Psychogenic breathlessness or pseudo-dyspnea is a condition where the patient suffers from shortness of breath time to time. This disease is often confused with a similar breathing disorder called Chronic Dyspnea. While there are a lot of factors involved in chronic dyspnea, like allergens and pulmonary diseases, psychogenic breathlessness has more to do with the current state of mind.

One of the most challenging factors is the diagnosis and differentiation between both conditions. Sometimes, the psychogenic breathlessness is so concentrated that there is no way to differentiate between the two.

Procedure of Diagnosis of Psychogenic Breathlessness:

Here are the steps that doctors typically follow to diagnose Psychogenic Breathlessness

To differentiate between the two diseases (Chronic Dyspnea and Psychogenic Breathlessness), the doctor will ask the patient to try breathing harder. A patient with chronic dyspnea will find it even harder to take a breath when he or she tries to. However, a person with psychogenic dyspnea will show improved conditions when they try to breathe harder

A thorough examination of the chest will be done

Blood tests and lung function test (spirometry) will also be conducted to rule out pulmonary diseases

Causes of Chronic dyspnea:

Allergens causing allergic bronchitis (also known as asthma) is the main reason behind Chronic Dyspnea. Other common causes of the true or chronic dyspnea are heart diseases, COPD which occurs because of smoking. Then there are rare disorders like ILD (sarcoidosis), neuromuscular diseases, infections, anemia, obesity/deconditioning.



Causes of Psychogenic dyspnea or psychogenic breathlessness:

Acid reflux: Acid reflux can cause certain sensation on the inner lining of the esophagus (esophagitis). The esophagus has several nerve endings on the inner linings, when the acidic reflux touches these nerve endings, a temporary breathlessness occurs.

Anxiety: People with anxiety can also develop breathlessness. Though exercises help for a short period of time, a patient needs to see a psychiatrist for this condition.

Panic Attacks: These are also a cause for breathlessness. The temporary feeling of choking is common in people who experience panic attacks.

Treatment:

Medication: Medicine for acidity is prescribed to patients having Pseudo-Dyspnea, due to acid reflux.

Anxiety pills and Talking therapy: People suffering from anxiety are recommended to see a psychiatrist for better evaluation of their problem. Medications (anxiety pills) prescribed by the psychaitrist may help in controlling the breathing pattern in a person. Psychological therapies (Talking therapy) have been effective for people suffering from breathlessness due to anxiety.

Placebo: If the problem remains unsolved and unknown, sometimes doctor prescribes placebo medication, for example sweetened aerosol. Doctors believe that if the patient thinks he/she is taking a real medication, his/her condition can be controlled by eluding the mind.

It is important to remember that Psychogenic Breathlessness is as real as chronic breathlessness and patient doesn t pretend to have this condition. When the first symptoms of it start appearing, a specialist doctor (pulmonologist) should be consulted who after confirming the diagnosis of psychogenic breathlessness, may refer you to a psychiatrist or psychologist for further treatment.

Psychogenic Breathlessness - Causes, Symptoms and Treatment of It!

The coronary arteries supply the heart with oxygen-enriched blood and nutrients. If these arteries become damaged or diseased; they could cause Coronary artery disease or CAD. Plaque deposits on the walls of the arteries are the most common cause of this disease. This plaque is usually the result of high cholesterol levels. As the plaque builds up, the passage of blood flow is reduced. This reduces the amount of blood that reaches the heart. In cases of a complete blockage, CAD can even cause a heart attack. Because of its slow progression, this disease is often not diagnosed until it reaches a dangerous stage. However, it can be prevented and treated if diagnosed in time.

In the early stages of CAD, symptoms are not very noticeable. Symptoms become visible only when blood flow to the heart reduces and the heart has to pump harder than normal. The most common symptoms experienced include:

Chest Pain: This is also referred to as angina. It may feel like a tightening of the chest or pressure on the chest as though someone is pressing against it. This type of chest pain may be triggered by emotional or physical stress. It is usually relieved within a few minutes of stopping the activity. Women may experience this pain as a sharp, fleeting pain in the back, arm or neck.
Breathlessness: When the heart does not receive enough blood, it has to work harder to pump blood through the body. This may be translated to breathlessness of shortness of breath when performing any type of physical activity. It can also cause extreme fatigue.
Heart Attack: A heart attack is the most severe symptom of coronary artery disease. This is caused by the complete blockage of a coronary artery. A heart attack can occur without any symptoms or be preceded by slight symptoms. The signs of an impending heart attack include pain in the chest and shoulder, shortness of breath and extreme sweating. The chest pain may also travel to the lower jaw. These symptoms are more pronounced in men as compared to women. Women have a higher tendency of experiencing atypical signs such as extreme fatigue.
Other symptoms that might indicate coronary artery disease are dizziness, nausea and an irregular heartbeat. The good news is that this disease can be prevented. Staying physically active, maintaining a healthy weight, reducing stress and eating a low fat and low salt diet can help reduce the risk of CAD.

Coronary Artery Disease (CAD) - What Are The Symptoms?

