injectables

Botox

Botox is a drug made from a toxin produced by the bacterium Clostridium botulinum. It's the same toxin that causes a life-threatening type of food poisoning called botulism. Doctors use it in small doses to treat health problems, including:

Temporary smoothing of facial wrinkles and improving your appearance
Severe underarm sweating
Cervical dystonia - a neurological disorder that causes severe neck and shoulder muscle contractions
Blepharospasm - uncontrollable blinking
Strabismus - misaligned eyes
Chronic migraine
Overactive bladder

Botox injections work by weakening or paralyzing certain muscles or by blocking certain nerves. The effects last about three to twelve months, depending on what you are treating. The most common side effects are pain, swelling, or bruising at the injection site. You could also have flu-like symptoms, headache, and upset stomach. Injections in the face may also cause temporary drooping eyelids. You should not use Botox if you are pregnant or breastfeeding.

Birth Control

What is birth control?

Birth control, also known as contraception, is the use of medicines, devices, or surgery to prevent pregnancy. There are many different types. Some are reversible, while others are permanent. Some types can also help prevent sexually transmitted infections (STIs).

What are the different types of birth control?

There are several different types of birth control, and they work in different ways:

Barrier methodsMale condomA thin sheath that covers the penis to collect sperm and prevent it from entering the woman's body. Condoms that are made of latex and polyurethane can help prevent STIs.Female condomA thin, flexible plastic pouch. Part of the condom is inserted into the vagina before intercourse to prevent sperm from entering the uterus. The uterus, or womb, is the place where the baby grows during pregnancy. Female condoms can also help prevent STIs.Contraceptive spongeA small sponge that you put into the vagina to cover the cervix (the opening of the uterus). The sponge also contains a spermicide to kill sperm.SpermicideA substance that can kill sperm cells. It comes in a foam, jelly, cream, suppository, or film. You put it into the vagina near the uterus. Spermicide can be used alone or with a diaphragm or cervical cap.Diaphragm and cervical capCups that are placed inside the vagina to cover the cervix. They may be used with spermicide. They come in different sizes, so it's important to see your health care provider to figure out which size works best for you.Hormonal methodsOral contraceptives ("the pill")Pills that a woman takes every day. They may contain only progestin or both progestin and estrogen.Contraceptive patchA patch that a woman puts on her skin each week. The patch releases hormones into the bloodstream.Vaginal ringA thin, flexible ring. The woman inserts the ring into the vagina, where it continually releases hormones for three weeks. She takes it out for the fourth week. After that week, she puts in a new ring.Injectable birth controlAn injection of a hormone that a woman gets once every three months. This is done in your provider's office.ImplantA single, thin rod that a provider inserts under the skin of a women's upper arm. It is done in your provider's office. The implant can last for four years.Long-acting reversible contraceptives (LARCs)Intrauterine device (IUD)A small, T-shaped device that a provider inserts into the uterus. This is done in the provider's office. IUDs can last from 3 to 10 years. There are two types: hormonal IUDs and copper IUDs.SterilizationTubal ligationA surgery that prevents a woman from getting pregnant. It is permanent.VasectomyA surgery that prevents a man from getting someone pregnant. It is permanent.What are some other forms of pregnancy prevention?

There are some types of pregnancy prevention that do not involve medicines, devices, or surgery:

Other forms of pregnancy preventionFertility awareness-based methodsThey are also called natural rhythm methods. They involve tracking the woman's fertility cycle and avoiding sex or using barrier methods on the days when she is most likely to get pregnant. This method may have higher pregnancy rates than other types.Lactational amenorrhea method (LAM)A form of natural birth control for breastfeeding mothers. It relies on the new mother feeding her baby only breastmilk for up to six months and having no periods or spotting during that time.WithdrawalDuring intercourse, the penis is pulled out of the vagina before ejaculation. The goal is to keep sperm from entering the vagina . But the sperm can leak out before the penis is pulled out, so this method has higher pregnancy rates than other types.What is emergency contraception?

Emergency contraception is not a regular method of birth control. But it can be used to prevent pregnancy after unprotected intercourse or if a condom breaks. There are two types:

Copper IUD, which is a small, T-shaped device that a provider inserts into the within 120 hours of unprotected intercourse.
Emergency contraceptive pills (ECPs), which are hormonal pills which the woman takes as soon as possible after unprotected intercourse.

