Health Care and Acne

One of the most embarrassing skin conditions is acne, and you can usually find a lot of it especially on the faces of teenagers. The typical look of acne is red spots that break out due to many reasons— stress, genetics, and other causes. Acne can be serious or moderate, and there are some cases that require ongoing treatment by health care professionals.

Here are some interesting statistics from the AAD (American Academy of Dermatology), which can also be located at this website--  http://www.aad.org/media-resources/stats-and-facts/conditions/acne :

• Acne is the most common skin disorder in the United States, affecting 40 million to 50 million Americans.
• Nearly 85 percent of all people have acne at some point in their lives, most often on the face, chest, and back.
• By mid-teens, more than 40 percent of adolescents have acne or acne scarring, which requires treatment by a dermatologist.
• The total direct cost associated with the treatment of acne exceeds $2.2 billion each year, including substantial costs for prescription and over-the-counter products.

According to Proactiv.com, from the moment you are born, your skin begins a lifelong process of shedding dead cells and producing oil. This process can be disrupted by your hormone balance, which changes throughout your life. The acne cycle is initiated when excess oil and dead skin cells combine to plug the pore of a hair follicle; behind the plugged pore, bacteria grow and multiply, triggering inflammation and swelling. That's an acne blemish.

Acne is what doctors call a chronic condition, which means it can last for years—even decades in adults. Because there is no cure, the key to a clear complexion is control and prevention with medicated daily maintenance therapy. The pimples you see today started as tiny microcomedones, or pre-pimples, deep inside your skin about three weeks before breaking out. Hundreds of tiny pre-pimples may be forming continuously in any of the thousands of pores on your face. Even when your skin looks clear, they may still be there—percolating invisibly under the skin's surface. Much more detail can be found at this website: http://www.proactiv.com/acne-information/what-causes-acne,default,pg.html .

Once a pore becomes clogged, it traps skin oil inside. Bacteria grows in this oil and can cause an inflammatory response in the skin. Acne lesions can be small and hardly noticeable, have a small white or black head, or can appear red with a white/yellow center. Sometimes a clogged pore will become so inflamed that it can lead to larger, more painful lesions called nodules or cysts, which can ultimately scar. Almost no one escapes some clogged pores and pimples, especially during adolescence--a fragile time when self-esteem and confidence is just emerging. Acne afflicts people of all ethnicities and is treated the same regardless, according to this site: www.Acne.org .

Your skin is healthiest and clearest when it is in balance. The more irritation your skin experiences, the more likely it is to break out. Conversely, the less irritation your skin experiences, the better it is able to remain clean. Sources of irritation include anything which rubs, scratches, or comes into prolonged contact with your skin, as well as anything which sends your skin out of balance such as overdryness, sunburns, shaving the face with irritating razors, and pore-clogging cosmetics. To best clear acne, try to keep your skin as untouched as possible. Acne is not caused by dirt, and washing your face, while it is fine to do up to twice per day, is going to do little to help with your acne. Much more info can be found at this site: http://www.acne.org/ .

People with acne often feel incredibly alone but the fact is, acne is the most common skin disease in the world, with tens of millions of sufferers, according to Proactive. More than 85% of Americans have acne breakouts at some time in their lives. Among teenagers, about 90% develop acne, and it can last all their teen years. Many adults have acne, too. Among adult women, about 50% experience acne breakouts at some point; among men, about 25%—and the chronic nature of the condition means adults may have to endure symptoms for decades if not treated with appropriate acne medication.

According to the NIH (National Institutes for Health), there are many myths about what causes acne. Chocolate and greasy foods are often blamed, but there is little evidence that foods have much effect on the development and course of acne in most people. Another common myth is that dirty skin causes acne; however, blackheads and other acne lesions are not caused by dirt. Stress doesn’t cause acne, but research suggests that for people who have acne, stress can make it worse. Factors that can cause an acne flare include:

• Changing hormone levels in adolescent girls and adult women before their menstrual period starts
• Oil from skin products (lubricants or cosmetics) or grease encountered in the work environment (for example, a kitchen with fry vats)
• Pressure from sports helmets or equipment, backpacks, tight collars, or tight sports uniforms
• Environmental irritants, such as pollution and high humidity
• Squeezing or picking at blemishes
• Hard scrubbing of the skin
• Stress.

Acne is often treated by dermatologists (doctors who specialize in skin problems), according to the NIH. These doctors treat all kinds of acne, particularly severe cases. Doctors who are general or family practitioners, pediatricians, or internists may treat patients with milder cases of acne. Depending on the extent of the problem, the doctor may recommend one of several over-the-counter (OTC) medicines and/or prescription medicines. Some of these medicines may be topical (applied to the skin), and others may be oral (taken by mouth).

There are several OTC topical medicines used for mild acne. Each works a little differently. Following are the most common ones:

• Benzoyl peroxide--Destroys P. acnes and may also reduce oil production.
• Resorcinol--Can help break down blackheads and whiteheads.
• Salicylic acid--Helps break down blackheads and whiteheads. Also helps cut down the shedding of cells lining the hair follicles.
• Sulfur--Helps break down blackheads and whiteheads.

Topical OTC medicines are available in many forms, such as gels, lotions, creams, soaps, or pads. In some people, OTC acne medicines may cause side effects such as skin irritation, burning, or redness, which often get better or go away with continued use of the medicine. If you experience severe or prolonged side effects, you should report them to your doctor.

