PACEMAKER! JUST WHAT THE DOCTOR ORDERED.(BY S. DOUGLAS)

Ever wondered what would happen to you if your heart started malfunctioning? But more specifically your pace maker? I’m sure we all would feel vulnerable, like wise which is normal. Contractions of the heart's chambers and its ability to pump blood to the lungs and throughout the body are dependent on the precious functioning of the heart's electrical system. Unfortunately, much like the electrical system in a car, which can occasionally malfunction, the heart's electrical system also can malfunction, and may result in a need for a pace maker implantation accordingly.

What we should know is that “a pacemaker is a system that sends electrical impulses to the heart to set the heart rhythm”. The pacemaker can be the original pacemaker of the heart or an electronic device.

However, about three years ago, I remembered my neighbour from the UK complaining that she had a rapid heartbeat, often felt tired and dizzy etc…. remembering her condition, a few days ago, we started talking about her heart and surprisingly she told me that she had an artificial pacemaker implantation. Further in our conversation she stated that her 1^st symptoms were light-headedness, dizziness, with a feeling that she would faint, as I recalled. Progressively the length of time of the episodes  got longer for about 5 minutes, like rapid heart rate etc… Nevertheless, she didn’t pay any consideration to what was happening to her and continued her normal daily activities in the UK like skiing and snowboarding on top of a mountain, where she got the worse episode, which lasted for about an hour, her chest felt tight, she found it hard to breathe, weak and she couldn’t even speak.

Knowing the talk “your health is your responsibility” she visited a heart specialist, had an ECG done, her carotid artery was checked and an ultrasound, where the doctor diagnosed arrhythmia: a condition in which the heart beats with an irregular rhythm. “An arrhythmia can occur if the electrical signal that control the heart beat are delayed or blocked”. Though the doctor didn’t know why she was having arrhythmia, the best way to diagnose was to have an ECG done while she was actually having the episode. Two weeks later she had a long episode of feeling lightheaded, fast heart beat etc, and this time the information was captured on ECG where analysis showed she had supraventricular tachycardia (SVT): that is an abnormal rapid heart rate. Her heart beat was erratic and jumping up to 220pbm. To resolve this issue, she had an ablation procedure. This is a procedure to scar or destroy tissue in your heart that’s allowing incorrect electrical signals to cause rapid heartbeat.

After the ablation, everything was normal for 9 months, until one day she noticed she had slow heartbeat, it was erratic, her heart beat went down to 38bmp, making it very difficult for breathing. As anyone would, she went back to the doctor, had an ECG done, which showed she had 3^rd degree heart block, a form of bradycardia, heart beat less than 60bpm. According to NHS choices, “in a third-degree heart block, there’s no transmission of electrical pulses between the atria and the ventricles through the AV node”. In her case her own natural pacemaker works well but the signal is blocked at the AV node.

Because of her condition, the major solution, was to have an electronic pacemaker implantation, a small device about the size of a matchbox weighing 20-50g. They made a pocket in her chest region to her left side inserted the pacemaker with the electric wires passing through her ribs to various parts of her heart/affected area. How it now works is that, “the pulse generator emits electrical impulses through the wires to your heart. If the pacemaker senses that your heart has missed a beat or is beating too slowly, it sends a signal at a steady rate, when the heart is beating normally, it doesn’t send out any signals.” Most pacemakers have a special sensor that recognises body movement or your breathing rate. This allows them to speed up the discharge rate when you’re active”.

Pacemaker implantation is one of the most common heart surgery carried out in the UK, so this issue is quite common, there is no need to freak out or feel vulnerable, you’ll be okay, but continue to eat healthy, exercise and take any precautionary measures as the doctor may order you.

Pacemaker! Just what the doctor ordered! Kate has her life normal again!

Diabetes at this age..Why? (By T.Charles)

At the age of 6, my little brother began experiencing symptoms such as weight loss, polyuria, polydipsia and polyphagia. It was very strange because this started happening suddenly. The symptoms prolonged for a few days so my mom decided to take him to a pediatrician. The pediatrician

checked him out and gave him some medications to try to stop the symptoms. However, the medications were not working.

