BRVO occurs when blood flows into retina but not out, causing swelling. Eye injections keep it in check.

As a teen, Violet Rice volunteered at a hospital in her hometown of Hagerstown, Maryland. That and the fact that her mother and several friends’ mothers were nurses led her to pursue that field.

During a nearly 30-year career, Violet served in several nursing capacities, including instructor, administrator and at the bedside.

“I liked working on the staff,” Violet shares. “I worked in a variety of specialty areas, including the operating room, emergency room, medical-surgical unit and rehabilitation unit. I can’t say that I had a favorite area because I liked them all.”

The majority of Violet’s career was in Maryland, with one notable exception.

“I was recruited to be director of nursing for a rehabilitation center in the Kingdom of Saudi Arabia. It was a two-year contract,” she reveals.

“I wouldn’t do it again. They have restrictions as far as women are concerned, and things have gotten quite unsafe over there. I would never go back.”

Violet, 81, retired in 1991 and relocated to Florida in 2015. Following her move, she began having trouble with blurry vision, halos around lights and difficulty seeing at night. Her eye doctor diagnosed her with cataracts and recommended surgery to remove them.

Cataracts are a clouding of the lens that develops from a breakdown of fibers or a clumping of proteins. They are removed surgically through an outpatient procedure typically performed on one eye at a time, with a week or two in between. During each surgery, the affected lens is removed and replaced with a synthetic lens.

Violet’s cataract surgery was delayed, however, by a complication in one eye.

“When I went for my presurgical examination, the doctor discovered inflammation in the retina of my left eye,” Violet elaborates. “He said that would have to be assessed before I could undergo cataract surgery.”

Violet was diagnosed with a retinal vein occlusion and referred to Thomas A. Barnard, MD, at Florida Retina Institute in Titusville.

Dr. Barnard, a board-certified, fellowship-trained retina specialist, performed a test on Violet’s left eye called optical coherence tomography, or OCT, which produces cross-sectional images of the retina.

“Ms. Rice came to us in May 2016 complaining of blurry vision,” Dr. Barnard recalls. “The OCT revealed swelling in the retina of her left eye. That finding confirmed the diagnosis of a branch retinal vein occlusion, or BRVO.”

Stiff Arteries

A BRVO occurs when a vein in the retina gets pinched off by an artery. Arteries carry oxygen-enriched blood to organs and tissues while the veins carry oxygen-depleted blood back to the heart. In the retina, arteries and veins run side-by-side and crisscross.

“The arteries are stiffer than the veins, so where there’s a crossing point, a vein will sometimes become kinked,” the doctor explains. “That kink prevents the blood that’s flowing into the retina from flowing back out. As a result, blood gets backed up and causes swelling, which leads to blurry vision.”

A BRVO can happen to anyone, Dr. Barnard points out, but there are factors that put an individual at higher risk.

“If a person has high blood pressure, diabetes or high cholesterol, they have a higher chance of developing a BRVO,” he observes. “It’s also more common as people get older because their arteries become stiffer over time. They stiffen even more if the person has high blood pressure or high cholesterol.”

Treatment typically involves injections into the eye of a medication that reduces retinal swelling, thus improving vision. The three FDA-approved medications used at Florida Retina Institute are bevacizumab (brand name AVASTIN^®), ranibizumab (LUCENTIS^®) and aflibercept (EYLEA^®). Sometimes, a steroid medication is used.

During the injection, the eye is numbed with topical anesthetic drops so patients typically feel little to no pain.

“The frequency of the injections depends on how quickly the swelling returns,” Dr. Barnard asserts. “For some people, we perform a few injections and the swelling stays away. In others, the swelling keeps coming back so we have to continue adding the medicine. Some people need it monthly. Others need injections every three or four months.”

A BRVO cannot be cured, nor does it resolve on its own or with treatment.

“We cannot get the kink out of the retinal vein,” Dr. Barnard explains. “But after a while, the body grows a new drainage channel, so eventually, the blood starts to flow more normally. The injections don’t fix the blocked vein, they just ease the swelling and, as a result, improve the blurry vision.”

Violet has been receiving EYLEA injections since 2016, and had her cataract procedures at the end of that year. She uses reading glasses but no longer needs glasses for distance.

In some people, a BRVO will settle down and cause less swelling, Dr. Barnard says. However, it’s common for the occlusion to remain symptomatic long term and require ongoing treatment.

“Ms. Rice hasn’t been able to go longer than six weeks between injections before the swelling returns and her vision is affected,” the doctor notes. “With the schedule that we’re following, however, we’ve been able to get the vision in her left eye to 20/20.”

