Brain Lesions

What is a lesion? You scrape your knee, and that's a lesion, an area of damage on the skin of your leg. But what are lesions in the brain? And what causes them? How serious are brain lesions? Here is information about this confusing and unsettling health concern. Read on to find out what the symptoms are and how brain lesions are treated.
What are brain lesions?
A lesion is an area of tissue that has been damaged through injury or disease. So a brain lesion is an area of injury or disease within the brain. While the definition sounds simple, understanding brain lesions can be complicated. That's because there are many types of brain lesions. They can range from small to large, from few to many, from relatively harmless to life-threatening.
What causes brain lesions?
Brain lesions can be caused by injury, infection, exposure to certain chemicals, problems with the immune system, and more. Many times the cause is not known.
What symptoms might indicate a brain lesion?
Symptoms of a brain lesion vary depending on the type, location, and size of the lesion. Symptoms common to several types of brain lesions include the following:
Headaches
Neck pain or stiffness
Nausea, vomiting, and lack of appetite
Vision changes or eye pain
Changes in mood, personality, behavior, mental ability, and concentration
Memory loss or confusion
Seizures
Fever
Difficulty moving
What are the different types of brain lesions?
Although they share a common definition -- injury or damage to tissue within the brain -- brain lesions vary greatly. Here are some common brain lesions.
Abscesses: Brain abscesses are areas of infection, including pus and inflamed tissue.They are not common, but they are life threatening. Brain abscesses often occur after an infection, usually in a nearby area, such as an ear, sinus, or dental infection.They can also appear after injury or surgery to the skull.
Alzheimer's disease and other dementias: Alzheimer's disease and some types of dementia are another group of brain lesions. In these lesions, nerve cells die, leaving behind damaged areas of the brain. Gradually, brain function in those areas decreases.
Arteriovenous malformations (AVMs): AnAVM is a type of brain lesion that occurs during early development. Arteries and veins in the brain grow in a tangle and become connected by tube-like structures called fistulae. The arteries are not as strong as normal.The veins are often too wide because of the constant flow of blood directly from the arteries through the fistulae to the veins.These fragile vessels may rupture, leaking blood into the brain.In addition, the brain tissue may not receive enough blood to function properly.
Cerebral infarction: Infarction refers to death of tissue. So a cerebral infarction is a brain lesion in which a cluster of brain cells have died. Most often, this brain lesion is caused by a stroke.
Cerebral palsy: This type of brain lesion occurs early in a child's development, from before birth until age 3.Cerebral palsy does not progress over time.The brain lesions affect the child's ability to move, which can also make communication and related skills difficult.
Multiple sclerosis (MS): With this condition, the immune system attacks and damages the nerve linings in the brain and spinal cord. These lesions make it difficult for messages to be sent and received properly between the brain and the rest of the body.
Tumors: Tumors are clumps of cells that grow abnormally from normal tissue. Some tumors in the brain are noncancerous, or benign. Others are cancerous. They may start in the brain, or they may spread from elsewhere in the body. They may grow quickly or they may remain stable.
How are brain lesions diagnosed?
The methods used to find and diagnose brain lesions depend on the symptoms. In many cases, CT and MRI imaging studies help pinpoint the location, size, and characteristics of the lesions. Blood and other lab tests may also be done to look for signs of infection.
How are brain lesions treated?
Treatment depends on the type of brain lesion. The goals of treatment may be to provide a cure, relieve symptoms, or improve the quality or length of life. Common approaches for treating brain lesions include the following:
"Wait and see"-- If the lesion is not causing problems and is not growing, you may only need periodic checkups.
Surgical removal of the lesion, if possible. New surgical techniques may make it possible to remove even hard-to-reach lesions.
Chemotherapy and radiation therapy for lesions that are cancerous.
Medication to fight infections, such as antibiotics or other anti-microbials.
Medication to calm the immune system or otherwise change the immune system's response.
Medication or other therapies to relieve symptoms associated with the brain lesion.
How can I find out more about brain lesions?
Brain lesions take many forms, so diagnosing and treating them can be complex. That's why it's important to discuss your individual questions about brain lesions with your doctor. Together, you can determine the best way to proceed in identifying, treating, and living with brain lesions.

A Family In Denial

ASSI - Brandy and Ray J is hard for me to watch, Ray J seems to be misinformed regarding factual information. For example, he mentioned that he has been in the business for twenty years and Brandy and Sonja, the mother both state that they have been in the business for fifteen years. Ray J claimed that he had the number one dating show for "The Love of Ray J" one and two, but was not really looking for love something all of new, except for the women on the show. On this episode of "Brandy and Ray J, A Family Business" both dealt with relationship issues. Ray J had to deal with reunion show for "The Love of Ray J Two", he was nervous because he neglected to tell Ms. Berry that he had no love for her and was without any future plans for them as a couple. Brandy was dealing with her on again and off again feelings regarding her date with Flow Rider, a rap artist who wanted to take her to the Grammies but Management seemed to think that it isn't good for either artist. However, Brandy wanted to go and was seemingly torn regarding her feelings for Flow Rider but could not stop talking about him and when he makes the decision that they should not go to the Grammies together it dawns on her that she really wanted to accompany him to the Grammy.

Sonja is struggling with her dual roles as Manager and Mother, she agrees as a manager that it was not good business for Brandy to attend the Grammies as Flow Riders date, but as a mother wanted Brandy to go because Brandy really wanted to go. Sonja wanted Ray J to handle things with Ms. Berry in a honest and respectful manner; however, she wanted him to light firer to Cocktail at the reunion show because she felt like cocktail was out of line, and he needed to stand up for himself as a man and not allow a woman to make him look bad. Sonja is the mother bear who refuses to allow anyone to harm her baby cub in any manner. He mother had to bail him out of the confusion with cocktail and he went to cocktail to console her while Ms. Berry was waiting in the wings, the only reason cocktail backed off was due to his mother stepping in and telling her that she needed to leave. He walk around with bottles of Champagne which is probably preventing him from thinking rationally about the situation that he placed himself in for the love of money. Ms. Berry was more poised and mature than Ray J, she gave him an out, and he wasn't mature enough to take it.

