tag:blogger.com,1999:blog-7263888836199609352024-03-12T15:03:42.541-07:00Medicana"The Medical Site for Hypochondriacs!"
A wealth of information about diseases and conditions written in an informal, easy to read manner.Mauigirlhttp://www.blogger.com/profile/15529827915262851910noreply@blogger.comBlogger40125tag:blogger.com,1999:blog-726388883619960935.post-9461202992589015652009-10-14T14:28:00.000-07:002009-10-14T15:09:31.733-07:00Irresponsible Advice About the Swine Flu VaccineBill Maher should stick to politics. He's been Twittering that <a href="http://twitter.com/billmaher/status/4403617471">people who get swine flu shots are idiots</a> and also <a href="http://well.blogs.nytimes.com/2009/10/13/bill-maher-vs-the-flu-vaccine/">mouthed off on his "Real Time With Bill Maher" show about the vaccine</a>, implying that getting the vaccine was the same thing as being injected with the disease, which it is not.<br /><br />Now ordinarily this would not be a big deal. I mean, who would look to a talk show host for medical advice? Unfortunately, with this being a new vaccine, and a high level of suspicion about the government's ability to do anything whatsoever running rampant in the country, this just encourages those who are dubious about it to feel justified in skipping it. This would not be a good idea.<br /><br />The H1N1 (swine) flu is a different strain of flu virus. Unlike the usual seasonal influenza that is more apt to be severe in the elderly, with the H1N1 virus, younger people are more vulnerable and become sicker than their elders. <br /><br />This may be because the new H1N1 virus <a href="http://chronicle.augusta.com/stories/2009/09/20/met_548798.shtml">is related to the deadly 1918 Spanish flu</a>, and since variants of the 1918 flu type were in circulation for several generations after it first appeared, people 65 and over tend to be less vulnerable to the new flu since they have had exposure to its cousin in the past.<br /><br />In addition, those who were vaccinated against the swine flu strain that was prevalent in 1976 may also have a certain degree of cross-immunity to the new H1N1 virus.<br /><br />This leaves younger people at most risk for severe illness in this new pandemic. In addition, pregnant women, whose immunity is lowered by their condition, and those with specific health problems, are also vulnerable.<br /><br />There are two kinds of vaccine: One injectable, which is a killed virus that is incapable of causing illness, and a nasal spray version that is a weakened virus. It is recommended that those with impaired immunity only receive the injected vaccine.<br /><br />It is the height of irresponsibility on Maher's part to be blathering about a medical subject about which he obviously knows very little, and contradicting Dr. Bill Frist, his guest on the show, who was trying to get across the importance of vaccination.<br /><br />There are reasons some people shouldn't receive either vaccination. If they are allergic to eggs, as my mother is, they cannot receive any flu vaccines because the virus used to create them is incubated in eggs. In addition, there may be concerns about the preservative, thimerasol, which is used in the injectable vaccines for both H1N1 and regular seasonal flu. <br /><br />And of course, it is always a personal decision whether one wants to have a shot or not. But to make that decision, a person needs to be armed with the facts, not a talk show host's personal aversions. If you want the facts, <a href="http://cbs4.com/health/swine.flu.h1n1.2.1234085.html">please go to this site and read up on them</a>. Then you can make a truly informed decision about receiving the H1N1 vaccination.<br /><br /><em>(cross-posted at <a href="http://www.mauigirlsmeanderings.blogspot.com">Mauigirl's Meanderings</a>)</em>Mauigirlhttp://www.blogger.com/profile/15529827915262851910noreply@blogger.com9tag:blogger.com,1999:blog-726388883619960935.post-75264266596252082042009-02-21T15:03:00.000-08:002009-02-21T22:22:09.368-08:00Alice in Wonderland SyndromeWell, I'm finally back here. The excitement of the election and the inauguration of Barack Obama has finally died down a bit and I'm able to tear my brain away from politics enough to concentrate on doing some medical research.<br /><br />It also helps that I recently discovered a brand new condition that is fascinating to me and will be of interest, I'm sure, to all of you hypochondriacs out there.<br /><br />I discovered it because a friend recently told me that when she was a child she experienced spells where everything around her - the door, the window, the furniture, whatever - seemed abnormally large and she felt abnormally small. This experience was accompanied by a distinctive odor. I immediately thought that if this was something neurological, which it appeared to be, it probably had a name like "Alice in Wonderland Syndrome," since it sounded so much like what happened in the story..."One pill makes you larger, one pill makes you smaller..."<br /><br />So, being me, I had to go Google it. Imagine my surprise when I found there really is a syndrome called <a href="http://www.medterms.com/script/main/art.asp?articlekey=24174">Alice in Wonderland Syndrome</a>!