We, the doctor, as well as the patient, cannot thank you enough for one specific role in the hospital, the medical assistance. Just imagine it, can you remember your memorable experience in hospital that don't deling with the nurse? Of course, there is some doctor in your memories, but mainly it consists of nurses, and medical assistance. But did you know that nurses are one of the hardest job to do?
If only once, just once you, as medical assistance, wrongly said "the patient needs amphetamine" and not "the patient need neuralgin", that would be change the whole prescription. According to the United States Department of Labor, "Medical Assistant employment is projected to grow much faster than average, ranking medical assisting among the fastest growing occupations over the next decade. Job opportunities should be excellent, particularly for those with formal medical assistant training."
Last night i stuck into one particular online medical assistant school, and stuck particularly on fact that the program will allow you to study online at your own pace and convenience. Most students complete the program in about 6-8 weeks. However, you can take as long as needed. There are no deadlines or time limits and medical assistant training program is very affordable.
6-8 weeks? Thats so very short time! Can you be a professional medical assistant during the time? The fact is, yes. In my experience, 6-8 weeks is time needed when you want to be a very very basic medical assistance, with the basic knowledge..with the basic salary. Experienced medical assistants may advance their careers to office management or support positions. Medical Assisting, combined with additional training, can also lead to other healthcare positions, such as medical technology or nursing.
If i check their medical assistant training page, they have a good curriculum, as stated below,Medical Terminology, Human Body Planes, Basic Human Anatomy and Physiology, Medical Office Professionalism, Patient Communication, Medical Records, Basic Medical Law, Scheduling Appointments, Medical Billing and Insurance Claims, Infection Control, Surgical Instruments, Emergency Care, Clinical Equipment, Patient History and Physicals, EKG and Lab Testing, Specimen Collection and Lab Safety, Introduction to Patient Medications.
Online Medical Assistant Clinical Labs: Virtual Phlebotomy Lab (Collecting a Blood Sample), Virtual Injection Lab , Medication injections, Measuring A Pulse, Introduction to CPR and Basic Ultrasound.
That is the basic of medical assistant knowledge, but that doesn't stop pre-medical assistant to start, since according to the United States Department of Labor, "job prospects are excellent for Medical Assistants. Employment is projected to grow much faster than average, ranking medical assistants among the fastest growing occupations over the 2006-16 decade. Job opportunities should be excellent, particularly for those with formal training. Most Medical Assistants work in doctors offices, hospitals, clinics or other health care settings. A Medical Assistant assists with administrative tasks and minor procedures to keep the doctor's offices and health care facilities running smoothly. Helping to drive job growth is the increasing number of group practices, clinics, and other health care facilities that need a high proportion of support personnel, particularly medical assistants who can handle both administrative and clinical duties. In addition, medical assistants work primarily in outpatient settings, a rapidly growing sector of the health care industry. Job seekers who want to work as a medical assistant should find excellent job prospects. Medical assistants are projected to account for a very large number of new jobs, and many other opportunities will come from the need to replace workers leaving the occupation. Those with formal training or experience should have the best job opportunities."
For the tuition fee $645 (The regular tuition fee for online Medical Assistant distance education program is $1,215) i think this medical assistant school is one of the most affordable in the market.
The Importance of Medical Assistance
The Brain Nerve Cells
Epilepsy is a condition in which a person has recurrent seizures. A seizure is defined as an abnormal, disorderly discharging of the brain's nerve cells, and did you know what brain nerve cell is?
The brain and spinal cord are made up of many cells, including neurons and glial cells. Neurons are cells that send and receive electro-chemical signals to and from the brain and nervous system. There are about 100 billion neurons in the brain. There are many more glial cells; they provide support functions for the neurons, and are far more numerous than neurons.
There are many type of neurons. They vary in size from 4 microns (.004 mm) to 100 microns (.1 mm) in diameter. Their length varies from a fraction of an inch to several feet.
