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When He Stood Up Quickly, He Sometimes Fainted. What Was It?

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When He Stood Up Quickly, He Sometimes Fainted. What Was It?

Years earlier than, the affected person had fallen within the bathtub, damaged his ribs and punctured a lung. Blood crammed his chest and collapsed the lung. He needed to be rushed to the hospital. Sufferers who’re caught in mattress whereas within the hospital are liable to creating blood clots within the veins of their legs as a result of they’re immobilized. Clots kind when blood isn’t shifting. These sufferers are often began on blood thinners to scale back that threat. As a result of this man had bled into his chest, blood thinners weren’t a great possibility for him. Clots that kind due to immobility block veins and trigger swelling and ache, however they may also be lethal in the event that they journey by the physique and find yourself within the lungs or mind. So his docs had chosen to place a filter in the principle vein that introduced blood from his legs again to his coronary heart — a vessel referred to as the inferior vena cava — to catch any clots that shaped and broke free.

These filters are presupposed to be eliminated a number of months later when the danger of clotting goes down, however many should not eliminated on schedule. This one had been left in place for greater than 15 years. What if, Slief urged after explaining this historical past, the filter had executed its job and captured clots and so they have been now blocking all the vessel? May that trigger his positional hypotension? Centor listened thoughtfully. He’d been a health care provider for 45 years and had by no means seen this. And but it was an fascinating concept. Definitely value contemplating.

One of many many benefits of the V.A. Hospital system is that it has computerized medical information going again a long time. Slief did a deep dive into this man’s medical historical past and hit what seemed like some promising outcomes. Seven years earlier, the person had a CT scan that confirmed an virtually whole blockage of his vena cava. Was it potential that the additional blood that was presupposed to go from the legs to the mind when the person stood up didn’t get there quick sufficient due to the narrowed vena cava?

There was actually no option to take a look at this speculation, but it surely made sense. They defined to the affected person that the subsequent step was to get the filter out. The affected person was desirous to attempt. The staff reached out to Dr. Invoice Parkhurst on the College of Alabama at Birmingham Hospital, who specialised in this type of process.

The affected person was sedated for the operation. Parkhurst put a tiny tube by an incision into the affected person’s jugular vein in his neck and slowly superior it down previous the guts into the vena cava the place the filter was situated. These contraptions appear to be daddy longlegs with tiny hooks at every foot to carry them in place within the vein. The place the physique of the insect can be situated was a small hook. Parkhurst used a tiny gripping device to know the hook and pull the filter up by the vena cava and out by the small incision within the affected person’s neck. Subsequent Parkhurst inserted tiny balloons that he inflated to reopen the threadlike stream by the narrowed vena cava. He then positioned a stent to carry the vessel open. He continued this course of down the first vein of every leg. The process took six hours and required 9 stents, however lastly there was good blood move between the legs and the guts.

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The primary time the affected person stood up after this process, he was amazed. The dizziness was gone. It has been 4 months and it hasn’t come again. No weak legs, no lightheadedness, no falls. His toes are nonetheless numb, however he can dwell with that as long as they continue to be on the bottom and he stays upright.

Slief is modest about making this obscure analysis. There are solely a handful of case experiences within the medical literature. Nonetheless, Slief advised me, it does make you marvel if possibly that is occurring extra usually than reported. He’s definitely going to be searching for it.


Lisa Sanders, M.D., is a contributing author for the journal. Her newest e book is “Analysis: Fixing the Most Baffling Medical Mysteries.” If in case you have a solved case to share, write her at Lisa.Sandersmdnyt@gmail.com.

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Summer is tick season, but these tips can help you avoid the bloodsucking bugs

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Summer is tick season, but these tips can help you avoid the bloodsucking bugs

Tick season is starting across the U.S., and experts are warning the bloodsuckers may be as plentiful as ever.

Another mild winter and other favorable factors likely means the 2024 tick population will be equal to last year or larger, some researchers say.

“It’s very bad and has only been getting worse,” said Susanna Visser of the Centers for Disease Control and Prevention.

TICK BITES AND LYME DISEASE: WHAT TO DO IF A TICK BITES YOU OR YOUR PET

An increasing variety of ticks are pushing into new geographical areas, bringing unusual diseases. Exotic southern species like the Gulf Coast tick and the lone star tick are being detected in New York and other northern states, for example.

