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Ear, Nose & Throat Associates |
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September 2007 News Archives
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August 6: Thyroid Cancer Rates Rise, KETV Omaha
Thyroid cancer is diagnosed at a rate of about 35,000 cases a year in the United States, and experts said the number of diagnoses is growing.
The disease mainly targets women between the ages of 20 and 45.
University of Nebraska Medical Center Dr. Bill Lydiatt is the divisional director of head and neck surgery for the hospital. He treated Bethany Bauer, who was diagnosed at age 21 when a lump was found in her neck during and annual exam.
Doctors removed her entire thyroid after the lump was determined to be cancerous.
Bauer takes a hormone pill every day and is cancer–free and healthy.
But she said that just hearing the word cancer can be very scary.
"I called my mom, and I was really scared, because you never think of yourself having cancer – especially at 21. So, it was very scary," she said.
"The good news is people still doing very well with thyroid cancer," Lydiatt said. "The cure rate is still very high depending on the age and size and type of cancer. There are several different types."
Besides a lump, the doctor said, there aren’t any early symptoms. Patients may have a sore throat and feel strange when swallowing.
Lydiatt is also a thyroid cancer survivor. He said he found a lump just below his Adam’s apple.
He recommends self–exams.
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August 7: For doctors, diagnosing gets a technological boost, USA Today
By Erin Donaghue, USA TODAY
Pediatrician Stephen Borowitz was walking the floors of the University of Virginia Children’s Hospital with his residents when he was presented with an unusual case.
The patient was a boy who was very ill with a severe childhood disease called hemorrhagic shock and encephalopathy syndrome. Borowitz says the boy had significant neurological damage and was fed through an intravenous feeding tube.
The immediate problem was that he had a fever. But he was showing other symptoms that didn’t match his condition. "He had developed diarrhea, which is extremely unusual for him, and he seemed uncomfortable," Borowitz says.
Borowitz worried that the culprit was a bloodstream infection, a typical problem with patients with intravenous feeding tubes. But something still didn’t seem right.
So Borowitz and his residents consulted Isabel, a Web–based medical technology that generates a list of possible diagnoses based on the patients’ symptoms.
"I put all his symptoms into Isabel and it came up with a number of ideas," he says. "One of them was gallbladder disease, which I probably should have thought of, but I didn’t."
An ultrasound was ordered, and gallbladder disease was indeed the problem, and it may not have been related to the boy’s pre–existing condition or his feeding tube.
Misdiagnoses are common
According to a 2003 Journal of the American Medical Association review of autopsy studies, doctors misdiagnose 8% to 24% of the time. Cognitive errors, such as latching onto a diagnosis that seems the most likely without considering other possibilities – which experts call "anchoring" – are among many root causes, according to Jerome Groopman, chairman of experimental medicine at Harvard University and author of the book How Doctors Think.
The solution for some is technology. Doctors are increasingly using the Internet, even search programs as basic as Google, when they’re stumped, according to "Googling for a Diagnosis," a British Medical Journal study last year.
Although Isabel is used in only 18 hospitals, interest in similar decision-support systems is growing in the medical community, according to the American Medical Informatics Association. Priced at around $50,000 a year for a typical 300 bed hospital, Isabel is considered a robust tool, highly rated by the Healthcare Information and Management Systems Society.
"One of the things I try to model for my residents is that I’m trying to learn new things even though I’ve been doing this for a long time," Borowitz says.
"It’s the acknowledgment that I’m fallible and I need to use all the tools I can to make sure I’m giving the best care."
When doctors diagnose, they "match" a patient’s symptoms against the patterns of several likely diseases, narrowing down the list as they go, according to Lawrence Weed, professor emeritus of medicine at the University of Vermont. This decision–making process, known as combinatorial thinking, involves juggling too much information for it to be successful without the aid of technology, Weed says.
"The mind can’t possibly deal with the complexity of the problem that a patient presents," Weed says. "What if you said, ‘Let’s give (doctors) eight years of geography at Harvard and then let them to drive across the country without a map’?"
Weed developed Problem Knowledge Couplers – a technology that "couples" patient symptoms with relevant medical literature. With Couplers, patients can enter their symptom information into the Web–based tool and walk through the medical knowledge with their doctor. About 50 private employers now provide access to Couplers.
A correct diagnosis can hinge on a doctor recalling a crucial piece of information – one he or she may have learned years ago in medical school or read in a journal months ago, says physician and Isabel developer Joseph Britto. Similar to Couplers, Isabel allows doctors to "click through" medical knowledge related to a possible diagnosis. Isabel, Britto says, was developed to help doctors reduce errors by lightening the "burden of memory."
