Healthy Living

At the Backus Arthritis Center, our rheumatologists see other conditions as well. Over the past few weeks I have seen a few patients with a rare condition called vasculitis, which is an inflammation of the blood vessels.

There are multiple types of vasculitis — some affect only the skin and others that also affect internal organs.

The symptoms of vasulitis are based on the organ impacted. For example, when it affects only the skin, we see a rash usually on the lower extremities that does not lighten, or you can get ulcers in the legs. When it affects the lungs it can cause shortness of breath and cough. When it affects the nerves it may lead to numbness and weakness in a hand or foot.

Vasculitis takes on various forms — it can be mild or it can be life-threatening, and can be a single episode ot multiple episodes. Based on the size of blood vessels we can determine the type of vascultits. In some patients a specific cause of vasculitis cannot be determined.

We have a wide variety of tests that can help us determine the cause. One of them is called antineurophil cytoplasmic antibody (ANCA). We also tend to biopsy the area of vasculitis such as the skin, lungs, kidney or the nerves.

Sometimes it is associated with an underlying arthritic disorder like rheumatoid or lupus. Other times it is related to chronic infections like Hepatitis B and C. We have also seen it develop in some patients on certain kinds of medications.

Some types of vasculitis are age-specific. A vasculitis called Kawaski’s disease is seen only in children. Giant Cell Arteritis (GCA) develops in people over the age of 50.

Once we have figured the cause of the vasculitis, we then consider treatment options.

If it is medication-induced, we stop the medication. If the underlying problem is infection, the infection needs to be treated and the vasculitis may need to be treated at the same time depending on the severity.

One of the most commonly used medications is prednisone, which is a steroid. We also use other powerful medications to aggressively treat the vasculitis. Recently a new medication called Rituxamab has been approved for the management of Wegners Granulomatosis, which is a severe form of vasculitis.

With aggressive treatment, patients’ life expectancies have increased, but these medications have side effects, most importantly are infections and secondary malignancies. Patient education is an important part of the treatment plan, including disease-specific information and medication side effects.

Sandeep Varma, MD, is a rheumatologist and Medical Director at the Backus Arthritis Center. This column should not replace advice or instruction from your personal physician. If you want to comment on this column or others, visit the Healthy Living blog at www.backushospital.org/backus-blogs or e-mail Dr. Varma or any of the Healthy Living columnists at healthyliving@wwbh.org

The words “congestive heart failure” sound frightening, as if your heart were on its last legs and there was nothing you could do about it.

Although it is true that this disease can be serious, it is not true that there is nothing you can do to fight it.

But first, let’s talk about the disease itself. Congestive Heart Failure (CHF) is caused by there being more water in your cardiovascular system — veins, arteries and capillaries — than your heart can pump.

There can be many causes, but the end result is that you have what is called fluid volume overload. This is merely a fancy way of saying there is too much water in your body.

Sometimes this water will build up in the veins to the point where it starts to settle in places it shouldn’t.

It might leak into parts of your body that are typically lower such as your feet, ankles and legs causing them to swell. The water might also leak into your lungs, causing you to feel as if you can’t breathe. This can be very frightening and it is the main reason that people come to the hospital.

How can you prevent it? Just remember where salt goes, water follows. If you eat lots of salt, then you will also keep more water in your body.

Any food that is canned, preserved or processed is likely to have too much salt in it. High salt foods may include canned soups, frozen dinners, fast food and smoked salted meats.

Any meat processed pork product such as ham, bacon or sausage usually has a large amount of salt. Soda and other soft drinks can also be high in sodium. When in doubt, read labels for sodium content. Since a person’s tolerance for salt can vary, you should discuss how much salt you can have with your doctor.

Finally, how do you know if you’re keeping in too much water? Do you have to wait for swelling or shortness of breath to occur? The answer is no — you can keep track by weighing yourself every morning in the same clothes after using the bathroom. If you gain more than 2 pounds in 24 hours then you may have too much water in your system and should contact your doctor.

If you would like to learn more about Congestive Heart Failure you can visit the American Heart Association’s Website at www.heart.org. You are also welcome to join the Backus Hospital’s Cardiac Support Group held in the Backus Medical Office Building Conference Room on the second Wednesday of every month at 6 p.m. For more information, call 860-889-8331, ext. 2554.

Matthew Hughes is a registered nurse on Backus Hospital’s E-4 cardiac unit. This column should not replace advice or instruction from your personal physician. If you want to comment on this column or others, visit the Healthy Living blog at www.backushospital.org/backus-blogs or e-mail Mr. Hughes or any of the Healthy Living columnists at healthyliving@wwbh.org

Weakness on one side of a person’s face, inability to elevate one arm completely and slurred speech are the hallmarks of an evolving stroke. These simple signs can diagnose the onset of stroke with approximately 90% certainty.

The month of May is set aside each year to raise awareness of the devastating impact of stroke on society.

Despite new, effective treatments available for stroke in the form of powerful “clot busting” medications like recombinant thromboplastin activator (rTPA), prevention remains the best “treatment.”

Major risk factors for stroke include diabetes, hypertension, high cholesterol, obesity, cardiac disease and smoking. Many of these conditions are controllable with regularly scheduled medications.

Unfortunately, medications alone are only part of the solution. Lifestyle changes including smoking cessation, diet and regular exercise are crucial. These steps toward better health require self-discipline and a willingness to accept personal responsibility to make good choices.

