Blog Posts

Is It Crohn’s Disease or Ulcerative Colitis?

January 14th, 2019

Both Crohn’s disease and ulcerative colitis (UC) are types of inflammatory bowel disease (IBD). Crohn’s and UC have many things in common: they both cause inflammation, swelling and sores in the lining of the digestive tract, and they’ve got many symptoms in common. Yet, they’re distinct disorders that affect different areas of the GI tract.

It’s estimated that 1.6 million Americans suffer with IBD. It occurs in men and women equally, but is more common in Caucasians than in other ethnic groups. Crohn’s and UC can occur at any age, but are most often diagnosed before age 30, especially Crohn’s, which is most common between the ages of 15 and 30.

There are a couple of factors that differentiate Crohn’s and UC. For one, Crohn’s can develop anywhere in the digestive tract, from the mouth to the rectum, while UC is confined to the large intestine (colon). In addition, Crohn’s can penetrate into the deep layers of the lining of the digestive tract, while UC stays in the top layers.

There’s another difference between Crohn’s and UC. In Crohn’s, the inflammation can “skip” portions of the intestine. It can affect two separate sections and leave areas of normal tissue in between diseased portions. UC doesn’t do that. It affects a continuous portion of the large intestine.

Both types of IBD have similar symptoms, which can be aggravated by outside factors such as diet and stress. Those factors can trigger flare-ups of Crohn’s and UC. Symptoms of these disorders include:

  • Abdominal pain
  • Cramping
  • Persistent diarrhea
  • Constipation
  • Bloody stools
  • Urgency to have bowel movements
  • Fever
  • Fatigue
  • Loss of appetite
  • Weight loss

Doctors don’t know the exact cause of Crohn’s disease and UC, but they run in families so researchers suspect genetics are a factor. Both Crohn’s and UC are disorders of the immune system, which is the body’s natural defense system. The immune system releases defensive substances in response to foreign or invading cells it detects in the body.

It’s believed that in Crohn’s and UC, something triggers the immune system to mistakenly recognize cells of the lining of the GI tract as “foreign” and attack them, causing inflammation. Inflammation comes from the Greek work for “flame”. It literally means, “to be set on fire.” That explains most of the IBD symptoms.

Because the symptoms of Crohn’s and UCs are similar, your doctor will need to use tests to diagnose which disorder you have. Proper diagnosis is critical because treatment is based on the type of IBD you have.

While Crohn’s and UC both have abdominal pain as a symptom, the pain of UC is typically found in the lower left side of the abdomen. Knowing this may help your doctor determine which set of tests to order for you, because tests differ for the diagnosis of Crohn’s and UC.

If your doctor suspects Crohn’s, he or she may order certain endoscopy tests to get a better look at your digestive tract. Endoscopy is a minor procedure during which a small instrument with a camera and light on its end is threaded through your GI tract to look for abnormalities.

For Crohn’s disease, your doctor might use an instrument that is inserted into your rectum to look at the bottom half  of your digestive system. This is a colonoscopy. Your doctor also might use a scope that is inserted into your mouth to examine the upper part of your digestive system. This is an upper endoscopy.

For UC, doctors often use a test with an instrument inserted into the rectum that examines the rectum and lower colon. This type of endoscopy is a sigmoidoscopy. Your doctor may also suggest you get a total colonoscopy, which examines the entire colon.

If you’re diagnosed with Crohn’s or UC, your doctor may prescribe certain medications. He or she may start you on a course of corticosteroids or other anti-inflammatory medicines. A medication to suppress your immune system may also be prescribed. Later, your doctor may add a biologic, such as STELARA® or ENTYVIO®, as a combination therapy.

You may be asked to keep a diary to try to uncover foods or situations, such as those that are especially stressful, that trigger flare-ups of these disorders. Once you identify your triggers, you can work to decrease or eliminate them with diet and lifestyle changes.

Medical treatments are the mainstay for Crohn’s and UC, but in severe cases, surgery may be necessary. Surgery is generally used in cases where there are complications from the disorders. These complications may include bowel perforation, excessive bleeding, development of a cancerous growth or severe, uncontrollable inflammation.

For Crohn’s, surgery may involve removing diseased sections of the digestive tract. In severe cases of UC, the surgical removal of the entire large intestine and rectum may be required.

Whatever you do, don’t self-diagnose. If you’re suffering any of the symptoms of IBD, see your doctor and let him or her diagnose Crohn’s or UC the right way!

 

Think About Your Thyroid

January 7th, 2019

Happy New Year! I hope your holidays were joyful – and safe. January is generally the time when we set our priorities for the year. Many of us make resolutions to improve our bodies on the outside, such as losing weight. But here, we’re going to take a closer look at our bodies on the inside. Today, we’re going to think about our thyroids.

The thyroid is a gland that’s part of the body’s endocrine system. It’s responsible for making and releasing a steady amount of thyroid hormones into the bloodstream. These hormones regulate metabolism, the process of breaking down the food you eat into energy. Your metabolism affects how fast your body performs its daily functions.

