Blog Posts

Brushing Up on Dental Hygiene

October 26th, 2020

The US Centers for Disease Control and Prevention (CDC) reports that 69 percent of Americans ages 35 to 44 have lost at least one of their permanent teeth. The CDC also notes that by age 50, Americans have typically lost an average of 12 teeth, including their wisdom teeth. Further, among adults ages 65 to 74, 26 percent have lost all their teeth.

You don’t have to be one of those statistics. You can keep your teeth – and your smile – throughout your lifetime by maintaining a healthy mouth and practicing good dental care. October is National Dental Hygiene Month, a time to spread the word that odorless breath, strong teeth, and clean gums are all part of good overall oral health.

This month also serves as a perfect opportunity to review a few key strategies for brushing up on your dental hygiene practices. Good oral hygiene is the best way to prevent cavities, gum disease, and other dental disorders. It also helps prevent bad breath. Oral hygiene consists of both personal and professional care.

On the personal side, everybody knows they’re supposed to brush their teeth twice a day with fluoride toothpaste. But do you know the proper brushing technique? To begin, hold your toothbrush at a 45-degree angle. Aim its bristles at the spot where your teeth meet your gums. Brush gently, using short, back-and-forth strokes across the sides and tops of your teeth. Brush for at least two minutes.

Be sure to use a soft-bristled toothbrush, and don’t brush too hard because it can harm your gums. Replace your toothbrush every three months, or sooner if the bristles become frayed or irregular. Don’t forget to clean between your teeth daily with floss or an interdental cleaning device such as a Waterpik. And use a mouthwash. It can go where brushing and flossing can’t.

Your lifestyle habits can have an impact on your oral health as well. To best maintain a healthy mouth and keep your teeth, adopt a diet that’s tooth-friendly. It should include plenty of nuts, fruits, cheese, chicken, and vegetables. Cheese causes your salivary glands to produce more saliva, which neutralizes the acid. Acid damages your teeth.

For overall better oral health, it’s also recommended that you stop smoking and limit your intake of soda and alcohol. Tobacco can cause periodontal complications including oral cancer, and soda and alcohol contain phosphorus, which on its own is important for health. But too much phosphorus depletes your body of calcium, and that can lead to tooth decay and gum disease.

Good dental hygiene also has a professional component, which includes seeing your dentist regularly. The standard recommendation is to visit your dentist twice a year for check-ups and cleanings. But your dentist may want to see you more or less often, so talk with your dentist about the frequency that’s best for you.

During a routine dental visit, your dentist or a hygienist will clean your teeth and check for cavities and gum disease. Your dentist will also evaluate your risk for other oral problems and check your mouth, face, and neck for signs of cancer. X-rays of your teeth are generally taken once a year, but your dentist may recommend other procedures to help diagnose a suspected dental condition.

Not only is good dental hygiene key to maintaining a healthy mouth and keeping your teeth for a lifetime, but it’s also important for your body’s overall health. Research study after research study has shown that people who have poor oral health have higher rates of cardiovascular problems such as heart attack or stroke than people with good oral health.

Several theories about how this happens have been proposed. One suggests that the bacteria that infect the gums and cause gum disease travel through the blood vessels to other areas of the body. There, they cause blood vessel inflammation and damage, and tiny blood clots, heart attacks, and strokes may follow.

Another theory suggests that it’s not the bacteria, but the body’s immune response to it that sets off the vascular damage. A third theory states that there may be no direct connection between gum disease and cardiovascular disease, but a third factor, such as smoking, is a risk factor for both conditions.

What’s more, gum disease associated with a particular bacterium called porphyromonas gingivalis has been linked to rheumatoid arthritis and pancreatic cancer.

However you look at it, brushing up on your dental hygiene is a good way to go. Make it the focus of this Dental Hygiene Month and always.

Down Syndrome Defined

October 22nd, 2020

Generally speaking, people have 23 pairs of chromosomes for a total of 46 chromosomes. Chromosomes are rod-like structures on DNA that store your genes, the material that carries the instructions for inherited traits such as hair color, skin color, and height. For each pair of chromosomes, you get one from your mother and one from your father.

A person with Down syndrome has a third copy of one chromosome, chromosome 21, instead of the usual pair. This extra copy of chromosome 21 disrupts the course of normal brain and body development. Those with Down syndrome typically have distinct physical features and often experience physical and mental delays and disabilities.

Down syndrome is the most common chromosomal condition identified in the United States. Each year, approximately 6,000 American babies are diagnosed with Down syndrome. It occurs in about one in every 700 babies. According to the National Down Syndrome Society, there are more than 350,000 people living with Down syndrome in the US.

Certain physical features are common in people with Down syndrome. These features include a slightly flattened face, particularly the bridge of the nose, almond-shaped eyes that slant upward, a short neck, small ears, bulging tongue, small hands and feet, short stature, and poor muscle tone. People with Down syndrome may have some or all of these features to varying degrees.

