Author Archive

Hand(y) Tips For Staying Healthy

December 1st, 2022

We all know that bacteria and viruses, including the coronavirus that causes COVID-19, trigger infections that can be serious and even life-threatening. These germs are easily spread when you touch contaminated objects or surfaces and then touch your nose, mouth or eyes, where the malicious microbes can enter your body and make you ill.

Consider all the objects you touch in a typical day. These may include doorknobs, elevator buttons, ATM keys, touchscreens and your cellphone. When you touch these objects, any germs on their surfaces are transferred to your hands.

Then you touch your face.

Think you don’t? The Association for Professionals in Infection Control and Epidemiology estimates that people touch their face at least 23 times an hour!

Frequent handwashing is a powerful tool for avoiding illness and spreading germs to others. The first full week of December is National Handwashing Awareness Week. It’s an excellent opportunity for us to take our mothers’ admonitions to heart and revisit the healthy habit of washing our hands.

Handwashing can protect you from COVID-19, respiratory infections such as pneumonia and gastric infections that cause diarrhea. These conditions can be deadly to some people, including older individuals, those with weakened immune systems, infants and children. About 1.8 million children under age 5 die each year from diarrheal diseases and pneumonia, which are the top killers of children worldwide.

Educating people about proper handwashing has been shown to reduce the number of people who get sick with diarrhea by 23 to 40 percent. It can also reduce respiratory illnesses, including colds, by 16 to 23 percent. Further, it cuts down school absenteeism due to gastrointestinal illness by 29 to 57 percent.

It’s important to wash your hands thoroughly after using the toilet and changing a baby’s diaper because feces can get on your hands. Studies show that a single gram of human feces, which is about the weight of a paper clip, can contain 1 trillion germs!

Other times you should wash your hands include:

• When your hands are visible dirty.
• Before, during and after preparing food.
• Before eating.
• Before and after caring for a sick person.
• Before and after treating a burn or wound.
• Before changing contact lenses.
• After blowing your nose, coughing or sneezing.
• After touching or feeding your pet, walking your dog and handling animal waste.
• After touching garbage.
• After handling money.

Washing hands with soap and water has been found to eliminate more germs that washing with water alone.

The steps for washing hands effectively include:

  1. Rinse your hands under clean running water at a comfortable temperature. Warm water isn’t more effective at killing germs than cold water.
  2. Apply the soap of your choice. It doesn’t matter if you use bar soap, liquid or foam. Antibacterial soap is not necessary to use every day outside of health care facilities.
  3. Lather up for 20 seconds. Be sure to get in between your fingers, on the back of your hands and wrists, and under your nails, where germs collect.
  4. Rinse and dry thoroughly with a clean towel.
  5. If you are using a public restroom, use a paper towel to turn off the faucet and turn the door handle when leaving.

When running water and soap aren’t available, use a hand sanitizer. Choose one that contains at least 60 percent alcohol. Ethanol alcohol and isopropyl alcohol are acceptable.

When using a hand sanitizer, place the amount recommended by the manufacturer on your hands and vigorously rub it into both hands. Make sure to cover all areas, including your wrists and under your nails. Continue rubbing until your hands air dry.

If frequent handwashing dries your skin, consider using a moisturizing soap, such as glycerin, or a hand cream or lotion after washing to keep your skin smooth and moist.

Washing your hands only takes 20 seconds. It may be the best time you devote to your health, and the health of others.

Patti DiPanfilo

Handling Holiday Stress

December 1st, 2022

The holidays are a happy season for celebrating with family, friends and coworkers. But for many people, it is also a time of heightened anxiety and stress. Often, people get worked up from the increased responsibilities, lofty expectations and soaring financial pressures that go with the holidays, and that causes distress.

It’s impossible to avoid all stressful situations. Chances are there will be increased traffic – and maybe bad weather, road closures and delays – at this time of year. But you don’t have to add to that stress by trying to accomplish everything. Tell yourself that you don’t have to be perfect; repeat it until you believe it.

If you get stressed out during the holidays, this blog is for you. We’ll explore some suggestions for staying calm during the holidays.

No Christmas, Hanukkah, Kwanzaa or other holiday celebration is going to be perfect, so don’t set unrealistic expectations for your family activities. Don’t get overwhelmed by the pressure of creating holiday events that resemble a Norman Rockwell portrait. Keep in mind that as families grow and change, traditions and rituals change as well.

Instead of trying to fit in all of your traditions, identify the most important ones and take small steps to make them a reality. Be open to creating new traditions as well. For example, if your adult children can’t be with you, make them part of your celebration by sharing emails, photos and videos.

And when your family is gathered, set aside any differences you may have. Accept your family members as they are, even if they haven’t lived up to your expectations. Be understanding if others become distressed when something goes wrong. They’re probably feeling the stress of the holidays just like you.

Be proactive. The holidays are about bringing people together, not driving them apart. Focus on good memories and what family members have in common. Don’t debate differences of opinion during holiday dinner. There are more appropriate times and places for those discussions.

Keep things in perspective. It helps to remember that the holiday season is short. If something goes wrong, it’s not the end of the world. That situation will quickly pass. To recover, think of the good things in your life and accept that there’s time after the holidays to do more of the things you didn’t have time to do during the actual holiday season.

