Idiopathic Thrombocytopenic Purpura Symptoms

idiopathic thrombocytopenic purpura

Idiopathic thrombocytopenic purpura, or ITP, is a syndrome in which the blood does not clot properly due to a low number of thrombocytes, commonly known as platelets. Platelets are blood cell fragments produced in bone marrow that stick together, or clot, to seal cuts and stop bleeding.

An individual with ITP will often have purple bruises on the skin or in membranes such as the mouth. The bruises indicate bleeding has occurred underneath the skin. More extensive bleeding can create a hematoma, which is a collection of clotted blood under the skin that looks and feels like a lump. ITP is not contagious and cannot be passed from one person to another. However, it is possible for a pregnant woman affected by the syndrome to pass the symptoms to her baby during delivery.

The Cause of ITP

The exact cause of ITP is unknown. Therefore, it is labeled as idiopathic, which means "of unknown cause." Doctors do know that the syndrome is a result of a malfunction within the immune system. Antibodies produced by the immune system mistakenly attach themselves to platelets which targets the platelets for disposal. The spleen recognizes the antibodies and removes the platelets from the individual's system, resulting in a low number of platelets. As the amount of platelets decreases, the risk for bleeding increases.

The syndrome is not usually dangerous until the platelet count reaches 10,000 platelets per microliter of blood. At this point, internal bleeding may occur despite the absence of injury. When ITP occurs in children, the syndrome usually follows a viral infection. However, no correlation between infection and ITP exists for adult cases.

The Symptoms of ITP

ITP exists in two forms: acute and chronic. Acute ITP will last six months or less, mostly occurs in children and is the most common type of ITP. Chronic ITP lasts six months or longer and can affect an individual for a lifetime. This form usually affects teenagers and adults. Women contract the syndrome two to three times more often than men. Knowing the symptoms of ITP is necessary to know whether or not to seek treatment. The symptoms of this syndrome include:
  • easy and excessive bruising.
  • excessive bleeding from cuts and scrapes.
  • spontaneous bleeding from gums or nose.
  • blood appearing in urine or stool.
  • heavy menstrual flows.
  • excessive bleeding during surgery.
ITP is not a serious or life-threatening condition. However, doctors and dentists should be informed if a patient has ITP in order to be prepared for any extensive bleeding during surgery or other medical procedures.

Treatment for ITP

Children and adults with mild cases of ITP often never need treatment for the syndrome. Typically, a hematologist, a doctor specializing in blood disorders, will monitor the individual's platelet counts on a regular basis to ensure the count does not become dangerously low. Several treatment options exist for individuals with severe cases of ITP. Immunosuppressant drugs, such as prednisone or Rituxan, can increase platelet levels by suppressing activity in the immune system. Another treatment option for severe ITP is a splenectomy, which removes the spleen. The spleen is responsible for disposing cells that antibodies have marked for destruction. Therefore, removing the spleen can help preserve these cells.

Preventing Symptoms of ITP

ITP is not a serious condition, and the syndrome rarely creates dangerous complications. However, there are certain steps individuals can take to relieve the symptoms. Individuals with ITP should avoid over-the-counter medications that affect platelets, such as ibuprofen and ASPIRIN®. ITP patients should also protect themselves from injury as much as possible to decrease the occurrence of bleeding under the skin. Avoiding sports or other recreational activities may be necessary. This population should also seek immediate medical care for infections, especially those who have had splenectomies. Individuals with ITP should also be under the supervision of a hematologist to regularly monitor platelet counts.

Living with ITP does not require drastic lifestyle changes or treatments for most individuals. Staying informed and paying attention to symptoms can help individuals with ITP effectively manage the syndrome for the duration.

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Tennessee Teenager Cries Tears of Blood

tears of blood
Calvino Inman regularly sheds tears of blood, up to three times a day and up to an hour each time. The first time it happened his mother, Tammy Mynatt, rushed him to the Emergency Room but by the time they arrived, the bleeding had stopped. Inman was so frightened that he asked his mother if he was going to die.