<br /><br />According to <a href="http://www.healthcentral.com/migraine/types-of-headaches-251140-5.html">HealthCentral.com</a>, Alice in Wonderland Syndrome was first described by C.W. Lippman in 1952, but J. Todd actually named the syndrome "Alice in Wonderland" syndrome in his 1955 article, <a href="http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1826192&blobtype=pdf">"The Syndrome of Alice in Wonderland,"</a> in the Canadian Medical Association Journal. As a result, the syndrome is sometimes also called Todd's Syndrome.<br /><br /><strong>What Are the Symptoms of Alice in Wonderland Syndrome?</strong><br /><br />According to the <a href="http://www.migraine-aura.org/content/e27891/e27265/e26585/e43013/index_en.html">Migraine Aura Foundation</a>, the syndrome refers to "a variety of self-experienced body image disturbances affecting the experience of the size, mass, shape of the body or its position in space."<br /><br />Sometimes the affected person experiences a feeling of everything around them being much larger and they themselves feel smaller (macropsia) or vice versa - where they feel very large and everything around them seems very small (micropsia). These perceptions are also known as macro-somatognosia or micro-somatognosia.<br /><br />These symptoms can appear along with other distortions, in time, vision, or other senses (including smell, which would explain the odor my friend experienced).<br /><br />Sufferers may also see changes in the size of body parts such as their hands.<br /><br />Following is a <a href="http://everything2.com/e2node/Alice%20in%20Wonderland%20syndrome">full list of possible additional symptoms</a>:<br /><br /><em><span style="color:#000099;"><strong>"- feeling as if walking doesn't get them anywhere, as if they were walking on a treadmill<br />- the perception that only parts of their body are larger/smaller than normal<br />- - the feeling of walking on sponges<br />lingering touch sensation, i.e. after you've touched something, you continue to feel it after you've stopped touching it. Touch sensation hallucinations can also occur.<br />- lingering sound sensation, i.e. you continue hearing something after the noise has stopped<br />- anxiety<br />- loss of limb control and general discoordination, usually because of distorted perceptions of where one's body is in relation to surroundings<br />- agnosia / memory loss (though this is thought to be more of a side-effect: If you're having to think really hard about every movement, it's hard to pay attention to anything else and thus hard to remember things.)"</strong></span></em><br /><br /><strong>What Causes It?</strong><br /><br />Alice in Wonderland Syndrome can be caused by/associated with:<br /><br />- Migraines (the symptoms of AIWS may be part of the "aura" that precedes a migraine; often no headache is actually experienced).<br />- Certain drugs (including cough syrups containing dextromethorphan)<br />- Viruses (Epstein-Barr, which causes Mononucleosis, or other viruses)<br />- Epilepsy<br />- Brain tumors<br />- Schizophrenia<br />- Delirium Tremens (from alcohol abuse)<br /><br /><strong>What Are the Treatments?</strong><br /><br />Generally there is no specific treatment for AIWS; the root cause is what must be treated. For the most common cause, migraines, there are a number of remedies, as well as dietary restrictions that can help mitigate the symptoms. See this link to the <a href="http://www.mayoclinic.com/health/migraine-headache/DS00120">Mayo Clinic</a> for full information about migraine headaches.<br /><br />For more information on treatment for epilepsy, see this link to <a href="http://www.epilepsy.com/">Epilepsy.com.</a><br /><br />Often the syndrome occurs in young children and eventually they may outgrow it. Others don't experience it until adulthood.<br /><br /><strong>Will You Get It?</strong><br /><br />Probably not, unless you are a migraine sufferer. According to <a href="http://pedsinreview.aappublications.org/cgi/content/abstract/15/3/94">Pediatrics in Review</a>:<br /><br /><em><strong><span style="color:#000099;">"In the US it is estimated that 8.7 million females and 2.6 million males suffer from disabling migraine. The occurrence of migraine is greatest in adulthood, but this disorder is one of the most common causes of headache in children as well. In a 14-year longitudinal study of more than 9000 school children, Billie reported that 5% had had migraine attacks by 15 years of age. </span></strong></em><br /><em><strong><span style="color:#000099;"></span></strong></em><br /><em><strong><span style="color:#000099;">A recent population-based study in Olmsted County, Minnesota, suggests an even greater incidence in this age range. For example, the highest incidence of newly diagnosed migraine headaches appearing in males, 246 per 100 000 person-years, occurred in those aged 10 to 14 years</span>."</strong></em><br /><br />For an interesting article on the subject, see <a href="http://abcnews.go.com/primetime/Story?id=3581479&page=1">this article</a> from WABC news.Mauigirlhttp://www.blogger.com/profile/15529827915262851910noreply@blogger.com38tag:blogger.com,1999:blog-726388883619960935.post-65210744147653339752008-04-12T10:39:00.001-07:002008-04-12T11:14:49.373-07:00Help for Hypochondriacs!A friend found a handy tool for us hypochondriacs on the "Real Simple" website. It's called the:<br /><br /><a href="http://www.realsimple.com/realsimple/gallery/0,21863,1603934,00.html">Hypochondriac's Handbook.</a><br /><br />The "handbook," which is a 12-page web article, deals with such diverse subjects as chronic thirst (not necessarily diabetes), breast pain (not necessarily cancer) chronic headaches (not necessarily a brain tumor), and so on.