Tuesday, June 21, 2011

Respecting kidneys

By Richard P. Holm MD

Your two bean-shaped fist-sized filtering organs called the kidneys, as the comedian says, “just don’t get no respect.” We take them for granted until they stop working.

But there is more to these inglorious and obscure organs than you would think. Each day something like 200 quarts of blood are pushed through the kidneys to remove about 2 quarts of urine loaded with toxins and waste products. But these guys aren’t just filtering out waste.

Kidneys know when to remove excess water when over-loaded or to conserve water when dehydrated; they know how to and when to balance electrolytes and body chemicals; they stimulate the bone marrow to make blood when red cells are low; they stimulate bones to grow and to strengthen when needed; and along with several other body systems, they measure, manipulate, and balance the blood pressure in order to get oxygenated blood out to all the cells of the body.

So what can hurt these magnificent unappreciated organs and then what should we do to protect them?

Inherited and genetically caused problems, autoimmune illnesses, birth defects, aging blood vessels, infections, blocking kidney stones, certain medicines, and even environmental toxins all can cause kidney trouble.

Of course if blood pressures are too high then kidneys can be harmed, but the opposite is true, too. That is, sometimes sick kidneys may be the cause of high blood pressure, making it hard to know which one is the egg and which one is the chicken.

By far the most common destroyer of kidneys, however, is a prolonged exposure to high sugar levels. Indeed, diabetes mellitus is responsible for about 40% of all kidney failure, and with the epidemic of obesity and diabetes in this country, we are facing a future where there will be more people suffering with kidney failure than ever before.

The formula for each individual to best avoid such a fate has to do mostly with living a healthy life-style, that is to get regular exercise and eat a balanced smaller portioned diet.

Your kidneys deserve a little respect.

Wednesday, June 8, 2011

To straighten the bones of children

By Richard P. Holm M.D.

The history of medicine is filled with stories of bonesetters, and in the middle ages they even had a guild. These people splinted broken bones with sticks, leather, and clay casts, and were separate from physicians and barber surgeons.

Then in the 1700s, Nicholas Andre’ a professor of medicine at the University of Paris, formally described methods to treat boney deformities in newborn children such as clubbed feet with splinting. He described similar methods used for the straightening of young tree saplings. Andre’ wrote a textbook on the subject titled L’Orthopedie. The ancient Greek word orthos means free from deformity, to straighten, to make right; and the Greek word paideia refers to the art of raising a child. Literally orthopedics means to straighten the bent bones of children. Together they provide for the name of a present day surgical specialty, but other things needed to happen first.

In the mid-1800s ether and then chloroform were discovered. Available and popularized during the Civil War, anesthesia made amputations a way to save lives after limbs were shattered from dirty gunshot wounds. It wasn’t until after the war that we learned of bacteria and discovered how antiseptic methods could prevent the need for amputation, and avoid infection after surgery. Just about at the same time, X-rays were discovered by Wilhelm Roentgen, which allowed for the marvelous and revealing image of our internal boney structure.

This all set the stage for expanding the orthopedic focus from just casting deformities of children. In the 1890s a well-known bonesetter from Liverpool, England, Evan Thomas encouraged his son Hugh to go to Medical School, and afterward taught Hugh bone setting and casting methods, which at the time were not being taught in Medical School. Hugh and his nephew Robert Jones worked together to develop orthopedic surgical methods in treating not just deformed children, but also bone injuries to construction workers, and then war injuries to military men during World War I.

And thus we have come from bonesetters, and straightening the bones of children, to the marvelous field of orthopedic surgery.

Wednesday, June 1, 2011

Tornado Alley

By Richard P. Holm M.D.

Did you know that three out of four tornadoes in the world happen in the U.S. and that many of them occur in this neck of the woods? They call it tornado alley starting early in Texas, and progressively later in the season through the spring and summer up through Oklahoma, Missouri, Kansas, Nebraska, and the Dakotas. That said tornadoes can happen anywhere and at any time of the year.

A tornado typically forms when a cold front with wind going one way bumps up against warm moist air with wind going the other way. The theory goes that updrafts on one side, and falling rain on the other can start these opposing winds spinning. When one end of the twisting wind is sucked into the updraft of a tall thundercloud, the speed of the whirling is enhanced and becomes concentrated as it tightens down into a funnel, much like a skater spins faster as the arms and legs come in.

About two percent of tornadoes reach speeds of up to 300 mph causing 70% of the damage, and 70% are minimally destructive, with winds of less than 110 mph.

The major rule to protect oneself from tornadoes is to avoid flying debris. Experts advise avoiding windows, (and not wasting time opening them.) If you are in a sturdy permanent home, go to a lower central windowless room, maybe under a stairwell, or in a bathtub. Get low and cover with a mattress or sleeping bag if possible. If in a mall or church, avoid large spaces; find a hallway, bathroom, or smaller windowless room and crouch.

If you are in a mobile home or a vehicle of any kind, get out, as these are all extremely dangerous in a tornado. In a vehicle, if you can safely drive away, do so. Otherwise get off the road, get out and away from anything that can roll over or fall on you. If you cannot find a permanent sturdy building, you are safer in a lower spot or ditch away from cars or trees. Lie flat or crouch; face down, with your arms covering your head. Avoid bridges as they offer little protection against flying debris.

It is wise to make a plan and be prepared since we live in tornado alley.