'n Hand en tand bekgeveg teen die asemdief PH (Pulmonale Hipertensie)

[Meraai vannie Baai]

Groot verligting toe ek raaklees dat daar voortaan meer aandag gegee gaan word wanneer pasiente met 'n hartmurmer gediagnoseer word. Hierdie algemene afwyking kan soms tot erntige nagevolge lei as die toestand vererger.

Heart murmur - innocent or abnormal?
If you have long-term untreated or improperly treated mitral regurgitation, you can develop a type of high blood pressure that affects the vessels in the lungs (pulmonary hypertension). A leaky mitral valve can increase pressure in the left atrium, which can eventually cause pulmonary hypertension. This can lead to heart failure on the right side of the heart.

Bron: http://www.mayoclinic.org/…/mi…/symptoms-causes/dxc-20121850

As jy meer inligting oor hierdie toestand soek:
http://www.mayoclinic.org/diseases-conditions/heart-murmurs/basics/causes/con-20028706

[PM]

Ongelukkig is hierdie toestand nog redelik onbekend.  Hoop maar dit sal meer aandag geniet.

[Meraai vannie Baai]

Bewusmakingsveldtogte het alreeds daartoe bygedra dat al hoe meer dokters bedag is op simptome maar soos jy tereg noem PM, dit is ondanks al die veldtogte nog steeds nie 'n bekende toestand nie. As ek kyk na die lesersgetal hier, het ons 'n deeltjie bygedra en voel dit vir my of die pad wat ons stap met die asemdief ironies genoeg, met 'n doel geskied het.

Om positief te bly is nie altyd maklik nie. Die vrees vir dit wat die toekoms inhou wanneer jy met 'n raar (terminale) skeet gediagnoseer word, is die realisering van 'n nagmerrie.

Baie pasiente erken openlik dat hulle volstruispolitiek speel as dit by derglike toestande kom. Hierdie goed kom ongevraagd op jou pad en hoe jy daarmee deel is vir elkeen 'n unieke ervaring, selfs al het jy dieselfde simptome as miljoene ander in dieselfde bootjie. Ongelukkig is dit meestal nie 'n probleem waarvoor daar altyd antwoorde/oplossings gaan wees nie.

[PM]

Ons kan maar net hoop. 

[Meraai vannie Baai]

Pulmonale Hipertensie en Pneumonia

PH pasiente het 'n baie groter risiko wanneer hulle infeksie kry. Veral longinfeksies. Waar gesonde persone met die regte behandeling, tuis kan aansterk en volkome herstel is die prentjie heelwat anders vir die ouens wat se gestel alreeds afgetakel is weens kroniese siektes. Vir hierdie pasiente is hospitalisasie lewensbelangrik. Sterftesyfers weens longontsteking vir die reeds kritiek-siek pasient is so hoog soos 1 uit 10 tot 20 waar die syfer vir gesonde persone 1 uit 'n 100 is.

Pneumonia is an inflammation of the lungs, and can be life-threatening, especially among the elderly and those with serious underlying health conditions.

If you are already in poor health. You are more likely to become seriously ill with pneumonia. Pneumonia is a common cause of death in people who are already unwell - for example, people in the late or terminal stages of a cancer.

Bron: http://pulmonaryhypertensionnews.com/pulmonary-hypertension-pneumonia/

Omdat die hart reeds oorwerk is, kan pneumonia bydra tot vergroting van die hart en die ander organe ontneem word van genoegsame suurstof. PH pasiente voer alreeds 'n oorlog teen kortasem, duiseligheid, palpitasies en borspyne. Suurstofvlakke kan lewensgevaarlik laag daal.

If left untreated, oxygen levels can fall to life-threatening levels. If the body's tissues - especially in the heart and brain - do not get the oxygen they need, confusion, coma, heart failure and eventually death may result.

Dit is verstommend om te weet dat langdurige pneumonia, pulmonale hipertensie kan meebring!

The majority of patients with severe and prolonged pneumonia end up suffering from pulmonary hypertension due to lung instability, as explained in the study “Variable prevalence of pulmonary hypertension in patients with advanced interstitial pneumonia.”

