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Hip fractures and Ingrown toenail

Ingrown Toenail. In later years the toenails may become hardened, thickened, and sometimes very irregular. This, however, does not constitute an ingrown toenail. The ingrown process occurs only after the nail has been trimmed back too far, and then grows forward against the skin in front of it. The nail grows into this skin much as a needle would, and the penetration of skin in a contaminated region like the toe, often results in a painful infection, accompanied by pus formation and bleeding.

Ingrown toenails can be prevented by allowing the end of the toenail to grow beyond the end of the toe. Once a toenail has been cut too short, and it starts growing into the skin in front of it, the nail must be mechanically elevated from the skin, by cotton packing or other measures. These relief measures are undertaken frequently in an infected area, and should be attempted only by physicians or foot specialists trained in the treatment of ingrown toenails.

Hip Fractures. One of the unfortunate calamities of later years is fracture of the hip, incurred through accidental falls. The


Fig. 144. The broken hip is the most feared fracture of later years. This is because of the brittleness of the bone and the fact that most falls are onto the hip area.

Fig. 145. Surgical repair of a broken hip is effective with the use of a “nail” pinning the bone together across the fracture line. This is a most satisfactory treatment in an otherwise very difficult fracture.

hip can be broken at any age, but is more liable to occur during later years when the bones become weaker. Youthful bones are tough and strong; they bend slightly and are hard to break. In age, however, the bones acquire a glass-like brittleness and shatter easily. The hip joint’s outer position makes it absorb considerable punishment in falls, and is therefore, a likely spot for a fracture. A broken bone at this site of course, means the entire leg is useless, since its sole body support must come through the hip joint itself.

Hip fractures can be nearly painless if the broken bones are rammed together and held impacted in a correct position. However, the usual broken hip renders the patient entirely helpless, because the bones are separated and there is severe pain in any kind of motion.

Treatment of a fractured hip, as in any fracture, requires the broken bones to be put together and held in place. There are several ways of doing this, but the most desired method today is nailing the bone fragments together. To do this, a special nail is driven down the inside of the bone through the bone marrow and through the line of fracture, threading the bone fragments together. This treatment has allowed many patients considerable relief of pain with early leg motion, and quicker return to normal activity. It must, of course, be undertaken by a physician with experience in repairing fractures.

Congestive Failure and Coronary Occlusion of the heart

Heart Failure {Congestive Failure, Dropsy). The normal heart pumps more than enough blood for all body functions, but the diseased heart may not be able to pump the minimum required by the body, and then heart failure is said to be occurring. The heart does not fail all at once but by slow degrees, and is usually

Fig. 59. Heart or anginal pain (in shaded region) is variable, generally left-sided, also in the left arm. Pain distribution is due to nerve arrangements to and from the heart region. Pain in the left arm is, therefore, usually more significant than pain in the right arm.

marked by increasing shortness of breath, pressure in the chest and a frequent flip-flopping sensation of the heart. Water logging of the body may be noticeable as heart failure begins and body water begins gravitating down into the lower legs. Normal size legs in the morning then become considerably swollen by evening.

Caused by diseases which greatly weaken the heart muscle, heart failure is often a result of childhood rheumatic fever, or in later years, arteriosclerosis of the heart arteries themselves. The physician can markedly strengthen the weakened heart with digitalis-like drugs, and other drugs effective in combating the heart failure, to promote a stronger normal heart function.

Heart Attack (Coronary Occlusion, A Coronary). Heart attack means a sudden block of a coronary (heart) artery by a blood clot stopping the blood flow to a quickly damaged portion of the heart muscle. If this damage is slight, it might even go unnoticed, but if damage to the heart is severe, it is likely to stop beating, with death following quickly. It is apparent that there are many degrees of severity in heart attacks.

The pain in the chest can be excruciating, causing nausea, weakness, pallor and perspiration similar to extreme exhaustion, and the patient may collapse. A heart attack is nearly always suspected, but cannot be known with accuracy until an electrocardiogram has been taken. Possible candidates for heart attack are the fifty-year-old (and younger) individuals, including those who have never known any discomforts or disease. Most vulnerable of all is the person with already existing heart disease who must take extra precaution to spare his heart, and promote as strong and healthy a heart muscle as possible.

The person who dies a few moments after his heart attack could not benefit from any known treatment, but for those who live through the early attack, the physician, with marvelous drugs, can greatly magnify chances of survival. A yearly check-up of the heart condition in all people of fifty years is necessary for sane regard of good health.

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