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Abdominal pain is one of the most common complaints that brings individuals to the emergency room. We spoke with emergency physician Bret Frey, MD, to ask about when and where to seek care for abdominal pain.   Dr. Frey advises that any time you feel something is developing inside your body that is substantially different from what is normal for you, understand that something is wrong. He further explains that warning signs of an acute medical situation include fever, vomiting or a rapid change in function and ability to move due to pain. These symptoms indicate that one needs to be evaluated by a medical professional.   This evaluation will include the care team conducting an examination and asking a series of questions to determine if additional diagnostics, such as lab work or imaging, are needed. Be prepared to discuss where the pain is and what it feels like, in addition to how long it’s been bothering you and if it’s constant or intermittent.  While appendicitis often comes to mind when thinking about abdominal pain, Dr. Frey says that this is not the bulk of cases that the Emergency Department sees. In fact, often the pain does not have a specific diagnosis, but our team of board-certified emergency physicians are experienced in assessing and caring for those experiencing the acute symptoms he described.   “We often don’t come away with an answer about exactly what it is, but we substantially rule out life threats in a very methodical and systematic way,” said Frey.  The abdomen includes many organs, including the stomach, liver, small and large intestines, gallbladder and pancreas. In addition, pain stemming from your chest, pelvis or back may be felt in the abdominal area.  If you are experiencing abdominal issues that are persistent but not an emergency, talk to your primary care doctor about what you are experiencing, and be prepared to review the history of this pain, medications, allergies and diet. He or she will be a good partner to review conditions such as gas, heartburn, constipation, diarrhea, inflammation or menstrual and ovulation pain. Drinking plenty of water is always an important part of supporting your health.

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Alzheimer’s disease is not normal forgetfulness as we age. Instead, it is a specific form of mental decline. And according to the Alzheimer’s Association it accounts for nearly 80 percent all dementia cases. Natasa Dragicevic, MD, PhD., behavioral neurologist and Alzheimer’s disease specialist with Renown Institute for Neurosciences, weighs in on diagnosing it and the importance of early medical action. How to Diagnose Alzheimer’s Disease In general, the signs of Alzheimer’s disease occur slowly, getting worse over time. For example, forgetfulness is a daily search – for shoes, keys and other misplaced items. Not only is memory affected, but also speech patterns and behavior. There is no single test for Alzheimer’s disease. “Specifically, a neurologist should be the one to diagnose Alzheimer’s disease given differences in presentation,” clarifies Dr. Dragicevic. “And ideally a behavioral neurologist (Alzheimer’s sub-specialist) will be managing the treatment,” she adds. Brain Imaging Diagnosing Alzheimer’s disease involves multiple approaches and medical providers. In short, medical history is reviewed along with a physical exam, lab tests and other diagnostic testing. “A medical workup includes a variety of tests. These include MRI and other brain imaging, as well as neurological and psychological testing. Furthermore, a lumbar puncture is performed to look for markers of the disease,” she states. What Causes Alzheimer’s disease? Although no one knows the cause, researchers think many factors play a role. Uncontrollable risk factors include your genetics and having a family member with the disease. However, the controllable risk factors include: reducing the risk of head injury and keeping your heart healthy. It’s important to realize that high blood pressure, high cholesterol, stroke and diabetes play a role in brain health. Blood loss to the brain causes vascular dementia, leading to long-term blood vessel damage. Symptoms of Alzheimer’s disease Generally speaking, the signs of this disease differ in each person. Yet noticeable behaviors include: • Losing the way to familiar places • Forgetting to pay bills • Trouble finding the right words when talking • Repeating questions • General confusion • Social withdrawal Alzheimer’s Disease – Benefits of Early Diagnosis Equally important, spotting Alzheimer’s disease early allows more time to benefit from medications and possible clinical trials. Likewise, nutrition and exercise changes can be made, increasing blood flow to the body, and perhaps delaying symptoms. Early diagnosis also allows for personal health decisions and quality-of-life conversations to take place.   According to the Alzheimer’s Association, these benefits include: 1. Medical advantage 2. Emotional and social comfort 3. Time to plan ahead 4. Cost savings A Brain Supporting Lifestyle “At the present time, treatment is limited,” explains Dr. Dragicevic. “Usually Alzheimer’s is a progressive ongoing disease – any management at this time is purely symptomatic.” However, she states the following lifestyle changes can help support brain health: • New hobbies such as painting, pottery, music classes or learning a new language • Crosswords, puzzles and playing games, such as Scrabble • Brain challenging mobile apps, such as Luminosity • 30-45 minutes of mild to moderate physical activity per day, such as walking • Eating a Mediterranean diet (primarily plant based foods)

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