"In the traditional medical environment, people expect you to know everything," says Napoleon Knight, a physician at the Carle Foundation Hospital near Chicago, who uses Isabel in the emergency room to help diagnose his patients. "It can be difficult sometimes to keep all that knowledge right at the top of your brain so you can pull it out when you really need it."
‘Cookbook’ medicine?
Groopman, however, fears that placing too much emphasis on technology will take the spotlight off clinical judgment.
’With these cookbook–type recipes for diagnosis and treatment, the risk is that’s it’s garbage in, garbage out," Groopman says. "They’re only as good as the physician who is identifying what the key symptom or key finding is about the patient."
Many doctors who use Isabel argue that technology doesn’t supersede individual judgment but rather acts as an aid in the decision-making process.
"Certainly it will never take the place of judgment," Knight says. "There’s still a lot that you learn about an individual patient just by walking into the room and seeing the look on their face, or by placing your hand on their forehead."
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August 8: Allergy sufferers in for rough ragweed season, Dallas Morning News
Wet–dry punch means it’s open sneezin’
By STELLA M. CHÁVEZ
Longtime allergy sufferer Maria Vanloody of Garland tries to quell the pain in her sinuses while on a visit to her allergist as phlebotomist Stephanie Hall prepares to draw a blood sample.
Sneezing more these days? Are your eyes a bit more watery? Do you feel lousier all around? You and many others with allergies are experiencing the effects of an earlier–than–normal ragweed season – the time of year when staying indoors might actually be better for your health.
Here’s what allergy sufferers can expect during the next two miserable months, according to Drs. Richard L. Wasserman, an allergist and clinical professor of pediatrics at UT Southwestern Medical Center, and Ramon Garcia, an internal medicine doctor in Garland:
Why are allergy sufferers experiencing problems right now?
We’re in the middle of a fall pollen season that began early because of heavy spring rains that lasted through the early part of summer. Those rains triggered healthier plant growth. The dry and windy weather has allowed pollen to spread more easily. So ragweed, which typically starts pollinating the third week of August, began a couple of weeks early this year. Just this week, ragweed jumped from a moderate level of 46 to a high level of more than 200 on the pollen count index.
Is this season more unusual than other seasons?
Not necessarily. Pollen counts vary from year to year based on the weather. This year may feel different because symptoms have started earlier than usual. Keep in mind that the Dallas–Fort Worth area is ranked No. 2 among the nation’s top 100 allergy capitals by the Asthma and Allergy Foundation of America.
How much longer can allergy sufferers expect to have symptoms?
Ragweed has a longer season than other plants. The pollen count normally peaks in mid–September and lasts until about a week before Thanksgiving or when the first frost hits.
What are the symptoms?
Nasal itch, sneezing, runny nose. If the problem persists, a person could experience stuffiness and post–nasal drip. Some people may also have watery and bloodshot eyes. Headaches and a loss of concentration can also develop.
If left untreated, could allergies lead to more serious problems?
It could increase a person’s risk of developing asthma or a chronic cough, particularly in children. The problem is easier to treat if caught early.
What should people do to limit allergy symptoms?
- See a doctor or allergist. An allergist can identify what is causing the allergic reaction and prescribe medication to control the problem. Some over–the–counter medicine is helpful, but prescription medicine, such as nasal spray, may be most effective.
- While you may be tempted to open the windows to let in the cool breeze, don’t. It could aggravate symptoms.
- When driving, keep car windows up and use the air conditioning.
- Avoid raking or mowing. If you have to do yard work, wear a mask.
- Take a shower soon after being outdoors to wash off the pollen.
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August 11: The ABCs of Getting Your Zzzzs, The Washington Post
(HealthDay News) – Sleep doesn’t have to be a struggle, say sleep experts at the Medical College of Georgia Sleep Disorders Center, who point to a few simple steps to improve sleep time and quality.
Keeping a regular sleep schedule throughout the week, including weekends, will improve overall sleep cycle, the experts say.
Adults should get seven to eight hours of sleep a night for optimal functioning during the day. Although it might be tempting, experts say it is best not to nap or sleep in on weekends. Rather, budget time every day to allow enough sleep time.
Working out can also help, the specialists say.
TV and caffeine before bed are true enemies of sleep, as is a cluttered bedroom. Make the room restful for sleep. Keep it at a comfortable temperature and minimize distracting outside noises with drapes, shutters or soft music.
If these home remedies don’t help and fatigue is affecting daily activities, it may be time to consult a sleep expert. Many adults are not aware that they suffer from sleep apnea, a disorder in which a person wakes up when their breathing is interrupted during sleep. A sleep study can identify sleep apnea and other disorders that affect sleep.
