VHC Physician Group » Health LibraryHealth Library » http://www.vhcphysiciangroup.com Fri, 25 Mar 2016 18:19:32 +0000 en-US hourly 1 http://wordpress.org/?v=4.1 Why You Should Try Yoga http://www.vhcphysiciangroup.com/health-library/10-good-reasons-to-try-yoga/ http://www.vhcphysiciangroup.com/health-library/10-good-reasons-to-try-yoga/#comments Mon, 09 Jun 2014 15:23:26 +0000 http://www.vhcphysiciangroup.com/health-library/10-good-reasons-to-try-yoga/

What is yoga, and why is it so popular? Yoga is a series of stretches and poses that
you do with breathing techniques. It offers the powerful benefits of exercise. And
since yoga is gentle, almost anyone can do it, regardless of your age or fitness level.

Yoga is a 5,000-year-old discipline from India. It was developed as a practice to
unite the mind and body. There are many branches of yoga. All yoga styles can help
balance your body, mind, and spirit, but they achieve it in various ways.

Some yoga styles are intense and vigorous. Others are relaxing and meditative. No
matter which type you choose, yoga is a great way to stretch and strengthen your body,
focus your mind, and relax your spirit.

Benefits of yoga

Yoga can make you stronger and more flexible. It’s a great way to stay limber and
energetic. You’ll also feel more focused and alert. And yoga can help you feel great
and function better in your daily life. Yoga can also help improve these conditions:

  • Poor blood circulation

  • High blood pressure

  • Arthritis

  • Osteoporosis

  • Limited mobility

  • Lower back pain

  • Difficulty breathing

  • Headaches

  • Tension or stress

  • Depression

Yoga’s gentle movements are a big reason for why it’s so popular. Yoga is good for
people who haven’t been active in a while. It’s good for people who have certain health
conditions like arthritis or osteoporosis. You can change the exercises to fit your needs.
But yoga is also great if you’re already fit and want a challenging workout. As you
become more strong and flexible with yoga, it’s easier to do other kinds of exercise
like dancing, walking, or swimming.

Yoga can help you:

  • Reduce your risk for injury. Each yoga pose targets specific muscles. This helps you increase your flexibility
    and reduce your risk for injury.

  • Reduce stress. Yoga can help soothe the mind and lower stress levels. It does this by focusing
    the mind on the moment and the movements.

  • Increase your concentration. A main part of yoga is rhythmic, focused breathing. This can help you focus.

  • Understand the mind and body connection. Yoga requires you to focus all your energy on each movement or pose exactly.
    This can help you feel the mind and body work together.

  • Gain strength and stamina. More vigorous styles of yoga promote strength and stamina.

  • Improve balance and stability. Balancing poses require you to use your core muscles. This can help you improve
    your overall stability.

  • Improve posture. Yoga poses strengthen and open tight areas of the body like the shoulders and
    muscles of the upper back. This can help you keep good posture.

  • Develop body awareness. Yoga requires you to contract or relax specific muscles as you stretch into
    each pose. This can help you become more aware of your body’s strengths and weaknesses.

Types of yoga

You have many types of yoga to choose from. They use different kinds of movements
called poses. You may prefer a certain type, depending on your goals and fitness level:

  • Hatha yoga. This form of yoga is the most popular in the U.S. It’s known as the yoga of
    force. It emphasizes strengthening and purifying the body. It involves physical
    postures (asanas) and breathing techniques (pranayama).

  • Iyengar yoga. This style of yoga focuses on alignment. It is fluid and dancelike. It uses
    props like wooden blocks, straps, chairs, bolsters, and blankets to help you
    achieve and hold postures you otherwise couldn’t hold.

  • Ashtanga yoga. This kind of yoga is sometimes called ashtanga vinyasa or power yoga. It’s intense
    and fast-paced. It’s designed to build your endurance and strength. You do a
    series of postures in 1 continuous, flowing movement. You link the motions to
    breathing patterns.

  • Bikram yoga. You do this form of yoga in a very hot room, unlike many other types of yoga.
    Bikram yoga involves a set of 26 postures that you practice twice per session.
    First you do standing and balance poses. Then you do back bends, forward bends,
    and twisting postures.

  • Restorative yoga. This type of yoga does not use active postures. It focuses instead on the relaxation
    part of yoga.

  • Kripalu yoga. This is a gentler, slower-moving style of yoga. It’s between restorative yoga
    and the more vigorous forms.

Strength-training with yoga

Many people think yoga is essentially a stretching regimen. It is that, but it’s also
much more. How do you strengthen your muscles with yoga? Simply by getting into a yoga
posture and holding it. Yoga can give you stronger muscles with poses such as:

  • Downward facing dog pose. This strengthens your arms and legs.

  • Half moon pose. This strengthens your legs and ankles.

  • Plank pose. This strengthens your arms, wrists, and back.

  • Locust pose. This strengthens the back of your torso, legs, and arms.

How to get started

It’s easy to find all kinds of yoga classes. Check with your local community centers.
Look at nearby gyms, dance studios, and health clubs. Or, check out Yoga Journal’s
Yoga Teacher Directory to see regional and national lists of yoga teachers and associations.

It is important to find the right yoga style for you and a teacher you like. It’s
hard to know what a class is like until you attend it. Even when 2 teachers use the
same terms to describe their classes, the classes may be quite different.

