Archive for July, 2011
The kidneys usually function well after spinal cord injury. However, voluntary control of the bladder is usually lost. The bladder can become overfilled, resulting in high bladder pressures, and backing-up of urine into the upper urinary tract can lead to serious complications, including kidney failure. At one time, kidney failure was a common cause of death in people with spinal cord injury, but it is now a rare complication. Modern techniques for bladder management, especially intermittent catheterization, have revolutionized the care of individuals with spinal cord injury. Some major problems with bladder care do persist, however.
Some individuals with spinal cord injury cannot retain urine in their bladder and they urinate involuntarily, even when taking medications designed to suppress bladder contraction. Scientists are working to develop better methods of preventing this involuntary bladder contraction. Some people have an incompetent or “leaky” urethral sphincter, which allows urine to leak from the bladder at inconvenient times-Urologists can sometimes inject artificial material directly into the sphincter to tighten it. Urologists and biomechanical engineers are working to develop an implantable artificial urethral sphincter, but we don’t yet know whether these efforts will be successful.
For people who retain urine in the bladder and are unable to urinate, scientists are now developing methods for computerized electrical control of the bladder. In one system, an electrical stimulator produces contraction of the bladder’s muscles, causing it to empty. This research is still at an early stage but may someday lead to an implantable, artificial system for overall bladder control. The device would keep track of the volume of urine in the bladder, signal when the bladder is full, then stimulate the bladder to empty when so instructed. For some people, electrical stimulation of the bladder may need to be combined with an artificial sphincter system to achieve full bladder control.
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1. Is there a history of problem drinking in your family?
5 No
4 One close relative
3 More than one close relative
2 I used to have a drinking problem
1 I currently have a drinking problem
2. On the average, how many cigarettes a day do you smoke?
5 None, and I never have
4 None now, but I used to smoke regularly
3 Less than half a pack
2 About a pack a day
1 More than a pack a day
3. How many times in the past year have you been hospitalized?
5 Not at all
4 Once, for a minor problem or childbirth
3 More than once, but only minor problems, no surgery
2 Once for major illness or surgery
1 More than once for major illness or surgery
4. Does your family have a history of cancer, or other immune-suppressive disorders?
5 No history
3 One immediate family member
2 More than one immediate family member
1 I myself have had such disorders
5. How many prescription medicines are you now taking?
5 None
4 One or two
3 Three or four
2 Five or six
1 More than six
6. Do you use illicit drugs?
5 No
4 Not now, but I used to
3 Yes, but infrequently
2 Yes, regularly
1 I am/have been a problem drug user
7. How often do you eat cured or processed meats? (i.e., bacon, sausage, luncheon meats)
5 Never
4 Very infrequently
3 At least once a week
2 Several times a week
1 At least once a day
8. When you shop, do you read food labels for additives?
5 Yes, and I avoid foods with a lot of additives
4 Sometimes, but I don’t always bother
2 Very rarely
1 I don’t really care at all
9. Based on your recent health, do you expect to get sick in the next six months?
5 Definitely not
4 Probably not
3 Maybe one minor cold or flu
2 Probably more than one minor illness 1 I am sick right now
10. Are you taking antibiotics for any medical problem?
5 No
4 Not now, but within the last year
3 Off and on
1 Yes
11. Do you have allergy problems?
5 Never
4 I used to, but no longer
3 Mild, seasonal problems only
2 Mild year-round problems
1 Allergies are a real problem for me
12. How do you describe your health?
5 Excellent, as always
4 Better than before, and still improving
3 Usually good
2 Not as good as it used to be
1 Poor, or getting worse
13. How regular are your bowel movements?
5 Very regular
4 Usually regular
3 Bouts with diarrhea
2 Not very regular
1 Often constipated
14. Which best describes your attitudes about health?
5 The way I live effects my health. I make it a point to treat my body well.
4 Though usually in good health, I’m destined to be sick occasionally.
3 My health is about average, and there’s not much I can do about it.
2 In 20 years, I will be much less healthy than I am now.
1 I worry a lot about my health.
15. Overall, your diet is:
5 Excellent
4 Better than average
3 About average
2 Could be better 1 Poor
TOTAL LIFE-STYLE IQ SCORE
*65\242\2*
Pseudotumor cerebri literally defined means a false tumor of the brain. Although less than an ideal name for a medical problem, the disorder represents a condition in which there occurs an increase of pressure inside the skull. What distinguishes this condition from many other disorders that cause an increase of pressure, such as a brain tumor, is the absence of any identifiable abnormality of the brain tissue. A person affected with pseudotumor cerebri, more recently called “benign intracranial hypertension,” will experience headache as the major symptom of the condition. If the disorder is allowed to worsen for a prolonged period of time, a reduction of vision and ultimate blindness can occur.
The headache associated with pseudotumor cerebri is usually of a nonspecific nature. It is constant and not terribly intense. Pain in the forehead region, behind the eyes, and over the top of the head is common. Interestingly, most but not all persons affected by this disorder are overweight women.
The cause of pseudotumor cerebri remains obscure. In some cases, it has been associated with the use of birth-control pills and other hormone substances (such as cortisone), the taking of a urinary antibiotic called naladixic acid, being pregnant, being obese, or having anemia or low calcium in the blood. Other glandular problems have also been associated with the disorder. In children, pseudotumor cerebri has been observed when tetracycline or too much or too little vitamin A is ingested.
Most cases of pseudotumor cerebri occur without identifiable cause and, as mentioned, the patients are often overweight women. The diagnosis is established by observing swelling of the optic nerves by looking into the eyes with an ophthalmoscope. The increase in pressure is confirmed by performing a lumbar puncture, after tests to rule out a brain tumor and other various conditions have been performed. If the diagnosis is made early in the course of the illness and before visual damage occurs, pseudotumor cerebri can be easily treated by reducing the pressure inside the skull with the use of special medications. In most instances, pseudotumor cerebri does not pose any serious threat to life or health, unless, of course, it is allowed to worsen over months and years.
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