“My Vision Has Improved”

Dr. Barnard regularly monitors Violet’s BRVO using OCT imagery. If swelling is observed, he moves forward with the EYLEA injection into her left eye.

“My vision has improved, and it’s maintaining,” Violet enthuses. “I do have one spot in my left eye that’s sort of a grey spot. But other than that, I’m functioning pretty well.”

Violet has high praise for the retina specialist as well as his staff.

“Dr. Barnard is great,” she raves. “He’s very gentle and considerate. He’s also proficient, competent and knowledgeable. He explains things and takes time to answer any questions. I don’t feel rushed when I’m with him. Trusting the doctor treating my eyes is the top thing on my importance list.

“The staff is very professional and respectful to everyone. They’re friendly and willing to answer questions. Even though they’re busy, they maintain a welcoming and congenial relationship with patients. They carry out their duties in an effective and efficient manner. I highly recommend Florida Retina Institute.”

© FHCN staff article. Photo by Jordan Pysz. mkb

Protocol restores vertebral cushions using injections of natural healing factors.

On May 4, 1970, members of the Ohio National Guard fired into a crowd of anti-war protestors at Kent State University, killing four students and wounding nine others.

The event, which became known as the Kent State massacre, triggered a massive student strike across the nation that forced hundreds of colleges and universities to temporarily cease operations. It was also instrumental in turning the tide of public opinion against the war in Southeast Asia.

Janet Goff was just a teenager then, but nearly 53 years later, she can still recall the anxiety she felt as a Kent resident during those events and their aftermath.

“We moved around because my dad was in the military, but he chose to retire in Kent,” recounts Janet, 68. “I was in high school at the time. My sister was actually working in the university’s ROTC building when all that broke out. It was a pretty scary time.”

When Janet became an adult, she left Kent, married and began traveling again, this time with her husband. Initially. Janet was a stay-at-home mom to their son. When her son got older, Janet began working outside the home to help with the family finances.

“I mostly did administrative-type work,” Janet relates. “I was a pharmacy technician for a while, and I worked in different offices. I worked for an engineering company and a brand development company. I was also a certified aerobics instructor. Of all my jobs, I liked teaching aerobics the best. It was fun helping women get in shape.

“I taught aerobics at the YMCA, at an after-school program for teachers and at several churches. I taught at a women’s fitness camp every summer. I also taught after-work classes for various corporations including Ohio Bell, the telephone company. I went to the jobsite, where a room was set up for the class.”

Now retired, Janet remains active. She fills her days with gardening, working out, biking and running. She also volunteers at church and a nursing home. But several years ago, her lifestyle took a hit when low back pain flared and grew progressively worse.

“I’m so active. … I feel like I’m 20 years younger.” – Janet

“I fought the pain for quite a while,” she says. “I think a lot of the problem was overuse and physical strain. I cut down a lot of trees, did a lot of yardwork and lifted a lot of things. For years, nothing stopped me, but I think that’s how I hurt myself.

“The pain was mostly in my hip, lower back and buttocks, and it was a sharp, shooting pain that eventually got so bad that I couldn’t get up or down or even stand because it felt like my leg wouldn’t hold me up.

“I had to quit exercising and doing yardwork and even had trouble cleaning my house at times. I was always hurting, and when you’re in pain like that, you don’t want to do anything but lie around. That’s what happened to me, and I put on a lot of weight because of it.”

Over the years, Janet visited several chiropractors who tried physical therapy, massage therapy, ice and heat, but those treatments provided only short-term relief.

Then her massage therapist recommended she visit Dr. Jeffrey P. Johnson, lead provider at Johnson Medical Center in Venice. After a detailed examination, he determined the primary source of Janet’s pain was the facet joints in her lower spine.

“Those joints were degenerated and arthritic,” Dr. Johnson reports. “As a result of the degeneration, the material that cushions the bones of those joints had worn away, which allowed the bones to rub against each other, causing pain.”

The facet joints are pairs of small joints at each vertebral level of the spine. They connect the vertebrae and allow the spine to bend forward and backward. They are also a common cause of back pain.

In Janet’s case, Dr. Johnson first tried treating that pain with chiropractic and physical therapy. When those approaches alone failed to provide long-term relief, Dr. Johnson recommended another treatment called regenerative therapy.

Alternative to Surgery

Regenerative therapy is a nonsurgical option in which renewing substances are injected into the joint to stimulate the body’s ability to heal itself.

Because injections are less invasive than surgery, patients recover much faster and there is less risk for complications such as bleeding and infection, which can occur with joint replacement and other types of surgery.

“Regenerative therapy provides an option for patients with conditions that I would have previously referred for surgery,” Dr. Johnson affirms. “It’s been a terrific addition to our practice, where we also use rehabilitation therapy, laser therapy, chiropractic and other modalities to assist with the process of rehabilitating damaged joints.

“The goal is for the treatment to be a long-term restorative event, not just a short-term fix. And best of all, it works. We’re seeing tremendous results with our regenerative therapy protocol. Within weeks of beginning treatment, patients are experiencing terrific relief from their joint pain. In a matter of months, we’re seeing an increase in the joint cushioning and true healing of the joint. You don’t see that level of healing with joint replacement or other surgery.”

Janet was deemed an excellent candidate for Johnson Medical Center’s regenerative therapy.

That protocol begins with a simple blood draw. The blood is then placed in a centrifuge, where it’s spun down to create enriched plasma, which contains healing and growth factors that help the body regenerate damaged tissue.

At Johnson Medical Center, a typical course of regenerative therapy calls for the patient to receive three weekly injections of enriched plasma.

“We then inject another material called micro human tissue, which contains even more of the vibrant substances that promote the body’s healing ability,” Dr. Johnson relates.

Micro human tissue is obtained from women who donate their babies’ umbilical cords following healthy births. The umbilical cord has protective tissue that surrounds the arteries and veins and is a vital component of fetal development.

“The enriched plasma gets the joint ready for the micro human tissue, which is the last injection of our protocol,” Dr. Johnson informs. “Micro human tissue is the most effective tissue we use to promote healing.”

At Johnson Medical Center, all regenerative therapy injections are administered by Mahendra Poonai, RN, APRN, FNP-BC, under ultrasound guidance, which ensures appropriate placement at the site of the degeneration and/or injury.

“Mahendra has traveled across the country to receive the best training in regenerative therapy techniques,” Dr. Johnson assures. “He has developed expertise in using ultrasound to get the enriched plasma and micro human tissue exactly where it needs to be for the treatment to be the most effective. It’s a very precise technique, and Mahendra does it well.”

As part of her treatment, Janet also received trigger point injections. This involves injecting a local anesthetic, sometimes combined with a natural anti-inflammatory medication, into a trigger point, which is a sensitive area of tight muscles, to relax the muscles and relieve pain. Mahendra delivers these injections as well.

“20 Years Younger”

After Dr. Johnson explained the regenerative therapy protocol to Janet, she was enthusiastic about trying the treatment. Once she did, she was amazed by how rapidly she noticed a difference in her pain.

“The therapy started working really quickly, within a couple of days of getting the micro human tissue injection,” Janet enthuses. “It alleviated the pain in my lower back, which is now gone. I have zero pain, which is just amazing.

“And thanks to that, I’m moving around again. I’m very active. I’m running, biking, exercising and gardening. I’m running around like I used to do. I feel like I’m 20 years younger, and because I’m stronger and more active, I’ve lost 12 pounds.”

Janet says she is delighted with the work and manner of Dr. Johnson as well as Johnson Medical Center’s staff.

“Dr. Johnson is a very nice man,” she raves. “His practice is very personable. He likes to talk to you about stuff, and he checks up on you during your treatment. The staff at Johnson Medical Center is also super nice and helpful. I definitely recommend them and have already given their number out to several people. I always tell people about them.”

Initial Problem

For Dawn Hucul and her husband, the annual migration from suburban Detroit to Florida began in 2006. Now, the couple spends the majority of the year — seven months — in the Sunshine State.

“We officially changed our residency to Florida last year,” says Dawn, a homemaker who often assisted her husband in his professional endeavors.

“My husband and I have done many things. My husband owned his own business. He’s an engineer. We’ve done a lot of work with the car companies. We built some homes, redid some homes. Today, we golf, ride bikes and try to live healthy, full, rounded lives.”

Nevertheless, Dawn’s health was recently compromised by a painful problem with her wrists.

“I had an issue with tendonitis, arthritis and carpal tunnel so severe I was facing surgery,” Dawn describes. “On a radio station in Michigan, I heard about a laser outfit that treats hockey players, sports people and people who’ve had surgery.

“The laser treatment was outside the insurance realm, but they offered one session for free. I thought, I’m going to give this a try before I go the surgery route. It worked spectacularly, but it’s an ongoing process. The results are cumulative. The more you do it, the more the inflammation goes down and the better you feel.”

After traveling to Florida, Dawn’s husband began looking for a local practice that offers the laser treatment. His search led him to Johnson Medical Center, which uses a better laser than the one that effectively addressed Dawn’s wrist pain.

“I feel better than I did before. The difference is just unbelievable.” – Dawn

“Dr. Johnson’s laser has kept my problem under control for years,” Dawn reports. “Then last year, not long after we came down to Florida, I totally overdid it. I overexercised, overcleaned my house and overused my neck. I couldn’t move my neck, which was awful.”

For help, Dawn returned to Johnson Medical Center, where spinal x-rays showed degeneration and disc problems in Dawn’s lower back and neck.

“It was a combination of pulled muscles and rubbing bones,” Dawn offers “It was a chiropractic and a soft tissue problem. I was in a really bad way.”

No Surprise

Finding degeneration in her lumbar spine was no surprise to Dawn. She’s struggled with sciatica and pain in her lower back for years.

“I’ve always had problems, but I didn’t know degeneration was the reason for my lumbar and sciatic issues,” Dawn relates. “I always thought it was because I had overdone something, like exercising, cleaning the house or gardening.

“But that’s not always the case. Sometimes, you actually have a problem, and this one left me in severe pain. It was a catch-your-breath pain, like Oogh. And my thoracic nerves were involved, so I couldn’t sneeze or take a deep breath without pain.

“It was a pain so bad that it affected my life, my personality, my relationships. If one person is in pain, it passes through the entire family.”

To alleviate the problem, Dr. Johnson recommended regenerative therapy. He was confident it could ease Dawn’s pain. Because she was eager to return to her active lifestyle, Dawn agreed to try the protocol.

“I was at the point where I had to do something, just to get back home to Michigan,” Dawn asserts. “We’d been in Florida since late November, and here I was still suffering in April.”

Dawn’s treatment began with trigger point injections, which “helped immensely right away,” according to Dawn. She then received enriched plasma and micro human tissue injections. She also underwent physical therapy.

“Now, my pain level is zero,” Dawn enthuses. “And I’m very active. I golf, swim, do cardio exercise twice a week and do hot yoga. I also do strength training twice a week.

“And I do everything better than I did before. I feel better than I did before. The difference is just unbelievable.

“I believe my success comes from a combination of Dr. Johnson’s protocol and doing everything I’m supposed to do to keep myself strong and healthy, everything Dr. Johnson and his team recommended.

“That’s why, if someone is on the fence about getting this regenerative therapy, I would say to them: You absolutely should try regenerative therapy before you do anything invasive. It makes that much of a difference.

“Going to Johnson Medical Center is an amazing experience. They have everything: the laser, the change-my-life physical therapy, the chiropractic and regenerative therapy. And everybody there knows what’s happening. Everybody’s on the same page, and everybody wants you to get better.”

© FHCN staff article. Photos by Jordan Pysz. mkb

Therapy replenishes depleted nutrients, thereby restoring health and well-being.

As the owner of a tile company, Dennis* wears a lot of hats. He manages sales, customer service and finances. He loves his work, but there are times when the heavy load leaves him stressed and tired.

“It’s a family-owned business,” Dennis notes. “I took it over about 35 years ago. As part of my job, I do installations and sell tile, granite and marble. I also do a lot of running around.”

At the end of last year, the strain of the job began affecting Dennis physically and mentally. He lacked energy, motivation and focus. Dennis mentioned these symptoms during an appointment with Dr. Jeffery P. Johnson at Johnson Medical Center.

After administering some tests, Dr. Johnson discovered Dennis was deficient in several key vitamins and nutrients. He suggested Dennis try IV infusion therapy, which Johnson Medical Center recently added to its regimen of treatment options.

“Dr. Johnson took some extra time and explained IV infusion therapy and the benefits of receiving vitamins and other nutrients through an IV,” Dennis states.

With IV (intravenous) therapy, medications, vitamins, nutrients or other liquids are given through a tube inserted into a vein. With IV infusion, delivery occurs over time using a controlled drip. IV push uses a rapid injection from a syringe that is inserted into the tube.

“I figured I’d give infusion therapy a shot because I’ve always been told that when you take vitamins as pills only a small percentage gets absorbed into your body,” Dennis recalls. “I thought this would be much more effective.”

Dennis is right. Only 30 percent of vitamins taken as pills are absorbed, whereas 100 percent of the vitamins delivered through IV infusion reach the bloodstream.

Johnson Medical Center offers several generic IV mixtures, or cocktails, as well as custom blends of vitamins and minerals to address each patient’s specific health issues.

Glutathione Links

Infusion therapy at Johnson Medical Center is designed to replenish depleted nutrients, such as vitamins, antioxidants and amino acids, thereby restoring health and well-being.