Talk with your health care provider before you begin yoga or any other kind of exercise.
It’s a good idea to take a class with an experienced teacher. Let the teacher know
about any health conditions you may have like high blood pressure or arthritis. Tell
him or her about any injuries or physical problems. A good teacher will know which
exercises are best for you, and tell you which poses to avoid.

Give it a try

Yoga can help you get fit for life. It helps you deal with stress, pick up your child,
control your dog, carry groceries, or work in your garden. It also can help to prevent
or ease back pain and muscle or joint injury, and give you self-reliance and self-esteem.

Yet, one of the most important benefits of any yoga routine isn’t physical — it’s
the quieting of the mind. The bottom line is learning to pay attention. You fine-tune
your attention, beginning with the body, and then moving to the mind. As you get deeper
into your practice over the years, you start to see the mental and spiritual benefits.

Online Source: National Institutes of Health. Yoga for Health: An Introduction

Date Last Reviewed: 2/3/2015

Date Last Modified: 3/9/2015

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12-Step Recovery Program http://www.vhcphysiciangroup.com/health-library/12-step-recovery-program/ http://www.vhcphysiciangroup.com/health-library/12-step-recovery-program/#comments Mon, 09 Jun 2014 15:24:09 +0000 http://www.vhcphysiciangroup.com/health-library/12-step-recovery-program/

A 12-step recovery program is a way to give support and education to people who want to stop their use of alcohol or drugs. This kind of self-help program is often done in a group setting. Or it may be done one-on-one with a counselor. Family members may be a part of the process. A 12-step program is not considered a treatment program for alcohol or drug abuse. But it can serve as an important type of support.

The belief behind a 12-step program is that once a person is an addict or alcoholic, he or she is always an addict or alcoholic. The person must admit to being powerless over the drugs or alcohol. He or she must vow to take one day at a time. A 12-step program asks each member to turn his or her problems over to a “higher power.” However, the program is not linked to any religion. The program teaches the person to change negative attitudes and behaviors into positive ones. Use of drugs or alcohol is not allowed while taking part in a 12-step recovery program.

Date Last Reviewed: 1/26/2010

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22q11.2 Deletion Syndrome http://www.vhcphysiciangroup.com/health-library/22q11-2-deletion-syndrome/ http://www.vhcphysiciangroup.com/health-library/22q11-2-deletion-syndrome/#comments Mon, 09 Jun 2014 15:34:22 +0000 http://www.vhcphysiciangroup.com/health-library/22q11-2-deletion-syndrome/

What is 22q11.2 deletion syndrome?

22q11.2 deletion syndrome is a genetic disorder. In this syndrome, a tiny piece of chromosome 22 is missing. This can cause many medical problems. These problems may range from heart defects and developmental delays to seizures and effects on facial appearance. These might include cleft palate (an opening in the roof of the mouth).

In 22q11.2 deletion syndrome, a tiny piece of chromosome 22 is missing from the long arm of chromosome 22, at a location called q11.2. 

Most people affected by the syndrome do not experience all the health problems that are associated with it. In general, health problems that are present due to 22q11.2 deletion syndrome can be managed with treatment, especially if they are detected early. 

In the mid-1960s, an endocrinologist named Dr. Angelo DiGeorge recognized that a particular group of clinical features frequently occurred together, including the following: 

  • Hypoparathyroidism (underactive parathyroid gland), which results in hypocalcemia (low blood calcium levels) 

  • Hypoplastic (underdeveloped) thymus or absent thymus, which results in problems with the immune system 

  • Conotruncal heart defects (such as tetralogy of Fallot, interrupted aortic arch, ventricular septal defects, vascular rings) 

  • Cleft lip and/or palate

The signs and symptoms of 22q11.2 deletion syndrome can vary from one affected person to another. For that reason, several disorders and collections of symptoms caused by this syndrome have had other names in the past. These names, some of which are still used occasionally, include: 

  • DiGeorge syndrome

  • Velocardiofacial syndrome (VCFS)

  • Shprintzen syndrome

  • Conotruncal anomaly face syndrome (CTAF)

  • Sedlackova syndrome

In addition, some children with the syndrome were previously diagnosed with Opitz G/BBB syndrome or Cayler cardiofacial syndrome. Doctors now understand that these disorders all share the same genetic cause as 22q11.2 deletion syndrome. 

Who is affected by 22q11.2 deletion syndrome?

About one in 4,000 people have 22q11.2 deletion syndrome. Some medical experts believe this number should be higher; some people with the chromosome defect have less severe symptoms that may not be diagnosed as 22q11.2 deletion syndrome. Thus, they are unaware they have the syndrome. 

What causes 22q11.2 deletion syndrome?

Most people with 22q11.2 deletion syndrome are missing about 30 to 40 genes. The exact function of many of these genes remains a mystery. But one gene, TBX1, probably accounts for the syndrome’s most common physical symptoms. These include heart problems and cleft palate. Another nearby gene, called COMT, may also help explain the increased risk for behavior problems and mental illness in people with the syndrome. 