People with moderate-to-severe inflammatory acne may be treated with prescription topical or oral medicines, alone or in combination, according to the NIH. Several types of prescription topical medicines are used to treat acne. They include:

• Antibiotics. Help stop or slow the growth of bacteria and reduce inflammation

• Vitamin A derivatives (retinoids). Unplug existing comedones (plural of comedo), allowing other topical medicines, such as antibiotics, to enter the follicles. Some may also help decrease the formation of comedones. These drugs contain an altered form of vitamin A. Some examples are tretinoin, adapalene, and tazarotene.

• Others. May kill P. acnes and reduce oil production or help stop or slow the growth of bacteria and reduce inflammation. Some examples are prescription strength benzoyl peroxide, sodium sulfacetamide/sulfur-containing products, or azelaic acid.

For patients with moderate-to-severe acne, doctors often prescribe oral antibiotics. Oral antibiotics are thought to help control acne by curbing the growth of bacteria and reducing inflammation. Prescription oral and topical medicines may be combined. Much more detailed material about acne can be located at this website: http://www.niams.nih.gov/health_info/acne/ .

Oil in the skin is a contributing factor to acne. According to a study published in the Journal of the Academy of Nutrition and Dietetics, some of that excess oil production may be diet-related. This study found that high glycemic foods and dairy products can cause changes in the body that lead to increased cellular growth and oil production, which can increase the chances of developing acne. Yikes! Better cut back on that cheddar. But, what’s a glycemic index?

The glycemic index, according to this website, http://www.myhealthnewsdaily.com/3615-high-glycemic-foods-acne.html , is a measure of the speed at which sugar in food enters your bloodstream. High-glycemic foods are those that have the fastest blood sugar response. So, things like cupcakes and white bread are considered high glycemic. It’s important to note, though, that the glycemic index isn’t a measure of a food’s nutritional value, fat content, or anything else. It simply indicates how it will affect your blood sugar levels. It can be confusing, to say the least.

Here are some tips for eating a low-glycemic diet without stressing out:

--Avoid processed foods. Whole foods are usually lower on the glycemic index than processed foods. Apple juice will spike your blood sugar at a much faster rate than eating a whole apple.

--Try a protein pairing. Because protein is harder to digest, it can bring down the overall glycemic index of a meal. Just don’t use cheese or other dairy products as your protein. Remember, those may also cause acne.

--Choose fiber. Since it can’t be digested by the body, fiber is low on the glycemic index. Eat foods that are high in fiber, and there’s a good chance you'll steer clear of high GI foods.

The good news is that acne is treatable, and in many cases does not cause too much damage to the skin. However, if you are experiencing issues with it that are causing concern, see your doctor. He can suggest and prescribe some options to help you. Also, in more severe cases, your physician can refer you to a specialist. Dermatologists can help you with acne that is more chronic and difficult to manage. Although acne can be embarrassing socially, remember that in most cases it is temporary. Watch your diet and your daily skin regimen to self-manage most acne issues.

Until next time.

Health Care and Leprosy

Back in Biblical times, thousands of years ago, when someone shouted “Unclean, unclean,” that usually meant the person was suffering from a dreaded disease, typically leprosy. In that time it was commonly believed that you could catch that horribly disabling and fatal illness simply by being near someone or breathing the same air near the affected individual. Plus, it was a legal requirement for the victim to announce the fact they were in the area by shouting out those words. That way, everyone within ear shot could run the other way. Leprosy was seen as a plague on those who had it and a direct result of sin against their god.

A lot of knowledge about leprosy has been gained since then, as in most all medicine. According to the World Health Organization (WHO), leprosy was recognized in the ancient civilizations of China, Egypt and India. The first known written mention of leprosy is dated 600 BC. Throughout history, the afflicted have often been ostracized by their communities and families. Although leprosy was treated differently in the past, the first breakthrough occurred in the 1940s with the development of the drug Dapsone, which arrested the disease. But the duration of the treatment was many years, even a lifetime, making it difficult for patients to follow.

The WHO reports that leprosy is a chronic infectious disease caused by Mycobacterium leprae, an acid-fast, rod-shaped bacillus. The disease mainly affects the skin, the peripheral nerves, mucosa of the upper respiratory tract and also the eyes. Leprosy is curable and treatment provided in the early stages averts disability. Here are some key facts about this disease:

• Official figures show that almost 182,000 people, mainly in Asia and Africa, were affected at the beginning of 2012, with approximately 219,000 new cases reported during 2011.

• M. leprae multiplies very slowly and the incubation period of the disease is about five years. Symptoms can take as long as 20 years to appear.

• Leprosy is not highly infectious. It is transmitted via droplets, from the nose and mouth, during close and frequent contacts with untreated cases.

• Untreated, leprosy can cause progressive and permanent damage to the skin, nerves, limbs and eyes.

• Early diagnosis and treatment with multidrug therapy (MDT) remain the key elements in eliminating the disease as a public health concern. Here is more detail about leprosy found on the WHO website: http://www.who.int/mediacentre/factsheets/fs101/en/index.html.

The medical name for leprosy is Hansen's disease, according to American Leprosy Missions (ALM). Norwegian doctor Armauer Hansen was the first to view the bacillus under a microscope in 1873. The bacteria attack nerve endings and destroy the body's ability to feel pain and injury. Without feeling pain, people injure themselves and the injuries can become infected, resulting in tissue loss. Fingers and toes become shortened and deformed as the cartilage is absorbed into the body. Repeated injury and infection of numb areas in the fingers or toes can cause the bones to shorten. The tissues around them shrink, making them short.

