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As a service from us to you: we have gathered thousands of health information articles. All the articles are authoritatively sourced, constantly updated, bi-lingual, and searchable. Please come back any time you want straightforward, correct answers to health information questions.

Bone Marrow Transplantation

Bone marrow is the spongy tissue inside some of your bones, such as your hip and thigh bones. It contains immature cells, called stem cells. The stem cells can develop into red blood cells, which carry oxygen throughout the body, white blood cells, which fight infections, and platelets, which help the blood to clot.

A bone marrow transplant is a procedure that replaces a person's faulty bone marrow stem cells. Doctors use these transplants to treat people with certain diseases, such as:

  • Leukemia
  • Severe blood diseases such as thalassemias, aplastic anemia, and sickle cell anemia
  • Multiple myeloma
  • Certain immune deficiency diseases

Before you have a transplant, you need to get high doses of chemotherapy and possibly radiation. This destroys the faulty stem cells in your bone marrow. It also suppresses your body's immune system so that it won't attack the new stem cells after the transplant.

In some cases, you can donate your own bone marrow stem cells in advance. The cells are saved and then used later on. Or you can get cells from a donor. The donor might be a family member or unrelated person.

Bone marrow transplantation has serious risks. Some complications can be life-threatening. But for some people, it is the best hope for a cure or a longer life.

NIH: National Heart, Lung, and Blood Institute

Breast Reconstruction

If you need a mastectomy, you have a choice about whether or not to have surgery to rebuild the shape of the breast. Instead of breast reconstruction, you could choose to wear a breast form that replaces the breast, wear padding inside your bra, or do nothing. All of these options have pros and cons. What is right for one woman may not be right for another.

Breast reconstruction may be done at the same time as the mastectomy, or it may be done later on. If radiation therapy is part of the treatment plan, your doctor may suggest waiting until after radiation therapy.

If you're thinking about breast reconstruction, talk to a plastic surgeon before the mastectomy, even if you plan to have your reconstruction later on.

A surgeon can reconstruct the breast in many ways. Some women choose to have breast implants, which are filled with saline or silicone gel. Another method uses tissue taken from another part of your body. The plastic surgeon can take skin, muscle, and fat from your lower abdomen, back, or buttocks.

The type of reconstruction that is best for you depends on your age, body type, and the type of cancer surgery that you had. A plastic surgeon can help you decide.

NIH: National Cancer Institute

Choosing a Doctor or Health Care Service

We all want high-quality health care, but it's hard to know how to choose. There are many things to consider, including:

  • What your insurance covers
  • Whether a health care provider or service is accredited
  • The location of a service
  • Hours that the service is available
  • Whether you like a health care provider's personality

On this page you'll find information to help you choose a health care provider or service.

Chronic Pain

What is chronic pain?

Pain is a signal from your nervous system that something may be wrong. It is an unpleasant feeling, such as a prick, tingle, sting, burn, or ache. Pain may be sharp or dull. You may feel pain in one area of your body or all over. Each person feels pain differently, even if the reason for the pain is the same.

Pain might be acute or chronic. The type of pain is based on how long and how often you have pain. Acute pain starts suddenly and goes away when the cause is treated or healed. This pain lets you know that you may be injured or have a problem you need to take care of. Chronic pain lasts longer than three months or the time in which you should have healed.

If you have chronic pain, it can occur most days or every day and may last for weeks, months, or even years. It can affect all aspects of daily life, including your mood and relationships. Treatment may not get rid of chronic pain, but it can help with your symptoms.

What causes chronic pain?

Sometimes, acute pain can become chronic pain. The original cause may have been an injury or infection, or you may have an ongoing cause of pain, such as arthritis or cancer. In some cases, there is no clear cause. Environmental factors and psychological factors such as mood and stress can make chronic pain worse.

What are the symptoms of chronic pain?

Since people feel pain in different ways, two people could have the same issue, but each may have different symptoms. Chronic pain can occur anywhere in your body and may cause other symptoms such as fatigue, mood changes, or difficulty sleeping. If you have depression or stress, it may make chronic pain worse.

Who is more likely to get chronic pain?

Many older adults have chronic pain. Women also report having more chronic pain than men, and they are at a greater risk for many pain conditions. Some people have two or more chronic pain conditions. You may be more likely to have chronic pain if you have certain medical conditions such as:

  • Headaches or migraines
  • Cancer
  • Fibromyalgia
  • Arthritis
  • Nerve damage
  • Back problems
How is chronic pain diagnosed?