She made him go to the hospital to take a few tests. The next day, he was immediately rushed to the hospital. When we arrived at the hospital the nurse tested his blood sugar and it was very high. It was so strange to us because we were wondering why does a six-year-old have high blood sugar.

The doctor gave him insulin which is a hormone produced in the pancreas by the islets of Langerhans, which regulates the amount of glucose in the blood. It was understood that his pancreas was not producing this hormone resulting in high blood sugar which caused these symptoms.

The news was given to the family and the first thing that one said was you were giving him plenty sweets man he got diabetes. Many people think that diabetes is just caused by having an unhealthy diet which is type 2 diabetes. This is false because there is also Type 1 diabetes which is usually diagnosed in children and young adults.

In type 1 diabetes (insulin-dependent), the body does not produce insulin. The body breaks down the sugars and starches you eat into a simple sugar called glucose, which it uses for energy. Insulin is a hormone that the body needs to get glucose from the bloodstream into the cells of the body. With the help of insulin therapy and other treatments, young children can learn to manage their condition and live long, healthy lives. In most people with type 1 diabetes, the body's own immune system which normally fights harmful bacteria and viruses, mistakenly destroys the insulin-producing (islet) cells in the pancreas.

People with type 2 diabetes (insulin-independent) make insulin, but their cells don't use it as well as they should. At first, the pancreas makes more insulin to try to get glucose into the cells. But eventually it can't keep up, and the sugar builds up in your blood instead. It is mostly caused by being overweight.

Symptoms of type 1 and type 2 diabetes include:

• Being very thirsty (Dehydration)
• Peeing a lot
• Blurry vision
• Being irritable
• Tingling or numbness in your hands or feet
• Weight loss

Diabetes Mellitus is a disease which cannot be cured. However, once you eat the right foods and take your medication, it should not be a problem for you at all. Don’t forget, there are two types of diabetes mellitus (type 1 and type 2) so if one of your young friends or siblings is diagnosed with this disease, don't just think about an unhealthy diet (type 2) but also think of type 1 diabetes which is autoimmune or genetic.

Sickle cell anemia. By Omin Fountain

"A food cooking later wi"." What u saying you making a turn?" You didn't have to ask,he didn't have a reason not to hang out.He was almost always the first to arrive.Although he was limited by having to use clutches at all times that did not seem to keep him back.He always had the most interesting story, a normal day of school with his friend pushing him on a wheel barrow and him falling off. He said that was the reason for his "extra legs".He was an out going individual attending all activities in the village,however he did had to pause and take a break ever so often,due to fatigue being one of the symptoms of his aliment. His feet would seem swollen after a long day of walking and would have sores which seemed like they took extra time to heal.He would appear to be in distress and seem slower than usual.
After days of not seeing him,when asked the usual response was" ambulance bring mistake down again wi".It was a painful crises that he tired to hide,which was as a result of inadequate blood supply to the body tissues.

The impaired circulation is caused by the blookage of various blood vessels from the sickling of red blood cells. The sickled red blood cells slow or completely stop the  normal flow of blood through the tissues. This lead to excruciating pain,often requiring hospitalization and medication for relief.The pain can change its location form one body area to another. Bones are frequently exposured. Pain in the abdomen with tenderness is common. Fever is frequently associated with the pain crisis. A pain cris can be prompted by dehydration, infection,injury and cold exposure.

The term sickled cell disease describes a group of inherited red blood cell disorders. People with this disease have
abnormal hemoglobin called hemoglobin S or sickle hemoglobin in their red blood cells. Hemoglobin is a protein in red blood cells that carries oxygen throughout the body.

Sickle cell anaemia is a life long illness and someone suffering from this has to be evaluated every 3-12 months based on their age. The spleen does not work as effectively and this in turn causes the individual to be at a  higher risk of confhinvolves the use s,whic which nfecion.Penicillin however have been found to decrease the chance of this occurring.