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September 17: Cancer Care Might Impair Driving, HealthDay News
Side effects of treatment for head and neck cancer may cause patients to experience problems with driving skills, a new study suggests.
Reduced head and neck mobility, cognitive impairment, pain and psychological distress are among the side effects that can impair driving.
"Driving is a complex task that requires adequate cognitive, psychomotor and visuoperceptualmotor functions that work together. These functions can be compromised to a greater or lesser extent in patients with cancer in the head and neck region who have received cancer treatment," wrote researchers at the Medical University of South Carolina in Charleston.
They evaluated the driving skills of 10 head and neck cancer patients (average age 56) and a control group of 56 people in the general community (average age 48).
The average brake reaction time and steering variability (vehicle offset from the center of the driving line in inches) was significantly greater in the cancer patients (3,134.92 milliseconds and 271.26 inches) than in the control group (2,299.8 milliseconds and 46.45 inches).
The two groups had similar results in average speed, total number of collisions, and on simulator driving performance scores.
The study is published in the September issue of the journal Archives of Otolaryngology–Head & Neck Surgery.
The researchers recommended further research into how cancer treatment affects patients' driving skills and safety.
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September 22: Hearing aids have gone sleek, chic and high–tech, The Wall Street Journal
By LAURA JOHANNES
The Wall Street Journal
Choosing a hearing aid is getting complicated.
Racing green, or cabernet red? A sleek geometric triangle, or an artsy teardrop-like curve? Switzerland’s Bernafon AG offers a red one with a white cross that might coordinate with your Swiss Army knife.
And it’s not just about looks: Computer technology is improving the sound quality of hearing aids, as well as the ability to customize the devices. Devices can be programmed to tune out sounds like high-pitched clanking of silverware and the dull hum of voices at a noisy restaurant. Some devices let users hear their Bluetooth cell phones through a hearing aid. And many newer hearing aids are so tiny as to be hardly noticeable.
“Technology in hearing aids has become extremely sophisticated at the high end,” said Nancy Catterall, director of audiology at Thomas Jefferson University in Philadelphia. Even the less-expensive digital hearing aids, she adds, “are as good as the higher-end devices were several years ago.”
But as hearing aids become more complex, the array of new choices can be confusing. Even the trusty old volume control — which everyone understands — is increasingly being replaced by tech-sounding phrases such as “integrated signal processing.” And with prices that can reach $2,000 to $6,000 a pair, it’s easy to overspend on a device that exceeds your needs, audiologists say. If your needs are mainly talking to family at home and watching television, you don’t need a high-end device, audiologists say.
Some hearing experts also warn against choosing a device just for its small size. Chris Halpin, an audiologist at the Massachusetts Eye and Ear Infirmary in Boston, said he feared the new emphasis on small and hip was resulting in “wimpy” devices that don’t have enough amplification power to help patients with serious hearing problems. With the complexity of hearing aids today, it is important to find a practitioner with whom you have good personal chemistry, and who will take the time to let you try various devices, Halpin said.
The cost of hearing aids is generally not covered by insurance.
Hearing loss can be caused by age, or can be a side effect of some medicines or a lifetime of listening to loud music or on-the-job noise. By age 65, nearly a third of Americans have hearing loss, and 40 percent to 50 percent develop it by age 75, according to the National Institutes of Health. But resistance to hearing aids is high: According to the NIH, only one in five of the people who could benefit from a hearing aid wears one.
Increasingly, people buying hearing aids are rejecting the old-fashioned “custom-fitted” mold, which fits into the ear like a giant flesh-colored ear plug.
“They try to make them blend in with your skin, but they look terrible, like a glob of wax in your ear,” said Craig Kuhns, 56, an operating-room nurse from Dallas.
He recently chose a set of red-and-black Audeo devices from Switzerland’s Phonak AG that perch behind his ears and extend into the ear canal via a clear, nearly invisible tube. In addition to having aesthetic appeal, the new, smaller behind-the-ear devices are popular for their “open fit,” which doesn’t block natural hearing.
“The new devices have opened up the world of hearing aids to people who rejected them because of the feeling of being plugged up,” said Allen Senne, director of audiology at the House Ear Clinic in Los Angeles.
The newer, smaller devices have driven overall sales of behind-the-ear devices from 44 percent last year to 50.2 percent of hearing-aid sales in the first half of this year — exceeding sales of in-ear molds for the first time since 1982, said the Hearing Industries Association, a Washington, D.C., trade group of hearing-aid makers.