What else should I know about birth control?

When deciding which birth control type is right for you, there are many different factors to consider:

Do you want to have children someday? How soon?
Do you have any health conditions?
How often do you have sex?
How many sex partners do you have?
Do you also need protection from HIV and other STIs?
How well does the birth control method work?
Are there any side effects?
Will you be able to use it correctly every time?
How much does it cost?

Your provider can answer your questions about birth control to help you select the best type for you.

NIH: National Institute of Child Health and Human Development

Joint Disorders

What are joints?

Your joints are places where two or more bones come together. Your shoulders, elbows, hips, knees, and knuckles are all joints. Your spine has joints, too.

But joints are more than bones. They include the soft tissues around them, such as cartilage, tendons and ligaments. Cartilage is the hard slippery flexible tissue that covers the ends of your bones at a joint. Tendons are tough, flexible bands that connect your muscles to your bones so you can move your joints. Ligaments connect the bones of the joint to each other to keep them stable when you move.

What are joint disorders?

Joint disorders are diseases or injuries that affect your joints. Injuries can happen because of overuse of a joint. Or you could have a sudden injury, such as an accident or a sports injury.

What diseases can affect the joints?

Many diseases can affect the joints. They often cause joint pain and make your joints stiff, red, or swollen. Most of them are chronic. That means they last a long time. Some may never go away completely. Some of the diseases that affect the joints include:

Arthritis. Arthritis may cause joint pain and swelling. There are many types of this disease. Osteoarthritis is the most common type. Over time, arthritis can cause severe joint damage. It can affect people of all ages. A joint injury when you're young may cause osteoarthritis later in life.
Lupus. This autoimmune disease affects many parts of the body and can cause joint and muscle pain. Some types of lupus often cause arthritis.
Sjögren's Syndrome. This autoimmune disease affects glands that make moisture in many parts of the body. The main symptoms are dry eyes and mouth, but it often causes joint pain, too.

Treatments are different depending on the disease. But most treatments include medicines and therapies to relieve pain and other symptoms.

What types of joint disorders happen from sudden injuries?

Joint disorders from sudden injuries include:

Sprains and strains. Sprains are stretched or torn ligaments. Acute strains are stretched or torn muscles or tendons that happen from a sudden injury or movement, such as lifting a heavy object.
Dislocated joints. A joint is dislocated when the bones are pushed or pulled out of position. A joint dislocation is a medical emergency.

Treatment depends on the type of injury. You can treat many sports injuries at home. But you should call your health care provider if you:

Have a lot of joint pain, swelling or numbness
Can't put weight on the joint
Have pain from an old injury with more swelling, an unstable joint, or a joint that isn't normal in another way

What types of joint disorders happen from overuse?

Overuse injuries usually damage the soft tissues of the joint. They can happen when you work a joint too hard by doing the same movements over and over. For example, you could get an overuse injury from playing a musical instrument, playing sports, or doing certain jobs, such as carpentry or painting.

Joint overuse injuries include:

Bursitis. The bursa is a small fluid-filled sac. It works as a pad between the bones of a joint and the moving parts around it, such as muscles, tendons and skin. With bursitis, the bursa becomes irritated and swollen with extra fluid. Overuse is the most common cause, but injuries, infections and other conditions, such as arthritis, can cause bursitis.
Tendinitis. This condition happens when you overuse a tendon. It swells and makes the joint painful to move.
Chronic strain. A strain becomes chronic when your muscles or tendons stretch or tear slowly over time from repeating the same movements.

The treatments for bursitis, tendinitis, and chronic strain are often the same. They usually include rest, keeping the injured joint higher than your heart, and taking medicine to reduce swelling. Your provider may recommend gentle exercise and other treatment. In some cases, your provider may suggest an injection (a shot) of medicine into the joint. If these do not help, you may need surgery.

How can I keep my joints healthy?

Getting enough physical activity is one of the most important things you can do to prevent or slow joint disorders. Activity strengthens the muscles around your joints and helps them work better.

When you play sports, wear the right equipment to protect your joints, such as knee pads. If you already have joint problems, ask your provider what type of activities are best for you.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases

Diabetes Medicines

What is diabetes?

Diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose comes from the foods you eat. The cells of your body need glucose for energy. A hormone called insulin helps the glucose get into your cells.

type 1 diabetestype 2 diabetes

What are the treatments for diabetes?

Treatments for diabetes can depend on the type. Common treatments include a diabetic meal plan, regular physical activity, and medicines. Some less common treatments are weight loss surgery for either type and an artificial pancreas or pancreatic islet transplantation for some people with type 1 diabetes.

Who needs diabetes medicines?

People with type 1 diabetes need to take a diabetes medicine called insulin to control their blood sugar.

Some people with type 2 diabetes can control their blood sugar with healthy food choices and physical activity. But for others, a diabetic meal plan and physical activity are not enough. They need to take diabetes medicines.

The kind of medicine you take depends on your type of diabetes, daily schedule, medicine costs, and any other health conditions that you have. Over time, you may need to take more than one diabetes medicine.

What are the types of medicines for type 1 diabetes?

If you have type 1 diabetes, you must take insulin because your body no longer makes it. There are different types of insulin that start to work at different speeds, and the effects of each last a different length of time. Your health care provider will measure your blood glucose to decide on the type of insulin. You may need to use more than one type.

You will also need to check your blood sugar at home. Your provider will tell you how often. The results of your blood sugar testing can help you make decisions about food, physical activity, and medicines.

You can take insulin several different ways. The most common are with a needle and syringe, an insulin pen, or an insulin pump. If you use a needle and syringe or a pen, you have to take insulin several times during the day, including with meals. An insulin pump gives you small, steady doses throughout the day. Less common ways to take insulin include inhalers, injection ports, and jet injectors.

In rare cases, taking insulin alone might not be enough to manage your blood sugar. Then you would need to take another diabetes medicine.

What are the types of medicines for type 2 diabetes?

There are several different medicines for type 2 diabetes. Each works in a different way. Many of them are pills. There are also medicines that you inject under your skin, such as insulin.

Over time, you may need more than one diabetes medicine to manage your blood sugar. You might add another diabetes medicine or switch to a combination medicine. A combination medicine contains more than one type of diabetes medicine in the same pill. Some people with type 2 diabetes take both pills and injections.

Even if you don't usually take insulin, you may need it at special times, such as during pregnancy or if you are in the hospital.

What else should I know about taking medicines for diabetes?

Even if you take medicines for diabetes, you still need to eat a healthy diet, stop smoking, take your other medicines, and get regular physical activity. These will help you manage your diabetes.

It is important to make sure that you understand your diabetes treatment plan. Talk to your provider about:

What your target blood sugar level is
What to do if your blood sugar gets too low or too high
Whether your diabetes medicines will affect other medicines you take
If you will have any side effects from the diabetes medicines

You should not change or stop your diabetes medicines on your own. Talk to your provider first.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Dystonia

Dystonia is a movement disorder that causes involuntary contractions of your muscles. These contractions result in twisting and repetitive movements. Sometimes they are painful.

Dystonia can affect just one muscle, a group of muscles or all of your muscles. Symptoms can include tremors, voice problems or a dragging foot. Symptoms often start in childhood. They can also start in the late teens or early adulthood. Some cases worsen over time. Others are mild.

Some people inherit dystonia. Others have it because of another disease. Researchers think that dystonia may be due to a problem in the part of the brain that handles messages about muscle contractions. There is no cure. Doctors use medicines, Botox injections, surgery, physical therapy, and other treatments to reduce or eliminate muscle spasms and pain.

NIH: National Institute of Neurological Disorders and Stroke

Heart Health Tests

Heart diseases are the number one killer in the United States. They are also a major cause of disability. If you do have heart disease, it is important to find it early, when it is easier to treat. Blood tests and heart health tests can help find heart diseases or identify problems that can lead to heart diseases. There are several different types of heart health tests. Your health care provider will decide which test or tests you need, based on your symptoms (if any), risk factors, and medical history.

Cardiac Catheterization

Cardiac catheterization is a medical procedure used to diagnose and treat some heart conditions. For the procedure, your provider puts a catheter (a long, thin, flexible tube) into a blood vessel in your arm, groin, or neck, and threads it to your heart. The provider can use the catheter to:

Do a coronary angiography. This involves putting a special type of dye in the catheter, so the dye can flow through your bloodstream to your heart. Then your provider takes x-rays of your heart. The dye allows your provider to see your coronary arteries on the x-ray, and to check for coronary artery disease (CAD). CAD is caused by plaque buildup in the arteries.
Take samples of your blood and heart muscle.
Examine your heart valves.
Do procedures such as angioplasty or minor heart surgeries to repair congenital heart defects or replace heart valves.