Tests and Specialists Come Up Empty

Inman has had MRIs, ultrasounds, CAT scans and has seen several specialists, but nothing can give them a concrete explanation. Ophthalmologist Rex Hamilton believes he may be suffering from haemolacria, which literally means “bloody tears.” He told Good Morning America, “That is just a descriptive term of the manifestation of the bloody tears. It says nothing about what’s causing that. It’s a one-in-a-million kind of condition.”

Is Teenager Possessed?

Kids that go to school with Inman are afraid, thinking he may be possessed. While cases are uncommon, they are not unheard of. Some cultures treat this type of thing with fear, while others associate it with stigmata, meant to represent the blood of Jesus on the cross. Other examples of eye-ducts crossing wires are people who drink milk and squirt it out of their eyes, and smokers who blow smoke out of their ears.

Indian Girl Bleeds Through Skin

13-year-old Twinkle Dwivedi of India has a disorder where she loses blood through her skin without any cuts or scratches. She must undergo transfusions after pints of blood seep through her eyes, nose, hairline, neck and soles of her feet. Medics believe this is an extreme version of a rare blood platelet disorder that has no cure. Her blood is dangerously low in clotting particles, making her blood watery.

Hamilton Eye Institute Study

Dr. Barrett G. Haik, Director of University of Tennessee’s Hamilton Eye Institute, says haemolacria is common in people who have experienced extreme trauma or have recently had a serious head injury. Haik and a team of researchers published a 2004 study in the Journal of the American Society of Ophthalmic Plastic & Reconstructive Surgery between February 1992 and January 2003. Only four cases were recorded and in all cases the bleeding stopped on its own.

Hamilton Eye Institute to Do Analysis

Dr. James C. Flemming, ophthalmologist at the Hamilton Eye Institute, is reviewing Inman’s medical records, looking for complications such as blood clots, growth or tumor near the eye, or even a simple infection. An analysis will also include a psychological evaluation to rule out the possibility the tears were faked. There have been cases where children seeking attention found creative ways to simulate haemolacriatic symptoms. Tammy Mynatt just wants someone to help her son.

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10 Tips For Day Surgery Procedure Patients

day surgery procedure

Day Surgery admission enables a surgical procedure to be undertaken with preparation, recovery and discharge home all on the same day. As successful Day Surgery is a streamlined and time-efficient process, the patient should be well-prepared and organised to minimise delays and maximise safety. Follow these ten handy tips that address areas of concern for patients and staff to achieve a Day Surgery procedure experience that runs smoothly from start to finish.

1. Day Surgery Information is Important

  • Patients must read the pre-surgery instructions provided by the hospital or Day Surgery Unit.
  • Always follow exactly the advice given by the doctor and hospital.
  • Patients should arrive on time. Day Surgery Unit schedules are carefully arranged. Check where and when the patient needs to present. Allow time for traffic, parking and finding the location of the Day Surgery centre within the hospital.

2. X-rays and Scans

  • The most recent X-rays and scans of the area on which surgery will be performed should always be brought to hospital.
  • Surgery may be cancelled if the surgeon cannot access the images.

3. Fasting For Day Surgery Procedures

  • Patients must remember to keep fasting before surgery, following the times given by the doctor or hospital. Fasting for surgery requires abstaining from all food and drink including throat lozenges, cough syrups, bubblegum and dissolvable sweets.
  • If food or drink is consumed by mistake, patients should note the time and inform the Day Surgery nurse on arrival. This is of extreme importance as insufficient fasting time before anaesthetic has the potential to cause life-threatening complications.

