develop later in childhood. A neonatologist specializes in illnesses affecting newborns, both premature and full-term.
Cyanosis is the major indication that there is a problem with your newborn. Your child's physician may have also heard a heart murmur during a physical examination. A heart murmur is simply a noise caused by the turbulence of blood flowing through the openings that allow the blood to mix.
Other diagnostic tests are needed to help with the diagnosis, and may include the following:
chest x-ray - a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
electrocardiogram (ECG or EKG) - a test that records the electrical activity of the heart, shows abnormal rhythms (arrhythmias or dysrhythmias), and detects heart muscle stress.
echocardiogram (echo) - a procedure that evaluates the structure and function of the heart by using sound waves recorded on an electronic sensor that produce a moving picture of the heart and heart valves.
cardiac catheterization - a cardiac catheterization is an invasive procedure that gives very detailed information about the structures inside the heart. Under sedation, a small, thin, flexible tube (catheter) is inserted into a blood vessel in the groin, and guided to the inside of the heart. Blood pressure and oxygen measurements are taken in the four chambers of the heart, as well as the pulmonary artery and aorta. Contrast dye is also injected to more clearly visualize the structures inside the heart.
Treatment for transposition of the great arteries:
Specific treatment for transposition of the great arteries will be determined by your child's physician based on:
your child's age, overall health, and medical history
extent of the disease
your child's tolerance for specific medications, procedures, or therapies
expectations for the course of the disease
your opinion or preference
Your child will most likely be admitted to the intensive care unit (ICU) or special care nursery once symptoms are noted. Initially, your child may be placed on oxygen, and possibly even on a ventilator, to assist his/her breathing. Intravenous (IV) medications may be given to help the heart and lungs function more efficiently.
Other important aspects of initial treatment include the following:
A cardiac catheterization procedure can be used as a diagnostic procedure, as well as initial treatment procedure for some heart defects. A cardiac catheterization procedure will usually be performed to evaluate the defect(s) and the amount of blood that is mixing.
As part of the cardiac catheterization, a procedure called a balloon atrial septostomy may be performed to improve mixing of oxygen-rich (red) and oxygen-poor (blue) blood.
A special catheter with a balloon in the tip is used to create an opening in the atrial septum (wall between the left and right atria).
The catheter is guided through the foramen ovale (a small opening present in the atrial septum that closes shortly after birth) and into the left atrium.
The balloon is inflated.
The catheter is quickly pulled back through the hole, into the right atrium, enlarging the hole, allowing blood to mix between the atria.
An intravenous medication called prostaglandin E1 is given to keep the ductus arteriosus from closing.
Within the first 1 to 2 weeks of age, transposition of the great arteries is surgically repaired. The procedure that accomplishes this is called a "switch," which roughly describes the surgical process.
The operation is performed under general anesthesia, and involves the following:
The aorta is moved from the right ventricle to its normal position over the left ventricle.
The pulmonary artery is moved from the left ventricle to its normal position over the right ventricle.
The coronary arteries are moved so they will originate from the aorta and take oxygen-rich (red) blood to the heart muscle.
Other defects, such as atrial or ventricular septal defects or a patent ductus arteriosus, are commonly closed.
Postoperative care for your child:
After surgery, infants will return to the intensive care unit (ICU) for a few days to be closely monitored during recovery.
While your child is in the ICU, special equipment will be used to help him/her recover, and may include the following:
ventilator - a machine that helps your child breathe while he/she is under anesthesia during the operation. A small, plastic tube is guided into the windpipe and attached to the ventilator, which breathes for your child while he/she is too sleepy to breathe effectively on his/her own. After a transposition of the great arteries, children will benefit from remaining on the ventilator overnight or even longer so they can rest.
intravenous (IV) catheters - small, plastic tubes inserted through the skin into blood vessels to provide IV fluids and important medicines that help your child recover from the operation.
arterial line - a specialized IV line is placed in the wrist or other area of the body where a pulse can be felt, that measures blood pressure continuously during surgery and while your child is in the ICU.
nasogastric (NG) tube - a small, flexible tube that keeps the stomach drained of acid and gas bubbles that may build up during surgery.
urinary catheter - a small, flexible tube that allows urine to drain out of the bladder and accurately measures how much urine the body makes, which helps determine how well the heart is functioning. After surgery, the heart will be a little weaker than it was before, and, therefore, the body may start to hold onto fluid, causing swelling and puffiness.
