Dr. Josyann Abisaab

The pain of a broken bone usually sends the victim straight to the emergency room, whether or not there is certainty that a bone is actually broken. A careful examination including an x-ray, by an emergency room doctor such as Dr. Josyann Abisaab can usually determine with a great deal of certainty whether a bone was indeed broken.

A bone will break if there is more pressure placed on the bone than what the bone can handle. The bone can either split or break, and in either case this break, no matter how large, is called a fracture. If the broken edge of the bone breaks through the skin, then the fracture is called either an open fracture or a compound fracture.

A stress fracture is caused by repetitive or prolonged forces acting against the bone, resulting in a hairline fracture within the bone.

It is easy to mistake a dislocated bone from a broken bone, but since both situations require immediate attention as emergencies, and the immediate treatment for both is the same, there is no reason do differentiate them before you get to the emergency room.

Some causes of a broken bone:

Broken Bone in Forearm

• Falling
• Accident
• Direct blow to the bone
• Repetitive actions like running can cause a stress fracture to develop in the foot, ankle, tibia and even the hip

Symptoms of a broken bone:

• Conspicuous looking out-of-place or misshapen limb or joint
• Swelling, bleeding, bruising
• Significant and intense painful sensations
• Numbness, tingling
• Skin is broken and bone is sticking out
• Limb cannot be moved, or its mobility is limited

The Knee

When all the parts of the body are working together well, it is easy to forget how each and every muscle, bone, and organ are essential for a painless, well-functioning body.

A good example of this is when someone has a knee injury. In just a moment the person goes from painless walking, bending, climbing stairs, crouching and stretching, to a person who experiences pain with every bend of the leg at the knee.

The knee is the largest joint in the body. Joints are the places where two bones come together. The knees provide the body with stability, flexibility and allow your legs to straighten up, bend and swivel. The knee is made up of bones, cartilage, ligaments and tendons. A damaged knee can be damaged in any one, or several of these parts.

It is important to seek the care of a physician, and if the injury is severe, and emergency room physician such as Dr. Josyann Abisaab would be able to diagnose and advise the patient about what treatment is required, and if a specialist is needed such as an orthopedist or a physical therapist.

The Worst Has Been Averted

The catastrophe taking place now in Japan has brought the world’s attention to what could happen when there is a leak, or worse, at a nuclear power plant and radiation is released into the environment. Thankfully it looks like there will not be a major nuclear disaster in Japan as experts continue to bring the situation under control. Nevertheless there has been acknowledgment that a certain amount of radioactivity was released into the water supply and atmosphere. What does that mean for the health of the people affected by their proximity to the power plants and to those further away?

Nuclear Plant Workers Exposed

It has been reported that some of the workers who are struggling to prevent a meltdown have already suffered radiation sickness and other injuries from hydrogen buildup explosions inside the reactor’s buildings.

“The scariest outcome from such releases of radiation are the immediate effects, which are going to be only felt by personnel who have to go into the building and shut it down,” radiation biologist Jacqueline P. Williams, PhD, said. Williams is a researcher in the department of radiation oncology at the University of Rochester, N.Y.,  Dr. Josyann Abisaab’s alma mater.

Dr. Williams continued to explain that the long term effects of exposure to high levels of radiation are primarily the development of a variety of cancers, most commonly leukemia and thyroid, lung and breast cancer.

Danger So Far Minimal

Another expert on radiation adds that it is easy to overestimate the danger of exposure to radiation. Henry D. Royal, MD was a co-leader of the international team that studied the effects on health caused by the nuclear disaster at Chernobyl. Dr. Royal is currently the do-director of the Mallinckrodt Institute of Radiology at Washington University in St. Louis.
“In Chernobyl, people living within 1 to 2 kilometers of the plant, who stayed indoors, received about 50 millisieverts of radiation — equivalent to about five CT scans,” Royal explained. “And in Fukushima, we are not talking about Chernobyl. This may be worse than Three Mile Island, but nothing like Chernobyl.”

“The Chernobyl cloud technically covered a huge area. It did follow the jet stream and everything else,” Williams says. “But radioactive particles have substance, they have weight. The bigger the particle, the quicker it falls out of the cloud. So the contamination area where you have risks from contamination are relatively close to the disaster site. As far as I am aware, the cancers from Chernobyl radiation occurred in and around Chernobyl itself.”

US Not at Risk

People in the United States are concerned that radiation from Japan could possible reach their shores. Radiation experts at Oregon State University department of radiation and physics have state that no radiation from Japan is expected to arrive in the US.

“Any radioactive contaminants released will end up raining out of the atmosphere into the Pacific Ocean, where they will be diluted and absorbed, or in the very near vicinity of the plants,” Kathryn Higley, PhD, says in a news release. “This is not Chernobyl.”