People with Down syndrome typically have some degree of developmental disability, but it’s generally mild to moderate. They may be slow to reach developmental milestones such as crawling, walking, and talking. Mental and social delays may result in impulsive behavior, poor judgment, short attention spans, and slow learning.

There are also certain medical problems that are common in people with Down syndrome. These conditions include congenital (meaning present at birth) heart defects; obstructive sleep apnea, a condition in which breathing temporarily stops while the person is sleeping; hearing loss; ear infections; eye disorders, and thyroid problems. People with Down syndrome must be routinely monitored for these conditions by a health care provider.

There are three types of Down syndrome: trisomy 21, translocation Down syndrome, and mosaic Down syndrome. Trisomy 21 is the most common, occurring in about 95 percent of Down syndrome cases. With trisomy 21, each cell in the body has three separate copies of chromosome 21.

Translocation Down syndrome occurs in about 3 percent of cases. With this type, an additional full or partial copy of chromosome 21 is present, but it attaches, or translocates, to another chromosome, usually chromosome 14, instead of existing on its own.

People with translocation Down syndrome can inherit the condition from an unaffected parent who is a carrier of the genetic rearrangement. In one-third of cases of Down syndrome resulting from translocation, there is a hereditary component, accounting for about 1 percent of all cases of Down syndrome.

Mosaic means mixture or combination, so people with mosaic Down syndrome have a mixture of cells with three copies of chromosome 21 and cells with the normal two copies. People with this type of Down syndrome, which occurs in about 2 percent of cases, may have milder symptoms and effects because they have fewer cells with an extra chromosome 21.

The cause of Down syndrome is unknown, but certain factors increase your risk of having a baby with the syndrome. One factor is the mother’s age. Your risk of having a baby with Down syndrome increases as you get older, especially if you are age 35 or older. Still, the majority of babies with Down syndrome are born to mothers younger than 35 because there are many more births in younger women.

In addition, if you or your partner are a carrier of the translocation Down syndrome gene, you can pass it on to your baby. And if you already have a baby with Down syndrome, your risk of having another baby with the same syndrome is increased.

If you want to know if your baby has Down syndrome before it is born, there are two types of tests that can be done: screening tests and diagnostic tests. Screening tests can reveal if your baby has a higher risk, but cannot determine if your baby definitely has Down syndrome. Screening tests typically include various blood tests and ultrasound.

Diagnostic tests can determine if your child has Down syndrome, but there’s a slightly higher risk for miscarriage associated with these tests. One diagnostic test is chorionic villus sampling, which analyzes a tissue sample removed from the placenta to look for genetic disorders.

Other diagnostic tests include amniocentesis, which examines some of the amniotic fluid surrounding your baby in the uterus, and percutaneous umbilical cord sampling, which involves taking a small amount of blood from the baby’s umbilical cord to check for chromosomal defects.

If you choose not to have these prenatal tests, Down syndrome will be diagnosed when your baby is born. If your doctor suspects Down syndrome, he or she will take a sample of your baby’s blood for karyotype testing. This test is done to identify and evaluate the size, shape, and number of chromosomes. It can detect three copies of chromosome 21.

Many problems associated with Down syndrome are lifelong, but early intervention, beginning in infancy, can help people overcome the challenges and live long lives. In 1960, babies born with Down syndrome often didn’t see their 10th birthday. Today, the average life expectancy of individuals with Down syndrome is 60 years, with many living into their 60s and 70s.

What’s more, many people with Down syndrome are able to work and fully participate in social activities. These people live full and meaningful lives.

The Bottom Line on Breast Cancer

October 12th, 2020

It’s October, and everybody knows October is National Breast Cancer Awareness Month. Look around. Pink ribbons are everywhere. The color pink is a reminder to get the facts about breast cancer and then get screened. And men, don’t think this doesn’t apply to you. Though it is much more common in women, men can get breast cancer, too.

Group of People and Breast Cancer Concept

Consider these facts. About one in eight American women will develop breast cancer over the course of her lifetime. Breast cancer is the second most common cancer in women after skin cancer and the second leading cause of cancer death in women. Only lung cancer kills more women each year.

The American Cancer Society estimates that 276,480 new cases of invasive breast cancer and 48,530 new cases of noninvasive breast cancer will be diagnosed in American women in 2020. Sadly, about 42,170 women are expected to die from it.

Further, the ACS estimates that about 2,620 new cases of invasive breast cancer will be diagnosed in men in 2020, and about 520 men will die of breast cancer. A man’s lifetime risk for developing breast cancer is about one in 883.

Breast cancer occurs when cells in the breast start growing uncontrollably. Most of the time, but not always, these extra cells collect and form tumors. These are the lumps that can often be detected in the breasts on your self-exams or mammograms.