Early signs include spots on the skin that may be slightly red, darker or lighter than normal skin. The spots may also become numb and have lost hair. Often they appear on the arms, legs or back. Sometimes the only sign may be numbness in a finger or toe. If left untreated, hands can become numb and small muscles are paralyzed, leading to curling of the fingers and thumb. When leprosy attacks nerves in the legs, it interrupts communication of sensation in the feet. The feet can then be damaged by untended wounds and infection. If the facial nerve is affected, a person loses the blinking reflex of the eye, which can eventually lead to dryness, ulceration and blindness. Bacteria entering the mucous lining of the nose can lead to internal damage and scarring which in time causes the nose to collapse. Untreated, leprosy can cause deformity, crippling and blindness, according to ALM.

Leprosy is transmitted primarily through coughing and sneezing. In most cases, it is spread through long-term contact with a person who has the disease but has not been treated. Scientists don't fully understand how leprosy is spread. Most people will never develop the disease even if they are exposed to the bacteria. Approximately 95% of the world population has a natural immunity to leprosy. Approximately 5,000 people in the U.S. are cured but suffer from the effects of leprosy and continue to receive care through outpatient clinics and private physicians. Approximately 150 people are diagnosed with leprosy each year in the U.S, per American Leprosy Missions. More info can be found on their website: http://www.leprosy.org/ .

According to the National Institutes for Health (NIH), most cases are in the South, California, Hawaii, and U.S. islands. Effective medications exist. Isolating people with this disease in "leper colonies" is not needed. People with long-term leprosy may lose the use of their hands or feet due to repeated injury because they lack feeling in those areas. Prevention consists of avoiding close physical contact with untreated people. People on long-term medication become noninfectious (they do not transmit the organism that causes the disease). Call your health care provider if you have symptoms of leprosy, especially if you've had contact with someone who has the disease. Cases of leprosy in the United States need to be reported to the Centers for Disease Control and Prevention. Much more info can be found at this website: http://www.nlm.nih.gov/medlineplus/ency/article/001347.htm .

Leprosy is a disease that largely has been contained in most places in the world, especially in the US, even though there are new cases every year that are diagnosed. However, most people who contract this disease are located in more impoverished third world nations where sanitary living conditions are not readily available, or that have limited access to health care, or who live in a population largely ignorant of disease prevention. As with any health care need, always talk with a medical professional for proper diagnosis and treatment.

Until next time.

Health Care and GERD

When you swallow anything, that item goes through a tube that connects your mouth to your stomach whether it is a liquid or a solid substance. That bodily throughway is called an esophagus. When that area gets irritated, you can suffer from more serious medical issues including a condition called GERD—Gastroesophageal Reflux Disease. If you have symptoms similar to heartburn or acid indigestion that is not caused by eating certain types of spicy food, you may have GERD.

Also known as acid reflux, GERD can cause serious damage to your esophagus over time. The burping, heartburn, and spitting up associated with GERD are the result of acidic stomach contents moving backward into the esophagus (called reflux), according to KidsHealth.org. This can happen because the muscle that connects the esophagus with the stomach (the esophageal sphincter) relaxes at the wrong time or doesn't properly close.

Many people have reflux regularly and it's not usually a cause for concern. But with GERD, reflux occurs more often and causes noticeable discomfort. After nearly all meals, GERD causes heartburn, also known as acid indigestion, which feels like a burning sensation in the chest, neck, and throat. In babies with GERD, breast milk or formula regularly refluxes into the esophagus, and sometimes out of the mouth. Sometimes babies regurgitate forcefully or have "wet burps." Most babies outgrow GERD between the time they are 1 and 2 years old. But in some cases, GERD symptoms persist. Kids with developmental or neurological conditions, such as cerebral palsy, are more at risk for GERD and can have more severe, lasting symptoms. Much more info can be found at this site: http://kidshealth.org/parent/medical/digestive/gerd_reflux.html .

The symptoms of GERD may include persistent heartburn, acid regurgitation, nausea, hoarseness in the morning, or trouble swallowing, according to the American Academy of Otolaryngology (AAO). Some people have GERD without heartburn. Instead, they experience pain in the chest that can be severe enough to mimic the pain of a heart attack. GERD can also cause a dry cough and bad breath.

According to the AAO, GERD can be diagnosed or evaluated by a physical examination and the patient’s response to a trial of treatment with medication. Other tests that may be needed include an endoscopic examination (a long tube with a camera inserted into the nose, throat, windpipe, or esophagus), biopsy, x-ray, examination of the esophagus, 24 hour pH probe with or without impedance testing, esophageal motility testing (manometry), and emptying studies of the stomach. Endoscopic examination, biopsy, and x-ray may be performed as an outpatient or in a hospital setting. Endoscopic examinations can often be performed in your ENT’s office, or may require some form of sedation and occasionally anesthesia.

Most people with GERD respond favorably to a combination of lifestyle changes and medication. Medications that could be prescribed include antacids, histamine antagonists, proton pump inhibitors, pro-motility drugs, and foam barrier medications. Some of these products are now available over the counter and do not require a prescription. Children and adults who fail medical treatment or have anatomical abnormalities may require surgical intervention. Such treatment includes fundoplication, a procedure where a part of the stomach is wrapped around the lower esophagus to tighten the lower esophageal sphincter muscle (LES), and endoscopy, where hand stitches or a laser are used to make the LES tighter. You can find more details about GERD at this site: http://www.entnet.org/HealthInformation/GERD-and-LPR.cfm .

