Category: Conditions

Keeping Bones Strong!

x-ray-bonesLiterally meaning “porous bone”, osteoporosis is a very common bone disease causing bones to be weak and brittle. Like other tissues in our body new bone cells are created to replace the old ones but in osteoporosis, the body loses too much bone, can’t keep up with replacing the old bone cells, or both. This can cause bones to break under normally benign situations like a low fall or coughing. Broken or fractured bones can be painful and lead to life-altering loss of mobility.

Osteoporosis is an increasingly common disease causing over 2 million broken bones every year in the United States. It is estimated that one in two women and about one in four men over the age of 50 will break a bone due to this disease. Interestingly, many people – 84% – don’t test or get treated for osteoporosis after a bone fracture even though that is often the first indicator of the disease. Because of this missed connection to osteoporosis and its painless development, it is sometimes referred to as “the silent disease”. Fractured or broken bones especially in the hip, wrist, and spine, a decrease in height, and a curved spine can be indicators for osteoporosis.

Some factors may increase a person’s risk for developing the disease, including:

  • Family history
  • Aging
  • Postmenopausal women or those with low estrogen
  • Sedentary lifestyle
  • Low calcium and vitamin D intake
  • Underweight or obesity (excessive abdominal fat)
  • Some medications
  • Certain medical conditions
  • Smoking
  • Over-consumption of alcohol

Recognizing risk factors empowers people to take control of their situation and make active decisions about their health. While a common disease often associated with the elderly, osteoporosis is by no means a normal part of aging. Luckily, it is preventable and manageable. There are lots of resources available but a balanced diet, exercise, and maintaining a healthy body weight go a long way for prevention. As an added bonus it also helps prevent other conditions like heart disease and diabetes! Even if you don’t drink milk, there are alternatives for calcium and vitamin D (which helps the body absorb the calcium). Pay attention to how your medicine or other health conditions can affect your bone density. Speak to your healthcare provider about specific risk factors, prevention options, and screening as they apply to you.

The National Osteoporosis Foundation experts point out, “…that osteoporosis is often considered a pediatric disease with geriatric consequences…” because almost all of a person’s bone mass is developed by the ages of 18 for females and 20 for males. Lifestyle decisions throughout life can have an impact on later health so it’s never too early or late to start making conscious, healthy decisions. Conversations between the older and younger generations may help improve future health projections.


A Heart Healthy Diet

fruit, watermelon heart cutoutFebruary is American Heart Month. The heart is the pump that keeps the body going. It has physical and emotional meanings for us so it’s important to take care of it. There’s also reason to believe that preventing heart disease may help with preventing dementia. A great way to take care of the heart is to be conscious of what we’re eating. These are some tips for a heart-healthy diet.

Fiber. It’s not the most glamorous aspect of nutrition but it’s extremely important for everyone. Eat lots of fruits, vegetables, and whole grains to make sure you’re getting enough daily. Not only does it help keep you regular but it also helps lower your LDL – the bad cholesterol. For adult women aim for about 28g and adult men should get about 34g of fiber. These amounts can vary with age.

Fats. Not all fats are created equal. There are three types: saturated, unsaturated (mono- and poly-), and trans fatty acids. Opt for unsaturated fats like canola, peanut, and olive. These types of fats are less likely to clog your arteries compared to butter and lard. Omega-3 fatty acids, notably found in fish, are thought to help in several ways like clearing plaque in arteries and lowering blood pressure. Avoid trans fats as best you can. These have been shown to have negative effects on the body especially in terms of cardiovascular health. It is not found much in natural food, presenting mostly in processed foods, which, many dieticians can agree aren’t very good for you anyway.

Speaking of processed foods. Here it is again: Reduce the amount of processed foods you consume. Not just for the trans fats but the amounts of salt and sugar can be problematic. Keep an eye on nutrition labels to keep within recommended levels.  When cooking, try using seasonings to flavor foods instead of adding salt. The case for sugar alternatives is long and complicated, so be mindful of how much you consume in general.

Manage portion sizes. How much you eat is just as important as what you’re eating. Excessive calorie intake can lead to weight gain which can lead to stresses on the heart. Actual serving sizes of foods may change depending on diet needs but it’s important to get the appropriate amount of sustenance. It may be a good idea to limit the consumption of red and processed meats while making sure to eat 3.5oz serving of fish twice a week. And be sure to get at least 5 cups of fruit and vegetables daily! Food diaries are popular for those looking to track their nutritional intake and it’s even easier with the growing number of apps available.

Don’t forget to exercise! Diet and exercise go hand in hand for living a heart-healthy lifestyle. Getting the blood pumping has many heart benefits like raising the “good” cholesterol, managing blood sugar, and keeping weight in check. 150 minutes a week of moderate exercise is a good starting point but always talk to your doctor before starting a new workout regime.