Manufacturers say even the smallest devices are adequately powerful for people with mild to moderate hearing loss, but add that larger devices often provide optimum results. Denmark’s Oticon A/S, for example, says people who want the best sound quality should choose its more traditional-looking Epoq model rather than the tiny triangle-shaped Delta it markets as “so cool that you’ll be tempted to show it off.”
Audiologists recommend that people looking for a hearing aid get a thorough hearing test and see a doctor to make sure hearing loss isn’t correctible with medication or surgery.
When buying a hearing aid, the first choice is whether to go with analog or the more-popular digital devices. Analog hearing aids can be less expensive. But digital hearing aids — in which incoming sound is processed with a computer chip before being fed into the ear — enables almost limitless massaging of the sound.
The Phonak Audeo, for example, automatically switches among four programs — one for music, one for quiet, one for speech alone and one for speech and noise together. Both the Audeo and the GN ReSound Azure from Denmark’s Great Nordic AG remember if you make a volume change — and automatically make the same adjustment next time they encounter a similar sound pattern.
On some devices, you also can use a remote to manually switch between the various “listening programs” or override the computer. For example, many of the hearing aids will automatically put the device in “directional” mode when they sense background noise, emphasizing sounds in front of you and softening others. If you are having a conversation with a person in front of you, that helps. But if you are in a crowded room waiting for someone who may hail you from behind, you might want to change the setting, said Thomas Powers, an audiologist with Siemens Hearing Instruments.
Beware, though, an omission on many sleek new devices: volume control. Widex Hearing Aid Co. of Long Island City, N.Y., for instance, offers several lines — including a new tiny m-series with “integrated signal processing” software but no volume adjuster. The company says the software helps create clearer sound.
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September 25: Sleep–deprived, Times Union
A tired fisherman learns his exhaustion is tied to disorders
By CATHLEEN F. CROWLEY, Staff writer
The proverb "They that sleep catch no fish" proved true for professional angler Tim Costa.
Costa quit the professional bass fishing tour in 2001 because he couldn't stop nodding off during competition. At home in Catskill, he fell asleep on the couch and snoozed until bedtime. He missed his son's soccer games and begged out of walks with his wife.
Costa thought his daily struggle to stay awake was normal.
"You don't want to complain because you think everybody feels the way you do," said Costa whose brown eyes and buzzed hair make him look like Matt Lauer. "I didn't know any different."
What followed were five years of odd jobs, medical appointments and increasing difficulty staying awake until he was finally diagnosed with multiple sleep disorders.
Costa, 36, is back on the tour and competed in the recent FLW Outdoors Stren Series on the Hudson River in Catskill. His love of fishing fueled his comeback, but he said he has another mission. Costa hopes to educate people about narcolepsy, sleep apnea and other sleep disorders as he travels from one competition to the next and through invitations to speak at conferences that deal with sleep disorders.
Reading the shoreline, watching his boat's electronics, controlling the boat's movements with a foot pedal while pitching his line take constant concentration.
But by 10 a.m. on competition day, Costa couldn't stay awake. His head bobbed as he fought sleep.
He directed his anger and frustration into himself, giving him an adrenaline rush that would get him through the rest of the day.
"I'm kind of a mind-over-matter kind of guy, just git out there and git it done no matter what it takes," he said in a drawl shaped by his youth in Pennsylvania and years in Texas.
He rose to 26th in the rankings on the Wal-Mart BFL Cowboy Division, but the sleepiness was getting worse. His competitive edge was gone. He quit.
Home was no better.
"He looked like death or somebody who was a heavy drug user," said Carol Johnson, Costa's wife. "His eyes were sunk in and dark underneath. His skin looked real ruddy. He looked deprived."
Toxic tiredness
Costa switched jobs frequently, believing that his sleepiness meant he was bored with the job. He couldn't read more than a paragraph of a magazine article or watch a full movie without falling asleep. He never had enough energy for chores around the house.
"It was a toxic kind of tiredness. It consumes you," Costa said. "Imagine being so exhausted your whole body feels like pins and needles. Your arms and legs feel long and heavy. I just had to go sit down and let it happen."
His family wondered if he didn't care about them or was just plain lazy.
"I love the guy, but it wasn't easy," Johnson said. "It got to the point where I said, 'You've got to do something about this or you go live somewhere else.' But honestly, what really was the determining factor was when it started to affect his fishing."
Costa's family physician tested him for depression, heart disease, neurological problems and sent him to sleep studies. Costa was diagnosed with obstructive sleep apnea, a condition where the muscles at the back of the throat become so flaccid during sleep that they obstruct the airway. Costa said he'd stop breathing for minutes and would wake with a gasp.