About 90 percent of 22q11.2 deletion syndrome cases occur randomly at fertilization or early in fetal development. So most people affected with the disorder have no previous family history of it. However, they may pass the condition on to their children. The remaining 10 percent of cases are inherited from either the mother or the father. When the condition is inherited, other family members could also be affected. Because a person who has this chromosome deletion has a 50 percent chance of passing the deletion to a child, both parents are generally offered the opportunity to have their blood studied to look for the deletion. 

What are the signs and symptoms of 22q11.2 deletion syndrome?

The signs and symptoms of 22q11.2 deletion syndrome may vary widely, even among family members. At least 30 different signs or symptoms have been associated with this disorder, but most affected people only have some symptoms.  

The most common symptoms include: 

  • Heart defects, which are usually present from birth 

  • Palate abnormalities, such as cleft palate and speech difficulties 

  • Middle ear infections or hearing loss 

  • Feeding difficulties 

  • Low levels of calcium in the blood, due to problems with the parathyroid glands, which can trigger seizures 

  • Immune system problems that can increase risk for infections 

  • Kidney abnormalities 

  • Spine problems, such as scoliosis (curvature in the spine) and abnormalities in the bones of  the neck or upper back 

  • Learning difficulties, especially with nonverbal material, and developmental delays 

  • Communication and social interaction problems, including autism 

  • An increased risk for mental illness, such as anxiety, depression, or schizophrenia in adulthood

Facial features of children with 22q11.2 deletion syndrome may include the following: 

  • Small ears with squared upper ear

  • Hooded eyelids

  • Cleft lip and/or palate

  • Asymmetric (uneven) facial appearance when crying

  • Small mouth, chin, and side areas of the tip of the nose  

The symptoms of 22q11.2 deletion syndrome may resemble other problems or medical conditions. Always consult your child’s doctor for a diagnosis. 

How is 22q11.2 deletion syndrome diagnosed?

In addition to a prenatal history, complete medical and family history, and a physical examination, diagnostic procedures for 22q11.2 deletion may include: 

  • Blood tests and tests to examine for immune system problems

  • X-ray. A diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film 

  • Echocardiography. A procedure that evaluates the structure and function of the heart, by using sound waves recorded on an electronic sensor that produce a moving picture of the heart and heart valves 

  • Fluorescent in situ hybridization (FISH) studies. When features of conotruncal heart defects, clefting, other facial features, hypocalcemia, and absent thymus are identified, a blood test is usually ordered to look for a deletion in the chromosome 22q11.2 region. FISH is specifically designed to look for small groups of genes that are deleted. If the FISH test finds no deletion in the 22q11.2 region and the features of VCFS are still strongly suggestive, then a full chromosome study is usually performed to look for other chromosome defects that have been associated with this syndrome. 

If a 22q11.2 deletion is detected in a child, then both parents are offered the FISH test to see if this deletion is inherited. In approximately 10 percent of families, the deletion has been inherited from one of the parents. Any individual who has this 22q11.2 deletion has a 50 percent chance, with each pregnancy, of passing it on to a child.           

How is 22q11.2 deletion syndrome treated?

There is no cure for 22q11.2 deletion syndrome, but many of its related health problems can be treated. Parents can help their child by seeking early, competent care.  

Specific treatment for 22q11.2 deletion syndrome will be determined by your child’s doctor based on the following: 

  • Your child’s age, overall health, and medical history

  • The extent of the disease

  • The type of disease

  • Your child’s tolerance for specific medications, procedures, or therapies

  • Expectations for the course of the disease

  • Your opinion or preference 

Treatment will also depend on the particular features in any given child and may include the following: 

  • A cardiologist will evaluate heart defects and may correct them with an interventional procedure or surgery. 

  • A plastic surgeon and a speech pathologist will evaluate cleft lip and/or palate defects. 

  • Speech and gastrointestinal specialists will evaluate feeding difficulties. Some children with the syndrome have severe feeding difficulties and need tube feedings in order to get adequate nutrition. Feeding difficulties are not usually related to heart or palate problems, but rather to intestinal problems caused by the syndrome. 

  • Immunology evaluations should be performed in all children with this deletion. Patients with T-cell dysfunction are at risk for recurrent infections. Those with severe T-cell disorders should avoid live viral vaccines. All blood products for transfusions (if needed) should be irradiated unless cleared by an immunology doctor. 

Other common problems that may require treatment include: 

  • Low calcium. This is common in children with the syndrome, especially right after birth. But it can also recur during stressful periods, such as during puberty or following surgery. A child may need to take calcium supplements as well as vitamin D to help absorb the calcium. A referral to an endocrinologist (doctor who specializes in treating conditions affecting the endocrine system) may be recommended.

  • Developmental difficulties. Young children with 22q11.2 deletion syndrome may be slow to achieve developmental milestones, such as sitting, walking, and talking. The International 22q11.2 Deletion Syndrome Foundation recommends that parents consider physical therapy (PT), occupational therapy (OT), and speech therapy for their affected children. PT strengthens large muscles and helps children meet developmental milestones. OT focuses on small muscles used for skills, such as tying shoes and buttoning clothes. It can also help with feeding problems. Speech therapy can help address language delays that may become apparent after a child turns one year old. 

A child’s doctor or parents may request an evaluation to determine what services are available to assist in the management of a child with 22q11.2 deletion syndrome. 

