What happened to you is actually not that unusual. I do believe that, with some diet changes and maybe a visit to your regular doctor, we may have a chance to make another gout attack much less likely.
Gout is a type of arthritis caused by uric acid crystals forming inside the joint or a space between two bones. The most common location for gout is at the base of a big toe, but it can affect other joints as well.
Uric acid is a product of a breakdown of purines -- substances found in foods like beans, asparagus, mushrooms and certain meats and seafood. The most common symptoms of gout are a red, swollen, painful toe or other joint and, for some, fatigue and fever. The intensity is the worst in the first 12 to 24 hours, but the symptoms may continue for weeks. It is important to know that this is a self-limiting illness, which means that it will eventually go away even when not treated by any medication.
Gout affects about 1 to 2 percent of the population in the United States. It is generally more common in men, but it can attack women, especially after menopause. It is a very old disease -- it was known by Egyptians in ancient times. It has been called the "disease of the kings" due to its presumed association with eating certain foods and alcohol.
Now you may ask why exactly the uric acid crystallizes inside the joints. It is due to one of two reasons. There may be too much of the uric acid made by the body, which happens in about 10 percent of cases. But, more often, the kidneys are unable to get rid of the uric acid properly and, as a result, there is just too much uric acid in the blood. The level of uric acid can be measured by a blood test and, to some extent, can guide treatment and diet modifications. Interestingly enough, gout attacks are influenced by outside temperatures, which is why they happen more often in early morning. Uric acid may also crystallize in other parts of the body, causing funny-looking, small, painless lumps around joints and tendons, which doctors call "tophi." Gout is also associated in some people with kidney stones -- again caused by the uric acid.
This disease does run in families, but just because your dad or mom has had it does not mean you will get it as well.
It is also associated with elevated blood pressure, obesity and elevated cholesterol. As we have mentioned before, excessive alcohol use (more than two drinks daily) is one of the risk factors. Some medications can make gout attacks more likely. Simple aspirin and commonly used water pills -- known in "doctor talk" as thiazide diuretics -- have been associated with gout.
On the other hand, coffee and vitamin C, as well as dairy foods and physical exercise, may be protective for gout sufferers. as they lower uric acid levels in the blood.
2012年1月4日星期三
2011年10月19日星期三
Patient Sues Hospital, Nurse in Painkiller Theft
Hearing Larry King describe his kidney stone surgery from last November can make anyone squirm.
“It felt to me like someone was taking needles and pushing them down through your back and into your kidney,” says King.
On Tuesday, King filed a lawsuit against Allina Health Systems, Abbott Northwestern Hospital, and his former nurse, Sarah Casareto.
Earlier this year, Hennepin County prosecutors accused Casareto of stealing King’s pain medication during surgery. Through a plea deal, the charge was dismissed. As long as Casareto does not violate her three year probation, she will avoid jail time, fines, and her record will remain clean.
“I think that was one of the deciding factors with going forward with the civil case. Justice was not served,” said King’s attorney, Tony Nemo from the Meshbesher and Spence law firm. “Michael Vick was mean to some dogs. He got 23 months. This woman was mean to a patient and walked. She's not going to walk in this case."
King says everything started off normal at Abbott Northwestern Hospital on Nov. 8, 2010. But when his nurse started wheeling him toward radiology, things started to get weird.
“It was at that point she said to m, 'You are going to have to man up here and take some pain because you are going into surgery and we can't give you that much medication,'” said King. "That made me nervous because my radiologist said it would be fine and, ''You won't feel any significant pain.'”
King said he felt extraordinary pain and heard conversations going on around him during surgery, but said Casareto was noticeably absent.
“At one point, I could hear him talk to the nurse again and say, 'Get over here.' I didn't know where she was, but at one point when I was locked up tight -- I don't know if I was panicking at that point, but I lifted myself up with my forearm and turned to look where she was. I couldn't see her. I didn't know where she was. Doctor took his forearm and just rested it on my back,” recalled King. “Finally, a tech reached over and said "breathe" and put me out. At that point, I don't remember anything more.”
That was about half way through the hour-long procedure.
“He was supposed to be given Fentanyl and Versed, which gives you sort of amnesia,” said Nemo. “So, the fact that he remembers anything is shocking.”
King’s attorney and Hennepin County prosecutors have said he was given about a third of the medication Casareto had signed out from the hospital. Coworkers told investigators she was acting bizarre, dropping syringes, staggered in the operating room and was later found with at least two unlabeled syringes in her pockets.
“Falling asleep, rocking back and forth, and talking about going to a happy place. This guy was having a procedure done without anesthetic. He wasn't in a happy place and she was not going to put him there,” said Nemo. “She was in such a state, I don't think she could add and subtract -- and she could have easily killed him by overdosing him.”
Casareto’s lawyer, Brian Toder, said statements from the same surgical staff contradict what King claims. After the criminal case was dismissed, Toder says he is surprised by the civil suit.
During the criminal proceedings earlier this year, Casareto missed some court appearances because she was in drug treatment. Toder says she is no longer in treatment and said she never lost nursing license.