According to the National Institutes for Health (NIH) risk factors for GERD or reflux include:

• Alcohol (possibly)
• Hiatal hernia (a condition in which part of the stomach moves above the diaphragm, which is the muscle that separates the chest and abdominal cavities)
• Obesity
• Pregnancy
• Scleroderma
• Smoking

Heartburn and gastroesophageal reflux can be brought on or made worse by pregnancy and many different medications. Such drugs include:

• Anticholinergics (e.g., for seasickness)
• Beta-blockers for high blood pressure or heart disease
• Bronchodilators for asthma
• Calcium channel blockers for high blood pressure
• Dopamine-active drugs for Parkinson's disease
• Progestin for abnormal menstrual bleeding or birth control
• Sedatives for insomnia or anxiety
• Tricyclic antidepressants

If you suspect that one of your medications may be causing heartburn, talk to your doctor. Never change or stop a medication you take regularly without talking to your doctor, according to the NIH. More material about GERD can be found at this website: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001311/ .

Depending on how severe your GERD is, according to this website: http://heartburn.about.com/od/gerdacidrefluxdisease/a/gerd_acidreflux_3.htm , treatment may involve one or more of the following lifestyle changes, medications, or surgery:

Avoid reflux producing foods--These foods include:

• Fried foods
• Fatty foods
• Citrus fruits
• Tomato products
• Caffeine
• Alcoholic beverages
• Citrus fruit drinks
• Chocolate
• Peppermint
• Pepper

If you smoke, stop--Smoking inhibits the production of saliva. Saliva is one of your body's defenses against damage to the esophagus. Saliva also aids in neutralizing refluxed acid. Smoking also stimulates the production of stomach acid, and can weaken and relax the lower esophageal sphincter (LES).

Do not drink alcohol--Alcohol increases the production of stomach acid, relaxes the lower esophageal sphincter, allowing stomach contents to reflux back up into the esophagus, and can make the esophagus more sensitive to stomach acid.

Lose weight if needed--Obesity increases abdominal pressure, which can then push stomach contents up into the esophagus. Losing weight may help reduce acid reflux.

Eat small meals--Large meals expand your stomach and increase upward pressure against the esophageal sphincter.

Wear loose-fitting clothes--Clothing that fits tightly around the abdomen will squeeze the stomach, forcing food up against the LES, and cause food to reflux into the esophagus. Clothing that can cause problems include tight-fitting belts and slenderizing undergarments.

Avoid lying down for 3 hours after a meal--Gravity helps to keep the stomach juices from backing up into the esophagus. Lying down with a full stomach makes reflux more likely.

Raise the head of your bed--With the head higher than the stomach, gravity helps reduce this pressure. You can elevate your head in a couple of ways. You can place bricks, blocks or anything that's sturdy securely under the legs at the head of your bed to raise it 6 to 8 inches. A foam wedge under the mattress can also be used. You can also use a wedge pillow to elevate your shoulders and head.

According to Fox News, popular over-the-counter medications like Tums, Maalox, Rolaids and Mylanta neutralize stomach acid and provide fast-acting relief in mild or isolated cases of acid reflux. Some antacids come in liquid form to coat the lining of the esophagus and help reduce the amount of acid in the stomach. But they won’t aid in reducing inflammation of the esophagus associated with GERD. More details about medicines to control GERD can be found at this site: http://www.foxnews.com/story/0,2933,412202,00.html .

GERD can be serious. If you suspect you may have it, see your doctor. Don’t put off an appointment if you are suffering from the symptoms. It may be that you have other health related issues, but if you really have acid reflux, your family physician can help you deal with it.

Until next time.

Health Care and Colonoscopy

When your primary care doctor raises the topic about any invasive procedure, most of the time people cringe about the thought of any type of surgery or medical treatment involving going inside your body. For men especially, a colonoscopy is typically going to come up in conversation with your physician if you are close to the age of 50, or have any type of abnormal bleeding in your urine or other waste. A colonoscopy can be a “routine” way of finding out if there are any abnormalities in your colon. For any patient, though, there is nothing routine about this procedure.

Additionally, men over the age of 75 have a higher risk of additional health care problems. According to HealthLeaders Media, colonoscopies in seniors over age 75 should not be performed because risks of harm outweigh benefits; as many as 30% of these "potentially or probably inappropriate" procedures were still being performed, with huge pattern variation across the nation, especially in Texas.

For patients between 70 and 74, "procedures were repeated too soon after a negative exam," increasing the odds of avoidable harm, such as "perforations, major bleeding, diverticulitis, severe abdominal pain or cardiovascular events." The guidance, from the U.S. Preventive Services Task Force, which was released in 2008, also set a 10-year interval for routine colonoscopies for people between age 70 to 75 unless the patient develops certain symptoms.

"For example, in adults between the ages of 76 to 85, there are some considerations that would support the use of screening colonoscopy, such as a patient has a higher risk of developing an adenoma. But in general, screening guidelines indicate that should be exception, rather than the rule,” according to a study released in the Journal of American Medicine (JAMA). Much more detail about this particular focus for colonoscopies in seniors can be found at this website: http://www.healthleadersmedia.com/content/HEP-290006/Colonoscopy-Potentially-Inappropriate-for-30-of-Seniors## .

According to the American Cancer Society (ACS), a colonoscopy is an exam that lets a doctor closely look at the inside of the entire colon and rectum. The doctor is looking for polyps (pah-lips) or signs of cancer. Polyps are small growths that over time can become cancer. The doctor uses a thin (about the thickness of a finger), flexible, hollow, lighted tube that has a tiny video camera on the end. This tube is called a colonoscope. The colonoscope is gently eased inside the colon and sends pictures to a TV screen. Small amounts of air are puffed into the colon to keep it open and let the doctor see clearly.