Thyroid hormones regulate many body processes. These include your breathing, heart rate, body weight, temperature, cholesterol level, muscle strength and even women’s menstrual cycles. It’s important that these hormones stay at a consistent level in your bloodstream.

The thyroid is shaped a little like a butterfly and sits at the base of your throat just below your voice box. It’s about two inches long and has two lobes that lie on either side of your windpipe. The lobes are connected by a small strip of tissue called an isthmus.

The main hormones produced by the thyroid are triiodothyronine or T3 and thyroxine or T4. T3 and T4 are made by special cells called follicular epithelial cells. The thyroid also makes calcitonin in its C-cells.  Calcitonin regulates the amount of calcium and phosphorus in your blood and inhibits the breakdown of your bones.

The amount of T3 and T4 in your blood is controlled by two other glands, the pituitary in the center of the skull below the brain, and the hypothalamus in the brain. The hypothalamus produces a hormone that signals the pituitary to release its thyroid stimulating hormone (TSH). TSH tells the thyroid to release more or less T3 and T4 to maintain a balance.

When there’s an imbalance, too much or too little T3 and T4 in your blood, your body reacts. Too little thyroid hormone is a condition called hypothyroidism. It occurs when your thyroid doesn’t make enough of its hormones. Too much thyroid hormone is called hyperthyroidism.

With hypothyroidism, your metabolism slows down. Common symptoms include weight gain, sluggishness, fatigue, dry skin and hair, intolerance to cold, and depression. With hyperthyroidism, your metabolism speeds up. Symptoms include irritability, racing heartbeat, muscle weakness, weight loss and sleep problems.

There are multiple causes of thyroid disorders like hypothyroidism and hyperthyroidism. Hypothyroidism may be caused by inflammation of the thyroid gland that can lower the amount of hormones produced or by a hereditary disease of the immune system called Hashimoto’s thyroiditis. An iodine deficiency can affect the production of thyroid hormone as well.3 Removal of the thyroid also gives you hypothyroidism.

Causes of hyperthyroidism include Grave’s disease, a condition in which the entire thyroid is overactive. Sometimes, just one or a few nodules inside the thyroid produce too much hormone. Too much iodine can cause some people to have too much thyroid hormone and some to have too little.

Treatment of these disorders focuses on restoring normal blood levels of the thyroid hormones. Treatment for hypothyroidism is hormone replacement with a synthetic version in pill form. Your doctor will monitor your hormone levels with periodic blood tests and adjust your dose accordingly.

Treatment for hyperthyroidism is a little trickier. To normalize hormone levels, your doctor may use medications to block hormone production or radioactive iodine to disable your thyroid. Another treatment option is removal of the thyroid. This will give you hypothyroidism, as can the radioactive iodine. Then, you’ll have to take the hormone replacement therapy.

Thyroid disorders, including hypothyroidism, are lifelong conditions. But by following your doctor’s instructions and having your hormone levels monitored regularly, you can still live a normal, healthy life.

A Letter to FCS

December 16th, 2018

Image from Rare DR - Rare Disease ReportIt took Tampa local Charles “Alvin” Middleton more than 10 years to receive an accurate diagnosis of familial chylomicronemia syndrome (FCS), a rare genetic lipid disorder that causes fat buildup in the body and often leads to unpredictable and potentially fatal attacks of pancreatitis. Alvin has been in and out of the hospital for more than a decade, and once was put into a medically induced coma for more than 40 days. His husband and family were told at the time that he had a 5% chance of survival. Alvin still suffers from daily symptoms including severe fatigue, abdominal pain and brain fog, and recently had to leave his job. His only option is to adopt a lifelong extremely restrictive low-fat diet (10-12 grams of fat per day), but even that is not often not prevent his symptoms.

Alvin decided to write a letter to his disease, looking back on his journey and voicing his frustrations as well as his hope for a treatment for this devastating disorder. There are no approved treatments available for FCS, which is why Alvin and the entire FCS community as part of a new national campaign are urging the FDA and pharma industry to approve a treatment currently in development – you can learn more via this recent press release.

Here is Alvin’s “Dear FCS” letter:

Dear FCS,

Looking back 11 years ago, I considered myself normal. Someone who had a job, hung out with friends and family, and was in relatively good health. But then our journey together started when I experienced my first symptom because of you, severe stomach pain while on a flight home to Tampa Bay. An ambulance was my welcome home vehicle as I was immediately brought to the emergency room, where I was diagnosed with acute pancreatitis. The doctor said that my case was so bad there was only a 5% chance I would survive. I didn’t know it at the time, but because of you I would eventually undergo seven surgeries, have my gallbladder and spleen removed, be in and out of the hospital with pancreatitis, and see doctors every other week. I am grateful that after a decade a young hospitalist finally figured out that you are the cause of my constant pain and frequent hospitalizations – but I am writing this letter to tell you I want nothing to do with you!