4. Medications and Day Surgery

  • If fasting from midnight for surgery, it is usual for patients to take their morning medications with a sip of water, but always follow the instructions given by the doctor or hospital. These instructions may include stopping some medications days before surgery, especially if they promote bleeding, and other medications like diuretics (fluid tablets) may be with-held on surgery day only. Bring medications to hospital if clarification of the instructions is needed.
  • Diabetic patients will not be eating before surgery so should have instructions from the doctor regarding with-holding diabetic medications and/or reduction of insulin dosage. The patient’s blood glucose level will be checked at regular intervals by the Day Surgery nurse. If the pre-surgery patient notices any symptoms of hypo-glycaemia they should alert the nurse immediately.

5. Provide Patient Information to the Day Surgery Nurse

Patient safety and well-being will be enhanced if this information is prepared for Day Surgery
  • a list of the regular medications the patient takes
  • the date that any medications were ceased before surgery
  • any patient allergies
  • any pain-killers taken on surgery day before arriving at hospital
  • a list of phone numbers of the person (plus back-ups) to collect patient after recovery from the Day Surgery procedure.

6. Sight and Hearing

  • Day Surgery patients who wear glasses or contact lenses should bring the corresponding case for safe storage as they cannot be worn to the operating theatre.
  • Patients who wear spectacles for reading should bring them to hospital as they may need to read or sign consent forms or paperwork.
  • Hearing aids should be worn to hospital so the doctors and nurses can communicate well with the patient before and after surgery.

7. Teeth

  • Dentures should be worn to hospital. A decision on whether to remove dentures will be made by the anaesthetist as dentures left in place may allow a better fit of the anaesthetic equipment.
  • For fragile partial plates or teeth on wire fittings removal before surgery may be safer so bring a case for storage. If patients have any loose teeth or removable capped teeth they should inform the Day Surgery nurse.

8. Personal Care Before Day Surgery

  • Surgery patients should shower in the morning on the day of operation. Depending on the procedure to be done and the hospital protocols, patients may be asked to use an anti-bacterial wash. Menstruating patients should use pads not tampons.
  • Loose clothing should be worn to make it easier to dress and be comfortable after surgery.
  • Makeup or nail polish should not be worn for Day Surgery procedures.

9. Possessions

  • Patients can minimise stress by not bringing money or valuable items to hospital. Mobile telephones are not necessary as the Day Surgery nurse will contact the relative or friend on the patient’s behalf to advise of discharge time.
  • Jewellery and body piercings should not be worn as they will have to be removed before surgery. The Day Surgery nurse cannot take responsibility for valuables while the patient is in theatre or recovering from anaesthetic after surgery.

10. Discharge Time Expectations

  • Day Surgery patients should not expect any discharge time quoted to be definite; it can only be an estimate as discharge time is dependent on known and unknown variables. Patients will avoid undue stress if they relax and anticipate Day Surgery may take the whole day, perhaps into the evening, and refrain from making arrangements based on exact time-frames for discharge.

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Temporomandibular Joint (TMJ) Disorder Overview

temporomandibular joint

The most complex joints in the body are the two temporomandibular joints (TMJ). These joints are located in front of the ears and connect the lower jaw (mandible) to the temporal bone of the skull. Temporomandibular joints are complex, both rotating and sliding, and involve numerous components: muscles, nerves, tendons, ligaments, bones, connective tissue, and teeth.

TMJ Symptoms are Varied and Mimic Other Health Issues

TMJ is difficult to diagnose because many of the symptoms of TMJ are also symptoms that can be attributed to other heath problems. Some symptoms are periodic; some improve over time while others can worsen. Symptoms of TMJ are described as:
  • pain in the shoulders or neck
  • migraines or chronic headaches
  • stiffness of the jaw muscle
  • limited movement of the jaw or locking of the jaw
  • painful clicking jaw
  • popping, or grinding of the jaw when opening or closing the mouth
  • ear pain such as pressure or ringing in the ears
  • decreased hearing
  • dizziness or vision problems
Other health issues have to be ruled out before a TMJ diagnosis is considered. TMJ patients may see a multitude of providers that include primary doctors, specialists such as ear, nose and throat doctors, chiropractors and dentists before a diagnosis of TMJ is made.

