Monday, August 30, 2010
Social Security & Lupus
Lupus sometimes renders it’s victims unable to work, however, the Social Security Administration (SSA) does not always recognize that fact. If Lupus has caused you to no longer be able to sustain work, you may be eligible for Social Security Disability.
You can view the Adult Disability Starter Kit for answers to your questions about applying for benefits and a worksheet that will help you gather the needed information. You can then apply for benefits online, or you can make an appointment to apply by phone or in person by calling 1-800-772-1213.
The Lupus Foundation of America and other Lupus organizations have lobbied on behalf of Lupus patients seeking Social Security Disability for many years. Things are better than they were in the past. Getting support, however, can still be an uphill battle!
The creator of this site, Kendra Isola, fought with the SSA for five years and she learned two things that she says every disability applicant should know. First, you need a representative. You can be represented by a lawyer or another organization that represents disability claimants, but you need somebody in your corner that knows the “lingo.” A denial can be based on something as simple as things being worded wrong in the application. Most representatives do not charge an up front fee. You only pay if you win.
Second, you may need help from your Congress people. Kendra endured five denials over five years. She was so fed up that she wrote Senator Tom Harkin about her situation. After review of the case, Senator Harkin’s office made one phone call and Kendra was approved that very day. If you feel you have not been considered fairly, you can write or email your Senators and Representatives to ask for assistance.
Other helpful ideas:
File as soon as you are unable to work, you can only get benefits from your application date.
File all paperwork and requested information in a timely manner.
Have each of your doctors fill out an RFC (Residual Function Capacity) form. An example RFC form can be found here: http://www.legisit.com/forms/SSA-4734-U8.pdf
Have family members write about how your illness affects your daily life.
Get regular, ongoing medical care.
Share all of your symptoms and limitations with your doctors, ask them to record it in your medical record.
Your local Vocational Rehab Office may also be able to help you obtain benefits.
If you are denied file an appeal immediately. It make take several tries before you are approved.
Take all medications as prescribed, keep appointments and follow your doctor's instructions. Non-compliance may be a reason for denial.
Stay friendly with the people working on your case.
Always keep copies of everything you file with the SSA, you never know
Whether you are just starting out with your application or if you have been denied several times, we hope you will learn tips that help you get your application for Social Security approved!
Source: cure4lupus.org
http://webcache.googleusercontent.com/search?q=cache:xfHs6DRzc2kJ:cure4lupus.org/store/index.php%3Fmain_page%3Dpage%26id%3D30%26chapter%3D6+lupus+ssa&cd=6&hl=en&ct=clnk&gl=us
You can view the Adult Disability Starter Kit for answers to your questions about applying for benefits and a worksheet that will help you gather the needed information. You can then apply for benefits online, or you can make an appointment to apply by phone or in person by calling 1-800-772-1213.
The Lupus Foundation of America and other Lupus organizations have lobbied on behalf of Lupus patients seeking Social Security Disability for many years. Things are better than they were in the past. Getting support, however, can still be an uphill battle!
The creator of this site, Kendra Isola, fought with the SSA for five years and she learned two things that she says every disability applicant should know. First, you need a representative. You can be represented by a lawyer or another organization that represents disability claimants, but you need somebody in your corner that knows the “lingo.” A denial can be based on something as simple as things being worded wrong in the application. Most representatives do not charge an up front fee. You only pay if you win.
Second, you may need help from your Congress people. Kendra endured five denials over five years. She was so fed up that she wrote Senator Tom Harkin about her situation. After review of the case, Senator Harkin’s office made one phone call and Kendra was approved that very day. If you feel you have not been considered fairly, you can write or email your Senators and Representatives to ask for assistance.
Other helpful ideas:
File as soon as you are unable to work, you can only get benefits from your application date.
File all paperwork and requested information in a timely manner.
Have each of your doctors fill out an RFC (Residual Function Capacity) form. An example RFC form can be found here: http://www.legisit.com/forms/SSA-4734-U8.pdf
Have family members write about how your illness affects your daily life.
Get regular, ongoing medical care.
Share all of your symptoms and limitations with your doctors, ask them to record it in your medical record.
Your local Vocational Rehab Office may also be able to help you obtain benefits.
If you are denied file an appeal immediately. It make take several tries before you are approved.
Take all medications as prescribed, keep appointments and follow your doctor's instructions. Non-compliance may be a reason for denial.
Stay friendly with the people working on your case.
Always keep copies of everything you file with the SSA, you never know
Whether you are just starting out with your application or if you have been denied several times, we hope you will learn tips that help you get your application for Social Security approved!
Source: cure4lupus.org
http://webcache.googleusercontent.com/search?q=cache:xfHs6DRzc2kJ:cure4lupus.org/store/index.php%3Fmain_page%3Dpage%26id%3D30%26chapter%3D6+lupus+ssa&cd=6&hl=en&ct=clnk&gl=us
Saturday, August 28, 2010
The Spoon Theory
by Christine Miserandino www.butyoudontlooksick.com
My best friend and I were in the diner, talking. As usual, it was very late and we were eating French fries with gravy. Like normal girls our age, we spent a lot of time in the diner while in college, and most of the time we spent talking about boys, music or trivial things, that seemed very important at the time. We never got serious about anything in particular and spent most of our time laughing.
As I went to take some of my medicine with a snack as I usually did, she watched me with an awkward kind of stare, instead of continuing the conversation. She then asked me out of the blue what it felt like to have Lupus and be sick. I was shocked not only because she asked the random question, but also because I assumed she knew all there was to know about Lupus. She came to doctors with me, she saw me walk with a cane, and throw up in the bathroom. She had seen me cry in pain, what else was there to know?
I started to ramble on about pills, and aches and pains, but she kept pursuing, and didn’t seem satisfied with my answers. I was a little surprised as being my roommate in college and friend for years; I thought she already knew the medical definition of Lupus. Then she looked at me with a face every sick person knows well, the face of pure curiosity about something no one healthy can truly understand. She asked what it felt like, not physically, but what it felt like to be me, to be sick.
As I tried to gain my composure, I glanced around the table for help or guidance, or at least stall for time to think. I was trying to find the right words. How do I answer a question I never was able to answer for myself? How do I explain every detail of every day being effected, and give the emotions a sick person goes through with clarity. I could have given up, cracked a joke like I usually do, and changed the subject, but I remember thinking if I don’t try to explain this, how could I ever expect her to understand. If I can’t explain this to my best friend, how could I explain my world to anyone else? I had to at least try.
At that moment, the spoon theory was born. I quickly grabbed every spoon on the table; hell I grabbed spoons off of the other tables. I looked at her in the eyes and said “Here you go, you have Lupus”. She looked at me slightly confused, as anyone would when they are being handed a bouquet of spoons. The cold metal spoons clanked in my hands, as I grouped them together and shoved them into her hands.
I explained that the difference in being sick and being healthy is having to make choices or to consciously think about things when the rest of the world doesn’t have to. The healthy have the luxury of a life without choices, a gift most people take for granted.
Most people start the day with unlimited amount of possibilities, and energy to do whatever they desire, especially young people. For the most part, they do not need to worry about the effects of their actions. So for my explanation, I used spoons to convey this point. I wanted something for her to actually hold, for me to then take away, since most people who get sick feel a “loss” of a life they once knew. If I was in control of taking away the spoons, then she would know what it feels like to have someone or something else, in this case Lupus, being in control.
She grabbed the spoons with excitement. She didn’t understand what I was doing, but she is always up for a good time, so I guess she thought I was cracking a joke of some kind like I usually do when talking about touchy topics. Little did she know how serious I would become?
I asked her to count her spoons. She asked why, and I explained that when you are healthy you expect to have a never-ending supply of “spoons”. But when you have to now plan your day, you need to know exactly how many “spoons” you are starting with. It doesn’t guarantee that you might not lose some along the way, but at least it helps to know where you are starting. She counted out 12 spoons. She laughed and said she wanted more. I said no, and I knew right away that this little game would work, when she looked disappointed, and we hadn’t even started yet. I’ve wanted more “spoons” for years and haven’t found a way yet to get more, why should she? I also told her to always be conscious of how many she had, and not to drop them because she can never forget she has Lupus.
I asked her to list off the tasks of her day, including the most simple. As, she rattled off daily chores, or just fun things to do; I explained how each one would cost her a spoon. When she jumped right into getting ready for work as her first task of the morning, I cut her off and took away a spoon. I practically jumped down her throat. I said ” No! You don’t just get up. You have to crack open your eyes, and then realize you are late. You didn’t sleep well the night before. You have to crawl out of bed, and then you have to make your self something to eat before you can do anything else, because if you don’t, you can’t take your medicine, and if you don’t take your medicine you might as well give up all your spoons for today and tomorrow too.” I quickly took away a spoon and she realized she hasn’t even gotten dressed yet. Showering cost her spoon, just for washing her hair and shaving her legs. Reaching high and low that early in the morning could actually cost more than one spoon, but I figured I would give her a break; I didn’t want to scare her right away. Getting dressed was worth another spoon. I stopped her and broke down every task to show her how every little detail needs to be thought about. You cannot simply just throw clothes on when you are sick. I explained that I have to see what clothes I can physically put on, if my hands hurt that day buttons are out of the question. If I have bruises that day, I need to wear long sleeves, and if I have a fever I need a sweater to stay warm and so on. If my hair is falling out I need to spend more time to look presentable, and then you need to factor in another 5 minutes for feeling badly that it took you 2 hours to do all this.
