A Simple Guide to Multiple Myeloma

A Simple Guide to Multiple Myeloma
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What is Multiple Myeloma?
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Multiple myeloma is cancer of the bone marrow which occurs from the uncontrolled growth of plasma cells, a form of immune-protective white blood cells.
Normally plasma cells make antibodies to fight infections.
The disease is called multiple myeloma because myeloma cells can occur in multiple bone marrow sites in your body.

What are the Risk factors in Multiple Myeloma?
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1.Age. The majority of people who develop multiple myeloma are older than 50, with most diagnosed around age 70.

2.Sex. Men are more likely to develop the disease than are women.

3.Exposure to radiation and working in petroleum-related industries.

4.History of a monoclonal gammopathy of undetermined significance.

5.Obesity. Your risk of multiple myeloma is increased if you're overweight or obese.

What are the causes of Multiple Myeloma?
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The exact cause of Multiple Myeloma is not known.
However doctors do know that multiple myeloma begins with one abnormal plasma cell in your bone marrow . This abnormal cell then starts to multiply. Because abnormal cells don't mature and then die as normal cells do, they accumulate slowly reducing the number of healthy cells.
Myeloma cells may circulate in low numbers in the blood, populating other bone marrow sites far from where they began. Uncontrolled plasma cell growth can damage bones and surrounding tissue.

What are the Symptoms of Multiple Myeloma?
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Common symptoms include:
1.Anemia or pallour can occur as myeloma cells replace oxygen-carrying red blood cells in your bone marrow,
2.fatigue
3.Bone pain.
4.Nausea
5.Loss of appetite
6.Mental confusion
7.Presence of abnormal proteins produced by myeloma cells in your blood or urine. These proteins which are antibodies are called monoclonal, or M, proteins.
8.High level of calcium in your blood. This can occur when calcium from affected bones dissolves into your blood. A high calcium level in your blood may cause symptoms such as:
9.Excessive thirst and urination
10.Constipation

How do you diagnose Multiple Myeloma?
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Multiple myeloma can be diaqgnosed before you ever have symptoms through blood and urine tests.Blood and urine tests
1.blood test called serum protein electrophoresis separates your blood proteins and can detect the presence of M proteins in your blood.
When found in urine, they're referred to as Bence Jones proteins.
2.Another blood test to check for beta2-microglobulin — another protein produced by myeloma cells
3. Imaging.
a.X-rays of your skeleton can show whether your bones have any thinned-out areas, common in multiple myeloma.
b. magnetic resonance imaging (MRI) or computerized tomography (CT) scanning.
4.Bone marrow examination is done by using a needle to remove a small sample of
bone marrow tissue. The sample is then examined under a microscope to check for myeloma cells.

What are the Complications of multiple myeloma?
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Multiple myeloma can result in several complications:
1.Impaired immunity. Myeloma cells inhibit the production of antibodies needed for normal immunity which may make you more likely to develop infections, such as pneumonia, sinusitis, bladder or kidney infection, skin infections and shingles.

2.Bone problems. Multiple myeloma also can affect your bones, leading to erosion of bone mass and fractures. The condition may cause compression of your spinal cord. Signs of this medical emergency include weakness, or even paralysis, in your legs.

3.Impaired kidney function.
Higher calcium levels in the blood related to eroding bones can interfere with your kidneys' ability to filter your blood's waste. The proteins produced by the myeloma cells can cause similar problems, especially if you become dehydrated.

4.Anemia. As cancerous cells crowd out normal blood cells, multiple myeloma can also cause anemia and other blood problems.

What are the Treatment of Multiple myeloma ?
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There is no cure for multiple myeloma.
However, with good treatment results you can usually return to near-normal activity.
The appropriate multiple myeloma treatment depends on the stage of the illness, medical status and general health.
Chemotherapy.
Chemotherapy involves using
1.Anti Cancer medicines taken orally as a pill or given through an intravenous (IV) injection to kill myeloma cells. Chemotherapy is often given in cycles over a period of months, followed by a rest period.
2.Corticosteroids. Corticosteroids such as prednisone and dexamethasone (Decadron) have been used for decades to treat multiple myeloma.
3.Thalidomide is currently FDA-approved in conjunction with the corticosteroid called dexamethasone for the treatment of newly diagnosed cases of multiple myeloma. This drug is given orally.

Radiation therapy.
This treatment uses high-energy penetrating waves to damage myeloma cells and stop their growth. Radiation therapy may be used to target myeloma cells in a specific area to more quickly shrink a tumor that's causing pain or destroying a bone.