Ek wil graag 'n paar struikelblokke op ons onlangse pad met longonsteking in beide longe (dubbele longontsteking in die volksmond) deel.
Heel eerste het die dokter die X-strale vir ons gewys en die swaar mediese termes van die verslag voorgelees waarvan ons natuurlik niks verstaan het nie. Al wat ons geweet het is dat hospitalisasie dringend nodig was.

Die termes op die verslag sal ek uiteensit met verduideliking en skakels na meer inligting. Kennis is mag.

1. Cardiomegaly:
Cardiomegaly is a general term used to describe any condition that results in an enlarged heart and a symptom of cardiomyopathy, or disease of the heart.

Vir die formule wat gebruik word om die hart te meet, is daar op hierdie skakel 'n pragtige uiteensetting met grafiese voorstelling:
http://www.med.umich.edu/lrc/coursepages/m1/anatomy2010/html/clinicalcases/cardiomegaly/cardiomegaly.html





BRON: https://www.youtube.com/watch?v=bU0Nm7JFJtU

2. Pleural Effusions:
A pleural effusion means that there is a build-up of fluid between a lung and the chest wall.

Vir meer inligting: http://patient.info/health/pleural-effusion-leaflet

3. Costophrenic Angle Blunting:
Costophrenic angle blunting is a radiological finding or diagnosis. Word Costo is used to describe disease related to ribs and phrenic word is used to describe disease close to diaphragm. The acute angle between rib and diaphragm is considered normal when angle is less than 30 degree and blunt when angle is more than 30 degree. Angle becomes blunt in patients suffering with pleural effusion.

Vir meer inligting: http://www.epainassist.com/chest-pain/lungs/costophrenic-angle-blunting

4.  Basilar Consolidation/Collapse
"consolidation of the lungs" most commonly means a bacterial infection, or pneumonia, is present. A consolidated area contains thick, viscous fluid made up of bacteria, white blood cells and other debris.

Collapse: One of the conditions where the air sacs (alveoli) in the lungs deflate abnormally. In this case, the outcome is a complete or partial collapse of the lung(s).

Vir meer inligting: http://www.ehow.com/about_6556204_basilar-consolidation_.html
http://www.newhealthguide.org/Bibasilar-Atelectasis.html

5. Heart Failure:
Signs of fluid retention due to heart failure include swelling in the legs, ankles or stomach; increased urination; and weight gain, notes WebMD. Dizziness and confusion result from inadequate amounts of blood reaching the brain, while fatigue is the result of too little blood circulating to the muscles and major organs.

Die volgende skakel is omvattend in die beskrywing van presies wat pneumonia is:
http://patient.info/health/pneumonia-leaflet

[Meraai vannie Baai]

PNEUMONIA COMPLICATIONS

Pneumonia can usually be treated successfully without leading to complications. However, complications can develop in some patients, especially those in high-risk groups. These complications can be related to the pneumonia or to the drugs used to treat the pneumonia. In addition, pneumonia may result in worsening of chronic conditions such as chronic obstructive pulmonary disease (emphysema) or congestive heart failure.

Complications due to the pneumonia include:

●Fluid accumulation – Fluid can develop between the covering of the lungs (pleura) and the inner lining of the chest wall; this is called a pleural effusion. If the fluid becomes infected as a result of pneumonia (called empyema), a chest tube (or less commonly, surgery) may be needed to drain the fluid.

●Abscess – A collection of pus in the area infected with pneumonia is known as an abscess. They can usually be treated with antibiotics; rarely, surgical removal is needed.

●Bacteremia – Bacteremia occurs when the pneumonia infection spreads from the lungs to the bloodstream. This is a serious complication since infection can spread quickly from the bloodstream to other organs. Bacteremia can also cause the blood pressure to be dangerously low.

●Death – Although most people recover from pneumonia, it can be fatal in some cases. The 30-day mortality rate is approximately 5 to 10 percent among patients admitted to a general medical ward but is as high as 30 percent in patients with severe infection requiring admission to an intensive care unit.

