Blog Posts

A Look at Lupus

May 17th, 2021

Lupus is a chronic autoimmune disease in which your body’s immune system, which fights infection from germs such as bacteria and viruses, becomes overactive and attacks normal, healthy tissue instead. It is a complicated disorder that affects different people in different ways. Due to its complex nature, people sometimes call lupus the “disease of 1,000 faces.

There are different types of lupus including systemic lupus erythematosus, or SLE, which is the most common type, SLE causes inflammation of the connective tissues, such as cartilage and the lining of blood vessels, but can involve many organs and systems as well. These include the skin, joints, kidneys, lungs, central nervous system and blood-forming system.

Cutaneous lupus is a form of lupus that is limited to the skin. Drug-induced lupus is a lupus-like disease caused by an overreaction to certain medications, including some drugs used to treat high blood pressure, arrhythmia and tuberculosis. Symptoms typically go away once you stop taking the medication.

Most pregnant women with lupus will have healthy babies. However, around 1 percent of women with autoantibodies related to lupus will have a baby with neonatal lupus. Autoantibodies are immune system proteins that target and react to your own organs and tissues by mistake. Most problems associated with neonatal lupus resolve within six months, but the most serious complication, congenital heart block, requires a pacemaker.

The exact cause of lupus is unclear, but it is more common in people with a family history of the disease. Researchers think it may develop in response to certain hormones, such as estrogen. The fact that nine out of 10 people with lupus are women seems to support that theory, but more research is needed. Most experts believe that lupus is caused by a combination of genetic, hormonal and environmental factors.

Lupus can cause inflammation and pain in many parts of the body and often damages the skin, joints, kidneys, blood, heart and lungs. Because it affects so many areas of the body, lupus can cause a wide range of symptoms.

Common signs and symptoms of lupus include: fatigue; pain or swelling in your joints; swelling in your hands, feet or around your eyes; fever; sensitivity to sunlight or fluorescent light; and chest pain with deep breathing. If your skin and hair are involved, you may have a butterfly-shaped rash on your cheeks and nose, called a malar rash; hair loss; sores in your mouth or nose; and Reynaud’s disease, the discoloration of your fingers and toes in response to stress or cold.

Diagnosing lupus can be challenging because other disorders have similar symptoms. Your doctor will begin with an in-depth medical history and physical examination. There is no single test that can determine if you have lupus, but your doctor may start with blood tests, which can show how your immune system is working and if there’s inflammation in your body. The most useful blood tests look for the autoantibodies that are present in people with lupus.

Urine tests may also be used to see if there’re any problems with your kidneys, and a biopsy may be taken of your skin or kidneys to see if they are damaged, which can be caused by lupus.

Your doctor will look at the entire picture — medical history, symptoms and test results — to determine if you have lupus.

There are potential complications associated with lupus. These include inflammation of the heart (myocarditis and endocarditis) or the membrane that surrounds it (pericarditis). Endocarditis can damage the heart valves and cause heart murmurs. The kidneys can also become inflamed (nephritis), making then unable to effectively rid the body of waste products and toxins.

If you have lupus, you are at high risk for diabetes and pleuritis, an inflammation of the chest cavity lining. You may also be susceptible to pneumonia. Autoimmune disorders such as lupus can contribute to inflammation of the spinal cord (transverse myelitis) and blood vessels (vasculitis). It also increases your risk for atherosclerosis, which contributes to heart attack.

Currently, there is no cure for lupus, but people who have the disease can generally manage their symptoms with treatment, which includes medication. Medications can reduce pain and swelling, regulate immune system activity, balance hormones and reduce or prevent joint and organ damage.

Several types of medications are used to treat lupus. Nonsteroidal anti-inflammatory drugs (NSAIDS) decrease inflammation and are often used to treat joint or chest pain, fever and swelling. Corticosteroids act like the hormone cortisol to help regulate blood pressure and the immune system. Cortisol is also a powerful anti-inflammatory.

Antimalarial medications are often prescribed to treat skin rashes, mouth sores and joint pain. Immunosuppressants are used to control inflammation and an overactive immune system. They are especially useful when corticosteroids have failed to bring symptoms under control. Other drugs are used as well, and clinical trials are ongoing that are studying even more treatments.

The medication therapies that are currently available make it possible for people with lupus to effectively manage their symptoms and live active, healthy lives. Researchers hope that through their work, they’ll be able to identify lupus at an earlier stage, so complications can be prevented before they occur.

Improving Employee Health

May 10th, 2021

In 1979, the President’s Council on Physical Fitness, Sports and Nutrition founded the National Association for Health and Fitness, which in turn created Global Employee Health and Fitness Month. The aim of this annual observance in May is to promote the benefits of a healthy lifestyle to employers and their employees through worksite health promotion activities and environments.