<br /><br />Time Magazine has also recently published articles about hypochndriacs. <a href="http://www.time.com/time/magazine/article/0,9171,490690,00.html">How to Heal a Hypochondriac</a> talks about the tendency of medical students to become raging hypochondriacs as they gain more and more medical knowledge, truly illustrating Alexander Pope's contention that "a little knowledge is a dangerous thing."<br /><br />The article goes on to talk about hypochondriacs in general:<br /><br /><em><strong>"For doctors in training, nurses and medical journalists, hypochondria is an occupational hazard. The feeling usually passes after a while, leaving only a funny story to tell at a dinner party. But for the tens of thousands who suffer from true hypochondria, it's no joke. Hypochondriacs live in constant terror that they are dying of some awful disease, or even several awful diseases at once. Doctors can assure them that there's nothing wrong, but since the cough or the pain is real, the assurances fall on deaf ears. And because no physician or test can offer a 100% guarantee that one doesn't have cancer or multiple sclerosis or an ulcer, a hypochondriac always has fuel to feed his or her worst fears."</strong></em><br /><br />Sound like you? I know it sounds like me. Apparently we hypochondriacs are becoming a big wasteful clog in the medical system's pipes. And if you found this site by searching the Internet, you, like me, are part of the problem, and there is even a name for us - cyberchondriacs!<br /><br /><strong><em>"According to one estimate, hypochondria racks up some $20 billion in wasted medical resources in the U.S. alone. And the problem may be getting worse, thanks to the proliferation of medical information on the Internet. 'They go on the Web,' says Dr. Arthur Barsky, a psychiatrist at Harvard Medical School and Brigham and Women's Hospital in Boston, 'and learn about new diseases and new presentations of old diseases that they never even knew about before.' Doctors have taken to calling this phenomenon cyberchondria.'"</em></strong><br /><br />Luckily for us, there are those who are taking our situation seriously. <br /><br /><em><strong>"...a few clinicians, like Barsky and Columbia University neuropsychiatrist Dr. Brian Fallon, have begun to take the condition more seriously. 'It's not correct to say there's nothing wrong with a hypochondriac," Fallon asserts. "There is something wrong, but it's a disorder of thought, not of the body.' And, as he points out, disorders of thought are neither imaginary nor untreatable."</strong></em><br /><br />Dr. Fallon realized that hypochondriacs had a lot in common with those who suffer from Obsessive-Compulsive Disorder, or OCD.<br /><br /><strong><em>"'Both disorders,' he says, 'involve intrusive, worrisome thoughts, the need for reassurance and a low tolerance for uncertainty.' Psychiatrists had lately come to think that OCD could be treated with Prozac and similar drugs, and Fallon decided the medications might work for hypochondria as well. With only 57 subjects, the study was too small to be definitive, but it was certainly promising: about 75% of those who got the drug showed significant improvement." </em></strong><br /><br />I can vouch for the fact that since I've been on a low dose of Prozac for the past several years, I am much less apt to go into panic mode and have an anxiety attack when I notice a new symptom, nor am I as apt to immediately assume I have some new disease the second I hear about it (it usually takes at least a few days now!).<br /><br />Because some of the patients who responded were actually being given placebos, Dr. Fallon concluded there may be other causes of hypochondria, such as depression (stemming from guilt or loss) or a tendency to overanalyze and overreact to every bodily sensation, which is called "somatization."<br /><br />Whatever the cause, hypochondria becomes a vicious cycle, and it is hard to break. To deal with this, Barsky recommends cognitive behavior therapy.<br /><br /><strong><em>"'Just as focusing on a pain makes it seem more significant, ignoring it can make it seem much less,' says Barsky. Patients are also instructed to counter panicky thoughts with self-reassurance, reminding themselves, for example, that stomach pain almost never means stomach cancer. Both cognitive therapy and medication seem to work, and at this point it's hard to say whether one is better than the other."</em></strong><br /><br />Let's hope both doctors and patients become more aware of hypochondria and try to treat it. This way it will be a win-win for both!Mauigirlhttp://www.blogger.com/profile/15529827915262851910noreply@blogger.com12tag:blogger.com,1999:blog-726388883619960935.post-26197613868547812152008-03-29T13:56:00.000-07:002008-03-30T11:10:31.689-07:00Updates on Alzheimer's DiseaseAlzheimer's Disease is of particular interest to me, since my mother-in-law has it, and my father did too in his last years, although we never had a specific diagnosis.<br /><br />Those of you who follow my other blog may be aware that in February we had a family crisis of sorts. My father-in-law, who is my mother-in-law's caretaker, was suddenly stricken ill (life-threatening bleeding in his intestines from diverticulosis) and hospitalized. Since we were unable to properly care for my mother-in-law, we needed to find respite care for her until my father-in-law recovered.