Sleep apnea most often affects men, particularly over age 60, said Dr. Martha Boulos, a neurologist at Albany Medical School who has special training in sleep disorders. People who are obese are also susceptible to the disorder.
When the airway is blocked, Boulos said the brain shifts from a deep sleep to a superficial stage of sleep so the person becomes more aware of the oxygen deprivation and can control their airway. Sometimes the person never fully wakes.
"They don't get to the deep stages of sleep, so they don't regenerate enough energy to maintain daily activity," Boulos said.
Costa said he'd get a full night's sleep but wake up feeling worse.
He underwent surgery, called the Pillar Procedure, where small rods were placed in his soft palate to stiffen the flap of tissue in the back of his mouth. It cured his sleep apnea.
Costa slept soundly at night, but his days didn't improve.
Sleep attack
In 2005, he could only stay awake for 90 minutes before he needed to nap for 20 minutes. Then he suffered his first full-blown sleep attack.
Shopping at Wal-Mart, Costa reached down into a freezer to pick up a bag of frozen chicken. The coldness caught him by surprise and he collapsed to the ground. He lost control of his muscles. He couldn't talk, but he could see and hear. The paralysis lasted eight or 10 seconds.
The attack was cataplexy, a classic symptom of narcolepsy.
"It's not unusual to find other sleep disorders overlap and present in the same patient," Boulos said.
Narcolepsy is a neurological disorder caused by the brain's inability to regulate sleep-wake cycles normally. It causes sleep intrusions where features of Rapid Eye Movement sleep break through during wakefulness, Boulos said.
Cataplexy, for example, mimics the loss of muscle tone that naturally occurs during REM sleep that prevents sleepers from acting out their dreams.
After excessive daytime sleepiness, cataplexy is often the earliest symptom of narcolepsy. Some episodes involve no more than a momentary sense of weakness in a small number of muscles, like mild drooping of the eyelids. It is often triggered by strong emotions, including surprise, anger and laughter.
In retrospect, Costa recalls times when his knees buckled under him. He had attributed it to bad knees from running but now realizes they were small cataplexy events.
The frequency of Costa's attacks increased from one or two times a week, to once or twice a day. They occurred at the slightest aggravation, like telling his son to stop pulling the dog's tail. His family became adept at shielding his head as he collapsed.
Costa also experienced vivid dreaming, hallucinations that occur when falling asleep or waking up. Also a sign of narcolepsy, the hallucinations represent another intrusion of an element of REM sleep into the wakeful state.
"You don't ever remember falling asleep and you don't remember waking up," Costa said. "That's really hard on a person."
Treatment
Costa underwent another sleep study. While most sleepers take 90 minutes to get to REM sleep, Costa reached REM in about a minute. The results confirmed he had narcolepsy.
The cause of narcolepsy is unknown, but doctors are making progress in treating it.
Costa takes a non-narcotic stimulant to stay awake during the day, and a serotonin re-uptake inhibitor to prevent cataplexy attacks.
"My daily life is 360 degrees different," he said. "I can read full articles now. I can fish all day without getting tired. I can work all day without tiring and can even go home and install a washing machine for my wife."
There are 200,000 American diagnosed with narcolepsy, but Costa believes there are many more.
"They think that living exhausted is normal, just like I did," he said.
But being more alert doesn't mean the fishing is any easier. Like dozens of professional fisherman at the Catskill's competition, Costa didn't catch a single bass that met the 15-inch length requirement.
Signs of narcolepsy
- Excessive daytime sleepiness
- Sleep attacks
- Sudden loss of muscle tone
- Sleep paralysis -- sudden inability to move or speak while falling asleep or waking up
- Vivid dreams while falling asleep or waking up
Source: National Institutes of Health
Sleep apnea symptoms
- Loud snoring
- Periods of not breathing (apnea)
- Awakening unrested in the morning
- Abnormal daytime sleepiness, including falling asleep at inappropriate times
- Morning headaches
- Recent weight gain
- Limited attention
- Memory loss
- Poor judgment
- Personality changes
- Lethargy
Source: National Institutes of Health
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September 25: Rare disease doesn't keep Graham woman down, Times News
By CHARITY APPLE/Times-News
Danette Anderson poses for a recent photo at her Graham home. Anderson was diagnosed with Wegener’s granulomatosis 11 years ago and has gone on to raise $66,000 for research.
Danette Anderson has dealt with sinus infections most of her life.
“I’d have one or two a year, get a round of antibiotics and everything would be hunky-dory,” she said in an interview Friday afternoon.
All that changed in 1996.
“I got some antibiotics but the whole left side of my face was stopped up. The only thing that helped was to put hot rags on my face in the tub.”
By the end of December, Anderson was referred to Chapman McQueen at UNC Hospitals. After X-rays and CT scans, McQueen told her “that something else is going on here.”
“He said it was one of four diseases and Wegener’s granulomatosis was one he mentioned,” she said.
At the time, the Graham resident had no idea what Wegener’s was, much less that she might be suffering from it. In January, 1997, Anderson underwent sinus surgery. A biopsy revealed sores and ulcers on the right side of her face. She seemed to recover from the surgery just fine but by the middle of March, her right ear was bothering her. Then she developed “saddle nose” — “a side effect of Wegener’s, I later found out. It’s where your nose caves in.”
Allergy tests revealed that yes, Anderson was allergic to mold and mildew but a blood test showed that she did indeed have Wegener’s granulomatosis, a rare autoimmune disease which affects people of all ages from children to older adults.
Wegener’s is one of several diseases classified as vasculitis and it is defined by The Vasculitis Foundation as “an inflammation of blood vessels, arteries, veins or capillaries.” The disease affects 1 in 30,000 people and there is no indication as to what causes it or if it is hereditary.
In an educational pamphlet the foundation indicates that when “inflammation occurs, it causes changes in the walls of blood vessels, such as weakening and narrowing that can progress to the point of blood vessel blockage.”
Symptoms can include:
- Fatigue/weakness
- Chronic sinusitis/nasal allergies
- Cough/shortness of breath
- Lung inflammation
- Asthma
- Joint pain/facial soreness
- Abdominal pain/gastrointestinal bleeding
- Kidney problems (bloody or dark urine)
- Nerve problems (numbness, weakness or pain)
- Changes in vision
- Severe headaches
- Skin lesions/rashes
- Fever
“I would have headaches that were so bad that I’d have to put my head down on the desk,” Anderson said. “And I just felt so tired all of the time.”
After the diagnosis, Anderson was admitted to the hospital eight times.
“We can joke about it now — the fact that I was a frequent visitor,” she said. “But back then, it was so scary. I wasn’t sure if I would come home or not.”
Anderson is currently taking the medication CellCept and has been on prednisone “pretty much the whole time.”
Vasculitis Awareness Week is this week and Anderson is doing her part to get the word out about the disease. During the last six years, she’s helped raise $66,000 for the Vasculitis Foundation. A Poker Run was held just a couple of weeks ago and it raised $10,000; all of the bands donated their time. The Alpacas have played the event all six years.
“This isn’t for me. This doesn’t help with my medical bills or anything. It goes toward research and education,” she said. “This is supposed to be a rare disease but every time I turn around, I meet someone diagnosed with it.”
Anderson, 49, is doing OK now. She works as an accountant at Andersen Products in Haw River. Her family and co-workers are supportive of her fund-raising efforts. She is married to Randy Anderson and has two daughters and two grandchildren and another grandchild on the way.
“I’ve been very fortunate. Right now, I just kind of go with the flow. I’m so susceptible to illnesses. I have to have a flu shot and a pneumonia shot. But I can’t slow down. I can’t stop living. If I slow down, the disease is winning.”
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September 28: Drinking may dampen hearing in the short term, Reuters Health
NEW YORK (Reuters Health) – If you have a hard time hearing conversation at a bar, it may not be because of the noise, a study suggests.
Alcohol, UK researchers found, seems to temporarily drain a person's hearing -- particularly when it comes to discerning the sounds of conversation.
In a study of 30 healthy volunteers, they found that as participants drank, their hearing became less acute. Lower-frequency hearing, which is necessary for discerning speech, suffered the most, the researchers report in the online journal BMC Ear, Nose and Throat Disorders.
It's a "well observed phenomenon" that alcohol seems to build people's tolerance to loud noise, according to the study authors, led by Tahwinder Upile of the University College London Hospitals.
But bouts of so-called "cocktail party deafness" may not result from the noisy drinking environment alone, the researchers note.
To study the short-term effects of alcohol on hearing, Upile's team recruited healthy adults between the ages of 20 and 40 who had no history of hearing problems. The volunteers had their hearing tested before and after having a predetermined number of drinks in the research lab.
In general, the researchers found, the higher a volunteer's alcohol level -- as measured by breath test -- the greater the deterioration in hearing. The hearing loss tended to be more significant in relatively older volunteers, as well as those who said they had a history of heavy drinking.
It's not clear why drinking may have this effect, but alcohol could either damage the auditory nerves or affect the brain's processing of sound, according to Upile's team.
In this study, the hearing loss was short-lived. Volunteers who returned for tests the following week were back to their normal hearing levels. However, it's possible that regular drinking could alter people's hearing over time, the researchers note.
"There remains a huge scope for further research," they conclude.
SOURCE: BMC Ear, Nose and Throat Disorders, online September 18, 2007
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September 28: Treating sleep apnea good for the heart, Reuters UK
By Anthony J. Brown, MD
NEW YORK (Reuters Health) - Treatment of the nighttime breathing disorder, obstructive sleep apnea, with continuous positive airway pressure (CPAP) seems to have a beneficial impact on early signs of atherosclerosis (hardening of the arteries), Brazilian researchers report.
Obstructive sleep apnea (OSA) occurs when the soft tissues at the back of the throat repeatedly collapse during sleep, temporarily cutting off breathing. It has been linked to heart attack and stroke, and both associations appear to be fueled through effects on atherosclerosis. Whether effective treatment of OSA would reduce the plaque burden, however, was unclear.
Dr. Luciano F. Drager and colleagues from University of Sao Paulo Medical School assessed changes in the thickness of the neck artery and other parameters among 24 patients with severe OSA randomized to receive CPAP or no treatment for 4 months. Considered the most effective therapy for OSA, CPAP involves wearing a face mask through which the CPAP device delivers pressurized air to keep the airways open.
The control group experienced no changes in any of the parameters measured during follow-up. In the CPAP group, by contrast, the investigators documented reductions in the thickness of neck arteries and in the stiffness of the arteries.
The CPAP group also experienced healthy reductions in CRP -- a marker of inflammation associated with an increased risk of cardiovascular disease -- and catecholamines -- compounds that constrict blood vessels, increase heart rate and boost blood pressure.
"The magnitude of improvement on validated markers of atherosclerosis after CPAP is in some aspects comparable to that observed for statins used in patients with dyslipidemia," Drager told Reuters Health. "However, in opposite to the main effect of statins promoting significant lipid-lowering effects, we did not observe any significant reductions in lipids but in markers of inflammation and sympathetic activation."
Drager cautioned that further studies are needed to determine if CPAP slows the progression of atherosclerosis in OSA patients.
SOURCE: American Journal of Respiratory and Critical Care Medicine, October 2007.
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September 28: HPV and Men: Should Boys Be Vaccinated Against the STD?, Fox News
By Tina Benitez and Marrecca Fiore
Anal cancer is not something you often read or hear about in the daily news.
Maybe it’s too taboo to talk about this part of the body. Actress Farrah Fawcett did not mention what type of cancer she is battling, but, according to reports, the 59-year-old actress has a rare form of anal cancer.
The cancer itself is also rare, affecting more than 4,600 people each year, according to the American Cancer Society (ACS). It isn’t top of mind. However, the number of cases of the cancer has remained at a steady number since last year, which means, it has not gone away.
In 2006, there were approximately 4,660 new cases of anal cancer in the U.S. and around 660 deaths, according to the ACS. This year, more than 4,600 cases are expected.
Likewise, oral cancer, that is cancers of the throat, tonsils and back of the tongue, are not cancers commonly discussed. In fact, of the 45,000 new cases of head and neck cancers expected this year, only 10,000 will affect the back of throat area. Oral cancer is on the decline in America, except in men over the age of 45.
The culprit in the rise in both oral and anal cancers in men is the human papillomavirus (HPV), a sexually transmitted disease that can form in the genital area of men and women including the skin of the penis, vulva (area outside the vagina), anus or in the linings of the vagina, cervix or rectum.
The number of HPV cases, while still high in women, is increasing in the male community, particularly in gay men, according to Dr. Robert Mayer, vice chairman of academic affairs at the Dana-Farber Cancer Institute in Boston.
One of the main factors leading to HPV and eventually, anal cancer, is engaging in anal sex. In addition to anal sex, other risk factors include having multiple sex partners, frequent anal redness or soreness and smoking.
The cancer may be mistaken for skin cancer, since the tumors can initially form on the skin area outside of the anus, which is the same skin that is on the buttocks.
“Virally, it’s a condition that is sexually transmitted,” said Mayer. “It’s the same virus that causes anal cancer. For many years, it was associated with venereal warts, giving a connotation that it was related to some form of sexual activity. For years, it occurred mostly with women, but now it’s occurring with a larger percentage of (gay) men. It’s related to sexual practices and the passage of virals in the anus.”
Oral Cancer
Although HPV and cervical cancer can be readily diagnosed in women through annual pap smears, men don’t normally undergo any sort of tests that would detect oral HPV or throat cancer, said Dr. Erich M. Sturgis, of the University of Texas M. D. Anderson Cancer Center in Houston.