Dialysis is a very important and life-saving procedure. It is performed to replace kidney function in case of renal failure. Wastes and extra fluids in the blood are filtered out during this process. To be able to perform Dialysis, the connection between the patient s bloodstream and the equipment for performing Dialysis (dialyzer) outside the body is established. This connection is created through Dialysis Access Surgery. It is a type of Vascular Surgery which forms the vascular opening for access during Dialysis. Thus, Dialysis Access Surgery is the lifeline for the survival of the patient.

Types of Vascular Access for Dialysis- 
There are three types of Vascular Access for Dialysis: Arteriovenous (AV) Fistula, Arteriovenous (AV) Graft, and Venous Catheter.

  Arteriovenous (AV) fistula is a surgical connection of an artery to a vein. An AV fistula is usually placed in the upper arm or in the forearm. It causes extra blood to flow into vein making it grow large. A larger vein hence provides easy access to blood vessels. An AV fistula is preferred over other methods as it lasts longer than other methods of access and provides a good flow of blood. Moreover, it is less prone to infection and blood clots than other methods. Before an AV Surgery, a Vessel Mapping Test is sometimes performed for assessing the blood vessels most suitable for Dialysis. An AV fistula is performed under local anaesthesia and requires two to three months for maturation before hemodialysis. If it fails to mature, the procedure is repeated.

  Arteriovenous (AV) graft is performed when AV fistula fails to mature. It is hence the second most preferred choice for long-lasting access to vascular tissues for Dialysis. An AV graft is a looped plastic tube which establishes a connection between an artery and a vein. Like AV fistula, AV graft is also performed under local anaesthesia. It is slightly more difficult to maintain than an AV fistula.

  A venous catheter is used for short- term hemodialysis. It is a tube which is inserted into chest, neck, leg, or near groin for vascular access. After exiting the body, the tube splits into two halves. In the case where a renal disease has made quick progression leaving little or no time for the AV fistula or AV graft to mature, a venous catheter is used to establish the required vascular connection. This procedure is also performed under local anaesthesia. It is a tool for emergencies but is not suited for long- term use. It can cause narrow vein due to an infection,
scarring, or blood clot. If long- term venous catheter is used, it is tunnelled under the skin which has fewer problems associated with it and is more comfortable. 

How to Care for a Vascular Access?
  Get checked for infections and other problems before each hemodialysis session;
  Use the operated site for access only for the intended use;
  Always keep the access clean;
  Prevent cutting or bumping the access;
  Check for thrill/ vibration in the access and inform the doctor if any;
  Do not put pressure on the access site;
  Do not put blood pressure cuff around the access arm;
  Do not wear jewellery or tight-fitting garments over the site;
  Do not lift a weight.

Take Away-
Vascular Surgery for Dialysis is performed to provide vascular access for the procedure. AV fistula is the most preferred type followed by an AV graft. A venous catheter is recommended to be used only in case of an emergency when there is not much time left for the other two options to mature.

Vascular Surgery - Can It Help For Dialysis?

Heart attack, also known as myocardial infarction, is a severe condition where death of the heart muscle occurs because of the loss of blood supply. The blood loss usually happens because of the blockage of a coronary artery. Due to electrical instability, ventricular fibrillation is caused. Heart attacks may result in permanent brain damage or even death.

Symptoms of heart attack
There are many early symptoms and signs of heart attack, which should be recognized. Symptoms of heart attack vary from person to person. Here is a list of the primary heart attack symptoms:

Chest pain and discomfort:
Chest pain is the basic symptom of a heart attack and occurs in different forms. The chest pain has a pressure, fullness and squeezing sensation and starts from the center of the chest. The pain may go away and re-occur and may spread down to other limbs of the body.
Headache, toothache:
The chest pain occurring due to a heart attack spreads all over the body and the jaw. Even the back and head are affected. Sometimes pain in these regions is present while chest pain is absent.
Shortness of breath:
A gasping sensation or feeling shortness of breath is another common sign of a heart attack. Such breathing difficulty is called dyspnea. The shortness of breath occurs before or during the chest pain.
Nausea and vomiting:
The feeling of nausea or sickness in the stomach is another possible symptom. It is accompanied by belching or burping and sometimes, the heart attack is associated with a feeling of indigestion. Nausea is more common in women. Vomiting also occurs alongside nausea.
General epigastric discomfort:
In several cases, patients describe the pain of a heart attack as stomach pain. The pain is heavy and uncomfortable and persists for several minutes.
Sweating:
Perspiration or sweating occurs during a heart attack and the patient experiences cold sweat in avid amounts.

Emergency treatment for heart attack-
A person who has a heart attack should be rushed to a hospital.
Several tests are carried out to detect the cause of the attack. A 12 lead ekg is carried out to supervise electrical activity within the heart and detect the damaged areas.
Blood tests are undertaken to check enzymes and in certain cases, cardiac catheterization is required where pictures of the blood vessels are examined.
Emergency medicines are given to the patient to stop the formation of blood clots and include aspirin, heparin and other drugs. Other medicines are given for thrombolytic therapy, which dissolve already formed blood clots. They work to reduce the heart damage. Nitrates are also used.