Instead of the blood moving through the blood steam easily, sickle cells can clog blood vessels. When blood can't get where it is needed,the body's tissues and organs don't have the oxygen they need to stay healthy.
Normal blood cells last about 4 months in the bloodstream but fragile sickle cells breakdown after only about 10-20 days.
People with sickle cells have other problems because their blood isn't moving through the body as well as it should just like the case of the young nan.And these includes:
Higher chance of getting infection, higher chance of getting stroke and a condition called Acute Chest Syndrome, which is caused by inflammation, infection or blood vessels in the lungs that are blocked by sickled cells.


This young man would still be alive if drugs such as hydroxyurea was available to him to ease the pain and complications. Also if a bone marrow transplant was available cause its the only potential cure for sicked cell anemia.

It is possible  to avoid passing down the disease genetically by getting advice from a genetic cconselor if you plan to have a child and carry the sickle cell trait.

Weak, Diseased, Hereditary or lifestyle HEART DISEASE? (YOU CAN’T RUN OR HIDE FROM IT) (By Sarahn Lawrence)

Yesterday, I went to visit a 63 years old family friend who is a retired nurse. She has been extremely ill lately and has been so ill for the past months, she started fearing death. She had symptoms such as excessive urination at night, fatigue, reduced exercise ability, palpitations,shortness of breath with activity, swelling of the abdomen, legs, ankles, or other part of the body and trouble breathing while lying down. She has been to so many doctors in the past and was diagnosed with exercise-induced bronchospasm, which is a narrowing of the airways in the lungs that is triggered by strenuous exercise. It causes shortness of breath, wheezing, coughing and other symptoms during or after exercise. She also has bilateral carpal tunnel which is a medical condition due to compression of the median nerve as it travels through the wrist at the carpal tunnel and some mild peripheral neuropathy which is a result of damage to your peripheral nerves, often causes weakness, numbness and pain, usually in your hands and feet. As time went by her symptoms started getting worse she started having constant edema, swelling of the ankles and shortness of breath.

Doctors at the hospital automatically assumed that her symptoms were related to hypertension, diet or even diabetes. She was then advised to travel overseas for further medical attention to see a cardiologist, which she did. They did an echocardiogram and realized some changes in the electrical conduction in the heart, and wanted to know what are these changes and why it was happening. The doctors then realized there where little star like structures in the walls of her ventricles just dispersed little areas of thickening that looked like stars after reviewing her echoes. They then insisted she do a myocardial biopsy to look for Amyloid, which came back positive. Amyloid is a disease called protein misfolding. There are normally soluble proteins that become insoluble for a number of reasons and deposits abnormally in tissues and organs around the body. She was then diagnosed with Familial Amyloidotic Cardiomyopathy (FAC). She inherited the genetic mutation from both her mother and father.

Normally before finding out patients has FAC, they are diagnosed with seemingly unrelated symptoms because it affects multiple organs with unspecific symptoms. FAC is an inherited progressively debilitating and often fatal disease caused by mutation in the TTR Gene. This gene is called transthyretin, which is the type that affects family members. The proteins that transport thyroxin and retinol the hereditary form of TTR there is a mutation, which makes the protein abnormal. The TTR protein has a different structure, which makes it unstable, and it tends to form this Amyloid fibril that then gets deposited into the body. The hereditary form of TTR amyloid usually affects the nerves causing neuropathy or the heart or sometimes both. There are 2 other proteins which normally affects the heart and they are called AL (Amyloid light chain) Immunoglobulin which is a protein which fights infections and due to abnormal cells in bone marrow it forms too much light chains and they form amyloid to deposit in tissues and organs in the body and secondly, the Wild type (Age related or senile) where the protein is normal with no mutations. It’s mysterious that the proteins become misfolded and form the amyloid substance and deposit it in heart or ligaments or carpal tunnel.

