Splenomegaly exists in all patients, and is typically associated with hypersplenism, early satiety, and, in children, growth (height) retardation. Anemia and throm-bocytopenia, resulting in fatigue and bleeding tendency, respectively, are among the earliest presenting signs and most prominent features of Gaucher disease. In almost all symptomatic patients, there is some degree of hepatomegaly but only rarely are liver function tests abnormal.
Bone involvement is among the more variable and probably the most debilitating features, particularly the recurrent attacks of ''bone crises'' experienced primarily in childhood. The incidence of these episodes abates with age. The occurrence of pathological fractures, avascular necrosis of the heads of femur and humeri, and compression fractures of the spine are well-documented complications of severe skeletal involvement. Osteopenia and osteoporosis may be important findings even among young adults.
Pulmonary involvement is recognized as an uncommon finding in type I disease; among the neuronopathic forms, it is generally the penultimate cause of death.
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The use of dumbbells gives you a much more comprehensive strengthening effect because the workout engages your stabilizer muscles, in addition to the muscle you may be pin-pointing. Without all of the belts and artificial stabilizers of a machine, you also engage your core muscles, which are your body's natural stabilizers.