Remember what’s important. Our consumer culture has a way of robbing the holiday season of its authentic meaning and cashing in on a time that once had personal significance to us. For you, that significance may surround family, community or faith. Take time to reestablish what made the season significant for you in the first place. Volunteer in the community or help someone in need to reaffirm what the season is all about.

Many people spend excessive amounts of money in pursuit of perfect gifts, but that can intensify stress. Remember, you can’t buy happiness with expensive gifts. Before you go shopping, determine how much you can really afford to spend on gifts and stick to your budget. Try online shopping to avoid crowded malls and the stress that goes with them.

As an alternative to buying expensive gifts for everyone on your list, consider donating to a charity in a loved one’s name, giving homemade gifts or starting a family gift exchange.

Accept that there’s only so much time during the holidays and you cannot attend every party and event. Your friends will understand if you can’t make their get-together. They’re in the same boat with similar limits on time. Skip seeing The Nutcracker, even if it’s a holiday tradition. The ballet will run again next year, when you may have more time to see it.

Skip the alcohol. Drinking alcohol is a big contributor to holiday stress. A drink or two in moderation probably won’t hurt, unless you’re a recovering alcoholic. But drinking can lead to serious problems, including the potential of arrest for driving under the influence or, even worse, an auto crash that causes injury or death. Consider drinking something festive and nonalcoholic. It’s a safer choice and will reduce your stress level.

Make sure to take care of your health. Get adequate sleep and don’t forget regular workouts, even when your time is consumed by holiday preparations and activities. Your body needs sleep to recharge and renew its cells. Even with the crunch on your time, try to get eight hours of sleep each night.

Exercise is a natural stress reliever. It rids the body of stress hormones and releases endorphins, the body’s feel-good neurotransmitters. Exercise has been found to reduce anger, tension, fatigue and confusion. Studies show that when regular exercisers become inactive, they begin to feel depressed and fatigued after just one week.

If you’ve tried multiple stress-relieving tips and still suffer, consider seeing a professional for help. A therapist can teach you additional strategies for easing the stress of the season or any other time.

Patti DiPanfilo

Playing It Safe When Selecting Gifts For Kids

November 30th, 2022

A tradition common during the holidays is the giving of gifts to loved ones, particularly children. But it’s important that the presents are appropriate for children’s ages, skills and abilities, and that any toys given are well-made and safe.

Those are the key messages of National Safe Toys and Gifts Month, observed each December.

The Consumer Product Safety Commission (CPSC) has developed a strict set of toy standards. The CPSC closely monitors and regulates toys made in or imported into the United States to be sure they meet those standards. The commission issues recalls of toys that don’t meet the standards and are deemed unsafe.

Toys are recalled for various reasons, including unsafe levels of lead, the presence of choking or fire hazards or any other issues that can make them dangerous.

Click for a list of product recalls for 2022 from Safe Kids Worldwide.

Even with these standards, about 200,000 toy-related injuries in children 14 and younger are treated in American emergency rooms each year. The majority of these injuries are not serious; the children are treated and released. Still, a handful die each year of toy-related causes. There’s good news, though. The number of injuries and deaths has been steadily decreasing over the past 10 years.

Many times, injuries occur when parents give their children toys that are meant for older children. Before giving a toy, read the label to make sure it is age appropriate. Even if the child seems advanced compared with others the same age, the youngster still shouldn’t play with toys labeled for older children. Age levels for toys are determined by safety factors, not intelligence or maturity.

The best way to avoid a toy-related injury is to be proactive when selecting toys and other gifts for children. Here are some tips to follow before purchasing:

• Read all instructions and warnings listed on the packaging.
• Avoid buying toys with sharp edges, rigid points or spikes.
• Buy toys that can withstand impact and will not break into pieces that can be a choking hazard or cause other injuries.
• Look for the letters “ASTM” on the toy or packaging. That means the toy has met the safety standards set by the American Society for Testing and Materials.
• Avoid toys that shoot, such as BB guns, or include parts that fly off.

Here are some additional tips to keep in mind during National Safe Toys and Gifts Month:

• Learn how to properly use the toy first, then teach the child how to use it.
• Buy quality toys. They might be more expensive, but high-quality materials are less likely to break into pieces and lead to injury.
• Inspect gifts as the child opens them to be sure they are safe before allowing the youngster to play with the toys.
• If you give sports equipment, also give the appropriate protective gear for the sport, such as helmets for bicycles or riding toys. Make sure the gear is sized to fit the child.
• A gift that includes art supplies should be labeled “nontoxic.”
• Keep small toys, “button” batteries and other potential choking hazards away from children younger than 3.
• Keep deflated balloons away from children under 8. Immediately throw away balloons that won’t inflate or have popped.
• Discard plastic wrapping and other toy packaging before they become dangerous playthings for young children.

According to World Against Toys Causing Harm (WATCH), online shoppers are at a disadvantage because they cannot physically inspect the toys before purchasing them. Unfortunately, there are some disreputable online retailers that may omit warnings and provide incomplete or misleading information regarding toy safety. Further, unsafe and recalled toys can resurface on online websites.

If shopping for toys online, be sure to carefully inspect the toy and its packaging for obvious hazards before giving it to the child.