Cardiac CT Scan

A cardiac CT (computed tomography) scan is a painless imaging test that uses x-rays to take detailed pictures of your heart and its blood vessels. Computers can combine these pictures to create a three-dimensional (3D) model of your whole heart. This test can help providers detect or evaluate various heart problems, including:

Coronary artery disease
Calcium buildup in the coronary arteries
Congenital heart defects
Problems with the aorta (the main artery that carries blood away from the heart)
Problems with heart function and valves
Pericardial diseases

Before you have the test, you get an injection of contrast dye. The dye highlights your heart and blood vessels in the pictures. The CT scanner is a large, tunnel-like machine. You lie still on a table that slides you into the scanner, and the scanner takes the pictures.

Cardiac MRI

Cardiac MRI (magnetic resonance imaging) is a painless imaging test that uses radio waves, magnets, and a computer to create detailed pictures of your heart. It can help your provider figure out whether you have heart disease, and if so, how severe it is. A cardiac MRI can also help your provider decide the best way to treat heart problems such as:

Congenital heart defects
Coronary artery disease
Heart valve problems
Pericarditis
Cardiac tumors
Damage from a heart attack

The MRI is a large, tunnel-like machine. You lie still on a table that slides you into the MRI machine. The machine makes loud noises as it takes pictures of your heart. Sometimes before the test, you might get an injection of contrast dye. The dye highlights your heart and blood vessels in the pictures.

Chest X-Ray

A chest x-ray creates pictures of the organs and structures inside your chest, such as your heart, lungs, and blood vessels. It can reveal signs of heart failure, as well as lung disorders and other causes of symptoms not related to heart disease.

Coronary Angiography

Coronary angiography (angiogram) is a procedure that uses contrast dye and x-ray pictures to look at the insides of your arteries. It can show whether plaque is blocking your arteries and how severe the blockage is. Providers use this procedure to diagnose heart diseases after chest pain, sudden cardiac arrest (SCA), or abnormal results from other heart tests such as an EKG or a stress test.

You usually have a cardiac catheterization to inject the dye into your coronary arteries. Then the provider will take special x-rays while the dye is flowing through your coronary arteries. The dye lets your provider study the flow of blood through your heart and blood vessels.

Echocardiography

Echocardiography, or echo, is a painless test that uses sound waves to create moving pictures of your heart. The pictures show the size and shape of your heart. They also show how well your heart's chambers and valves are working. Providers use an echo to diagnose many different heart problems, and to check how severe they are.

There are several different types of echocardiography. For transthoracic echocardiography (the most common type), a technician applies gel to your chest. The gel helps sound waves reach your heart. The technician moves a transducer (wand-like device) across your chest. The transducer connects to a computer. It transmits ultrasound waves into your chest, and the waves bounce (echo) back. The computer converts the echoes into pictures of your heart.

Electrocardiogram (EKG), (ECG)

An electrocardiogram, also called an ECG or EKG, is a painless test that detects and records your heart's electrical activity. It shows how fast your heart is beating and whether its rhythm is steady or irregular.

An EKG may be part of a routine exam to screen for heart disease. Or you may get it to detect and study heart problems such as heart attacks, arrhythmia, and heart failure.

For the test, you lie still on a table and a nurse or technician attaches electrodes (patches that have sensors) to the skin on your chest, arms, and legs. Wires connect the electrodes to a machine that records your heart's electrical activity.

Stress Testing

Stress testing looks at how your heart works during physical stress. It can help to diagnose coronary artery disease, and to check how severe it is. It can also check for other problems, including heart valve disease and heart failure.

For the test, you exercise (or are given medicine if you are unable to exercise) to make your heart work hard and beat fast. While this is happening, you get an EKG and blood pressure monitoring. Before or after the test, you might also have an echocardiogram, or other imaging tests such as a nuclear scan. For the nuclear scan, you get an injection of a tracer (a radioactive substance), which travels to your heart. Special cameras detect the energy from the tracer to craeate pictures of your heart. You have pictures taken after you exercise, and then after you rest.

