What Is Cardiovascular Disorder

To understand Cardiovascular disorder we have to study the function of cardiovascular system. Functions of the cardiovascular system include (1) transporting nutrients to cells, (2) removing waste products through the intestines and other excretory organs, and (3) pumping oxygenated blood from the heart via the arteries and returning deoxygenated blood via the veins. The cardiovascular system works in tandem with the respiratory and nervous systems. It works with the respiratory system by taking the oxygen inhaled into the lungs to the rest of the body, and delivering carbon dioxide from the body to the lungs for expulsion. Impulses from the the sympathetic and parasympathetic nervous systems help regulate the heartbeat.

The heart is a cone-shaped organ, about the size of a clenched fist. Contrary to popular belief, the heart is not on the left side of the chest; it is almost central, but its most prominent pulsation is felt beneath the left nipple. It pumps blood throughout the body and averages 70 beats per minute in an average adult. This is accomplished via nerve impulses and contractions of muscles. The heart is loosely enclosed in a fibrous, protective, bag-like enclosure called the pericardium. The heart is comprised of 4 chambers. The top portion houses the atrium, of which there are right and left valves. The bottom portion of the heart contains the chamber known as the ventricle, of which there are also right and left valves.

Cardiovascular disease comprises of several symptoms and disorders; coronary artery disease (including arteriosclerosis, atherosclerosis, angina and myocardial infarction), hypertension, rheumatic heart disease and congenital heart disease. Coronary artery disease is the most frequent cause of death from cardiovascular disease.

In modern system of medicine, the drugs often used in the treatment are antiarrhythmics, antihypertensives, antiadrenergics, diuretics, antianginals and anticoagulants. These drugs are effective but have a number of side effects like severe headaches, mild constipation, shortness of breath, dizziness, loss of appetite, heartburn etc. In chronic cases, the treatment is obviously prolonged. 

The herbal system has a number of medicines that not only provide symptomatic relief but attacks the root cause without any known side effects. so we should try some herbal and alternate medicines also by consulting the experts.

What Do We Know About Blast Injuries Speculating About the Boston Marathon Bombing

Remains of a low order device

The Disease Management Care Blogs thoughts and prayers go out to the Boston Marathon bombing victims and their families. Like all Americans, it hopes the death rate remains low and is confident that the survivors recovery will be a credit to the world-class skill of the physicians and nurses staffing Bostons ERs, operating rooms and ICUs.

While it was digesting the horrific details, the DMCB was struck by the likelihood that the Afghan and Iraq wars as well as multiple terrorist attacks have enhanced our ability to deal with blast injuries.

What have we learned?

As outlined in this abstract, the initial explosion results in "primary" injury, fragment or shrapnel injuries are "secondary," being bodily thrown results in "tertiary" blunt injury while the burns and other trauma are "quaternary."  Its difficult to survive a primary injury because the supersonic compressive air wave travels though the human body and "shears" any organ with an air/water interface, such the lung and intestines; thats also why ear drums rupture.

According to the CDC, primary injuries are more likely with "high order" explosives such as military grade bombs or TNT.  "Low order" gun powder (the image above is from a "pipe" bomb) or petroleum-based devices are less likely to result in supersonic shock waves. That - and reports of "white smoke" - may account for the initially low mortality rate at the Marathon. Interestingly, body armour does not protect against a primary injury and a ruptured ear drum is a poor predictor of its presence.

Unfortunately, the stress wave can also cause bone fractures and, if severe enough, "transosseous" amputation.  The DMCB was dismayed by reports of some of the victims losing their limbs, which suggests the devices were large if "low-order" bombs.  Amputations were common in the 05 London terror bombings because the victims were in close proximity to the devices and the blast waves were at ground level.  Initial reports from Boston suggest the devices were placed in trash receptacles, which, if it turns out to be true, would fit the pattern.

If victims are in shock from bleeding, the DMCBs uneducated first impulse would be to correct the low blood pressure and give lots of intravenous fluids and blood.  It turns out that combat surgeons have discovered that kind of aggressive therapy can increase the rate of death and complications. The best current approach appears to be the use of "hypotensive resuscitation" and more liberal use of blood products (plasma, platelets and pack cells or whole blood) versus fluids. 

If you live in Boston and want to donate blood, you can check this out.

Given the standard emergency triaging, the DMCB suspects the secondary, tertiary and quaternary victim counts are still being compiled.  In addition, it will be some time before we understand the incidence of traumatic brain injuries and their associated symptoms of unbalance, hampered motor function, disordered vision, decreased communication and depression. The etiology and our ability to predict it remains a topic of research.

The Rise of the Medical Director What One ACOs Good News Tells Us

Medical Directors prepare for battle

The VP of Finance finally agreed to a meeting. In order to make maximum use of their time, however, he had a simple request: submit an agenda of topics first and then hed be happy to let his administrative assistant set up an appointment.

In that game of organizational politics, Finance VP: one. Senior VP and Medical Director: zero.

The lost voice mails. The patronizing glances. The unanswered emails. The skeptical grins. The condescending nods. Every lead doctor, medical director and physician VP is exquisitely familiar with the tut-tuting attitude that lingers just below the surface, ready to spring when their opinion on how to best serve patients bumps into the organizations budgeteers. Those finance guys know that the typical physician is used to spending dollars like a Miami-Dade ICU on a 98 year-old. They know those "white coats" are incapable of understanding costs, margins and cash flow. Better that they get out of the way and let the money experts call the shots, eh?

Call it the clinical-finance tension. Like government revenue vs. cutting taxes. Sales vs. customer service. The DMCBs premium cable TV perences vs. the spouses unreasonable penny-pinching.

Which is one of the reasons why the Disease Management Care Blog found this New York Times article interesting.  If this is any indication of what is going on nationwide in the delivery of medical services, the implication is that the physician leaders perspectives are in the ascendancy in their organizations. Not only is there a pervading belief that keeping patients like Ms. Cline away from the emergency room is important for the bottom line, but that achieving clinical outcomes is no longer secondary to making budget.  While typical news reporters havent picked up on the clinical-finance tension that lurks in health insurance and delivery organizations, the very fact that most of the NYTs interviewing involves physicians is telling.

The playing field is currently level.

Which brings up four points:

1. The DMCB suspects the genesis of the NYT article was this presentation at a recent AHIP meeting.  Thanks to reading the DMCB, you also know that a lot more background detail on the Advocate-BCBS Illinois collaboration is here.

2.  Abstracts, presentations and news articles are one thing, but having results reported in a peer-reviewed setting is another.  The DMCB readers know that theyll withhold final judgment until it sees some transparently presented hard numbers.

3.  While Medical Directors are currently playing on a level playing field, disappointing budget results, financial losses and failure to achieve savings could not only tilt things against the clinicians again, itll quickly undo the merits of "doing the right thing."  That alone is a good reason to hope that the health system "accountability" arrangements like ACOs survive.

4.  The secret sauce to Advocates success?  Care Coordinators.  More on that in tomorrows post.

What Men Want Women to Know

Men Will Talk About Feelings

Was your guy raised as a traditional, stoic, mans man? If so, let me walk you through 18 relationship secrets, gathered from psychologists who study gender roles. Secret No. 1: It may be easier for your man to talk about feelings indirectly. Ask what hed do during a romantic weekend. Or what he thought the first time he met you. His answers will reveal how he feels and bring you closer.

Men Say "I Love You" With Actions

Some men per to express their feelings through actions rather than words. Your guy may say "I love you" by fixing things around the house, tidying up the yard, or even taking out the trash -- anything that makes your world a better place.

Men Take Commitment Seriously

Men have a reputation for being afraid to commit. But the evidence suggests men take marriage seriously. They may take longer to commit because they want to make sure they are onboard for good. In a survey of currently married men, 90% say they would marry the same woman again.

He Really Is Listening

When youre listening to someone talk, you probably pipe in with a "yes" or "I see" every now and then. Its your way of saying, "Im listening." But some guys dont do this. Just because a man isnt saying anything doesnt mean hes not listening. He may per to listen quietly and think about what youre saying.

Shared Activities Form Bonds

Men strengthen their relationships primarily through shared activities more than by sharing thoughts or feelings. For many men, activities like sports and sex make them feel closer to their partner.

Men Need Time for Themselves

While shared activities are important, men also need time for themselves. Whether your guy enjoys golf, gardening, or working out at the gym, encourage him to pursue his hobbies, while you make time for your own. When both partners have space to nurture their individuality, they have more to give to each other.

Men Learn From Their Fathers

If you want to know how a man will act in a relationship, get to know his dad. Some say men learn about their relationship role by watching and listening to their fathers. How they are with each other and how the father relates to the mother can predict how a man will relate to his wife.

Men Let Go Faster Than Women

Women tend to remember negative experiences longer and may have lingering feelings of stress, anxiety, or sadness. In contrast, men are less likely to dwell on unpleasant events and tend to move on more quickly. So while you may still want to talk about last nights argument, your guy may have already forgotten about it.