Long-term outlook for children with 22q11.2 deletion syndrome

A small percentage of children with severe heart defects and immune system problems caused by 22q11.2 deletion syndrome will not survive the first year of life. However, with the proper treatment of heart defects, immune system disorders, and other health problems, the vast majority of children with a 22q11.2 deletion will survive and grow into adulthood. These children will generally need extra help throughout school and will need long-term care for their individual health needs. 

Although it is not common, some children with the syndrome may have behavioral conditions, such as autism, attention deficit disorder (ADD/ADHD), obsessive compulsive disorder (OCD), or anxiety. According to the Velo-Cardio-Facial Syndrome Educational Foundation, most individuals with the syndrome have some behavioral problems. The occurrence of psychiatric disorders is higher for adults with 22q11.2 deletion syndrome, but medical researchers are still investigating the exact nature and risk of these disorders.

Publication Source: Clinical Experience in T Cell Deficient Patients. Cole, TS. Allergy, Asthma and Clinical Immunology. 2010;6(9):s1-10

Publication Source: Management of Genetic Syndromes. Cassidy, S. 2010;3:263-84.

Online Source: National Library of Medicine

Online Source: National Human Genome Research Institute

Online Source: National Center for Biotechnology Information GeneReviews

Date Last Reviewed: 6/29/2013

Date Last Modified: 7/1/2013

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24-Hour Urine Collection http://www.vhcphysiciangroup.com/health-library/24-hour-urine-collection/ http://www.vhcphysiciangroup.com/health-library/24-hour-urine-collection/#comments Mon, 09 Jun 2014 15:35:12 +0000 http://www.vhcphysiciangroup.com/health-library/24-hour-urine-collection/

What is a 24-hour urine collection?

A 24-hour urine collection is a simple lab test that measures what’s in your urine.
The test is used to check kidney function. A 24-hour urine collection is done by collecting
your urine in a special container(s) over a full 24-hour period. The container(s)
must be kept cool until the urine is returned to the lab.

Urine is made up of water and dissolved chemicals, such as sodium and potassium. It
also contains urea, which is made when protein breaks down, and creatinine, which
is formed from muscle breakdown. Normally, urine contains specific amounts of these
waste products. If these amounts are not within a normal range, or if other substances
are present, it may be a sign of a certain disease or condition.

Why might I need a 24-hour urine collection?

Twenty-four hour urine collection helps diagnose kidney problems. It is often done
to see how much creatinine clears through the kidneys. It’s also done to measure protein,
hormones, minerals, and other chemical compounds.

Conditions that can cause kidney disease include:

  • Diabetic nephropathy. This is aresult of uncontrolled diabetes. It causes high levels of protein (albumin)
    in the urine and can lead to kidney damage.
  • High blood pressure. Abnormally high blood pressure can lead to permanent kidney damage.
  • Lupus nephritis. Inflammation of the kidneys can be caused by lupus, an autoimmune disease where the
    immune system attacks the kidneys and damages them.
  • Frequent urinary tract infections.
  • Prolonged urinary tract blockage.
  • Alport syndrome. Thisinherited health problem causes vision and hearing problems, as well as progressive
    scarring of the kidneys.
  • Nephrotic syndrome. Thiscondition that has several different causes. It is characterized by protein in
    the urine, low protein in the blood, high cholesterol levels, and tissue swelling.
  • Polycystic kidney disease. This genetic disorder is characterized by the growth of many fluid-filled cysts in
    the kidneys. This makes the kidneys larger and, over time, takes over and destroys
    working kidney tissue.
  • Interstitial nephritis or pyelonephritis. This is an inflammation in the small structures in the kidney. It’s often caused by
    infection.
  • Screening for preeclampsia in pregnancy. Preeclampsia is a dangerous health problem that sometimes occurs in pregnancy. It’s
    associated with blood pressure and organ failure. 

There may be other reasons for your health care provider to recommend 24-hour urine
collection.

What are the risks of a 24-hour urine collection?

Twenty-four hour urine collection is a safe, easy test. People can collect urine on
their own.

Certain factors or conditions may interfere with the accuracy of a 24-hour urine collection.
These factors include:

  • Forgetting to collect some of your urine
  • Going beyond the 24-hour collection period and collecting too much urine
  • Losing urine from the specimen container through spilling
  • Not keeping urine cold while collecting it
  • Acute stress
  • Vigorous exercise
  • Certain foods, such as coffee, tea, cocoa, bananas, citrus fruits, vanilla, can change
    urine test results

There may be other risks depending on your specific medical condition. Be sure to
discuss any concerns with your health care provider before the procedure.

How do I get ready for a 24-hour urine collection?

  • Your health care provider will explain the procedure and you can ask questions.
  • Make sure you understand if you need to avoid certain foods while collecting your
    urine.
  • No other preparation is needed.
  • You will be given large containers to store your urine and a container to urinate
    into. Make sure you know how to use them and have a cold place to store the urine
    while you’re collecting it. For instance, a refrigerator or in a cooler on ice.
  • You may be instructed to start the collection at a specific time.
  • If possible, choose a 24-hour period when you will be at home so you do not have to
    transport your urine.
  • If you are pregnant or think you may be, tell your health care provider.
  • Make sure your health care provider has a list of all medicines (prescription and
    over-the-counter), herbs, vitamins, and supplements that you are taking.

