April 2013
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April 2013 posts

MS Research Update: How reliable are biomarkers measured by multiple providers?

Mobility issues secondary to strength, balance, and walking problems affect up to 80 percent of people with multiple sclerosis (MS). Providers and therapists use a variety of scales and tools to measure the extent of these issues such as:

 

  • The Berg Balance Scale (BBS) is a measure of balance that uses a 14-item scale and is scored based upon the results 0-56.
  • The 6-minute walk (6MW) is a measure of walking endurance.
  • Handheld Dynamometry (HHD) is a way to quantify manual muscle strength testing.

 

There is a lot of emerging research about “MS biomarkers,” which are values that look for ways to predict how patients will do in the future. The above tests are “physical biomarkers” of patient performance that may be able to be used as measures of disease state and change over time.

 

Often patients and clinicians are left wondering how accurate the results of these tests are. For instance, if provider A performs a functional test on a patient, will provider B get the same results if administering the same test to the same patient?

Carotid Stenosis: What you need to know

Carotid stenosis is a build of up plaque in the large arteries that supply the brain with blood. This buildup of plaque increases the risk of transient ischemic attack (TIA) and stroke. Risk factors for carotid artery stenosis include hypertension, hyperlipidemia, obesity, and tobacco use. Symptoms of carotid artery stenosis include facial droop, weakness or numbness on one side of the face and body, slurred speech, garbled speech, gait instability, dizziness, and visual disturbances including blurred vision, loss of vision and double vision.

Carotid artery stenosis can be diagnosed with several diagnostic studies including carotid ultrasound, MR angiography (MRA), CT angiography (CTA), and cerebral angiogram.

Treatment options for carotid artery stenosis vary depending upon the severity of stenosis, history of TIA or stroke, and...

Croup: coughs that go bark in the night

Croup is a common childhood illness that can be very frightening to a parent or child. It often starts with the symptoms of a mild cold, such as a runny nose, or sore throat. The child goes to bed as usual and then wakes suddenly in the middle of the night with a barking cough. Often they gasp in between the coughs and make a high-pitched noise called stridor when they breathe in.

Thankfully, croup is rarely dangerous. Most children can be treated at home. But it can be a scary illness for both the parent and the child.

It is important to know how to treat croup at home and when to seek help from your doctor or the emergency room....

Multiple Sclerosis Center Celebrates First Anniversary

One year ago today, the first patients visited the brand new Multiple Sclerosis (MS) Center at Swedish Neuroscience Institute. The 11,700-square-foot facility was designed around the patient experience as part of the MS Center’s commitment to treating the whole person and addressing each patient’s individual emotional, psychological, social and physical needs in a supportive environment.

Since we opened our doors on April 9, 2012, we’ve hit a few new milestones:

  • More than 5,400 total patients, including 620 new faces, from around the world received care from our comprehensive treatment team in the last 12 months.

  • We welcomed three new providers: neurologist Peiqing Qian, M.D.; physical therapist Kim Kobata, PT; and neuro-psychiatrist Lina Fine, M.D., M.Phil.

  • We completed the Pigott Terrace. The 1,500-square-foot outdoor therapy terrace includes a one-of-a-kind system that enables patients to ...

Current Exercise Concepts for People with Parkinson’s Disease

Research over the last several years has shown the positive benefits of exercise for people with Parkinson’s disease. Participants in physical therapy exercise programs demonstrate improved reaction time and balance, increased endurance and augmented strength. These gains in function can result in decreased falling, more energy to get around the home or community, and ultimately a better quality of life.

Evidence also points to HOW you exercise as an important variable in slowing the disease process. Concepts such as neural priming, movement visualization, whole body exercise, and intensity of practice all contribute to functional gains for people with PD.

Come to Swedish/Issaquah on April 22 to hear about these concepts AND get a chance to practice these exercises in class. The event is FREE. Please...

Caring for your child's cast

Kids of all generations from all walks of life have one thing in common and that is the love of play and imagination. Play structures, a couch turned to a fort, or their sworn innate ability to fly can take a sour turn. As much as we would like to wrap our little Spider Mans, Incredible Hulks and Wonder Women in bubble wrap, unfortunately life’s little incidences are inevitable.

If ever the time comes where your Super Hero suffers from an injury and needs a cast, it is time to put on your Super Parent costume.

Here are some helpful tips on cast care for the Super Parent:

  • Bathing: Absolutely no showers. We ask parents to give kids a bath instead, keeping the casted limb outside of the tub. In addition, we suggest wrapping the cast with a towel and covering with a newspaper bag or bread bag and closing it off with a rubber band at the top for added protection.
  • Itching: The golden rule of having a cast is DO NOT STICK ANYTHING IN THE CAST! Scratching an itch with an object can cause the skin to break underneath the cast, leaving room for infection. If your child has itching, tapping on the outside of the cast or using a hair dryer set on cool can help.
  • If a cast...

Tips for getting the most out of your inhalers

“Darn! My inhaler is out and I am going to have to call today, a Sunday, to get a refill…”

Spring is here! And that means asthma season is back, and with the nicer weather, pollen counts are high. Flowers are wonderful and the trees beautiful, but if you are like me, some of those plants have your number. The beautiful smells come with itchy eyes, sneezes, and for some, a serious amount of wheezing.

Patients are reaching for their inhalers more often, and sometimes getting into serious respiratory trouble, especially if their medication is running short. Inhalers are expensive, too, and so using them optimally is both financially and healthfully important.

Fortunately, a couple of tricks can really help maximize an asthma spray’s value.

The medication comes out fast and hard when you squeeze the canister, and it can be difficult to time your breath to inhale the dose well, plus with the energy of the release being so high, a lot of misted drug can zoom right out of your mouth. The trick is to use a ‘spacer’, and the simplest is a rolled up piece of paper, to about a one inch diameter. Tuck the sprayer in the far end, wrap your lips around the outside of the other end, and take your leisure squeezing and breathing! The tube holds the mist in place for a few seconds, letting you better coordinate your inhalation and improve substantially the amount of drug you get to where it is needed.

The second tip is to use a steroid inhaler daily if you need your rescue inhaler more than a few times a week. The rescue inhaler will become less effective the more you use it if you don’t directly treat the inflammation of the allergic response in your bronchial tubes with a low dose of cortisone type medication. The dose of the latter is small and will not cause harm to the rest of your system if used according to directions, but it will keep your rescue medication most beneficial!

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