“Don’t let your child unwrap a potential safety hazard this holiday season,” states Joan Lawrence of The Toy Association, a site for toy safety information. “By shopping smart, you can ensure safe play.”

Patti DiPanfilo

Observing World AIDS Day

November 30th, 2022

December 1 is observed as World AIDS Day, which is dedicated to increasing awareness about AIDS and HIV. AIDS is a global pandemic that began in 1981 and has persisted as an international public health issue.

Since the pandemic began, an estimated 40 million people worldwide have died from AIDS. In addition, an estimated 37.7 million people are currently living with HIV. In the United States, an estimated 1.2 million people 13 and older are infected with HIV. About 13 percent — one out of seven— don’t know they’re infected and need to be tested.

HIV, or human immunodeficiency virus, is an infectious germ that attacks the body’s infection-fighting immune system. Specifically, it attacks and destroys a type of white blood cell called CD4 cells. These cells help coordinate the immune response to bacteria and viruses by stimulating other immune system cells to fight the germs.

This digitally colored electron micrograph image from the CDC shows HIV budding (in green) from a cultured CD4 white blood cell.

When CD4 cells are compromised, the immune system doesn’t work properly. As a result, the person become susceptible to other illnesses called opportunistic infections. Without treatment, HIV gradually destroys the immune system and will progress to AIDS, acquired immunodeficiency syndrome.

HIV is spread through contact with certain body fluids of people infected with the virus. These body fluids include blood, semen, preseminal fluid, rectal fluids, vaginal fluids and breast milk. In most cases, HIV is spread by having unprotected anal or vaginal sex or by sharing drug equipment, such as syringes and needles, with an infected person.

The body can’t rid itself of HIV, and there’s cure for the infection. Once infected with HIV, a person has it for life.

Many people feel no symptoms during the first few months after infection and may not know that they’ve been infected. Others experience flu-like symptoms within two to four weeks after becoming infected with HIV. This time frame is considered Stage 1, or acute HIV infection.

Possible symptoms include fever, chills, rash, night sweats, muscle aches, sore throat, fatigue, swollen lymph nodes and mouth sores. Some people experience no symptoms and do not feel sick during this stage. As the disease progresses, symptoms may expand to include weight loss, diarrhea and cough.

Even with symptoms, the only way to know for sure if someone been infected with HIV is to get tested. There are several types of tests available from a doctor’s office, hospital or community health center. There are even HIV tests you can take at home.

If you suspect that you’ve been exposed, get tested.

Stage 2 is chronic, or asymptomatic. During this stage, the virus is still active but not reproducing as quickly. A person often has no symptoms during this stage but can still spread HIV to others. Without treatment, this stage can last for 10 years or more before progress to Stage 3, which is AIDS.

A diagnosis of AIDS is made if the CD4 count drops to less than 200 cells per cubic millimeter of blood. (A normal count ranges from 500 to 1,500.) AIDs may also be diagnosed if certain opportunistic infections develop. These include pneumocystis pneumonia, a lung infection; Kaposi sarcoma, a skin cancer; cytomegalovirus, which typically affects the eyes; tuberculosis, which mainly infects the lungs; and candidiasis, a fungal infection.

HIV is treated with a combination of medications known as antiretroviral therapy (ART). In most cases, ART suppresses the HIV so that it is undetectable in the blood. The amount of the virus in the blood is called the viral load. People with HIV that take ART as prescribed and get and keep an undetectable viral load can live long, healthy lives and will not spread HIV to uninfected partners through sex.

In the US, most people with HIV don’t develop AIDS because ART stops the progression of the disease. Although an AIDS diagnosis indicates severe damage to the immune system, ART can still help. Without treatment, however, people with AIDS typically survive about three years.

To help prevent HIV and AIDS, use a latex condom during vaginal, anal or oral sex, and never share needles to inject drugs.

There are other ways to prevent HIV, including preexposure prophylaxis (PrEP), a medication taken daily if at risk for infection. Postexposure prophylaxis (PEP) is medication taken within 72 hours of possible exposure to prevent the virus from taking hold.

If you do become infected with HIV, take your ART and visit your doctor as recommended. Remember; ART enables people with HIV to live healthy, productive lives. It also serves to prevent further spread, reducing the risk of onward transmission by 96 percent.

Patti DiPanfilo

Hearing Aids Mask The Buzz Of Tinnitus

Exes back in business together to help others hear their best.

Dr. Anastasia Knoblach

After traditional masking attempts failed to relieve her of the constant buzzing in her ears, a condition known as tinnitus, audiologist Anastasia Knoblach finally found relief from a most unlikely source: her past.

Tinnitus is the perception of sound when there’s no external source. The condition is often described as “ringing in the ears,” but it can also come in the form of hissing, whistling, roaring, pulsing, screeching, swooshing or a strong buzz as it does with Dr. Knoblach.

“My tinnitus sounds like cicadas buzzing incessantly,” Dr. Knoblach describes. “It interfered with my hearing, interrupted my concentration and affected my sleep. It was extremely frustrating because it was there all the time, day and night, every day.

“I tried to ignore my tinnitus while I looked for treatment options, specifically tinnitus masking. But it seemed the more I subjected my ears to different masking stimuli, the more noticeable the tinnitus became. Then I started getting headaches. I was afraid I was going to have to live with that sound of cicadas for the rest of my life.”