You have caused me, my husband, family and friends tremendous pain over the years. Not only have you caused a significant decline in my physical health but now I am also often emotionally and spiritually withdrawn. Life with you can be a lonely experience. I try to be strong for my friends and family, and especially my husband who has been my rock throughout this journey. You also cost me thousands of dollars that I could have used to help others and now I have accumulated $2 million in medical debt. You even tried to kill me 10 years ago, forcing me into the ICU for more than 40 days in a medically induced coma, but God had a different plan for me.

I feel like I try to please you, but nothing works. I follow the strict low-fat, no carbohydrates, and no sugars diet and exercise regularly as directed by my doctor. I take my prescribed medication. Yes, I sometimes cheat and eat food I’m not supposed to, but generally I do everything I am told — and yet you still cause me pain. Doctors who didn’t know about you would tell me I must not be maintaining the suggested diet, exercising enough, or taking care of myself. Every time I was hospitalized with severe vomiting and pain, doctors would accuse me of drinking alcohol or not following my strict diet. Sometimes I thought I was crazy or a hypochondriac, but it was all you. I was so discouraged and frustrated by many doctors’ responses that I disconnected from the conversation and gave up all hope that I would ever find the cause of my pancreatitis attacks and other symptoms.

I have known for years that something was seriously wrong with me. There have been times when I have been so fatigued from the constant pain that I just wanted to give up on life. You took away my love of gardening, cooking, socializing with my friends, being able to go someone’s house and eat without getting sick, and most recently you forced me to leave my job. You are the reason for my constant fear, anxiety and stress about my health which, combined with feeling out of control and powerless, can be overwhelming. Often, I forget that feeling terrible every day isn’t normal.

Life with you can be a lonely experience. It has ended my career and changed me forever in many ways. Despite the many challenges I’ve faced, the most rewarding experience of my journey has been meeting other FCS patients and knowing that I’m not alone. By sharing our stories with one another and how you have impacted our lives, we are encouraged and hopeful that someone is going to find a treatment to beat you. Together we are building a stronger community of support and sharing information that can help improve our quality of life and educate others who might not know about you. If one person sees my story and learns about you, then all my efforts are worthwhile.

Charles “Alvin” Middleton

Hope For Hypothyroidism

December 11th, 2018

Hypothyroidism is a big word for underactive thyroid.Hypo” means “beneath” or “below.” “Thyroidism” refers to the function of the thyroid. Hypothyroidism, then, means “beneath function” of the thyroid.

Created for the National Cancer Institute, http://www.cancer.gov

Hypothyroidism is a common condition. Estimates vary because millions of people have the disorder and don’t know it, but approximately 10 million Americans have the condition.

Look at it another way. About 4.6 percent of the population of the US ages 12 and older has hypothyroidism. Fortunately, most of those cases are mild. Still, that’s nearly five people out of every 100 people. Women are more likely than men to develop the disorder, and it’s more likely to occur in people age 60 and older.

Let’s learn a little more about hypothyroidism. We’ll start with the basics. The thyroid is an endocrine gland, which means it secretes its hormone directly into the blood instead of through a duct. The thyroid looks a little bit like a butterfly, and it sits in the lower front part of the neck. It produces and secretes thyroid hormones.

The thyroid controls metabolism, the process by which your body uses food for energy. If your thyroid hormone levels are lower than they need to be, which is the result of an underactive thyroid, that process can’t happen efficiently. Your body produces less energy, and your metabolism slows down.

When your metabolism slows, you may notice some changes in how you feel and function. Symptoms of hypothyroidism can be vague and are common to many other disorders, so you may not initially attribute them to hypothyroidism, but tell your doctor about them anyway. Symptoms to look out for include:

  • Fatigue
  • Weight gain
  • Constipation
  • Depression
  • Dry skin
  • Greater sensitivity to cold temperatures
  • Muscle and joint pain
  • Slower heart rate
  • Swelling of the thyroid gland (goiter)

If you experience any of these symptoms, your doctor will perform a complete medical history and physical exam. If your doctor suspects hypothyroidism, he or she will order blood tests to checks hormone levels. They may include tests to measure your levels of thyroid-stimulation hormone (TSH) and T4 (thyroxine).

T4 is the main hormone made by the thyroid. TSH is made by the pituitary gland, the “master gland” in the body. TSH controls when and how much T4 the thyroid produces and releases. Lower than normal T4 levels in your blood usually mean you have hypothyroidism. People can have increased TSH with normal T4. This is called subclinical, or mild, hypothyroidism.

There are many potential causes of hypothyroidism. One is an autoimmune disorder, when the immune system mistakenly thinks the thyroid gland cells are foreign invaders and attacks them. Then there aren’t enough cells remaining to make the hormones.. The most common autoimmune disorder is Hashimoto’s thyroiditis.

Other causes of hypothyroidism include radiation treatment of the thyroid or head and neck region for cancer; inflammation of the thyroid gland; certain medications including amiodarone, lithium, interferon alpha and interleukin-2; congenital defects; surgical removal of all or part of the thyroid; too much or too little iodine, which is necessary to make thyroid hormone; and damage to the pituitary gland.