Stem cell transplantation.
This treatment involves using high-dose chemotherapy usually high doses of melphalan along with transfusion of previously collected immature blood cells (stem cells) to replace diseased or damaged marrow. The stem cells can come from you or from a donor, and they may be from either blood or bone marrow

Treating complications
Back pain. Taking pain medication or wearing a back brace can help relieve the back pain you might experience with multiple myeloma.
Infections. Antibiotics may be necessary to help treat infections or to help reduce your risk of them.
Bone loss. You may take medications called bisphosphonates which bind to the surface of your bones and help prevent bone loss.
Anemia. If you have persistent anemia, your doctor may prescribe erythropoietin injections. Erythropoietin is a naturally occurring hormone made in the kidneys that stimulates the production of red blood cells. .
Kidney complications. People with severe kidney damage may need dialysis

A Simple Guide to Hypertension

A Simple Guide to Hypertension

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What is Hypertension?

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Hypertension, or high blood pressure, refers to a condition in which the blood is pumped around the body above normal pressure.

It is a silent disorder and the only way to detect it is to have your blood pressure checked.

When is it High Blood Pressure?

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Blood pressure is not fixed. It varies with time of day or night, physical activity and emotional factors. Therefore, blood pressure has to be taken under resting condition and on more than one occasion.

A blood pressure reading of 120/80 is read as 120 over 80 millimetres of mercury.

The top number is your systolic pressure. This is the pressure in your arteries when your heart pumps.

The bottom number is your diastolic blood pressure. This is the pressure measured in your arteries when your heart relaxes between pumps.

Blood pressure may vary from 90/60 in a young healthy person to 130/80.

Normal blood pressure is below 130/80.

Blood pressure between 130/80 and 139/89 is called "pre-hypertension".

Blood pressure of 140/90 or above is considered high.
Hypertension is present when your blood pressure is persistently at or above 140/90( at least 3 consecutive readings).

What are the Causes of Hypertension?

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In 95% of cases, there is no definite known cause and it is known as essential hypertension. Older people and men are more likely to develop high blood pressure.

It also tends to run in families. Although, you may inherit the tendency to get high blood pressure, other lifestyle choices (eating an unhealthy diet, smoking, not exercising) will often determine if you eventually get the disease.

The other 5% of high blood pressure cases are due to kidney disease, glandular (hormone/endocrine) problems or a side effect of some medications and are called secondary hypertension.

Listed below are some causes of secondary hypertension:

Adrenal gland tumours

Cushing's syndrome

Kidney disorders

Kidney failure

Use of medications, drugs, or other chemicals

Pregnancy or the use of oral contraceptives

Diabetes mellitus

Obesity

What are the Symptoms of Hypertension?

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Hypertension often causes no noticeable symptom but can cause damage of various organs in the body if the blood pressure remains persistently high. It is thus often called the silent killer. Over years it can lead to damage to the heart and blood vessels, making it more likely that the individual will develop a stroke or heart attack.

Occasionally, especially when the blood pressure is extremely high, the individual may experience:

Headaches,

Dizziness,

Alterations in vision.

Confusion

Nausea

Vomiting

Anxiety

Excessive perspiration

Redness of the face or other areas

Muscle tremors

Angina-like pain: crushing central chest pain

How is Hypertension Assessed?

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Assessment of hypertension is important in determining the known causes of Hypertension (5%) and in the treatment of the condition:

1. Medical history

2. Physical examination

3. Evidence of complications

4. Blood and urine tests

5. Chest x-ray

6. ECG (electrocardiogram)

What are the Complications of Hypertension?

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Hypertension is an important risk factor for coronary heart disease and cerebrovascular disease e.g. strokes.

Poorly controlled hypertension ultimately can cause damage to blood vessels in the eye, thickening of the heart muscle and heart attacks, hardening of the arteries (arteriosclerosis), kidney failure, and strokes.

An elevation of the systolic and/or diastolic blood pressure increases the risk of developing

1. Heart (cardiac) disease,

2. Kidney (renal) disease,

3. Hardening of the arteries (atherosclerosis),

4. Eye damage, and

5. stroke (brain damage).

These complications of hypertension are often referred to as end-organ damage because damage to these organs is the end result of chronic (long duration) high blood pressure.

For that reason, the diagnosis of high blood pressure is important so efforts can be made to normalize blood pressure and prevent complications.

It was previously thought that rises in diastolic blood pressure were a more important risk factor than systolic elevations, but it is now known that in people 50 years or older systolic hypertension represents a greater risk.

Prevention, early detection and adequate treatment of hypertension are necessary to prevent complications of hypertension.

What is the Treatment of Hypertension?

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The aim of treatment is to reduce the risk of complications.

This is done in 2 ways:

Control of high blood pressure

Management of the risk factors eg obesity, diabetes, raised blood cholesterol

Every hypertensive patient or person at risk of developing high blood pressure should adopt a healthy lifestyle.

This means eating wisely:

A diet with reduced salt,

Low fat and high fibre.

Keep your weight in the healthy range,

Exercise regularly,

Not smoke or drink and

Manage your stress better.

Occasionally, marginally raised blood pressure goes back to within the normal range when the patient loses weight, exercises more and cuts down salt intake.

If these measures are not successful, then drug treatment is necessary.