Willie, the father needs a little more back bone, he is a little to passive and friendly, which can be good and bad, and he truly sees himself in his son and tries to relate to Ray J without being hard on him. I guess he is being understanding but that's not what he needs. Ray J needs his family to level with him, they all give it a shot but in such a nice and comforting way that he gets it but still lacks the maturity needed to relate to women. However, the show ends with him breaking things off with Ms. Berry over the phone. Why didn't anyone council him to have a face-to-face meeting with her, after all she waited five months to see him and learn if there was a possibility for a love connection with this young man, especially since she had his back during the reunion show and kept it 100 with him. He could have done the same thing with her but chose not to because he lacked the maturity to handle the situation like a man.

I am waiting to see more of a connection between Sonja and Willie....I like that Brandy has a good support system with her friends, it was nice to see her and Kelly Rowland have dinner together, and that her other non celebrity friends went bowling after she learned that she was not going to attend the Grammies with Flow Rider. Ray J is living in a fantasy world but sometimes you have to dream the impossible and take ownership of the things you want for yourself. He seems to be good at that and there isn't anything wrong with dreaming the impossible it is the only way to make your dreams come true.

LisaRaye and the Comeback

ASSI - LisaRaye McCoy is on a comeback and perhaps her reality show is the key to getting her back in the business. On the last episode of the "Real McCoy," LisaRaye made a signature milkshake concocted by her and her daughter, Kai. The name of the milkshare is LisaRaye's Love Thing and can be purchased at Millions of Milkshakes in LA. She met with the Director of Stomp the Yard and also rode a horse in the Wild Bill Picket's Rodeo Race. Unfortunately her team was disqualified because her racing partner's hat fell into her eyes causing her to circle inside the barriers instead of outside of the barriers. LisaRaye wasn't happen, she likes to win, and is extremely competitive; however, she was a good sport. I am glad to see she is comfortable wearing her signature White clothes regardless of the event. She must keep extra clothes in her designer bags. On the next episode, LisaRaye is headed to Atlanta, GA where she will visit her sister DaBrat, and host stripper pole dancing contest at Magic City.

Grand Oasis Playa

ASSI - We were looking for some place warm to go for my life partner's birthday. I went to my favorite travel site skyauction.com to see what hot spots were available for a great price. We booked four days at Grand Oasis Playa in Cancun Mexico and had the best time. I was somewhat concerned about the quality of the resort due to the written reviews that I read. Especially since most reviews wrote that Grand Oasis Playa is a three star resort. We like to stay at four and five star resort; however, skyauction always have such great prices for lesser resorts that we have taken a chance at staying at under four star resorts, and to our surprise have been more than pleasantly pleased with our accommodations. I also realized that other resorts are probably writing negative resorts regarding their competitors. The food at Grand Oasis Playa was okay at the buffets but at the three other restaurants the food was delicious, the only thing that I did not care for was the house Red Vino it was tasteless. The resort recently up graded all of the rooms, the lobby is open and airy with plenty of seating, there are two pool areas one on the beach and one located in the front of the resort next to the sushi bar, there are outdoor Jacuzzis as well as suites with Jacuzzis, there is a spa and fitness room, and swinging beds outside next to the sushi bar.

The resort is all inclusive, there are about four bars, and enough restaurants to satisfy your palate. The rooms are clean, spacious, has a safe for three dollars a day, some have balconies, plenty of towels, and flat screen televisions. We took a cold shower our first night because my partner thought there was not hot water. We reported the problem only to learn that we had not turned on the hot water. I didn't try it because I was told that it did not work but because my partner misread the knobs turned on what he thought was the hot water and when it didn't get warm, his brain did not inform him to try the cold water knob; therefore, we took cold showers that wasn't too bad but because we thought that there wasn't any hot water it seemed worse than it was. Caution, there are a number of peddlers walking the beach selling sterling silver jewelry but buyer beware do not buy any of the items sold on the beach. The items are cheap and not real.

I stayed away from Mexico because I had heard the water was undrinkable and will make you sick and that the State Department had put out a warning to all American citizens to stay away due to criminal activity, claims were made that there were gunmen in the hills waiting to rob Americans, and the Island was unsafe to visit. The band was lifted. Therefore, we decided to give Cancun a try and had the best time, we went to the Ancient Mayan Ruins at Chichen Itza, Tulum another Mayan Ruins tourist spot, went on two time share presentations, went on a Jungle Tour (in a two passenger boat) that was a snorkeling excursion to a beautiful coral reef and enjoyed a couples message that was absolutely fabulous. Our stay in Mexico literally flew by, we met some really nice people from the States, and visited other resorts where we had just as much fun for the day. As I see it, if you have yet to visit Cancun you must place it on your list of places to visit, take plenty of $2 dollar bills for tips, see as much as you can while your there, take the bus around town instead of a cab its less expensive at $1.50 a person, and the beach is really nice but I am unable to speak of the water. It is the only beach that we have visited that I did not get in the water, except for when I went snorkeling. I give Grand Oasis Playa three and a half blinks.

