Dupuytren’s contracture – what are the signs and symptoms of Dupuytren’s contracture?

Dupuytren's contracture
Dupuytren’s contracture

Dupuytren’s contracture (Dupuytren’s disease) is a condition that affects the hands and fingers. It causes one or more fingers to bend into the palm of the hand. It can affect one or both hands, and sometimes affect the thumb.

Dupuytren’s contracture occurs when the connective tissue in the palm thickens. Often the tissue thickens in one small area first and a “nodule” forms (a small, hard lump about 0.5-1cm) under the skin of the palm. The nodule sometimes feels tender to begin with, but this usually passes. More nodules may then develop.

 The nodules are non-cancerous (benign) and the condition isn’t life-threatening for those who develop it, although it can be a nuisance to live with.

Over time, the nodules can extend and form cords of tissue. These cords can shorten (contract) and, if the cords run along a finger or thumb, they can pull it, so it becomes bent towards the palm. These contractures are often mild and painless, but they can get steadily worse over time.

Read more about the symptoms of Dupuytren’s contracture and diagnosing Dupuytren’s contracture.

Why it happens

The exact cause of Dupuytren’s contracture is unknown, but it’s thought to be related to your genes, as it often runs in families.

If you have the gene that causes Dupuytren’s contracture, other factors such as diabetes, smoking and certain medications (for example, medication for epilepsy) may activate the condition. However, it’s not clear how significant these factors are.

Read more about the causes of Dupuytren’s contracture.

Who’s affected

Dupuytren’s contracture is fairly common. It can affect both sexes, but affects men more than women. The condition usually occurs during later life, although cases have been reported in children. Most cases occur in men over 50 and women over 60.

The condition seems to be more common in people of North European descent. It’s thought the gene associated with the condition was brought to the UK by the Vikings.

Preventing Dupuytren’s contracture

As the exact cause of Dupuytren’s contracture is unknown, it may not be possible to prevent the condition.

However, if you’re at risk of developing the condition – for example, if you’ve had it in the past, or if you have a family history of it – stopping smoking (if you smoke) may reduce your risk.

Treating Dupuytren’s contracture

Many cases of Dupuytren’s contracture are mild and don’t need treatment. Treatment may be helpful if the condition is interfering with the normal functioning of your hand.

Non-surgical treatments include radiation therapy and injections with a medication called collagenase.

Alternatively, a minor procedure that involves using a needle to cut the contracted cord of tissue (needle fasciotomy) may be used in the early stages of the condition.

In more severe cases, surgery can help to restore hand function. The two most common surgical techniques are:

open fasciotomy – where the shortened connective tissue is cut to relieve tension

fasciectomy – where the shortened connective tissue is removed

Surgery for Dupuytren’s contracture can’t always fully straighten the affected finger or thumb, and the contracture can recur after surgery. If a contracture does recur, further surgery may be possible.

Having surgery to remove the first nodule that appears won’t stop the condition from progressing, as this won’t stop the condition occurring elsewhere in the palm. It’s usually best to avoid surgery until a contracture develops that interferes with use of the hand.

Read more about treating Dupuytren’s contracture and recovering from Dupuytren’s contracture surgery.

Ongoing research

Some other treatments have been suggested for Dupuytren’s contracture, but there’s currently not enough medical evidence to support their use.

For example, the National Institute for Health and Care Excellence (NICE) doesn’t recommend the use of vitamin E cream or ultrasonic therapy. Trials into other possible treatments are under way.

Dupuytren’s contracture often runs in families and genetic research hopes to identify the genes responsible for the condition. This could lead to the development of treatments that prevent contractures occurring in the first place.

Purition – road testing a new wholefood protein shake! Is this a way to help you lose weight?

Purition - a wholefood protein shake
Purition – a wholefood protein shake

Purition is not a diet, it’s a nutritional upgrade” I was told.  Though, to be fair, I’m not 100% sure what that means.  But Purition deserves a hearing as they do have something interesting on offer.

However, a week or two ago, I received an email from a lady at Purition asking me if I’d like to try out the new their new protein shake.  Because it was a Friday afternoon I was feeling what might be called “PR friendly” so I said yes.

To my surprise a box arrived the next day.  This is not a comment about Purition by the dire standards of delivery services in the UK.  In it were six packets of their non-vegan Protein shake.  Purition do do a vegan product but I’ve not tried it so don’t want to comment.

Okay so what is Purition?  Just another protein shake?

Well the way Leanne their PR lady described it was as follow “Our product is a healthy, wholefood protein shake, that’s an alternative to junk filled meal replacements and artificial protein shakes. We only use clean and natural ingredients, absolutely no artificial nasties. 70% of the product is made from a blend of seeds and nuts, along with Madagascan vanilla pods and other natural ingredients for our flavours. It is much more than just a protein powder. The shakes provide a quick, low carb, low sugar breakfast smoothie or lunch when you don’t have time to cook. We care about nutrition and ensuring that people are aware about what they are eating, and what can be hidden in their food products.”