Hypothyroidism can’t be cured, but in almost all cases, it can be controlled. To treat your low thyroid hormone level, your doctor will replace what your thyroid can no longer make with a synthetic hormone, generally levothyroxine. The levothyroxine pills contain a hormone exactly like the T4  your thyroid produces on its own, so your body can function normally. Your doctor will order regular blood tests to monitor your hormone levels while on the medication.

Some people with hypothyroidism continue to have symptoms while on T4 hormone replacement therapy. They may be give a preparation with the addition of another thyroid hormone called T3. There are challenges, however, to administering T3 so that it is used efficiently and provides its full benefit. A new study out of Rush University Medical Center may have this problem solved.

The study, published in the journal Thyroid in October, offers hope to the 10 to 15 percent of hypothyroidism patients who respond poorly to standard T4 hormone replacement treatment. The study looked at a metal-coordinated molecule to assist in the absorption and metabolism of thyroid hormones.

T3 is necessary to normalize  functional hormone levels in the blood. Unfortunately, T3 metabolizes very quickly, and the body often does not get its full benefits. The goal of the study was to find a way to sustain the level of T3 in the blood so patients benefitted from the additional hormone.

A new drug was studied called poly-zinc-liothyronine (PZL); liothyronine is T3. In the study, researchers successfully treated laboratory rats that had been made hypothyroid with a tablet containing PZL. PZL is a compound made of zinc bound to three L-T3 molecules. The study showed that when researchers took T3 alone, it was immediately absorbed. PZL was not.

More research needs to be conducted before PZL is ready for widespread use. Research includes safety tests in animals and clinical trials in humans. But if you’ve got hypothyroidism that’s not responding to levothyroxine, this study offers hope. You may have a new treatment for your condition in just a few years.

Prostate Cancer Prospects

December 3rd, 2018

In October, we got a glimpse of what was happening in research on breast cancer. This week, I thought I’d give you an update on what’s being studied in prostate cancer. Prostate cancer, as we learned recently, is the second most common cancer in men behind skin cancer and the second leading cancer killer in men, behind lung cancer.

Studies are ongoing as researchers look for the causes and new treatments for prostate cancer, as well as for more effective ways to detect and prevent it. Research is being done in universities and medical centers all over the world. The American Cancer Society breaks down some of the work currently underway. Here’re are a few examples.

On the genetics front, research into the link between gene changes and prostate cancer is helping scientists better understand how this cancer develops. Knowing this might help other scientists design medications that target those changes. It also might help develop tests to detect abnormal genes that can then help identify men at high risk for prostate cancer.

The use of the PSA test is also being studied. Researchers are looking at better ways to measure the total amount of PSA in your blood. They’ve suggested using newer tests that are more accurate than the PSA test. The newer tests include the phi, which combines the results of total PSA, free PSA and proPSA.

In most cases today, doctors use transrectal ultrasound (TRUS) to guide the needle during a biopsy. A newer technique making biopsies more accurate is the color Doppler ultrasound. An even newer approach being studied enhances the Doppler technique by injecting a contrast agent with microbubbles that helps improve the images.

New treatments for early-stage prostate cancer are also being studied. One is high-intensity focused ultrasound (HIFU). HIFU kills prostate cancer cells by heating them with highly focused ultrasonic beams. HIFU has been used in other countries for a while, but is just now being studied for use in the US. It’s being looked at for safety and effectiveness.

There have been some breakthroughs in prostate cancer research in the news recently, and I thought I’d share a few I found with you. These are the reported results of specific research studies recently concluded. These studies offer good news for some men with prostate cancer.

One article reported on a clinical trial on a new technique for radiation therapy. This innovative form of treatment delivers the radiation in only five treatment sessions. A typical course of radiation treatment is 37 sessions.

This clinical trial looked at the effects of stereotactic ablative radiotherapy, which is a highly targeted form of radiation therapy that uses several beams of radiation at one time. The multiple beams intersect at the tumor and deliver a high dose of radiation to the cancer. At the same time, the surrounding, healthy tissue receives only a very low dose.

Another study looked at the effectiveness of immunotherapy on an especially aggressive form of prostate cancer. Men with this form have a much worse survival rate than men with other forms of prostate cancer. Researchers found these men may respond unusually well to this type of therapy, giving them the possibility of an effective form of treatment.

The research found that men with this form of prostate cancer have specific faults in their tumors that make their DNA error prone and unstable, so their survival is half as long as other men with advanced prostate cancer. However, their unstable tumors are more likely to trigger an immune response, which makes them good candidate for immunotherapy.

More good news for men with aggressive prostate cancer, this one a non-metastatic, castrate resistant form with a quickly rising PSA level. Castrate resistant means your cancer no longer responds to the treatments to reduce testosterone, on which your cancer feeds. This form of cancer has not had an effective treatment to date.