●Cardiovascular events – Some studies have shown that patients who have had pneumonia are at increased risk of having a cardiovascular event, such as a heart attack during recovery from the pneumonia, and the risk persists for several years after the episode of pneumonia.

Vir meer inligting: http://www.uptodate.com/contents/pneumonia-in-adults-beyond-the-basics

[Meraai vannie Baai]

'n Ongure deel van ontsteking in die asemhalingsstelsel is die liggaam se natuurlike manier om van slym ontslae te raak. Die kleur en voorkoms van hierdie slym verklap baie meer as wat ons ooit sou kon dink. Met 'n sputum toets kan vasgestel word of die ontsteking bakteries van aard, 'n virus of ander oorsake is.

Dit kan selfs verklap of daar hartversaking is (wat vir die PH pasient meer kommerwekkend is weens die feit dat die hart reeds onder verhoogde stres en abnormale drukking funksioneer). Hierdie skuimerige slym kan ook 'n teken wees van gastroesofájico reflux disease.

https://www.reference.com/health/am-coughing-up-white-foamy-phlegm-93ef7974228a3963#

A cough that produces white, foamy phlegm is a possible symptom of heart failure, states Harvard Medical School. Heart failure occurs when the heart is unable to pump enough blood for the body to function properly, explains the National Heart, Lung, and Blood Institute.

Patients who cough as a result of heart failure usually experience the worst coughing while lying down on a flat surface, explains Harvard Health Publications. If the coughing produces white mucus, it is frothy and thin, although these patients may also exhibit dry coughing.

http://www.wisegeekhealth.com/what-is-frothy-sputum.htm

Frothy sputum is foam-like mucus coughed up from the airways. It is a sign of respiratory distress and can occur in association with a number of different medical conditions. Patients who develop frothy sputum should make an appointment to see a medical professional, and may want to consider an emergency room if they are having difficulty breathing or feel extremely disoriented. Some respiratory illnesses onset very quickly and can be fatal or severely debilitating if not treated rapidly.

Patients with frothy sputum may cough more than usual and produce foamy clots of mucus. Sometimes it is tinged pinkish, indicating that bleeding may be occurring in the airways. In a medical evaluation, a doctor may take a sample for analysis in a pathology lab. An evaluation can determine if the frothy sputum contains viruses, bacterias, or other clinical indicators that might explain why it is occurring.


Pulmonary Edema

Pulmonary edema is one of the most common causes of frothy sputum. This occurs when there is too much pressure in the blood vessels in the lungs, and they start releasing drops of blood into the surrounding tissue. This often leads to frothy pink mucus. Pulmonary edema is most commonly a symptom of congestive heart failure, a condition where the heart doesn't pump efficiently. It can also be caused by heart attacks, inhaling poisons, and near-drowning.

Pneumonia

Thick and reddish, greenish, or yellow sputum is normally associated with pneumonia.

[PM]

Die inligting wat jy bied is altyd van onskatbare waarde.  Ek hoop dit gaan beter met jou, dink aan julle elke dag.  As ek op my kniee gaan en die mooiste kleinste blommetjies afneem, dan dink ek aan jou.  Jy is altyd in my gedagtes.   

[Meraai vannie Baai]

Gaan elke dag 'n bietjie beter dankie liefste matertjie. Ek kniel saam met jou om die mooi van elke blom te geniet 

[Meraai vannie Baai]

Met hierdie plasing wil ek 'n teer puntjie aanraak rakende die onkunde van ander oor diegene wat hand om die lyf lewe met 'n kroniese gesondheidsprobleem.

Ons het alreeds gesels oor die gereelde aanhoor van 'maar jy lyk glad nie siek nie' en gepaardgaande frons van beskuldiging wat die opmerking vergesel - veral as jy graag fotos deel wanneer jy en jou gesin ontspan en die lewe geniet.  Bewaar jou siel as jy normaal voorkom iewers tussen in!  Jy is dan veronderstel om 'n terminale siekte te he, hoe durf jy stralend en om alles te kroon, blakend gesond lyk?

