There are multiple health observances celebrated in March. One of them is National Kidney Month. Our kidneys play an important role in our overall health and well-being, so we should give them a little love and attention once in a while. Let’s learn more about how your kidneys function to keep you feeling your best and how you can help protect them in this blog.

Your kidneys are bean-shaped organs about the size of a computer mouse that sit at the lowest level of your ribcage, one on each side of your spine.

The kidneys are responsible for maintaining a healthy balance of water, salt and minerals — including sodium, calcium, phosphorus and potassium — in your blood. If these substances aren’t in balance, your body’s nerves, muscles and other tissues may not function properly.

The kidneys also remove extra fluid, acid, waste products and drugs from your body. They release hormones that regulate blood pressure; produce a form of vitamin D that promotes strong, healthy bones; and control the production of red blood cells.

A kidney is made up of about a million functional units called nephrons. A nephron consists of a filtering apparatus called a glomerulus, which is made up of tiny blood vessels and is attached to a tubule. Blood enters each glomerulus and is filtered. The remaining fluid passes along the tubule, where chemicals and water are added or removed based on the body’s needs. The fluid that’s left becomes urine, which is passed through the ureters to be stored in the bladder.

The kidneys filter about 200 quarts of fluid every 24 hours. About 2 quarts are removed from the body as urine. The remaining 198 quarts of fluid are recovered and returned to the body. The kidneys filter all the blood in your body every 30 minutes.

Diseases of the kidneys, specifically chronic kidney disease (CKD), are major causes of illness and death. Fifteen percent of adults in the US are estimated to have CKD, which equates to about 37 million people, or one in seven. Because early CKD generally has no signs or symptoms, most cases are undiagnosed.

When present, warning signs that you may be developing kidney disease may include fatigue, trouble sleeping, itchy skin, swollen feet, muscle cramps, puffiness around your eyes in the morning and frequent urination, particularly at night.

There are also symptoms that may indicate the disease is progressing to kidney failure, also called end-stage renal disease (ESRD). That’s when the kidneys lose all ability to filter fluid and waste products from the blood.

Symptoms of the progression to ESRD may include nausea, vomiting, loss of appetite, changes in urine output, fluid retention, anemia, decreased sex drive, sudden rise in potassium levels and inflammation of the pericardium, the fluid-filled sac that surrounds the heart.

Diabetes is the leading cause of kidney disease. It accounts for about 44 percent of cases. Consistently high blood glucose (sugar) associated with diabetes damages the blood vessels, including in the kidneys. As a result, the kidneys cannot filter blood as efficiently as they should, and excess fluid and waste build up in the body. That can lead to other health problems, including heart disease and stroke.

Other risk factors for chronic kidney disease include having high blood pressure; having a family history of kidney disease; being older; having heart disease; smoking; being obese; being African American, Native American or Asian American; and having an abnormal kidney structure.

Controlling diabetes and high blood pressure are essential to maintaining kidney health. Other ways to keep kidneys healthy and prevent kidney disease include:

• Maintain a healthy weight
• Quit smoking
• Exercise regularly (Regular exercise can help with weight loss and reduce blood pressure.)
• Eat a diet rich in fruits, vegetables, whole grains, lean meats and low-fat dairy
• Avoid extra salt (Eating a lot of salty food can disrupt the body’s balance of minerals.)
• Stay hydrated (Drinking plenty of water helps kidneys remove toxins from the blood.)
• Limit use of over-the-counter medications (Routinely taking certain OTC medications, such as NSAIDS, can damage kidneys over time. If managing a condition with pain, such as arthritis, talk with a doctor about alternatives to daily pain medication.)

Patti DiPanfilo

The American Psychiatric Association defines eating disorders as behavioral conditions characterized by severe and persistent disturbances in eating behaviors and associated distressing thoughts and emotions. This year, National Eating Disorders Awareness Week is February 20-26. The observance serves as a time to learn more about these disorders and to support the people who suffer from them.   

Eating disorders are serious illnesses that can lead to nutritional deficiencies and dangerous medical complications, even death. They are associated with an intense preoccupation with weight, body shape and food, which leads to dangerous behaviors. These behaviors include restrictive eating, binge eating, purging by vomiting or misusing laxatives and compulsive exercising.  

Eating disorders are prevalent in the US, affecting approximately 30 million Americans. That includes 20 million females and 10 million males. Most eating disorders develop during adolescence and young adulthood but can occur at any age. Often, eating disorders occur with mental health conditions such as depression, anxiety and substance abuse disorder.  

The most common eating disorders are anorexia nervosa, bulimia nervosa and binge eating disorder.  

Anorexia nervosa is characterized by self-starvation and weight loss resulting in low weight for height and age. People with anorexia nervosa often see themselves as “fat” even though they are underweight.

There are two subtypes:

• Restrictor: people limit their food intake to the point of starvation.
• Binging and purging: people eat a lot (binge) and make themselves regurgitate (purge).

Anorexia nervosa can lead to serious health issues. including heart problems such as arrythmias (heartbeats that are too fast, too slow or irregular) and heart failure (inability of the heart to pump enough blood to meet the body’s needs). Other serious consequences include anemia, low blood pressure, kidney problems and bone loss.  