I think she was starting to understand when she theoretically didn’t even get to work, and she was left with 6 spoons. I then explained to her that she needed to choose the rest of her day wisely, since when your “spoons” are gone, they are gone. Sometimes you can borrow against tomorrow’s “spoons”, but just think how hard tomorrow will be with less “spoons”. I also needed to explain that a person who is sick always lives with the looming thought that tomorrow may be the day that a cold comes, or an infection, or any number of things that could be very dangerous. So you do not want to run low on “spoons”, because you never know when you truly will need them. I didn’t want to depress her, but I needed to be realistic, and unfortunately being prepared for the worst is part of a real day for me.
We went through the rest of the day, and she slowly learned that skipping lunch would cost her a spoon, as well as standing on a train, or even typing at her computer too long. She was forced to make choices and think about things differently. Hypothetically, she had to choose not to run errands, so that she could eat dinner that night.
When we got to the end of her pretend day, she said she was hungry. I summarized that she had to eat dinner but she only had one spoon left. If she cooked, she wouldn’t have enough energy to clean the pots. If she went out for dinner, she might be too tired to drive home safely. Then I also explained, that I didn’t even bother to add into this game, that she was so nauseous, that cooking was probably out of the question anyway. So she decided to make soup, it was easy. I then said it is only 7pm, you have the rest of the night but maybe end up with one spoon, so you can do something fun, or clean your apartment, or do chores, but you can’t do it all.
I rarely see her emotional, so when I saw her upset I knew maybe I was getting through to her. I didn’t want my friend to be upset, but at the same time I was happy to think finally maybe someone understood me a little bit. She had tears in her eyes and asked quietly “Christine, How do you do it? Do you really do this everyday?” I explained that some days were worse then others; some days I have more spoons then most. But I can never make it go away and I can’t forget about it, I always have to think about it. I handed her a spoon I had been holding in reserve. I said simply, “I have learned to live life with an extra spoon in my pocket, in reserve. You need to always be prepared.”
Its hard, the hardest thing I ever had to learn is to slow down, and not do everything. I fight this to this day. I hate feeling left out, having to choose to stay home, or to not get things done that I want to. I wanted her to feel that frustration. I wanted her to understand, that everything everyone else does comes so easy, but for me it is one hundred little jobs in one. I need to think about the weather, my temperature that day, and the whole day’s plans before I can attack any one given thing. When other people can simply do things, I have to attack it and make a plan like I am strategizing a war. It is in that lifestyle, the difference between being sick and healthy. It is the beautiful ability to not think and just do. I miss that freedom. I miss never having to count “spoons”.
After we were emotional and talked about this for a little while longer, I sensed she was sad. Maybe she finally understood. Maybe she realized that she never could truly and honestly say she understands. But at least now she might not complain so much when I can’t go out for dinner some nights, or when I never seem to make it to her house and she always has to drive to mine. I gave her a hug when we walked out of the diner. I had the one spoon in my hand and I said “Don’t worry. I see this as a blessing. I have been forced to think about everything I do. Do you know how many spoons people waste everyday? I don’t have room for wasted time, or wasted “spoons” and I chose to spend this time with you.”
Ever since this night, I have used the spoon theory to explain my life to many people. In fact, my family and friends refer to spoons all the time. It has been a code word for what I can and cannot do. Once people understand the spoon theory they seem to understand me better, but I also think they live their life a little differently too. I think it isn’t just good for understanding Lupus, but anyone dealing with any disability or illness. Hopefully, they don’t take so much for granted or their life in general. I give a piece of myself, in every sense of the word when I do anything. It has become an inside joke. I have become famous for saying to people jokingly that they should feel special when I spend time with them, because they have one of my “spoons”.
© Christine Miserandino
My best friend and I were in the diner, talking. As usual, it was very late and we were eating French fries with gravy. Like normal girls our age, we spent a lot of time in the diner while in college, and most of the time we spent talking about boys, music or trivial things, that seemed very important at the time. We never got serious about anything in particular and spent most of our time laughing.
As I went to take some of my medicine with a snack as I usually did, she watched me with an awkward kind of stare, instead of continuing the conversation. She then asked me out of the blue what it felt like to have Lupus and be sick. I was shocked not only because she asked the random question, but also because I assumed she knew all there was to know about Lupus. She came to doctors with me, she saw me walk with a cane, and throw up in the bathroom. She had seen me cry in pain, what else was there to know?
I started to ramble on about pills, and aches and pains, but she kept pursuing, and didn’t seem satisfied with my answers. I was a little surprised as being my roommate in college and friend for years; I thought she already knew the medical definition of Lupus. Then she looked at me with a face every sick person knows well, the face of pure curiosity about something no one healthy can truly understand. She asked what it felt like, not physically, but what it felt like to be me, to be sick.
As I tried to gain my composure, I glanced around the table for help or guidance, or at least stall for time to think. I was trying to find the right words. How do I answer a question I never was able to answer for myself? How do I explain every detail of every day being effected, and give the emotions a sick person goes through with clarity. I could have given up, cracked a joke like I usually do, and changed the subject, but I remember thinking if I don’t try to explain this, how could I ever expect her to understand. If I can’t explain this to my best friend, how could I explain my world to anyone else? I had to at least try.
At that moment, the spoon theory was born. I quickly grabbed every spoon on the table; hell I grabbed spoons off of the other tables. I looked at her in the eyes and said “Here you go, you have Lupus”. She looked at me slightly confused, as anyone would when they are being handed a bouquet of spoons. The cold metal spoons clanked in my hands, as I grouped them together and shoved them into her hands.
I explained that the difference in being sick and being healthy is having to make choices or to consciously think about things when the rest of the world doesn’t have to. The healthy have the luxury of a life without choices, a gift most people take for granted.
Most people start the day with unlimited amount of possibilities, and energy to do whatever they desire, especially young people. For the most part, they do not need to worry about the effects of their actions. So for my explanation, I used spoons to convey this point. I wanted something for her to actually hold, for me to then take away, since most people who get sick feel a “loss” of a life they once knew. If I was in control of taking away the spoons, then she would know what it feels like to have someone or something else, in this case Lupus, being in control.
She grabbed the spoons with excitement. She didn’t understand what I was doing, but she is always up for a good time, so I guess she thought I was cracking a joke of some kind like I usually do when talking about touchy topics. Little did she know how serious I would become?
I asked her to count her spoons. She asked why, and I explained that when you are healthy you expect to have a never-ending supply of “spoons”. But when you have to now plan your day, you need to know exactly how many “spoons” you are starting with. It doesn’t guarantee that you might not lose some along the way, but at least it helps to know where you are starting. She counted out 12 spoons. She laughed and said she wanted more. I said no, and I knew right away that this little game would work, when she looked disappointed, and we hadn’t even started yet. I’ve wanted more “spoons” for years and haven’t found a way yet to get more, why should she? I also told her to always be conscious of how many she had, and not to drop them because she can never forget she has Lupus.
I asked her to list off the tasks of her day, including the most simple. As, she rattled off daily chores, or just fun things to do; I explained how each one would cost her a spoon. When she jumped right into getting ready for work as her first task of the morning, I cut her off and took away a spoon. I practically jumped down her throat. I said ” No! You don’t just get up. You have to crack open your eyes, and then realize you are late. You didn’t sleep well the night before. You have to crawl out of bed, and then you have to make your self something to eat before you can do anything else, because if you don’t, you can’t take your medicine, and if you don’t take your medicine you might as well give up all your spoons for today and tomorrow too.” I quickly took away a spoon and she realized she hasn’t even gotten dressed yet. Showering cost her spoon, just for washing her hair and shaving her legs. Reaching high and low that early in the morning could actually cost more than one spoon, but I figured I would give her a break; I didn’t want to scare her right away. Getting dressed was worth another spoon. I stopped her and broke down every task to show her how every little detail needs to be thought about. You cannot simply just throw clothes on when you are sick. I explained that I have to see what clothes I can physically put on, if my hands hurt that day buttons are out of the question. If I have bruises that day, I need to wear long sleeves, and if I have a fever I need a sweater to stay warm and so on. If my hair is falling out I need to spend more time to look presentable, and then you need to factor in another 5 minutes for feeling badly that it took you 2 hours to do all this.
I think she was starting to understand when she theoretically didn’t even get to work, and she was left with 6 spoons. I then explained to her that she needed to choose the rest of her day wisely, since when your “spoons” are gone, they are gone. Sometimes you can borrow against tomorrow’s “spoons”, but just think how hard tomorrow will be with less “spoons”. I also needed to explain that a person who is sick always lives with the looming thought that tomorrow may be the day that a cold comes, or an infection, or any number of things that could be very dangerous. So you do not want to run low on “spoons”, because you never know when you truly will need them. I didn’t want to depress her, but I needed to be realistic, and unfortunately being prepared for the worst is part of a real day for me.
We went through the rest of the day, and she slowly learned that skipping lunch would cost her a spoon, as well as standing on a train, or even typing at her computer too long. She was forced to make choices and think about things differently. Hypothetically, she had to choose not to run errands, so that she could eat dinner that night.