A new lump in your breast or armpit is one symptom of breast cancer, but there are others as well. You might notice thickening or swelling of an area of your breast or irritation or dimpling of your breast skin. Look for red or flaky skin near the nipple, as well as secretions from the nipple other than breast milk. Changes in the size and shape of your breast and pain in any area of the breast are other breast cancer symptoms.

If you have any of these symptoms, visit your doctor for a proper diagnosis.

Breast cancer is the result of a mutation, or abnormal change, in the genes that regulate the growth and reproduction of breast cells. About 5 percent to 10 percent of breast cancers are inherited, or caused by mutations passed on from your parents. The rest are caused by abnormal changes that occur as a result of aging and life in general.

That makes getting older a risk factor for breast cancer, one you can’t do anything about. Other risk factors for breast cancer you cannot control include getting your period before age 12 and menopause after 55, having dense breasts, having a personal or family history of breast cancer, and having been treated with radiation therapy.

There are also risk factors for breast cancer you can control, things like being physically inactive, being overweight, drinking a lot of alcohol, and taking hormones. In addition, having your first baby after age 30, not breastfeeding, and never having a full-term pregnancy can also increase your risk for breast cancer.

You can’t change your age or your genes, but there are steps you can take to reduce your risk for breast cancer. A few of these suggestions are no-brainers. We already know that we should maintain a healthy weight, exercise regularly, and limit our alcohol consumption to one drink a day.

These suggestions you may not have heard. For one, think hard and have a heart-to-heart discussion with your doctor about the risks of taking the Pill or hormone replacement therapy (HRT). They may not be right for you. If you have a baby, consider breastfeeding, if you’re able. If you have a family history or a genetic mutation, talk to your doctor about ways you can lessen your breast cancer risk.

With breast cancer, as with most cancers, early detection is critical to treatment success. It’s best to find it before the cancer cells have had a chance to invade the nearby lymph nodes and spread to other areas of the body. Maintaining a routine screening schedule can assist with early detection.

The first part of the screening process is regular breast self-exams. You know the look and feel of your breasts, so you’re likely to notice changes such as lumps, pain, or differences in size or shape. You should also get routine clinical breast exams by a doctor or nurse, who use their hands to feel for lumps in your breasts.

The next step is to get a mammogram. The American Cancer Society’s Breast Cancer Screening Guideline recommends that women begin yearly mammograms by age 45. They can switch to having mammograms every other year at age 55. If lumps are detected, your doctor may perform a biopsy to determine if their cells are cancerous.

If cancer is detected, there are many approaches to treating it. Doctors often use more than one approach for each patient.

Chemotherapy is a common approach. It uses drugs to kill cancer cells and shrink tumors. Surgery, called mastectomy, is often used to remove the breasts and the tumors. Radiation therapy uses high-energy rays directed at the spot of cancer to kill cancer cells. Unfortunately, chemotherapy and radiation therapy have uncomfortable side effects.

Doctors use additional treatment approaches including hormonal therapy, which doesn’t allow the cancer cells to get the hormones they need to survive. Another approach is biological therapy, which works with the immune system, your body’s natural defense against disease. Biological therapy helps the immune system to fight cancer. It also helps control the side effects of other cancer treatments.

Breast cancer is the subject of much research, and if you’re interested, you can participate in a clinical trial to test the safety and effectiveness of new drugs and treatments. To find a clinical trial near you, ask your doctor or go to clinicaltrials.gov.

Now, you’ve got the facts on breast cancer. Put on something pink and share what you’ve learned!

Highlighting Health Literacy

October 5th, 2020

One of the biggest problems that health care providers have to deal with pertains to health literacy, which is a person’s ability to understand health care information and navigate the health care system. Currently, health literacy in the United States is woefully deficient.

So what exactly is health literacy?

There are many definitions out there, but the concept behind them is essentially the same. An example comes from the American Medical Association Foundation, which defines health literacy as: “the ability to obtain, process and understand basic health information and services needed to make appropriate health decisions and follow instructions for treatment.

The Center for Health Care Strategies puts it more simply. In their definition, health literacy refers to “the skills necessary for an individual to participate in the health care system and maintain good health.” The skills they identify are reading and writing, calculating numbers, communicating with health care professionals, and using health technology such as electronic diabetes monitors.

The Network for the National Library of Medicine agrees that health literacy involves using a certain set of skills. The network suggests that “health literacy requires a complex group of reading, listening, analytical and decision-making skills, as well as the ability to apply these skills to health situations.”

According to the US Centers for Disease Control and Prevention (CDC), anyone who needs health information and services also needs health literacy skills. You can use those skills to find appropriate information and services, communicate your needs and preferences, and respond to the information and services.

Health literacy skills also enable you to understand the choices, consequences, and context of the information you receive. With such understanding, you can make decisions based on which information and services match your needs and preferences.