Another phase in the care and treatment of stroke is rehabilitation. The modalities involved in neurologic rehabilitation have recently become highlighted with Congresswoman Gabriel Giffords' assassination attempt. Early intervention with physical, speech and occupational therapies can mean the difference between a life of dependence and a full, functional return.

Technology in the form of computer programs that repeatedly train and test patients’ abilities are now an important part of any rehabilitation plan. This month, thanks to a donation, The William W. Backus Hospital will be opening a new rehabilitation area. This facility will be located on the hospital wing where most stroke patients are treated, allowing for easy accessibility for patients and staff.

While recognizing the early signs of stroke is crucial to recovery, it is only the beginning of a journey toward recovery.

Anthony G. Alessi, MD, is Medical Director of The William W. Backus Hospital Stroke Center and in private practice at NeuroDiagnostics, LLC, in Norwich. If you want to comment on this column or others, visit the Healthy Living blog at www.backushospital.org/backus-blogs or e-mail Dr. Alessi at aalessi@wwbh.org

With all the serious illnesses in the world, you might wonder why The William W. Backus Hospital and Plainfield Recreation Department are organizing a community kickball tournament at the Plainfield Central School on Saturday, May 14.

Believe it or not, this is actually serious business.

One of the goals of our ongoing Enjoy LIFE (Lifelong Investment in Fitness and Exercise) is to instill lifestyle changes to last a lifetime.

Whether it is taking a walk, going for a bike ride, or, yes, playing the old schoolyard game of kickball, one of the most important things we can do is to encourage families to be active – together.

The fact that there is an obesity problem in eastern Connecticut is well documented. We know that children who are overweight tend to be overweight as adults, and this can lead to many serious health problems.

We also know that children look up to their parents, and tend to emulate their behaviors. So if you spend the weekend sitting around the television set, chances are your children might too.

But if you are active, and make it a routine to exercise together as a family, the odds are better that you will be healthier and your children will be too.

Making it fun is important. Running 20 monotonous laps around a track might not be your children’s idea of fun. But playing a game of “horse” on your driveway basketball court, going to the local roller skating rink, or going bowling might be more up their alley.

Spending quality time with family is so important. Doing it in a healthy way is even better. You might just be able to kickstart a lifetime of comraderie, healthy behaviors and memories by participating in our kickball tournament. It’s worth a try. The games, open to adults and children, begin with registration at 9 a.m. and the games at 9:30 a.m. For more information, call the Plainfield Recreation Department at 860-564-1819.

Alice Facente is a registered nurse and clinical educator with the The William W. Backus Hospital Education Department. This column should not replace advice or instruction from your personal physician. If you want to comment on this column or others, visit the Healthy Living blog at www.backushospital.org/backus-blogs or e-mail Ms. Facente or any of the Healthy Living columnists at healthyliving@wwbh.org

The latest news on cancer rates in Connecticut isn’t good. According to the Centers for Disease Control our state ranks 6th for overall cancer incidence among all 50 states.

In eastern Connecticut, which includes New London and Windham counties, the news doesn’t get much better. We have the highest lung cancer rates in the state: Windham County is first with 80 cases per 100,000 people and New London County is second at 77.8 cases per 100,000 people.

While breast cancer tends to get all the headlines, lung cancer is actually more deadly – it accounts for more cancer deaths than the next four cancer types combined (colon, breast, prostate and pancreas). It is estimated that lung cancer kills nearly 160,000 people a year, and the overall five-year survival rate is only 15%.

Risk factors include:

• Tobacco. Smoking one pack of cigarettes a day for 10 years or more markedly increases your risk for lung cancer. Quitting smoking and being a non smoker decreases your risk.
• Occupational exposures. These included smelting of metals, mining, milling, shipyards and manufacturing of plastics.
• Genetic factors. Having a first degree relative with lung cancer increases your risk, regardless of tobacco use.
• Gender. Female smokers are at a proportionally higher risk than male smokers.
• Chronic lung disease. Chronic obstructive pulmonary disease is also a risk factor for lung cancer.

So the question remains, why are lung cancer rates so high in our region? One reason might be that we have some of the highest rates of smoking statewide. Also, there previously was a large number of milling, textile, and manufacturing industries in eastern Connecticut, which may have increased exposure to carcinogens.

Treatment for lung cancer bridges many specialties, including surgery, chemotherapy, and radiation therapy. One or a combination of these modalities can be used.

At Backus Hospital, we offer patients access to the latest treatment options and some clinical trials. This includes specialized surgical treatment, specifically minimally invasive thoracic surgery. Studies show this technique results in less post-operative pain, decreased hospital length of stay and a faster return to work.

Prevention is obviously the best medicine. But if you or a loved one does have lung cancer, it is comforting to know our region has access to excellent oncologists at Eastern Connecticut Hematology & Oncology, oncology-certified nurses at the Backus Cancer Center, a radiation therapy department that is affiliated with Yale-New Haven Hospital, excellent pulmonologists, and cutting-edge surgery.

Juan Escalon, MD, is a board-certified thoracic surgeon with Backus Physician Services. This column should not replace advice or instruction from your personal physician. If you want to comment on this column or others, visit the Healthy Living blog at www.backushospital.org/backus-blogs or e-mail Dr. Escalon or any of the Healthy Living columnists at healthyliving@wwbh.org