Ancient Mayan Ruins

ASSI - We had the opportunity to visit one of the seven wonders in the world while vacationing in Cancun, Mexico. Chichen Itza is one of many impressive pyramids in the world. The ancient Mayan world is centered on the Yucatan Peninsula. I was in total awe, it was a wow moment, when we I saw the pyramid. and all of the ancient ruins. I lacked the patience and was anxious to see all of the ruins; therefore, did not stick around to learn about the pyramid and Mayan culture. Shame on me but nothing a google search cannot handle. It was crowded with tourist and vendors, the vendors were out of control, they approached you every half a second selling handmade wood carvings, blankets, t-shirts, and etc. We only had an hour to tour the grounds, tit was hot and wanted to keep it moving. It took us an hour and a half to get there from the hotel, we stopped at a designated souvenir shop operated by Mayan people, but was a waste of time because the novelty items were over priced for the same stuff peddled on the grounds at Chichen Itza for a 4th of the price. We went back to the souvenir shop for dinner, which should have been our only stop, but the tourist companies have an agreement with the Mayans. Overall the trip was beyond worth it. As I see it, if and when you visit Chichn Itza wear comfortable shows preferably sneakers, take a pair of sun glasses, a couple bottles of water, a hand towel, a light snack, and small bills. Charge your camera battery the night before, download any pics on your memory card and delete them, digital cameras with video are permitted without a fee. There is a fee for camcorders. I give the ancient Mayan ruins at Chichen Itza, five blinks

Perry Does It Again in Too

ASSI - Tyler Perry is back with a follow-up to his movie, Why Did I Get Married, regarding four couples who get away for a weekend retreat, and learn more about each other than they wanted to know. In "Why Did I Get Married, Too" the entire cast: Janet Jackson, Malik Yoba, Sharon Leal, Tasha Smith, Michael Jai White, Richard T. Jones, Jill Scott, Lamman Rucker, and Tyler Perry return to deal with all of the unresolved issues from one. Tyler is a good director, screen writer and producer who knows what resonates with Black movie goers. "Why Did I Get Married, Too is reminiscence to opening Pandora's box. The couples are harboring relationship issues that are manifesting in an unhealthy ways.

Would we be interested in Perry movies if they were without DRAMA and more DRAMA,? Is DRAMA the key ingredient to a successful movie? The rumor mill circulating the film tauted it as Perry's best film. I beg-to-differ it was about the same as his other movies. Is it worth seeing on the big screen? No! You can wait for it to come out on DVD where it will probably do better in sells than the box office. Perry claims that other directors are going to take note of Janet's performance and book her for other films, I disagree, she was alright but it was not an Oscar winning performance. I liked the movie for the eye candy. My eyes love what it sees when looking at Lamman Rucker, Richard T. Jones, and Michael Jai White who I had the pleasure of meeting at a restaurant in Seattle, Washington was worth it for me.

Tasha Smith connects a little too well with her character, I know she had a blast playing Angela the none trusting wife of Marcus, played by White. Patricia, played by Jackson, is tormented over the lost of her son and simply cannot find her way back to her husband, Gavin. Terry who is Perry's character loves his wife but does not feel the love in return until her little secret is revealed. Scott plays, Sheila who is newly married and dealing with a new addition, new husband, a new home, and a old husband who just want go away. It is all too much for her husband Troy, played by Rucker, who is struggling with finding employment. There relationship is early similar or should I say exactly like Bird and Lem's situation in Soul Food the movie. I thought that Louis Gasset, Jr. and Cicely Tyson's characters, were going to be insightful, and be the positive influence the couples needed to rekindle their relationships. What was I thinking? It's a movie things are not supposed to make sense, just entertain.

As I see it, Why Did I Get Married, Too is an entertaining movie that tackles the same issues that couples, in the real world, face daily. It's how we deal with these issues that makes a difference in our lives. In the movies, there is a script that actors follow; therefore, we should not get ourselves all wrapped up in their on screen lives. If you see yourself or your relationship in any of these couples, get some help. I give "Why Did I Get Married, Too two and half blinks.

Celebrity Reality - Take Over

ASSI - Are celebrities taking over scripted reality shows? Is this merely another lucrative acting gig for them? What segment of their shows are unscripted by them or the network? Although I watch many of the scripted reality shows, I do miss well written and acted situational comedies and dramas, and with the a new crop of shows scheduled. I am curious to see what captures my attention. I really liked the family Crews that airs on BET, the finale aired this week, it is one of the few reality shows that I actually like. It has the flavor of the Cosby and Bernie Mac show. Terry Crews, plays the father on "Everybody Hates Chris", he is a handsome man, to me, and one who loves his wife and five children. The baby and only son, Isiah is three but acts like he is five, and is smart, insightful, and cute. I would love to see a second season of The Family Crews and BET should negotiate for more episodes per season.

I also hope to see another season of ":Let's Talk About Pep" that aired on VHI, starring Pep (Sandy Denton) from Salt-N-Pepper rap duo, "Let's Talk About Pep" was the Black version of Sex in the City, Sandy (PeP) and three of girlfriends get together once a week to dish about their dates, and other outings that happened since their last meeting. It might even remind you of the show "Girlfriends." The cast of women include, Jacque Reed from BET nightly news; Joumana Kidd, former wife of NBA player Jason Kidd, and Kittie who is the around the way girl, the Kim Catrel of the group. I did look forward to seeing that show every week and just when it was getting good it was over. I was a little over hearing every week that Pep still had her four years, she felt a need to inform was weekly that she has not had sex in four years. Jacque is looking to have a baby, has never had an orgasm, and has a man check list. It seems that there was much missing in Joumana's marriage due to the fact that she is a recent divorcee, who was interested in finding a hot body to replace the cold one, and Kittie was looking for someone with a higher freak meter than hers but when she meets her match, she couldn't handle it. She broke the girlfriend code and brought the drama. "Let's Talk About Pep" was an entertaining show that I enjoyed watching, I am looking forward to the next season.

