"Stop the heart?"

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Why do cardiac surgeons stop the heart during surgery?

The conventional technique in coronary bypass surgery includes, among other elaborate procedures, arresting the heart in order for the surgeon to have a quiet (non-beating) and "bloodless" field to do the delicate stitching connection on the tiny (size of a round toothpick) arteries on the surface of the heart. The patient is protected with a heart-lung machine (Pump) that provides circulation and oxygenation while the heart is not beating. After the completion of the coronary bypass, normal heart beat resumes. Today, with additional hands-on specialized training, the cardiac surgeon is able to do coronary bypass on a beating heart, amazingly as it may sound. The procedure is called OPCAB (Off-Pump Coronary Artery Bypass), a minimally invasive technique that does not require the use of the Pump and the coronary bypass is performed on a beating heart. At the Cebu Cardiovascular Center of Cebu Doctors' Hospital, we have found this technique to be most advantageous for appropriately selected heart patients, who recover faster and go home sooner.

What causes diarrhea in babies?

There are various possible causes of diarrhea in infants, but most common cause is viral intestinal infection due to enteroviruses. Other causes are bacteria (salmonella, shigella, E. coli, campylobacter), food or milk allergy, food poisoning (contaminated food, shellfish, mushrooms) parasites (ascaris, giardia), from side effect of antibiotics they are taking, and Rotavirus infection (the worst). There are no effective drugs for viral intestinal infection. Over-the-counter drugs for diarrhea can be dangerous for infants and younger children. These medications usually worsen the intestinal injury by transferring valuable fluid and salt (sodium) out of the circulating blood stream into intestinal walls, leading to swelling of the intestines. This fluid "escape" (transfer) dehydrates the baby even when the diarrhea appears to have stopped. Dehydration is very dangerous in infants and young children. Dehydration can kill within matter of hours. Oral fluid replacement for mild diarrhea, and intravenous fluid infusion for more severe ones, are the treatment of choice, and each works wonders. When diarrhea occurs, seek medical consultation the same day. A delay may jeopardize the life of your child.

Why do lungs collaspse?

Pneumothorax (medical term for collapsed lungs) literally means "air (pneumo) inside the chest cavity (thorax)," causing the lungs to collapse. Normally, the spongy lungs inside the chest are like inflated balloons inside a sealed air-tight cavity. There is no air inside the chest cavity; the air is inside the balloons (lungs) only, which our body uses for oxygenation and removal of carbon dioxide (air exchange during breathing). As a matter of fact, there is a vacuum (negative pressure) inside the chest, which is one factor that keeps the lungs inflated. The outer surfaces of the lungs all around are hugging the inside wall of the chest cavity, smack against the chest wall, with no space between them but a vacuum. Any opening in the chest wall or laceration of the lungs (like stab wound or gunshot wound) will make the negative pressure inside the chest (vacuum) rapidly suck in air from the environment, which is positive (higher) pressure, into the chest cavity. Since the chest is a fixed, unyielding, cavity, surrounded by ribs all around, the air that is suck in accumulates and fills up the chest, putting pressure, squeezing and crowding out the soft and spongy lungs, causing them to collapse. The treatment is inserting a chest tube to suck OUT the air inside the chest and allow the lungs to expand and function properly.

Do steroid inhalers help prevent asthmatic attacks?

In combination with steroid pills, yes, inhalers with steroids cut down asthmatic attacks by 50%, according to Brian H. Rowe, M.D., lead researcher of the University of Alberta in Edmonton in an article in the Journal of the American Medical Association. Those who presented to the Emergency Rooms and sent home only on steroid pills had more relapses, compared to those discharged on steroid pills and nasal inhaler with steroids.

Do herbal medications increase the risk of surgery?

Herbal drugs like Gingko, ginseng, or garlic can cause increased risk of excessive bleeding and other complications among patients undergoing surgery, according to an article from the Pritzker School of Medicine at the University of Chicago published in the Journal of the American Medication Association. These medications, taken by about 12% of Americans, interact with drugs prescribed for surgery, increasing the potency of anesthetic agents, and preventing normal clotting of blood. St. John's Wort increases metabolism, Ephedra causes irregular heartbeat, ginseng can aggravate low blood sugar level, kava and valerian exaggerates the effects of anesthetic agents, and Echinacea makes the patient prone to poor wound healing and infection. It is most important for patients to tell their surgeons what medications, herbal or proprietary, they are taking, because many of these may have to be stopped weeks before surgery to prevent complications. To begin with, the fundamental question is: Are any of these herbal medications really as safe, beneficial and effective as they are claimed to be? The US-FDA, the Philippine BFAD, and the international medical community, are still waiting for scientific proofs on the efficacy, value and safety of these, and dozens of other, herbal medications on the market. The final verdict is not out yet.

What gadget can prevent sudden cardiac death?

An medical device that can prevent sudden death among heart patients is called AICD (automatic implantable cardioverter defibrillator). It is a small titanium shelled unit (about 2 x 3 x 1 inches), larger than a heart pacemaker, which is implanted under the skin in the left or right upper chest. This unit has a computerized component that senses the heart rhythm round the clock. When serious or fatal heart rhythm disturbance occurs, this AICD rapidly (within seconds) cardioverts (shocks) the heart back to normal sinus (normal) rhythm and thus prevent sudden cardiac arrest. AICD was the unit recently implanted in U.S. Vice President Dick Cheney, who did well and was discharged from the hospital the same day after the implant.

Why causes milk intolerance?

Some people (many Asians) have intolerance to milk, to any food made with milk, and to other dairy products. This is caused by lactase deficiency. Lactase is an enzyme normally present in our digestive system. People who, from infancy to adult life, have been drinking milk, or consuming dairy products regularly, produce adequate amount of lactase in their digestive system to help digest these foods. Those who did not develop the habit of drinking milk or eating dairy products from early on have diminished or insufficient lactase enzyme, and therefore, unable to digest lactose (complex sugars in dairy foods). When they start drinking milk or eating dairy products later in life, these individuals are unable to digest the lactose in their digestive tract, which results in abdominal discomfort, gas, cramps, sensation of bloating, and even diarrhea. Today, there are lactase pills (one of them called Lactaid, with 9000 FCC Lactase units) available in drug stores. These pills are heaven-sent for countless individuals, who would otherwise not enjoy milk, ice cream, milk shakes, pizzas, cakes and other desserts, creamy soups, sauces, and other dairy products. If you think you have lactose intolerance, consult your physician about lactase dietary supplement.

©2003Raoul R. Diez, M.A.O.D.