But there’s a big problem. An estimated 90 million Americans, nearly 36 percent, have low health literacy. And it affects certain populations more than others.

For example, Hispanic adults have lower health literacy skills overall than any other ethnic or racial group. Low health literacy is also more common in people who speak another language or speak English as a second language, as well as in older people, people with lower socioeconomic status or education, and people who are uninsured or on Medicare or Medicaid.

It’s imperative that we improve health literacy in this country because low health literacy is having a negative effect on how Americans use the health care system and on overall health outcomes. And as a result of increased use of services and poor outcomes, low health literacy is making an enormous impact on the nation’s health care costs.

The authors of a report titled “Low Health Literacy: Implications for National Health Policy” estimate the impact of low health literacy on the nation’s economy to be between $106 billion and $238 billion annually. That amount, the authors point out, represents between 7 percent and 17 percent of all personal health care expenditures.

To achieve optimal health, you must be an active participant in your health care. But people with low literacy often don’t have the skills necessary to clearly describe their symptoms to their health care provider, or fully understand their diagnosis and follow the instructions for their treatment. Many are simply unable to play an active role in their care.

And that affects the way they use the health care system. Many avoid going to the doctor, and when they have a health concern, they go to the emergency room for care instead. Studies show that people with low health literacy are 2.3 times more likely to visit the emergency room. And with that comes an associated increase in hospital admissions.

Health literacy affects overall health and mortality as well. Low health literacy has been linked to increased frequency of depression, physical limitations, and chronic diseases such as heart disease, stroke, diabetes, and asthma.

Making matters worse, people with low health literacy often have little understanding of their chronic disease. And because they are less engaged in their health care, they are less likely to use preventive services or follow instructions for managing their chronic disease. As a result, people with low health literacy have a much higher risk of complications and death.

Health care providers, health educators, and patients all have roles to play if we’re going to boost health literacy in America. Patients must be willing to engage with their providers and listen to what they say. Providers and educators can do their part by following these Four Simple Strategies for Improving Your Patients’ Health Literacy:

  • Use plain language in both verbal and written communication
  • Use visual aids
  • Recommend and use technology – Research shows that nearly 90 percent of Americans use the internet and 81 percent own a smartphone. Using these technologies can be a good way for providers to get their message to patients.
  • Use effective teaching methods – Some techniques include talking slowly, asking open-ended questions, and asking patients to repeat instructions given to them.

Why is health literacy important? It’s important because it allows you to make good decisions about your health. Health literacy also enables you to get appropriate medical care, take your medications correctly, and manage chronic diseases. And most importantly, it helps you lead a healthy lifestyle so you can live a full and healthy life.

AFib: Hurried Heartbeats

September 21st, 2020

Atrial fibrillation, or AFib, is the most common type of irregular heartbeat, or arrhythmia. With AFib, your heart beats much faster than the normal 60 to 100 beats per minute. To create a normal heart rhythm, or sinus rhythm, your heart’s upper and lower chambers must work in concert. But with AFib, the activity of those chambers is out of sync.

The heart pumps blood to the rest of the body, and the pumping is controlled by the heart’s own electrical system. Each heartbeat is essentially an electrical impulse that navigates through the heart. The impulse is generated by a small mass of specialized tissue in the right upper chamber, or atrium, of the heart called the SA node.

The SA node sends the electrical charge to the AV node, which is located in the wall of tissue that separates the right and left atria called the interatrial septum. The AV node conducts the impulse from the atria to the ventricles, the bottom chambers of the heart. Each impulse moves blood through the atria into the ventricles, from where it is pumped out to the rest of the body.

With AFib, the atria don’t move blood into the ventricles effectively, so the ventricles can’t pump blood to the body efficiently. This can cause your heart to beat irregularly, to be very rapid and feel like quivers or thumps in your chest. AFib can lead to serious heart-related complications including heart failure.

When blood is not pumped efficiently out of the ventricles, it is more likely to clot. If a blood clot leaves the ventricles and enters the bloodstream, it can lodge in an artery going to the brain and cause a stroke. People with atrial fibrillation are 5 to 7 times more likely to have a stroke than the general population. And about 15 to 20 percent of people who have strokes have this heart arrhythmia.

It is estimated that between 2.7 million and 6.1 million people in the United States have AFib. It is more common with age, so as our population gets older, this number will increase. Further, more than 454,000 hospitalizations in which AFib is the primary diagnosis occur each year, and AFib contributes to about 158,000 deaths annually. And that number is expected to rise.

A congenital heart disorder can cause AFib, and certain diseases and conditions that can damage your heart can result in arrhythmia. Possible causes of atrial fibrillation include high blood pressure, heart attack, coronary artery disease, heart valve disease, chronic lung disease, previous heart surgery, an overactive thyroid or metabolic disease, a viral infection, and exposure to stimulants such as caffeine, cocaine, tobacco or alcohol.