Quit smoking. There’s no way around it and you’ve probably seen it everywhere. All the hard work done through diet and exercise could be negated by smoking tobacco. Quitting may be even better than any heart drug on the market and it decreases your chance of dying from heart disease by 33%.

There are no shortcuts to health so it’s important to keep up with a healthy lifestyle. There is never a bad time to start but there may certainly be benefits to sooner rather than later. Let now be the time you take your health and your life in your hands.

Happy heart day!

Epilepsy – A Growing Condition

brain electricty

Epilepsy is a broad-term neurological condition that causes seizures. It affects people of all ages, genders, races, and status.

  • Epilepsy affects 65 million people globally — 3.4 million are in the US.
  • 1 in 26 people will develop epilepsy during their lifetime in the US.
  • There are 150,000 new cases of epilepsy in the US every year.
  • More people now live with epilepsy than ever before.

Types of Epilepsy

There are several types of epilepsy that a person can suffer from and the type of epilepsy can change over time. It’s important to remember that all forms of epilepsy are seizures but not all seizures are epileptic. In 2017, the International League Against Epilepsy (ILAE) changed the name and categorization of seizures so you may see the same seizure as different names. Epilepsy can be divided into two categories- generalized and focal – and each has their own breakdowns.  

Generalized –

This type of seizure affects both of the left and right sides of the brain at the same time.

Tonic-Clonic: Once called “grand mal” these are what are often depicted in Hollywood. This may cause you to lose control of your body. You may cry out, seize up, spasm, and lose consciousness. If the seizure lasts for more than three minutes, call 911, as this can lead to breathing problems and increase the risk of biting the tongue or cheek.

Tonic: These seizures that cause the arms, legs, and body to tense are often less than 20 seconds long. They usually occur during sleep but can cause a person to fall if they are standing. This is common in Lennox-Gastaut, a syndrome of epilepsy.

Clonic: These can last several minutes and are when the muscles spasms causing the face, neck, and arms to jerk rhythmically.

Myoclonic: Almost as if receiving a shock, the muscles will jerk suddenly during this type of seizure.  

Atonic: Instead of tensing up, the muscles go limp in this type of seizure. You may drop things or fall during these episodes. Though these are often short – 15 seconds – a person may have multiple in a row. This is often seen in people with Lennox-Gastaut and Dravet syndromes.

Absence seizures: Sometimes referred to as “petit mal”. During this type of seizure, you may stare blankly and become disconnected from the world around you. These last only moments and it’s common to not remember having one. This is found often in children younger than 14 years old.

This is a fascinating article about a young boy who suffers from epilepsy and his family’s journey of managing it through diet after medications failed to work. He has had epilepsy since a young age and it has changed through his time with it. His twin sister also suffers from epilepsy but with more success with conventional methods, showing that each person’s condition and needs are very unique

Focal –

This was called partial seizures and is localized in just one area of one hemisphere.

Simple focal seizures: This can affect your senses. You may smell or taste things and you may have twitching in your limbs. You may feel hot, cold, dizzy, or other sensations but you are typically aware and likely to remain conscious.

Complex focal seizures: You might lose consciousness but seem awake. This focuses more on the emotion and memory parts of your brain and can cause you to cry, laugh, or simple physical motions like lip smacking. It can take several minutes to come out of an episode.

Secondary generalized seizures: This seizure starts in one part of the brain and then spreads to both sides.

Epilepsy goes beyond just the types, different groups of factors that play a role in the condition can be specified even more as a syndrome as part of the diagnosis.

When to call 911

Not every seizure is an emergency so it’s important to distinguish when to call for help especially since they are not so uncommon. 1 in 10 people have seizures so one day you may be in a position help someone during theirs.

Call 911 if:

  • The seizure lasts more than 5 minutes
  • It is their first seizure
  • There is a second seizure in close succession to the first
  • They have trouble breathing or waking when the seizure is over
  • The person gets hurt during the seizure or it happens in water
  • They are pregnant or has a medical condition like diabetes or heart disease

For most seizures, it is helpful to:

  • Check for a medical bracelet or other information
  • Keep the environment and others around them calm
  • Comfort and speak to them in a normal calming voice
  • Stay with them until the seizure is over and they are fully conscious. Keep them in a safe place to sit and tell them what happened.
  • Offer to call for a taxi or a person to see them home safely

Tonic-Clonic seizures may need a little extra care because of the nature of the seizure. They may cry out, jerk, or fall. Because of this, it is best to ease them to the floor and turn them to one side. Place something soft and flat under their head like a folded sweater and remove anything dangerous away. Remove any glasses and jewelry that may restrict breathing. Remember to time the seizure and if it lasts longer than 5 minutes to call 911. It is unnecessary to hold a person down during their seizure, just make sure the area around them is clear, and do not put anything into their mouth. CPR is usually unnecessary as the person will breathe normally again once the seizure is over. Food and water is not recommended until they are fully awake and conscious.