In FAC the walls of the ventricular parts of the heart becomes thicker due to substances called Amyloidosis. The muscle cells of the heart are disrupted and Amyloid fibrils goes in between heart cells and causes disfunction. The heart should be flexible but it causes the heart to be much stiffer than normal. Its not that the heart is weak its just that the walls of the heart is too thick and inflexible making it hard for the heart to get filled with blood, and when you can’t get enough blood into the heart there isn’t enough to send to the body. This causes conditions such as heart failure when there isn’t enough blood to meet the demands of the body and pressure can then build up in the heart causing a syndrome called congestive heart failure.

However the issue was resolved just in time since she was placed on the heart transplant list. She received a new heart in January of this year and the transplant was done successfully.

            

An excuse to play copaweson (by Kezia Carbon)

I believe that there is no one better to do this topic, it's right up my alley. But anyways! I am sure that everyone has seen at least one Judge Judy commercial break where some medical product is being advertised, with the nice music and the white lady's voice. And then at the very end when stating the side effects, she starts to speak very quickly. "Side effects may include stroke, allergic reactions.........or even may result in death".

A drug for inflammatory heart disease was advertised on one of the commercial breaks. Although we did not directly address this illness in class, we did cover some aspects of it.

Inflammatory Heart Disease as its name implies is the swelling of the heart muscles, pericardial sac and myocardium. Perhaps you will remember the cardiac tamponade we discussed in class; where the pericardial sac fills with fluid, pressure is exerted on the heart and ventricles are unable to effectively pump blood out of the heart.

Inflammatory heart disease is caused by pathogens, viruses, bacteria and toxic materials from the environment.......which includes people. When heart muscle especially the myocardium is infected by viruses, it results in chest pain, shortness of breath, edema, fatigue, and pain in heart muscle, oh and back to the commercial.......death! 

Antibiotics can be used to treat the disease and if heart failure occurs, long term medications will have to be taken. But as the saying goes, prevention is always better than cure. So if you are in an uncomfortable situation, especially during carnival and independence season, you know, when all these foreigners are here, use inflammatory heart disease as your scapegoat.

References

The Inflammatory Heart Diseases. Lu.L.,Sun.R. https://www.ncbi.nlm.nih.gov/pubmed/25682012  

Inflammation and Heart Disease. American Heart Association.<http://www.heart.org/HEARTORG/Conditions/Inflammation-and-Heart-Disease_UCM_432150_Article.jsp#.WK8e7NIrKM8> 

I can't breathe. Am I going to die? (By Dora Prevost)

When I was younger I rarely got sick. I vaguely remember that one time I got the flu and had to be placed under the nebulizer because I had extreme wheezing and breathing difficulties. However that was short lived. I had a really high metabolism back then and would eat to my heart’s content and gained nothing. A knack many people admired but I detest. I literally weighed just above 85 pounds in 2nd form and did not gain much until my final year of secondary school but overall I was a healthy, agile young individual. 

Changes in my body became apparent in college. I gained a significant amount of weight which was a plus but on the downside I always felt fatigue and had really intense headaches.  If that was not bad enough my skin became extremely pale, especially in the facial region and I had difficulty focusing in class and felt extremely lightheaded when I moved around.  I brushed off the symptoms and assumed that they were due to an increase work load, lack of sleep since I was a double major at the time and the fact that I had gained weight.  Silly me!!

Fast forward a few months, while studying for final exams I felt an intense pain in my chest, an ache which had became a norm for me, along with breathing difficulties.  However this time, it was INTENSE!!! Breathing was no longer involuntary.  I felt like I was going to die…  A doctor visit and a few tests later confirmed that I had a condition called Iron Deficiency Anemia. 

So much for being healthy…

Iron deficiency is a nutritional deficiency that leads to anemia. Iron deficiency anemia is a condition in which blood lacks adequate healthy red blood cells.  This could be due to internal bleeding, pregnancy, loss of blood due to menstruation, inability to absorb iron or in my case inadequate iron intake.  As the name implies, iron deficiency anemia is due to insufficient iron in the body.  Iron is important because the body uses it to produce a substance called hemoglobin which is found in the red blood cells. It carries oxygen through the body.  Inadequate iron means, hemoglobin is not being produced as it should, hence oxygen is not carried throughout the body at its precise rate.