One nutrient that is available with IV therapy is glutathione, known as the master antioxidant. Increased levels of glutathione (pronounced gloota-THIGH-own) in the bloodstream have been linked to a decreased risk of many serious disorders.

“Glutathione is like a miracle nutrient,” reports Dr. Johnson. “It has been shown to help fight different types of cancer, viral infections, asthma, allergies and rheumatoid arthritis. There are also cardiovascular conditions helped by glutathione, including atherosclerosis, angina, hypertension and stroke.”

Thyroid and pancreatic function can be improved as well. These organs contribute to diabetes and hypothyroidism. Other disorders that can be affected by higher glutathione levels include inflammatory skin conditions, chronic fatigue, COPD (chronic obstructive pulmonary disease) and gastric ulcers.

“This super antioxidant also helps with neurologic and brain issues, including Parkinson’s disease, Alzheimer’s disease, migraine headaches and depression,” Dr. Johnson adds. “In addition, it has been shown to improve arthritic joints.”

With or without glutathione, Johnson Medical Center infusions have many benefits. That’s particularly true in Florida, where summer poses a special threat. With the high heat and humidity, it’s easy for Floridians to become dehydrated, especially during outdoor activity. Signs of dehydration include increased thirst, dry mouth and skin, decreased urine output, headaches and dizziness. IV therapy can quickly bring the body back into balance.

“Many people don’t realize they’re not drinking enough water, and that has everything to do with mental clarity, healthy organs and good skin,” notes Dr. Johnson. “With an IV infusion, people receive substantial fluids. The fluids rehydrate them and instantaneously perk them up, clearing the mind and replenishing the organs and skin.”

Dehydration can sap the body of critical fluids and nutrients. The same is true of certain medications.

“Many medications, including some for high cholesterol, hypertension and pain, can deplete the body of vitamins, minerals and antioxidants,” observes Dr. Johnson. “These medicines actually consume some of the vitamins and minerals people are putting into their bodies.

“But when vitamins are taken orally, they’ve got to make their way through the gastrointestinal system, where much of them are lost. IV infusion therapy bypasses that by putting the nutrients directly into the vein. This way, clients get hydration from the fluids and every bit of the needed vitamins.”

Dr. Johnson notes that people respond differently to IV therapy. Some feel results immediately while others – including Dennis – need two or three treatments before experiencing significant improvement.

“It was after the third treatment that I started to notice a difference, and it was huge,” Dennis confirms. “I thought, Wow, this really works. I feel great. The infusions gave me a big boost in energy, and I could definitely tell that something positive was happening.

“I’ve been doing IV infusion therapy for several months, and my energy level is much higher, and my awareness is much better. The bottom line is, I feel a whole lot better than I did before. Thanks to IV infusion therapy, I feel like I’m on top of my game again.”

Continuing IV Therapy

As Dennis completed more treatments, he began to appreciate their many benefits to his physical health and state of mind. He even realized a benefit he never expected.

“I used to get stressed out pretty easily, especially if things at work weren’t going well or there was a problem,” Dennis offers. “But now, I’m handling those situations much better. I feel like I’m more focused as well.

“And my skin looks better. I was surprised by that, but I’ve had a lot of people tell me that I look better than I did before. I honestly believe that has something to do with the cocktail of vitamins I’ve been receiving through Dr. Johnson’s IV infusion therapy.”

Dennis is so happy with the results that he plans to continue receiving regular infusions. At the same time, the staff at Johnson Medical Center will continue to monitor the vitamin and nutrient levels in his bloodstream.

“I had bloodwork done a couple of weeks ago, and it showed I was lacking some nutrients,” Dennis explains. “In response to that, the staff at Johnson Medical Center simply adjusted my therapy to ensure I was getting everything needed. It’s that simple.

“And I want to say that everyone at Johnson Medical Center is great. They’re all good people and they are genuinely concerned about your well-being. I enjoy going to the clinic, and I have no problems when I make appointments.

“I recommend IV infusion therapy and Johnson Medical Center to anybody.”

© FHCN staff article. mkb
* Patient’s name changed at his request

The thyroid is a small, butterfly-shaped gland measuring about 2 inches across at the base of the neck. Its sides, or lobes, lie on either side of the windpipe and are connected by a strip of tissue called an isthmus. The thyroid manufactures hormones that control metabolism, the process by which the body changes food and drink into energy.

The two main hormones produced by the thyroid are triiodothyronine (T3) and thyroxine (T4). These tell cells how much energy to use to function optimally. When the thyroid is healthy, it maintains a proper balance of T3 and T4 to keep metabolism working at the correct rate.