Tinnitus masking is a feature available in some hearing instruments that replaces the annoying ringing or buzzing with a more pleasing sound. The aim of masking is that both the tinnitus and the masking sound will be relegated to the background of the patient’s attention, providing relief from the constant noise.

When traditional tinnitus maskers failed, Dr. Knoblach grew discouraged. But then she discovered an effective solution in a previous life.

“It seemed wherever I worked, there were copies of Florida Health Care News in the lobby,” Dr. Knoblach observes. “Every now and then I’d pick up a copy, only to find my ex-husband’s latest success story right there on the cover. And yes, we used to work together too.”
Dean Knoblach, BC-HIS, is a board-certified hearing instrument specialist at Knoblach Hearing Care in Largo.

The Knoblachs married in 2001 but parted ways after living and working together for 10 years. They’ve been divorced nearly 12 years “It felt too awkward to ask my ex-husband for help with something I should be able to correct myself,” Dr. Knoblach admits. “Then one day, while discussing our daughter, Dean started rambling on about some hearing instrument he fixed. I probably just wanted him to stop talking, but it came out as an abrupt, I bet you can’t fix mine. And that’s what started us talking about all the challenges I was experiencing.”

A Sensorineural Reaction

Tinnitus is not a disease, Dean stresses. Rather, it is the symptom of an underlying condition. While genetics and medications can sometimes be the culprit, most often the cause is an acoustic trauma to the auditory nerve.

In these cases, the patient was subjected to sound waves so intense that the cilia (tiny hair cells in the auditory nerve) were literally pushed into each other, creating the continuous signal of a frequency to be transmitted the brain.

“This is evident to anyone that has discharged a firearm without ear protection,” Dean describes.

The result is immediate tinnitus combined with temporary hearing loss. Though the symptoms usually subside in a few minutes, if the intense sounds become repeated through routine exposure, the auditory nerve can become permanently damaged, producing a never-ending stream of sound at that frequency.

“That constant sound is tinnitus, and it is frustrating,” Dean says. “It is like having a 500-pound gorilla constantly putting its hand in front of your face. You can live with it for a while. But after a while, you start thinking, Can I just get a break from this?”
Custom hearing instruments with properly tuned tinnitus maskers give Dr. Knoblach that break.

“I put them in and about 20 seconds later my cicada bugs are turned into clear speech with a very light breeze in the background,” she reports.

Several hearing aid manufacturers carry some type of masking feature in their high-end models, but while some carry just one or two options for masking, others carry over a dozen, with abilities to stream endless options from the internet.

“It is our job at Knoblach Hearing Care to determine what combination of particular technology and unique programming is necessary to properly address each individual’s needs,” Dean asserts. “There is never one model that works for all, but with the right technology and proper settings, most cases are correctable.”

Rectifying the problem is essential for safeguarding patients’ mental and emotional health, Dean adds. Chronic tinnitus sufferers can experience severe complications such as anxiety, insomnia and even severe depression.

The “Art” of Sound

By the time Dr. Knoblach turned to her ex-husband for help, the tinnitus had her feeling anxious and depressed, and it was disrupting her sleep. Dean was determined to fix what Dr. Knoblach couldn’t.

“She may have a doctorate in what we do, but I work in the trenches of producing results on a daily basis,” Dean says. “I tried several unique sounds before discovering one that covered up Dr. Knoblach’s tinnitus. The one that finally worked was Brownian noise, named after Robert Brown, a 19th century Scottish botanist who first discovered a certain kind of random microscopic motion in nature now referred to as Brownian motion.”

Examples in nature can be found in thunderstorms, waterfalls or heavy rain. Random sounds that many find comforting and soothing.

“I felt hope because for the first time in years I didn’t hear that buzzing sound,” Dr. Knoblach relates. “But the masking sound used to cover it was so loud that it sounded like a hurricane. I thought, Great, this is worse yet!

Dean quickly fixed that problem.

“Frequency by frequency Dean removed parts of the Brownian Noise, eventually leaving only the parts that covered up my incessant buzzing,” Dr. Knoblach notes. “After that, the frustrating buzzing was replaced by the sound of a light breeze, which eventually sounded as natural as living by a beach.”

As Dr. Knoblach’s case shows, tinnitus masking is something of an art form. Dean likens it to an artist painting natural looking camouflage over a canvas of sharp intense colors.

“It is the art of covering up an unpleasant sound with a much more soothing one, then reducing that until it’s barely noticeable,” Dean says. “People may think the masking sound must be louder than the original tinnitus sound it is covering up, but that’s not the case.

“The masking sound just has to be different – different and pleasant to the patient. Attractive and soft enough to be soothing and comfortable, yet strong enough at just the right pitch to effectively cover up the tinnitus.

“No matter which masking sound is found to be most effective, once the sound is programmed into the hearing device, the patient can simply wear the device and instantly hear better with no noticeable tinnitus. Some models are the size of a pencil eraser and can be comfortably worn all night.”

Career Change

“The frustrating buzzing was replaced by the sound of a light breeze, which eventually sounded as natural as living by a beach.” – Dr. Anastasia Knoblach

Dr. Knoblach reports that her treatment at Knoblach Hearing Care has been incredibly successful. As long as she wears the devices, she no longer hears the buzzing cicadas. It’s a thrilling outcome for her.