NIH: National Heart, Lung, and Blood Institute

Tendinitis

Tendons are flexible bands of tissue that connect muscles to bones. They help your muscles move your bones. Tendinitis is the severe swelling of a tendon.

Tendinitis usually happens after repeated injury to an area such as the wrist or ankle. It causes pain and soreness around a joint. Some common forms of tendinitis are named after the sports that increase their risk. They include tennis elbow, golfer's elbow, pitcher's shoulder, swimmer's shoulder, and jumper's knee.

Doctors diagnose tendinitis with your medical history, a physical exam, and imaging tests. The first step in treatment is to reduce pain and swelling. Rest, wrapping or elevating the affected area, and medicines can help. Ice is helpful for recent, severe injuries. Other treatments include ultrasound, physical therapy, steroid injections, and surgery.

Anesthesia

What is anesthesia?

Anesthesia is the use of medicines to prevent pain during surgery and other procedures. These medicines are called anesthetics. They may be given by injection, inhalation, topical lotion, spray, eye drops, or skin patch. They cause you to have a loss of feeling or awareness.

What is anesthesia used for?

Anesthesia may be used in minor procedures, such as filling a tooth. It could be used during childbirth or procedures such as colonoscopies. And it is used during minor and major surgeries.

In some cases, a dentist, nurse, or doctor may give you an anesthetic. In other cases, you may need an anesthesiologist. This is a doctor who specializes in giving anesthesia.

What are the types of anesthesia?

There are several different types of anesthesia:

Local anesthesia numbs a small part of the body. It might be used on a tooth that needs to be pulled or on a small area around a wound that needs stitches. You are awake and alert during local anesthesia.
Regional anesthesia is used for larger areas of the body such as an arm, a leg, or everything below the waist. You may be awake during the procedure, or you may be given sedation. Regional anesthesia may be used during childbirth, a Cesarean delivery (C-section), or minor surgeries.
General anesthesia affects the whole body. It makes you unconscious and unable to move. It is used during major surgeries, such as heart surgery, brain surgery, back surgery, and organ transplants.

What are the risks of anesthesia?

Anesthesia is generally safe. But there can be risks, especially with general anesthesia, including:

Heart rhythm or breathing problems
An allergic reaction to the anesthesia
Delirium after general anesthesia. Delirium makes people confused. They may be unclear about what is happening to them. Some people over the age of 60 have delirium for several days after surgery. It can also happen to children when they first wake up from anesthesia.
Awareness when someone is under general anesthesia. This usually means that the person hears sounds. But sometimes they can feel pain. This is rare.

Back Pain

If you've ever groaned, "Oh, my aching back!", you are not alone. Back pain is one of the most common medical problems, affecting 8 out of 10 people at some point during their lives. Back pain can range from a dull, constant ache to a sudden, sharp pain. Acute back pain comes on suddenly and usually lasts from a few days to a few weeks. Back pain is called chronic if it lasts for more than three months.

Most back pain goes away on its own, though it may take awhile. Taking over-the-counter pain relievers and resting can help. However, staying in bed for more than 1 or 2 days can make it worse.

If your back pain is severe or doesn't improve after three days, you should call your health care provider. You should also get medical attention if you have back pain following an injury.

Treatment for back pain depends on what kind of pain you have, and what is causing it. It may include hot or cold packs, exercise, medicines, injections, complementary treatments, and sometimes surgery.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases

Bursitis

A bursa is a small, fluid-filled sac that acts as a cushion between a bone and other moving parts, such as muscles, tendons, or skin. Bursitis occurs when a bursa becomes inflamed. People get bursitis by overusing a joint. It can also be caused by an injury. It usually occurs at the knee or elbow. Kneeling or leaning your elbows on a hard surface for a long time can make bursitis start. Doing the same kinds of movements every day or putting stress on joints increases your risk.

Symptoms of bursitis include pain and swelling. Your doctor will diagnose bursitis with a physical exam and tests such as x-rays and MRIs. He or she may also take fluid from the swollen area to be sure the problem isn't an infection.

Treatment of bursitis includes rest, pain medicines, or ice. If there is no improvement, your doctor may inject a drug into the area around the swollen bursa. If the joint still does not improve after 6 to 12 months, you may need surgery to repair damage and relieve pressure on the bursa.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases