Have you ever heard of slow twitch and fast twitch muscle fibers? Muscles that are predominantly made up of fast twitch muscle fibers are our quick reacting, higher contractile force muscles that fatigue rather quickly. Muscles made up of predominantly slow twitch muscle fibers are our less explosive muscles that are much longer lasting than their counterpart. You often hear of these two types of muscle fibers when comparing track sprinters to marathon runners. It may seem strange to think of slow and fast twitch muscle fibers within the 4 layers of our pelvic floor muscles but they are there.
It is this combination of slow and fast twitch muscle fibers that requires us to work, not only the quick flicks or quick contractions of the sphincter muscles of our pelvic floor, but also the steady, endurance of the levator ani muscles.
Let's take a quick review of the layers of the pelvic floor. The outermost layer is our anal sphincter. The contraction of this muscle is the easiest to...
The drug metformin is not recommended for people with
kidney disease. For this reason, some people think that metformin causes kidney disease. But new evidence
suggests that metformin might actually protect the kidneys.
For many people with type 2 diabetes , metformin is a very
effective drug. In everyone, the liver is a sort of "mother" organ. When blood
glucose (BG) levels go down, the liver releases some glucose into the blood to
make sure all the other organs get enough glucose energy to work properly.
When you eat and your BG levels start going up, the liver
is supposed to stop pushing all this glucose out into the bloodstream.
But for some reason, in people with type 2 diabetes, like
an oversolitous mother, the liver doesn't stop feeding the bloodstream after
meals. "Eat eat!" I can hear it say to a bloodstream already stuffed with
glucose. And this continued release of glucose into the bloodstream after
meals is one reason people with type 2 go high after me...
I received an interesting question by e-mail recently, which brought up several good points to review. The author asked: "Can a patient use metformin after a heart attack (after 12 years of using metformin) assuming the patient has good renal function? My question is if metformin should be avoided forever after an acute myocardial infarction or just temporarily withheld after the heart attack in a patient with an adequate renal and liver function (also without congestive heart failure or hypersensitivity to metformin)." I answered: "According to the USPI (the "label") for Glucophage brand of metformin, GLUCOPHAGE and GLUCOPHAGE XR are contraindicated [should not be used] in patients with: Renal disease or renal dysfunction (e.g., as suggested by serum creatinine levels =1.5 mg/dL [males], =1.4 mg/dL [females] or abnormal creatinine clearance) which may also result from conditions such as cardiovascular collapse (shock), acute myocardial infarction, and septicem...
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