Met 'n klop en instap val die nuuskierige agie sommer by die voordeur in: "Ek het jou fotos op FB gesien. Jy lyk so gesond? Geen suurstof nie en jy het gestap..." En dan trek die frons van voorkop tot ken.

Sou jy waag om wel fotos te plaas/deel waar jy ander 'n kykie gee in wat agter die skerms in jou lewe aangaan word jy beskuldig daarvan dat jy 'n sketevraat of aandagsoeker is en hulle hou verby 

'n Siek samelewing voorwaar. Hierdie is 'n geen-wen-situasie en vermorsing van kosbare asem/energie. Waarom voel ons dan skuldig? Dit is nie net ek wat so voel nie - hierdie ervarings word wyd gedeel!

Denise Reich skryf:

Social media photos and observations of chronically ill people smiling and looking “normal” or doing errands have even been used to deny or remove disability benefits, which is quite possibly the most troubling thing of all. It’s hard to understand that disability determination specialists, doctors and government benefits administrators — people who supposedly are knowledgeable about a wide range of health conditions — don’t accept the concepts of good days, payback and invisible illnesses that do not always have linear trajectories.

Nobody ever seems to consider what’s happening outside and around that Facebook photo they’re snarking about. The fact that it might have been the first time in weeks that chronically ill patient got to do something really fun eludes them. They don’t realize how much those activities cost in terms of pain, fatigue and reduced function. They look at one photo or one Facebook status about one day and think they’re an expert on your life.

’m not sure what these people think we’re supposed to do every day. We have incurable chronic illnesses. We often spend most of our time either at home or in treatment as it is. We’re often exhausted and in a lot of pain. If we’re not able to work full time, are we supposed to forgo any and all moments of joy, distraction, social interaction or enjoyment? Will that help us in any way? Being sick is extremely hard for many of us. It’s even harder when hurtful, judgmental types decide that illness should invalidate the fact that we have the same needs as anyone else. Instead of telling chronically ill individuals to shake off comments and accusations, maybe the onus should be on these hecklers to refrain from making them and mind their business. Is it really that hard to leave other people alone?

Bron: https://themighty.com/2016/08/why-i-wont-apologize-for-having-fun-while-sick/

[Meraai vannie Baai]

Ek het gistermiddag 'n opvolgafspraak by ons dokter gehad na my onderonsie met dubbele longontsteking. As gevolg van die newe effekte van 'n vergrote hart en meegaande gevare van hartversaking, het hy my toelaatbare inname van vog beperk tot 1 liter per dag. Dit stel groot uitdagings aan die pasient, veral met die somer in aantog.

Vergewe asseblief die plasing in Engels wat ek leen vanuit Asemdief se bewusmakingsblad.

Being on an extreme fluid restriction (1 liter per day) can be challenging but worth it when diuretics are not enough to get rid of excess fluid. Usually, just limiting sodium is enough to help your body get rid of those extra fluids. Most people do not need to limit their fluids until heart failure is advanced or severe.

Too much fluid in your body can make it harder for your already-weakened heart to pump. This can make symptoms, such as swelling and shortness of breath, worse. If you want to read more on tips how to make sure you stay in the prescribed limit, please follow links provided.

Tracking your fluid intake: My doctor suggested to fill a 1 liter bottle with water. As you drink fluids, take an equal amount of water from the bottle. When the bottle is empty you have reached your fluid limit and should stop drinking.

Remember: Any food that will melt, that has a high water content, or that contains a lot of liquid should be measured and counted as part of your fluid intake too. That means you need to count ice cream, gelatin, ice, juicy fruits, and soup.

Staying away from alcohol is sound advice because it can raise your blood pressure which makes your heart work harder, specially when you have heart failure. Since you are allowed only a limited amount of fluid each day, it is best to choose healthier fluids.