Now, a study out of Northwestern University Medicine may have a treatment. The study showed that a medicine currently used to treat men with advanced metastatic prostate cancer significantly lowered the risk of metastasis or death when used in men with this aggressive form of prostate cancer.

The results, the researchers noted, showed several benefits for patients, including a decline in PSA levels and less need for additional anticancer treatments, which can have a negative impact on your quality of life. The lead researcher stated that more study is needed to determine if long-term survival is impacted.

These are just a few examples of the research being done to get a better understanding of prostate cancer and its treatment. If you’re a man at risk for prostate cancer or if you’ve already been diagnosed with it, take heart. Much is being done to get you through it successfully.

Pondering Prostate Cancer

November 26th, 2018

In October, we got an education on breast cancer. Now, in November, it’s time to take a look at the second most common cancer affecting American men, behind skin cancer: prostate cancer. The American Cancer Society estimates there’ll be close to 164,690 new cases of prostate cancer diagnosed in the US in 2018, and more than 29,000 deaths.

ACS also says about one man in nine will be diagnosed with prostate cancer during his lifetime, and about one in 41 will die from it. In fact, prostate cancer is the second leading cause of death in American men, trailing only lung cancer. The good news is that more than 2.9 million men in the US who’ve been diagnosed with prostate cancer at some point are still alive today.

The prostate is part of the male reproductive system. It’s a gland that produces some of the fluid in semen that nourishes and transports sperm. It also contracts and forces this fluid out through the penis during orgasm.

The prostate sits below the urinary bladder and in front of the rectum. The urethra, the tube that carries urine and semen out of the body through the penis, runs through the middle of the prostate, so the prostate also plays a role in urine control in men.

Prostate cancer begins when cells in the prostate gland start to grow out of control. If it’s diagnosed early, prostate cancer is very treatable. However, prostate cancer develops slowly, and there may be no symptoms in the early stages. Often, symptoms only become noticeable when your prostate has become large enough to affect function. Common symptoms include:

  • Frequent need to urinate, especially at night
  • Difficulty beginning or maintaining a urine stream
  • Painful urination
  • Blood in the urine
  • Painful ejaculation
  • Difficulty achieving or maintaining an erection2

On the simplest level, prostate cancer is the result of changes in the DNA of normal prostate cells. These changes can be inherited or acquired during your lifetime. We don’t know exactly what causes the acquired DNA changes, but researchers have discovered some risk factors that may contribute.

Problems can happen anytime a prostate cell divides into two new cells because when it divides, it has to copy its DNA, and that’s an opportunity for errors to occur. The more often and quickly prostate cells divide and grow, the more chances for errors. Therefore, anything that speeds up the process of dividing cells increases the likelihood cancer will develop.

Androgens, or the male hormones such as testosterone, promote prostate cell growth. A higher level of androgens in your body might contribute to an increased risk for prostate cancer in some men. Other risk factors for prostate cancer include age, diet, race (it’s more common in African American men), geography (it’s more prevalent in developed nations) and chemical exposure.

Screening is a way to look for signs of a disease before symptoms appear. There are two common screening tests for prostate cancer, the digital rectal examination (DRE) and the prostate-specific antigen (PSA) blood test. PSA is a protein excreted by the prostate that helps semen remain a fluid. An excess of this protein in the blood, however, is one of the initial signs of prostate cancer.

The ACS and other leading authorities recommend that men discus with their doctors the risks and benefits of these tests before choosing if, when and how often to have them done.

Your doctor will use these tests to help diagnose prostate cancer, along with a complete medical history and physical examination. If the test results are abnormal, your doctor may order other tests such as a biomarker test, a PCA3 test and a transrectal ultrasound. He or she may recommend a biopsy to take samples of prostate tissue to look for cancer cells under a microscope.

If your cancer is in an early stage and is only in your prostate gland, your doctor may suggest watchful waiting or active surveillance. This approach involves carefully monitoring this slow-growing cancer without beginning active treatment.

Treatment for prostate cancer may include one or a combination of surgery, radiation therapy, chemotherapy, hormonal therapy and vaccine therapy. Surgery involves removing the entire prostate gland and, if necessary, some nearby lymph nodes. Surgery can be performed using an open or laparoscopic technique.

Radiation therapy uses high-energy x-rays or particles to kill prostate cancer cells. It can be accomplished by using an external machine with its beams aimed at your prostate gland or by placing radioactive seeds directly on your prostate.

Chemotherapy uses powerful medications given by mouth or through a vein to kill cancer cells. Chemotherapy drugs pass through the entire body, so they’re a good option when your prostate cancer has spread beyond your prostate to other areas of your body.

The aim of hormonal therapy is to reduce the level of male hormones in your body or stop those hormones from affecting the prostate cancer cells. Male hormones stimulate these cancer cells to grow, so hormonal therapy uses surgery or medications to stop the testicles from making these hormones.

Unlike vaccines for viral infections, which boost your body’s immune system to fight the infection, the prostate cancer vaccine charges up the immune system to fight prostate cancer cells. The vaccine hasn’t been shown to stop prostate cancer from progressing, but it has been shown to help men with this cancer live a little longer.