"Lisa Raye the Real McCoy" aired Thursday night at 9:00 pm on TVOne, it was a double header two episodes in one night. I am happy that Lisa Raye is back to business, focused on her career, and doing whatever to get that paper. Lisa revealed that White is her signature color and she wears it well. What's up with all the flamboyant stylist on these shows, most of them look a hot mess, but are trusted and revered by their celebrity clients. How and where do they meet these people? Why is it that a gay man can dress a woman, seemingly, better than a woman. Are there any lesbian women dressing men? According to Lisa Raye, she has a Rolls Royce that her former husband, Michael Eugene Misick gave her as a gift, but she is paying the $9,000.00 a month note. Attention ladies, Lisa Raye married her husband a month after meeting him, and within two years everything fell apart. It seems that his representative misrepresented him, made him out to be someone that he wasn't, and now she is fighting to settle the financial terms of her divorce. She is an extremely overly affectionate mother who loves-up on her daughter, with lots and lots of kisses, initially it caught me off guard, it felt a little incestuous, but I understand the unconditional love a mother has for her child. However, it is classic "It is not what you do but how you do it" situations.

Tiny and Toya are back for another season, premiering Tuesday, April 13, 2010 at 10:00 pm on BET...from the promos airing it looks like Tiny has finally opened her nail salon or will open it during the season, she has owned the shop for over a year, but had not been proactive regarding getting it open, she had other priorities to deal with, TI who is her significant other and Rap star and father of one or two of her children was top priority, last season he went to prison for attempting to purchase fire arms from an under cover cop. With TI temporarily out of the way she can focus on other ventures like her music and shop, I am sure when he returns things will be all about TI. It appears that Tiny made herself over during his absence. Hopefully he will like the changes. We will see Toya come into her own, according to the highlights she styled the young girl group that Tiny put together, and maybe we will learn what became of Toya's meeting with a publisher, she was interested in writing a book. It seems that family is big to these Southern Black Belles, I am hopeful that Toya made a difference in her mother's life, perhaps the mother entered rehab for her drug addiction, and just maybe we will learn if Toya is still dating that football player she went out with last season. I did see them at the BET Awards show together. I will probably catch the second run of the show, BET will air it a couple of times a day, and have a marathon leading to the final episode.

Brandy and Ray J, the sister and brother, acting and singing team are allowing the cameras into their lives, so that the public can better understand their family ties. Their show "A Family Business" can be seen on VHI on Sunday at 9:00 pm. I am unsure if this one is going to hold my attention, I am already a little bias toward the mother, I think she is a bit brash, cold, and down right rude. An over bearing mother with nothing to do but try and control the lives of her children. I am unsure if it is her camera persona or the way she really is, and the father seems to be a down-to-earth fun-loving-guy who has lots of patience.

What is Chili from TLC on? Have you seen the promos for her new show? "What Chili Wants" that airs on VHI on Sunday at 10:03 pm. She is looking for The One but her criterion list seems a little unrealistic but obtainable if that's what she really wants. According to Chili, the man must be gorgeous, sensitive, charming, love God, love her son, love her mother, and cannot drink or smoke, or eat pork. To help her find a man that completes the check list. She hires, Tionna Tee Smalls, author of "Girl, Get Your Mind Right" a no nonsense young woman from Brooklyn, New York to guide her to The One. However, to Chili, she is not understanding why she is unable to find love. She is a talented and attractive woman, who is handling her own, so why is it difficult for her to seal the deal? Is she really looking for love or is this just an avenue to make some revenue? Rarely does any of the men or women who are so call looking for love find it, but they seem to have a good time on during the journey. It is not for everyone but for those who subscribe to dating different men and women at the expense of a network, have a producer plan excursions, dates, and outings with handsome men and women all vying for your attention, have a stylist dress you in the finest designer wear, eat at the best restaurants, live life to the fullest on camera for thirty to forty five days, and receive a pay check for doing so? All I have to say is, "Sweet!"

Shauni O'Neal, the soon to be ex wife of NBA, Player Shaquel O'Neal, developed a show for VHI titled what else, "Basketball Wives" what will viewers learn from the scripted show, I don't know, but I am sure to tune in to see what I am not missing. It airs on Sunday at 10:00 pm.

An Unsual Case

ASSI - Case 39 is without a release date in the United States. It premiered on August 13, 2009 in New Zealand and opened to rave reviews. This is a must see movie, it is filled with suspense, the cast (Renee Zellwiger, Bradly Cooper, and Jodell Ferland) were convincing, and it is a surprising thriller that will defiantly keep your attention. I saw this movie last evening and was pleasantly surprised. Case 39 started out innocently, I wondered where it was going, and then it went there and didn't stop until the very end. This movie was well written, directed, and cast perfectly each actor assumed the role of their characters. This movie will spawn conversation, it is truly a date night movie, a day out with the girls, or you can go with yourself. As I see it, whatever you do see Case 39 on the big screen, it is worthy of the price of a movie ticket, and is more than a movie it is an experience. I give Case 39 four blinks.

American Express My Card of Choice

We have been so preoccupied with the Waterbury project that there has been little time for other things. Today that changed. It is more than imperative that I praise the card that works for me. I am absolutely beyond satisfied with being an American Express Card Member. I am privileged enough to have a Discover, Master, and Visa Card but they do not compare to the level of optimum customer service provided by American Express.

I am praising American Express because several merchants have attempted to access additional fees to my card. The charges were disputed and American Express investigated the charges and sided in my favor. I also rented a car that was insured through American Express. Someone broke the passenger window in an attempt to steal our GPS out of the vehicle. American Express covered the cost of the repair with the rental car company. It was hassle and stress free.

Unlike Discover and Visa, I disputed a charge that clearly should have been reversed with Discover; however, Discover sided with the merchant without investigating the charge. As a result, I stopped using my Discover card three years ago. Visa was a different story all together. I phoned visa to inform them of a purchase made in Brazil while on vacation. Visa instructed me to return the item, after the item was returned; Visa sent me a letter stating that Visa is without authority to reverse the charge due to the merchant’s return policy. Excuse me, I followed their instructions and now I was without the merchandise and still had to cover the cost of the item.

Many letters were written, countless phone calls were made, and it took eleven (11) months for the matter to be resolved. A Visa Representative actually tried to strong arm/intimidate me by telling me to stop writing and calling them because Visa stood by their decision. I could not believe the response that I had received; therefore, I wrote the President of the company and received a call from the representative who informed me to stop calling that a credit would be issued.