Based on your medical condition, your health care provider may request other specific
preparation.

What happens during a 24-hour urine collection?

A 24-hour urine collection may be done on an outpatient basis or during a hospital
stay. Procedures may vary depending on your condition and your health care provider’s
practices.

Generally, a 24-hour urine collection follows this process:

  1. You will be given one or more containers for collecting and storing your urine. A
    brown plastic container is typically used. A specimen pan that fits in the toilet
    or a urinal may be used to collect the urine. You will need to transfer the urine
    from the collecting container to the storage container, and will need to keep it cold.
  2. The 24-hour collection may start at any time during the day after you urinate, but
    your health care provider may tell you when to start. It is common to start the collection
    the first thing in the morning. It is important to collect all urine in the following
    24-hour period.
  3. Do not save the urine from your first time urinating–the starting time. Flush this
    first specimen, but note the time. This is the start time of the 24-hour collection.
  4. All urine, after the first (flushed) specimen, must be saved, stored, and kept cold,
    either on ice or in a refrigerator, for the next 24 hours.
  5. Try to urinate again at the same time, 24 hours after the start time, to finish the
    collection process, but if you cannot urinate at this time, it is not a problem.
  6. Once the urine collection has been completed, the urine containers will need to be
    taken to the lab as soon as possible. If you are doing the urine collection at home,
    you will be given instructions on how and where to take it.
  7. Depending on your specific medical condition, you may be asked to repeat the collection
    over several days.

What happens after a 24-hour urine collection?

There is no special type of care after a 24-hour urine collection. However, your health
care provider may give you other instructions after the procedure, depending on your
particular situation.

Next steps

Before you agree to the test or the procedure make sure you know:

  • The name of the test or procedure
  • The reason you are having the test or procedure
  • The risks and benefits of the test or procedure
  • When and where you are to have the test or procedure and who will do it
  • When and how will you get the results
  • How much will you have to pay for the test or procedure
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24-Hour Urine Collection Podcast http://www.vhcphysiciangroup.com/health-library/24-hour-urine-collection-podcast/ http://www.vhcphysiciangroup.com/health-library/24-hour-urine-collection-podcast/#comments Mon, 09 Jun 2014 15:23:53 +0000 http://www.vhcphysiciangroup.com/health-library/24-hour-urine-collection-podcast/

Detailed information on 24-hour urine collection, including the reasons and preparation
for the procedure, how the procedure is performed, after care, and anatomical illustrations
of the kidney and urinary system.

Play Audio

Date Last Modified: 2010-01-12

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24-Hour Urine Protein http://www.vhcphysiciangroup.com/health-library/24-hour-urine-protein/ http://www.vhcphysiciangroup.com/health-library/24-hour-urine-protein/#comments Mon, 09 Jun 2014 15:24:06 +0000 http://www.vhcphysiciangroup.com/health-library/24-hour-urine-protein/

Does this test have other names?

24-hour albumin test, proteinuria test

What is this test?

This test measures the amount of protein in your urine.

Healthy kidneys usually filter protein out of the blood and absorb the protein. Then
they send it back into the blood while waste material is passed out of your body as
urine. But when your kidneys aren’t working the way they should, protein may pass
into your urine. Protein in your urine is a condition called proteinuria, albuminuria,
or microalbuminuria.

Many different chronic diseases, including kidney disease and diabetes, can cause
protein in your urine. During pregnancy, protein in your urine can mean a very dangerous
condition called preeclampsia, or extremely high blood pressure.

This test may be ordered after a dipstick urine protein test. That test needs only
one urine sample that’s collected at your healthcare provider’s office.

Why do I need this test?

If you are pregnant, you may have this test as a part of routine prenatal care to
screen for preeclampsia.

You may also have this test if your healthcare provider suspects that you have protein
in your urine. Proteinuria may not cause symptoms in the early stage. But as kidney
function worsens, you may notice these symptoms:

  • Swollen face

  • Swelling in your hands or feet

  • Foamy urine

  • Higher level of blood creatinine

You may also need this test if you:

  • Are diabetic

  • Have high blood pressure

  • Have a family member who has chronic kidney disease

  • Are at risk for kidney disease

What other tests might I have along with this test?

Your healthcare provider may also order a urine albumin-to-creatinine ratio test,
which measures the ratio of protein to waste in your urine. Your provider may also
order an ultrasound of your kidneys. He or she may also order blood tests, such as
antinuclear antibody or complement, to check for conditions that cause kidney problems.

What do my test results mean?

Many things may affect your lab test results. These include the method each lab uses
to do the test. Even if your test results are different from the normal value, you
may not have a problem. To learn what the results mean for you, talk with your healthcare
provider.

Results are given in milligrams (mg). Normal urine protein in adults is less than
150 mg within a 24-hour period.

How is this test done?

This test requires a 24-hour urine sample. For this type of urine sample, you must
collect all the urine you make in 24 hours. Empty your bladder completely first thing
in the morning without collecting it and note the time. Then collect your urine every
time you go to the bathroom for the next 24 hours in a special container or containers.
The containers must be kept cool until you return them to your provider.

Does this test pose any risks?

This test poses no known risks.

What might affect my test results?