“She simply agreed not to practice until after there was resolution to the criminal case, followed by an appearance before the Nursing Board," Toder said.
“It felt to me like someone was taking needles and pushing them down through your back and into your kidney,” says King.
On Tuesday, King filed a lawsuit against Allina Health Systems, Abbott Northwestern Hospital, and his former nurse, Sarah Casareto.
Earlier this year, Hennepin County prosecutors accused Casareto of stealing King’s pain medication during surgery. Through a plea deal, the charge was dismissed. As long as Casareto does not violate her three year probation, she will avoid jail time, fines, and her record will remain clean.
“I think that was one of the deciding factors with going forward with the civil case. Justice was not served,” said King’s attorney, Tony Nemo from the Meshbesher and Spence law firm. “Michael Vick was mean to some dogs. He got 23 months. This woman was mean to a patient and walked. She's not going to walk in this case."
King says everything started off normal at Abbott Northwestern Hospital on Nov. 8, 2010. But when his nurse started wheeling him toward radiology, things started to get weird.
“It was at that point she said to m, 'You are going to have to man up here and take some pain because you are going into surgery and we can't give you that much medication,'” said King. "That made me nervous because my radiologist said it would be fine and, ''You won't feel any significant pain.'”
King said he felt extraordinary pain and heard conversations going on around him during surgery, but said Casareto was noticeably absent.
“At one point, I could hear him talk to the nurse again and say, 'Get over here.' I didn't know where she was, but at one point when I was locked up tight -- I don't know if I was panicking at that point, but I lifted myself up with my forearm and turned to look where she was. I couldn't see her. I didn't know where she was. Doctor took his forearm and just rested it on my back,” recalled King. “Finally, a tech reached over and said "breathe" and put me out. At that point, I don't remember anything more.”
That was about half way through the hour-long procedure.
“He was supposed to be given Fentanyl and Versed, which gives you sort of amnesia,” said Nemo. “So, the fact that he remembers anything is shocking.”
King’s attorney and Hennepin County prosecutors have said he was given about a third of the medication Casareto had signed out from the hospital. Coworkers told investigators she was acting bizarre, dropping syringes, staggered in the operating room and was later found with at least two unlabeled syringes in her pockets.
“Falling asleep, rocking back and forth, and talking about going to a happy place. This guy was having a procedure done without anesthetic. He wasn't in a happy place and she was not going to put him there,” said Nemo. “She was in such a state, I don't think she could add and subtract -- and she could have easily killed him by overdosing him.”
Casareto’s lawyer, Brian Toder, said statements from the same surgical staff contradict what King claims. After the criminal case was dismissed, Toder says he is surprised by the civil suit.
During the criminal proceedings earlier this year, Casareto missed some court appearances because she was in drug treatment. Toder says she is no longer in treatment and said she never lost nursing license.
“She simply agreed not to practice until after there was resolution to the criminal case, followed by an appearance before the Nursing Board," Toder said.
2011年9月29日星期四
Pregnant woman's wreck has happy ending
Monique Whitfield started feeling pain in her lower back and stomach sometime Tuesday morning.
Could this be the onset of labor, she wondered, or was it kidney stones acting up again?
"I didn't know," Whitfield admitted.
Regardless, she needed to get it checked out. So she got in her car and headed toward Baptist Memorial Hospital-Golden Triangle.
But she decided to take a quick detour first.
Whitfield owns a beauty salon in Columbus, and the power bill was due.
She took the Main Street exit onto Highway 82 eastbound, and at around 12:15 p.m., she lost control of her car.
"It didn't go as planned," Whitfield said.
As Whitfield was driving along the exit ramp, her car ran off the right side of the road. The dark blue Dodge Ram Charger knocked down a light post and highway signage, traveled down a slope and ended entrenched in the trees alongside the highway.
"It was already slippery because it had been raining," Whitfield said. "When I got to the curb, I hit the brakes, and I lost control of the car."
She was nine months pregnant.
'Two angels'
Derek Whitfield, Monique's husband, was the first one to receive a phone call from his wife after the crash.
"I was scared," he said. "I didn't know. Anything could have happened (to the pregnancy)."
Monique Whitfield was unable to open her door due to trees and bushes surrounding the wrecked vehicle.
"It was awful," Monique Whitfield said.
However, two passersby saw the accident and called for help.
"Thank God for the two people who did see the accident," Diane Moore, Monique's mother, said. "I thank God for the two angels he sent."
Emergency response units rushed to the scene, removed shrubs and branches to get a stretcher near the driver's side door and carried Monique from the vehicle to a nearby ambulance. She was transported to BMH-GT.
Could this be the onset of labor, she wondered, or was it kidney stones acting up again?
"I didn't know," Whitfield admitted.
Regardless, she needed to get it checked out. So she got in her car and headed toward Baptist Memorial Hospital-Golden Triangle.
But she decided to take a quick detour first.
Whitfield owns a beauty salon in Columbus, and the power bill was due.
She took the Main Street exit onto Highway 82 eastbound, and at around 12:15 p.m., she lost control of her car.
"It didn't go as planned," Whitfield said.