“Masking out the incessant, nagging sound of tinnitus can change a person’s entire outlook on life,” she enthuses. “It certainly did for me. I was amazed. I thought for a long time that it couldn’t be done. What Dean accomplished was nothing shy of liberating for me. Now, I feel normal again.

“And Dean was so nice. It was the first time we spent any real time together in 12 years. I thought it would be awkward, but it wasn’t at all. On my follow up appointment, Dean gave me a tour of the whole practice, and I was amazed to see all the changes he made over the years. Somewhere between the sound studios and repair lab I joked, Got any openings around here? I was shocked to hear Dean say his staff specialist recently retired and he was looking for a replacement.

Now, with over 60 years combined experience Dean and Anastasia once again provide a wide array of services to the hearing impaired community.

© FHCN staff article. Photos by Jordan Pysz. mkb

Discussing Diabetes

November 26th, 2022

November is American Diabetes Month, so let’s discuss this chronic metabolic disease that affects 37.3 million adults in the United States. The Centers for Disease Control and Prevention report that one of five aren’t even aware they have the disease. Yet, it’s the seventh leading cause of death in the country.

When you eat food — particularly carbohydrates such as bread, rice and pasta — your body breaks it down into a simple sugar called glucose, which enters your cells to be used as fuel. But glucose cannot enter your cells without help, which comes from a hormone made by your pancreas called insulin. Insulin serves as the “key” to help glucose get inside your cells.

With diabetes, your body doesn’t make enough or any insulin, or cannot use the insulin it makes efficiently, which is called insulin resistance. As a result, the level of glucose in your bloodstream increases. High blood glucose levels over time can lead to serious health complications, such as cardiovascular disease, nerve damage (neuropathy), kidney damage, eye damage (retinopathy) and even death.

There are three main types of diabetes: Type 1, Type 2 and gestational.

Type 1 diabetes, which accounts for approximately 5 percent of cases, is an autoimmune disorder. With this type, your body’s infection-fighting immune system mistakenly attacks the insulin-producing beta cells in your pancreas. Type 1 can occur at any time but is most often diagnosed in young children, teens and young adults.

Type 2 diabetes is the most common, affecting up to 95 percent of cases. With Type 2, your body becomes resistant to the effects of insulin and glucose builds up in the bloodstream. It typically develops over many years and is most often diagnosed in adults older than 35, although it’s being seen with greater frequency in young children, teens and younger adults.

Gestational diabetes develops in some pregnant women It typically goes away after the pregnancy, but patients are at a higher risk for developing Type 2 diabetes when they are older.

There also is is a condition called prediabetes if blood glucose levels are higher than normal but not enough to be formally diagnosed with Type 2 diabetes.

Symptoms of Type 1 and Type 2 diabetes are similar, but their onset is more rapid with Type 1. Symptoms appear slowly, over time, with Type 2. General symptoms include increased hunger, increased thirst, weight loss, frequent urination, blurry vision, fatigue and sores that are slow to heal.

Most women with gestational diabetes experience no symptoms. Pregnant women are routinely tested for diabetes between the 24th and 28th weeks of pregnancy, so getting regular prenatal care is important to detect and treat this condition before it causes damage to the mother and baby.

There are different causes for each type. Researchers don’t know what causes the immune system to attack beta cells in the pancreas that result in Type 1 diabetes but suspect that genetics plays a role. They also surmise a virus may activate the immune system to attack beta cells.

Type 2 is associated with a combination of genetics and lifestyle factors. The condition runs in families. It is more common in people who are overweight, eat an unhealthy diet and have a sedentary lifestyle. Having high blood pressure, high cholesterol, high triglycerides or prediabetes also puts someone at a higher risk for developing Type 2 diabetes.

Gestational diabetes is caused by hormonal changes during pregnancy. The placenta produces hormones that make cells less sensitive to the effects of insulin, causing high levels of blood glucose in the bloodstream. If a woman is overweight while pregnant or has a family history of Type 2 diabetes, she is at a greater risk for developing gestational diabetes.

Those with Type 1 diabetes must take insulin every day to survive. In many cases, Type 2 diabetes can be managed with a healthy lifestyle, which includes eating a healthy diet, getting regular physical activity, not smoking and maintaining a healthy weight. If that’s not enough, patients must to take oral medication and/or receive insulin injections.

Treatment for gestational diabetes includes special meal plans and scheduled physical activity. In some cases, medication or insulin injections may become necessary to keep blood glucose levels at a healthy level.

Type 1 diabetes cannot be prevented. However, there are some things that can reduce the risk for developing Type 2 and gestational diabetes, including:

• Eat a healthy diet high in fiber and non-starchy vegetables.
• Be physically active. Aim for 30 minutes most days of the week.
• Maintain a healthy weight.
• Quit smoking.
• Get seven to nine hours of sleep per day.
• Lower stress. Try deep breathing, meditation, yoga, tai chi or another relaxation technique.

Patti DiPanfilo

A Closer Look At Pancreatic Cancer

November 17th, 2022

November is Pancreatic Cancer Awareness Month, so let’s take a few minutes to ponder this deadly disease. First, let’s learn a little bit about the pancreas and its important contributions to the body’s day-to-day functioning.