The body’s immune system is a marvelous apparatus which protects us from an incredible number of substances in the environment that could harm us. When the immune system breaks down, or is in a weakened state, the body is subject to great harm from common and usually relatively harmless illnesses. The common cold or the flu can be lethal to someone with a non-functional immune system.

Allergic reactions however, are the immune system ‘over functioning.’ Substances which are harmless to most people, like pollen, animal hairs, or bee stings, cause the immune system to react in such a way which can create a physiological response which can be anything from discomfort like a runny nose to a life threatening situation like anaphylaxis.

As an emergency room physician Dr. Josyann Abisaab believes people should be aware of the signs of anaphylaxis so that if they should ever be confronted with such a reaction, either in a child or adult, they will know how to respond.

Shock is one of the signs of anaphylaxis. Shock is when there is a sudden and large fall in the body’s blood pressure creating a situation where the organs do not receive the blood supply they need to function properly. Considering the serious danger this can put someone in, the best response is to immediately call an ambulance so the person having the reaction can get the care he needs as soon as possible.

COPD stands for Chronic Obstructive Pulmonary Disease. This illness is composed mainly of three separate chronic illnesses; chronic bronchitis, chronic asthma and emphysema. The main cause of COPD in the United States today is smoking, which accounts for about 90% of the cases. And although not every smoker will get COPD, it is estimated that about 15% of smokers will. It is not completely understood yet if passive smoking (inhaling cigarette smoke from a nearby smoker) can contribute to the development of COPD; it is known that children living with people that smoke are more likely to develop respiratory infections and the symptoms of asthma.

Emergency room physicians such as Dr. Josyann Abisaab urge smokers to try and reduce the amount they smoke, or even better, quit smoking altogether. Evidence shows that if a patient with COPD stops smoking, their decline in respiratory function slows down to the same level as a non-smoker, showing that it is “never too late to quit.”

The Centers for Disease Control’s Advisory Committee on Immunization Practices recommends that every person over 6 months old should be vaccinated against the influenza virus. They voted for this policy last winter, on February 24, 2010. Their recommendation was that there should be “universal” flu vaccination in the United States and that the  program at that time should be expanded to meet this goal, which was done.

The groups most ‘at risk’ should be especially careful to get their flu shots early in the season which begins in September, but it is not too late even now, in January. If you fall into any of the following groups and are still not vaccinated, it is wise to heed the advice of the CDC and do so at once. As of January 1st, 2011 those with Medicare coverage are entitled to free flu vaccines, so now there is no reason to delay taking this important step to protecting your health.

1. Pregnant women
2. Anyone over 50 years old
3. Children who are younger than 5 years old, but there is a special urgency for those between 6 months and 2 years old
4. Anyone of any age with some chronic medical conditions. Check with your doctor.
5. Those who live in nursing homes or other care facilities long-term.
6. People who come into frequent contact or live with others who are at high risk for the complications of the flu, which includes but is not limited to:

a.    Those who work or live with young children, especially if the children are less than 6 months old and are too young to be vaccinated themselves.
b.    Those who come in contact with persons at high risk for the complications the flu can cause.
c.    Any health care workers.

Having a child with asthma can be very stressful. It is hard to know when an ER visit is necessary. Emergency care doctors such as Dr. Josyann Abisaab recommend you prepare for such a visit in advance, and become familiar with the symptoms that need emergency care. Some of them are:

• If your child’s coloring changes; blue or gray lips and/or fingernails
• If your child has difficulty talking
• If your child’s peak flow reading drops below 50% and does not improve with medication
• If your child repeatedly uses rescue medications for severe flare-up symptoms which do not go away after five or ten minutes, or return quickly.
• If the areas between the ribs, below the ribs and in the neck pull in dramatically while your child inhales

USA Today featured this interesting story recently, covering one solution that the Louisville Metro Emergency Medical Services have found to the problem of overcrowding in the emergency room.  Whether you are a potential emergency room patient, or an emergency room doctor like Dr. Josyann Abisaab, it’s certainly worth a read.

With the new program in place, the lowest priority calls are being diverted to a nurse who can spend time with patients and help them to find treatment and solutions.   While the program is a fresh idea in America, it’s widely used in the United Kingdom and Australia, says Jeff Clawson, medical director for the National Academies of Emergency Dispatch.

If you, or someone you know, have recently had Salmonella poisoning, it’s important to understand your various treatment options.  Many patients will come to the emergency room and receive treatment from the emergency room doctors, like Dr. Josyann Abisaab, while others will seek out their primary care physician.

Most people with salmonellosis recover on their own in four to seven days with no antibiotics or other treatments.  The main goal of salmonellosis treatment is to prevent dehydration. In order to prevent Salmonella infections, it’s very important to cook food thoroughly to prevent food poisoning and to wash hands carefully during food preparation.

Children should also know to wash their hands after handling a pet.  Don’t keep pet reptiles in the home if you have children under five, and monitor children at a petting zoo or farm.