As Whitfield was driving along the exit ramp, her car ran off the right side of the road. The dark blue Dodge Ram Charger knocked down a light post and highway signage, traveled down a slope and ended entrenched in the trees alongside the highway.
"It was already slippery because it had been raining," Whitfield said. "When I got to the curb, I hit the brakes, and I lost control of the car."
She was nine months pregnant.
'Two angels'
Derek Whitfield, Monique's husband, was the first one to receive a phone call from his wife after the crash.
"I was scared," he said. "I didn't know. Anything could have happened (to the pregnancy)."
Monique Whitfield was unable to open her door due to trees and bushes surrounding the wrecked vehicle.
"It was awful," Monique Whitfield said.
However, two passersby saw the accident and called for help.
"Thank God for the two people who did see the accident," Diane Moore, Monique's mother, said. "I thank God for the two angels he sent."
Emergency response units rushed to the scene, removed shrubs and branches to get a stretcher near the driver's side door and carried Monique from the vehicle to a nearby ambulance. She was transported to BMH-GT.
2011年9月19日星期一
Nurse Accused of Stealing Pain Meds Gets Probation
The nurse who reportedly told her patient to "man up and take some pain" after allegedly stealing a portion of his intended fentanyl dose has copped a plea that will keep her out of jail.
Sarah Casareto, RN, received 3 years' probation as part of the plea agreement. The alleged theft occurred while she was tending to patient Larry King, 56, who was on his way to the OR forkidney stone
"Clearly I remember (the "man up" comment)," Mr. King told local reporters. "I can't really use the language I'd use to describe what it's like when you lay on that table and can hear and feel everything they're doing to you."
OR personnel reportedly had to hold down the screaming and moaning Mr. King during the procedure. Ms. Casareto, who was said to appear drugged, told him to "Go to your beach. Go to your happy place."
Ms. Casareto's attorney says he was prepared to call witnesses who would have denied that Mr. King was in excessive pain during the procedure. But he refused to comment further, citing Ms. Casareto's pending review before the state nursing board, where she will attempt to regain her license.
Tony Nemo, Mr. King's attorney, says he "vigorously" opposed the plea deal and is pursuing civil lawsuits against Ms. Casareto and the hospital that formerly employed her.
"Due to confidentiality we cannot discuss current or former employees," said Abbot Northwestern in a statement issued at the time of Ms. Casareto's arrest in February. "She no longer works (at the hospital). Patient safety is our primary concern."
Sarah Casareto, RN, received 3 years' probation as part of the plea agreement. The alleged theft occurred while she was tending to patient Larry King, 56, who was on his way to the OR for
"Clearly I remember (the "man up" comment)," Mr. King told local reporters. "I can't really use the language I'd use to describe what it's like when you lay on that table and can hear and feel everything they're doing to you."
OR personnel reportedly had to hold down the screaming and moaning Mr. King during the procedure. Ms. Casareto, who was said to appear drugged, told him to "Go to your beach. Go to your happy place."
Ms. Casareto's attorney says he was prepared to call witnesses who would have denied that Mr. King was in excessive pain during the procedure. But he refused to comment further, citing Ms. Casareto's pending review before the state nursing board, where she will attempt to regain her license.
Tony Nemo, Mr. King's attorney, says he "vigorously" opposed the plea deal and is pursuing civil lawsuits against Ms. Casareto and the hospital that formerly employed her.
"Due to confidentiality we cannot discuss current or former employees," said Abbot Northwestern in a statement issued at the time of Ms. Casareto's arrest in February. "She no longer works (at the hospital). Patient safety is our primary concern."
2011年5月15日星期日
PlayStation Network Up and Running Again
Sony’s PlayStation Network service in the United States and Europe is partially restored, after being shut nearly a month ago due to a massive security breach affecting over 100 million online accounts.
Operations are currently limited to online gaming, chat, and music streaming services. Sony told the Associated Press it plans on fully restoring the network by the end of May.
A phased restoration of its Qriocity movie and music services which shares PlayStation Network’s server also began Sunday according to Sony Computer Entertainment Inc. spokesman Satoshi Fukuoka.
Limited services will also resume in Australia, Canada, New Zealand and the Middle East, and Sony plans on restoring service in Asia as well.
The popular PlayStation Network links users worldwide in live play. The system was shut down on April 20 after a hacker attack was discovered. Personal data, including credit card numbers, was at stake, but Sony said Sunday it had not received any reports of illegal fraudulent activity.
Operations are currently limited to online gaming, chat, and music streaming services. Sony told the Associated Press it plans on fully restoring the network by the end of May.
A phased restoration of its Qriocity movie and music services which shares PlayStation Network’s server also began Sunday according to Sony Computer Entertainment Inc. spokesman Satoshi Fukuoka.
Limited services will also resume in Australia, Canada, New Zealand and the Middle East, and Sony plans on restoring service in Asia as well.
The popular PlayStation Network links users worldwide in live play. The system was shut down on April 20 after a hacker attack was discovered. Personal data, including credit card numbers, was at stake, but Sony said Sunday it had not received any reports of illegal fraudulent activity.
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