Dr. Randy Wysong wonders:


Estrogen is one of the most powerful of female hormones. It binds to tissue in the uterus and breasts by attaching to estrogen receptor sites. It is then transported into the cytoplasm of the cell and on to genetic material to work its estrogenic effect by stimulating specific protein syntheses.

Compounds in plants that mimic estrogen are called phytoestrogens and can competitively bind to estrogen receptor sites. By usurping the estrogen receptor cite they exclude the more powerful estrogen produced by the body. But once attached they exert a more mild estrogenic effect. Phytoestrogens are normally 40 times weaker than estrogens. They can also lower luteinizing hormone levels, which tend to rise at menopause causing symptoms such as hot flashes.

Phytoestrogens include triterpines (actein, cimici-fugicide, 27-desoxyacetylacteol), isoflavones (daidzein, genestein, biochanin, formononetin), aromatic acids (isoferulic acid, ferulic acid, salicylic acid) and others. They are found naturally in seeds, nuts, legumes (such as soy) and vegetables.

The oral use of phytoestrogens as isolated nutrients or as a part of natural foods has been shown in scientific studies to decrease hormone-related problems associated with menstruation, menopause and oncogene (tumor) expression.

Clinical studies have demonstrated the following impressive effects with these plant based nutrients:

1. In a study of 625 menopausal female patients, results from 131 doctors showed 80% measured improvements in associated ailments;

2. Comparisons to estrogen therapy and Valium in 60 patients showed a superior response to the Kupperman Menopausal Index;

3. Compared to estrogen and placebo, better results were obtained on the Kupperman Index, the Hamilton Anxiety test and vaginal lining testing;

4. A double-blind study of 110 females showed improvement in blood hormone levels;

5. In 60 women who had partial hysterectomies and were experiencing surgical menopause, symptoms were relieved;

6. Epidemiological studies of Eastern societies that consume much higher levels of natural dietary phytoestrogens show them to be far more free of menopausal or menstrual problems and to have a much lower incidence of estrogen sensitive cancers.

Estrolog-type phytoestrogens have been used since the 1950’s in Europe and are highly successful and safe. The only possible contraindications would be in the presence of pregnancy, lactation, estrogen-dependent tumors and heart disease.

Phytoestrogens will not result in the more immediate and more powerful effects characteristic of pharmaceuticals… nor do they have the attendant dangerous side effects. On the other hand, problems that may have developed in the body over decades cannot be expected to be resolved in a day or two. Restoring healthy balances takes time and usually several weeks must pass before results can be seen. Patience and commitment to an ideal of safe, natural nutrition and supplementation combined with a healthy life-style is critical to long-term results.

Zeneca Pharaceuticals. Tamoxifen Patient Insert. Zeneca, Inc. Wilmington, DE. 1998.

For further reading, or for more information about, Dr Wysong and the Wysong Corporation please visit www.wysong.net or write to wysong@wysong.net. For resources on healthier foods for people including snacks, and breakfast cereals please visit www.cerealwysong.com.

Dr Brooke R. Seckel wonders:


If you are considering a face lift or any facial rejuvenation procedure it is important to understand what a face lift can and cannot achieve and the many variations of the face lift technique that are designed to correct individual variations in facial aging that appear on different faces. Your face is unique and your face lift or facial rejuvenation procedure needs to be customized to create a pleasing result on your face.

Excellent results and beautiful rejuvenation can be achieved safely with modern face lift techniques:

Most important for you is the skill and experience of your doctor. Honest expert evaluation of your face and a clear explanation of the procedure that is best for you are essential. I have written a book called Save Your Face and in chapter 10 you will find an important guide on how to choose a plastic surgeon, questions you should ask, and warnings about potential situations that I think you should avoid.