The exam itself takes about 30 minutes. Patients are usually given medicine to help them relax and sleep while it’s done. Your doctor decides how often you need this test, usually once every 10 years, depending on your personal risk for colon cancer. It’s important for you to talk with your doctor to understand your risk for colon cancer, the guidelines you should follow for testing, and whether you need to start having the tests at age 50 or earlier.

Plus, these exams are usually not painful, according to the ACS. Patients are given medicine to make them sleep through a colonoscopy, so they don’t feel anything. During both of these tests, air is pumped into the cleaned-out colon to keep it open so that doctors can get the best pictures. The air pressure may cause some discomfort and cramping, but it should not hurt. As with most medical tests, complications are possible with both of these tests. Some can be serious — for instance, bleeding and puncture of the colon — but they are very uncommon. Make sure you understand how these tests work, how you can expect to feel during the test, and possible problems that may come up. Much more detail can be found at this website: http://www.cancer.org/healthy/findcancerearly/examandtestdescriptions/faq-colonoscopy-and-sigmoidoscopy .

Per the Cleveland Clinic, here is what you should expect after a colonoscopy:

• You may feel some cramping or a sensation of having gas, but this quickly passes.

• If a biopsy was taken or a polyp was removed, you may notice light rectal bleeding for one to two days after the procedure. If you have a large amount of rectal bleeding, high or persistent fevers, or severe abdominal pain within the next 2 weeks, please go to your local emergency room and call the doctor who performed your exam.

• If polyps were removed or a biopsy was taken, the doctor performing your colonoscopy will tell you when it is safe to resume taking your blood thinners. You will also be told if you need to stop taking medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), which include aspirin, ibuprofen (Motrin®, Advil®) and naproxen (Aleve®).

Note: To follow are other important questions to ask your doctor. Keep in mind that each doctor and/or his or her health care facility has their own unique set of instructions for their patients. Most doctors/health care facilities are in general agreement with the following answers. However, ALWAYS ask your doctor for his/her specific instructions. Additional tips are as follows:

--Driving home. If sedation has been given, a responsible adult (a family member or friend) must drive you home.

--Being alone when home. For safety reasons, you probably shouldn’t be alone. Ask your doctor how long you should remain with family or friends.

--Returning to normal diet and activities. Unless otherwise instructed, most patients can return to their normal diet immediately following the colonoscopy. Other typical advice is to avoid alcohol, driving, regular activities, and operating machinery for 24 hours following the procedure.

More details can be found at this site: http://my.clevelandclinic.org/services/colonoscopy/hic_colonoscopy_procedure.aspx .

Also, another option is for a virtual colonoscopy. According to the Mayo Clinic, the virtual colonoscopy is an exam used to detect changes or abnormalities in the large intestine (colon) and rectum. During virtual colonoscopy, an imaging technique known as computerized tomography (CT) is used to produce hundreds of cross-sectional images of the abdominal organs. The images are combined and digitally manipulated to provide a detailed view of the inside of the colon and rectum. Unlike traditional colonoscopy, virtual colonoscopy doesn't require sedation or the insertion of a scope into the colon. Virtual colonoscopy is one option used to screen for colon cancer. Discuss your colon cancer screening options with your doctor to determine whether virtual colonoscopy is the right option for you. The Mayo Clinic has a lot of material about this health care topic and more, beginning at this website: http://www.mayoclinic.com/health/colonoscopy/my00621 .

If you have any concerns about getting a colonoscopy, see your doctor or closest available health care provider. They are painless, and in the vast majority of cases have no lasting side effects. In most cases, your health insurance should cover most of the cost. Additionally, if any abnormalities are found during the procedure, they are addressed at the time and with any required follow up. Don’t be afraid to get one, especially if your physician recommends it. Although preparing for one and recovery can be a little uncomfortable, the results with a clear screening can be worth the aggravation, especially if you have positive results and are clear from any more medical issues. The old saying “An ounce of prevention is worth a pound of cure,” is particularly valid with a colonoscopy.

Until next time.

Health Care and Senior Memory Loss

Memory loss can be caused by a variety of issues. Anyone can suffer from losing their ability to remember—illness, aging, blood loss, medications, injuries, and more. Catastrophic memory loss can occur with more serious problems related to accidents or diseases. An example would be amnesia, when the brain cannot function to allow even the simplest of information to be recalled like your name or even motor skills for muscle movement.

Any of these types of memory loss are topics for further discussion. This particular blog post deals in greater detail with memory loss for seniors, who are more likely than the general population to have multiple issues concerning the lack of ability to remember who, what, when, and where, and sometimes how.

As you age your brain begins to shrink naturally, according to this web article by Kenney Myers: "24 BLOGS WITH THINGS YOU CAN DO TO KEEP YOUR BRAIN SHARP AS YOU AGE". However, if you eat right and stay active you can actually reverse the shrinkage. Another way to keep your brain sharp is by using your brain to do puzzles that will challenge you. You can also take a class. When you are learning something new, you are using a different part of your brain, and in essence you are exercising your mind. One of the easiest ways to keep your brain sharp is to stay socially active, whether it’s in person or online. There are 24 tips providing you some more ideas of things you can do to keep your brain in tip top shape, located at this site: http://www.kenneymyers.com/blog/24-blogs-with-things-you-can-do-to-keep-your-brain-sharp-as-you-age/ .