When we got to the end of her pretend day, she said she was hungry. I summarized that she had to eat dinner but she only had one spoon left. If she cooked, she wouldn’t have enough energy to clean the pots. If she went out for dinner, she might be too tired to drive home safely. Then I also explained, that I didn’t even bother to add into this game, that she was so nauseous, that cooking was probably out of the question anyway. So she decided to make soup, it was easy. I then said it is only 7pm, you have the rest of the night but maybe end up with one spoon, so you can do something fun, or clean your apartment, or do chores, but you can’t do it all.
I rarely see her emotional, so when I saw her upset I knew maybe I was getting through to her. I didn’t want my friend to be upset, but at the same time I was happy to think finally maybe someone understood me a little bit. She had tears in her eyes and asked quietly “Christine, How do you do it? Do you really do this everyday?” I explained that some days were worse then others; some days I have more spoons then most. But I can never make it go away and I can’t forget about it, I always have to think about it. I handed her a spoon I had been holding in reserve. I said simply, “I have learned to live life with an extra spoon in my pocket, in reserve. You need to always be prepared.”
Its hard, the hardest thing I ever had to learn is to slow down, and not do everything. I fight this to this day. I hate feeling left out, having to choose to stay home, or to not get things done that I want to. I wanted her to feel that frustration. I wanted her to understand, that everything everyone else does comes so easy, but for me it is one hundred little jobs in one. I need to think about the weather, my temperature that day, and the whole day’s plans before I can attack any one given thing. When other people can simply do things, I have to attack it and make a plan like I am strategizing a war. It is in that lifestyle, the difference between being sick and healthy. It is the beautiful ability to not think and just do. I miss that freedom. I miss never having to count “spoons”.
After we were emotional and talked about this for a little while longer, I sensed she was sad. Maybe she finally understood. Maybe she realized that she never could truly and honestly say she understands. But at least now she might not complain so much when I can’t go out for dinner some nights, or when I never seem to make it to her house and she always has to drive to mine. I gave her a hug when we walked out of the diner. I had the one spoon in my hand and I said “Don’t worry. I see this as a blessing. I have been forced to think about everything I do. Do you know how many spoons people waste everyday? I don’t have room for wasted time, or wasted “spoons” and I chose to spend this time with you.”
Ever since this night, I have used the spoon theory to explain my life to many people. In fact, my family and friends refer to spoons all the time. It has been a code word for what I can and cannot do. Once people understand the spoon theory they seem to understand me better, but I also think they live their life a little differently too. I think it isn’t just good for understanding Lupus, but anyone dealing with any disability or illness. Hopefully, they don’t take so much for granted or their life in general. I give a piece of myself, in every sense of the word when I do anything. It has become an inside joke. I have become famous for saying to people jokingly that they should feel special when I spend time with them, because they have one of my “spoons”.
© Christine Miserandino
Saturday, August 21, 2010
Asperger Syndrome is associated with gluten intolerance and brain development problems in the womb.
SOURCE: http://webcache.googleusercontent.com/search?q=cache:GuiAE7v7NZkJ:members.cox.net/harold.kraus/gluten/anno_symptoms_files/defects.htm+Lupus+and+Asperger's+Syndrome+link&cd=21&hl=en&ct=clnk&gl=us
Birth Defect : a physical or biochemical defect (...) that is present at birth and may be inherited or environmentally induced. Merriam-Webster's Medical Dictionary, 2002
Celiac Disease and Birth Defects
Disclaimer
Contents:
Birth Defects Associated with Celiac Disease:
· Neural Tube Defects
· Heart defects and Heart Autoimmunity
· Brain/Developmental Disorders
· Allergies
See also: Links to Neurological Studies, other Research Articles, and Celiac Web Sites
Contact / Feedback
This page provides summaries and links to studies the association of Celiac Disease with some birth defects and congenital conditions. Another page on this site provides summaries and links to studies about Celaic Disease, Fertility and Miscariage. There are many studies available, please consider those offered here as only a starting point.
Summary
It is recognized that untreated Celiac women have higher risk of birth defects in their pregnancies, and studies reveal that the observed birth defects can be prevented with the gluten free diet therapy. How much higher? In the studies referenced below, seems to be several times higher. How much prevention? It seems that the excessive risks due to untreated Celiac Disease are effectively eliminated by treatment of Celiac Disease through diet.
In many gluten sensitive women, obvious symptoms of Celiac Disease may only appear “temporarily” (if at all) during pregnancy. So, it is no surprise to be able to find reports of women who are diagnosed with Celiac Disease only after having a pregnancy that resulted in spina bifida, meningomyelocele, or miscarriage.
But two things related to this subject are now unquestionable: First, minor to severe folate deficiency is a common result of common Celiac Disease. Second, folate deficiency is a major cause of neural tube defects. Common results of neural tube defects are miscarriage, spina bifida, anencephaly, and meningomyelocele.
A number of Developmental Disorders are associated with gluten sensitivity. Some conditions seem to relate to the child’s reactions to food and would be considered as an inherited condition. But other conditions seem to relate to subtle brain injuries suffered while subject to the mother’s nutritional deficiencies and imbalanced immune system as caused by gluten sensitivity. These could be considered “birth defects” since they are present at birth, but may not be noticed for months or years. (Some argue these aren’t necessarily “defects” considering the contributions some “sufferers” of such conditions as ADHD, Asperger’s Syndrome, and Autism have made to humanity.)
Given that if there is never gluten in the diet of a person with the genes for gluten sensitivity, then those genes seem to provide extra protection against a common virus. Is this really a defect? So, one may question which is the real defect, the genes for gluten sensitivity or an otherwise nutritionally deficient diet of wheat?
Birth Defects Associated with Celiac Disease:
These are some of the birth defects and associated with pregnancies and infants of untreated Celiac women:
Neural Tube Defects
Heart defects and Heart Autoimmunity
Brain/Developmental Disorders
Allergies
Neural Tube Defects
See also:
Subdivisions of the Neural Tube
Development and Differentiation of the Neural Tube
An important defect associated with untreated maternal Celiac Disease is failure of the Neural Tube to fully develop. The result may be a mild as a dimple over the tailbone or a severe as a completely missing brain. Neural tube defects are caused by folate deficiency, and folate deficiency is a common effect of Celiac Disease.
It is important to note that these neural tube defects as far as they relate to gluten happen only when a mother is gluten sensitive and eats gluten.
Summary of some Neural Tube Defects associated with untreated maternal Celiac Disease
Condition Name
Description
Outcomes
Pilonidal Cyst
Dimple or cyst in skin near tail bone
Ranges from a dimple over the tailbone to adult infections and lower back pain
Spina Bifida
Incomplete closure of the spine
Ranges from an odd dimple or fold to exposed spine. May result in varying degrees of lower body paralysis.
Congenital Hydrocephalus
Fluid on the brain
Miscarriage and stillbirth are possible. Surgery after live birth may prevent disability.
Meningomyelocele
Protrusion of the spinal membranes and spinal cord outside of the body.
Miscarriage and stillbirth are possible and common.
Anencephaly
Most of the brain and spinal cord are missing.
Miscarriage and stillbirth are possible and common.
Since the optic nerves, retinas, and olfactory nerves also form from the neural tube, abnormalities in these senses may also be related to folate and maternal gluten sensitivity.
Heart defects and Heart Autoimmunity
Heart defects and autoimmune myocarditis in fetuses and newborns has also been associated with Celiac Disease in the mother, but more literature is available linking maternal Lupus with infant heart defects. However, Celiac Disease can easily be and often is a misdiagnosed as lupus (see Gluten Sensitivity Masquerading as Systemic Lupus Erythematosus). Celiac Disease or gluten sensitivity may generally underlie of accompany many cases of SLE.
Brain/Developmental Disorders
Downs Syndrome is associated with maternal folate dificiencty
Asperger Syndrome is associated with gluten intolerance and brain development problems in the womb. But, unlike Autism in which the patient’s own food intolerances play a large role, Asperger Syndrome may be largely affected by the mother’s food intolerances during pregnancy. Much the same may be said of ADHD, which itself may generally be the result of the mothers untreated food sensitivities and aggravated by the child’s food sensitivities. More information with respect to gluten and developmental disorders is available though the Developmental Disorders page.
Birth Defect : a physical or biochemical defect (...) that is present at birth and may be inherited or environmentally induced. Merriam-Webster's Medical Dictionary, 2002
Celiac Disease and Birth Defects
Disclaimer
Contents:
Birth Defects Associated with Celiac Disease:
· Neural Tube Defects
· Heart defects and Heart Autoimmunity
· Brain/Developmental Disorders
· Allergies
See also: Links to Neurological Studies, other Research Articles, and Celiac Web Sites
Contact / Feedback
This page provides summaries and links to studies the association of Celiac Disease with some birth defects and congenital conditions. Another page on this site provides summaries and links to studies about Celaic Disease, Fertility and Miscariage. There are many studies available, please consider those offered here as only a starting point.
Summary
It is recognized that untreated Celiac women have higher risk of birth defects in their pregnancies, and studies reveal that the observed birth defects can be prevented with the gluten free diet therapy. How much higher? In the studies referenced below, seems to be several times higher. How much prevention? It seems that the excessive risks due to untreated Celiac Disease are effectively eliminated by treatment of Celiac Disease through diet.