What a face lift can achieve

· Restoration of a full youthful cheek

· A smooth tight jaw line

· A youthful smooth neckline

· Some elevation of the lateral brow

· Removal of jowls

· Correction of loose skin around the mouth

· Improvement in Marionette lines and Nasal labial fold lines

What a face lift cannot achieve

· Wrinkle removal

· Eyelid rejuvenation

· Removal of crow’s feet

· Removal of eye bags

· Removal of eyelid hooding

The different Types of Face lift Procedures

There are so many different names used to describe the face lift that it can be very confusing for you the patient. Terms like week end lift, mini lift, S lift, non-surgical face lift, thread lift, lifestyle lift are often used and it is hard for you the patient to know what these terms mean. Below I will try to describe the variations of the face lift procedure hopefully shed some light on this subject for you.

The Standard Face lift

The standard face lift involves an incision around the ear and undermining or freeing the loose facial skin from the deeper facial attachments. Once the skin is free to move it is drawn tight back to a more youthful and normal position on the face and the excess skin is removed from the area around the ear and the incision is closed. This relatively straightforward operation can produce excellent results and has “stood the test of time”. Elements of the standard facelift are used in virtually all of the facelift variations listed below. The main difference is that the underlying “musculo-aponeaurotic” tissues are not always tightened.

One common variation of the standard face lift is the SMAS Plication which involves tightening the deep layers with a stitch rather than actually excising or removing some of the deep tissue layer. The standard face lift with “SMAS Plication” is the most common face lift I perform. Published reports document the superiority and effectiveness of this technoique.

The SMAS Face lift

The SMAS face lift involves dissecting, and tightening the deeper tissue called the SMAS layer in addition to the standard facelift dissection of the skin. This is done to provide additional tightening of the face and presumably provide a longer lasting result. Studies have cast doubt on whether SMAS lifting provides a longer result, but most face lifts today include some modification of the SMAS.

The SMAS stands for “superficial muscular aponeurotic system” and describes a firm fibrous tissue layer beneath the facial skin that attaches the facial skin to the underlying facial muscles. When this tissue is tightened during a face lift additional facial tightening is achieved.

The classic SMAS face lift involves dissecting beneath and elevating the SMAS layer, excising some of the excess and suturing the SMAS layer to tighten it.

I achieve the same effect by “plicating “the SMAS layer which means I do not dissect beneath the layer but fold the layer on itself with a suture to tighten the SMAS.

I do not dissect beneath the SMAS because the facial nerves run below the SMAS and I fear damage to the facial nerve. In my experience the placation provides the same result and is safer

The Extended SMAS Face lift

The extended SMAS face lift involves a more extensive dissection beneath the SMAS layer in an attempt to get a more extensive tightening of the facial skin especially down around the mouth. In my experience I am able to get this correction by undermining skin only and plicating the SMAS.

I avoid the extended SMAS face lift because in my opinion the facial nerves are more exposed to injury by this technique

The Deep Plane Face lift

The deep plane face lift involves a more extensive dissection beneath the SMAS layer and some of the facial muscles such as the orbicularis occuli. Proponents argue a more effective correction of cheek laxity and lower and mid face correction especially around the mouth. Longer lasting results are reported and this technique is purported to be safer for people who have smoked in the past.

Beautiful results have been achieved by the originator of this procedure, Dr Sam Hamra of Texas. Others have experienced an increased incidence of nerve injury. My own experience is that while excellent results are possible, some patients find an objectionable change in the appearance of their mouth.

Some studies have shown that the SMAS Plication technique mentioned above provides superior cosmetic results.

Subperiosteal Face lift

The subperiosteal face lift involves undermining beneath the deepest facial layer adjacent to the bone. This technique is designed to elevate and tighten all of the lax soft tissue on the face. Theory holds that undermining in the area next to the bone, deep to the nerves, also helps avoid nerve injury. Nerves still can be injured by this blind deep dissection. The subperiosteal face lift is an extensive operation and in my experience offers no advantage over the standard face lift with SMAS placation

The Lateral Brow Lift

The lateral brow lift is a modification of the face lift to treat laxity and sagging of the upper third of the face, the outside portion of the eyebrow and the upper cheek. An incision is made in or on the hairline on the side of the forehead, the skin is undermined, pulled tight and the excess removed.

This technique can be effective when only the side or lateral potion of the eyebrow and the upper cheek are lax. However care must be taken to avoid displacement of the hairline and injury to the frontal branch of the facial nerve, which if injured can cause the brow to droop.