The amount of T3 and T4 produced is regulated by two other glands: the pituitary and hypothalamus. The pituitary gland, located at the base of the brain, is often called the “master gland” because it controls the activities of many other glands. It creates thyroid-stimulating hormone (TSH), which signals the thyroid to produce and release more or less T3 and T4.

The pituitary responds to signals from the hypothalamus, located in the brain just above the pituitary gland. The hypothalamus releases thyrotropin-releasing hormone (TRH), which controls how much TSH the pituitary releases.

Hyperthyroidism, or overactive thyroid, occurs when the thyroid makes too much T3 and T4. Hypothyroidism, of underactive thyroid, happens when there is not enough T3 or T4.

Hyperthyroidism affects between 1 and 3 percent of the US population and is more common in women. The most common cause of overactive thyroid is Graves’ disease, an autoimmune disorder in which the immune system mistakenly attacks the thyroid. Nodules on the thyroid can also cause it to be overactive.

Symptoms of hyperthyroidism include racing heart rate, restlessness, irritability, increased sweating, anxiety, trouble sleeping, thin skin, brittle hair and nails, muscle weakness, weight loss, increased appetite, frequent bowel movements and bulging eyes (common with Graves’ disease).

Diagnosing overactive thyroid typically involves blood tests that measure the levels of thyroid hormones and TSH. The doctor may give radioactive iodine and measure how much the tnyroid absorbs. The thyroid uses iodine to make hormones. If the thyroid absorbs a lot of the radioactive iodine, it’s likely overactive.

Doctors may also use an ultrasound, an imaging test that sends high-frequency sound waves through body tissues. The echoes that are created are turned into video or photographic images.

The goal of treatment for hyperthyroidism is to destroy the thyroid or block it from making its hormones. This may be done using antithyroid medications; radioiodine therapy, in which a large dose of radioactive iodine damages the thyroid; or surgery to remove part or all of the thyroid.

With hypothyroidism, the thyroid cannot produce a sufficient amount of T3 and T4. This can cause metabolism to slow down. Underactive thyroid is often caused by a condition called Hashimoto’s thyroiditis, an autoimmune disorder causing inflammation of the thyroid, surgery that removed the thyroid or damage caused by radiation treatment.

Hypothyroidism signs and symptoms include fatigue; increased sensitivity to cold; constipation; dry skin; weight gain; muscle aches, tenderness or stiffness; pain, stiffness or swelling in joints; thinning hair; slow heart rate; depression; puffy face; and horse voice.

To diagnose underactive thyroid, a doctor will perform a complete physical exam and history of symptoms. Blood tests are used to measure levels of T4 and TSH.

Treatment for hypothyroidism is hormone replacement therapy with a synthetic version of the thyroid hormones. This treatment usually involves taking the medication levothyroxine.

January is National Thyroid Awareness Month. Celebrate it by giving some thought to your thyroid.

Patti DiPanfilo

Glaucoma refers to a group of progressive eye diseases that cause vision loss by damaging the optic nerve in the back of the eye. The optic nerve is a bundle of more than 1 million nerve fibers that carry messages from the retina, where light is converted into nerve impulses to the brain. The brain interprets the impulses as visual images.

January is National Glaucoma Awareness Month. Let’s learn more about glaucoma, which affects about 3 million Americans and 80 million people worldwide. It is the second leading cause of blindness in the world, behind cataracts.

One of the main risk factors for glaucoma is increased pressure in the eyes, or intraocular pressure (IOP). High IOP damages optic nerve fibers, leading to vision loss. IOP increases when the fluid that bathes and nourishes the front of the eye, called aqueous humor, cannot drain as fast as it is created and builds up.

Fluid drains through an area called the drainage angle, located where the colored part of the eye (iris) meets the white covering over the eye (sclera). One of the main structures of the drainage angle is the trabecular meshwork, which plays an important role in draining aqueous humor from the eye and maintaining a consistent IOP.

In addition to high IOP, other risk factors for glaucoma include being older (it is more common in people ages 60 and older), being African American or Latino, having a family history of glaucoma, having diabetes (people with diabetes are twice as likely to develop glaucoma), being very nearsighted or farsighted, using corticosteroids long-term and having a thin cornea.

Anyone with a risk factor should see an eye doctor for an annual exam.