I have never had to write more than one letter or call American Express more than once regarding a disputed charge. American Express is the card that best represents me. I love the level of serviced that I have received since becoming a card member in 2005. American Express has exceeded my expectations. I am a lifer. There is an annual fee for having an American Express Card; however, the benefits you receive as a card member are worth the fee. American Express offers various cards and each one has different benefits; therefore, it is worth researching all of the cards offered to determine which card is right for you. As I see it, we all have a choice in the card we use to make credit purchases, and if you are without an American Express card you should look into having one. However, you must be responsible with any and all credit cards that you have. Only charge things that you can afford to pay-off within thirty days and avoid maxing out any and all cards.

2 Bedroom For Rent on 54 Jewelry St ($850 each month plus utilities)

54 Jewelry St Waterbury Ct 1 Bedroom ($650 each month plus utilities)

Pacemaker

A pacemaker/implantable cardioverter defibrillator (ICD) insertion is a procedure in which a pacemaker and/or an ICD is inserted to assist in regulating problems with the heart rate (pacemaker) or heart rhythm (ICD).

When a problem develops with the heart's rhythm, such as a slow rhythm, a pacemaker may be selected for treatment. A pacemaker is a small electronic device composed of three parts: a generator, one or more leads, and an electrode on each lead. A pacemaker signals the heart to beat when the heartbeat is too slow.

A generator is the "brain" of the pacemaker device. It is a small metal case that contains electronic circuitry and a battery. The lead (or leads) is an insulated wire that is connected to the generator on one end, with the other end placed inside one of the heart's chambers.
The electrode on the end of the lead touches the heart wall. In most pacemakers, the lead senses the heart's electrical activity. This information is relayed to the generator by the lead.

If the heart's rate is slower than the programmed limit, an electrical impulse is sent through the lead to the electrode and the pacemaker's electrical impulse causes the heart to beat at a faster rate.When the heart is beating at a rate faster than the programmed limit, the pacemaker will monitor the heart rate, but will not pace. No electrical impulses will be sent to the heart unless the heart's natural rate falls below the pacemaker's low limit.Pacemaker leads may be positioned in the atrium or ventricle or both, depending on the condition requiring the pacemaker to be inserted. An atrial dysrhythmia/arrhythmia (an abnormal heart rhythm caused by a dysfunction of the sinus node or the development of another atrial pacemaker within the heart tissue that takes over the function of the sinus node) may be treated with an atrial pacemaker.

A ventricular dysrhythmia/arrhythmia (an abnormal heart rhythm caused by a dysfunction of the sinus node, an interruption in the conduction pathways, or the development of another pacemaker within the heart tissue that takes over the function of the sinus node) may be treated with a ventricular pacemaker whose lead wire is located in the ventricle.
It is possible to have both atrial and ventricular dysrhythmias, and there are pacemakers that have lead wires positioned in both the atrium and the ventricle. There may be one lead wire for each chamber, or one lead wire may be capable of sensing and pacing both chambers.

A new type of pacemaker, called a biventricular pacemaker, is currently used in the treatment of congestive heart failure. Sometimes in heart failure, the two ventricles (lower heart chambers) do not pump together in a normal manner. When this happens, less blood is pumped by the heart.
A biventricular pacemaker paces both ventricles at the same time, increasing the amount of blood pumped by the heart. This type of treatment is called cardiac resynchronization therapy.

An implantable cardioverter defibrillator (ICD) looks very similar to a pacemaker, except that it is slightly larger. It has a generator, one or more leads, and an electrode for each lead. These components work very much like a pacemaker. However, the ICD is designed to deliver an electrical shock to the heart when the heart rate becomes dangerously fast, or €œfibrillates."
An ICD senses when the heart is beating too fast and delivers an electrical shock to convert the fast rhythm to a normal rhythm. Some devices combine a pacemaker and ICD in one unit for persons who need both functions.

The ICD has another type of treatment for certain fast rhythms called anti-tachycardia pacing (ATP). When ATP is used, a fast pacing impulse is sent to correct the rhythm. After the shock is delivered, a "back-up" pacing mode is used if needed for a short while.
The procedure for inserting a pacemaker or an ICD is the same. The procedure generally is performed in an electrophysiology (EP) lab or a cardiac catheterization lab.

Other related procedures that may be used to assess the heart include resting and exercise electrocardiogram (ECG), Holter monitor, signal-averaged ECG, cardiac catheterization, chest x-ray, computed tomography (CT scan) of the chest, echocardiography, electrophysiology studies, magnetic resonance imaging (MRI) of the heart, myocardial perfusion scans, radionuclide angiography, and ultrafast CT scan.

The heart is, in the simplest terms, a pump made up of muscle tissue. Like all pumps, the heart requires a source of energy in order to function. The heart's pumping energy comes from an indwelling electrical conduction system.
An electrical stimulus is generated by the sinus node (also called the sinoatrial node, or SA node), which is a small mass of specialized tissue located in the right atrium (right upper chamber) of the heart.
The sinus node generates an electrical stimulus regularly at 60 to 100 times per minute under normal conditions. This electrical stimulus travels down through the conduction pathways (similar to the way electricity flows through power lines from the power plant to your house) and causes the heart's chambers to contract and pump out blood.
The right and left atria (the two upper chambers of the heart) are stimulated first and contract a short period of time before the right and left ventricles (the two lower chambers of the heart).
The electrical impulse travels from the sinus node to the atrioventricular (AV) node, where it stops for a very short period, then continues down the conduction pathways via the "bundle of His" into the ventricles. The bundle of His divides into right and left pathways to provide electrical stimulation to both ventricles.

This electrical activity of the heart is measured by an electrocardiogram (ECG or EKG). By placing electrodes at specific locations on the body (chest, arms, and legs), a tracing of the electrical activity can be obtained. Changes in an ECG from the normal tracing can indicate one or more of several heart-related conditions.

Dysrhythmias/arrhythmias (abnormal heart rhythms) are diagnosed by methods such as EKG, Holter monitoring, signal-average EKG, or electrophysiological studies. These symptoms may be treated with medication or procedures such as a cardiac ablation (removal of a location in the heart that is causing a dysrhythmia by freezing or radiofrequency).

A pacemaker may be inserted in order to provide stimulation for a faster heart rate when the heart is beating too slowly, and when other treatment methods, such as medication, have not improved the heart rate.
An ICD may be inserted in order to provide fast pacing (ATP), cardioversion (small shock), or defibrillation (larger shock) when the heart beats too fast.
Problems with the heart rhythm may cause difficulties because the heart is unable to pump an adequate amount of blood to the body. If the heart rate is too slow, the blood is pumped too slowly.

If the heart rate is too fast or too irregular, the heart chambers are unable to fill up with enough blood to pump out with each beat. When the body does not receive enough blood, symptoms such as fatigue, dizziness, fainting, and/or chest pain may occur.

Some examples of rhythm problems for which a pacemaker or ICD might be inserted include:
atrial fibrillation - occurs when the atria beat irregularly and too fast
ventricular fibrillation - occurs when the ventricles beat irregularly and too fast
bradycardia - occurs when the heart beats too slow
tachycardia - occurs when the heart beats too fast
heart block - occurs when the electrical signal is delayed after leaving the SA node; there are several types of heart blocks, and each one has a distinctive ECG tracing

There may be other reasons for your physician to recommend a pacemaker or ICD insertion.
Possible risks of pacemaker or ICD insertion include, but are not limited to, the following:
bleeding from the incision or catheter insertion site
damage to the vessel at the catheter insertion site
infection of the incision or catheter site
pneumothorax - air becomes trapped in the pleural space causing the lung to collapse
If you are pregnant or suspect that you may be pregnant, you should notify your physician. If you are lactating, or breastfeeding, you should notify your physician.
Patients who are allergic to or sensitive to medications or latex should notify their physician.
For some patients, having to lie still on the procedure table for the length of the procedure may cause some discomfort or pain.
There may be other risks depending upon your specific medical condition. Be sure to discuss any concerns with your physician prior to the procedure.

Your physician will explain the procedure to you and offer you the opportunity to ask any questions that you might have about the procedure.
You will be asked to sign a consent form that gives your permission to do the test. Read the form carefully and ask questions if something is not clear.
You will need to fast for a certain period of time prior to the procedure. Your physician will notify you how long to fast, usually overnight.

If you are pregnant or suspect that you are pregnant, you should notify your physician.
Notify your physician if you are sensitive to or are allergic to any medications, iodine, latex, tape, or anesthetic agents (local and general).
Notify your physician of all medications (prescription and over-the-counter) and herbal supplements that you are taking.
Notify your physician if you have heart valve disease, as you may need to receive an antibiotic prior to the procedure.

Notify your physician if you have a history of bleeding disorders or if you are taking any anticoagulant (blood-thinning) medications, aspirin, or other medications that affect blood clotting. It may be necessary for you to stop some of these medications prior to the procedure.
Your physician may request a blood test prior to the procedure to determine how long it takes your blood to clot. Other blood tests may be done as well.
You may receive a sedative prior to the procedure to help you relax. If a sedative is given, you will need someone to drive you home afterwards.
The upper chest may be shaved or clipped prior to the procedure.
Based upon your medical condition, your physician may request other specific preparation.

A pacemaker or implanted cardioverter defibrillator may be performed on an outpatient basis or as part of your stay in a hospital. Procedures may vary depending on your condition and your physician's practices.

Generally, a pacemaker or ICD insertion follows this process:
You will be asked to remove any jewelry or other objects that may interfere with the procedure.
You will be asked to remove your clothing and will be given a gown to wear.
You will be asked to empty your bladder prior to the procedure.
An intravenous (IV) line will be started in your hand or arm prior to the procedure for injection of medication and to administer IV fluids, if needed.
You will be placed in a supine (on your back) position on the procedure table.
You will be connected to an electrocardiogram (ECG or EKG) monitor that records the electrical activity of the heart and monitors the heart during the procedure using small, adhesive electrodes. Your vital signs (heart rate, blood pressure, breathing rate, and oxygenation level) will be monitored during the procedure.
Large electrode pads will be placed on the front and back of the chest.
You will receive a sedative medication in your IV before the procedure to help you relax. However, you will likely remain awake during the procedure.
The pacemaker or ICD insertion site will be cleansed with antiseptic soap.
Sterile towels and a sheet will be placed around this area.
A local anesthetic will be injected into the skin at the insertion site.
Once the anesthetic has taken effect, the physician will make a small incision at the insertion site.
A sheath, or introducer, is inserted into a blood vessel, usually under the collarbone. The sheath is a plastic tube through which the pacer/ICD lead wire will be inserted into the blood vessel and advanced into the heart.

It will be very important for you to remain still during the procedure so that the catheter placement will not be disturbed and to prevent damage to the insertion site.
The lead wire will be inserted through the introducer into the blood vessel. The physician will advance the lead wire through the blood vessel into the heart.
Once the lead wire is inside the heart, it will be tested to verify proper location and that it works. There may be one, two, or three lead wires inserted, depending on the type of device your physician has chosen for your condition. Fluoroscopy, (a special type of x-ray that will be displayed on a TV monitor), may be used to assist in testing the location of the leads.
Once the lead wire has been tested, an incision will be made close to the location of the catheter insertion (just under the collarbone). You will receive local anesthetic medication before the incision is made.

The pacemaker/ICD generator will be slipped under the skin through the incision after the lead wire is attached to the generator. Generally, the generator will be placed on the non-dominant side. (If you are right-handed, the device will be placed in your upper left chest. If you are left-handed, the device will be placed in your upper right chest).
The ECG will be observed to ensure that the pacer is working correctly.
The skin incision will be closed with sutures, adhesive strips, or a special glue.
A sterile bandage/dressing will be applied.

In the hospital, after the procedure, you may be taken to the recovery room for observation or returned to your hospital room. A nurse will monitor your vital signs for a specified period of time.
You should immediately inform your nurse if you feel any chest pain or tightness, or any other pain at the incision site.
After the specified period of bed rest has been completed, you may get out of bed. The nurse will assist you the first time you get up, and will check your blood pressure while you are lying in bed, sitting, and standing. You should move slowly when getting up from the bed to avoid any dizziness from the period of bedrest.
You will be able to eat or drink once you are completely awake.
The insertion site may be sore or painful, but pain medication may be administered if needed.
Your physician will visit with you in your room while you are recovering. The physician will give you specific instructions and answer any questions you may have.
Once your blood pressure, pulse, and breathing are stable and you are alert, you will be taken to your hospital room or discharged home.
If the procedure is performed on an outpatient basis, you may be allowed to leave after you have completed the recovery process. However, if there are concerns or problems with your ECG, you may stay in the hospital for an additional day (or longer) for monitoring of the ECG.
You should arrange to have someone drive you home from the hospital following your procedure.

At home, you should be able to return to your daily routine within a few days. Your physician will tell you if you will need to take more time in returning to your normal activities. In addition, you should not do any lifting or pulling on anything for a few weeks. You may be instructed not to lift your arms above your head for a period of time.
You will most likely be able to resume your usual diet, unless your physician instructs you differently.
It will be important to keep the insertion site clean and dry. Your physician will give you specific bathing instructions.

Your physician will give you specific instructions about driving. If you had an ICD, you will not be able to drive until your physician gives you approval. Your physician will explain these limitations to you, if they are applicable to your situation.
You will be given specific instructions about what to do if your ICD discharges a shock. For example, you may be instructed to dial 911 or go to the nearest emergency room in the event of a shock from the ICD.

Ask your physician when you will be able to return to work. The nature of your occupation, your overall health status, and your progress will determine how soon you may return to work.

Notify your physician to report any of the following:
fever and/or chills
increased pain, redness, swelling, or bleeding or other drainage from the insertion site
chest pain/pressure, nausea and/or vomiting, profuse sweating, dizziness and/or fainting
palpitations

Your physician may give you additional or alternate instructions after the procedure, depending on your particular situation.

Pacemaker/ICD precautions
The following precautions should always be considered. Discuss the following in detail with your physician, or call the company that made your device:

Always carry an ID card that states you are wearing a pacemaker or an ICD. In addition, you should wear a medical identification bracelet that states you have a pacemaker or ICD.
Use caution when going through airport security detectors. Check with your physician about the safety of going through such detectors with your type of pacemaker. In particular, you may need to avoid being screened by hand-held detector devices, as these devices may affect your pacemaker.
You may not have a magnetic resonance imaging (MRI) procedure. You should also avoid large magnetic fields.
Abstain from diathermy (the use of heat in physical therapy to treat muscles).
Turn off large motors, such as cars or boats, when working on them (they may temporarily €œconfuse" your device).
Avoid certain high-voltage or radar machinery, such as radio or television transmitters, electric arc welders, high-tension wires, radar installations, or smelting furnaces.

If you are having a surgical procedure performed by a surgeon or dentist, tell your surgeon or dentist that you have a pacemaker or ICD, so that electrocautery will not be used to control bleeding (the electrocautery device can change the pacemaker settings).
You may have to take antibiotic medication before any medically invasive procedure to prevent infections that may affect the pacemaker.

Always consult your physician if you have any questions concerning the use of certain equipment near your pacemaker.

When involved in a physical, recreational, or sporting activity, you should avoid receiving a blow to the skin over the pacemaker or ICD. A blow to the chest near the pacemaker or ICD can affect its functioning. If you do receive a blow to that area, see your physician.
Always consult your physician when you feel ill after an activity, or when you have questions about beginning a new activity.

Parkinson's Disease

Parkinson's disease (also known as Parkinson disease or PD) is a degenerative disorder of the central nervous system that often impairs the sufferer's motor skills, speech, and other functions.
Parkinson's disease belongs to a group of conditions called movement disorders. It is characterized by muscle rigidity, tremor, a slowing of physical movement (bradykinesia) and, in extreme cases, a loss of physical movement (akinesia). The primary symptoms are the results of decreased stimulation of the motor cortex by the basal ganglia, normally caused by the insufficient formation and action of dopamine, which is produced in the dopaminergic neurons of the brain. Secondary symptoms may include high level cognitive dysfunction and subtle language problems. PD is both chronic and progressive.
PD is the most common cause of chronic progressive parkinsonism, a term which refers to the syndrome of tremor, rigidity, bradykinesia and postural instability. PD is also called "primary parkinsonism" or "idiopathic PD" (classically meaning having no known cause although this term is not strictly true in light of the plethora of newly discovered genetic mutations). While many forms of parkinsonism are "idiopathic", "secondary" cases may result from toxicity most notably of drugs, head trauma, or other medical disorders. The disease is named after English physician James Parkinson, who made a detailed description of the disease in his essay: "An Essay on the Shaking Palsy" (1817).

Jay Z New LP The Blueprint 3

AHSI....Jay Z is still the man to beat in the rap game. His new album, The Blueprint 3 , demonstrates his veteran status by showcasing the skill level he has in rap music. He "walks the walk and talks the talk". I heard the entire album for the first time, thanks to rhapsody.com via mtv.com, this morning. Some of the underground songs and freestyles have been floating around the Internet for weeks causing me to anticipate that this album would be a great buy to close out the summer. With songs featuring some of the artists that are currently dominating the charts like Rhianna, Kanye West, Drake, Kid Cudi, Swizz Beats, Pharell and Young Jeezy, you will be able to find a song for everyone in the house, car and office. I give this album 4 eyeballs and I would suggest adding it to your music collection.