The Forehead Lift

The forehead lift is a procedure I rarely do since the advent of Botox. Proper use of Botox can correct most forehead laxity caused by contraction of the frown muscles and the standard face lift corrects most lateral brow laxity of the outside portion of the eyebrow.

A forehead lift requires and incision within or at the hairline all the way across the forehead. The results can be excellent if you are willing to accept the scar. One problem however is that for a long lasting result the frown muscles must be removed and this can result in a permanent depression or contour deformity in the mid forehead in the frown area. In the past the frown muscles could be neutralized through an upper blepharoplasty eyelid incision, but again Botox has made this operation unnecessary for most people who want to correct laxity of the middle portion of the forehead.

The Mid face or Cheek Lift

The mid face lift or cheek lift is designed to tighten the cheeks and help improve the nasal labial fold lines. This is a modification of the face lift which involves an incision along the crease in front of the top part of the ear extending up onto the hairline.

The cheek lift or mid face lift is effective for people who have laxity in the cheek and nasal labial fold lines but have no laxity along the jaw line and neck.

The cheek lift or mid face lift is becoming very popular among younger patients who have early facial laxity in the midface. Cheek sagging is often the first facial aging change to occur, and younger patients are choosing to have a cheek lift or midface lift before further facial sagging extending to the neck and jaw line occur.

The Neck Lift

The neck lift is designed to tighten sagging neck skin below the jaw line and chin. The neck lift is a good choice for younger patients who only have loose skin beneath the chin and jaw line.

In some cases the neck lift can be accomplished through a small incision beneath the chin which is well hidden. This procedure is also called a platysmaplasty or corset platysmaplasty. In some cases with more extensive neck laxity an incision behind the ear is also required.

The Short Scar Face lift

The short scar face lift describes a face lift performed through an incision which runs only in front of the ear in the skin crease. The incision behind the ear and above the ear in the hairline is avoided.

Some authors show very impressive results showing improvement in face and neck laxity with this technique. This procedure is effective for younger patients with mid face laxity and less extensive neck and forehead laxity. The smaller incision is advantageous cosmetically and should require less healing and down time.

The Mini Lift

The mini lift or mini face lift means many things to many people. Most commonly the mini lift term is used by patients who want a face lift but don’t want to call it a face lift!

To me a mini face lift is a smaller procedure than the standard face lift and is useful in patients who have early facial laxity in the cheek and jaw line who do not have extensive neck laxity.

Usually I can use a short scar or an upper scar along the upper portion of the ear crease into the hairline.

The mini lift or mini face lift is a less extensive procedure and works well for younger patients and older patients with minimal facial laxity.

The Lifestyle Lift

I include the lifestyle lift here because so many people ask me about it. I only know what I read. I have not trained in nor have I ever done or seen a lifestyle lift performed. I have seen patients who claim they have had a lifestyle lift. As advertised the lifestyle lift is done without general anesthesia or IV sedation and claims are made that recovery is less than a traditional face lift.

The Non-surgical Facelift

When most people use the term non-surgical face lift they are talking about skin tightening with the various new skin tightening machines. Some misuse this term by applying it to extensive soft tissue filler injections

The newer skin tightening technology uses radiofrequency energy or infrared energy to heat the deep layers of the skin to cause contraction and tightening but first cools the skin before the energy is applied to prevent injury and ablation of the superficial skin by the heat energy. Thus the skin is tightened but the surface is not ablated, thus non-ablative skin tightening. There is no down time following non-ablative skin tightening unlike the older CO2 laser resurfacing skin tightening.

Several new skin tightening machines are available. The LuxIR by Palomar, and the Titan by Cutera utilize infrared energy for skin tightening. The Aluma by Lumenis and Thermage utilize infrared energy for skin tightening. Refirme by Syneron uses a combination of light energies with radiofrequency for skin tightening.

All of the machines achieve about similar results when used properly. Generally there is less discomfort with the Infrared skin tightening machines. Complications have been minimal although some serious complications occurred with Thermage skin tightening early on.