There are two main types of glaucoma:

• Open-angle glaucoma is the most common, affecting up to 90 percent of Americans with glaucoma. It develops when tiny deposits build up in the eye’s drainage canals and slowly clogs them so fluid cannot drain efficiently. It typically has no symptoms early on. As the disease progresses, peripheral (side) vision may diminish. Because the disease can get to that point without symptoms, it is often called the “silent thief of sight.”

• Angle-closure glaucoma occurs when the iris is too close to the eye’s drainage angle. It can block the drainage angle so fluid cannot drain and IOP increases. If the angle gets completely blocked, IOP increases rapidly and causes symptoms. This is called acute angle-closure glaucoma. Signs of an attack include sudden blurry vision, severe eye pain, eye redness, headache, nausea, vomiting and rainbow-colored halos around lights.

Acute angle-closure glaucoma is a medical emergency. Anyone experiencing one of these symptoms should seek help immediately.

Because it causes no symptoms early on, it is possible to have glaucoma and not know it. So, routine eye exams are important to catch glaucoma before it can severely damage the optic nerve.

A doctor may perform one or more tests to check for glaucoma. These include a dilated eye exam to view the optic nerve, a gonioscopy to examine the drainage angle, tonometry to measure IOP, optical coherence tomography (OTC) to look for changes in the optic nerve that may indicate glaucoma, a visual acuity test (eye chart test) to check for vision loss and a visual field test to check peripheral vision.

If you have glaucoma, it is important to start treatment right away. A person cannot regain any vision already lost, but treatment can help slow the progression of the disease and reduce the risk of additional vision loss. To treat glaucoma, doctors typically use medications, laser procedures or surgery.

The most common medications for glaucoma are prescription eyedrops. These work by decreasing the production of aqueous humor or increasing its flow out of the eye. More than one eyedrop may be prescribed to control IOP.

The doctor may use a laser to help fluid drain from the eye. Lasers can be used to treat open-angle and angle-closure glaucoma. A laser can open the drainage angle, make a tiny hole in the iris to let the fluid flow more freely and treat areas in the eye’s middle layer to lower fluid production.

If eyedrops and laser treatments don’t lower IOP, the doctor may suggest surgery. There are several procedures that can help drain the fluid, including trabeculectomy microsurgery, in which the doctor creates a new drainage channel.

Minimally invasive glaucoma surgery (MIGS) makes tiny openings in the trabecular meshwork and places tiny devices, such as stents and microshunts, to help drain fluid. MIGS is most often performed as an add-on procedure after cataract surgery.

Now that you’ve had a glimpse at glaucoma, share what you’ve learned this National Glaucoma Awareness Month.

Patti DiPanfilo

National Blood Donor Month has been observed every January since 1970. It serves as a yearly reminder of the need for blood donations. According to the American Red Cross, someone in the US needs blood every two seconds. If you donate blood you can save a life, or several lives if your blood is separated into its components: red blood cells, platelets and plasma.

Some facts and stats about blood needs and blood supply, from the Red Cross:

• Approximately 29,000 units of red blood cells are needed every day in the US.
• Nearly 5,000 units of platelets and 6,500 units of plasma are needed every day in the US.
• Nearly 16 million blood components are transfused each year in this country.
• A person injured in a motor vehicle crash can require as many as 100 units of blood.
• Blood and its components cannot be manufactured. They can only be obtained from donors.
• Only 3 percent of eligible Americans donate, an estimated 6.8 million.
• In this country, 13.6 million units of whole blood and red blood cells are collected in a year.

People with certain disorders, such as hemophilia and sickle cell disease, can require routine blood transfusions. Many of the estimated 1.9 million people who will develop cancer this year will need blood, sometimes daily, during chemotherapy treatment. Many people undergoing major surgery and those experiencing complications of childbirth will require blood as well.

The need for blood is great; so is the need for increasing the number of donors. Donating is easy, safe and only takes about an hour. Here’s what to expect.

In Florida, a donor must be in general good health and feeling well on donation day, be at least 17 years old (16 with parental consent) and weigh at least 110 pounds.

When arriving at the donation site, the volunteer will sign in, show ID and complete the registration paperwork, which includes general information such as name, address and phone number. The volunteer will also be asked to read important information about blood donation.

The next step is a medical history and mini-physical. An employee of the donation site will ask questions about health history, travel history and medications. The employee will also take a pulse, blood pressure, temperature and a small sample of blood for testing. These measures must all fall within established limits for to continue.

After passing the mini-physical, the donor will be directed to the donation area and instructed to lie on a table or cot. A phlebotomist (an employee trained to draw blood) will disinfect the arm and insert the needle. The typical donation is 1 pint, or unit, of blood. The donation itself takes about 8 to 10 minutes.