Many different medicines may affect your test results. These include:

  • Antibiotics

  • Vitamin C supplements

  • Certain medicines used to treat Parkinson disease

Having a fever or exercising strenuously just before the test may also affect your
result. Collecting too much urine or not enough urine may affect your result.

How do I get ready for this test?

You may need to skip exercising for a certain time before the test. Let your healthcare
provider know if you have a fever or have been ill recently.

Your provider will tell you if you should not take certain medicines on the day of
the test. In addition, be sure your provider knows about all medicines, herbs, vitamins,
and supplements you are taking. This includes medicines that don’t need a prescription
and any illicit drugs you may use.

 

Publication Source: Assessment of Urinary protein excretion and evaluation of isolated non-nephrotic proteinuria
in adults. UpToDate.

Publication Source: Basic Examination of Urine. McPherson RA, Ben-Ezra J. Henry’s Clinical Diagnosis and
Management by Laboratory Methods. Chap. 28, pp. 445-79.

Publication Source: Collection of a 24 hour urine specimen. UpToDate.

Online Source: Protein in Urine, American Kidney Fund

Date Last Reviewed: 10/22/2015

Date Last Modified: 1/11/2016

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5 Exercises to Prevent an Aching Neck http://www.vhcphysiciangroup.com/health-library/5-exercises-to-prevent-an-aching-neck/ http://www.vhcphysiciangroup.com/health-library/5-exercises-to-prevent-an-aching-neck/#comments Mon, 09 Jun 2014 15:23:38 +0000 http://www.vhcphysiciangroup.com/health-library/5-exercises-to-prevent-an-aching-neck/

One of the things many of us take for granted is a pain-free neck. It’s only when
we have a stiff or painful neck that we wish we had taken preventive measures. The
exercises discussed below are to strengthen and stretch a normal neck. If you have
preexisting neck pain or a spine condition, check with your healthcare provider before
doing these exercises.

There are several causes of neck pain, including poor posture and soft tissue abnormalities
due to injury or wear and tear. Soft tissues include muscles, ligaments, and tendons.
In rare instances, an infection or tumor may cause neck pain. On occasion, neck problems
can lead to pain in the shoulders, upper back, and/or arms.

Necks need exercise, too

The muscles in your neck can be exercised and strengthened just like other muscles
in your body. Plus, exercise will improve your neck’s range of motion. Make sure you
check with your healthcare provider before doing neck exercises. Stop at once if any
movement causes you pain.

Before you begin a neck exercise, it’s important to find the proper starting position
for your head. This helps prevent exercise-related injuries. Do this by putting your
head squarely over your shoulders, then move it straight forward and then back. This
back or base position is your starting point. For each of the following exercises,
begin with 5 repetitions and build up to 10.

Rotations. Sitting or standing, turn your head slowly to the left and then to the right as far
as you can, comfortably. Hold each stretch for 10 to 30 seconds.

Demonstration of head rotations.

Shoulder circles. While standing, raise your shoulders straight up, then move them in a circle around,
down and back up again. Circle in both directions.

Demonstration of shoulder circles.

Side stretches. While standing, stretch your neck slowly to the left trying to touch your ear to your
shoulder. Repeat on the right side.

Demonstration of side stretches.

Resistance exercises. Place your right hand against your head above your ear and gently press, resisting
the movement with your neck. Do the same with your left hand on the other side.

Demonstration of resistance exercises.

Head lifts. Lie on your back with your knees bent and feet flat on the floor. Lift and lower your
head, keeping your shoulders flat on the floor. Next, lie on one side and lift your
head toward the ceiling. Repeat this movement on your other side and while lying on
your stomach. Demonstration of head lifts.

Easy preventive measures

Proper neck posture, a simple matter of good body mechanics, can offer you protection
from neck pain. Here are suggestions from the American Academy of Physical Medicine
and Rehabilitation and other experts that can help prevent the misuse or overuse of
your neck:

  • Don’t sit in one place for a long time. If you’re stuck at your desk, place items
    around your office so that you are forced to get up or stretch to get them.

  • Maintain good posture for your neck. Adjust your desk chair so your hips are slightly
    higher than your knees. Your head and neck will then naturally assume the correct
    position. When traveling, place a small pillow or rolled up towel between your neck
    and the headrest.

  • Don’t sleep with too many pillows or with a pillow that’s too thick.

  • When talking on the phone, don’t cradle the phone between head and shoulder. If you’re
    on the phone often, switch to a headset or speakerphone.

  • If you are reading or typing from other materials, raise the pages to eye level.

  • If you have corrected vision, keep your prescription current so you don’t have to
    crane your neck forward to see clearly.

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5 Home Safety Threats You Might Overlook http://www.vhcphysiciangroup.com/health-library/5-home-safety-threats-you-might-overlook/ http://www.vhcphysiciangroup.com/health-library/5-home-safety-threats-you-might-overlook/#comments Mon, 09 Jun 2014 15:35:21 +0000 http://www.vhcphysiciangroup.com/health-library/5-home-safety-threats-you-might-overlook/

You’re a careful parent who steers children away from things that could harm them.
But hidden threats lurk in every house—sometimes where you least expect them. For
safety’s sake, look through your home often. Keep an eye out for not-so-obvious hazards.
Here are 5 of them:

Scalding tap water

It is common for a home’s water heater to be set above 120°F (48.8°C); this can cause
a scald burn to a child in seconds. Scalding hot tap water causes 3,800 injuries and
more than 30 deaths a year. A lot of victims are young kids.