The pancreas is an oblong organ that sits across the back of the abdomen, between the stomach and the spine. It consists primarily of two types of cells. Exocrine cells make key enzymes for digestion, which they release into tiny tubes called ducts. Endocrine cells produce hormones such as insulin and glucagon, which help the body absorb glucose (sugar) for energy and control glucose levels in the blood. Endocrine cells release their hormones directly into the bloodstream.

Pancreatic cancer develops when abnormal cells grow out of control and form a mass, or tumor. About 95 percent of pancreatic cancers start in the exocrine cells. These are called pancreatic adenocarcinomas. About 7 percent of pancreatic cancers begin in the endocrine cells. Those are called pancreatic neuroendocrine tumors, or PNETs.

According to the American Cancer Society, pancreatic cancer accounts for about 3 percent of all cancer diagnoses in the US and is responsible for 7 percent of cancer deaths. The society estimates that about 62,210 Americans will be diagnosed with pancreatic cancer in 2022 and about 49,830 people will die from it.

Pancreatic cancer is often called a “silent cancer” because it generally has no detectable symptoms in early stages. Consequently, it typically progresses and affects other organs and tissues before it is diagnosed.

When present, pancreatic cancer symptoms can include yellowing of the skin or eyes (jaundice), dark urine, pain in the abdomen or lower back, digestive upset (nausea, vomiting or indigestion), fatigue, depression, blood clots, decreased appetite, unexplained weight loss and sudden onset of diabetes.

The cause is unknown, but certain factors have been identified that increase the risk for developing this cancer. These include smoking cigarettes, being obese, not exercising regularly, eating a diet high in fat and processed meats, drinking heavily, being exposed to chemicals and pesticides, having Type 2 diabetes or a chronically inflamed pancreas, being African American, being male, being older than 55 and having a family history of pancreatic cancer.

To diagnose pancreatic cancer, a doctor will begin with a thorough review of the patient’s symptoms and medical history. The doctor will likely order a CT or MRI scan to get a detailed image of the pancreas. Other tests may include endoscopic ultrasound and endoscopic retrograde cholangiopancreatography (ERCP).

These tests are performed through an endoscope – a thin, flexible tube with a tiny camera attached to its end that is passed down the throat and into the digestive system. During these endoscopic procedures, a doctor can obtain a sample of tissue to study under a microscope to look for cancer cells. This is called a biopsy.

Blood tests are also used to look for certain tumor markers that may indicate pancreatic cancer. Tumor markers are substances that are often found in high concentrations when cancer is present. Tumor marker CA 19-9 may be helpful in diagnosing pancreatic cancer. Carcinoembryonic antigen (CEA) is another tumor marker for pancreatic cancer, but it’s not used as often as CA 19-9.

Once a diagnosis of pancreatic cancer has been made, the doctor will assign a stage based on test results. The stage of a cancer indicates the size of the tumor and how far it has spread from where it originated. The stages of pancreatic cancer include:

• Stage 0 – Abnormal cells that could become cancerous are present in the pancreas.
• Stage 1 – Tumors are in the pancreas only.
• Stage 2 – Tumors have spread to nearby abdominal tissue or lymph nodes.
• Stage 3 – The cancer has spread to major blood vessels and lymph nodes.
• Stage 4 – The cancer has spread to other organs, such as the liver.

Treatment for pancreatic cancer depends on the stage. The goals of treatment are to kill the cancer cells, prevent the spread of the disease and relieve symptoms. Treatment may include surgery, chemotherapy, radiation therapy, targeted drug therapy and immunotherapy.

If the cancer is localized to the pancreas, it may be possible to eliminate the cancer cells by surgically removing all or part of the pancreas. A common procedure for pancreatic cancer is the Whipple procedure during which the surgeon removes the head of the pancreas and sometimes the entire pancreas, along with a portion of the stomach, the first part of the small intestine, the gallbladder, the bile duct and other tissue.

Chemotherapy uses drugs to kill cancer cells. Radiation therapy destroys cancer by focusing high-energy rays on the cancer cells. These treatments may be used before surgery to shrink tumors or after surgery to eliminate any remaining traces of the cancer.

Targeted drug therapy is a type of cancer treatment that targets proteins that control how cancer cells grow, divide and spread. Immunotherapy works the immune system to recognize and destroy cancer cells.

Because pancreatic cancer is typically not diagnosed until it is in its advanced stages, it continues to be difficult to treat and cure. Fortunately, the outlook for people with this cancer is improving. Ongoing research and clinical trials, along with new treatments, are expanding the average five-year survival rate for people with pancreatic cancer.

Patti DiPanfilo

A Little Epilepsy Education

November 9th, 2022

This is National Epilepsy Awareness Month. In observance, we dedicate this blog to providing a little education on the disorder. Epilepsy is a chronic brain disease characterized by recurring, unprovoked seizures, which are sudden, unexpected alterations in consciousness and behavior. Epilepsy seizures are caused by sudden surges of abnormal electrical activity within the brain initiated by damaged brain cells.

According to the Epilepsy Foundation, epilepsy is the fourth most common neurological disorder, after migraine, stroke and Alzheimer’s disease. In the United States, it’s estimated that 1.2 percent of the population has active epilepsy. That works out to 3.4 million Americans. Worldwide, about 65 million people have the disorder. Epilepsy can develop at any age, but diagnosis most often occurs in early childhood or after age 60.