Afterward, the donor will be offered snacks and a drink to help the body get back to normal after losing the fluids during blood donation. It is recommended that the volunteer stay least 10 minutes to be sure there is no dizziness and enough strength to continue daily activities.

The donor should avoid alcoholic beverages for 24 to 48 hour after giving blood. Also, no workouts or hard physical activity for 24 hours after donating. If there is bleeding from the donation site, raise an arm and apply pressure to the spot for a few minutes. If the area bruises, place ice on it. Wait 56 days before donating again.

My donation site, and most others, makes the results of my mini-physical available to me on a secure website a day or two after my donation. The results include my cholesterol level, which my doctor and I are keeping an eye on because it tends to run high. This is another advantage of blood donation.

Patti DiPanfilo

Happy New Year! Let’s start off 2023 by delving right into a January health observance: Cervical Health Awareness Month. This observance was created to encourage women to be more attentive to their cervical health and also to learn more about some of the disorders that can affect the cervix. We’ll describe three of those disorders in this blog.

The cervix is the lower, narrow end of the uterus (womb) that forms a canal between the uterus and the vagina, the tube-like organ that serves as a passageway out of the body. Common disorders of the cervix include cervicitis, cervical stenosis and cervical cancer.

Cervicitis is inflammation of the cervix. It may be caused by a sexually transmitted infection (STI) such as gonorrhea, chlamydia, herpes or trichomoniasis. These STIs are typically passed through vaginal, anal or oral sex. Cervicitis can also be caused by irritation of the cervix from contact with the spermicides or latex in condoms, as well as with douches, tampons and diaphragms.

In many cases, cervicitis has no symptoms. When symptoms are present, they may include vaginal discharge that contains pus, pain or bleeding during sex, and vulvar or vaginal irritation. Cervicitis is very common. It has been estimated that more than half of all adult women will have the disorder at some point in their lives.

The best way to detect cervicitis is to see a health care provider for routine pelvic exams and Pap tests. The provider may also test for STIs. Treatment for cervicitis typically involves antibiotics. Treating sexual partners may also be recommended. Cervicitis can’t always be prevented, but the risk for getting STIs can be reduced by using a condom.

With cervical stenosis, the passageway through the cervix is very narrow or closed. It often causes no symptoms, but it may cause menstrual abnormalities. These may include amenorrhea (no periods), dysmenorrhea (painful periods) and abnormal bleeding. Cervical stenosis may also result in infertility because sperm cannot get through the narrowed cervix to fertilize the egg.

Cervical stenosis is often the result of another disorder or condition. Common causes include cancer of the cervix or lining of the uterus (endometrial cancer), previous procedures on the cervix or uterus, radiation treatment, endometriosis, and cysts or abnormal growths on the cervix.

If symptoms are present, a doctor will likely order tests to rule out cancer. These tests may include a Pap or HPV test and an endometrial biopsy. But before these tests, the doctor will likely perform a dilation and curettage (D&C) to widen the cervix. This way, the doctor can access the cervix to take samples of the cells for testing.

Treatment for cervical stenosis typically involves widening the cervix by inserting small, lubricated metal rods in progressively larger sizes. In an attempt to keep the cervix open, the doctor may place a tiny tube, called a stent, in the cervix for four to six weeks.

There are no known steps for preventing cervical stenosis.

Cervical cancer is a disease in which the cells of the cervix become abnormal and grow out of control. Small changes that occur in the DNA of the cells tell them to multiple excessively, and those extra cells accumulate into masses, or tumors.

Approximately 14,000 Americans are diagnosed with cervical cancer each year, and around 4,000 die. It is most frequently diagnosed in patients ages 35 to 44. Almost all cervical cancers are caused by the human papillomavirus (HPV), a common virus that is spread through sexual contact including anal, oral and vaginal sex.

Early stages of cervical cancer often have no symptoms. When it has advanced, it may cause watery or bloody discharge from the vagina that has a bad smell, or vaginal bleeding after sex, between periods or after menopause. Menstrual periods may be heavier and last longer than normal.

Routine gynecological screenings with a pelvic exam and a Pap test can detect most cases of cervical cancer. The doctor may also order an HPV test to look for signs of HPV infection. The treatments typically used for cervical cancer include radiation therapy, chemotherapy, surgery, targeted therapy and immunotherapy.

There are some steps to can take to help prevent cervical cancer. See a doctor for regular pelvic exams and Pap tests, use condoms during sex, and limit sexual partners. If eligible, consider getting vaccinated against HPV.

Patti DiPanfilo

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. Let’s 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

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

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