According to The Record Searchlight in Redding, California, medical professionals classify diseases and disorders according to stages. There is such a classification for dementia called the Global Deterioration Scale for Dementia that runs from Stage 1 (no symptoms present) to the final Stage 7, where the brain loses the ability to tell the body what to do. Do you keep your medications and vitamins in containers with the names of the days? Do you have to make a to-do list or a shopping list when you go to the grocery store? Have you ever misplaced your reading glasses or keys? The good news is that the Global Deterioration Scale for Dementia includes a further description of Stage 2: "This stage would be similar to how a normal adult would function under high stress or fatigue."

Dementia is a growing disease among our elderly population. Most of us know someone who has dementia or is dealing with a loved one afflicted by the disease. It is scary to think about the possibility that is could happen to you. So it is natural to be concerned when you can't recall a name or misplace something important.

There is a difference between forgetfulness and memory loss. According to The Record Searchlight, you probably forgot to do things and misplaced your stuff when you were younger and didn't worry about it. Your brain is largest in your 20s and after that you slowly lose brain cells and make fewer chemicals that help your brain cells work. As you get older, it may be hard to tell whether moments of forgetfulness are normal and simply inconvenient, or the start of something more serious. When forgetfulness becomes consistent and produces strange things, it may be time to talk to your doctor. Here are some examples:

--Losing your keys is OK. Finding your keys and not knowing their function is not.
--Putting your hairbrush in the second drawer of your vanity instead of the top drawer is OK. Putting your hairbrush in the freezer is not.
--Getting lost in a new town or place is OK. Getting lost in your own neighborhood is not.
--Forgetting the name of an acquaintance you rarely see is OK. Forgetting the name of one your children is not.

More info about this topic can also be found at this website: http://www.redding.com/news/2011/jul/20/senior-living-when-to-know-when-memory-loss-is-a/ .

If you're concerned about your senior moments, it's important to discuss your symptoms with a physician. According to Duke Health, start with your primary care physician. A general internist or family physician can do a lot to uncover problems that may be contributing to memory loss. A review of your current prescription and non-prescription medications is essential, because many medications can affect memory and overall brain function.

Often, your primary care physician will be able to diagnosis the reason for your memory difficulties. However, specialists may be useful when the exact diagnosis remains unclear or the patient and family desire a second opinion. There are three types of specialty physicians who evaluate memory problems: neurologists, psychiatrists, and geriatricians.

Even when memory loss is not indicative of dementia, other illness, or medication effects, it can still be troublesome. Here are some ideas to help keep your memory as sharp as possible. Simple changes that help you stay organized can greatly improve your daily function and decrease the anxiety that occurs when items are misplaced or events missed, according to Duke Health. For example:

• Keep a calendar and write down all important information.
• Always put your keys in the same place.
• Schedule bill payment and other important tasks.
• Make lists and check off tasks that have been accomplished.

In the meantime, it's worth keeping in mind that, for most older adults, senior moments are simply momentary annoyances that do not represent anything more serious. And because a growing body of research proves the close connection between mental and physical health, you can enhance your mental function by taking steps to make your overall lifestyle healthier and more active. For much more detailed material about memory loss, go to this website: http://www.dukehealth.org/health_library/health_articles/memory_loss_when_to_worry .

According to this article: http://www.helpguide.org/life/prevent_memory_loss.htm , the same practices that contribute to healthy aging and physical vitality also contribute to healthy memory. Here are some tips to help you if you want to deal with preventing or slowing memory loss:

• Exercise regularly. Regular exercise boosts brain growth factors and encourages the development of new brain cells. Exercise also reduces the risk for disorders that lead to memory loss, such as diabetes and cardiovascular disease. Exercise also makes a huge difference in managing stress and alleviating anxiety and depression—all of which leads to a healthier brain.

• Stay social. People who don’t have social contact with family and friends are at higher risk for memory problems than people who have strong social ties. Social interaction helps brain function in several ways: it often involves activities that challenge the mind, and it helps ward off stress and depression. So join a book club, reconnect with old friends, or visit the local senior center. Being with other people will help keep you sharp!

• Watch what you eat. Eat plenty of fruits and vegetables and drink green tea as these foods contain antioxidants in abundance, which can keep your brain cells from “rusting.” Foods rich in omega-3 fats (such as salmon, tuna, trout, walnuts, and flaxseed) are particularly good for your brain and memory. Eating too many calories, though, can increase your risk of developing memory loss or cognitive impairment. Also avoid saturated and trans fats, which can help your cholesterol levels and reduce your risk of stroke.

• Manage stress. Cortisol, the stress hormone, damages the brain over time and can lead to memory problems. But even before that happens, stress causes memory difficulties in the moment. When you’re stressed out, you’re more likely to suffer memory lapses and have trouble learning and concentrating.

• Get plenty of sleep. Sleep is necessary for memory consolidation, the process of forming and storing new memories so you can retrieve them later. Sleep deprivation also reduces the growth of new neurons in the hippocampus and causes problems with memory, concentration, and decision-making. It can even lead to depression—another memory killer.

• Don’t smoke. Smoking heightens the risk of vascular disorders that can cause stroke and constrict arteries that deliver oxygen to the brain.

When you get older, your brain can play tricks on you. Age is not always the sign of wisdom if you have too much memory loss. Work with your physician, family, and friends to find ways to help keep you mentally sharp. Exercise as much as possible, and eat well. Avoid habits that drain you. The longer you avoid dealing with losing your memory, the quicker it will happen. Do your best to keep your mind active. No one wants to be forgetful, but seniors especially hate losing what they spent a life time to remember.