Almost half of all US worksites provide health promotion activities through some type of employee wellness program, an initiative within the organization that fosters healthy lifestyles among its employees. Employee wellness programs vary in the types of services and activities offered, but in the long run, they all appear to benefit the employees – and the employers.

What’s included in a company’s employee wellness program generally depends on the size of the organization, its budget for wellness initiatives and which activities make the most sense for its employee population. The most successful programs address multiple dimensions of employee wellbeing, including their physical, emotional, social, occupational and financial wellbeing.

To help improve employee wellbeing across all dimensions, companies can employ a wide variety of solutions. These may include: health risk assessments, fitness classes or gym reimbursement, health coaching, health education, flu shots, financial counseling/planning, flexible work schedules, free health food, health fairs, on-site/near-site health clinics, telemedicine, tobacco cessation, weight management and wellness challenges.

In many cases, the benefits of providing an employee wellness program outweigh the cost of providing the program. Employees spend most of their time at work, so linking their wellness goals with an overall work-life balance can positively impact the company’s bottom line business outcomes.

For one thing, employee wellness programs lower the employees’ elevated health risks, such as high blood pressure and high cholesterol, which can lead to heart disease and stroke. Managing risk translates into improved overall health. This ultimately reduces use of medical services and lowers medical costs to the employee and employer.

In addition, organizations with good wellness programs can experience reduced absenteeism for a number of reasons. Employees with good general health typically don’t miss work. Employees who can manage stress well have lower absenteeism. Employees with normal blood pressure, cholesterol and glucose are less likely to miss work, and those who are not overweight or obese are less likely to get sick and miss work.

Poor employee productivity at work is called presenteeism. That’s when you’re at work but not really working, and it’s been linked to poor health. Employee wellness programs that impact employee lifestyles and improve health eliminate presenteeism and increase employee productivity. These programs also help to retain and recruit employees to the company, as many workers today look for factors beyond salary when choosing an employer.

Not so fast! Researchers reported conflicting results in a study published in the April 2019 edition of JAMA. In their study, researchers analyzed data from 160 worksites employing nearly 33,000 people. About 10 percent of the employers in the study offered wellness programs that addressed topics such as exercise, nutrition and stress.

The researchers compared employees with and without access to a wellness program over 18 months and discovered that those who had access to a wellness program reported significantly higher rates of exercise and weight management efforts.

BUT, those with and without wellness programs had similar self-reported health behaviors and outcomes; similar results on 10 heath measures, including blood pressure, cholesterol and body mass index; similar use of medical resources; and similar absenteeism and job performance.

So what’s the bottom line when it comes to employee wellness programs? Do they work or don’t they? It’s clear more research is needed to determine the true effectiveness and benefit of these programs. For example, a study lasting longer than 18 months might yield much different results.

If you started exercising more, lost weight, quit smoking and/or began eating healthier because of what you learned though an employee wellness program, you’ll definitely reap benefits that will positively impact your overall health. That’s the true bottom line.

Minding Mental Health

May 3rd, 2021

May is a great month! Spring is in full bloom (which isn’t entirely GOOD news for those of us with allergies), and it’s a time to celebrate our very special Moms. There’s another tradition we observe in May. It’s the time we become more aware of mental health and mental illness. Mental illness is a huge issue, and there’s still a lot of misinformation about it in our popular culture.

The American Psychiatric Association defines mental illness as “any health condition involving changes in thinking, emotion or behavior (or a combination of these). Mental illness is associated with distress and/or problems functioning in social, work or family activities.” Still, the majority of people with mental illness continue to function in their daily lives despite their illness.

Almost everyone is touched in some way by mental illness. It affects one in five adults, nearly 47 million Americans. And of those, 11 million are living with serious mental illness, one that limits major life activities. Serious mental illnesses include disorders such as major depression, bipolar disorder and schizophrenia.

In addition, 14.8 million people in the US have an alcohol use disorder and 8.1 million have an illegal drug disorder. Further, 2 million Americans have an opioid disorder, which includes prescription pain reliever and/or heroin abuse.

Why are so many people affected by mental illness? The exact cause of mental illness is unknown, but researchers have uncovered a few factors that may contribute to its development. One is genetics. Many mental illnesses run in families, suggesting people inherit at least a susceptibility to developing a particular illness.

An imbalance of brain chemicals called neurotransmitters has been linked to some types of mental illness as well. These chemicals help your brain cells communicate with each other. If they can’t communicate properly because the chemicals are out of whack, clear messages can’t get through the brain.

Another contributing factor is psychological trauma such as severe physical, emotional or sexual abuse endured as a child, witnessing a traumatic event or experiencing significant loss. Environmental factors can also contribute. These include the death of someone close to you, a divorce or a big change in your life, such as a new job. These factors often foster substance abuse.

Whatever the cause, mental illness is just that, an ILLNESS, not a weakness in your character.

Mental illness runs the gamut, from mild depression to psychotic schizophrenia. Each illness has its own set of symptoms, but I’m giving you a few general signs and symptoms so you know what to watch out for, in yourself and others. These are some of the common signs and symptoms of mental illness:

• Sleep or appetite changes
• Mood changes
• Withdrawal and loss of interest in activities
• Problems thinking
• Decrease in functioning
• Illogical thinking
• Nervousness
• Unusual behavior

If you notice these symptoms and are willing to get help, consult a qualified mental health professional. These providers understand mental illness and can recommend the best course of treatment for you. If you ever feel like hurting yourself or others, call your local crisis hotline or 911.

There is no medical test for diagnosing mental illness, but your doctor may use tests to rule out a medical reason for your symptoms. To make a diagnosis, your mental health professional will follow the guidelines outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), published by the American Psychiatric Association.

The DSM-5 lists criteria including feelings, symptoms and behaviors over a period of time that you must meet in order to be officially diagnosed with a mental illness. The mental health professional gleans this information through interviews with you about your symptom history.

Many people with mental illness achieve strength and recovery through participating in individual or group treatment. The specific treatment chosen for you is based on the type of mental illness you have and the severity of your symptoms.

The most common methods of treatment are medication and psychotherapy, or a combination of both. Other options that may be considered including hospitalization, day treatment, group therapy and specific therapy such as cognitive behavioral therapy.

Medications don’t cure mental illness but they can control symptoms, and your doctor may use one or more types of medication to treat you. Common psychiatric medications for treating mental illness include antidepressants, anti-anxiety medications, mood-stabilizing medications and anti-psychotic medications.

Psychotherapy, or talk therapy, aims to help you identify and change troubling emotions, thoughts and behaviors. It provides a supportive environment that allows you to talk openly about your feelings, as well as your experiences and relationships, which may be contributing factors to your condition.

In most cases, treatment is effective, but you’ve got to be compliant. If you’re prescribed medication, take it. If it causes intolerable side effects, tell your doctor. Maybe you can try another drug. Psychotherapy helps more than you might think, but you’ve got to participate. Treatment may take time to work, but if you comply, you’ll likely feel better and function fully.

Soothing An Irritable Bowel

April 26th, 2021

Irritable bowel syndrome, or IBS, is a syndrome, a set of symptoms that occur together and are associated with a particular abnormality or condition. The most common symptoms of IBS, which affects your large intestine, or colon, include abdominal pain, cramping, bloating and gas, and a change in bowel habits.

There are three types of IBS. One is IBS with constipation (IBS-C). With IBS-C, it may be difficult to move your bowels. You may not move your bowels often, and you may feel an urge to move your bowels but can’t. With IBS with diarrhea (IBS-D), another type, you may frequently have loose stools, feel an urgent need to move your bowels and have cramps or belly pain.

A third type is IBS with mixed bowel habits (IBS-M), which is characterized by symptoms of both IBS-C and IBS-D. With IBS-M, you may have both hard and lumpy bowel movements and loose and watery ones on the same day.

It’s important for your health care provider to determine which type you have because certain medicines work well on one type but can make the symptoms of another type worse. Your provider may diagnose IBS even if you don’t fit neatly into one of these types. Many people have normal bowel movements on some days and abnormal bowel movements on other days.

The exact cause of IBS is unknown, but researchers believe that a combination of factors may lead to its development. Different factors may lead to IBS in different people.

We do know that IBS is a functional gastrointestinal disorder, which leads to problems with how your brain and GI system work together. These problems cause your digestive tract to be very sensitive and change how your bowel muscles contract. Symptoms of IBS, including abdominal pain, diarrhea, and constipation occur as a result.

In addition, several risk factors for IBS have been identified. You may be at a higher risk if you have a family history of IBS; suffer with emotional stress, depression, or anxiety; have food intolerances; experienced difficult early life events, such as physical or sexual abuse; have a severe infection in your digestive system; or have an overgrowth or change in the bacteria in your small intestine.

Further, research suggests that genes may make some people more likely to develop IBS.

IBS doesn’t lead to other GI conditions, such as inflammatory bowel disease or cancer, but its symptoms can be uncomfortable enough to interrupt your daily life. If you suffer with the symptoms of IBS, don’t wait to see your health care provider.

To diagnose IBS, your provider will review your symptoms, looking for a pattern that suggests IBS. The provider will also review your personal and family history, and perform a thorough physical exam. During the exam, your provider usually checks for abdominal bloating, listens to sounds within your belly and taps on your abdomen to check for tenderness and pain.

Your provider may use blood tests, stool samples, and x-rays to help rule out other diseases that have symptoms similar to those of IBS. Depending on your symptoms, medical history, and other factors, your provider may recommend a flexible sigmoidoscopy or colonoscopy to get a detailed look at your colon. These tests are typically done to rule out more serious diseases of the colon.

There is no cure for IBS. Treatment is directed at relieving symptoms. For many people with IBS, the key to managing symptoms is to avoid those things that trigger them. Triggers may be certain foods or even stress and anxiety. It may help to keep a “food diary” for a while to learn which foods trigger symptom flare-ups for you.

Your provider will design a treatment plan that suits your specific needs, but typical treatment options include dietary and lifestyle changes. Dietary changes may include: avoiding caffeine (it stimulates the intestines), increasing fiber in your diet, limiting cheese and milk (be sure to get calcium from other sources), avoiding deep-fried and spicy foods, and drinking plenty of water. A nutritionist can help you plan a healthy diet that meets your needs.

Lifestyle changes include: exercising regularly, quitting smoking, using relaxation techniques to de-stress, and eating smaller meals more often. If your symptoms don’t improve with these dietary and lifestyle changes, your provider may recommend medication.

Specific medications are used to treat the constipation of IBS-C and the diarrhea of IBS-D. Your provider may prescribe antidepressant medications if you have depression and anxiety along with intense abdominal pain. Probiotics, which are “good bacteria,” may be used to help improve your IBS symptoms.

Because we don’t know what causes IBS, you can’t do anything to prevent it. But if you have IBS, you can prevent symptom flare-ups by learning your triggers it and avoiding them. Living with IBS can be challenging, but if you follow your provider’s treatment plan, you can manage it and live a healthy life.

You Can Defeat Diabetes

April 19th, 2021

The cells in your body need a steady source of energy to function. They get it from a simple sugar called glucose that is released when the food you eat is broken down. But glucose can’t get into your cells on its own. It needs the help of insulin, a hormone produced by the beta cells of your pancreas.

Diabetes is a chronic metabolic disease that develops when your pancreas doesn’t produce insulin or your body can’t use insulin efficiently, a condition called insulin resistance. Without insulin, glucose builds up in your bloodstream and your cells are starved of the energy they need to survive. This can lead to complications with your eyes, heart, kidneys and nerves. In severe cases, it can lead to coma and death.

The National Diabetes Statistics Report 2020, released by the CDC’s Division of Diabetes Translation, revealed that 34.2 million Americans – just over 1 in 10 – have diabetes. Another 88 million – approximately 1 in 3 American adults – have prediabetes, a condition in which your blood glucose level is high but not high enough for a diagnosis of diabetes. More than 84 percent of people with prediabetes don’t know they have it.

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

With type 1 diabetes, your pancreas doesn’t produce insulin because your immune system mistakenly attacks and destroys its beta cells. People with this type must take supplemental insulin every day. Type 1 is typically diagnosed in children, adolescents and young adults, but can occur at any age. About 5 to 10 percent of people with diabetes have type 1.

Gestational diabetes develops during pregnancy. It affects up to 10 percent of pregnant women in the US each year. With gestational diabetes, the placenta — which provides oxygen and nutrients for the growing baby – produces hormones that block the action of the mother’s insulin. It can lead to complications for the mother and baby.

In many cases, gestational diabetes can be treated effectively with diet and exercise alone. But in other cases, the mother must take oral diabetes medications or insulin injections to stabilize her blood glucose levels. Gestational diabetes typically resolves after the mother gives birth, but she is at a higher risk for developing type 2 diabetes later in life.

Type 2 diabetes is the most common type, affecting 90 to 95 percent of people with diabetes. It is typically diagnosed in people 45 years old and older and is characterized by insulin resistance. This type is caused by a combination of genetic and environmental factors. You are at a higher risk for type 2 diabetes if you have a family history of diabetes, are overweight or obese, are physically inactive or have prediabetes.

Symptoms of type 2 diabetes include: increased hunger or thirst, frequent urination, weight loss, blurry vision, extreme fatigue and sores that are slow to heal. The diagnosis is generally made using a fasting plasma glucose (FPG) test, A1C test or random plasma glucose (RPG) test. These tests measure the level of glucose in your blood. A consistently high level indicates diabetes.

Treatment for type 2 diabetes begins with lifestyle changes. These include eating a healthy diet full of fruits and vegetables, whole grains and lean protein such as poultry and fish. You should also avoid saturated and trans fats, exercise regularly, maintain a healthy weight and stop smoking. If lifestyle changes aren’t enough to lower your glucose level, you may need to take medication or insulin.

By living a healthy lifestyle – eating properly, exercising regularly, not smoking and taking your medication as needed – you can manage your blood glucose and defeat diabetes!

A Sneak Peek at Sarcoidosis

April 12th, 2021

What is sarcoidosis? It’s an inflammatory disease that most often affects your lungs and lymph nodes but can impact any organ in your body, including your eyes, skin and heart. Sarcoidosis is characterized by small clusters of inflamed cells, called granulomas, that form in the affected organ. Granulomas can alter the normal structure of the organ and interfere with its function.

Sarcoidosis affects between 150,000 and 200,000 people in the US and an estimated 1.2 million worldwide. Some people with sarcoidosis experience no signs and symptoms. When symptoms do appear – usually in people between the ages of 20 and 40 – they vary depending on the organ involved.

In many cases, people with sarcoidosis initially present with a classic set of signs and symptoms collectively referred to as Lofgren’s syndrome. Signs and symptoms associated with this syndrome include: fever, enlarged lymph nodes, swollen and painful joints, and a rash – typically found on the shins and ankles – that consists of raised red and tender bumps. This rash is called erythema nodosum.

Other common signs and symptoms of sarcoidosis include but are not limited to: fatigue; weight loss; irregular heartbeat; discoloration of the nose, cheeks, lips and ears; blurry vision; sensitivity to light, headaches; swollen legs; arm, leg or facial weakness; hoarse voice; enlarged liver or spleen; pain in your hands or feet; and a general feeling of ill health.

If your lungs are affected by sarcoidosis, you may experience shortness of breath, dry cough, chest pain or wheezing.

The exact cause of sarcoidosis is unknown. Some experts believe it results from an overreaction by your immune system to a foreign substance. These substances may include infectious agents, chemicals, dust and possibly your body’s own proteins. An immune system reaction causes inflammation. With sarcoidosis, inflamed cells collect and form granulomas.

Certain factors put you at a greater risk for developing sarcoidosis. These risk factors include: age; living or working near insecticides, mold or other substances that cause inflammation; family history of sarcoidosis; race or ethnicity – the condition is more common in people of African and Scandinavian descent; and gender – women are affected more often than men.

Diagnosing sarcoidosis can be challenging because its signs and symptoms are similar to those of other diseases. To make a diagnosis, your doctor will first review your medical history and perform a thorough physical exam. Tests your doctor may use to diagnosis sarcoidosis include: chest x-ray, high resolution CT scan, pulmonary function tests, bronchoscopy with biopsy, PET scan, gallium scan, blood tests, electrocardiogram and slit lamp test to examine your eyes.

In some people, particularly those who experience mild symptoms, sarcoidosis will resolve on its own without treatment. The goal of treatment, when it’s needed, is to reduce symptoms and maintain function of the affected organ.

Treatment of sarcoidosis begins with good health practices. You are encouraged to see your doctor routinely for check-ups, eat a balanced diet that includes plenty of fruits and vegetables, drink eight to 10 8-oz glasses of water daily, exercise regularly and manage your weight, get six to eight hours of sleep per night and quit smoking.

Medication treatment it typically reserved for people experiencing moderate to severe sarcoidosis symptoms. The oral corticosteroid prednisone, which reduces inflammation, is the most commonly used medication. Initially, a relatively high dose of corticosteroids is prescribed. This is followed by a slow tapering of the medication until the lowest effective dose is reached.

Unfortunately, corticosteroids, including prednisone, have side effects such as excessive weight gain, insomnia, acne and depression. Some people taking corticosteroids develop high blood pressure, cataracts, glaucoma, osteoporosis or diabetes. These medications also increase your risk for infection.

Other treatment options may be tried if you can’t take corticosteroids or find their side effects intolerable. For example, medications commonly used to treat arthritis, such as methotrexate and azathioprine, can suppress the inflammatory response of your immune system. These medications may be used in place of or together with corticosteroids. But they can be toxic to your liver, so regular blood tests to check liver function are necessary.

If the granulomas affect the function of an organ, you may develop complications, including permanent damage to your heart or lungs due to scarring of the tissue. So it’s important to visit your doctor as soon as you notice the signs and symptoms of sarcoidosis.

Autism Answers

April 5th, 2021

Autism, or more correctly autism spectrum disorder (ASD), is a complex developmental condition. Typically, people who have ASD face persistent challenges with communication and social interaction, and often perform repetitive behaviors. ASD is considered a “developmental disorder” because symptoms generally appear in the first two years of life.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the book of standards for diagnosing a host of conditions published by the American Psychiatric Association, divides the symptoms of ASD into two categories: problems with communication and social interaction, and problems with restricted or repetitive patterns of behavior or activity.

Problems with communication include having difficulty sharing emotions and interests, and maintaining a back-and-forth conversation. Your child may also struggle with nonverbal communication, such as maintaining eye contact or reading other people’s body language. Difficulties developing and maintaining relationships also fall under this category.

Your child may have ASD if they repeat movements, motions, or speech patterns, or rigidly adhere to a specific routine or behavior. Another symptom is an increase or decrease in sensitivity to a particular sensory input from the environment; for example, reacting strongly to a certain sound. Being fixated or preoccupied with an object or task is also a symptom listed in the DSM-5.

While people with ASD face many challenges, some may also have many strengths. Some people with ASD can learn things in detail and remember information for a long time. They may be strong visual and auditory learners, and be highly skilled in math, science, music, or art.

The exact cause of ASD is unknown, but research suggests there is no single cause. Rather, it’s believed that genetic factors combine with environmental influences to affect development in ways that lead to ASD.

There are certain factors that may increase your child’s risk for developing ASD. The suspected risk factors for autism include: having an immediate family member with the condition; having fragile X syndrome, tuberous sclerosis, or another genetic disorder; being born to older parents; having a low birth weight; having a metabolic imbalance; and being exposed while in the womb to certain medications, such as valproic acid or thalidomide. Multiple sources have concluded that the disorder isn’t caused by vaccines.

Typically, ASD symptoms become clearly evident during early childhood, between 12 and 24 months of age, but symptoms may appear sooner or later. The American Academy of Pediatrics recommends that all children be screened for autism at their 18- and 24-month well-child visits. But if your child is high-risk for ASD, additional screening may be recommended.

The Modified Checklist for Autism in Toddlers (M-CHAT) is a common tool used by many pediatric practitioners to screen for ASD. The M-CHAT is a simple survey that is filled out by the parents. The answers to the survey questions can help the provider determine if additional testing is needed.

A combination of tests may be used to diagnose ASD. These tests often include DNA testing for genetic diseases, behavioral evaluations, occupational therapy screening, and the Autism Diagnostic Observation Schedule (ADOS).

The ADOS uses planned social situations to trigger target responses and interpersonal interactions, which elicit a wide range of verbal, physical, and social exchanges between the tester and the person being tested. The reactions to the situations are given a score. A high overall ADOS score indicates a high degree of impairment due to ASD.

There is no cure for ASD, but research has shown that early intervention treatment services can improve your child’s development. Early intervention may include physical, occupational, and speech therapy to help your child with walking and talking. Additional therapy, such as play therapy, can help your child learn key social skills such as interacting with others.

Those with ASD may be referred to specialists who provide behavioral, psychological, and educational therapy, or skill-building interventions. These therapies, which are typically highly structured and intensive, are designed to reduce challenging behaviors, build skills necessary to live independently, increase strengths, and teach social, communication, and language skills.

If you suspect that your child has ASD or if you’re concerned about the way your child plays, learns, speaks, or acts, contact your child’s doctor and share your concerns. Have your child tested for ASD so a diagnosis can be made and treatment services can be initiated as soon as possible.

Intervene early and help your child with ASD reach their full potential!

Keeping Up With Kidney Health

March 29th, 2021

If you’re like most people, you have two kidneys, the bean-shaped organs about the size of your fist that lie just below the rib cage, one on each side of your spine. March is National Kidney Month, so let’s review what the kidneys do, examine a few common diseases that can affect them, and learn some ways you can help keep them healthy.

Adult and child holding kidney shaped paper, world kidney day, National Organ Donor Day, charity donation concept

The primary job of the kidneys is to filter waste products and excess fluid from your blood, but they perform other functions as well. They also help regulate blood pressure, make red blood cells, control the pH level in your body, and keep your bones healthy. Each of your kidneys is made up of about a million filtering units called nephrons.

But the kidneys are susceptible to damage and disease. The most common condition affecting the kidneys is chronic kidney disease, or CKD. According to the National Kidney Foundation, CKD affects an estimated 37 million people in the US. That’s 15 percent of the adult population, or 1 in 7 individuals. And 90 percent of those who have CKD don’t know they have it.

With CKD, your kidneys become damaged, usually by diabetes or high blood pressure, and can’t function properly. This can cause waste products to build up in your body, which can result in health problems such as anemia and heart disease. Uncontrolled CKD can lead to kidney failure, but early intervention can slow its progression and help preserve kidney function longer.

There are other conditions that can affect the kidneys as well. Glomerulonephritis develops when the tiny clusters of blood vessels in the nephrons called glomeruli become inflamed and damaged due to infection or disease and can’t ’do their job of filtering blood. As a result, your kidneys can’t remove wastes and excess fluid from your body. If it becomes severe, glomerulonephritis can lead to kidney failure.

Polycystic kidney disease, or PKD, is an inherited disorder in which fluid-filled cysts form throughout the kidneys. This causes the kidneys to become enlarged and lose function. In fact, PKD is the fourth leading cause of kidney failure. There may be other health complications as the kidney cysts grow larger, including high blood pressure, anemia, and liver disease.

The kidneys can also be affected by cancer. There are certain factors that increase your risk for kidney cancer, such as being obese or having a family history of the cancer, but it’s caused by inherited or acquired mutations to the genes that control kidney cell growth and reproduction.

These gene mutations cause the kidney cells to grow out of control and form tumors, which interfere with kidney function. Treatment for kidney cancer includes surgery, radiation therapy, immunotherapy, and chemotherapy.

Another kidney condition is kidney stones, which are hard deposits of minerals and salts. Kidney stones generally don’t cause symptoms while they’re forming, but can cause severe pain once they move into the ureter, the tube that connects the kidney to your urinary bladder. If you can’t pass the stones in your urine, you’ll need medical treatment to prevent infection.

There are things you can do to help prevent problems with your kidneys. First of all, it’s essential that you achieve and maintain good control over any chronic conditions that can lead to kidney damage and loss of function. These conditions include diabetes and high blood pressure.

Here are some other tips for maintaining kidney health:

•          Eat a diet that’s good for your entire body, one that’s rich in fruits, vegetables, whole grains, and low-fat or fat-free dairy products, and low in saturated and trans fats, sugar, and salt.

•          Quit smoking.

•          Maintain a healthy weight.

•          Stay active.

•          Get enough sleep. The National Sleep Foundation recommends between 7 and 9 hours of sleep per night.

•          Limit your alcohol intake. Men should have no more than two drinks per day; one drink per day for women.

•          Say well-hydrated. Drink fluids throughout the day.

Further, your doctor may also advise you to reduce your protein intake. Your kidneys must work harder to process the wastes that result from protein breakdown.

Follow these tips to prevent kidney disease and keep your kidneys healthy!

A Brief Overview of Brain Injuries

March 23rd, 2021

March is Brain Injury Awareness Month, and organizations such as the Brain Injury Association of America (BIAA) want you to know more about these dangerous injuries and their aftermath. Here’s a little information to help.

According to the BIAA, injuries to the brain that are not hereditary (passed down in families), congenital (present at birth), degenerative (get worse over time), or caused by birth trauma are considered acquired brain injuries, or ABIs. These injuries involve changes to brain activity that affect the physical integrity, metabolic activity, or functional ability of nerve cells in the brain.

There are many possible causes of ABIs. Electric shock is a typical cause of ABI, as is oxygen deprivation, stroke, seizure disorders, exposure to toxins, trauma, and tumors. Lightning strikes, certain infectious diseases such as pneumococcal and meningococcal meningitis, and substance abuse and overdoses are also common causes of ABIs.

A traumatic brain injury, or TBI, is a type of ABI that occurs when a sudden trauma causes damage to the brain.

The US Centers for Disease Control and Prevention define TBIs as brain injuries “caused by a bump, blow or jolt to the head, or a penetrating head injury that disrupts the normal function of the brain.” TBIs are most often the result of falls, but can also result from being hit by an object, a motor vehicle accident, or an assault.

TBIs are a common occurrence in this country. In fact, every 21 seconds in the US, someone sustains a TBI. According to the CDC, 2.8 million Americans suffer a TBI every year, and more than 56,000 people die as a result of their TBI. These injuries disable six times more people each year than spinal cord injuries, MS, HIV/AIDS, and breast cancer combined.

TBIs range from mild, when there’s a brief alteration in mental status, to severe, when there’s an extended period of unconsciousness and resulting disability. Most TBIs that occur each year are mild, commonly called concussions.

Concussions are caused by an injury, such as a blow to the head, that causes the brain to move rapidly back and forth inside the skull. Some people might sustain a cut or bruise on the face or head, but generally, there are no visible signs of a concussion.

You don’t have to lose consciousness to have a concussion, but many people do. Sometimes, someone with a concussion will look a little dazed and might forget what happened just before the trauma occurred. Most people fully recover, some within a few hours, some need a few weeks.

Concussions have become more common in sports on every level. This may be due to a growing emphasis on the risks for these injuries, especially in contact sports such as football. Fortunately, many coaches and trainers have been taught to recognize symptoms of concussion in their players and participants.

Severe brain injuries are those that cause unconsciousness or coma that generally lasts no more than a few weeks. With a severe brain injury, the person may suffer life-changing and debilitating problems.  Some people will remain in a coma and others will enter a different type of unconscious or minimally conscious state.

People with severe brain injuries rarely recover. Those who do are typically left with  a range of physical and neurological deficits that are difficult to overcome.

Brain injuries that do heal, don’t heal the same way as other injuries such as broken arms or legs. Healing involves a recovery of brain function, and how much and how fast varies. No two brain injuries are alike, so each person’s response to injury and recovery from it are different.

In general, patients with mild brain injuries tend to recover well. There may be minor residual symptoms such as headaches that improve over time. Approximately 60 percent of those with moderate brain injuries make a positive recovery, but an estimated 25 percent are left with a moderate degree of disability.

Only 25 to 33 percent of people with severe brain injuries achieve positive outcomes. About 33 percent do not survive, and the last few percent remain in a persistent vegetative state, in which they wake and sleep but are unconscious of the world around them.

There are a few steps you can take to help reduce the chances of sustaining a traumatic brain injury, including:

•          Drive safely. Buckle-up every time and never drive under the influence of drugs or alcohol.

•          Wear a helmet when riding a motorcycle, bicycle or horse; playing a contact sport; skiing or snowboarding; or inline skating.

•          Evaluate your fall risk. Review your medications with your doctor or pharmacist to identify any that may cause dizziness. Have your eyes examined regularly and update your glasses prescription as needed.

•          Use appropriate protective equipment to make your home and yard safe for children.

Multiply Your MS Knowledge

March 15th, 2021

National MS Education and Awareness Month, observed each year in March, is a nationwide effort by the Multiple Sclerosis Foundation and affiliated groups to raise awareness of multiple sclerosis. This year, we’re joining in that effort by dedicating this blog to a brief overview of MS.

A recent study funded by the National MS Society reports that there are nearly 1 million people living with MS in the United States, more than double the estimate from a previous study. MS is more common in women than men. It is typically diagnosed in people 20 to 40 years old, and is the most widespread neurological condition disabling young adults worldwide. 

MS is a chronic, progressive, immune-mediated disease that affects the central nervous system (CNS), which includes the brain, spinal cord, and optic nerves. By upsetting the CNS, MS disrupts the smooth flow of information within the brain, and between the brain and the rest of the body.

When someone has an immune-mediated disorder, their immune system attacks healthy tissue just like it attacks bacteria or a virus. With MS, your immune system attacks myelin, the fatty substance that surrounds and insulates nerve fibers. It also attacks the specialized cells that produce myelin and the nerve fibers themselves.

This assault on the myelin and nerve fibers results in inflammation, and that produces scar tissue, which is also referred to as sclerosis. With MS, there are multiple areas of scarring, hence the name multiple sclerosis.

Because MS affects the CNS, which controls the entire body, symptoms can involve any part of your body. Among the most common symptoms of MS are: muscle weakness, numbness and tingling, fatigue, dizziness and vertigo, muscle spasms, vision problems, walking difficulties, emotional changes and depression, learning and memory problems, and pain.

The exact cause of MS is unknown, but scientists believe it is triggered by a combination of factors, and several environmental risk factors have been identified. These include having a low Vitamin D level, smoking, and being obese. In addition, MS is known to occur more frequently in areas that are farther from the equator.

Exposure to certain viruses, such as the Epstein-Barr virus, or mononucleosis may increase your risk for MS, but researchers have yet to discover a direct link. Genetic factors may play a role as well. A susceptibility to MS may be passed down through your genes, but it’s believed that an environmental trigger is also required for MS to develop

There are four types of MS: clinically isolated syndrome (CIS), relapsing remitting MS (RRMS), secondary progressive MS (SPMS), and primary progressive MS, (PPMS). CIS is a pre-MS condition that involves a single episode of symptoms that lasts at least 24 hours. While this episode is characteristic of MS, it is not enough to warrant an actual MS diagnosis.

RRMS is the most common type of MS. Approximately 85 percent of people with MS are initially diagnosed with RRMS. With RRMS, you experience attacks of new or increasing symptoms, called relapses. These relapses are followed by remissions, periods of partial or complete recovery from the symptoms.

Some people with RRMS eventually transition to SPMS. With SPMS, there is a progressive worsening of neurological function over time. There may be occasional relapses as well as periods of stability. If you have PPMS, neurological function becomes progressively worse from the onset of your symptoms. Approximately 15 percent of people with MS have PPMS.  

No single test will confirm a diagnosis of MS. Your doctor will begin their evaluation with a thorough history and neurological examination. They will then employ certain tests, including an MRI, a spinal fluid analysis, and an evoked potentials test, to determine if you meet the diagnostic criteria for MS.

Your doctor will likely use additional tests as well in order to rule out other conditions that have similar symptoms to MS, such as Lyme disease, lupus, and Sjögren’s syndrome. 

MS is treated with medication that slows disease progression. Several medications called disease-modifying therapies (DMTs) have been approved by the FDA to treat the relapsing forms of MS. DMTs interact with different parts of the immune system and curb their function. These medications can be injected, infused, or taken by mouth as pills.

In addition, your doctor may use other medications and therapies, including corticosteroids, and physical and occupational therapy, to treat troubling MS symptoms such as pain, muscle weakness, and difficulty walking. With the treatments available today, people with MS can live long, full, happy lives.

Page 2 of 28