Some people have no symptoms and don’t know they have AFib. Their arrhythmia is typically detected during a physical exam when the doctor performs a test called an electrocardiogram, or ECG, which measures heart rhythm. Common symptoms of AFib include the following:

  • Rapid and irregular heartbeat
  • Fluttering or “thumping” in the chest
  • General fatigue
  • Dizziness, faintness or confusion
  • Chest discomfort
  • Shortness of breath
  • Weakness
  • Sweating

In addition to an ECG, your doctor may use other tests to help diagnose AFib. These may include a Holter or portable event monitor, which records your heart’s electrical activity over a period of time. Transesophageal echocardiography, or TEE, uses sound waves to take pictures of your heart through your esophagus. Your doctor uses this test to look for blood clots.

Treating AFib generally includes making certain lifestyle changes, including quitting smoking and limiting your intake of alcohol and caffeine. Also, control your high blood pressure and blood sugar levels, exercise regularly and maintain a healthy weight, and eat a heart-healthy diet that is low in salt, saturated fat, trans fats and cholesterol.

Initially, medications are used to treat atrial fibrillation. These include medications that control heart rhythm, which help return the heart to normal sinus rhythm. Thera are also medications that control heart rate. These work by preventing the ventricles from beating too rapidly. Anticoagulant medications, or blood thinners, which reduce the risk of blood clots and stroke, are also typically prescribed to patients with AFib.

Among the nonsurgical procedures for atrial fibrillation are electrical cardioversion and radiofrequency ablation. With electrical cardioversion, an electrical shock is placed on the outside of the chest to “reset” the heart to normal sinus rhythm.

During radiofrequency ablation, a catheter is inserted through a blood vessel and gently guided into your heart. Your malfunctioning tissue is destroyed using radiofrequency energy delivered through the catheter, and the tissue can no longer send abnormal signals.

Implanted pacemakers are among the surgical procedures for atrial fibrillation. Another is the maze heart surgery. During this procedure, the surgeon cuts small slits in the upper part of your heart. The scar tissue that results interferes with the transmission of electrical impulses that cause AFib, and normal heart rhythm is restored.

Conquering Childhood Cancer

September 15th, 2020

Childhood Cancer Awareness Month is observed every September by cancer organizations around the globe. According to the American Cancer Society, just over 11,000 children under the age of 15 will be diagnosed with cancer in 2020, and about 1,190 children are expected to die from it. After accidents, cancer is the second leading cause of death in children ages 1 to 14.

The most common cancers in children are not the same as the cancers seen most often in adults. When adults get cancer, it often begins in the lungs, breast, colon, prostate or skin. But in children, cancer tends to affect their white blood cells, nervous system, brain, bones, lymphatic system, muscles or kidneys.

How cancer spreads, as well as how it’s treated is typically different for children than adults as well. That’s mostly due to children’s unique responses to treatment. Another difference between childhood cancers and adult cancers is that the recovery rate is higher in children. Most children with cancer can be cured.

Thanks to advances in diagnosis and treatment over the years, 84 percent of children that are diagnosed with cancer now survive five years or longer. In the 1970s, that figure stood at 58 percent, so we’ve come a long way.

Acute lymphoblastic leukemia (ALL) is the most common childhood cancer, accounting for approximately 34 percent of all cancers in children. Leukemia is a cancer that begins in the bone marrow and spreads to the blood. From there, it can travel to other parts of the body. Three out of four leukemia cases are ALL.

Tumors of the brain and nervous system are also common in children. In fact, they make up about 27 percent of childhood cancers. Central nervous system tumors are cancers of the brain and spinal cord. They are the most common solid tumors that occur in childhood, and they have the highest mortality rate of childhood cancers.

Lymphoma is a less common childhood cancer that affects special cells called lymphocytes that are part of the body’s immune system. Lymphomas target the lymphatic system, the network of vessels, organs and tissues that carry clear fluid called lymph, which contains disease-fighting white blood cells, through the body.

There are two main types of lymphoma: Hodgkin lymphoma, also called Hodgkin disease, and non-Hodgkin lymphoma. Hodgkin lymphoma is a cancer of the lymph nodes. It can start almost anywhere in the body and then spread to just about any organ or tissue. These often include the liver, bone marrow and spleen.

Non-Hodgkin lymphoma affects the T and B lymphocytes, which are the immune system’s natural killer cells. These cells are produced in the bone marrow then travel to the body’s lymph glands, and to the thymus gland, intestinal tract, tonsils and spleen. Non-Hodgkin lymphoma can start in any of those areas.

Fortunately, childhood lymphoma is rare. Only about 8 percent of childhood cancers are lymphomas: 5 percent of children with cancer will have non-Hodgkin lymphoma while 3 percent will have Hodgkin lymphoma.