That explains my breathing difficulties.

                   

              Depiction of Normal red blood cells (left) and Iron Deficient red blood cells (right)

American Society of Hematology states that;

 Red blood cell (RBC) count and hemoglobin concentration are important clinical data because they determine the amount of oxygen the blood can carry. Hemoglobin concentration of whole blood is normally 13 to 18 grams per deciliter (g/dL) in men and 12 to 16 g/dL in women. Red blood cell count in men is approximately 4.7 to 6.1 million cells/ul (microlitre). The normal range in women is 4.2 to 5.4 million cells/ul

My hemoglobin levels were 7 grams per deciliter (g/dL) which was pretty low. 

The signs and symptoms of iron-deficiency anemia depend on its severity. Mild to moderate iron-deficiency anemia may have no signs or symptoms.  However if they do arise, it would include the following:

Iron deficiency cannot be corrected overnight. The goals of treating iron-deficiency anemia are to treat its underlying cause and restore normal levels of red blood cells, hemoglobin, and iron. Luckily, iron supplements and a change in diet can correct low iron levels within months.  

When will I ever grow up? (By Chari Peter)

"Why am I not like the other girls? " Rebecca is on her final year of university getting her Masters degree in Biology and Chemistry. Shes turning 25 this year but, she has the body of a 7 year old, literally. she wonder why she has no breasts, no hips and why she hasn't experienced period as yet.
Seeing that she is a Biology student, she is aware of the natural processes  in males as well as females but cant understand why she is this way. she beings questioning whether or not she will be able to make any kids since she has no signs of secondary sex characteristics.


Syndrome is a condition  characterised by delayed or absent puberty and impaired sense of smell. It is a sort of Hypogonadotropic hypogonadism. you're maybe wondering why  it is so long. to break it down for you , Hypogonadism according to medicine plus, is a condition in which the male testes or the female ovaries produce little or no sex hormones.
Hypogonadrotropic Hypoganadism (HH) is a form of hypogonadism that is due to a problem with the pituitary gland or hypothalamus.


The hormones which causes this syndrome are FSH ( follicle stimulating hormone), and LH ( luteinizing hormone). Both males and females can get the Kallmann syndrome.
The males and females will not grow/ develop the secondary sex characteristics.

• The males will often have a small penis and undescended testes
• they will not grow any facial hairs 
• their voice is not deeper
• they will have a lost in interest in sex
• The females will not 
• undergo menstruation
• have breast and hip development 

A man with Kallmann Syndrome

Both males and females will have problems in conceiving a child. This is because they are both infertile due to the non existence of secondary sex characteristics.  Can you imagine how traumatizing this experience is? all your dreams of " glowing up" will be crushed if you have this syndrome.

A few other signs and symptoms of Kallmann  syndrome are:

• loss of smell
• Kidney failure to develop the unilateral renal
• unformed bones in the fingers and the toes.

Some other individuals who has Kallmann syndrome  have bimanual synkinesis.. In this the image movement of one hand is mirrored by the other hand.
On May 24th 2017, a concerned mother spoke out this bimanual synkinesis on www.health.org
" My 17 month baby has a mirrored hand. IF  he scratched  his ear with his left hand, his Right hand is identical to the left but it is scratching the air. "



On famous person that we should all know is Jason Daniel Earles. He played the role Jackson Stewart in the Disney Channel sitcom Hannah Montana. Im sure we all wondered at one point why he looks the same as each season went by. e was actually 29 when he played that role of a 18 yr old boy. according to ... He suffers from kallmann syndrome.

Jason Daniel

Testing and treatments

• Blood tests are done to measure the hormones FSH, LH others such as TSH, Prolactin and testosterone. 
• Other test is MRI of the pituitary gland.
• To treat these, a medical doctor prescribes 
• Injection and patches of testosterone
• Estrogen and progesterone pills as well as the patches