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But the tick that experts warn of the most is a common blacklegged tick, which is found mainly in forests and spreads Lyme disease. Infection rates begin to peak in May, and U.S. health officials estimate nearly half a million Lyme disease infections happen annually.

Here’s a look at what’s expected this year and how you can protect yourself.

An adult deer tick, also known as the blacklegged tick, crawls on a fingernail at Connetquot State Park in Oakdale, New York on Dec. 27, 2011. (Bill Davis/Newsday RM via Getty Images)

TICK FACTS

Ticks are small, eight-legged bloodsucking parasites — arachnids, not insects — that feed on animals and sometimes people. Some ticks are infected with germs that can cause illness, and they spread those germs when they bite.

There is no widely accepted estimate of how many ticks there are from one year to the next, but there is a scientific consensus that they are an increasingly common health hazard in large portions of the United States.

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Blacklegged ticks — also known as deer ticks, since they feed on deer — are among the most common ticks in the eastern half of the U.S. They were plentiful centuries ago, then diminished when forests were cut down and deer were hunted, and rebounded alongside deer and wooded suburbs. The ticks have spread out from pockets in New England and the Midwest over a wider range.

Tick populations cycle throughout the year and their numbers depend on a few factors. They like warm, humid weather, and more can be seen after a mild winter. The more deer and mice available to feed matters, too.

Overall, the blacklegged tick population has been expanding for at least four decades, researchers say.

“This is an epidemic in slow motion,” said Rebecca Eisen, a CDC research biologist and tick expert.

2024 TICK SEASON FORECAST

Weather can play a role in the severity of a tick season.

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Very cold, dry winters can whittle down tick populations, but recent winters have been mild — a trend some attribute to climate change.

As Scott Williams, a tick researcher at the Connecticut Agricultural Experiment Station, said: “Winters are no longer limiting the tick population.”

Ticks can withstand the heat but tend to almost hibernate when it’s a dry summer. That happened in Maine in 2020 through 2022, said Chuck Lubelczyk, a vector ecologist at the MaineHealth Institute for Research.

But last year was a very wet year, and tick activity multiplied in Maine — the state with the highest incidence of Lyme disease in the country. Weather service predictions call for higher temperatures and precipitation, so “on paper, at least, it could be a very good year for the ticks,” Lubelczyk said.

In Wisconsin, adult ticks were out longer than usual due to a mild winter. The tick nymphs are starting to emerge, and a wet spring is setting the stage for the possibility that the population will be robust, said Xia Lee, an entomologist at the Wisconsin Department of Health Services.

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Ditto New York.

“It will be as bad as last year, or worse,” said Saravanan Thangamani, who studies ticks and tickborne diseases at SUNY Upstate Medical University in Syracuse.

WHAT IS LYME DISEASE?

Not all ticks are infected with disease-causing germs — about 20% to 30% of the blacklegged tick nymphs that emerge in the Northeast and Midwest this spring and into summer will be carrying the bacteria that causes Lyme disease, experts estimate.

Lyme disease symptoms tend to start between three and 30 days after a bite occurs and can include fever, headache, fatigue and a bull’s-eye-like rash. If you get bitten and develop symptoms, see a doctor to get treated with antibiotics.

HOW TO KEEP TICKS OFF OF YOU

Experts say the best thing to do is take steps to avoid a tick bite in the first place.

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If you go outdoors, make note of wooded areas and where grassy properties start bleeding into wooded areas. Ticks tend to perch on ankle-level vegetation with their upper legs outstretched, waiting to latch on to an unsuspecting dog or human.

Try to walk in the middle of paths, wear light-colored and permethrin-treated clothing and use Environmental Protection Agency (EPA)-registered insect repellents.

HOW TO CHECK FOR TICKS

When you come inside, check for ticks. They can be found anywhere on the human body, but common spots include around the waist, behind the knees, between fingers and toes, on underarms, in the belly button and around the neck or hairline.

They are harder to see when they are young, so look carefully and immediately pull them off with tweezers.

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The CDC does not recommend sending individual ticks to testing services for analysis, because a person might get more than one tick bite and the results from the tested tick may not be sufficient information.

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Pizza for Weight Loss? Top MD Says This Dough Makes It Possible

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