Anorexia nervosa has an extremely high mortality rate compared with other mental disorders. People with anorexia are at high risk of dying from complications related to starvation. Suicide is the second leading cause of death for people who have anorexia nervosa. 

People with bulimia nervosa typically eat large amounts of food and follow the binging with “compensatory behaviors,” such as vomiting, fasting, misusing laxatives or compulsively exercising. Those with bulimia nervosa often weigh within the normal limits for their age and height but intensely fear gaining weight. They are usually very dissatisfied with their body shape.    

Repeated exposure to stomach acids from purging can erode the enamel on the teeth and lead to cavities and gum disease. Other complications associated with bulimia include stomach ulcers, ruptures of the stomach or esophagus, dehydration, irregular heartbeat, low sex drive and gastroparesis, a condition in which the stomach takes too long to digest food. In addition, people with severe bulimia have a higher risk for heart attack. 

People with binge eating disorder experience a loss of control over their eating. They typically eat a lot of food in a short amount of time, even if they are not hungry, and feel intense distress or guilt afterward. But unlike bulimia, people with binge eating disorder do not purge after eating. An episode of binge eating can be triggered by stress, negative feelings about weight or body shape, availability of food or even boredom. People with this disorder may eat in secret so others cannot see how much they are eating. 

Many people with binge eating disorder are overweight or obese, which increases the risk for heart disease, stroke, Type 2 diabetes and many types of cancer. These people may also experience sleep problems, chronic pain, asthma, irritable bowel syndrome and fertility problems. Pregnant women with binge eating disorder tend to have more complications. 

Each disorder has its own symptoms, but there are some red flags to look out for. These include skipping meals or following an overly restrictive diet, leaving during meals to use the bathroom, eating more food during a meal than considered normal, frequently using laxatives for weight loss, exercising excessively and frequently talking about weight or dieting. 

The cause of eating disorders is a combination of several complex factors, including genetics, brain biology, personality, cultural and social ideals, and mental health issues. Your risk is increased if you have a family history of eating disorders, another mental health disorder and a lot of stress.  

Eating disorders are more common in those that engage in activities that stress weight, such as gymnastics, wrestling, dancing and modeling. Peer pressure is also a factor. 

If your doctor suspects an eating disorder based on your history and physical examination, you may be referred to a mental health professional, who use special interviewing and assessment tools to make the diagnosis and determine the type of eating disorder. They follow the guidelines set down by the American Psychiatric Association in its Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).  

Treatment for eating disorders depends on the type of disorder but usually involves psychotherapy, medication, nutritional counseling and weight monitoring. In severe cases, hospitalization or a stay in an inpatient treatment facility is required. Family support is essential in helping people with eating disorders cope and recover.   

Patti DiPanfilo 

According to the American Academy of Otolaryngology, ear, nose and throat disorders are one of the main reasons children see a physician. And ear infections are the most common reason parents bring their children to the doctor. February is Kids ENT Health Month, so this blog reviews a few of the more common ENT disorders that affect children.  

Just about every child will experience an ear infection at some point. My child was no exception; he had his share. Acute otitis media is a painful ear infection that occurs when the middle ear becomes inflamed and infected. The middle ear lies between the eardrum and the inner ear, where the cochlea and vestibular system are located.  

With acute otitis media, your child’s eustachian tube becomes swollen or blocked, and fluid gets trapped in the middle ear. That fluid can become infected and cause symptoms. Symptoms of otitis media include unusual irritability, difficulty sleeping or staying asleep, tugging at one or both ears, fever, fluid draining from the ear, loss of balance, difficulty hearing and ear pain. 

Treatment begins with home care, which includes applying warm, moist compresses over the ear and using over-the-counter eardrops and pain relievers. If over-the-counter products don’t do the trick, your child’s doctor may prescribe stronger eardrops and pain relievers. If your child’s symptoms persist after that, the doctor may recommend antibiotics to treat the infection. 

Enlarged tonsils and adenoids are also common in children. Tonsils and adenoids are collections of lymphoid tissue that help the body fight infection, but they can become enlarged if they become infected or irritated.  

Enlarged tonsils and adenoids are actually normal in some children. But in other children, the enlargement is due to a bacterial or viral infection, allergies, exposure to irritants or possibly even to gastroesophageal reflux disease (GERD).  

Usually, there are no obvious symptoms when the tonsils and adenoids are enlarged. But the condition may lead to difficulty breathing or swallowing and can cause your child to sound like he or she has a stuffy nose when talking. Enlarged tonsils and adenoids can also cause nosebleeds, bad breath and cough. 

In some cases, enlarged tonsils and adenoids can cause recurring ear or sinus infections, or sleep apnea, a sleep disorder in which the upper airway becomes blocked, causing the child’s breathing to stop and start during the night. 

Treatment for enlarged tonsils and adenoids begins by addressing the underlying cause, such as the allergies or infection. If this fails to achieve results, your child’s doctor may suggest removing the tonsils and adenoids. Surgery may be recommended if your child has sleep apnea or extreme difficulty when talking and breathing, or experiences multiple throat infections. 