BRONNE:
https://www.cardiosmart.org/~/media/Documents/Fact%20Sheets/en/tb1470.ashx
https://medlineplus.gov/ency/patientinstructions/000112.htm

[Meraai vannie Baai]

(PH) can be a devastating condition that can take a large part of daily routine away from patients, there are exercises that can help you keep moving, living life, and fighting back.
http://pulmonaryhypertensionnews.com/…/upper-body-exercises…

So dankbaar dat ek hierdie oefeninge ontdek het op een van die PH organisasies se bewusmakingsblaaie. Oefening is noodsaaklik en vir die PH pasient nie altyd so maklik nie. Met hierdie oefeninge kon ek byhou maar wil tog 'n waarskuwing gee. Die eerste vier nek-oefeninge en die 'crunch-exercise' kan duiseligheid vererger wat ongelukkig deel is van die asemdief simptome!

Die name wat gegee word aan die onderskeie oefeninge vergemaklik die onthou van die siklus wat gevolg word en kon nie help om wyd te glimlag vir sommiges.  Wie het nou kon dink dat 'folding sheets and holding on to a hundred dollar bill while rowing the boat like wonder women or a snow angel are actually exercises to help you breathe easier?'

 

Nog 'n wonderlike hulpmiddel om jou longe en asemhaling te verbeter is die eenvoudig, dog doeltreffende megheftertjie wat die fisioterapeut in die hospitaal vir my gebring het as geskenk. Jy suig en suig.... totdat jy die balletjies een vir een gelig kry en vir 'n paar sekondes bo kan hou.

In die begin kon ek nie een balletjie gelig kry nie al het ek hoe hard probeer suig 

Een maand later kon ek hierdie reeks fotos neem en het baie trots dit op my FB voorblad gaan deel.

Some people say life sucks but sometimes you can actually improve life by sucking.

[Meraai vannie Baai]

   As jou geheue in die kreukelkamer so kort is soos myne kan hierdie lysie met die benaming van die 'Upper Body Pulmonary Exercises' dalk net die oplossing wees as jy 'n paar keer saam met die DVD op die skakel geoefen het en dit nou op jou eie wil doen. Elke oefening word 10x herhaal en gaan gepaard met asem diep intrek en stadig uitblaas deur saamgeperste lippe.

Hier is die skakel weer:
http://pulmonaryhypertensionnews.com/…/upper-body-exercises…

Die reeks bestaan heel eerste uit vier 'neck exercises' wat ek so onthou 
1. Kopknik (op en af).
2. Kop links en regs op skouers onderskeidelik terwyl jy telkens in die middel stop.
3. Pigeon (laat lyf vorentoe sak en kom weer regop tussen asem in en asem uit).
4. Kopdraai van links na regs en herstel elke keer deur weer vorentoe te kyk.
 
Hierna volg die 'funny name exercises' - lekker asemhaal en uitblaas al sittende 

1. Chicken (arms soos vlerkies op en af na sye en terug).
2. Row the boat (arms gelig en dan roeibewegings).
3. Hundred dollar bill (knyp elmboge langs sye heeltyd, beweeg arms dan sywaarts en weer terug)
4. Touch down (arms na bo gelig en terug tot op bene in sittende posisie).
5. Snow Angel (arms uitgestrek langs sye en op na bo in Y vorm en terug).
6. Folding Sheets (hande bymekaar voor met uitgestrekte arms en vou denkbeeldig lakens oop en toe).
7. Wonder Woman (arms gekruis voor bors, oopgestrek na onder en agter en weer gekruis oor bors).
8. YMCA (arms gekruis op bene, leun vorentoe en beweeg hande af teen bene, herstel weer tot regop sittende posisie).
9. Easy Twisting (arms in sye, draai regs en herstel na middel, draai links en herstel na middel).
10. Hard Twisting (arms uitgestrek na vore, hande saamgeklem. Draai regs met arms reguit gestrek en herstel. Herhaal na linkerkant).
11. Weeping Willow (hierdie beweging lyk soos 'n ballerina. Begin met arm langs been, strek dan na bo en buig oor na links met arm oor kop geswaai. Beweeg terug na middel en laat arm sak langs been. Herhaal oefening na teenoorgestelde kant.
12. Slouch (sak af in stoel. Hou hande oor maag, haal diep asem en blaas uit vir vier tellings.