Neurons are nerve cells that transmit nerve signals to and from the brain at up to 200 mph. The neuron consists of a cell body (or soma) with branching dendrites (signal receivers) and a projection called an axon, which conduct the nerve signal. At the other end of the axon, the axon terminals transmit the electro-chemical signal across a synapse (the gap between the axon terminal and the receiving cell). The word "neuron" was coined by the German scientist Heinrich Wilhelm Gottfried von Waldeyer-Hartz in 1891 (he also coined the term "chromosome").
The axon, a long extension of a nerve cell, and take infromation away from the cell body. Bundles of axons are known as nerves or, within the CNS (central nervous system), as nerve tracts or pathways. Dendrites bring information to the cell body.
Myelin coats and insulates the axon (except for periodic breaks called nodes of Ranvier), increasing transmission speed along the axon. Myelin is manufactured by Schwann's cells, and consists of 70-80% lipids (fat) and 20-30% protein.
The cell body (soma) contains the neuron's nucleus (with DNA and typical nuclear organelles). Dendrites branch from the cell body and receive messages.
A typical neuron has about 1,000 to 10,000 synapses (that is, it communicates with 1,000-10,000 other neurons, muscle cells, glands, etc.).
DIFFERENT TYPES OF NEURONS
There are different types of neurons. They all carry electro-chemical nerve signals, but differ in structure (the number of processes, or axons, emanating from the cell body) and are found in different parts of the body.
* Sensory neurons or Bipolar neurons carry messages from the body's sense receptors (eyes, ears, etc.) to the CNS. These neurons have two processes. Sensory neuron account for 0.9% of all neurons. (Examples are retinal cells, olfactory epithelium cells.)
* Motoneurons or Multipolar neurons carry signals from the CNS muscles and glands. These neurons have many processes originating from the cell body. Motoneurons account for 9% of all neurons. (Examples are spinal motor neurons, pyramidal neurons, Purkinje cells.)
* Interneurons or Pseudopolare (Spelling) cells form all the neural wiring within the CNS. These have two axons (instead of an axon and a dendrite). One axon communicates with the spinal cord; one with either the skin or muscle. These neurons have two processes. (Examples are dorsal root ganglia cells.)
LIFE SPAN OF NEURONS
Unlike most other cells, neurons cannot regrow after damage (except neurons from the hippocampus). Fortunately, there are about 100 billion neurons in the brain.
GLIAL CELLS
Glial cells make up 90 percent of the brain's cells. Glial cells are nerve cells that don't carry nerve impulses. The various glial (meaning "glue") cells perform many important functions, including: digestion of parts of dead neurons, manufacturing myelin for neurons, providing physical and nutritional support for neurons, and more. Types of glial cells include Schwann's Cells, Satellite Cells, Microglia, Oligodendroglia, and Astroglia.
Neuroglia (meaning "nerve glue") are the another type of brain cell. These cells guide neurons during fetal development.
I hope that will give you some picture. Im sorry for being absent for a while..real life kills me :)
Trigeminal Neuralgia
Trigeminal neuralgia is a facial pain syndrome consisting of sharp, lancinating pain in the face. The pain is often described as shock-like stabs of pain. The pain is only on one side of the face and may be elicited by touching trigger points in the skin of gums. There is no associated numbness (unless there is co-existing multiple sclerosis). Often there may spontaneous remissions from pain lasting weeks to years. Interestingly, this pain usually responds to carbamazepine (Tegretol), an oral anticonvulsant medication.
Trigeminal neuralgia is usually caused by compression of the sensory (trigeminal) nerve within the skull by a small artery or vein at the point where the nerve joins the brain stem. Sometimes a small, benign tumor compressed the nerve, causing jolts of electrical shock–like pain to radiate into the face. A few percent of tic patients suffer from multiple sclerosis. In this case the inflammatory response affecting the brain also involves the trigeminal nerve, causing paroxysmal pain.