Certain cancers in adults and children are hereditary. But in adults, many other factors can contribute to the development of cancer. These include lifestyle and environment influences such as exposure to cigarette smoke, asbestos and ultraviolet radiation from the sun.

But in children, cancer is most often the result of DNA mutations that occur very early in the child’s life or while the child is still developing in the womb. As such, lifestyle and environmental factors play only a minor role in the development of childhood cancers.

There are multiple treatment options for childhood cancer. The treatment options chosen for your child depend on the specific type of cancer and how advanced it is. Among the types of cancer treatment are surgery, chemotherapy, radiation therapy, immunotherapy and stem cell transplants.

Each childhood cancer has its own specific signs and symptoms, but there are some general signs and symptoms. Possible signs and symptoms of cancer in children include the following.

  • An unusual lump or swelling
  • Easy bruising or bleeding
  • Ongoing pain in one area of the body
  • Unexplained fever or illness that doesn’t go away
  • Frequent headaches, often with vomiting
  • Sudden unexplained weight loss

If your child displays any of these signs and symptoms, take him or her to a physician for an evaluation. Early detection helps ensure a positive outcome from childhood cancer.

Raising Voices for MPN Awareness

September 8th, 2020

When asked to name a blood cancer, most people will respond with leukemia, lymphoma or myeloma. That’s not surprising because those are among the most common blood cancers. In fact, new cases of those cancers are expected to account for 9.9 percent of the estimated 1,806,590 new cancer cases diagnosed in the US in 2020.

But for this Blood Cancer Awareness Month, let’s take a closer look at another less common blood cancer called myeloproliferative neoplasms, or MPNs. Like other cancers, MPNs, which are a group of rare, chronic blood cancers, develop when there is uncontrolled cell growth. And the cells, in this case, are blood cells.

Normally, the marrow inside your bones produces cells called blood stem cells. These are immature cells that develop into mature blood cells over time. The mature blood cells include red blood cells, white blood cells and platelets. If you have an MPN, the stem cells in your bone marrow make too many of one of these blood cells.

There are several types of MPNs that are differentiated primarily by the specific blood cell that is affected. Two of the main types are polycythemia vera (PV), which is typified by an excessive amount of red blood cells, and essential thrombocythemia (ET), in which too many platelets are produced.

The third type of  MPN is myelofibrosis, or MF. This type of MPN is characterized by an accumulation of scar tissue in the bone marrow, a process called fibrosis. This fibrosis prevents the bone marrow from making the normal amount of healthy blood cells.

Many people have no symptoms when they are first diagnosed with MPNs. In fact, most MPNs are detected accidentally on routine blood tests that are being performed for other conditions. When symptoms are present, they tend to evolve gradually over time.

When they are noticeable, symptoms of MPNs may include: Pain or feeling of fullness below the ribs (due to an enlarged spleen), blood clots, weight loss, fatigue, pale skin, bone pain, infections and fever, loss of appetite, shortness of breath during exercise, itching and night sweats. Headaches, dizziness, blurred vision and elevated blood pressure are other possible symptoms.

Researchers don’t know what causes MPNs, but they believe there are probably multiple factors that contribute to their development. While the exact cause of MPNs is unknown, several risk factors for the disease have been identified.

One risk factor is exposure to toxins such as benzene and certain solvents or pesticides, as well as exposure to heavy metals such as mercury and lead. This exposure may lead to genetic changes in blood stem cells that can lead to the development of MPNs. Very high doses of ionizing radiation may increase the risk for MF. Around one-third of people with MF had PV or ET first.

Further, a mutation in a gene known as Janus kinase (JAK 2) has been discovered in a high percentage of people with MPNs. But researchers are still exploring the exact role of the JAK 2 mutation in MPN development.

To diagnose MPNs, your doctor will first perform a thorough physical exam and review of your medical history, including a history of your symptoms. Next, your doctor will order blood tests to look for cell abnormalities. These blood tests typically include a complete blood count (CBC), which determines how many of the different types of blood cells are present in your blood.

To confirm a diagnosis of an MPN, a sample of your bone marrow must be removed, or aspirated, and examined under a microscope to look for abnormal cells. This procedure is called bone marrow aspiration and biopsy. A bone marrow biopsy can also detect scar tissue and determine if you have MF.

Treatment for MPNs depends on whether you have PV, ET or MF, but may include: phlebotomy, which is the removal of a controlled amount of blood from your body; chemotherapy; interferon, which is a substance produced by the immune system that helps control the production of blood cells; aspirin therapy to reduce the risk of blood clots; drugs to reduce high platelet counts; and bone marrow transplant to treat MF.

On Thursday, September 10, we celebrate “MPN Awareness Day.” The goal of the education and support organization Voices of MPN is to shine a light on these rare, chronic blood cancers. Consider raising your voice for the cause by visiting the Voices of MPN website today!