Men Dont Pick Up on Subtle Cues

Men are more likely to miss subtle signals like tone of voice or facial expressions. And they are especially likely to miss sadness on a womans face. If you want to make sure your guy gets the message, be direct.

Men Think About Sex ... A Lot

OK, so maybe this one is no secret. The majority of men under age 60 think about sex at least once a day, compared with only a quarter of women. And thats not all. Men fantasize about sex nearly twice as often as women do, and their fantasies are much more varied. They also think more about casual sex than women do. But thinking is not the same as doing.

Men Find Sex Significant

Its a myth that most men think sex is just sex. For many, sex is a very important act between two committed people. And just like most women, men find sexual intimacy to be most satisfying in the context of a committed relationship. One reason is that long-term partners know how to please one another better than strangers do.

He Likes It When You Initiate Sex

Most guys feel as though theyre the ones who always initiate sex. But they also like to be pursued and wish their partner would take the lead more often. Dont be shy about letting your guy know youre in the mood. Initiating sex some of the time may lead to a higher level of satisfaction for both of you.

Guys Arent Always Up for Sex

Men, much to many womens surprise, arent always in the mood for sex. Just like women, men are often stressed by the demands of work, family, and paying the bills. And stress is a big libido crusher. When a guy says, "not tonight," it doesnt mean hes lost interest in you. He just means he doesnt want to have sex right then.

Men Like Pleasing Their Partner

Your pleasure is important to your man. But he wont know what you want unless you tell him. Too many women feel uncomfortable talking about what they like and dont like. If you can tell him clearly in a way that doesnt bruise his ego, hell listen. Because he knows hell feel good if you feel good.

Guys Get Performance Anxiety

Most men get performance anxiety on occasion, especially as they age. Your guy may worry about his physique, technique, and stamina. If you can help him learn to relax and stay focused on the pleasures of the moment, sex will become less stressful.

Men May Stray When Needs Arent Met

If a man doesnt feel loved and appreciated in his relationship, he may turn elsewhere for satisfaction. For one man, that may mean burying himself in work. Another may develop a fixation on sports or video games. And some men cheat. To avoid this, partners need to work together to meet each others needs.

Hes Vested in You

Most men realize theres a lot to lose if a long-term relationship goes sour – not just each others company, but the entire life youve built together. If youre willing to work to strengthen your marriage, chances are your man will be, too.

Stay Humble We Dont Know What We Dont Know

Ive used this pic before. I dont care.

Id like to share a story with you. The other day in one of my classes, we were discussing the history of vitamin D. My professor told us a fascinating story about the early research on vitamin D and rickets, the bone disease children get as a result of a deficiency. This particular researcher, Leonard Findlay, had performed experiments with dogs, and he was convinced that rickets could be cured simply by exercising. In 1908, he published a paper detailing his experiments: "The Etiology of Rickets: A Clinical and Experimental Study".

What Findlay did, essentially, was induce rickets in dogs by keeping them sedentary. He would keep them locked up indoors in cages, providing them food of course, until they would develop symptoms of rickets. Then, as an experimental treatment, he would take some of the dogs outside and let them run around. Allowing the dogs to run around outside cured their rickets, and so Findlay assumed that exercise was the reason why.


Today we know that rickets is caused by a lack of vitamin D. As you may know, we can get vitamin D from simple sun exposure. It wasnt the exercise that cured Findlays dogs; it was the sun. But put yourself in Findlays shoes for a moment... if you didnt know that we could make vitamin D from the sun, how would you ever even identify that as a factor in your experiment? You wouldnt... because we just dont know what we dont know. Based on what we knew at that time, his experiment was air tight.

In hindsight, the idea that exercise cures rickets is absurd. But think about it in the context of the future... well likely be saying the same thing 100 years from now about what we believe to be true today. In any experiment, the goal is to control for the desired variable as best we can, so that we can be sure the results are due to that one variable and no other. We try to do this, or course. But in reality, theres no way to know what we dont know, and we cant control for that. 

Take an example. Say were testing the effectiveness of a gluten-free diet on symptoms of irritable bowel syndrome (IBS). So we recruit people with IBS, put half of them on a gluten-free diet, and keep the other half on their normal diet. We make sure both eat the same amount of calories, carbs, fat, and protein. The only difference appears to be the presence of gluten, but is it really? What dont we know? Well, for starters, we dont know much at all about the gut. Im talking about the microorganisms that live there, what their roles are in our health, and how food might impact it. We also cant quantify the impact of stress... what if its extremely stressful for someone to give up gluten? How does that impact things? We know very little of the compounds in food... take a carrot for example. We know of dozens and dozens of compounds within a carrot, and there are likely dozens more that are unidentified. On top of that, we really only know the biological function of a select few of them! What else dont we know? We just dont know! As you can see, nothing can be 100% controlled for, and nothing is really known for sure.