“Cervical cancer is so well established,” he said. “In fact, well before we had the HPV vaccination, we were able to prevent cervical cancer and catch cervical cancer early because of the good screening methods. We don’t have the same kind of methods of screening for cancers of the throat and oral HPV.”
Men also are a “hidden reservoir” for the virus and can pass the disease onto their female partners, Sturgis said.
It’s for these reasons that Sturgis believes research is needed to determine whether the HPV vaccine, sold under the brand Gardasil and currently available to young girls in the U.S., is effective for boys.
“I’m aware that drug companies are studying their vaccinations in men,” he said. “And that’s hopefully going to provide evidence that the vaccine is effective in preventing the virus in men.”
Sturgis said some of the studies of the HPV vaccine and men are focused on men who are at high risk for anal cancer.
“It’s a group that is more likely to get (regular) anal or genital swabs and, therefore, it’s easier to track the disease,” he said.
In the meantime, men and women should view cervical, oral and anal cancers as sexually transmitted diseases, or at least understand that these potentially deadly cancers are more often than not caused by a sexually transmitted disease, and protect themselves, Sturgis said.
“Condoms will protect against the virus somewhat,” he said. “But women should be examined each year, and if they do have an abnormal pap smear, they should be treated and make sure their partners are treated.”
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September 30: Snorers’ cure in a 2–ounce bottle? Not exactly, LA Times
Antisnoring throat sprays do almost nothing for snoring but may help with congestion. Go figure.
By Chris Woolston, Special to The Times
The products: Over the years, inventors have patented hundreds of gadgets to combat snoring. If necessity breeds invention, it's safe to say that lots of people desperately need a quiet night's sleep. The National Sleep Foundation estimates that 37 million Americans snore habitually, which translates to millions of bleary-eyed partners and probably billions of nights spent on the couch.
None of those gadgets has managed to stop the roar coming from our bedrooms, but there's another option -- antisnoring throat sprays, available over the Internet and at drugstores everywhere. The sprays typically contain a mixture of oils such as menthol and peppermint along with water, alcohol and glycerin.
There's no shortage of sprays from which to choose. One Internet site lists 18 brands, such as Snorix, SnoreStop and SnoreBGone. The Healthy Skeptic and Mrs. Skeptic recently tried Snore Relief Cool Mint Throat Spray from Breathe Right, the same company that makes those Band-Aid-like nasal strips.
Following the instructions, we each took three sprays 30 minutes before bedtime. The spray was minty and a bit numbing, not unlike a throat lozenge. The 2-ounce bottle, good for about 90 sprays (30 nights), costs nearly $14.
The claims: Most throat sprays claim to ease snoring by lubricating the tissue in the throat. As the Breathe Right website explains, greasing up the throat will "minimize vibrations and control the snoring sound." Another product with a similar name goes much further. According to its website, Snorelief is "one of the most exciting breakthroughs in the health care industry in recent years."
The bottom line: In our one-night trial of Snore Relief, Mrs. Skeptic snored louder than usual. No one's complaining, but it was enough to wake up anyone within a 3-yard radius. Oddly, Mrs. Skeptic herself slept through it. (The Healthy Skeptic doesn't snore. Ever. No matter what anyone says.)
The professional verdict isn't much better. Throat sprays are almost completely useless against snoring, says Dr. Craig Schwimmer, medical director of the Snoring Center in Dallas and a spokesman for the American Academy of Otolaryngology. There's no reason to think that lubricating the throat would have any effect on snoring, Schwimmer says. People snore because their throat muscles become so relaxed that they sag into the airway and rattle with every deep breath, not because their throats need a lube job.
According to Schwimmer, throat sprays do have one potential benefit: The menthol and other oils might help clear up nasal congestion that can turn up the volume on snoring. People who are stuffy because of colds or allergies have to breathe extra hard to get air at night, which means their snoring tends to be a little louder than usual. Dr. Derek Lipman, an ear, nose and throat specialist in Portland, Ore., and author of "Snoring from A to ZZZZ," says there's no evidence that throat sprays can do anything more than bring very minor relief to congested snorers.
There's plenty of evidence, though, that many snorers need much more than a spray. By Lipman's estimate, 15% to 20% of heavy snorers briefly stop breathing during sleep, a condition called sleep apnea. Among other things, apnea robs people of deep sleep and greatly increases the risk of heart disease.
Symptoms of sleep apnea include loud snoring, gasping for air during sleep and feeling groggy even after a full night's sleep.
People who think they might have this condition need to see a doctor, Lipman says.
In Lipman's opinion, trying to treat a serious snoring problem with a throat spray is a little like "taking Tylenol for a brain tumor." Even if symptoms eased a bit, he says, the threat remains.
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