There’s more good news from the American Cancer Society. Prostate cancer is very survivable. ACS put together the relative survival rates of men with prostate cancer according to the most recent data and including all stages of the cancer. The results: The five-year relative survival rate is 99 percent. The ten-year relative survival rate is 98 percent, and the 15-year relative survival rate is 96 percent.

Men, don’t wait till you’re experiencing symptoms. Talk with your doctor and see of prostate cancer screening is right for you. It might catch a cancer when it’s most treatable and survivable.

COPD Uncovered

November 20th, 2018

Someone I know and love was a smoker for most of her life. A few years ago, after a very difficult struggle, she finally quit. Unfortunately, the years of smoking had already done some damage to her lungs, and now she’s suffering from COPD. The weirdest part is she doesn’t seem to understand how she got the disorder. She doesn’t get the connection.

She should have. In the United States, the single biggest cause of COPD is cigarette smoking. In fact, about 90 percent of those who have the disorder are smokers or former smokers. Among people who smoke, 20 percent to 30 percent of them develop COPD. Smoking’s not the only cause, just the most common.

Other causes of COPD include long-term exposure to lung irritants including air pollution and breathing in chemical fumes, dust or toxic substances at home or at work. In rare cases, COPD can be caused by a genetic mutation. Some people have a defect causing a deficiency in the protein alpha-1 antitrypsin, which protects the lungs from damage.

COPD, or chronic obstructive pulmonary disease, actually refers to a group of progressive lung diseases that, over time, make it harder for you to breathe and perform your activities. The two most common diseases and those usually associated with COPD are chronic bronchitis and emphysema.

Most people who have COPD have both chronic bronchitis and emphysema, but the severity of each condition varies from person to person. Thus, the general term COPD is more accurate.

In its early stages, you may not notice the symptoms of COPD or may chalk up the changes to “getting older.” But catching COPD early is imperative to effective treatment and management, so contact your doctor if you notice any of the following symptoms:

  • Persistent coughing, especially with a lot of mucus
  • Wheezing or noisy breathing
  • Difficulty breathing or increasing shortness of breath
  • Chest tightness
  • Frequent respiratory infections
  • Fatigue
  • Bluish fingernails or lips

To diagnose COPD, your doctor will evaluate your symptoms, take your complete health and family history, perform a physical examination and review test results. The test most commonly used to diagnose COPD is spirometry, a simple test of how well your lungs work.

National Heart, Blood and lun institute

The image shows how spirometry is done. The patient takes a deep breath and blows as hard as possible into a tube connected to a spirometer. The spirometer measures the amount of air breathed out. It also measures how fast the air was blown out.

During a spirometry test, you blow air into a mouthpiece that is attached to a small machine. This machine then measures the amount of air you blow out as well as how fast you blow it. This test can find COPD in its earliest stages and can be used to determine how severe it is. Your doctor will likely use the spirometry results to guide his or her treatment planning.

Your doctor may also order other tests including a chest x-ray or chest CT or to more closely examine your lungs. These tests can also help rule out other disorders as the cause of your symptoms. Through a blood sample, an arterial blood gas test can show how well your lungs are moving oxygen into your blood and removing carbon dioxide from it.

Because every person with COPD has different degrees of chronic bronchitis and emphysema, treatment is tailored to the patient’s unique situation. Treatment is designed to ease symptoms, prevent complications and slow disease progression. It may include medications, oxygen therapy, pulmonary rehabilitation, surgery, and lifestyle changes.

Medications called bronchodilators to help relax the muscles of the airway, which opens the airway so you can breathe easier. Sometimes, glucocorticosteroids, which help reduce inflammation, are added. These medications are generally inhaled through an inhaler or nebulizer. Your doctor may also recommend you get yearly flu and pneumonia shots to reduce your risk of getting those infections, which can harm your lungs.

If your oxygen level gets low, you may be prescribed oxygen therapy to improve that and help you breathe better. With this, you inhale fresh oxygen through prongs in your nose or a mask. Pulmonary rehabilitation may include an exercise program, disease management training, nutrition advice, and counseling. The goal is to help you stay active and able to perform your daily activities.

In severe cases of COPD, surgery may be needed when other treatments have failed. Surgery may be done to remove large air sacs from the lungs or to remove damaged lung tissue. As a final resort, lung transplantation may become necessary. During a transplant, your diseased lungs are removed and replaced with healthy lungs from a donor.

Lifestyle changes can help to both manage the symptoms of COPD you already have and prevent progression of the disease. The first thing you need to do is quit smoking if you do. There are tons of resources on the internet and in your community to help you do this. Also, take steps to protect yourself from exposure to secondhand smoke and chemical fumes.

There’s no specific diet recommended for people with COPD, but a healthy diet is important for maintaining overall health and strength. For your meals, chose a variety of nutritious vegetables, fruits, grains, proteins, and dairy. Drink plenty of non-caffeinated fluids to help keep mucus on the thin side.