Which I translate from PRspeak to “If you have one for breakfast you won’t feel hungry till lunch”.  And as it weighs in at £12.99 for six packets seems quite reasonable price considering.  (For Americans it is about $16.00 at today’s rate while for those in the Eurozone would play around 15 Euros).  Though this is for what they describe as the trial box!  I expect it is more if you by on a regular basis.

Purition - bags of it
Purition – bags of it

Okay so does it work?   The answer has to be a resounding yes.  Both my wife and I had lunch late on both the days we tried the product and I can honestly say I felt no urge to eat for over five hours.  My wife backed this up and she had a morning of heavy meetings!

So yup it’s a winner from that point of view especially as it is seriously low in calories.

But there is a downside.

It tastes horrible and you get bits in your teeth.  My advice, for what’s worth, is to down it in one.  You can pretend you’re on a drinking bout somewhere just outside Tomsk rather than on a health kick.

So would I use it?  The answer is yes.  A few seconds of unpleasantness do help you lose a load of weight if used properly.   (They also tell me that it’s useful for recover after exercise).

I also asked if T2 diabetics can use Purition.  The answer came back “and I shall quote in full) “’Purition makes a great breakfast (or lunch) for anyone, not using insulin, to help regulate their blood sugar with their diet.

So for anyone diagnosed with a risk of developing type 2 diabetes or recently diagnosed with type 2 diabetes looking for a low-carb dietary intervention, widely regarded now as the only way to reverse T2 without medication.

Purition is safe to use if medicating with Metformin but should not be used by diabetics using insulin or insulin releasing tablets without medical supervision.

The slow release nutrients are low in sugar and carbs and will keep most people satisfied between meals without the need for snacking. Purition is all about setting the right foundations for a great food day.’

So there you have it.  I think it works.  If you have any question please use the comments section below and I’ll as Purition to reply!

Oh and if you want to try it you can pick it up here.

Many thanks!

Kimchee – What are the health benefits of kimchee!

Kimchee - what are the benefits to our health
Kimchee – what are the benefits to our health

Never heard of kimchee?  Then let me be the one to introduce you this really amazing (and healthy) food.

But before I start I should explain that my love of kimchee is about 25 years old now.  It started in a sadly long defunct restaurant in South Wimbledon, London whose name escapes me for the moment. (It was great and real shame it closed.)

The evening we went (a Saturday I think) my eating life changed.  For the first time I tried Kimchee – the spicy fermented cabbage which is the hallmark of Korean food.    Talking to the gentleman who ran the place I was told that there are around 100,000 different types of fermented and picked vegetable dishes on the peninsula.  It was then a decided (by my wife and I) that our next holiday had to be to Korea. When we went we find it was (and still was on subsequent visits) a paradise for those who love hot and tasty food, wonderful people, great scenery and some of the finest sights in Asia.  (Ad for Korea over but do go… you won’t regret it).

Back now to the discussion of kimchee and why it is good for you.

As you may have picked up fermented foods (such as sauerkraut) are the fashion of the moment.  Kimchee comes into this category of tasty things.

The first point is that kimchi (an alternative spelling) is low in calories and high in fibre which makes it a great part of a weight loss program!

Secondly it is very high in vitamins.  In particular vitamin A, vitamin B1, vitamin B2 and vitamin C.  I’m told that the vitamin C content is upped by the fermentation process.

Kimchee is also a great source of antioxidants.  You can read up about the benefits of anti-oxidants at our previous blog.

But most importantly it is probiotic.  According to the NHS “Probiotics are live bacteria and yeasts promoted as having various health benefits. They’re usually added to yoghurts or taken as food supplements, and are often described as ‘good’ or ‘friendly’ bacteria.”  Again we have a whole blogful of data here on probiotics.

So what is Kimchi useful for health-wise?

  1. Diabetes comes to mind. Koreans, it seems, have a lower incidence than say the
    Kimchi - why it is great for you
    Kimchi – why it is great for you

    US and this has been attributed to the kimchi in the diet.  And it does help reduce blood sugar levels.

  2. Yes I was a bit surprised by this as well!  But again the great bacteria produced by eating kimchee do their job!
  3. Lowers cholesterol. Now kimchi has a high level of garlic which may well help reduce Cholesterol.
  4. Boost the immune system.
  5. General digestive health including bowel problems. Here both the fibre and the bacteria come into play.
  6. Aids weight loss and helps fight obesity!
  7. Anti-aging properties. Collagen produced by the bacteria helps keep you skin in tip top condition!

So where can I get kimchee?  Well these days a lot of supermarket chain sell it otherwise specialist Asian stores are your beast!

Otherwise you might even want to consider making your own.  Here is the recipe I use.

PS  I should mention that kimchi smells quite strong.  So both my wife and I have had complaints when we have taken it into work.