Addiction Recovery Month 2020

August 31st, 2020

National Alcohol & Drug Addiction Recovery Month was created by the Substance Abuse and Mental Health Services Administration (SAMHSA), which is part of the US Department of Health and Human Services. With SAMHSA, we observe Recovery Month every September to increase awareness of substance use disorders and celebrate individuals in recovery.

Alcohol and drug addiction are also referred to as substance use disorders. Whether the substance is alcohol, opioids, stimulants or sedatives, substance abuse has a widespread impact on life in this country. Research has found that almost 21 million Americans have at least one addiction, and drug overdose deaths have more than tripled since 1990.

What’s more, substance use disorders take an enormous economic toll. One study calculated that drug and alcohol use in the US costs $1.45 trillion in economic loss and societal harm annually. That total includes $578 billion in economic loss and $874 billion in societal harm, which includes quality of life declines and premature death.

For years, many considered addiction to alcohol or drugs to be a moral failing, but that line of thinking has changed. The National Institute on Drug Abuse (NIDA) defines “addiction” as “a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use despite harmful consequences.”

Research has discovered that substance use disorders actually change the way the brain works. The substances affect communication pathways in the brain, which changes thought processes, emotions and behaviors. These brain changes can be long-term, lasting well after you stop using drugs or alcohol.

Drugs and alcohol affect the brain by hijacking its reward system. In a healthy brain, positive behaviors such as exercising or spending time with family turn on the brain’s reward system. This system rewards the behavior by making you feel good so you want to repeat the behavior. The brain does this by producing large amounts of the feel-good chemical dopamine.

The brain’s reward system works when you use drugs or alcohol as well. But after repeatedly using the substance, your brain can’t produce normal amounts of dopamine on its own any longer. As a result, you can’t enjoy activities you normally find pleasurable unless you’re using drugs or alcohol.

Further, you develop a tolerance to the number of drugs or alcohol you’re currently using and have to use more to achieve the same reward response.

Addiction can also send your emotional danger-sensing circuits into overdrive. When that occurs, you might become anxious or stressed when you’re not using drugs or alcohol. At that point, you may start using the substance to avoid negative feelings rather than to achieve a “high.”

In addition to changing your brain chemistry, drugs and alcohol can have other negative effects on your life. You can develop an abnormal heart rate and experience heart attacks. Injecting drugs can result in collapsed veins and infections in your heart valves. You can also develop problems with your muscles, kidneys or liver.

When you’re under the influence of drugs or alcohol, you may forget to practice safe sex and become infected with a sexually transmitted disease. Substance use disorders have legal and financial consequences as well if you drive under the influence of drugs or alcohol. Or you may lose your job if your employer requires a drug test and you fail.

Many people with substance use disorders deny that they have a problem with alcohol or drugs. Your doctor uses specific criteria to diagnose addiction. These criteria are outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association. These criteria include:

  • Lack of control – The substance is used in larger amounts or over a longer time than the person originally intended.
  • Desire to limit use – The person wants to cut back on use but is unable to do so.
  • Time spent — A considerable time is spent trying to acquire the substance.
  • Cravings – The user experiences an intense desire or urges to use their drug.
  • Lack of responsibility – Substance use takes priority over work, school or home obligations.
  • Loss of interest – The user stops engaging in important social or recreational activities in favor of drug use.

If any of these criteria apply to you, consider seeking treatment, which varies by person and substance being abused. There are many types of drug and alcohol rehabilitation, but inpatient rehabilitation programs are typically the most effective.

Some inpatient rehabilitation programs require stays of 30, 60 or 90 days, while other, long-term programs require stays of 120 days or longer. Rehabilitation programs typically include counseling, behavioral therapy and medications to manage cravings and withdrawal symptoms.

If you don’t know where to find treatment, contact SAMHSA’s National Helpline: 1-800-662-HELP (4357). The Helpline is a free, confidential treatment referral and information service for individuals and families facing mental or substance use disorders. Helpline staff can direct you to the help you need. If you suspect you have a problem, call today!

FDA Asks for Plasma Donations to Fight COVID-19

August 24th, 2020

In an effort to further combat the spread of Covid-19, the US Food and Drug Administration is encouraging people who have completely recovered from the virus to donate their plasma to help hospitalized patients who are currently fighting the virus.

The FDA made this request on Sunday, August 23, when it gave emergency approval to the expanded use of antibody-rich convalescent plasma for coronavirus patients.

People who have had COVID-19 and completely recovered from it now have plasma that contains COVID-19 antibodies, the FDA reports. These antibodies can help patients with COVID-19 fight the disease, the FDA says.

“Based on scientific evidence, the FDA concluded that this product may be effective in treating COVID-19 and that the known and potential benefits of the product outweigh the known and potential risks of the product in hospitalized COVID-19 patients,” the FDA says.

The use of convalescent plasma, or plasma collected from people who have recovered from the disease, is not new. It has been used on more than 70,000 COVID-19 patients already, which is why the FDA’s request amounts to an expansion of the therapy.