In many gluten sensitive women, obvious symptoms of Celiac Disease may only appear “temporarily” (if at all) during pregnancy. So, it is no surprise to be able to find reports of women who are diagnosed with Celiac Disease only after having a pregnancy that resulted in spina bifida, meningomyelocele, or miscarriage.
But two things related to this subject are now unquestionable: First, minor to severe folate deficiency is a common result of common Celiac Disease. Second, folate deficiency is a major cause of neural tube defects. Common results of neural tube defects are miscarriage, spina bifida, anencephaly, and meningomyelocele.
A number of Developmental Disorders are associated with gluten sensitivity. Some conditions seem to relate to the child’s reactions to food and would be considered as an inherited condition. But other conditions seem to relate to subtle brain injuries suffered while subject to the mother’s nutritional deficiencies and imbalanced immune system as caused by gluten sensitivity. These could be considered “birth defects” since they are present at birth, but may not be noticed for months or years. (Some argue these aren’t necessarily “defects” considering the contributions some “sufferers” of such conditions as ADHD, Asperger’s Syndrome, and Autism have made to humanity.)
Given that if there is never gluten in the diet of a person with the genes for gluten sensitivity, then those genes seem to provide extra protection against a common virus. Is this really a defect? So, one may question which is the real defect, the genes for gluten sensitivity or an otherwise nutritionally deficient diet of wheat?
Birth Defects Associated with Celiac Disease:
These are some of the birth defects and associated with pregnancies and infants of untreated Celiac women:
Neural Tube Defects
Heart defects and Heart Autoimmunity
Brain/Developmental Disorders
Allergies
Neural Tube Defects
See also:
Subdivisions of the Neural Tube
Development and Differentiation of the Neural Tube
An important defect associated with untreated maternal Celiac Disease is failure of the Neural Tube to fully develop. The result may be a mild as a dimple over the tailbone or a severe as a completely missing brain. Neural tube defects are caused by folate deficiency, and folate deficiency is a common effect of Celiac Disease.
It is important to note that these neural tube defects as far as they relate to gluten happen only when a mother is gluten sensitive and eats gluten.
Summary of some Neural Tube Defects associated with untreated maternal Celiac Disease
Condition Name
Description
Outcomes
Pilonidal Cyst
Dimple or cyst in skin near tail bone
Ranges from a dimple over the tailbone to adult infections and lower back pain
Spina Bifida
Incomplete closure of the spine
Ranges from an odd dimple or fold to exposed spine. May result in varying degrees of lower body paralysis.
Congenital Hydrocephalus
Fluid on the brain
Miscarriage and stillbirth are possible. Surgery after live birth may prevent disability.
Meningomyelocele
Protrusion of the spinal membranes and spinal cord outside of the body.
Miscarriage and stillbirth are possible and common.
Anencephaly
Most of the brain and spinal cord are missing.
Miscarriage and stillbirth are possible and common.
Since the optic nerves, retinas, and olfactory nerves also form from the neural tube, abnormalities in these senses may also be related to folate and maternal gluten sensitivity.
Heart defects and Heart Autoimmunity
Heart defects and autoimmune myocarditis in fetuses and newborns has also been associated with Celiac Disease in the mother, but more literature is available linking maternal Lupus with infant heart defects. However, Celiac Disease can easily be and often is a misdiagnosed as lupus (see Gluten Sensitivity Masquerading as Systemic Lupus Erythematosus). Celiac Disease or gluten sensitivity may generally underlie of accompany many cases of SLE.
Brain/Developmental Disorders
Downs Syndrome is associated with maternal folate dificiencty
Asperger Syndrome is associated with gluten intolerance and brain development problems in the womb. But, unlike Autism in which the patient’s own food intolerances play a large role, Asperger Syndrome may be largely affected by the mother’s food intolerances during pregnancy. Much the same may be said of ADHD, which itself may generally be the result of the mothers untreated food sensitivities and aggravated by the child’s food sensitivities. More information with respect to gluten and developmental disorders is available though the Developmental Disorders page.
Linking Celiac Disease to Systemic Lupus Erythematosus (SLE)
SOURCE: http://www.ncbi.nlm.nih.gov/pubmed/18223501
J Clin Gastroenterol. 2008 Mar;42(3):252-5.
Adult celiac disease followed by onset of systemic lupus erythematosus.
Freeman HJ.
Department of Medicine (Gastroenterology), University of British Columbia, Vancouver, BC. hugfree@shaw.ca
Abstract
BACKGROUND: Celiac disease has been associated with autoimmune disease (eg, autoimmune thyroiditis) and the appearance of different autoantibodies (eg, antidouble-stranded DNA). Conversely, tissue transglutaminase antibodies have been detected in autoimmune disorders, including systemic lupus erythematosus (SLE), but cases of celiac disease with SLE have been only rarely recorded.
METHODS: In this study, 246 patients with biopsy-defined celiac disease were evaluated for a prior diagnosis of SLE on the basis of American Rheumatological Association-defined clinical and serologic parameters.
RESULTS: There were 6 patients with celiac disease and SLE, or 2.4%, including 4 females and 2 males. Their mean age at diagnosis of celiac disease was 44.7 years and SLE 50 years. In all patients, the diagnosis of SLE was established from 2 years to more than 10 years after the diagnosis of celiac disease, with a mean of 5.3 years. The celiac disease in all 6 patients responded to a gluten-free diet with histologic normalization of the small intestinal biopsies. Despite this small bowel biopsy response, SLE appeared later in the clinical course of the celiac disease.
CONCLUSIONS: This study suggests that SLE occurs far more frequently in biopsy-defined celiac disease than is currently appreciated, and detection may be more likely if the period of clinical follow-up of the celiac disease is prolonged.
J Clin Gastroenterol. 2008 Mar;42(3):252-5.
Adult celiac disease followed by onset of systemic lupus erythematosus.
Freeman HJ.
Department of Medicine (Gastroenterology), University of British Columbia, Vancouver, BC. hugfree@shaw.ca
Abstract
BACKGROUND: Celiac disease has been associated with autoimmune disease (eg, autoimmune thyroiditis) and the appearance of different autoantibodies (eg, antidouble-stranded DNA). Conversely, tissue transglutaminase antibodies have been detected in autoimmune disorders, including systemic lupus erythematosus (SLE), but cases of celiac disease with SLE have been only rarely recorded.
METHODS: In this study, 246 patients with biopsy-defined celiac disease were evaluated for a prior diagnosis of SLE on the basis of American Rheumatological Association-defined clinical and serologic parameters.
RESULTS: There were 6 patients with celiac disease and SLE, or 2.4%, including 4 females and 2 males. Their mean age at diagnosis of celiac disease was 44.7 years and SLE 50 years. In all patients, the diagnosis of SLE was established from 2 years to more than 10 years after the diagnosis of celiac disease, with a mean of 5.3 years. The celiac disease in all 6 patients responded to a gluten-free diet with histologic normalization of the small intestinal biopsies. Despite this small bowel biopsy response, SLE appeared later in the clinical course of the celiac disease.
CONCLUSIONS: This study suggests that SLE occurs far more frequently in biopsy-defined celiac disease than is currently appreciated, and detection may be more likely if the period of clinical follow-up of the celiac disease is prolonged.
Saturday, August 14, 2010
http://www.hopkinslupus.org/lupus-info/lupus-affects-body/lupus-lungs/
LUNGS
About 50% of people with SLE will experience lung involvement during the course of their disease. Five main lung problems occur in lupus: pleuritis, acute lupus pneumonitis, chronic (fibrotic) lupus pneumonitis, pulmonary hypertension, and “shrinking lung” syndrome.
Pleuritis (Pleurisy)
Pleuritis, also known as pleurisy, is characterized by inflammation of the pleura, the two-layered membrane surrounding the lungs. If fluid forms and escapes the membrane, the condition is referred to as pleural effusion. Since inflammation of the pleura puts pressure on the lungs, people with pleuritis often experience pain when taking deep breaths. A pleural effusion is detectable on an x-ray, and pleurisy or a pleural effusion can be treated with NSAIDs or steroid medications. Antimalarials like Plaquenil may also be effective in preventing or fending off the condition.
Acute Lupus Pneumonitis
Acute lupus pneumonitis is a serious condition that affects anywhere from 1-10% of lupus patients. The condition is characterized by chest pain, shortness of breath, and a dry cough that may bring up blood. Acute lupus pneumonitis requires immediate treatment with high dose steroids and possibly immunosuppressive medications. Yet, even with successful treatment, some people develop lung scarring. Thus, it is very important that you speak with your physician if you experience any unfamiliar lung pains or symptoms.
Chronic (Fibrotic) Lupus Pneumonitis
As the name suggests, chronic lupus pneumonitis is the creeping cousin of acute lupus pneumonitis. Whereas the acute form comes on quickly, chronic lupus pneumonitis accumulates subtly over years. Some people with chronic lupus pneumonitis may have had acute lupus pneumonitis as some point during their lives, while others have not. Often the disease takes so long to develop that people do not realize or complain of the initial symptoms. While current inflammation can be treated with steroid medications, any scarring that occurs over time is permanent. Thus, it is very important that you remember to tell your doctor about any chest, lung, or breathing pain during regular visits. If caught early, chronic lupus pneumonitis can be treated.