Chronic pain lasts three months or longer or when pain continues after your body has healed. If the cause of your pain is unknown, your health care provider may:

  • Ask you about your medical history
  • Ask you to describe the pain and how it affects your life
  • Do a physical exam
  • Order blood tests or other medical tests
What are the treatments for chronic pain?

Chronic pain is not always curable, but treatments can help. Treatments may include medicines, including pain relievers. There are also non-drug treatments, such as acupuncture, physical therapy, and sometimes surgery.

Depending on the cause of your pain and your symptoms, your provider may also recommend lifestyle changes which may include suggestions for:

  • Improving mental health
  • Managing stress
  • Getting to and staying at a healthy weight
  • Adding low-impact exercise

Delirium

What is delirium?

Delirium is a mental state in which you are confused, disoriented, and not able to think or remember clearly. It usually starts suddenly. It is often temporary and treatable.

There are three types of delirium:

  • Hypoactive, when you are not active and seem sleepy, tired, or depressed
  • Hyperactive, when you are restless or agitated
  • Mixed, when you change back and forth between being hypoactive and hyperactive
What causes delirium?

There are many different problems that can cause delirium. Some of the more common causes include:

  • Advanced cancer.
  • Alcohol or drugs, either from intoxication or withdrawal. This includes a serious type of alcohol withdrawal syndrome called delirium tremens. It usually happens to people who stop drinking after years of alcohol use disorder (AUD).
  • Dehydration and electrolyte imbalances.
  • Dementia.
  • Hospitalization, especially in intensive care.
  • Infections, such as urinary tract infections, pneumonia, and the flu.
  • Medicines. This could be a side effect of a medicine, such as sedatives or opioids. Or it could be from withdrawal after stopping a medicine.
  • Metabolic disorders.
  • Organ failure, such as kidney or liver failure.
  • Poisoning.
  • Serious illnesses.
  • Severe pain.
  • Sleep deprivation.
  • Surgeries, including reactions to anesthesia.
Who is more likely to get delirium?

Certain factors put you at risk for delirium, including:

  • Being in a hospital or nursing home
  • Having dementia
  • Having a serious illness or more than one illness
  • Having an infection
  • Older age
  • Having surgery
  • Taking medicines that affect the mind or behavior
  • Taking high doses of pain medicines, such as opioids
What are the symptoms of delirium?

The symptoms of delirium usually start suddenly, over a few hours or a few days. They often come and go. The most common symptoms include:

  • Changes in alertness (usually more alert in the morning, less at night)
  • Changing levels of consciousness
  • Confusion
  • Disorganized thinking, talking in a way that doesn't make sense
  • Disrupted sleep patterns, sleepiness
  • Emotional changes: anger, agitation, depression, irritability, overexcitement
  • Hallucinations and delusions
  • Memory problems, especially with short-term memory
  • Trouble concentrating
How is delirium diagnosed?

Your health care provider may use many tools to make a diagnosis:

  • A medical history, which includes asking about your symptoms
  • Physical and neurological exams
  • Mental status testing, which checks for problems with your thinking and alertness
  • Lab and diagnostic imaging tests

Delirium and dementia have similar symptoms, so it can be hard to tell them apart. You can also have both at the same time. The differences between them are that:

  • Delirium starts suddenly and can cause hallucinations. It is mainly a problem with attention and staying alert. The symptoms may get better or worse and can last for hours or weeks.
  • Dementia develops slowly and does not cause hallucinations. It usually starts with memory loss. The symptoms don't change often, like they can with delirium. Dementia almost never gets better.
What are the treatments for delirium?

Treatment of delirium focuses on the causes and symptoms of delirium. The first step is to identify the cause. Often, treating the cause will lead to a full recovery. The recovery may take some time - weeks or sometimes even months. In the meantime, there may be treatments to manage the symptoms, such as:

  • Controlling the environment, which includes making sure that the room is quiet and well-lit, having clocks or calendars in view, and having family members around
  • Medicines, including those that control aggression or agitation and pain relievers if there is pain
  • If needed, making sure that the person has a hearing aid, glasses, or other devices for communication
Can delirium be prevented?

Treating the conditions that can cause delirium may reduce the risk of getting it. Hospitals can help lower the risk of delirium by avoiding sedatives and making sure that hospital rooms are kept quiet, calm, and well-lit. It can also help to have family members around and to have the same staff members treat the person each day (if possible).

Let us know what's on your mind. We will help. Whether now is the right time for hospice or later, at your request, we will schedule a meeting with you at the place of your choosing: your home, the hospital, your doctor's office, etc.

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