In my practice I find that non-ablative skin tightening is most helpful for younger patients who do not have severe aging changes and significant sun damage, people in their 30’s and 40’s who want to correct or tighten early skin sagging along the jaw line or jowl area, neck and cheeks. I use the LuxIR on these larger areas. For skin tightening around the eyelids I use the Aluma which has a smaller treatment head and a suction device that will pull the delicate peri ocular skin into the treatment chamber for skin tightening.

The field of non-ablative skin tightening is in its infancy and will definitely become more effective in the years ahead. The companies are improving their products frequently. For now however the people who benefit most from the skin tightening machines today are younger people who still have thick healthy skin with early aging changes.

The use of the term non-surgical face lift to describe non-ablative skin tightening is an overstatement with technology available for skin tightening today. At best a 30% result is possible when compared to a traditional face lift.

Result Oriented Face lift

A face lift can create a truly beautiful and refreshed look to your face:

The important components of a beautiful Face lift result are:

* A smooth, firm neck and jaw line

* A full elevated cheek high on the cheek bone

* A normal appearing ear lobe

* Hidden scars

* A normal “unoperated” appearance

* Looking “like you” just younger

The Face lift is one of the most enjoyable surgeries that I do. After 25 years in practice I usually achieve the result you want and it is a joy for me to share your happiness and enthusiasm for your new refreshed look.

The Face lift requires experience and skill and is a complex procedure which requires both artistry and a clear understanding and shared image of the final look you hope to achieve.

Your Consultation

When we meet I will talk with you and ask you to explain to me the specific facial rejuvenation goals you hope to achieve. I will examine you and tell you my findings and describe the areas where I think improvement can be made. I will demonstrate on your face the appearance that I believe the face lift will create on your face.

I will then recommend the procedure I feel is best for you. I will discuss the procedure, your recovery, and expectations and answer your questions. Photos of your face will be taken. You will be given an estimate or quote of the cost of the procedure. Financing plans are available.

The Face lift procedure

I perform different types of Face lifts designed to meet your specific needs for your unique face.

A Full face lift elevates and firms the entire face and neck, including the lateral brow, the cheek, the jaw line and the neck. A neck lift just tightens the neck and lower jaw. A midface lift or cheek lift tightens the cheeks and nasal labial folds. An upper face lift or brow lift elevates the outside of the eyebrow and the upper face.

A mini face lift is a less extensive full face lift which is appropriate for people who have minimal facial laxity and need only minor facial tightening or tuck. The mini lift is usually appropriate for younger people in their 30’s and 40’s, or those lucky people in their 50’s and up who have very little facial laxity.

A good face lift result requires tightening of both the skin and the deeper facial tissues which also sag with age. I tighten the deep layers of the face; the SMAS face lift, which tightens the deeper muscle like layer of the face. This is necessary to achieve a good result that lasts. Minor lifts that are advertised as being quick, easy and with no down time usually only involve skin removal and they do not last, often only a few months. A well done SMAS lift should last years.

Face lift Vectors

A very important concept in face lifting is the Vector. The vector is the direction of pull required to lift the face to a younger more attractive look. The appropriate face lift vector is unique to your face and the face lift must tighten your face along the appropriate vector if you are going to achieve the result you want.

When you see a person who has had a face lift and has the surprised look, or looks too tight, unnatural or like a “weasel”, it usually means that their surgeon did not tighten the face along the appropriate vector.

I always examine your face, determine the best most natural vector for your face and draw the vectors on your face before I make my lines to mark my planned face lift procedure. This helps to assure a natural looking face lift result.

Scars

No one wants scars on their face and everyone is concerned about face lift scars.

Usually face lift scars are not visible to those around you. 75% of the face lift scars are behind the ear or in the hairline and people do not see them unless they closely inspect you and look for them. Yes your hairdresser will know, but he/she is likely the only one other than your partner.

The 25 % of the scar that is in a visible location is also hidden. This scar is placed into the fold in front of your ear. It is usually not visible and is easily covered by your make up.

Your Ears

In my opinion, the worst sign of a bad face lift by an inexperienced surgeon is the “Spock ear” or “elf ear” deformity. This occurs when the ear lobe is fused to the cheek and pulled down to where it looks like the ear is attached to the angle of the jaw.

I have developed a very specific technique for creating a normal looking ear lobe following a face lift-check my photos; you will not see the “Spock ear”.

Pre OP

The pre operative visit is the time when we will sit down and clearly define your face lift goals. We will discuss what you hope to achieve and what I believe I can achieve with your face lift. I will try to give you an honest image of what you can expect for a result.

You will also undergo a history and physical exam to make certain that you are healthy and have no medication allergies or contraindications to surgery. An EKG (electrocardiogram) may be done if you have a history of heart problems or have reached a certain age. You will also be given prescriptions for post operative medications. You also will be asked to read and sign surgical consent forms which outline the risks, potential complications, limitations and expectations of face lift surgery.

The Operation

A full SMAS face and neck lift usually takes me about 90 minutes to 2 hours. If I am doing eyelid rejuvenation or 4 lid blepharoplasty at the same operation, as is often the case, then the surgery can take 3 hours. Mini lifts, neck lifts and cheek lifts usually take only an hour.

You are asleep during the surgery. I have very experienced superb anesthesiologists who will be taking care of you. Safety is our first concern. We use modern, very safe anesthesiology techniques, and take precautions to avoid nausea after surgery.

Following your surgery you will go to the recovery room where a nurse will take care of you and make sure you are comfortable.

Some patients prefer the comfort of an overnight stay in the hospital. In this case I will examine you the next morning, remove two tiny drains from behind your ear, remove your bandage, and have you shower and comb out your hair, and then discharge you. When you go home a small scarf placed over your head and a pair of sunglasses will usually hide the fact that you have had surgery.

For those of you who want to go home the same day after surgery, you will spend about 2 hours in the recovery room with a nurse taking care of you. As soon as you are comfortable, able to drink and eat a bland food such as crackers or cookies, and able to go to the bathroom, you will be discharged. The nurse will escort you by wheel chair to your car.

We require that someone bring you to the surgery center and take you home, and that you have someone staying with you the first night after your surgery.

Post op- What to expect

My patients do not always complain of pain following a face lift. Your face and neck will feel tight, which means that I have done my job correctly. After a few days the tight sensation will go away as the facial tissues relax. If you have had a blepharoplasty for eyelid rejuvenation you will have ice packs on your eyes to reduce swelling and bruising.

I place a bandage around your face which comes off the next day and you may shower and wash your hair on the first day after surgery. I usually place a tiny drain behind each ear which is removed the first day after surgery.

Bruising on the face is unusual; bruising when it does occur is usually on the neck and upper chest and is usually minimal and easily covered with make up.

Usually after 1 to 2 weeks you will be comfortable being seen in public and will be back to most normal activity. I ask you to wait 3 weeks before heavy weight lifting or aggressive work outs.

I have you take an herbal supplement called Arnica Montana before and after surgery which helps reduce bruising. I also have excellent mineral cover up make up to cover any visible bruising.

Consultation with Dr Seckel

I can tell you a great deal more about face lift and how it would work for you if I see you in person. Call me 978-844-3116 or contact me by email at drseckel@saveyourface.com. If you would like to email me your photos I can email you my thoughts about how I think a Face lift would work for you. For more information on face lift read my blogs on face lift.

I look forward to meeting you.

Andrew simon wonders:


Vagus Nerve Stimulation for Chronic or Treatment-Resistant Depression

About Vagus Nerve Stimulation(VNS)

VNS is not brain surgery, although it is a treatment that affects the function of the brain. Vagus Nerve Stimulation uses specific stimulation of the vagus nerve to send stimulation to specific parts of the brain that are involved in mood. It is not like Electro-Convulsive Therapy (ECT), a treatment that involves stimulation of the entire brain and induces convulsions in patients. In fact, patients may not even feel the stimulation from VNS since the vagus nerve does not have the type of nerves that carry pain signals. Nor does VNS interfere with drugs, and patients having Vagus Nerve Stimulation can continue taking their other drugs without worrying about side effects or interactions between drugs.

What is the Vagus Nerve ?

Vagus means “wandering” in Latin, and is the perfect description for the vagus nerve, the longest nerve in the body. It averages almost two feet in length and “wanders” throughout the upper body. The vagus nerve starts in the brain, goes down the neck and into the body where if affects the vocal cords, the acid content of the stomach, the heart, the lungs, and other organs. In the brain it projects to areas believed to be responsible for seizures, mood, appetite, memory and anxiety (note 3). However, the vagus nerve cord does not have many pain nerves, so stimulation of the vagus nerve is not painful, although some patients may feel some sensation when electrical pulses are generated.

The History of Vagus Nerve Stimulation

Vagus Nerve Stimulation has been used to treat epilepsy patients for years; the first human clinical trial was in 1988,(note 1) and the FDA approved VNS therapy for epilepsy in 1997 (note 2). So far over 22,000 people worldwide have had VNS therapy (note 3), and it has proven to be a safe and effective treatment for epilepsy. These patients have reported minimal side effects, which have tended to decrease over time. The efficacy of the treatment has also been shown to increase with longer treatment time (note 1).

When Vagus Nerve Stimulation was first approved for epilepsy, some patients reported an improvement in mood. Researchers decided to design a study specifically to measure changes in a patient’s mood and depression due to stimulation of the vagus nerve. In 1999, scientists began the first open label (no placebo group) study for depression with 60 patients. This first study found that there was indeed an improvement in mood for depressed patients. Based on this study, a more detailed and thorough study was designed to determine if Vagus Nerve Stimulation would be a safe, tolerable and effective treatment for chronic depression.

The recently completed one-year, double blind, placebo controlled trial had 235 patients from 21 participating hospitals in the United States, and showed clinically significant improvements due to treatment compared to baseline (note 2). The acute (short-term) phase lasted three months, during which half of the patients received stimulation (treatment group) and half did not (control group). The long-term phase of the study lasted an additional 9 months (for one year total treatment) of stimulation. The HRSD-24 (24 item clinician-rated Hamilton Rating Scale for Depression) improvements observed over the first year were highly significant. The results of this long-term, pivotal study were submitted to FDA in October 2003; the FDA’s decision on the use of Vagus Nerve Stimulation for depression is not anticipated before October 2004 (note 2). Of note, Vagus Nerve Stimulation therapy was approved for use in patients with treatment resistant depression in the European Union in March 2001, and in Canada in April 2001 (note 2) .

How Does Vagus Nerve Stimulation Therapy work ?

The Pulse Generator (battery) delivers a small amount of electrical current to the vagus nerve intermittently (30 seconds on and five minutes off ) (note 3) 24 hours a day, 7 days a week for up to 10 years. The stimulation is delivered automatically, so the patient does not have to do anything. Because there is nothing to remember, compliance is assured. The stimulation is not supposed to be uncomfortable, and some patients do not even feel the stimulation. A nurse at the doctor’s office can adjust the level of stimulation (amount of electricity delivered) if the patient ever feels uncomfortable. In the study currently being reviewed by the FDA, researchers noted several similarities between epileptic and depressed patients (note 4).

One of the most important similarities is that Vagus Nerve Stimulation treatment efficacy improves over time. The longer the patient receives stimulation, the better the results. In addition, both populations of patients share the following:

Assured adherence to treatment regimen

Safety of the procedure

Safety of the therapy

High continuation rates

No drug interactions

What is the surgery like?

Vagus Nerve Stimulation is NOT brain surgery, even though it is an invasive surgical procedure that changes the function of the brain. The stimulator is a pacemaker-like device that generates electrical pulses (Pulse Generator); it is implanted under the skin in the left chest through a small incision. While this may sound like a serious or dangerous procedure, it is not. The FDA has approved the use, and confirmed the safety of this procedure, and 22,000 patients have received the implant to treat epilepsy. The Vagus Nerve Stimulation surgery involves two small incisions, one in the chest and one at the lowest part of the neck. At no time is the brain physically manipulated by the surgeon.