PPS It is not just vegetables which are fermented.  I once tried fermented fish guts.  You should too.

 

 

Diabetes – What is Continuous Glucose Monitoring?

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Get your diabetes awareness tee shirt here.

What is Continuous Glucose Monitoring?

Continuous glucose monitoring (CGM) is a method of monitoring blood glucose levels through the use of a thin wire sensor placed just under the skin, which samples glucose levels every few minutes throughout the day. The information is transmitted to a device that enables the user to view the information in real time. The data is useful for individuals with diabetes who need to constantly monitor glucose readings in order to prevent dangerous highs or lows. CGM data is also stored for later upload to a computer to help evaluate trends and make treatment optimization.

Why Is It Important To Monitor Blood Glucose Levels?

Many people with diabetes may not have noticeable symptoms until their blood glucose levels are either too high or too low. Hyperglycemia occurs when blood glucose levels are too high. If left untreated, this can lead to more serious complications, such as ketoacidosis.

Alternatively, hypoglycemia occurs when blood glucose levels are too low. If hypoglycemia is left untreated, the individual may experience a seizure or lose consciousness. Blood glucose levels must be controlled in order to avoid serious complications of diabetes.

Monitoring Blood Glucose Levels With a Standard Blood Glucose Meter

The most traditional method of checking blood glucose levels is through the use of a small lancing device to prick the tip of the finger to obtain a drop of blood. The blood sample is inserted into a blood glucose meter, which then measures glucose levels. These meters provide a single data point in time, and are effective for many individuals with diabetes when used several times per day, including before and after meals. For individuals who may need to test their glucose levels more often, CGM may offer an easier and more effective solution than finger sticks alone.

Monitoring Blood Glucose Levels with a CGM

Continuous glucose monitoring is a blood glucose monitoring method that can provide more than 250 readings per day. Minimal finger-stick readings from a standard blood glucose monitor are still required to double check the CGM device accuracy.

All of these readings together provide a pattern of blood glucose levels that may identify trends. Healthcare providers can use these trends to understand fluctuating glucose levels and how they relate to:

●  The kinds of food a patient eats

●  The types of activity they do

●  Medications and dosages

Trends may also help reveal:

●  Fluctuations in glucose levels overnight, which are often undetected

●  Blood glucose spikes early in the morning

This information enables healthcare providers to understand the effectiveness of an individual’s current treatment plan, and to make adjustments when needed.

Making Continuous Glucose Monitoring More Convenient

A variety of insulin pumps now integrate with CGM systems, helping reduce the number of devices that have to be carried.  Newer models even have bright, color touchscreens like smartphones, making them simple to learn and use.

How Does Continuous Glucose Monitoring Work?

Continuous glucose monitoring uses a sensor that is placed under the skin of the abdomen for up to 7 days. The sensor reads the amount of glucose in the surrounding fluid using an enzyme called glucose oxidase, the same technology used for testing strips.

When glucose in the surrounding fluid interacts with glucose oxidase, the enzyme converts the glucose into hydrogen peroxide. The hydrogen peroxide reacts with platinum inside the sensor that then sends a signal to a transmitter. This signal is converted into a glucose reading.

Who Can Use Continuous Glucose Monitoring?

Individuals with diabetes who may benefit from the use of continuous glucose monitoring include those who:

●  Have unexplained extreme highs or lows in glucose levels

●  Have a diagnosis of gestational diabetes

●  Have consistent high or low blood glucose levels

●  Are currently using an insulin pump

Speak With Your Healthcare Provider

Continuous glucose monitoring systems may require extra training and practice to use the device properly. Speak with your healthcare provider and your diabetes management team to learn more about continuous glucose monitoring and to determine whether CGM would be an effective addition to your current diabetes management plan.

Resources:

http://www.niddk.nih.gov/health-information/health-topics/Diabetes/continuous-glucose-monitoring/Pages/index.aspx

http://www.webmd.com/diabetes/guide/continuous-glucose-monitoring

http://www.joslin.org/info/the_facts_about_continuous_glucose_monitoring.html

http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/checking-your-blood-glucose.html?referrer=https://www.google.com.mx/

http://www.brunet.ca/en/advices/the-importance-of-monitoring-blood-glucose-levels.html

http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/hyperglycemia.html?referrer=https://www.google.com.mx/

http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/hypoglycemia-low-blood.html

http://www.diabetesforecast.org/2014/05-may/anatomy-of-a-cgm-sensor.html?referrer=https://www.google.com.mx/

http://www.fauquierhealth.org/diabetes.diabetes_continuous_glucose_monitoring_right_for_me

What are the health benefits of walking?

So what are the health benefits of walking?

According to this fascinating infographic it can help with diabetes, dementia , arthritis, heart disease and depression.

I try to walk for a couple of hours a day so makes me happy!

Health Benefits of Walking

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