Dit is vir my wonderlik om weer 'n oefeningprogram te kan volg waar ek kan byhou

NS: Indien jy probleme het met duiseligheid wees asb. ekstra versigtig en vermy die oefeninge wat kan bydrae tot verergering. Dieselfde geld vir rugprobleme ens. Hou matigheid voor oge en pas aan waarby jou liggaam kan baasraak.

[Meraai vannie Baai]

Heesheid kan soms die enigste simptoom wees van twee lewensgevaarlike toestande naamlik PE (pulmonary emboli) en aanleiding tot Pulmonale Hipertensie (PH).

Indien jy dus vir maande lank gepla word deur onverklaarbare heesheid is dit tyd om spesiale aandag aan die 'gewone' verkoue simptoom te skenk.

In 1976, Schoenfield and Budinger reported a case in which severe dilatation of the thrombosed pulmonary artery was accompanied by hoarseness (2). In that case, PE was silent in onset and chronic in duration, and for months, the only symptom was hoarseness.

Besides the typical symptoms and signs of PE involving the pulmonary artery common trunk, such as sudden onset dyspnea, chest pain, and syncope (5), it is feasible that compression of the motor and sensitive branches of the RLN could cause other unusual clinical findings, such as voice box symptoms. Their presence in patients should alert the physician to the possible involvement of the pulmonary artery common trunk and its main branches, and to set up an urgent diagnostic strategy to deal with a life-threatening clinical condition.


Read More: http://www.atsjournals.org/doi/full/10.1164/ajrccm.187.1.108a#.V9YMqPl97IW

'... A 29-year-old lady presented with a 2-year history of hoarseness of voice. Physical examination revealed a mid-diastolic murmur and left vocal cord paralysis. Echocardiography confirmed mitral stenosis with pulmonary hypertension.'
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3433978/

Hoarseness of Voice in a Patient with Mitral Stenosis and Ortner’s Syndrome
Mitral stenosis is a valvular lesion typically seen in adults as a result of childhood rheumatic carditis. If the valve lesion is unrecognized and untreated, serious and potentially fatal complication can occur.

Read more: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3433978/

Ortner's syndrome is a rare cardiovocal syndrome and refers to recurrent laryngeal nerve palsy from cardiovascular disease. It was first described by Norbert Ortner (1865–1935), an Austrian physician, in 1897.

The most common historical cause is a dilated left atrium due to mitral stenosis, but other causes, including pulmonary hypertension, thoracic aortic aneurysms, an enlarged pulmonary artery and aberrant subclavian artery syndrome have been reported compressing the nerve.

Read more: https://en.wikipedia.org/wiki/Ortner%27s_syndrome

[Meraai vannie Baai]

Die bewusmakingsweek vir 'Invisible Illnesses' kom stadig maar seker alweer nader om die boodskap uit dra dat dit wat ons sien nie altyd is wat dit voorgee om te wees nie. Die maskers wat ons dra is soms letterlik en figuurlik.

Hoekom voel 'n mens so magteloos om jou eie pyn/vrese te erken as iemand na jou welstand verneem? Is dit omdat ons weet dat jou kruis dan hulle las word en jy voel dat dit onregverdig is? Die antwoord is JA. 

Intussen gaan ons ongesiens gebuk onder 'n las wat niemand alleen hoef te dra nie. Knak kniege en sak koppe - hang jou selfgemaakte kroontjie skeef en neig om af te val en in skerwe te spat. Wens jy ook dat die 'sondebok' soos in die ou testament, die woestyn ingestuur kon word.
 

Jy word gedurig vermaan om na jouself te kyk /jouself op te pas.

Dit is nie altyd so maklik as wat dit klink nie want daar is nagmerries van skuldgevoelens wat jou blootsry omdat jy nou hulp moet vra vir take wat voorheen gedoen was sonder inspanning... intussen glimlag ons wyd en braaf want daar is omgee-krukke van geliefdes wat ons staande hou.