Diuretics may be given to help the kidneys to remove excess fluid from the body.
chest tube - a drainage tube may be inserted to keep the chest free of blood that would otherwise accumulate after the incision is closed. Bleeding may occur for several hours, or even a few days after surgery.
heart monitor - a machine that constantly displays a picture of your child's heart rhythm, and monitors heart rate, arterial blood pressure, and other values.
Your child may need other equipment not mentioned here to provide support while in the ICU, or afterwards. The hospital staff will explain all of the necessary equipment to you.
Your child will be kept as comfortable as possible with several different medications; some which relieve pain, and some which relieve anxiety. The staff will also be asking for your input as to how best to soothe and comfort your child.
After discharged from the ICU, your child will recuperate on another hospital unit for a few days before going home. You will learn how to care for your child at home before your child is discharged. Your child may need to take medications for a while, and these will be explained to you. The staff will give you written instructions regarding medications, activity limitations, and follow-up appointments before your child is discharged.
Infants who spent a lot of time on a ventilator, or who were fairly ill while in the ICU, may have trouble feeding initially. These babies may have an oral aversion; they might equate something placed in the mouth, such as a pacifier or bottle, with a less pleasant sensation such as being on the ventilator. Some infants are just tired, and need to build their strength up before they will be able to learn to bottle feed. Strategies used to help infants with nutrition include the following:
high-calorie formula or breast milkSpecial nutritional supplements may be added to formula or pumped breast milk that increase the number of calories in each ounce, thereby allowing your baby to drink less and still consume enough calories to grow properly.
supplemental tube feedingsFeedings given through a small, flexible tube that passes through the nose, down the esophagus, and into the stomach, that can either supplement or take the place of bottle-feedings. Infants who can drink part of their bottle, but not all, may be fed the remainder through the feeding tube. Infants who are too tired to bottle-feed at all may receive their formula or breast milk through the feeding tube alone.
Caring for your child at home following a TGA surgical repair:
Pain medications, such as acetaminophen or ibuprofen, may be recommended to keep your child comfortable at home. Your child's physician will discuss pain control before your child is discharged from the hospital.
If any special treatments are to be given at home, the nursing staff will ensure that you are able to provide them, or a home health agency may assist you.
You may receive additional instructions from your child's physicians and the hospital staff.
Long-term outlook after TGA surgical repair:
Many infants who undergo TGA surgical repair will grow and develop normally. However, after TGA repair, your infant will need to be followed periodically by a pediatric cardiologist who will make assessments to check for any heart-related problems, which can include the following:
fast, slow, or irregular heart rhythms
leaky heart valves
narrowing of one or both of the great arteries at the switch connection site(s)
narrowing of the coronary arteries at their switch connection site
Prior to the early 1990’s, TGA was generally treated surgically with a Mustard procedure or a Senning procedure. These procedures created a tunnel, or baffle, in the atria to correct blood flow. In the late 1980’s, the arterial switch procedure was introduced. This procedure “switches” the aorta and pulmonary artery to the proper locations. However, the arterial switch procedure may not be indicated in certain situations.
For individuals whose TGA was repaired using a Mustard or Senning procedure, complications such as heart failure and dysrhythmias may develop in the second or third decade of life. There is also a risk for sudden death. Thus, these individuals should receive regular follow-up care at a center offering pediatric or adult congenital cardiac care throughout the individual’s lifespan.
Consult your child's physician regarding the specific outlook for your child.
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