The FDA cited at least a dozen studies as support for its recommendation, adding that “it is reasonable to believe” that convalescent plasma “may be effective in lessening the severity or shortening the length of COVID-19 illness in some hospitalized patients.”

Adding that early treatment is critical, an FDA official said that in patients 80 years or younger, those who received convalescent plasma within three days of diagnosis were about 35 percent more likely to be alive 30 days later than those who did not received the plasma.

Accounting for more than 55 percent of the blood’s physical makeup, plasma is the largest of the four components in a person’s blood, the part that carries all the other blood components throughout the body.

The FDA is urging recovered COVID-19 patients to donate their plasma because plasma is not like a drug that can be manufactured into millions of doses. It can only be obtained through donations from a small collection of people.

In order to donate plasma, former COVID-19 patients must have received their original diagnosis through a laboratory test, be at least 14 days removed from positive infection of the virus and meet all other donor qualifications.

The spread of COVID-19, which has been cited as the cause of more than 175,000 deaths in the US alone, has “caused unprecedented challenges to the US blood supply,” according to the FDA, which says one plasma donation can save as many as three lives.

“You can help ensure that blood continues to be available for patients by finding a blood donor center near you to schedule your donation,” the FDA concludes.

For further information about donating plasma, the FDA encourages potential donors to visit the following websites:

AAB

America’s Blood Centers

American Red Cross

Armed Services Blood Program

Blood Centers of America

Immunization: It’s Not Just For Kids Anymore

August 17th, 2020

Most people think immunization is just for kids. But National Immunization Awareness Month, which is celebrated in August, underscores the importance of vaccination for people of all ages. After all, the old adage that says “an ounce of prevention is worth a pound of cure” holds true throughout life.

The term immunization refers to the action of making people resistant (immune) to certain infectious diseases, many of which can be very serious or even deadly. Immunization is typically accomplished through inoculation with vaccines.

If you’re like me, you probably received a series of vaccines when you were a child. Over the years, the schedule of vaccines given to children and teens has evolved as doctors have learned more about various infectious diseases and new and improved vaccines become available.

For the current guidelines from the US Centers for Disease Control and Prevention, see Recommended Child and Adolescent Immunization Scheduled for Ages 18 and Younger.  And here, the American Academy of Family Physicians describes the recommended vaccines in greater detail: Childhood Vaccines: What They Are and Why Your Child Needs Them.

Most vaccines are made using a weakened version of the infectious germs, such as bacteria or viruses, that cause the disease, or materials that resemble those germs. Vaccines work by prompting your body’s own defense against disease, your immune system, to produce infection-fighting cells to attack the invading germs.

To better understand how vaccines work, let’s take a closer look at how the immune system fights infection.

When germs invade your body for the first time, your immune system uses certain white blood cells to destroy them. Special white cells called macrophages consume and digest the germs. B-lymphocytes produce disease-fighting antibodies that attack the germs, and T-lymphocytes attack cells in the body that have already been infected by the bacteria or virus.

Once antibodies are created in response to an initial infection, your body keeps them and uses them to fight future infections with the same germ. That’s how vaccines provide protection for the long haul. Many vaccines protect you for years, some for most of your life. But sometimes, a vaccine loses its effectiveness over time. In that case, you may require a “booster” later in life.

Adults need boosters of certain vaccines they received as children, such as the Tdap, which is the vaccine for tetanus, diphtheria and pertussis (whooping cough), and the vaccine against hepatitis B. People of all ages should get a tetanus booster every 10 years. A booster is recommended any time you’re exposed to the tetanus toxin as well.

It is also recommended that adults receive vaccines for diseases such as influenza, pneumococcal pneumonia and shingles. Here’s a rundown of the recommended vaccines for adults. In addition, vaccination against diseases that are common in other countries is recommended before you travel outside the US. Here’s more information about vaccines for travelers.

Immunization is important for two reasons: It protects you from disease, and it protects the people around you. How vaccines protect you has already been explored, but how do vaccines protect your community?

If a large number of people in a community are vaccinated and immune to a disease, the germs that cause it can’t spread from person to person as easily. Spreading germs this way can make the people around you sick and lead to an all-out outbreak of the disease. The protection that results from community-wide vaccination is called herd immunity.

There are some people who don’t get vaccinated because they fear side effects. Most vaccines cause only miner side effects such as a mild fever or soreness at the site of the injection. And there is no credible evidence that vaccination leads to autism, as some people suggest.

All in all, immunization is a safe and effective way to protect against many serious, possibly deadly, infectious diseases. Thanks to immunization, diseases such as polio and smallpox are near obliteration in this country.

Keeping Americans safe from those diseases and many others is why spreading the word about immunization is a priority of National Immunization Awareness Month.

Page 2 of 25