Solution: Set your hot water heater to no higher than 120° F (48.8°C), and check the
temperature of your tap water to ensure it is safe.

Unstable furniture

Each year, thousands of young kids are badly injured—and some die—when large TVs and
heavy furniture tip over on them. Often, the victims were climbing it, or pulling
themselves up on it, or falling against unstable furniture.

Solution: Double-check the stability of large furniture. Anchor stoves, bookcases,
shelves, or bureaus to the wall. Get rid of items that may tempt kids to climb.

Window blinds

Hundreds of children have strangled to death after getting tangled up in cords or
chains on window blinds. Window coverings sold before 2001 pose the most danger.

Solution: Secure the cords of older window coverings so children can’t reach them or
replace them with safer, cordless blinds. Move cribs, beds, and other furniture away
from windows. Use only cordless window coverings in children’s sleep and play areas. 

Poorly stored chemicals

Since the year 2000, the number of poisoning deaths has doubled among children. Many
poisons are found in the garage, kitchen or bathroom. They include pesticides, automotive
products, weed killers, and household cleaning and disinfectant products.

Solution: Store harmful chemicals in their original, labeled containers—safely out
of reach. Consider locked cabinets for storage. Never leave chemicals unattended when
you are using them.

Home trampolines

Backyard trampolines send tens of thousands of people younger than 20 to doctors and
emergency rooms each year. Injuries range from sprains, broken bones, and cuts—to
neck and spinal cord injuries, paralysis, and even death.

Solution: Avoid use of home trampolines. In gym classes or competitive sports, use
a trampoline only with strict adult guidance and supervision.

Publication Source: Council on Sports Medicine and Fitness. Trampoline Safety in Childhood and Adolescence.
Pediatrics (2012); 130(4); pp. s774-s779

Online Source: American Academy of Pediatrics. Protecting Kids from Furniture and TV Tip-Overs

Online Source: Centers for Disease Control and Prevention. Protect the Ones You Love: Child Injuries
are Preventable

Online Source: US Consumer Product Safety Commission. Childproofing Your Home

Online Source: US Consumer Product Safety Commission. Tap Water Scalds

Online Source: Environmental protection Agency. Prevent Poisonings in Your Home

Online Source: Safe Kids USA

Date Last Reviewed: 1/13/2016

Date Last Modified: 1/13/2016

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5-Hydroxyindoleacetic Acid (Urine) http://www.vhcphysiciangroup.com/health-library/5-hydroxindoleacetic-acid-urine/ http://www.vhcphysiciangroup.com/health-library/5-hydroxindoleacetic-acid-urine/#comments Mon, 09 Jun 2014 15:23:54 +0000 http://www.vhcphysiciangroup.com/health-library/5-hydroxindoleacetic-acid-urine/

Does this test have other names?

5-Hydroxyindoleacetic acid urine, 5-HIAA, HIAA

What is this test?

This test finds out how much 5-hydroxyindoleacetic acid (5-HIAA) is in your urine.

Your liver breaks down the hormone serotonin into 5-HIAA. This waste product is normally
sent from your body in your urine. Tumors called functioning carcinoids secrete serotonin.
Carcinoid tumors are found in the intestinal tract, lungs, appendix, and other body
tissues.

Why do I need this test?

You may need this test if you have symptoms of a carcinoid tumor. Carcinoid tumors
can occur anywhere, but most start in the small bowel. Signs and symptoms include:

  • Flushing in your face and neck

  • Diarrhea and abdominal cramps

  • Nausea and vomiting

  • Low blood pressure

  • Unexplained weight loss

  • Irregular heartbeat

  • Watery eyes

  • Asthma-like respiratory symptoms

  • Sexual dysfunction in men

What other tests might I have along with this test?

Your health care provider may also order a biopsy to help diagnose a tumor. Your provider
may also order a liver scan if he or she suspects that the tumors have spread.

What do my test results mean?

Many things may affect your lab test results. These include the method each lab uses
to do the test. Even if your test results are different from the normal value, you
may not have a problem. To learn what the results mean for you, talk with your health
care provider.

Normal results are 3 to 15 milligrams (mg) of 5-HIAA over 24 hours. Women generally
have lower levels than men.

Higher levels of 5-HIAA may mean you have:

  • Carcinoid tumors

  • Noncarcinoid tumors

  • Cystic fibrosis

  • Malabsorption

Lower levels of 5-HIAA may mean you have:

  • Depression

  • Migraines

How is this test done?

This test requires a 24-hour urine sample. For this sample, you must collect all of
your urine for 24 hours. Empty your bladder completely first in the morning without
collecting it and note the time. Then collect your urine every time you go to the
bathroom over the next 24 hours.

Does this test pose any risks?

This test poses no known risks.

What might affect my test results?

Eating certain foods containing serotonin can raise 5-HIAA levels. These foods include:

  • Cheese

  • Bananas

  • Pineapple

  • Kiwi

  • Plums

  • Tomatoes

  • Eggplant

  • Avocados

  • Certain nuts, including walnuts and pecans

Certain drugs can raise or lower your 5-HIAA levels. These include:

  • Aspirin

  • Acetaminophen

  • Ethyl alcohol

  • Some antidepressants

  • Cough medicines or antihistamines

  • Medicines to relax muscles

Strenuous exercise can also raise your 5-HIAA levels.