A heart attack is a severe condition and must be attended to immediately. Emergency treatment procedures are essential to save the life of an affected person.

Heart Attack - Signs, Symptoms and Emergency Treatment

Stroke is one of the major reasons for disability in adults. In the US alone, 7 million people suffer from a stroke in a year. After a stroke, the affected individual suffers from lots of health issues. They feel week and fatigued. An ache in one side of the body, inability to walk, and social disability are experienced. Emotional and cognitive functioning is disturbed. Continuum care is recommended for the affected individuals and they need interdisciplinary care to ensure they can do things independently. This is where occupational therapy plays a vital role.

What does the therapist do? 

Using a range of evidence-based methods, the occupational therapists can address the physical, emotional, and mental challenges caused by the stroke. Occupational therapy does not concentrate only on the ailment. It takes into account the emotional needs, desires, limitations, and activities of the stroke survivors. It helps them to recoup the skill to get the daily chores done independently. An occupational therapist surveys the home of the stroke survivor and evaluates the risk of hazards. The practitioner also helps the affected individuals in coping with the loss of vision and memory. The physical strength and fortitude are augmented. The major focus will be on making the affected reach the heights of performance in the valued occupations.

How does it help? 

Studies prove that occupational therapy does not only help one to recover faster, but also prevents worsening of the condition further. The stroke survivor, who receives the occupational therapy, is independent when it comes to daily living chores. Wouldn t it be a great improvement on the emotional health when the affected feels he or she can get things done with little or occasional help? Also, this reduces the caregiver burden. The family is relieved that the survivor can eat, bath, and take a few things without someone having to sit closer and help. This mentally boosts the caregivers and the family to motivate the survivor. The stroke survivor also looks forward to the rehabilitation treatment as the occupational therapy makes them feel great.

Transitional and community integration services can make sure that the patients are engaged in their specific environments, once they get back home after occupational therapy in the specialized care center. After a certain period, when the stroke survivors show considerable improvement, the practitioner again evaluates to find if activities like driving can be resumed by the clients. Community mobility of different choices is recommended if the client is not fit for driving. There are driver rehab programs and the driving skills can be regained.

An occupational therapist spends more time with the client than any other healthcare professional. This is because the practitioner is responsible for alleviating the challenges faced by the affected individual emotionally and physically. The practitioner not only helps the client to achieve the goals but also ensures that the client is psychologically motivated whenever he or she is discouraged. Rehabilitation can reverse the damage done to the brain. But it takes lots of efforts to learn the things to do them in a different way. An occupational therapist makes this goal easier for his or her clients.

Occupational Therapy For People Recovering From A Stroke! 

Language plays a very important role in our everyday life. Language disorders are common in neurological practices. A stroke directly affects one s brain and can cause neurological problems.

The consequences of neurological stroke language disorders are alexia, aphasia, alexia, acalculia, and agraphia. A large number of deaths worldwide are caused due to stroke. A severe stroke may impair a patient for life and cause communication disorders. The brain refuses to function properly after a stroke, thus accurate description and recognition become a challenging task.

Understanding the types of language disorders post-stroke

Stroke can severely damage a certain portion of your brain and hamper its proper functioning. One of the most common symptoms following a stroke is language loss. There can be different types of language loss, partial or even complete. Below are the types:

Aphasia

It means complete loss of language functioning. The patient s verbal communication is impaired and it results in difficulty in understanding both written and spoken language, repetition, naming, comprehension and other abnormalities. The blood vessels of the brain are affected causing its dysfunction. One-third of patients in the acute phase undergo this condition.

Alexia

A disconnection syndrome caused due to brain damage or trauma affects the patient s reading ability. It is also known as visual aphasia, text blindness, or word blindness. It is very different from dyslexia.

Agraphia

It is the inability to write unlike in the past. The motor control that allows you to write is disrupted and the patient writes wrong spellings or imaginary words and confuses the meanings.

Acalculia

This is also an acquired syndrome in case of which the patient cannot perform any mathematical calculations. Simple addition, subtraction, numbers and columns are a difficult task and go beyond understanding.

Language recovery

The process of recovery is difficult, slow and does not guarantee results. The severity of language impairment needs to be considered before going for therapy. Rehabilitation is necessary to avoid any depression or frustration in the patient.

Communication is essential. If a patient is suffering from aphasia, begin with simple words like  yes  or  no , hand gestures and nodding to address the basic needs.

Be patient and try to connect with the person emotionally.

Return to the daily routine. The homely environment can be beneficial and make sure you have an everyday list of words to learn or write.

The patient must be active and repeat words until you have the perfect pronunciation.

Keep a notepad handy. For patients who cannot talk and has difficulty in talking can write and express their feelings.

It is very important to stay stimulated. Motivation from friends and family relieves anxiety and can help the patient recover quickly. No two affected person goes through the same process, that s why understand and approach accordingly.

Early therapy is effective and patients may respond very well in groups and a safe environment. Visit the doctor at regular intervals to test your improvements, reflexes and language skills. Post-stroke, the patient s well-being should be a priority.

Know More About Neurological Stroke Language Disorders!

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