The Red Cross has an app that offers step-by-step first aid and advice including information about epilepsy and seizures. You can find more information about it and their other apps here.

Don’t Wait To Treat Psoriatic Arthritis


Psoriasis is a skin condition that forms red patchy scales that are itchy and can be painful. The lifecycle of kin cells is sped up causing them to build up rapidly on the surface. This is a chronic disease with no cure that can come and go. Management through lifestyle habits such as moisturizing, reducing stress, and quitting smoking may help alleviate symptoms. 

Psoriasis affects males and females at equal rates and is likely to first appear sometime between 15-35 years of age. According to the American Academy of Dermatology, 7.5 million people in the United States are affected and by the International Federation of Psoriasis Associations roughly 3% of the world has some type of psoriasis.

Psoriatic Arthritis

A type of psoriasis that affects the joints. Almost 30% of those with psoriasis later develop psoriatic arthritis but joint problems can begin prior to the appearance of surface lesions. It can cause stiffness, swelling, and joint pain anywhere from the fingertips to the spine and range from mild to severe pain. Like psoriasis, this may alternate between periods of flares and remission.

PsA that is considered mild can also be called oligoarticular, which means that no more than four joints are affected. Polyarticular, a more severe form, means that four or more joints are affected. Different classifications are dependent on which joints are affected. The spinal column, which includes the neck, lower back, and sacroiliac joints is called spondylitis and tends to co-exist with other forms of psoriatic arthritis. Enthesitis is the inflammation of where tendons or ligaments insert into the bones. Tissues in these areas can become solid (calcification or ossification) or ropey (fibrosis). Dactylitis, sometimes called “sausage digits”, is the swelling/inflammation of a whole toe or finger. It often affects multiple digits unevenly on the body.


  • Pain in the back (upper and lower) and neck
  • Tender, swollen joints
  • Stiffness (especially in the morning)
  • Swollen toes and fingers
  • Plaques (red, scaly patches of skin)
  • Pitting or separation from the nail bed
  • Fatigue


While there is no cure for PsA, there are treatment options to help manage the symptoms. Each person’s treatment plan is unique to their condition, so speak with your doctor about what your best options are. Treatment for psoriatic arthritis is important as studies have shown that delaying even just six months can cause permanent damage to joints.

There are various drug options to help manage symptoms:

    • NSAIDs (non-steroidal anti-inflammatory drugs) inhibit your body from creating the chemicals that cause inflammation. Over the counter (ibuprofen, aspirin, etc) and prescription options are available but can have undesired side effects.
    • DMARDs and Biologics are for when NSAIDs don’t work well or the condition is more severe. They are stronger and can have a delayed effect but may help stop or slow joint and tissue damage, swelling, and pain. Common DMARDs include Cyclosporine, Methotrexate, Sulfasalazine, Leflunomide. Biologics are a newer type of DMARD that block the protein that sources inflammation. These include Etanercept, Golimumab, and Infliximab to name a few.

Remicade®, an Infliximab biologic medication, has shown in clinical studies that it can help with pain, swelling, and stiffness, stop joint damage, and improve skin conditions. Integrated Neurology Services offer Remicade administration, among other infusion medicines.

  • Enzyme Inhibitors are new and for chronic inflammation. It also works in blocking a specific type of protein.
  • Steroids, specifically corticosteroids, help serious swelling and pain.
  • Surgery is typically the last resort option if nothing else works. Most PsA patients won’t need surgery but it is an option of treatment.

Again, a doctor will help with deciding on the best treatment plan for each individual’s condition.

Integrated Neurology Services’ Infusion Suite offers a comfortable location to receive prescribed infusion medications. Our facility includes cozy leather chairs, refrigerator, microwave, and free WiFi. Let us know how we can help in your infusion treatment options for psoriatic arthritis or any other condition that may need IV therapy.

The Lowdown on Myasthenia Gravis


What is Myasthenia Gravis (MG)?

Myasthenia Gravis is a chronic autoimmune neuromuscular disease that causes weakness in skeletal muscles. The name translates from Latin and Greek origins to “grave, or serious, muscle weakness”. This disease targets muscles that are responsible for breathing and moving body parts, like arms and legs, and is worse after active periods but improves with rest. Often, muscles that control talking, chewing, swallowing, facial expressions, the eyes, breathing, limb movement, and the neck are affected.

Over half of MG cases, eye problems were the first sign. These include ptosis, which is the drooping of one or both eyelids, and diplopia, double vision that improves if one eye is shut. Throat and face muscle symptoms are the first sign in about 15% of those who develop myasthenia gravis. These are the most common symptoms seen in myasthenia gravis patients.

Other symptoms include weakness of the neck, arms, and legs. These don’t usually present themselves without the above symptoms. Legs are less often affected than arms but may cause patients to waddle. More seriously, breathing can be affected and can be a critical issue. Continue reading “The Lowdown on Myasthenia Gravis”