What will we know in 100 years? Maybe itll be common knowledge that air conditioning gives us cancer!! Doubt it, but who knows!?

My point is this: we should always keep an open mind. We should always remember to stay humble and understand that we dont know it all. Theres no telling how things could change in the future!

On another note though, there are certain things we CAN take to the bank... like eating whole foods. Doing what humans have always done, and have been successful doing, is always a safe bet! 

40 Day Challenge – What is Your Goal

Are you struggling to make all the changes you know you should make for your health?

Looking for health answers but don’t know where to start?

Just need some encouragement in your health journey?

Welcome to the Wellness Challenge! 

 I’m so excited for the great information and prizes I get to share in the next 7 weeks!
Yep, you read that right, 7 weeks! Can you do it?
At the request of several of my readers, and to make your transition easier than mine was, I have put together a 40-day challenge to offer you support, recipes and giveaways! If you’ve been waiting for an excuse to try going grain free or ditching the sugar, now is your chance.
Please join me for Lent, or just for 40 days, to try living grain free. Your health will thank you, and if you don’t like it, you can always go back to the old way of eating.  What have you got to lose?
To help make the transition easier and to make sure we address all aspects of health, I’ve broken the challenge into Seven Mini Challenges. Each week, there will be a new challenge with specific goals, support and prizes!

Start A Wellness Journal!

Maybe your goal is to lose weight, maybe to sleep better or make improvements in your families diet. Whatever the goal, keeping a journal will help you both with accountability and support! Consider starting a Wellness Journal .
If you want to lose weight, post your measurements and *gasp* a picture if you want, if you are trying to clear up your skin, take a picture to document your progress. If you’re trying to improve your family’s health, show us their beautiful faces!
This is my favorite part of the Challenge personally, since I feel like I really get to “meet” you all.

And the Week One Mini Challenge Is…

Getting a solid nutritional foundation in place! Anyone surprised? Many of you may already be solid in this area, but I know that this is a huge struggle for many people! 
If you’re diet is already iron-clad, please offer some advice and encouragement for those who are struggling to make the change. This challenge will actually go a little longer than a week so that everyone has time to make the changes, and so we can get on a Monday-Friday schedule…

Nutrition Basics

Nutrition can have a tremendous impact on overall health and will be a large part of the focus of the challenge. If you’ve been a Wellness Mama reader for a while, you know that I’m not a fan of grains, sugars and starches and recommend removing them from your diet. Of course, only if you are making sure to get adequate nutrition from proteins, fats and vegetables.
Some foods, like beans, are of questionable nature, so for the duration of the challenge, I’d suggest removing them too! Others, like vegetable oils, margarine, and other frankenfats are toxic and should be avoided completely, challenge or not!

Mini Challenge #1
Cut out the grains, sugars, potatoes, beans and all processed foods from your diet and focus on getting maximum nutrition from meats, vegetables, healthy fats (coconut, olives, coconut oil, olive oil, tallow, lard, butter, unprocessed cream, etc) and fruits. 

Everyone is entering the challenge for different reasons, but if one of your goals is to lose weight or improve your physique, consider drastically reducing your carbohydrate intake.
If weight loss is a serious goal, this will mean that that morning bowl of oatmeal or potato salad at lunch is out. To keep it simple, just get your carbs from vegetables (minus potatoes) and you’ll be fine! One exception, if you struggle from low-thyroid, don’t drop your carbs too low for too long, as this can stress the thyroid, just make sure to get your carbs from healthy foods like sweet potatoes, winter squash, fruit, and grain-free baked goods!
[Note: Some people experience a "carb flu" as their body adjusts to not having a constantly available stream of glucose. This is temporary, but can be uncomfortable for the first couple of weeks. Check out these two posts by Dr. Michael Eades to help make the transition easier
Tips for Starting Low Carb Part I and Tips for Starting Low Carb Part II ]

We’ll be addressing some specifics that can help with your individual goals in the next few weeks (supplements, what type of exercise, etc) but nutrition is the single most important factor and all the other factor’s can’t fix a poor diet!

Here are a few free printables for quick reference:

• Here’s a full week of my premium Meal Plans (budget friendly!) and a corresponding shopping list!
• Foods to Avoid
• Foods to Eat in Moderation
• Foods to Consume Freely

What to Expect During a Well Baby Check Up

During the first year of a babys life, the pediatrician will carefully monitor everything about them. This is to make sure that your baby is growing properly and getting the right kinds of nutrition. During a well-baby check-up the doctor will carefully examine your baby from head to toe. These doctors visits continue throughout the first two years starting at every two weeks then four weeks then after a few months. Being diligent about having your baby examined by their doctor will help alleviate any medical surprises later on.