Ask your doctor about how much activity you should get and for suggestions for exercise that will be good for you. Maintain a healthy weight because being overweight makes your heart and lungs work harder.

The National Heart, Lung and Blood Institute estimates that 12 million American adults currently have COPD and another 12 million are undiagnosed or are developing the disease. The World Health Organization chimes in with its estimate that 210 million people worldwide have COPD. They go further to say they expect total deaths to increase more than 30 percent in the next ten years.  COPD is already the third leading cause of death in the US.

COPD has no known cure, but treatments and lifestyle changes can help you manage the disease, slow its progression, and most importantly, feel better and remain more active. If you notice any of the symptoms of COPD, don’t wait. See your doctor and get treatment started as soon as possible.

Solutions for Your Skin

November 13th, 2018

Your skin is the largest organ of your body. If you’re an average adult, you’ve got about eight pounds and 22 square feet of it. Skin is active, living tissue, and each of its three layers have jobs to do to protect the body and keep it healthy.

The outermost layer of the skin is the epidermis. It provides a waterproof barrier against germs, toxins and pollutants. This layer contains the cells that form the rough exterior surface of the skin that continuously sloughs off and regenerates. It also contains cells that alert your immune system to any infectious invaders.

Just below the epidermis is the dermis. This layer contains tough connective tissue, as well as hair follicles and sweat glands. It also contains collagen and elastin, the fibers that give skin its strength and elasticity. Blood vessels found here regulate body temperature, and nerves pick up sensations and relay the information to the brain.

The third layer is called the subcutis. It is made mostly of fat and connective tissue. The reserves of fat stored in this layer act a cushion to help protect your bones and muscles from bumps, bruises and falls.

Your skin gets its color from specialized cells called melanocytes. Melanocytes produce the pigment melanin. People who live in sunny climates have more melanin than people who live in climates with less sun exposures, so their skin is darker. Melanocytes reside in the epidermis.

People in all climates need to keep their skin vibrant and healthy so it can continue to perform its many jobs for the body. That means we have to take good care of our skin. Good skin care doesn’t have to be a complex process. It can be broken down to a few simple steps. Here are some tips you can follow:

Protect you skin from the sun. Too much sun exposure can cause wrinkles, age spots and other skin problems, and it increases your risk for skin cancer. To protect yourself, use a broad-spectrum sunscreen with an SPF factor of at least 30. Avoid the sun between the hours of 10 a.m. and 2 p.m. when the sun’s ray are strongest. Wear protective clothing, such as long-sleeved shirts, long pants and a wide-brimmed hat.

 

Eat a healthful diet. What you eat is as important as what you put on your skin. Your diet can improve your skin’s health from the inside out, so healthy skin begins with a healthful diet. Foods that have been found through research to be skin-healthy include mangoes, tomatoes, kale and soy. Also, cutting your alcohol consumption could lower your risk of developing non-melanoma skin cancer. Quitting smoking helps keep your skin healthy as well.

 

Keep your stress to a minimum. Scientists have identified some links between stress and some skin problems including itchy skin, scaly skin, hand rashes and flaky, oily or waxy patches on the scalp. If you’re struggling with stress and it’s affecting your skin, try stress reduction techniques such as tai chi, yoga or meditation.

 

 

Build a daily skin care routine. A daily routine can help you maintain overall skin health and improve specific concerns you may have, such as acne, scarring or dark spots. Start simply with a cleanser, serum, moisturizer and sunscreen. As you see how your skin reacts, you can add other products, such as an exfoliant, mask or spot treatment.

 

 

Keep your skin hydrated. Moisturizers revive the skin’s ability to repair and renew naturally. A good moisturizer will seal in moisture and keep the top layer of your skin hydrated. Choose one that has a humectant, which will attract moisture, an occlusive agent, which will retain moisture in the skin and an emollient, which will smooth out the spaces between the skin cells.

Take care of your skin so it can take care of you.

Diabetes and Your Eyes

November 4th, 2018

Do you have diabetes? If so, you’re certainly not alone. The American Diabetes Association estimates that 30.3 million Americans have diabetes and another 8.1 million have it but haven’t been diagnosed. Another 84.1 million people in the US have prediabetes, and nine out of ten aren’t aware of it. Still, 1.2 million new cases of diabetes are diagnosed in this country every year.

Maintaining healthy glucose (sugar) levels in your blood is a constant concern if you’ve got diabetes. Consistently high blood glucose can damage many parts of the body, such as the heart, kidneys and blood vessels. That includes the tiny blood vessels in the eyes, which can affect the retina, macula, lens and optic nerve.

When high glucose levels negatively affect the blood vessels in the retina, which is an area of light-sensitive tissue located in the back if the eye, it leads to a condition called diabetic retinopathy. There are two main types of retinopathy, nonproliferative and proliferative.