Causes and Treatments for TMJ

Not all causes of TMJ are known but genetic, hormonal, and biological factors can influence the development of TMJ disorder. Factors that can contribute to developing TMJ are teeth clenching or grinding of teeth, nail biting habits, an injury to the area, infections, previous dental treatments, or auto immune disease. Most TMJ patients report a hypersensitivity to pain.

TMJ is not recognized as a specialty in either the American Dental Association (ADA) or the American Medical Association (AMA) due to the lack of basic or clinical science; and most insurance companies will not cover treatment for TMJ because there is no standardized method of treatment. There is also no empirical evidence that TMJ can be prevented by any treatment. However, there are some treatments that seem to help diminish TMJ pain.

The National Institute of Health (NIH) suggests the following treatments:
  • self-care practices (eating soft food, avoiding extreme movements of the jaw such as yawning, avoiding repetitive movement such as chewing gum, or applying moist heat or cold to the area)
  • avoidance of treatments that cause permanent change to the bite or jaw such as crowns, bridges, grinding down of teeth
  • avoidance of surgery on the teeth or jaw area
  • replacement of the temporomandibular joint as a last resort
Many TMJ patients are fitted with a mandibular repositioning (MORA) device. Though this is a widely used treatment option; the scientific validity of the device is unproven. Over time, some symptoms go away without any treatment. Others seem to improve temporarily with some self-care practices. Other treatments include using a stabilization splint which is a nightguard that is fitted to the patient’s teeth. Over-the-counter bite guards are not recommended as they may actually increase pain if they shift the teeth.

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The Dog Days of Summer

dog days of summer
No matter your age, if you don’t take certain precautions, the hot weather can be a miserable experience. A lot of what we know about protecting ourselves is common sense but some people live more dangerously than others.

The hottest and muggiest days of summer have been known to fall between early July and early September. During this time period, the reward comes from an opportunity to move a bit slower, dress in clothes that reveal some skin and go to the beach or have a holiday cookout. This and more can be the result of experiencing the sultry days of summer as long as you follow these simple rules first.

Beating The Heat

  • Always dress children in light-colored cotton clothing. Babies should wear cotton t-shirts instead of going to an outing shirtless. Cotton can absorb heat and keep babies cooler. Also try shirts made from 100 percent Bamboo to reap the benefits of staying cool without perspiration.
  • If babies get sunburn, never put medicated lotions on their bodies unless instructed by a physician first. Instead, be sure to buy baby lotions with the necessary sunscreen protection already in them.
  • Choose sunscreens that have a broad spectrum of protection. Dry skin is not the only cause of wrinkles. Intense sunshine exposure is one of the leading causing of skin damage and wrinkles. Your options for sun protection are SPF moisturizers, basic sunscreens or tinted moisturizers.
  • Drink plenty of liquids and stay away from sugar filled carbonated drinks. Carbonated drinks have an alarming amount of sugar, overwhelming calories, harmful additives and can ruin your appetite for healthy foods that your body needs.
  • Senior citizens should try to stay in cool places during warm weather. Now that the dog days of summer are upon us, the risk of heatstroke among older people is much higher. If you do not have air conditioning, go somewhere that does. A movie theater, the mall, a friend or relatives or a community center for seniors are a few good places.
  • Try to do all chores in the morning or afternoon when it's cooler, instead of the peak hours between noon and 5 p.m. Never try to overexert yourself in warm weather. It slows you down and increases your chances of passing out. Arm yourself with water bottles and damp towels to keep cool even if you're just outdoors at a cookout.
  • If you have been out in the sun for an extended period of time and feel tired, weak and nauseated, drink plenty of liquids, soak in cool water and seek medical attention if symptoms are severe.

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