Pulmonary Hypertension
In order for the organs in your body to work, they must receive oxygen. The right side of your heart is responsible for pumping blood from your veins back to your lungs to receive oxygen; the oxygenated blood then returns to the left side of the heart, where it is pumped to the rest of the body for use. Pulmonary hypertension is a unique form of hypertension (high blood pressure) in which the blood vessel that carries blood from the heart to the lungs thickens, reducing the amount of blood that can move through it in a given amount of time. In order to counter this resistance, your heart must pump harder and faster. When the heart fails to keep up, the rest of the body suffers by receiving less and less oxygen (a condition called hypoxia).
Pulmonary hypertension occurs in about 10% of people with lupus. On rare occasions pulmonary hypertension responds to corticosteroids and immunosuppressive treatment. However, if it is not reversible (meaning, if it is not due to active lupus), then your doctor can discuss with you one of the FDA-approved medications for pulmonary hypertension.
“Shrinking Lung” Syndrome
“Shrinking lung” syndrome is another rare lupus complication. People with the condition feel a sense of breathlessness and reduced chest expansion. Some people with shrinking lung syndrome improve with corticosteroid or immunosuppressive therapy.
Sources
D’Cruz, D, Khamashta, MA, Hughes, G. Pulmonary Manifestations of Systemic Lupus Erythematosus. In: Wallace, DJ, Hahn, BH, eds. Dubois’ Lupus Erythematosus. 7th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2007:678-699.
Medsger, Thomas A. “Pulmonary Manifestations.” The Clinical Management of Systemic Lupus Erythematosus. Ed. Peter H. Schur. 2nd ed. Philadelphia: Lippincott-Raven, 1996. 87-94.
“Pulmonary hypertension.” American Heart Association. 1 July 2009.
Wallace, Daniel J. “Pants and Pulses: The Lungs and Heart.” The Lupus Book: A Guide for Patients and Their Families. 1st ed. New York: Oxford University Press, 1995. 81-98.
Friday, August 13, 2010
http://en.wikipedia.org/wiki/Obstructive_lung_disease
http://en.wikipedia.org/wiki/Obstructive_lung_disease
Obstructive lung disease
From Wikipedia, the free encyclopedia
Obstructive lung disease
Classification and external resources
MeSH D008173
Obstructive lung disease is a category of respiratory disease characterized by airway obstruction.
MeSH includes the following in this category:[1]
Asthma
Emphysema
Bronchitis
Chronic obstructive pulmonary disease
Cystic fibrosis is sometimes also included in this category.[2]
FEV1/FVC ratio is usually decreased.
Contents [hide]
1 Overview table
2 Scope
2.1 Chronic obstructive pulmonary disease
2.2 Asthma
2.3 Other obstructive lung diseases
3 See also
4 References
[edit]Overview table
Following is an overview of the main obstructive lung diseases. Chronic obstructive pulmonary disease is mainly a combination of chronic bronchitis and emphysema, but may be more or less overlapping with all conditions.[3]
Condition Main site Major changes Causes Symptoms
Chronic bronchitis - Bronchus - Hyperplasia and hypersecretion of mucus glands Tobacco smoking and air pollutants - Productive cough
Bronchiectasis - Bronchus - Dilation and scarring of airways - Persistent severe infections - Cough, purulent sputum and fever
Asthma - Bronchus - Smooth muscle hyperplasia - Excessive mucus
Inflammation
Immunologic or idiopathic Episodic wheezing, cough and dyspnea
Emphysema - Acinus - Airspace enlargement and wall destruction - Tobacco smoking Dyspnea
Bronchiolitis
(subgroup of chronic bronchitis) - Bronchiole - Inflammatory scarring and bronchiole obliteration - Tobacco smoking and air pollutants - Cough, dyspnea
Unless else specified in boxes then reference is [3]
[edit]Scope
[edit]Chronic obstructive pulmonary disease
Main article: Chronic obstructive pulmonary disease
Chronic obstructive pulmonary disease (COPD), also known as chronic obstructive airways disease (COAD) or chronic airflow limitation (CAL), is a group of illnesses characterised by airflow limitation that is not fully reversible. The flow of air into and out of the lungs is impaired.[4] This can be measured with breathing devices such as a peak flow meter or by spirometry. The term COPD includes the conditions emphysema and chronic bronchitis although most patients with COPD have characteristics of both conditions to varying degrees. Asthma being a reversible obstruction of airways is often considered separately, but many COPD patients also have some degree of reversibility in their airways.
In COPD, there is an increase in airway resistance, shown by a decrease in the forced expiratory volume in 1 second (FEV1) measured by spirometry. COPD is defined as a forced expiratory volume in 1 second to forced vital capacity ratio (FEV1/FVC) that is less than 0.7[5]. The residual volume, the volume of air left in the lungs following full expiration, is often increased in COPD, as is the total lung capacity, while the vital capacity remains relatively normal. The increased total lung capacity (hyperinflation) can result in the clinical feature of a "barrel chest" - a chest with a large front-to-back diameter that occurs in some individuals with COPD. Hyperinflation can also be seen on a chest x-ray as a flattening of the diaphragm.
The most common cause of COPD is cigarette smoking. COPD is a gradually progressive condition and usually only develops after about 20 pack-years of smoking. COPD may also be caused by breathing in other particles and gases.
The diagnosis of COPD is established through spirometry although other pulmonary function tests can be helpful. A chest x-ray is often ordered to look for hyperinflation and rule out other lung conditions but the lung damage of COPD is not always visible on a chest x-ray. Emphysema, for example can only be seen on CT scan.
The main form of long term management involves the use of inhaled bronchodilators (specifically beta agonists and anticholinergics) and inhaled corticosteroids. Many patients eventually require oxygen supplementation at home. In severe cases that are difficult to control, chronic treatment with oral corticosteroids may be necessary, although this is fraught with significant side-effects.
COPD is generally irreversible although lung function can partially recover if the patient stops smoking. Smoking cessation is an essential aspect of treatment[6]. Pulmonary rehabilitation programmes involve intensive exercise training combined with education and are effective in improving shortness of breath. Severe emphysema has been treated with lung volume reduction surgery, with some success in carefully chosen cases. Lung transplantation is also performed for severe COPD in carefully chosen cases.
Alpha 1-antitrypsin deficiency is a fairly rare genetic condition that results in COPD (particularly emphysema) due to a lack of the antitrypsin protein which protects the fragile alveolar walls from protease enzymes released by inflammatory processes.
[edit]Asthma
Main article: Asthma
Asthma is an obstructive lung disease where the bronchial tubes (airways) are extra sensitive (hyperresponsive). The airways become inflamed and produce excess mucus and the muscles around the airways tighten making the airways narrower. Asthma is usually triggered by breathing in things in the air such as dust or pollen that produce an allergic reaction. It may be triggered by other things such as an upper respiratory tract infection, cold air, exercise or smoke. Asthma is a common condition and affects over 300 million people around the world[7]. Asthma causes recurring episodes of wheezing, breathlessness, chest tightness, and coughing, particularly at night or in the early morning.
Asthma is diagnosed by the characteristic pattern of symptoms.
A peak flow meter can record variations in the severity of asthma over time. Spirometry, a measurement of lung function, can provide an assessment of the severity, reversibility, and variability of airflow limitation, and help confirm the diagnosis of asthma[7].
Asthma is treated by identifying and removing the triggers that set it off, if possible. The main form of long term management involves the use of inhaled corticosteroids. Inhaled bronchodilators, particularly beta agonists are used to relieve and control symptoms by reducing muscle spasm around the airways. An alternative way to control mild asthma is with a leukotriene antagonist tablet.
[edit]Other obstructive lung diseases
Cystic fibrosis is an inherited disorder of the CFTR gene, a chloride ion channel. The lack of this channel causes reduced water content of secretions. This affects the mucus secreted as part of the lung's defence and creates sticky, viscous mucus. This makes the lungs more susceptible to infection, inflammation and mucous plugging.
Bronchiectasis
Bronchiolitis
Allergic bronchopulmonary aspergillosis
In many parts of the world, the most common cause of obstructive lung disease is lung scarring after tuberculosis infection.
Obstructive lung disease
From Wikipedia, the free encyclopedia
Obstructive lung disease
Classification and external resources
MeSH D008173
Obstructive lung disease is a category of respiratory disease characterized by airway obstruction.
MeSH includes the following in this category:[1]
Asthma
Emphysema
Bronchitis
Chronic obstructive pulmonary disease
Cystic fibrosis is sometimes also included in this category.[2]
FEV1/FVC ratio is usually decreased.