Tic douloureaux is unique among pain disorders because nearly all treatments work for a period of time. Over the years peripheral nerve avulsion, heating, cooling, compressing, decompressing, chemical ablation, and irradiation have all enjoyed varying degrees of success. Because of the effectiveness of carbamazepine (Tegretol), its use is usually the first level of treatment. Other anticonvulsants may be tried, but these are not usually as effective. When oral medication fails to control this dreadful pain, other surgical measures are quite effective. These procedures have challenged the imagination of neurosurgeons
Gamma Knife Radiosurgery
Gamma Knife radiosurgery can successfully treat tic pain. A single, non-invasive morning treatment has resulted in excellent pain relief in 58%; good pain relief in 36% and failed pain relief in 6%. Transient facial numbness is rare. Long term recurrence rates are unknown. This treatment is a suitable alternative to anticonvulsant therapy and compares favorably to other treatments.
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A single 4 mm isocenter is focused on the left trigeminal nerve for Gamma Knife treatment.
Things you might need to know
Before any operation for epilepsy can be performed, there has to be a period of careful testing and evaluation.
These tests are done to make sure the surgery has a good chance of being successful and won't affect any of the important functions of the brain.
Most of the tests are used to pinpoint the area of the brain where seizures begin or to locate other areas, like speech and memory, that have to be avoided.
How many tests have to be done depends on the kind of operation that is being planned and how much information each test produces.
The following tests are most often used before a decision to operate is made:
Electroencephalography (EEG) : An electroencephalogram is a non-invasive, diagnostic test which records electrical activity on the surface of the brain, and can identify the location of the abnormally firing neurons. More Info
Magnetic Resonance Imaging (MRI) :Scans take pictures of the inside of the brain. MRI scans may show tumors, abnormal blood vessels, cysts, and areas of brain cell loss or other brain damage. More Info
Video EEG :In video-EEG, you are videotaped at the same time as your EEG is recorded. The recording is carried out for a long period of time, often several days. The doctor usually views the video and EEG images side by side on a split screen. In this way the doctor can see precisely how your behavior during seizures is related to the electrical activity in your brain. More Info
Neurological Exam :A neurological examination looks at how well your brain and the rest of your nervous system are functioning. Every time your doctor taps your knee with a hammer to see if your foot jumps, that's part of a neurological exam. More Info
Wada Test :The Wada test, also known as the Intracarotid Amobarbital Procedure (IAP), combines neuroimaging and neuropsychological testing methods to examine memory and language functions. It is used to evaluate patients being considered for epilepsy surgery, by examining the independent functions of the brain. More Info
Positron Emission Tomography (PET) :may be used in certain cases to help identify where seizures are taking place. PET measures how intensely different parts of the brain use up glucose, oxygen, or other substances. More Info
Single Photon Emission Computed Tomography (SPECT) :Individuals with epilepsy often have changes in blood flow to specific areas of the brain when a seizure begins. The SPECT measures blood flow between seizures and during seizures. The scans are then compared to identify the changes in blood flow in specific areas of the brain, thus identifying where seizures originate.
Decisions you need to take before head for a brain surgery
In trying to decide whether an adult or child will benefit from brain surgery, doctors want to know:
Is the problem really epilepsy?
Is it the kind of seizure that can be helped by an operation?
Have we tried hard enough to control the seizures with medicine, diet, or other treatment?
Might the condition get better without surgery?
Might it get worse without surgery?
Do the benefits outweigh the risks?
Can surgery be done safely in the affected area of the brain?
These are very individual questions with different answers for each person based on the medical history of the patient or his family; physical examinations; medical records; and a whole battery of pre-surgical tests.
All epilepsy surgery involves the brain. However, different types of operations may be done. In general they fall into two main groups:
Removal of the area of the brain that is producing the seizures.
Interruption of nerve pathways along which seizure impulses spread.
Lobectomy -- Seizures that begin in one or more areas of the brain are known as simple or complex partial seizures. The seizures can take on different forms, depending on where they originate in the brain. The brain is divided into areas called lobes. There are temporal lobes, frontal lobes, parietal lobes and occipital lobes. There are two of each lobe on either side of the head. An operation to remove all or part of these areas is called a lobectomy. This type of surgery may be performed when a person has seizures that start in the same lobe every time. It is sometimes possible to stop the seizures by removing the seizure-producing area if it can be safely done without damaging vital functions.
While there are risks in all surgical procedures, including the placement of depth electrodes and grids, most brain surgery for epilepsy appears to be relatively safe. The success rate for epilepsy surgeries depends on the type of operation performed and can usually be predicted after all the test results are available.