Seizures are usually classified into two groups: focal and generalized. Focal, or partial, seizures start in a A localized area on one side of your brain. Generalized seizures affect a wide area on both sides of your brain at the same time. There are multiple subtypes of focal and generalized seizures.

Recurring seizures is the main symptom of epilepsy. Seizure symptoms vary by subtype, but some general signs and symptoms include a temporary loss of consciousness; uncontrolled muscle movements (spasms); blank stare; alterations to the sense of taste, smell, sight, hearing or touch; dizziness; changes in breathing; and performance of repetitive movements, such as lip-smacking, chewing and hand-rubbing.

Some people with epilepsy have identified certain factors or situations that trigger their seizures. Some common triggers include lack of sleep, illness or fever, stress, bright or flashing lights, caffeine, alcohol or alcohol withdrawal, recreational drug use, skipping meals or overeating, hormonal changes, dehydration and use of certain medications, such as diphenhydramine, a common ingredient in over-the-counter cold, allergy and sleep remedies.

To help you uncover your triggers, try keeping a seizure journal. Record the date and time, everything you were doing, everything that was going on around you and what you were feeling before your seizure began. Share your journal with your doctor.

Epilepsy has many causes, including genetics. Certain types are more likely to run in families. Other potential causes include head injuries, brain infections, stroke, brain tumors, dementia, lack of oxygen to the brain, drug use during pregnancy, lack of oxygen at birth and blood vessel abnormalities in the brain. In up to 70 percent of cases, the cause is unknown.

Epilepsy is typically diagnosed after an individual has experienced at least two seizures that cannot be attributed to a known medical condition. Besides epilepsy, other conditions that can cause seizures include a brain infection or injury, high fever, drug abuse, electric shock and hypoglycemia (low blood sugar).

To help make the diagnosis, your doctor will perform a physical exam and ask about your seizure symptoms. The doctor will likely order blood tests to rule out other disorders as the source of your seizures. Your doctor may recommend an electroencephalogram (EEG), which measures the electrical activity in your brain, and an MRI or CT scan of your brain, which can reveal tumors and blood vessel abnormalities.

There are several treatment options for epilepsy. The goal of treatment is to reduce the number of seizures or stop them completely. Initial options include anti-epileptic medications and dietary therapy. If your epilepsy is resistant to those approaches, surgery to remove or disconnect the part of your brain causing the seizures may be recommended.

Between 70 and 80 percent of people with epilepsy can successfully control their seizures through medication or surgical techniques.

Another method for treating epilepsy seizures is deep brain stimulation. This involves surgically implanting electrodes into the specific areas of your brain where the seizures originate. These areas are identified through special neurological testing called brain mapping. A generator is also implanted into your chest. The generator sends electrical impulses to the electrodes in your brain to help reduce seizures.

Most seizures don’t require emergency medical attention. However, have someone call 911 if your seizure lasts for more than five minutes or if you have a series of seizures in a row without a recovery period in between.

Patti DiPanfilo

Highlighting Pulmonary Hypertension

November 4th, 2022

November is Pulmonary Hypertension Awareness Month. Pulmonary hypertension is high pressure in your pulmonary arteries, the blood vessels that carry blood from your heart to your lungs. Oxygen-poor blood returns to the right side of your heart. The lower chamber — the right ventricle — pumps the blood into the pulmonary arteries and into the lungs to be enriched with oxygen. Your heart then pumps the oxygen-rich blood to your body’s organs and tissues.

When your pulmonary pressure is consistently high, the arteries in your lungs can narrow, and your heart must work harder to pump blood into the lungs. Over time, this extra work weakens your heart and you can develop heart failure, a condition in which your heart can no longer pump enough oxygen-rich blood for your body’s daily needs.

Many things can cause pulmonary hypertension. These include certain congenital heart defects; connective tissue disease; coronary artery disease; liver disease, such as cirrhosis; hypertension (high blood pressure); blood clots in the pulmonary arteries; HIV; pulmonary fibrosis (a condition causing scarring in the lungs); chronic lung disease, such as emphysema; heart failure; and genetics.

Pulmonary hypertension may not cause any signs or symptoms at first. In many cases, shortness of breath or lightheadedness during activity is the first symptom. As the condition progresses, signs and symptoms may become more noticeable and may include:

• Increased shortness of breath, first with activity and eventually even at rest.
• Bluish lips and skin.
• Dizziness or fainting.
• Fatigue.
• Decreased appetite.
• Chest pain or pressure.
• Palpitations (rapid, pounding heartbeats).
• Swelling of the ankles, legs and belly.

The early signs and symptoms, such as shortness of breath and fatigue, are common to many other medical conditions. Therefore, diagnosis is often delayed until more serious symptoms develop.

Because pulmonary hypertension may be caused by many medical conditions, your doctor will perform a thorough medical history and physical exam, including a detailed discussion of your symptoms. This helps the doctor rule out other disorders.

Your doctor may order certain tests to aid in the diagnosis. These include blood tests; lung function tests; and imaging exams, such as a chest x-ray, CT or MRI, to get a closer look at your lungs and right ventricle. The doctor may recommend an echocardiogram, which uses sound waves to create moving pictures of your beating heart. This shows blood flow through your heart. A right heart catheterization can confirm the diagnosis of pulmonary hypertension.