Once medication is started, it important to continue treatment as well as continue with healthy lifestyle practices.
The goal of treatment is to reduce blood pressure to a level where there is decreased risk of complications. Your doctor will try to prescribe a single drug with minimal side effects to control your hypertension. But if a single drug does not work, he will prescribe two or more drugs.

Some of the common drugs used are:
1. Diuretics, which increase urination, to reduce salt and water retention and lower blood volume. They may be used alone or in combination with other drugs.

2. Beta-blockers, which slow the heart rate and cause the heart to beat less forcefully. 3.Calcium channel blockers which relax the blood vessels by slowing the entry of calcium into cells.

4. Angiotensin-converting enzyme (ACE) inhibitors which block the production of angiotensin II (which causes arteries to constrict and stimulate the release of a hormone which causes salt retention).

5. Angiotensin II receptor blockers (ARB) which relax blood vessels by blocking the action of angiotensin II.

Which drug is suitable for you depends on the effectiveness of the drug on your blood pressure and also on the side effects. If the the side effects are severe, it is advisable to change the medications until you have a suitable drug.

Treatment for most people is life-long.

Do not stop or reduce the dosage of your medications without consulting your doctor.

For effective blood pressure control, you should visit your doctor regularly to monitor your blood pressure. You can also monitor your own blood pressure at home with an electronic blood pressure monitor.

How do you prevent the risk of Hypertension?

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You can adopt these lifestyle measures to reduce your risk of high blood pressure.

Lifestyle changes are also important for those who already have high blood pressure.

1.Lose weight, if overweight. Excess weight adds to strain on the heart. In some cases, weight loss may be the only treatment needed.

2.Adopt a healthy diet. Dietary adjustments may be beneficial, especially a decrease of sodium in your diet. Sodium intake may have little effect in persons without hypertension but may have a profound effect in those with hypertension. Salt, MSG, and baking soda all contain sodium. Make sure you eat a diet rich in vegetables and fruit and low in fat.

3.Stay active. Do at least 30 minutes of moderate intensity exercises five or more days a week. You can break up the 30 minutes of exercise a day into 10 minute bouts. As your fitness level improves, do vigorous intensity exercise for 20 minutes a day at least 3 times a week for example, jogging or swimming continuous laps. Remember to consult your doctor before you embark on any exercise plan.

4.Stop smoking. If you are a smoker, stop smoking. Smoking greatly adds to the risk of suffering a heart attack or stroke.

5.Limit alcohol intake. Keep your alcohol intake to less than 1 or 2 standard drinks a day.

6.Learn to relax and avoid stress. Meditation, yoga, tai-chi are some ways in which you can learn to relax and lead a less stressful life.

REMEMBER that long term effective control of high blood pressure is crucial in reducing the risks of serious complications of HYPERTENSION !

A Simple Guide to Anaemia

A Simple Guide to Anaemia
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What is Anaemia?
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Anaemia is a blood condition in which the haemoglobin is lower than the average value of a normal person. The Haemoglobin is the red chemical in red blood cell which carries oxygen around our bodies.

What Causes Anaemia?
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The commonest causes of anaemia is:

1. blood loss such as excessive menstrual flow or
internal bleeding from the stomach or bowel

2. deficiency in the diet for foods rich in iron, vitamin B12 or folic acid.

3.inherited abnormalities (Thalassaemia)

4. kidney failure ,liver disease

5. cancer patients

5.certain drugs such as anti cancer drugs and toxic substances such as lead

6. infections (haemorhagic dengue fever) & worm infestation

7.radiation therapy,

8.surgery on the gastro-intestinal tract, particularly the stomach.

What are Symptoms of Anaemia?
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Easy fatigue :
This is due to lack of oxygen in the red blood cells
Pale skin :
The lack of haemoglobin cause the redness of the blood cells to be reduced hence the pale appearance of the skin.The finger nails and lower eyelids can be checked for the paleness.
Dizziness:
Giddiness occurs when there is insufficient oxygen supply to the nerve cells in the brain.
Unusually rapid heart beat:
Rapid heart beat may occur becuse the heart has to pump faster to supply enough oxygen to the body
Difficulty concentrating and headache:
These are caused by insufficient oxygen to the brain.
Leg cramps
Leg cramps are due to insufficient oxygen to the muscles.
Shortness of breath:
Breathing difficulty may occur as a result of insufficient oxygen in the lungs

What is the Treatment of Anaemia?
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1.Treat the underlying cause of the anaemia.

2.Eat a well-balanced diet that includes good sources of
iron (liver, meat, peas, beans, whole grain),
vitamin B12 (foods of animal origin only, including meats, liver and kidney, milk, cheese, fish, shell fish and eggs)
folic acid( present in most vegetables).
Vitamin C can make the stomach more acidic and can improve the absorption of iron in your diet.

3.Reduce your consumption of caffeine products and tea as they can decrease the absorption of iron.