* For temporal lobectomies, 65 to 85% of patients will be seizure-free.
Complications occur in about 4 out of every 100 of these operations. Depending on the kind of surgery that's performed, possible complications include: partial losses of vision, motor ability, memory or speech. Infection or temporary swelling of the brain may also sometimes happen.
Hemispherectomy -- A lobectomy removes a fairly small area of the brain. However, when a child has Rasmussen’s encephalitis, a rare, progressive disease affecting one whole hemisphere of the brain, a hemispherectomy to remove all or almost all of one side of the brain may be performed. While it seems impossible that someone could function with only half a brain (the other side fills up with fluid), children manage to do so because the half that remains takes over many of the functions of the half that was removed. Weakness on the side opposite the operation will continue, however. Hemisperectomies may also be performed when children are born with conditions that cause excessive damage to one side of the brain, such as bleeding in the brain prior to birth.
Excellent results for this operation, which involve removal of one half or almost one half of the brain, are being reported by the small number of very specialized centers doing these operations. However, there are more risks with hemispherectomies than with other types of epilepsy surgery.
Children who have hemispherectomy operations will continue to have loss of function on the side of the body opposite the side where the brain was removed.
Corpus Callosotomy -- Another kind of surgery for epilepsy is called a corpus callosotomy (split brain surgery).
The corpus callosotomy operation does not take out brain tissue. Instead, it interrupts the spread of seizures by cutting the nerve fibers connecting one side of the brain to the other. This nerve bridge is called the corpus callosum.
The seizures which may respond to this type of surgery include uncontrolled generalized tonic clonic (grand mal) seizures, drop attacks, or massive jerking movements.
These seizures affect both sides of the brain at once and there is usually no one area which can be removed to stop them from happening.
Seizures are usually not stopped entirely by the operation. Some type of seizure activity on one side of the brain or the other is likely to continue, but the effects are generally less severe than the repeated drop attacks or convulsions.
The corpus callosotomy operation is often done in two steps. The first operation partially separates the two halves of the brain but leaves some connections in place.
If the generalized seizures stop, no further surgery is done. If they continue, the doctors may recommend a second step that completes the separation.
Among patients having a corpus callosotomy (split brain operation), risks of major and minor complications after surgery are around 20 per 100 operations. Generalized seizures may stop or happen less often than before the operation. Partial seizures (that is, changes in movement, feeling or emotion without loss of consciousness) will probably continue and may even get worse. Still, the uncontrolled drop attacks and generalized tonic clonic seizures that the operation is designed to treat have risks of their own. Decisions to operate take all these possibilities into account.
Multiple Subpial Transection -- Some seizures originate in or spread to parts of the brain that are responsible for functions such as movement or language. Removing these areas would lead to paralysis or loss of language function.
A surgical technique called multiple subpial transection (MST) may be performed in these situations. It involves making small incisions in the brain which interfere with the spread of seizure impulses.
This technique may be used alone or in addition to a lobectomy.
Vagus nerve stimulation (VNS) -- is a type of treatment in which short bursts of electrical energy are directed into the brain via the vagus nerve, a large nerve in the neck. The energy comes from a battery, about the size of a silver dollar, which is surgically implanted under the skin, usually on the chest. Leads are threaded under the skin and attached to the vagus nerve in the same procedure. The physician programs the device to deliver small electrical stimulation bursts every few minutes. This is a relatively new type of treatment. It may be tried when other treatment is not effective. Just how it works to prevent seizures is being studied.
Brain Surgery : Introduction
I really feel that this post a bit late, but better late than never. Ok, so, here we go..
Epileptic seizures are produced by abnormal electrical activity in the brain. Surgical removal of seizure-producing areas of the brain has been an accepted form of treatment for over 50 years.
Brain surgery is one of the scariest operations a person can endure. While the thought itself is terrifying, brain surgery is necessary to combat certain cancers, aid victims of strokes and help head trauma victims lead a normal life. People who have to undergo brain surgery and their loved ones want to know if brain surgery is painful. The short answer is not as much as you might think.