Another common ENT issue in children is sinusitis. The sinuses are air-filled cavities behind the face lined with mucus membranes. Sinusitis is an infection of the sinuses near the nose.  

Sinus infections often develop after a cold or upper respiratory infection. These cause inflammation of the nasal passages that can block the opening of the sinuses into the nose. Allergies can also cause sinusitis due to the swelling of the nasal tissue and increased mucus production. 

Treatment for sinusitis may include a course of antibiotics, acetaminophen for pain, a decongestant and/or mucus thinner, and a nasal spray to reduce inflammation. Your child’s doctor may recommend that you run a cool humidifier in your child’s room to keep the air moist. 

In extreme cases, surgery on the sinuses may be needed. 

Allergic rhinitis, also known as hay fever, is another ENT problem that is common in children. Allergic rhinitis, which is a reaction that happens in the eyes, nose and throat, can be seasonal or year-round. The most common causes of allergic rhinitis in children include pollen from trees, grass or weeds; dust mites; mold; cockroach waste; and animal dander. These substances are called allergens because they trigger an allergic reaction. 

Symptoms of allergic rhinitis include sneezing, nasal congestion, nasal discharge, fatigue and skin rashes. Treatment generally involves giving your child antihistamines, decongestants and nasal sprays. If your child also has asthma, the doctor will treat those symptoms as well. 

Consider allergy shots if your child has severe allergic rhinitis. The shots are a type of immunotherapy. 

Patti DiPanfilo

February, not suprisingly, is American Heart Month. The human heart is about the size of a clenched fist and weighs between 8 and 12 ounces, depending on gender and body size. Heart disease is the leading cause of death in the United States, killing more than 600,000 Americans each year. That’s one out of every four deaths.

There are many types of heart disease – from rhythm disorders to genetic defects to valve conditions to blood vessel diseases. But this blog will focus on the most common type: coronary artery disease, or CAD.

CAD is very common in this country. More than 18 million adult Americans suffer with it. According to the Cleveland Clinic, that’s roughly the combined populations of New York City, Los Angeles, Chicago and Houston.

The coronary arteries are blood vessels that wrap around the outside of the heart and supply it with oxygen-enriched blood and nutrients. With CAD, the coronary arteries become narrowed by a buildup of plaque, which is made up of fat, cholesterol and other substances floating around in your blood. This process of plaque buildup in the arteries is called atherosclerosis.

Atherosclerosis occurs over many years, and you may experience no symptoms while it is happening. But as your arteries become increasingly narrow, you may begin to notice symptoms such as pressure or tightness in your chest (angina), shortness of breath and fatigue.

The buildup of plaque in coronary arteries can eventually block the flow of blood to the heart, leading to a heart attack. Symptoms of a heart attack include chest pain or discomfort; feeling weak, lightheaded or faint; pain or discomfort in the jaw, neck or back; pain or discomfort in one or both arms or shoulders; and shortness of breath.

If you experience these symptoms, seek medical help right away.

Over time, CAD can weaken your heart and cause complications such as heart failure, a condition in which your heart can no longer pump blood efficiently; abnormal heart rhythms; and cardiac arrest, the sudden and unexpected loss of heart function.

There are multiple risk factors for CAD, some you can’t control and some you can. Risk factors you can’t control include age. Men face a higher risk after age 45, and women are at a higher risk after age 55. Another uncontrollable risk factor is family history. Your risk increases if one of your family members has heart disease.

Risk factors you can control include being overweight and physically inactive, eating an unhealthy diet that is high in saturated fat and complex carbohydrates, smoking, and drinking more alcohol than is recommended.

If you’re at high risk for CAD or already have symptoms, your doctor may recommend one or more tests to assess your heart function and make a diagnosis. These tests include:
• Electrocardiogram, which records your heart’s electrical activity.
• Echocardiogram, which uses sound waves to evaluate your heart’s structure and function.
• Exercise stress test, which evaluates how your heart responds to vigorous activity.
• Cardiac catheterization, which involves inserting tubes into your coronary arteries to view the plaque and confirm CAD.

The first step in treating CAD is making positive changes to your lifestyle. Don’t smoke, eat a heart-healthy diet, exercise for 30 minutes most days of the week, limit your alcohol intake, get seven to nine hours of sleep a night and work to control any chronic conditions you may have, such as high blood pressure, high cholesterol and diabetes.

Some people need a procedure or surgery to treat their CAD. Coronary angioplasty is an interventional procedure in which a small balloon is used to widen your narrowed coronary arteries. Your doctor may place small mesh tubes called stents to help keep the arteries open.

Coronary artery bypass grafting (CABG) is a surgery that takes a blood vessel from another part of your body and attaches it to the coronary artery above and below the narrowed area or blockage. This “bypass” restores blood flow to your heart.

CAD can’t always be prevented because some of its risk factors are out of your control. But the positive lifestyle changes used to treat the disease can also be used to lower your risk.

Patti DiPanfilo

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