Contents [hide]
1 Overview table
2 Scope
2.1 Chronic obstructive pulmonary disease
2.2 Asthma
2.3 Other obstructive lung diseases
3 See also
4 References
[edit]Overview table
Following is an overview of the main obstructive lung diseases. Chronic obstructive pulmonary disease is mainly a combination of chronic bronchitis and emphysema, but may be more or less overlapping with all conditions.[3]
Condition Main site Major changes Causes Symptoms
Chronic bronchitis - Bronchus - Hyperplasia and hypersecretion of mucus glands Tobacco smoking and air pollutants - Productive cough
Bronchiectasis - Bronchus - Dilation and scarring of airways - Persistent severe infections - Cough, purulent sputum and fever
Asthma - Bronchus - Smooth muscle hyperplasia - Excessive mucus
Inflammation
Immunologic or idiopathic Episodic wheezing, cough and dyspnea
Emphysema - Acinus - Airspace enlargement and wall destruction - Tobacco smoking Dyspnea
Bronchiolitis
(subgroup of chronic bronchitis) - Bronchiole - Inflammatory scarring and bronchiole obliteration - Tobacco smoking and air pollutants - Cough, dyspnea
Unless else specified in boxes then reference is [3]
[edit]Scope
[edit]Chronic obstructive pulmonary disease
Main article: Chronic obstructive pulmonary disease
Chronic obstructive pulmonary disease (COPD), also known as chronic obstructive airways disease (COAD) or chronic airflow limitation (CAL), is a group of illnesses characterised by airflow limitation that is not fully reversible. The flow of air into and out of the lungs is impaired.[4] This can be measured with breathing devices such as a peak flow meter or by spirometry. The term COPD includes the conditions emphysema and chronic bronchitis although most patients with COPD have characteristics of both conditions to varying degrees. Asthma being a reversible obstruction of airways is often considered separately, but many COPD patients also have some degree of reversibility in their airways.
In COPD, there is an increase in airway resistance, shown by a decrease in the forced expiratory volume in 1 second (FEV1) measured by spirometry. COPD is defined as a forced expiratory volume in 1 second to forced vital capacity ratio (FEV1/FVC) that is less than 0.7[5]. The residual volume, the volume of air left in the lungs following full expiration, is often increased in COPD, as is the total lung capacity, while the vital capacity remains relatively normal. The increased total lung capacity (hyperinflation) can result in the clinical feature of a "barrel chest" - a chest with a large front-to-back diameter that occurs in some individuals with COPD. Hyperinflation can also be seen on a chest x-ray as a flattening of the diaphragm.
The most common cause of COPD is cigarette smoking. COPD is a gradually progressive condition and usually only develops after about 20 pack-years of smoking. COPD may also be caused by breathing in other particles and gases.
The diagnosis of COPD is established through spirometry although other pulmonary function tests can be helpful. A chest x-ray is often ordered to look for hyperinflation and rule out other lung conditions but the lung damage of COPD is not always visible on a chest x-ray. Emphysema, for example can only be seen on CT scan.
The main form of long term management involves the use of inhaled bronchodilators (specifically beta agonists and anticholinergics) and inhaled corticosteroids. Many patients eventually require oxygen supplementation at home. In severe cases that are difficult to control, chronic treatment with oral corticosteroids may be necessary, although this is fraught with significant side-effects.
COPD is generally irreversible although lung function can partially recover if the patient stops smoking. Smoking cessation is an essential aspect of treatment[6]. Pulmonary rehabilitation programmes involve intensive exercise training combined with education and are effective in improving shortness of breath. Severe emphysema has been treated with lung volume reduction surgery, with some success in carefully chosen cases. Lung transplantation is also performed for severe COPD in carefully chosen cases.
Alpha 1-antitrypsin deficiency is a fairly rare genetic condition that results in COPD (particularly emphysema) due to a lack of the antitrypsin protein which protects the fragile alveolar walls from protease enzymes released by inflammatory processes.
[edit]Asthma
Main article: Asthma
Asthma is an obstructive lung disease where the bronchial tubes (airways) are extra sensitive (hyperresponsive). The airways become inflamed and produce excess mucus and the muscles around the airways tighten making the airways narrower. Asthma is usually triggered by breathing in things in the air such as dust or pollen that produce an allergic reaction. It may be triggered by other things such as an upper respiratory tract infection, cold air, exercise or smoke. Asthma is a common condition and affects over 300 million people around the world[7]. Asthma causes recurring episodes of wheezing, breathlessness, chest tightness, and coughing, particularly at night or in the early morning.
Asthma is diagnosed by the characteristic pattern of symptoms.
A peak flow meter can record variations in the severity of asthma over time. Spirometry, a measurement of lung function, can provide an assessment of the severity, reversibility, and variability of airflow limitation, and help confirm the diagnosis of asthma[7].
Asthma is treated by identifying and removing the triggers that set it off, if possible. The main form of long term management involves the use of inhaled corticosteroids. Inhaled bronchodilators, particularly beta agonists are used to relieve and control symptoms by reducing muscle spasm around the airways. An alternative way to control mild asthma is with a leukotriene antagonist tablet.
[edit]Other obstructive lung diseases
Cystic fibrosis is an inherited disorder of the CFTR gene, a chloride ion channel. The lack of this channel causes reduced water content of secretions. This affects the mucus secreted as part of the lung's defence and creates sticky, viscous mucus. This makes the lungs more susceptible to infection, inflammation and mucous plugging.
Bronchiectasis
Bronchiolitis
Allergic bronchopulmonary aspergillosis
In many parts of the world, the most common cause of obstructive lung disease is lung scarring after tuberculosis infection.
Tuesday, August 10, 2010
http://www.svdpusa.org/
This charity was mentioned on Bill O'Reilly. It is the Society of St Vincent de Paul.
Friday, August 6, 2010
Cough, Vomit And Retching...anyone Have This?
You have come to the right place. Chronic cough is frequently caused by acid refluxing into the throat, and unfortunately, most doctors have never heard of this condition, which is called layngopharyngeal reflux (LPR). It can strike at any age, and is thought to be caused by a weakened upper esophogeal spinchter muscle (though researchers are currently investigating the possibibility that the larynx itself begins producing acid by mistake).
When the acid (super strong HCl, pH of 2) gets into the throat, it damages the soft tissues that have no natural protection against acid. A typical response is to constantly cough (or throat clear) to move the acid off the larynx.
Most LPR patients have 1 or more of the following symptoms: chronic cough (like you), chornic throat clearing, sensation of something stuck in the throat/"lump" in the throat. Some people also develop asthma-like symptoms that don't respond to asthma treatments. This happens because when the acid gets into the throat, it gets accidentally aspirated back down the other pipe - the windpipe and into the lungs, damaging the lung tissue.
But it's treatable, and despite what you read on this board, it does not require any tests at all to make a diagnosis. Instead, your doctor should go ahead and prescribe you the medication used to treat the condition. If you respond (improvement after about 30 days, though it can be earlier), it is sufficient to be considered a diangosis in itself. However, since you have had this condition for 15 years, they should schedule you for an endoscopy anyway - which is usually done under sedation, in which the doctor uses a scope to check the condition of your esophogous - looking for damage. However, the same medications that you will be on for LPR are used to treat a damaged esophogous, so you should absolutely go and start the medications now!
The medications are called Proton-Pump Inhibitors (PPIs) and they simply reduce the amount of acid your stomach produces. The less acid your stomach produces, the less that can escape and irritate your throat. Alas, it only treats the symptoms of the disease and not the cause, but it's the best we've got and can be very very effective.
Now this is the critical part - whatever PPI you choose to take, you MUST MUST MUST take 2 doses per day! Standard treatment for LPR is 2 doses, and most doctors do not know this, because they've learned that standard treatment for its sister condition, hearburn/GERD is 1 PPI dose per day. So it is probably going to be up to you to correct them if they are incorrect. If they resist, simply direct them to the U.S. government's pubmed database ([url]http://www.pubmedcentral.nih.gov/[/url]) where they can find citation after citation that confirms LPR must be treated with 2 doses of a PPI per day.
You can even search it yourself for "LPR" or "laryngeal reflux" or "laryngopharyngeal reflux" and pull up dozens of citations that describe the latest research and treatment.
In the U.S.A., we have 5 PPIs to choose from and they might have different names in your country. By prescription, we have Nexium, Aciphex, Prevacid and Protonix. Nexium is the latest drug on the market (2001) and though usually the most expensive here, is often the one that works when the others fail. It has a significantly different structure that my doctor says "allows more people to significantly metabolize it better". I've been on 2 doses of it per day for 4 years.
We also have an over-the-counter PPI (we can buy it without a prescription) called Prilosec. It used to be available by prescription, but went OTC when it lost its patent. Prilosec was the first PPI to ever be produced. It's maker, Astrazeneca, followed it up with Nexium in 2001. However, from reading the posts on this board over the last year, it seems that most people with LPR do not greatly benefit from Prilosec - it seems to be a better treatment for GERD. There are people with LPR on it - and seems mostly because it's a cheaper drug, but they aren't the ones I'm seeing who have achieved a good recovery, in general.
When you begin taking your PPIs, you need to consider the timing of your doses. Some people take them together first thing in the morning (like me) and many others take 1 dose in the morning and the other dose in the evening (because PPIs typically wear off after about 17 hours). You simply need to expermiment to find out what works best for you. My morning version works for me because I am a classic daytime refluxer - one of the hallmarks of LPR is the tendancy for a LPR patient to reflux and have symptoms mostly during the daytime when they are upright. As soon as I lie down, I stop coughing (no reflux when I am prone). This is the opposite of someone with GERD - who typically refluxes when lying down at night.
So for me, I need the double dose of my Nexium first thing in the morning when I wake up. If I stay up late I begin to feel it wear off, but as soon as I hop into bed, any breakthrough symptoms go away until I wake up in the morning.
And finally, you may need to experiment with which PPI you take. There are too many instances on this board where people have tried 4 or 5 of the PPIs before settling on the one that works for them. Not every PPI will likely work the same for you.