There is no cure for pulmonary hypertension, but treatment is available to help improve signs and symptoms and slow the progression of the disorder. The treatment you receive will depend, in part, on the cause of your condition and will focus on treating the cause. However, certain treatments are generally used no matter what the cause.

Medications such as diuretics, or water pills, reduce fluid buildup in your body. Anticoagulants, or blood thinners, help prevent blood clots from forming or growing larger. Inotropic agents improve the heart’s pumping ability. Vasodilators relax and open narrowed blood vessels and improve blood flow. A drug called digoxin helps your heart beat stronger and pump more blood. Your doctor may recommend therapy to raise the level of oxygen in your blood.

If medications don’t control your signs and symptoms, your doctor may recommend surgery. Surgical procedures includes atrial septostomy, an open-heart surgery in which the surgeon creates an opening between the upper left and right chambers of the heart (atria) to ease the pressure on the right side of the heart.

A lung or heart-lung transplant may be recommended in severe cases that don’t respond to any treatments. In these cases, your lungs or your heart and lungs are removed and replaced with healthy organs from a donor.

Certain lifestyle changes can also help improve your life with pulmonary hypertension. Consider making these changes:

• Quit smoking.
• Eat a healthy diet. Include a variety of fruits, vegetables, whole grains and lean protein. Ask your doctor if you need to limit anything in your diet, such as salt or vitamin K. Vitamin K, for instance, can affect how well blood-thinning medications work.
• Be physically active. Incorporate regular activity such as walking into your daily routine. Ask your doctor if there are any activities, such as lifting heavy objects, you should avoid.
• Seek emotional support. Living with a serious, chronic disorder such as pulmonary hypertension can cause emotional issues, such as anxiety and depression. Tell your doctor how you feel. He or she can direct you to the appropriate resources (counseling, medication, patient support group).

Patti DiPanfilo

SIDS: A Silent Killer

November 2nd, 2022

Sudden Infant Death Syndrome is the sudden, unexpected and unexplained death of a seemingly healthy baby less than 1 year old. SIDS is sometimes called crib death because it usually occurs when babies are asleep in their cribs. SIDS is a silent killer.

Reduce the risk of SIDS by laying your baby on his or her back at bedtime.

About 2,300 babies die of SIDS each year in the US. It is the most common cause of death in babies between the ages of 2 weeks to 1 year. It most often occurs in babies between 2 months and 4 months old. It occurs more often in African American and Native American babies than in Caucasian babies and is slightly more common in boys than in girls.

SIDS doesn’t have any recognizable symptoms. It happens to babies that appear healthy. A diagnosis of SIDS is one of exclusion. The diagnosis is generally made if no clear cause of death can be determined after a thorough investigation that includes an autopsy.

There are certain factors that increase a baby’s risk of dying from SIDS. The most important is laying down a baby to sleep on the stomach or side rather than the back. Other factors that increase risk include:

• A family history of SIDS.
• Being overheated with blankets or a high room temperature.
• Co-sleeping (sharing a bed with a parent or caretaker).
• Having a mattress that’s too soft.
• Having soft objects in the crib, such as stuffed toys, bumper pads, quilts and pillows
• Being born prematurely or having a low birth weight.
• A mother younger than 20 years old.
• A mother who received inadequate or no prenatal care.
• A mother who smoked, drank alcohol or took drugs during pregnancy.
• Exposure to secondhand smoke.

The cause of SIDS is unknown but researchers are studying certain theories. Many believe that SIDS is related to a baby’s inability to arouse from sleep when not getting sufficient oxygen from breathing. As a result, carbon dioxide builds up in the bloodstream. A high level of carbon dioxide can lead to death. Some researchers believe this occurs because the center in the baby’s brain that controls arousal is not fully developed.

The proposed “Triple-Risk Model” suggests that three factors combine to cause SIDS. This theory holds that SIDS occurs when an underlying brain abnormality and a triggering event, such as a poor sleep position (sleeping on the stomach), occur during a vulnerable stage in a baby’s development, essentially the first six months of life.

It may be frightening to know that there’re no symptoms to be alert for and no clear cause of SIDS, so there’s no way to prevent it from happening. But there are some tips for reducing a baby’s risk for SIDS. These include:

• Lay your baby on his or her back when putting him or her down for a nap and at night.
• Avoid overheating your baby. Don’t tightly swaddle your baby in a blanket and keep the room temperature at a level that’s comfortable for a lightly clothed adult.
• Don’t co-sleep with your baby or let your baby sleep with other children or adults.
• Choose a firm, safety-approved crib mattress and use a fitted sheet.
• Keep toys, bumper pads, fluffy blankets, quilts and pillows out of the crib when the baby is sleeping.
• Don’t smoke, drink or take drugs while pregnant and if breastfeeding.
• Get proper prenatal care during pregnancy.
• Don’t let anyone smoke around your baby.
• Set up your baby’s sleep area close to you but separate from your bedroom or those of other children.

In addition, make sure everyone who cares for your baby – including grandparents and other relatives, babysitters and friends – knows these recommendations. And consider sharing these tips with other parents and caregivers of infants.

Patti DiPanfilo

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