The surgery to implant the NCP System takes 45 minutes to two hours. Local, regional or general anesthesia (putting the patient to sleep) is used during the surgery; the doctor and anesthetist determine which type of anesthesia is best for each patient. Most Vagus Nerve Stimulation patients will have outpatient surgery, (note 3) but some patients may need to stay in the hospital overnight, and in that case they will need a family member or companion to take them home from the hospital.

Pieter De Wet wonders:


Most people that think of diabetes complications have strokes and heart attacks in mind. Do you know that there are multiple other diabetes complications out there that only doctors know about? Let’s change that and bring everyone up to date. Eye complications, foot complications, nerve complications and many more.

Eye Complications

Although damage to the eyes is the most feared complication, it is actually the most manageable. Generally, the disorders are very minor and there are a number of procedures available to treat them. Those who do not properly maintain their diabetes can face blindness when the tiny blood vessels attached to the retina are damaged. Cataracts (a clouding of the lens of the eye) and glaucoma (a buildup of pressure in the eye) can also be a cause of vision loss and the reason for having your eyes checked regularly by a professional is a part of good diabetes maintenance.

Foot Complications

Diabetics also run the risk of neuropathy, a condition that causes a person to lose feeling in their feet. Neuropathy takes away a person’s ability to feel pain or discomfort, meaning any signals of injury will be unheeded leading to further injury. On top of that, poor circulation in the feet reduces the ability to heal. Diabetics often face changes in their feet or toes leading to further problems. Diabetics are more likely to find themselves in the hospital due to foot problems than any other complications linked to diabetes.

Diabetes and Nerve Damage

Those with diabetes can develop nerve damage and when it occurs; it is likely due to a number of factors instead of just one. High blood glucose levels as well as low insulin levels, and irregular blood fat levels mixed with the duration of having diabetes all have a hand in damaging the nerves of the body.

Nerves in the bladder, genitals or intestinal tract can also become damaged. This is called autonomic neuropathy. Damage to these nerves can disrupt their function, making them work less efficiently. This is why diabetics often have trouble with their urinary tract or with maintaining an erection.

Kidney complications

Diabetes alone is the most prevalent cause of kidney failure and those with the disease often have to face this complication. Diabetes patients are likely to suffer frequent kidney and bladder infections. Thanks to the high levels of sugar in the blood, the kidneys work overtime filtering blood to get rid of waste. Although it can take years, the filters in the kidneys will eventually begin to leak. Kidneys with injured blood vessels just cannot properly cleanse the blood any longer. Waters and salts build up in the body, resulting in bloating and swelling.

Skin Complications

Those with diabetes can suffer from skin afflictions such as:

IC wonders:


You probably know someone who has experienced blindness. Two leading causes of blindness glaucoma and cataracts. Even though contact lens companies may not tell you up front that wearing contact lenses can cause blindness, multiple studies show that contact lenses may be a contributing factor in blindness, especially in developing countries. The World Health Organization (WHO) says that there are over 37 million blind people in the world, and roughly 90 percent of those people reside in developing nations where proper care is easy to practice..

So how can you avoid going blind because of your contact lenses? Follow the following 5 tips and talk to your optometrist about blindness.

1. Practice good hygiene. Good hygiene for you eyeballs? This isn’t anything special that you shouldn’t already be doing. Good hygiene for you eyes include washing your hands regularly and avoiding touching your eyes with any foreign object including your fingers. You can also wear UV resistant sunglasses to avoid UV radiation. When it comes to contact lens use you’ll want to make sure you don’t share anything with another contact lens wearer. That includes sharing contact lenses, cleaning solution, eye drops, moisturizers, storage containers and anything else that touches your eye.

2. Replace contacts regularly. Another reason contact lens wearers experience blindness is because they keep their contacts in too long and don’t replace them as recommended. If your contacts are designed for single use and are disposable, throw them out after first use. If they’re designed to last one month, don’t wear them for two months. Another reason is because people leave them in too long. If you keep your contact lenses in for 16 hours every day you may begin to experience additional dryness and irritation. When you no longer need your contacts in, take them out.