How do I get ready for this test?

Don’t eat foods containing serotonin for at least three days before the test or during
the testing period. You may also need to stop taking certain medicines before the
test. Be sure your health care provider knows about all medicines, herbs, vitamins,
and supplements you are taking. This includes medicines that don’t need a prescription
and any illicit drugs you may use.

 

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8 Tips for Communicating Well with Your Healthcare Provider http://www.vhcphysiciangroup.com/health-library/8-tips-for-communicating-well-with-your-doctor/ http://www.vhcphysiciangroup.com/health-library/8-tips-for-communicating-well-with-your-doctor/#comments Mon, 09 Jun 2014 15:25:21 +0000 http://www.vhcphysiciangroup.com/health-library/8-tips-for-communicating-well-with-your-doctor/

You may not know as much about cancer and its treatment as your healthcare provider
does, but you and your family are the only ones who can decide what is best for you.
As part of your team, remember that you have a part to play in your care.

1. Don’t be afraid to ask questions. Many healthcare providers want you to ask questions. You may not know which questions
to ask. It is often easy to forget questions you (or your family) may have, so you
may want to write your questions down before you go into the healthcare provider’s
office. It is also hard to remember everything you’re being told at each visit. Be
sure you or your family member writes down what your healthcare provider tells you.
You may want to record the conversation. Just make sure to ask your healthcare provider
if it is OK to do so.

2. Ask for reliable books, Internet sites, pictures, diagrams, or other visual aids. Ask your healthcare provider to show you where your cancer is in your body, what
will be removed, what will remain, and how the treatment will work. Being able to
picture your cancer and how treatment will affect it can be a powerful aid as you
make decisions.

3. Make sure you get the answers you need. Cancer is a complicated disease, and different people have different ways of understanding
what is happening to them. Don’t be shy to say, “I don’t understand. Would you please
explain it to me again?” Or, if needed, don’t be afraid to call back and ask to speak
with your healthcare provider or nurse again.

4. Don’t withhold information. Don’t tell your healthcare provider or nurse that you’re just fine when you’re not. Your healthcare provider and nurse need to know about new symptoms
and changes in how you feel. Tell them if you’re having pain. Share with them if you’re
using any other treatments along with your healthcare provider-prescribed cancer treatment.
Keep in mind that some alternative treatments like nutritional therapies interfere
with standard cancer treatments. Giving your healthcare providers a truthful picture
of what complimentary therapies you are using, or thinking of using, will help ensure
that your cancer treatments will be safe. All this information is important and will
help your team manage your treatment program in the best way possible.

5. Take a partner with you to your appointments and treatment. Your spouse, a significant other, a relative, a friend, or an adult child can be
helpful during these visits. Your partner can be a valuable set of ears and may even
ask questions you did not think of or didn’t remember. Talk before the visit to work
together as a team to make sure you know what questions or problems you want to talk
about. Your partner can be your advocate, asking the tough questions that you’re not
comfortable with. Having a partner with you is especially important if you’re on medication
or if you’re anxious or upset. You may be asked to sign a medical release form granting
your family member or friend the right to talk about your treatment or other concerns
with your medical team. That is done to protect your privacy. Talk with your partner
right after the visit about the information you received. While it is fresh, review
the information to make sure you both heard and understood the same things. Take notes
and write down other questions you may have. You can also use a tape recorder, but
make sure to ask the healthcare provider if it is OK to record your conversations.

6. Avoid the urge to get upset with the messenger. There is often no good way to give someone bad news. It is important to keep in mind
that your healthcare providers are doing everything they can to help you get well.

7. Make sure all your healthcare providers talk with each other. Often, you will have more than one healthcare provider, and each one should know
what is happening to you. Make a list of all your healthcare providers’ names, specialties, phone numbers, and addresses. Give
this information to each person on your list. This will make it easier for them to
consult each other, share reports and medical records, and talk about important issues
regarding your care. You may have to sign medical releases giving them permission
to share information and discuss your case with each other. This is done to protect
your privacy. When you visit one healthcare provider, ask if he or she has talked
with your other healthcare providers or gotten their reports.

8. Don’t be afraid to talk with your healthcare provider about problems or concerns. Your relationship with your healthcare provider is an important one. As with all
relationships in life, difficulties may arise, and talking about them can help. Be
clear and precise in stating your concerns and give examples. Listen to your healthcare
provider’s response and try to understand his or her perspective. Offer ways on how
to avoid these problems in the future. If you remain unhappy with your relationship,
you may decide to explore other options, such as switching healthcare providers. If
this happens, respectfully inform your healthcare provider of your decision and the
reasons, and ask for his or her help in transferring your care to your new healthcare
provider. Your primary care physician may help you with this as well.

Taking an active role in your care will help you get the information you need and
ensure that everyone is working with you to fight your cancer. Not everyone is comfortable
doing this. For some, it takes time to learn how to be an active team member. You
may be surprised at how good you and your partner will get at this over time.

Caregiver’s tip: Be an advocate for your loved one. Informed patients and families often have better
outcomes.

 

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