Low Level Laser for Hypokalemia- Update

Hypokalemia

Yulia, lovely young lady, hospitalized for 7^th times due to "paralysis". Yulia dearest, your working diagnosis was hypokalemia.

What is that?

Symptoms

The common symptoms for this kind problem are muscle weakness and cramping, and paralysis like yours, also paresthesias, palpitations, constipation, nausea or vomiting, abdominal cramping, polyuria, nocturia, or polydipsia.¹

What is kalium?

Kalium or Potassium is one of the body's major ions. Nearly 98% of the body's potassium is intracellular. The ratio of intracellular to extracellular potassium is important in determining the cellular membrane potential. Small changes in the extracellular potassium level can have profound effects on the function of the cardiovascular and neuromuscular systems.¹

Pretty Yulia, Potassium is about working of a cell.

How about the normal level

The reference range for serum potassium level is 3.5-5 mEq/L, with total body potassium stores of approximately 50 mEq/kg (ie, approximately 3500 mEq in a 70-kg person).

Hypokalemia is defined as a potassium level less than 3.5 mEq/L. ¹

Moderate hypokalemia is a serum level of 2.5-3 mEq/L. ¹

Severe hypokalemia is defined as a level less than 2.5 mEq/L.¹

Pathophysiology:

Hypokalemia may result from conditions as varied as renal or GI losses, inadequate diet, transcellular shift (movement of potassium from serum into cells), and medications.

Laser for Hypokalemi

Your father came to me , wonder if Low Level laser Therapy (LLLT) could work on this condition. I found Karu’s model. Karu’s model shows , light is absorbed by components of repiratory chain ( i.e. flavine dehydrogenase, cytochomes and cytochromes oxidase) which causean activation of the respiratory and the oxidation of the NAD pool , which leads to changes in the redox status of oth mitochondria and the cytoplasm. This in turn has an effect on membrane permeability/ transport , with changes in the Na ⁺ /H⁺ ratio and increase Na⁺/K⁺ ATPase activity.

How about your's dear?

The last time you were in hospital, your number just 1.5 mEq/L.(Severe hypokalemi). I gived you LLLT by transcutaneus, 45 minutes everyday, 10 times. It worked! At 4th administered, although your kalium still below 2.5 mEq/L, you felt strong enough, no muscle weakness. It was amazing.

Discussion :

Inadequate diet and GI problem could explained Yulia's . His father told me, her appetite not so good. She also prone for diarrhea.

So dear, yet LLLT help you , please take times to visit gastroenterologist.

Author: David Garth, MD, Consulting Staff, Department of Emergency Medicine, Mary Washington Hospital : eMedicine Specialties > Emergency Medicine > Endocrine And Metabolic ; Hypokalemia; Last Updated: September 20, 2005

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Seoul, 2007

Indonesian's delegate with de Lisa !!

Going to Istanbul, 2009



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----> Don't just day dreaming !!!

Low level laser for shoulder pain -after stroke - and shoulder injury

Causalgia, reflex sympathetic dystrophy, and the shoulder - hand - finger syndrome have been group into a characteristic medical condition that may cause severe, intractable pain and progressive functional impairment and disability

This condition is not rare for stroke problem

The circulation of upper extremity can be roughly divided into arterial and venous component : first, the arterial component. It is refers to cardiac pumping, proceeding to the distal portion of the extremity. The 2^nd are the venous return and lymphatic system. The muscles of the hand and arm force the fluid proximally by means of “pumps”

Mr Djoko, got stroke , nearly two years ago, hemiparetic with spasm at his right hand. This was the iniciating factor for his problem. He sent by neurologist due to pain on his right side. I found shoulder limitation , and swollen.

Low level laser given by transcutaneus approach 5 times ,everyday. I asked him to move his right extremity frequently.

Injury of shoulder

Mr Djoko visited my office again two weeks ago. This time, the pain suffered his left hand. almost a month ago, he slipped on stairs, grabbed the guard raill by his left hand. His tendon of biceps became overstrech.

Three times simultaneus transcutaneus low level laser not enough for this condition. It was very painfull for him, sometimes he feels pain on his chest

I used ILIB , combined with probe to delivery the laser. Probe go a long tendon biceps , also administered to ganglion stelata to block the nerve. Pain decreased , and diminished after the 7th treatment.













Discussion:

Pity mr Djoko. Yes, we could deliver laser as a nerve block, like using anesthetic agent.

An effective stellate block is judged if there is pain relief. Mr Djoko found, after stellate block using laser, the pain relief more rapid.

For both shoulder, the stiffness should be treated . active exercises of the shoulder and hand must be instituted as soon ans as energitically as the medical condition permits.

Mr Djoko found, along with pain decreasing , his hemiparetic side could moved more easily.

For his right arm, the problem iniciated only of his shoulder limitation , but for the left side, the manuver slipped on strairs sreching the biceps and the brachial plexus. So, it is more painfull, and more difficult to manage.
May be probe as anaesthetic was enough, but his fear must considerable. A man, both side hand injures , still works as goverment employee, it is fearfull.

There are some papers about laser for causalgia. I didn't find yet laser administered to the ganglion. I saw this kind aproach when I joined WALT Conggres in Tsukuba Japan, 2002.

prevent your back - exercise