And since you haven't been treated before, it may take about 30 days for you to notice improvement after beginning the PPI regimen, so hang in there and keep going - because given time, these medications usually work! Sometimes improvement comes faster, but you've probably developed a lot of erosions in your throat over time, and just like a cut or scrape on your skin, those erosions will need a few weeks of being acid-free to heal!
SOURCE::: http://www.healthboards.com/boards/showthread.php?t=398511
When the acid (super strong HCl, pH of 2) gets into the throat, it damages the soft tissues that have no natural protection against acid. A typical response is to constantly cough (or throat clear) to move the acid off the larynx.
Most LPR patients have 1 or more of the following symptoms: chronic cough (like you), chornic throat clearing, sensation of something stuck in the throat/"lump" in the throat. Some people also develop asthma-like symptoms that don't respond to asthma treatments. This happens because when the acid gets into the throat, it gets accidentally aspirated back down the other pipe - the windpipe and into the lungs, damaging the lung tissue.
But it's treatable, and despite what you read on this board, it does not require any tests at all to make a diagnosis. Instead, your doctor should go ahead and prescribe you the medication used to treat the condition. If you respond (improvement after about 30 days, though it can be earlier), it is sufficient to be considered a diangosis in itself. However, since you have had this condition for 15 years, they should schedule you for an endoscopy anyway - which is usually done under sedation, in which the doctor uses a scope to check the condition of your esophogous - looking for damage. However, the same medications that you will be on for LPR are used to treat a damaged esophogous, so you should absolutely go and start the medications now!
The medications are called Proton-Pump Inhibitors (PPIs) and they simply reduce the amount of acid your stomach produces. The less acid your stomach produces, the less that can escape and irritate your throat. Alas, it only treats the symptoms of the disease and not the cause, but it's the best we've got and can be very very effective.
Now this is the critical part - whatever PPI you choose to take, you MUST MUST MUST take 2 doses per day! Standard treatment for LPR is 2 doses, and most doctors do not know this, because they've learned that standard treatment for its sister condition, hearburn/GERD is 1 PPI dose per day. So it is probably going to be up to you to correct them if they are incorrect. If they resist, simply direct them to the U.S. government's pubmed database ([url]http://www.pubmedcentral.nih.gov/[/url]) where they can find citation after citation that confirms LPR must be treated with 2 doses of a PPI per day.
You can even search it yourself for "LPR" or "laryngeal reflux" or "laryngopharyngeal reflux" and pull up dozens of citations that describe the latest research and treatment.
In the U.S.A., we have 5 PPIs to choose from and they might have different names in your country. By prescription, we have Nexium, Aciphex, Prevacid and Protonix. Nexium is the latest drug on the market (2001) and though usually the most expensive here, is often the one that works when the others fail. It has a significantly different structure that my doctor says "allows more people to significantly metabolize it better". I've been on 2 doses of it per day for 4 years.
We also have an over-the-counter PPI (we can buy it without a prescription) called Prilosec. It used to be available by prescription, but went OTC when it lost its patent. Prilosec was the first PPI to ever be produced. It's maker, Astrazeneca, followed it up with Nexium in 2001. However, from reading the posts on this board over the last year, it seems that most people with LPR do not greatly benefit from Prilosec - it seems to be a better treatment for GERD. There are people with LPR on it - and seems mostly because it's a cheaper drug, but they aren't the ones I'm seeing who have achieved a good recovery, in general.
When you begin taking your PPIs, you need to consider the timing of your doses. Some people take them together first thing in the morning (like me) and many others take 1 dose in the morning and the other dose in the evening (because PPIs typically wear off after about 17 hours). You simply need to expermiment to find out what works best for you. My morning version works for me because I am a classic daytime refluxer - one of the hallmarks of LPR is the tendancy for a LPR patient to reflux and have symptoms mostly during the daytime when they are upright. As soon as I lie down, I stop coughing (no reflux when I am prone). This is the opposite of someone with GERD - who typically refluxes when lying down at night.
So for me, I need the double dose of my Nexium first thing in the morning when I wake up. If I stay up late I begin to feel it wear off, but as soon as I hop into bed, any breakthrough symptoms go away until I wake up in the morning.
And finally, you may need to experiment with which PPI you take. There are too many instances on this board where people have tried 4 or 5 of the PPIs before settling on the one that works for them. Not every PPI will likely work the same for you.
And since you haven't been treated before, it may take about 30 days for you to notice improvement after beginning the PPI regimen, so hang in there and keep going - because given time, these medications usually work! Sometimes improvement comes faster, but you've probably developed a lot of erosions in your throat over time, and just like a cut or scrape on your skin, those erosions will need a few weeks of being acid-free to heal!
SOURCE::: http://www.healthboards.com/boards/showthread.php?t=398511
Thursday, August 5, 2010
http://sniff.numachi.com/pages/tiPIGINEB4.html
The Famous Pig Song
The Famous Pig Song
(Clarke Van Ness, music by F. Henri Klickmann)
'Twas an evening in October, I'll confess I wasn't sober,
I was carting home a load with manly pride,
When my feet began to stutter and I fell into the gutter,
And a pig came up and lay down by my side.
Then I lay there in the gutter and my heart was all a-flutter,
Till a lady, passing by, did chance to say:
"You can tell a man that boozes by the company he chooses,"
Then the pig got up and slowly walked away.
Walked away, walked away,
He was really too particular to stay.
"You can tell a man that boozes by the company he chooses,"
Then the pig got up and slowly walked away.
Then I heard a gentle mooing, it was like a pigeon cooing,
As a home returning cow stopped in her stride,
And her eyes were big and gentle; her expression sentimental,
As she curtsied low and sat down by my side.
Then I saw her eyelids flutter and a tear fell in the gutter,
As the owner of the cow did loudly say:
"Leave that brute this moment, Sonja, or your milk will curdle on ya,"
Then the cow got up and slowly walked away.
Walked away, walked away,
She was really too particular to stay.
"Leave that brute this moment, Sonja, or your milk will curdle on ya,"
Then the cow got up and slowly walked away.
Then the moon began to shine in that old gutter I reclined in,
Thinking of the weakness of the human race,
When a dog sat down beside me, and I thought he came to chide me,
Till he gently licked the stubble on my face.
In the gutter, still reclining, I began "Sweet Adeline-ing,"
While the dog raised up his head to loudly bay;
Then his mistress said, "Come, Fido, that disgusting man may bite you,"
Then the dog got up and slowly walked away.
Walked away, walked away,
He was really too particular to stay.
Then his mistress said, "Come, Fido, that disgusting man may bite you,"
Then the dog got up and slowly walked away.
Down the street there came a clatter, and a gentle pitter-patter,
As a pair of goats along the gutter ran;
And it seemed that Billy knew me, for he quickly drew up to me,
While his wife munched on an empty sardine can.
Then again my pulse did flutter, and my heart was soft as butter;
Till the Nanny goat, unto her mate, did say:
"William dear, your social status don't include men such as that is,"
Then the goat got up and slowly walked away.
Walked away, walked away,
He was really too particular to stay.
"William dear, your social status don't include men such as that is,"
Then the goat got up and slowly walked away.
Then I started in to mutter and I rose up from the gutter,
Then I sadly went about my lonely way;
I was weary, sick and busted; I was really quite disgusted,
And I vowed to sign the pledge that very day.
For each humble, lowly creature, a great lesson he can teach ya,
Like the one learned while I in the gutter lay;
In the tavern, do not tarry, when you've got all you can carry,
But take up your load and slowly walk away.
Walk away, walk away,
For the "Horrors" is an awful price to pay,
In the tavern, do not tarry, when you've got all you can carry,
But take up your load and slowly walk away.
CODA
Now lately I've been thinking that I will quit my drinking.
I'm going to leave off whiskey, beer and grog,
For there's no consolation, but only aggravation,
You can't even find friendship with a hog.
(Alternate last stanza)
I began to scratch the gravel, on my all fours I did travel,
I rambled down the road the best I could.
When I awoke next morning, just as the day was dawning,
I was in a hog pen away out in the woods.
Then the hogs began to grumble, I started and I stumbled,
I fell right in their midst and there I lay.
Then one by one they started, till all the herd departed,
Yes, every hog got up and walked away.
Walked away, etc.
The Famous Pig Song
(Clarke Van Ness, music by F. Henri Klickmann)
'Twas an evening in October, I'll confess I wasn't sober,
I was carting home a load with manly pride,
When my feet began to stutter and I fell into the gutter,
And a pig came up and lay down by my side.
Then I lay there in the gutter and my heart was all a-flutter,
Till a lady, passing by, did chance to say:
"You can tell a man that boozes by the company he chooses,"
Then the pig got up and slowly walked away.
Walked away, walked away,
He was really too particular to stay.
"You can tell a man that boozes by the company he chooses,"
Then the pig got up and slowly walked away.
Then I heard a gentle mooing, it was like a pigeon cooing,
As a home returning cow stopped in her stride,
And her eyes were big and gentle; her expression sentimental,
As she curtsied low and sat down by my side.
Then I saw her eyelids flutter and a tear fell in the gutter,
As the owner of the cow did loudly say:
"Leave that brute this moment, Sonja, or your milk will curdle on ya,"
Then the cow got up and slowly walked away.
Walked away, walked away,
She was really too particular to stay.
"Leave that brute this moment, Sonja, or your milk will curdle on ya,"
Then the cow got up and slowly walked away.