3. Eat right. Senior Consultant Ophthalmologist and Rotarian with the Rotary Avoidable Blindness Program, Mr. Low Hong says that the eating right can help improve your eyesight. By eating right Mr. Hong advises eating traffic light-like vegetables. That means those vegetables that are red, green, and yellow. Those colored fruits can contain important chemicals required by the eye to function and have a clearer vision and you’ll see colors more clearly. Hong also advises eating carrots because they help improve your eyesight as well.

4. Sleep right. Position is more important that length says Hong when it comes to blindness and cataracts. When you sleep face down on your pillow you put pressure against your eyes and eye sockets that can lead to cataracts and eventually cataract surgery. Additional sleep also helps your eye recover from wearing contact lenses for prolonged periods. Sleep helps your eyes recover from any damage they might have experienced as a result of wearing contacts all day.

5. Avoid eye rubbing. This one may seem simple, but it is often overlooked. If your keep your hands out of your eyes, you’re less likely to develop an infection and scratch your cornea. Eye infections are a serious cause of blindness. Another serious cause is inadvertent eye damage usually caused by a foreign object. Stay aware when walking near trees with low hanging branches and whenever around objects that are hanging at eye level.

Blindness is serious and extremely difficult to treat. If you take precaution and recognize how valuable and fragile your eyes are, they’ll hopefully last you an entire lifetime!

James Monahan wonders:


LASIK is they key. If you’ve been in anguish over having to wear glasses all the time, get LASIK done and you never have to wear that pair again… ever.

LASIK is a surgical procedure intended to reduce the dependency on glasses or contact lenses. LASIK means Laser-Assisted In Situ Keratomileusis.

It permanently changes the shape of the cornea, the clear covering of the front of the eye.

During the LASIK procedure, a knife, called a microkeratome, is used to cut a flap in the cornea. A hinge is left at one end of this flap. The flap is folded back revealing the stroma, the middle section of the cornea.

Pulses from a computer-controlled laser vaporize a portion of the stroma and the flap is replaced.

While LASIK procedure may be the best thing to happen to your glasses-wearing self, this is not for everyone. If you fit any of the descriptions, LASIK is just not for you.

You don’t take risks. There are certain complications which are unavoidable in a certain percent of patients. LASIK procedure does not have long term data, so in the end, you really don’t know what you’re getting into.

Cost is and will be an issue. LASIK is refractive surgery and most medical insurance will not cover it. Although the cost is going down, it still in not significant and this procedure will put a hole in your pocket.

You required a change in your contact lens or glasses prescription in the past year. This is called refractive instability.

If you fit any of the profiles. If you are in your early 20’s or younger, if you have diabetes, if you are pregnant or breastfeeding and if you are taking medications that may cause fluctuations in vision.

You’re sick and your medications will affect wound healing. Certain conditions such as autoimmune diseases, immunodeficiency states and diabetes may prevent proper healing after the LASIK procedure.

If you actively participate in contact sports. You participate in boxing, wrestling, martial arts or other activities in which blows to the face and eyes are a normal occurrence.

You are not an adult. Currently, no lasers are approved for LASIK on persons under the age of 18.

Your doctor should also screen you for the following conditions or indicators of risk:

Blepharitis. Inflammation of the eyelids with crusting of the eyelashes, that may increase the risk of infection or inflammation of the cornea after LASIK. Large pupils. Younger patients and patients on certain medications may be prone to having large pupils under dim lighting conditions. This can cause symptoms such as glare, halos, starbursts, and ghost images (double vision) after surgery.

In some patients these symptoms may be incapacitating. For example, a patient may no longer be able to drive a car at night or in certain weather conditions, such as fog.

Thin Corneas. The cornea is the thin clear covering of the eye that is over the iris, the colored part of the eye. Most refractive procedures change the eye’s focusing power by reshaping the cornea. Performing LASIK procedure on a cornea that is too thin may result in blinding complications.

Previous refractive surgery. Additional refractive surgery may not be recommended. The decision to have additional refractive surgery must be made in consultation with your doctor after careful consideration of your unique situation.

Dry Eyes. LASIK surgery tends to aggravate this condition.

Once you’ve gone through this checklist and you’re cleared, go ahead and visit you’re eye doctor. No more glasses forever!