First the doctor will take your childs measurements. Tracking height and weight during the first year is helpful to doctors and parents. It helps measure your babys growth and also identify if there is a problem with their growth that may not be manifesting through other symptoms. After the measurements are completed the doctor will inspect the babys head. Primarily he will be looking to measure the space between gaps in a babys head. These spaces are left during fetal development so that the brain has room to grow and expand. Over time the soft spots or gaps between the skull bones will fuse together. In the meantime, it is important to be very careful with a baby and his surroundings. The smallest knock on the head can cause damage.

The next step in a well-baby check is to monitor the ears, eyes and mouth. Over the first few months your child becomes more reactive to the stimulants around her. In the doctors office it is expected that your child will respond to noise and light. Additionally, the pediatrician will make sure that there is no fluid build in up in the ears which can lead to ear infections or other problems. In the mouth, the doctor will be checking for signs of thrush. Finally the physician will inspect the baby for bruises, rashes, birthmarks and jaundice. There are many indications on a babys skin that can be related to a medical disorder. It is very important that at home you monitor any birthmarks or rashes and take the child to the doctors if they get worse or spread.

Caring for a child is a lifelong commitment but the hardest period is the first year of their life. There are hundreds of disorders and medical conditions that a baby can develop throughout the first 12 to 18 months. For this reason it is important that parents are diligent in taking their child to the doctors office and having them perform routine examinations. Most parents have nothing to worry about. As long as you are maintaining the best care possible at home, your child will likely grow up to be happy and healthy. During a well child check, your pediatrician can also watch for signs of genetic conditions that may manifest in your child.

Even after a child passes the toddler years, it is important to maintain regular clinical visits at least once a year. The more medical history that is on record, the easier it is for a doctor to determine the cause of an illness in the future.

Article by : Dr Ahan Newman

Article Source : What to Expect During a Well-Baby Check-Up

What is bourgeois sore care?

Put simply, �natural graze care' is serendipitous for your skin in a standard and chemical-free way. �Natural skin care' advocates enabling the skin to take care of itself (without any assistance from synthetic materials/ chemicals). �Natural skin care' is about inculcation of good habits in the accession you lead your day to day life. A assemblage of natural sore care measures are actually the same as those in that body millstone in run-of-the-mill.

So let's see what these natural skin care measures are.

Well the choicest and the foremost natural graze care measure is � �Drink a lot of water'. Around 8 glasses of bedew is a must trite. Water helps in flushing superficial the toxins from the body, importance a natural way. existent helps drag the overall upkeep of the body and promotes due health through all organs (not just abrasion).

General cleanliness is another inexpensive way of customary skin clog. routine shower, wearing clean clothes again sleeping on a spotless mattress/pillow are integrated part of standard cleanliness. coterminous all, clean skin is the key to keeping the skin disorders at bay.

Regular motion is the next thing on the cards. enterprise increases the mobility of blood that helps in getting rid of constitution toxins and keeping you healthy. Exercise also helps monopoly beating stress which is the worst enemy of good health.

sturdy food and eating habits are also recommended for natural skin care. Some type of food (e.g. oily food) is know to cause acne and should be avoided as much for possible. Your viand should be a hale mix of various nutrient providing foods. Raw fruits besides vegetables are known to provide freshness to your body and help in obtaining rid of body toxins.

A good sleep is also instrumental in maintaining good health besides in beating stress. thanks to a plain skin care measure, a good sleep delays slacking of skin.

Beating hardship is another natural skin care therapy. Stress causes overall damage to body further health. Drinking a collection of water, getting a sound sleep and exercise has already been mentioned as fretfulness busters. Indulging in a warm bubble bath, listening to music and playing your favourite pastime are also desired ways of beating pressure. Yoga is yet another way of beating stress; palpable is flashing gaining popularity amongst the masses.

Avoiding excessive show to sun (by wearing long sleeved clothes, hat and umbrella etc), is added average skin load strategy. Sunscreen lotions are also recommended as leading.

A lot of conventional further home made natural canker misfortune products/ measures are also known to enact very effective. Such measures are not only natural besides easy-to-follow, but also relatively inexpensive.

Besides that, a gathering of humdrum skin care products are available in the commercial market. These include things like lavender oil, aloe vera etc., which don't accept division side effects.