Then the moon began to shine in that old gutter I reclined in,
Thinking of the weakness of the human race,
When a dog sat down beside me, and I thought he came to chide me,
Till he gently licked the stubble on my face.
In the gutter, still reclining, I began "Sweet Adeline-ing,"
While the dog raised up his head to loudly bay;
Then his mistress said, "Come, Fido, that disgusting man may bite you,"
Then the dog got up and slowly walked away.
Walked away, walked away,
He was really too particular to stay.
Then his mistress said, "Come, Fido, that disgusting man may bite you,"
Then the dog got up and slowly walked away.
Down the street there came a clatter, and a gentle pitter-patter,
As a pair of goats along the gutter ran;
And it seemed that Billy knew me, for he quickly drew up to me,
While his wife munched on an empty sardine can.
Then again my pulse did flutter, and my heart was soft as butter;
Till the Nanny goat, unto her mate, did say:
"William dear, your social status don't include men such as that is,"
Then the goat got up and slowly walked away.
Walked away, walked away,
He was really too particular to stay.
"William dear, your social status don't include men such as that is,"
Then the goat got up and slowly walked away.
Then I started in to mutter and I rose up from the gutter,
Then I sadly went about my lonely way;
I was weary, sick and busted; I was really quite disgusted,
And I vowed to sign the pledge that very day.
For each humble, lowly creature, a great lesson he can teach ya,
Like the one learned while I in the gutter lay;
In the tavern, do not tarry, when you've got all you can carry,
But take up your load and slowly walk away.
Walk away, walk away,
For the "Horrors" is an awful price to pay,
In the tavern, do not tarry, when you've got all you can carry,
But take up your load and slowly walk away.
CODA
Now lately I've been thinking that I will quit my drinking.
I'm going to leave off whiskey, beer and grog,
For there's no consolation, but only aggravation,
You can't even find friendship with a hog.
(Alternate last stanza)
I began to scratch the gravel, on my all fours I did travel,
I rambled down the road the best I could.
When I awoke next morning, just as the day was dawning,
I was in a hog pen away out in the woods.
Then the hogs began to grumble, I started and I stumbled,
I fell right in their midst and there I lay.
Then one by one they started, till all the herd departed,
Yes, every hog got up and walked away.
Walked away, etc.
Wednesday, August 4, 2010
My New Monkey Song.
I chased a monkey up a Jasmine tree.. Monkey turned around looking back at me. He said I bet you think I'm a real Mon-Key... but I'm a statue turned around looking back at you!... mt.MT.Mt
Sunday, August 1, 2010
THREE :::Meet a grid rule
This link will need to be copy, cut. and pasted into the box at the top of your browser. http://www.gridrules.net/
What are Social Security’s Medical-Vocational Guidelines (the “Grid” Rules)?
When you apply for disability, Social Security evaluates your case using a very detailed set of rules. These rules are designed to help Social Security employees, no matter where they are located, evaluate every case in a uniform manner.
The Grid Rules Only Apply When You
Have Physical Limitations
At the top of this site, you will see buttons labeled “Sedentary,” “Light,” and “Medium.” These terms refer to your physical capacity for work, and are defined as follows:
Sedentary: Sedentary work means that you are able to sit for up to 6 hours in an 8 hour day, and lift up to 10 lbs. occasionally during a day
Light: Light work means that you can stand and walk for up to 6 hours in an 8 hour day, lift 10 lbs. frequently and 20 lbs. occasionally
Medium: Medium work means that you can stand and walk for up to 6 hours in an 8 hour day, lift 25 lbs. frequently and 50 lbs. occasionally
You can only use the grid rules if you have a physical limitation. Purely mental health problems or a pain diagnosis without lifting and standing restrictions will not allow you to use
What are Social Security’s Medical-Vocational Guidelines (the “Grid” Rules)?
When you apply for disability, Social Security evaluates your case using a very detailed set of rules. These rules are designed to help Social Security employees, no matter where they are located, evaluate every case in a uniform manner.
The Grid Rules Only Apply When You
Have Physical Limitations
At the top of this site, you will see buttons labeled “Sedentary,” “Light,” and “Medium.” These terms refer to your physical capacity for work, and are defined as follows:
Sedentary: Sedentary work means that you are able to sit for up to 6 hours in an 8 hour day, and lift up to 10 lbs. occasionally during a day
Light: Light work means that you can stand and walk for up to 6 hours in an 8 hour day, lift 10 lbs. frequently and 20 lbs. occasionally
Medium: Medium work means that you can stand and walk for up to 6 hours in an 8 hour day, lift 25 lbs. frequently and 50 lbs. occasionally
You can only use the grid rules if you have a physical limitation. Purely mental health problems or a pain diagnosis without lifting and standing restrictions will not allow you to use
TWO :::Prove that your functional capacity for work (i.e. Residual Functional Capacity) is less than sedentary
This link will need to be copy, cut. and pasted into the box at the top of your browser.
http://www.socialsecurity.gov/OP_Home/cfr20/404/404-1545.htm
It is the actual page from the social security administration for Disability Evaluation Under Social Security(Blue Book- September 2008). It is Your residual functional capacity.
http://www.socialsecurity.gov/OP_Home/cfr20/404/404-1545.htm
It is the actual page from the social security administration for Disability Evaluation Under Social Security(Blue Book- September 2008). It is Your residual functional capacity.
ONE :::Meet a listing
This link will need to be copy, cut. and pasted into the box at the top of your browser.
http://www.ssa.gov/disability/professionals/bluebook/AdultListings.htm
It is the actual page from the social security administration for Disability Evaluation Under Social Security(Blue Book- September 2008). It is the Listing of Impairments - Adult Listings (Part A.
http://www.ssa.gov/disability/professionals/bluebook/AdultListings.htm
It is the actual page from the social security administration for Disability Evaluation Under Social Security(Blue Book- September 2008). It is the Listing of Impairments - Adult Listings (Part A.
http://www.ssdanswers.com/three-winning-arguments-in-disability-cases/
Three Winning Arguments in Disability Cases
3
As a large federal bureaucracy, the Social Security Administration has a dizzying array of procedures and forms that it uses to process disability cases. Social Security procedure manuals require disability adjudicators and judges to use something called a "sequential evaluation process" to evaluate every disability case. In case you are interested, the five steps of the process are as follows:
Are You Working?
Is Your Condition “Severe”
Does Your Condition Meet a Listing?
Can You Perform Your Past Relevant Work?
Can You Perform Any Work
Hundreds of words have been written about each step of this process and the Appeals Council and District Courts produce voluminous written opinions that explain what each of these words mean and how they should be applied.
As a busy attorney dealing with disability cases on a day to day basis, I don't have the time or patience to deal with the minutia of Social Security jurisprudence. Instead, I worry about what it takes to win.
With apologies to the drafters of Social Security's POMS – Programs Operation Manual System, it has been my experience that there are 3 ways to win a case:
ONE :::Meet a listing
TWO :::Prove that your functional capacity for work (i.e. Residual Functional Capacity) is less than sedentary
THREE :::Meet a grid rule
You can read more about how I apply these three "theories of disability" in a back case by clicking on the link.
In my experience about 15 of cases that end up at hearings are decided under a listing theory and about 15% are grid rule cases. That leaves approximately 70% of the cases that I try as RFC cases. Note that my percentages may be similar or different that what you might experience where you live.
In my view, Social Security disability practice fits fairly neatly into this three theory box. I use this approach in every case in my office and I am always able to fit the facts of any particular case into one, two or all three of these arguments.
If you are a lawyer and you want to learn more about how I set up and manage my practice, I am teaching a course entitled "Creating a Social Security Disability Practice at Solo Practice University, an on-line learning resource.
3
As a large federal bureaucracy, the Social Security Administration has a dizzying array of procedures and forms that it uses to process disability cases. Social Security procedure manuals require disability adjudicators and judges to use something called a "sequential evaluation process" to evaluate every disability case. In case you are interested, the five steps of the process are as follows:
Are You Working?
Is Your Condition “Severe”
Does Your Condition Meet a Listing?
Can You Perform Your Past Relevant Work?
Can You Perform Any Work
Hundreds of words have been written about each step of this process and the Appeals Council and District Courts produce voluminous written opinions that explain what each of these words mean and how they should be applied.
As a busy attorney dealing with disability cases on a day to day basis, I don't have the time or patience to deal with the minutia of Social Security jurisprudence. Instead, I worry about what it takes to win.
With apologies to the drafters of Social Security's POMS – Programs Operation Manual System, it has been my experience that there are 3 ways to win a case:
ONE :::Meet a listing
TWO :::Prove that your functional capacity for work (i.e. Residual Functional Capacity) is less than sedentary
THREE :::Meet a grid rule
You can read more about how I apply these three "theories of disability" in a back case by clicking on the link.
In my experience about 15 of cases that end up at hearings are decided under a listing theory and about 15% are grid rule cases. That leaves approximately 70% of the cases that I try as RFC cases. Note that my percentages may be similar or different that what you might experience where you live.
In my view, Social Security disability practice fits fairly neatly into this three theory box. I use this approach in every case in my office and I am always able to fit the facts of any particular case into one, two or all three of these arguments.
If you are a lawyer and you want to learn more about how I set up and manage my practice, I am teaching a course entitled "Creating a Social Security Disability Practice at Solo Practice University, an on-line learning resource.
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