Until next time.

Health Care and Bulimia

Eating disorders have been around for many years, and they have been diagnosed by the mental health community as psychological issues regarding food. People who have issues about the consumption of food fall into several categories, and one of the most severe is bulimia, or the life-threatening habit of bingeing and purging.

According to the Mayo Clinic, bulimia nervosa, commonly called bulimia, is serious. People with bulimia may secretly binge — eating large amounts of food — and then purge, trying to get rid of the extra calories in an unhealthy way. For example, someone with bulimia may force vomiting or do excessive exercise. Sometimes people purge after eating only a small snack or a normal-size meal. Bulimia can be categorized in two ways:

• Purging bulimia. You regularly self-induce vomiting or misuse laxatives, diuretics or enemas after bingeing.

• Non-purging bulimia. You use other methods to rid yourself of calories and prevent weight gain, such as fasting, strict dieting, or excessive exercise.

However, these behaviors often overlap, and the attempt to rid yourself of extra calories is usually referred to as purging, no matter what the method. If you have bulimia, you're probably preoccupied with your weight and body shape, and may judge yourself severely and harshly for your self-perceived flaws. Because it's related to self-image — and not just about food — bulimia can be difficult to overcome. But effective treatment can help you feel better about yourself, adopt healthier eating patterns and reverse serious complications. More details on this disorder can be located at this site: http://www.mayoclinic.com/health/bulimia/DS00607 .

According to this website: http://womenshealth.gov/publications/our-publications/fact-sheet/bulimia-nervosa.cfm , bulimia is more than just a problem with food. A binge can be triggered by dieting, stress, or uncomfortable emotions, such as anger or sadness. Purging and other actions to prevent weight gain are ways for people with bulimia to feel more in control of their lives and ease stress and anxiety. There is no single known cause of bulimia, but there are some factors that may play a part:

• Culture. Women in the U.S. are under constant pressure to fit a certain ideal of beauty. Seeing images of flawless, thin females everywhere makes it hard for women to feel good about their bodies.

• Families. If you have a mother or sister with bulimia, you are more likely to also have bulimia. Parents who think looks are important, diet themselves, or criticize their children's bodies are more likely to have a child with bulimia.

• Life changes or stressful events. Traumatic events (like rape), as well as stressful things (like starting a new job), can lead to bulimia.

• Personality traits. A person with bulimia may not like herself, hate the way she looks, or feel hopeless. She may be very moody, have problems expressing anger, or have a hard time controlling impulsive behaviors.

• Biology. Genes, hormones, and chemicals in the brain may be factors in developing bulimia.

A person with bulimia may be thin, overweight, or have a normal weight, according to www.Women’sHealth.gov. Also, bulimic behavior, such as throwing up, is often done in private because the person with bulimia feels shame or disgust. This makes it hard to know if someone has bulimia. But there are warning signs to look out for. Someone with bulimia may use extreme measures to lose weight by:

• Using diet pills, or taking pills to urinate or have a bowel movement
• Going to the bathroom all the time after eating (to throw up)
• Exercising a lot, even in bad weather or when hurt or tired

Someone with bulimia may show signs of throwing up, such as:

• Swollen cheeks or jaw area
• Calluses or scrapes on the knuckles (if using fingers to induce vomiting)
• Teeth that look clear
• Broken blood vessels in the eyes

People with bulimia often have other mental health conditions, including:

• Depression
• Anxiety
• Substance abuse problems

Someone with bulimia may also have a distorted body image, shown by thinking she or he is fat, hating her or his body, and fearing weight gain. Bulimia can also cause someone to not act like her or himself. She or he may be moody or sad, or may not want to go out with friends. Visit their site for much more information about how bulimia manifests itself and how it can be treated.

If you are living with bulimia, you know how scary it feels to be so out of control. Knowing that you are harming your body just adds to the fear, according to information found at this website: http://www.helpguide.org/mental/bulimia_signs_symptoms_causes_treatment.htm . But take heart: change is possible. Regardless of how long you’ve struggled with bulimia, you can learn to break the binge and purge cycle and develop a healthier attitude toward food and your body. Taking steps toward recovery is tough. It’s common to feel ambivalent about giving up your binging and purging, even though it’s harmful. If you are even thinking of getting help for bulimia, you are taking a big step forward. Here are some steps to help with treating it:

• Admit you have a problem. Up until now, you’ve been invested in the idea that life will be better—that you’ll finally feel good—if you lose more weight and control what you eat. The first step in bulimia recovery is admitting that your relationship to food is distorted and out of control.

• Talk to someone. It can be hard to talk about what you’re going through, especially if you’ve kept your bulimia a secret for a long time. You may be ashamed, ambivalent, or afraid of what others will think. But it’s important to understand that you’re not alone. Find a good listener—someone who will support you as you try to get better.

• Stay away from people, places, and activities that trigger the temptation to binge or purge. You may need to avoid looking at fashion or fitness magazines, spend less time with friends who constantly diet and talk about losing weight, and stay away from weight loss web sites and “pro-mia” sites that promote bulimia. You may also need to be careful when it comes to meal planning and cooking magazines and shows.

• Seek professional help. The advice and support of trained eating disorder professionals can help you regain your health, learn to eat normally again, and develop healthier attitudes about food and your body.