Hot Springs in The Summer

ASSI - Three days into our trip we took a ride North East of Liberia to Las Hornillas a tourist volcanic activity center that has an active crater, hot springs, a water slide, and natural mud bath. There were pockets and mini pools of gurgling mud that actually feels good and is good for your skin at the right temperature. Smelling sulphur opens my passages and feels like I should be breathing it, but the verdict regarding the benefits of inhaling sulphur is out. When I was in St. Lucia we visited an active crater and the guide said the sulphur was healthy for the lungs. However, Marvin who was out tour guide at Las Hornillas said that we shouldn't breath it.

A quick stop in the natural steam room help to prepare our skin for the mud. I couldn't wait to spread the warm mud all over our bodies. As a first timer, I felt a little uneasy when I stepped into the bath of mud. It was comfortable temperature not too warm and not cold. There are two or three pots without bottoms that has the hot mud. We stood the entire time while applying the mud for about ten fun minutes, then we showered all the mud off, and got into the hot springs sauna that was inviting and relaxing. As I see it we had such a wonderful experience at Las Hornillas that when and if you make to Costa Rica you must plan a half day trip there, plus lunch was available for $10.00 and it was well worth it. The usual rice and beans, fish, salad, and juice.

Palo Verde River Tour

ASSI - Palo Verde River Tour was an afternoon excursion planned for my birthday. The Tempisque River is known as a bird sanctuary, with alligators, a multitude of iguanas, Howler monkeys, and White-throated capuchin (white faced) monkeys that were adorable. We spotted a Tinamidae, a Baltimore Oriole, and a few others that I am unable to identify at the moment. The half day trip river tour boat ride was shared with a friendly grandmother who was on vacation with her 14 year old granddaughter and husband Peggy, the grandmother was on her 8th trip to Costa Rica. She and her husband owns a condo near the beach in Playa Hermosa. There was also a family of four on the boat ride with us and all of us seem to enjoy the experience. It was a good start to my birthday.

Lunch was included in the tour. An authentic Costa Rican meal was served complete with beans and rice, mixed vegetables, a salad, beets. corn conch, pita chips, and a papaya juice mix. Digi our tour guide purchased a birthday cake for me, which was a pleasant surprise, and I am most appreciative for the kind gesture. The cake was a fruit cake but very different from the fruit cakes in the states, it was eatable, with small chunks of fruit that was only in the top of the cake. The ice cream help to make it tast better.

Dinner at Ginger's

ASSI - Based on the written reviews posted on Travel Advisor from guest who stayed at Condovac La Costa we had dinner at Ginger Restaurant. The reviews that I read stated Ginger's had the best food of all the restaurants in Playa Hermosa. It is a tapas restaurant better known as A La Cart, as vegetarians there were very few selections for us, but we managed to find a couple of dishes. We had Calamari and Ginger rolls that were good but simply not enough. I really like the decor, the service was great, and it is an open restaurant. There are two large sliding glass panels that were open, so the mosquitoes had a feast. The restaurant is aware that there is a need and was more than willing to hand us a can of insect repellent. We walked from the resort to Ginger's that was about 100 yards left of the resort.

Although there wasn't a large selection of dishes for us to devour, I recommend Ginger Restaurant, the food is served one dish at a time, and if you have about four or five dishes per person your appetite will be satisfied. I am unable to remember the brand of rojo vino (Red wine) that I had but it was really good even better than Shiraz, my wine of choice. I should have written it down. If and when we return to Costa Rica and we are staying near Ginger's I will definitely stop in for a bite to eat.

Costa Rican Animals in Heat

ASSI - The animals in Costa Rica were rather frisky. We captured ducks, donkeys, and dragon flies getting it on or attempting to get a piece and run. Animal and man are more alike than different. The donkey was comfortable with the back position, the ducks preferred the top method, and the dragon fly also enjoyed top pleasure. It was interesting to see, if your mind is as twisted as ours you will be just as amused. As I see it, without sex the world would cease to exist. We also had the pleasure of seeing a beautiful Toucan, Hermit Crabs, and Black Crabs. There were other exotic animals that we encountered but I am without the names at the moment. As soon as I can identify them I will post the pictures.

Tours Filled with Adventure

ASSI - What a fantabulous time we had in Costa Rica. The day tours were the best of any state or country that I have visited. We had the pleasure of booking all of our excursions through Marvdigi Tours. Our first excursion was a full day of adventure via Adventure Tours. We began with Horse Back Riding, then water tubing down the river, which was followed up with a 17 platform canopy zip line through a beautiful Gorge, we were supposed to have a hot mud bath and hot springs experience as well, but it all came to a medical halt. My other half had a panic attack after rock climbing up the mountain; therefore, we had a different mud bath and hot springs experience on Monday.

As an adrenaline junky, I was on a natural high, zipping across the gorge upside down was the most exhilarating, and I immensely appreciated the entire experience. The Horses were big, strong, and beautiful. We rode the horse from the stables to a water fall about a half a mile to a mile away from the stables. We then loaded a school bus and went deep into the woods, we exited the bus, and all adorned life jackets and received safety instructions regarding tubing down the river. The tubs were wrapped in a heavy covering with a bottom that prevents your buttocks from getting scrapped. The water was shallow on the day we were there; therefore, we bumped into lots of rocks. It felt like bumper cars on a tub or the ball in a ping pong game.

As I see it if you are looking for an experience of a lifetime, you must plan a trip to Costa Rica for a fun filled vacation, or an extended weekend. I thoroughly enjoyed our stay, it would have been nice if other family or friends would have joined us, but we met a number of really nice people who made the trip even better.

Bat Tree