The brain is the epicenter for emotion, conscious and unconscious function, thinking and memory. Your brain is the reason you recognize and feel pain, but oddly enough, your brain doesn’t have any pain receptors of its own.
Surgery can be performed on both children and adults. However, it is not a suitable treatment for everyone who has epilepsy, or for everyone with poor seizure control.
Brain surgery is a way of treating certain kinds of epilepsy that cannot be controlled with medication. Risks and benefits of surgery should be carefully discussed in advance with the doctors who are going to perform the operation. Certain testing is necessary before the operation. In some cases, surgery for epilepsy requires two operations.
Ask your doctor and the neurosurgeon that will be performing the operation how much pain you can expect. Brain surgery is performed with patients while they are awake and asleep. During the operation you will have anesthesia, either local or general. Either way, you will feel nothing during the brain surgery.
Learn about the post-operational pain. Once again, it is less than you might think. You will have a headache for a few days, and it will be a very strong one. Fortunately, you will be able to take pain medication to manage the pain. Nothing too strong, though. The doctors want you to be alert.
If you know someone who has undergone brain surgery you could ask them about the pain, or you could join a support group. Not all patients are good candidates for surgery.
Having brain surgery does not guarantee that a person will be free of seizures or won't have to take medicine anymore. However, chances are good that most people will have fewer seizures after surgery and many will become seizure-free.
Not all epilepsy-related surgery is performed on the brain. Therapy which delivers pulses of energy to the brain through a large nerve in the neck (VNS therapy) requires a different type of surgical procedure to set the system in place.
Brain surgery and VNS implants are accepted treatments for relief of seizures and are covered by most health insurance plans.
Cranial Ultrasound
Cranial ultrasound uses reflected sound waves to produce pictures of the brain and the inner fluid chambers (ventricles) through which cerebrospinal fluid (CSF) flows. This test is most commonly done on babies to evaluate complications of premature birth. In adults, cranial ultrasound may be done to visualize brain masses during brain surgery.
Ultrasound waves cannot pass through bones; therefore, an ultrasound to evaluate the brain cannot be done once the bones of the skull (cranium) have grown together. Cranial ultrasound can be done on babies before the bones of the skull have grown together or on adults after the skull has been surgically opened. It may be used to evaluate problems in the brain and ventricles in babies up to 18 months old.
Cranial ultrasound for babies
If an older baby is having the test, it may help to have the baby be a little hungry. The baby can be fed during the test, which will help the baby be comforted and hold still during the test.
Because ultrasound cannot penetrate bone, cranial ultrasound can be performed only on babies whose skull (cranial) bones have not yet grown together. However, duplex Doppler ultrasound can be done to evaluate blood flow and vessel spasms in the brain in children and adults.
Complications of premature birth include bleeding in the brain (intraventricular hemorrhage, or IVH) and periventricular leukomalacia (PVL). PVL is a condition in which the brain tissue around the ventricles is damaged, possibly from decreased oxygen or blood flow to the brain that may have occurred before, during, or after delivery. Both IVH and PVL increase a baby's risk of developing disabilities that may range from mild learning or gross motor delays to cerebral palsy or mental retardation.
IVH is more common in premature babies than in full-term babies. When it occurs, it most commonly develops in the first 3 to 4 days after birth. Most cases of IVH can be detected by cranial ultrasound by the first week after delivery. By contrast, PVL can take several weeks to detect. For this reason, cranial ultrasound may be repeated between 4 and 8 weeks after delivery if PVL is suspected. Several cranial ultrasound tests may be done to evaluate areas in the brain.
Cranial ultrasound may also be done to evaluate a baby's large or increasing head size, detect infection in or around the brain (such as from encephalitis or meningitis), or screen for brain problems that are present from birth (such as congenital hydrocephalus).
Magnetic resonance imaging (MRI) scanning may be done instead of cranial ultrasound to evaluate PVL or IVH in babies born prematurely.
Cranial ultrasound for adults
Cranial ultrasound may be done on an adult to help locate a brain mass. Because cranial ultrasound cannot be done once the skull bones have fused, it is only done once the skull has been surgically opened during brain surgery.