There is therapy available, according to www.HelpGuide.org. The treatment of choice for bulimia is cognitive-behavioral therapy. Cognitive-behavioral therapy targets the unhealthy eating behaviors of bulimia and the unrealistic, negative thoughts that fuel them. Here’s what to expect in bulimia therapy:

• Breaking the binge-and-purge cycle – The first phase of bulimia treatment focuses on stopping the vicious cycle of bingeing and purging and restoring normal eating patterns. You learn to monitor your eating habits, avoid situations that trigger binges, cope with stress in ways that don’t involve food, eat regularly to reduce food cravings, and fight the urge to purge.

• Changing unhealthy thoughts and patterns – The second phase of bulimia treatment focuses on identifying and changing dysfunctional beliefs about weight, dieting, and body shape. You explore attitudes about eating, and rethink the idea that self-worth is based on weight.

• Solving emotional issues – The final phase of bulimia treatment involves targeting emotional issues that caused the eating disorder in the first place. Therapy may focus on relationship issues, underlying anxiety and depression, low self-esteem, and feelings of isolation and loneliness.

If you suspect that your friend or family member has bulimia, talk to the person about your concerns. Your loved one may deny bingeing and purging, but there’s a chance that he or she will welcome the opportunity to open up about the struggle. Either way, bulimia should never be ignored. The person’s physical and emotional health is at stake. It’s painful to know your child or someone you love may be binging and purging. You can’t force a person with an eating disorder to change, and you can’t do the work of recovery for your loved one. But you can help by offering your compassion, encouragement, and support throughout the treatment process.

Until next time.

Health Care and Gout

In days gone by, gout was considered to be the “disease of kings” largely because those who usually had this malady were very wealthy or royalty. The primary thought was that only rich individuals developed gout because only they could afford the food and drink that led to this health care problem. Actually, there is no substantive connection as anyone could develop gout regardless of their social status. However, there are certain dietary conditions related to this health issue.

Gout is a kind of arthritis that occurs when uric acid builds up in blood and causes joint inflammation, according to the National Institutes for Health (NIH). Here are some symptoms:

• Acute gout is a painful condition that typically affects one joint.
• Chronic gout is repeated episodes of pain and inflammation, which may involve more than one joint.

Gout, according to the NIH, is caused by having higher-than-normal levels of uric acid in your body. This may occur if:

• Your body makes too much uric acid
• Your body has a hard time getting rid of uric acid

If too much uric acid builds up in the fluid around the joints (synovial fluid), uric acid crystals form. These crystals cause the joint to swell up and become inflamed. The exact cause is unknown. Gout may run in families. It is more common in men, in women after menopause, and those who drink alcohol. People who take certain medicines, such as hydrochlorothiazide and other water pills, may have higher levels of uric acid in the blood. The condition may also develop in people with:

• Diabetes
• Kidney disease
• Obesity
• Sickle cell anemia and other anemias
• Leukemia and other blood cancers

The condition may occur after taking medicines that interfere with the removal of uric acid from the body. More information is available at this site: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001459/ .

Acute gout will typically manifest itself as an acutely red, hot, and swollen joint with excruciating pain, according to the Centers for Disease Control (CDC). These acute gouty flare-ups respond well to treatment with oral anti-inflammatory medicines and may be prevented with medication and diet changes. Recurrent bouts of acute gout can lead to a degenerative form of chronic arthritis called gouty arthritis. Weight loss lowers the risk for gout. More info can be found at this site: http://www.cdc.gov/arthritis/basics/gout.htm .

According to the CDC, gout can be viewed in four stages:

o Asymptomatic tissue deposition occurs when people have no overt symptoms of gout, but do have hyperuricemia and the asymptomatic deposition of crystals in tissues. The deposition of crystals, however, is causing damage.

o Acute flares occur when urate crystals in the joint(s) cause acute inflammation. A flare is characterized by pain, redness, swelling, and warmth lasting days to weeks. Pain may be mild or excruciating. Most initial attacks occur in lower extremities. The typical presentation in the metatarsophalageal joint of the great toe (podagra) is the presenting joint for 50% of people with gout. About 80% of people with gout do have podagra at some point. Uric acid levels may be normal in about half of patients with an acute flare. Gout may present differently in the elderly, with many joints affected.

o Intercritical segments occur after an acute flare has subsided, and a person may enter a stage with clinically inactive disease before the next flare. The person with gout continues to have hyperuricemia, which results in continued deposition of urate crystals in tissues and resulting damage. Intercritical segments become shorter as the disease progresses.

o Chronic gout is characterized by chronic arthritis, with soreness and aching of joints. People with gout may also get tophi (lumps of urate crystals deposited in soft tissue)—usually in cooler areas of the body (e.g., elbows, ears, distal finger joints).

The big toe is the most common target, but gout can attack the feet, ankles, knees, and hands as well, according to Health Magazine online. An attack or “flare” can last for days or months. Men and obese people are at greater risk. If you’re prone to gout, the foods you eat—and don’t eat—play a key role in keeping your joints pain-free. Find a lot of material at this site: http://www.health.com/health/gallery/0,,20448674,00.html .

According to a lot of web based material, there are many reasons why anyone suffering from gout should consult their primary care physician or a medical provider for care and treatment of this disease. If not treated properly, more severe complications can result. Always talk with your doctor if you suspect you may be seeing symptoms that appear to be gout related. Consider what options are available, and find out what medications may be good for you. Also, think about your diet, as some foods can cause an increase in uric acid that can lead to gout. Prevention and disease maintenance go a long way to help with this disease.

Until next time.