Nonproliferative retinopathy has several stages. It progresses from mild to moderate to severe. It starts as small areas of balloon-like swelling in the tiny blood vessels. These areas may start leaking fluid into the retina. In the moderate stage, the blood vessels that feed the retina may start swelling and distorting, losing their ability to transport blood.

In severe nonproliferative retinopathy, many blood vessels become blocked, which deprives the retina of its nourishing blood supply. Growth factors are also released during this stage. These factors initiate the development of new blood vessels.

Retinal Detachment

In some people, the severe stage progresses into proliferative retinopathy. With that, new blood vessels start growing, but these vessels are very fragile and weak. They can leak blood, which can block vision. Scar tissue can also be created, which can cause the retina to pull away from the back of the eye, a condition called retinal detachment.

Another consequence of retinopathy is macular edema, which is swelling, or the build-up of fluid, in the macula. The macula is the area of the retina responsible for central vision. It’s the macula the enables you to recognize faces, read and drive. Macular edema is the most common cause of vision loss in people who have diabetic retinopathy.

Cataract

If you maintain good control of your blood glucose levels and your blood pressure, you’ll be less likely to develop diabetic retinopathy or, if you do, you’ll get a milder form of it. Those are risk factors you can control. Risk factors you can’t control are your genes and how long you’ve had diabetes.

Having diabetes puts you at higher risk for other eye conditions as well, including cataracts and glaucoma. Rapidly changing blood glucose levels can affect the eye’s lens and cause it to become cloudy. This can lead to a cataract. Anyone can get cataracts, but people with diabetes tend to get them earlier, and they progress faster.

Trabecular Meshwork

With glaucoma, pressure builds up inside the eye when fluid can’t be removed through the eye’s drainage system that includes the trabecular meshwork. High blood glucose levels damage the cells of this meshwork, so it can’t function properly. Fluid doesn’t drain and pressure builds up in the eye. If not treated, the pressure can damage the optic nerve, leading to permanent vision loss.

Diabetic retinopathy, macular edema and glaucoma usually have no early symptoms. You may not know you have these diseases until they’ve already done damage to your eyes and affected your vision. That’s why an annual examination by an eye specialist is so important. The specialist can check your eyes for signs of these disorders, so early treatment can be started.

According to the US Centers for Disease Control and Prevention, about 90 percent of diabetes-related vision loss can be prevented. Early detection is one of the ways to reach that goal, and it’s another reason for an annual eye exam. Another way to help prevent vision-stealing eye diseases is by maintaining good blood glucose and blood pressure control.

Following these simple tips can help save your vision. So can knowing these symptoms  that signal an emergency. If you notice any of these symptoms, call your doctor right away:

  • Black spots in your vision
  • Flashes of light
  • “Holes” in your vision
  • Blurred vision

New Hope for Parkinson’s Patients

October 29th, 2018

Married couples aren’t the only ones who sometimes wish their honeymoons would last a little longer. People being treated for Parkinson’s disease often express the same wish regarding their treatment. Before long, their wish may be granted.

A clinical trial that began in July at the University of Arizona is aimed at finding out if ketamine, a drug used to treat depression, can extend what physicians refer to as “the honeymoon period’’ for Parkinson’s patients being treated with levodopa.

Levodopa, an amino acid created naturally in the human body, has long been used to treat some of the symptoms associated with Parkinson’s disease, particularly the stiffness and slow movement that comes with it.

The problem is that levodopa typically works great for a few years. That’s what doctors call the honeymoon period. After that, severe side effects such as uncontrollable and involuntary movement of the arms, legs and head develop.

Research has shown that 40-percent of all Parkinson’s patients being treated with levodopa experience these side effects, known clinically as dyskinesia and that the only way to stop them is to halt the levodopa treatments.

The intentions of the three-year, $750,000 clinical trial is to determine if ketamine, which has also been used to treat chronic pain, can help reduce the rash of involuntary movements brought on by the use of levodopa.

The belief that it can is shared by two University of Arizona doctors who first discovered ketamine’s added potential in the treatment of Parkinson’s disease several years ago when they began using it as a pain reliever for Parkinson’s patients.

Parkinson’s disease is a chronic progressive neurological disease that is marked by the tremor of resting muscles, rigidity, slowness of movement, impaired balance, and a shuffling gait.

In addition to learning that ketamine helped ease pain in patients with Parkinson’s disease, the doctors discovered that the patients who were given ketamine treatments also experienced a noticeable reduction in dyskinesia.

The doctors later discovered that similar results were found when lab rodents with Parkinson’s disease were treated with ketamine, which can bring about some side effects of its own.

An increase in blood pressure and a feeling of disassociation with the body has sometimes been experience by people being treated with ketamine, which has also been used recreationally.

During the trial, however, the doctors intend to closely monitor blood pressure levels and they are confident the dosage needed to relieve the dyskinesia falls well below the dosage at which the disassociation effect is realized.

The trial is currently monitoring the effects of ketamine in 10 patients with Parkinson’s disease and is being conducted in conjunction with a separate study using rodents to determine how ketamine affects the brain.

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