<br /><br />We were suddenly plunged head-first into the world of caregiving, and the financial and legal issues associated with it.<br /><br />With the help of the hospital's social worker, we were able to find my mother-in-law a very nice nursing home for the time-being.<br /><br />Through the magic of the internet, we found a local attorney who was able to draw up a Power of Durable Attorney document for my father-in-law to sign (up until then we did not have that document, which is very important for any children of elderly parents to obtain). Without it we couldn't access his bank account or other assets to pay for anything he or my mother-in-law needed.<br /><br />Then we consulted with an eldercare attorney to get direction on the best way to handle the situation going forward.<br /><br />Currently my father-in-law is back home while my mother-in-law is still in the nursing home while we figure out what the next step should be. Should she stay permanently in the nursing home? Or is she still well enough to live at home, albeit with help? My father-in-law now admits that her care is too much for him, especially after his recent health problem. But if she goes permanently into a nursing home, the financial implications become problematic.<br /><br />As it is, we may have waited too long to address some of these eldercare issues, because it is uncertain whether we will be able to get Power of Attorney for my mother-in-law since she may not be deemed competent to sign the document; in that case it means going to court to obtain guardianship for her - which will involve about two more months of time and a $3000 legal bill.<br /><br />We also learned that because both of my in-laws' names are on the deed to their house, both of their signatures would be required to sell the house if they need to sell. If my MIL is not competent, then my father-in-law or we need guardianship so we can sign in her stead.<br /><br />The reason I'm sharing all this with you is for those who may have relatives in a similar situation. I hope you will heed my tale as a warning to go get the advice and legal documents you need before an emergency arises that forces you to do it. It would be a lot less stressful that way!<br /><br />The <a href="http://www.caregiver.org/caregiver/jsp/content_node.jsp?nodeid=406">Family Caregiver Alliance</a> contains a wealth of information on all aspects of caregiving and eldercare issues if you would like more information about this important subject.<br /><br />Now, on to the news:<br /><br /><a href="http://www.nlm.nih.gov/medlineplus/news/fullstory_60408.html">Researchers at Rhode Island Hospital and Brown University</a> learned that people with early Alzheimer's Disease were involved in more crashes and performed more poorly on road tests than those without the disease.<br /><br />I'm sure this comes as no surprise for those of us who have had a parent with Alzheimer's Disease. My father, never a good driver, first got lost more easily and then started hitting things fairly frequently as he began to develop dementia. When he finally had a more serious accident as a result of running a red light, we asked him to stop driving, and he agreed. Luckily no one was hurt. <br /><br />My husband's grandmother, who hadn't learned to drive until her husband died when she was 70, drove safely for about 10 years until she started to lose her grip. She drove a standard shift car, and one day suddenly couldn't remember how to change gears. That was when my in-laws realized she couldn't drive any more.<br /><br />If you have a loved one with early dementia and are concerned about their driving, the Caregivers Alliance link above has more information on how best to address this problem.<br /><br />According to Reuters, the <a href="http://www.nlm.nih.gov/medlineplus/news/fullstory_62638.html">NYU School of Medicine has discovered that PET scans can help diagnose Alzheimer's and other dementias</a>. PET (Positron Emission Tomography) <span style="color:#000099;"><em><strong>"correctly classified 94 percent of the normal subjects, 95 percent with Alzheimer's disease, 92 percent with dementia with Lewy bodies and 94 percent with frontotemporal dementia." </strong></em></span><span style="color:#000099;"><br /><br /><span style="color:#000000;">One of the problems with Alzheimer's Disease in the past has been the difficulty of accurately identifying it in the patient. Because Alzheimer's Disease and other forms of dementia may need different therapies, this is an important finding that should help doctors diagnose Alzheimer's earlier and with more accuracy.<br /><br />According to the reasearcher</span><em><strong>, "'Because the incidence of these disorders is expected to increase dramatically as the baby-boom generation ages,' she added, 'accurate diagnosis becomes extremely important, particularly at the early and mild stages of dementia when life-style changes and therapeutic interventions are supposed to be most effective.'"</strong></em></span><br /><br />In other news, <a href="http://www.nlm.nih.gov/medlineplus/news/fullstory_62154.html">researchers at the University of California</a> found that melatonin and light therapy can help Alzheimer's patients remain acclimated to the normal day and night sleep-wake cycle. <br /><br />Many Alzheimer's patients tend to wake up at odd hours of the night and sleep during the day when they could be interacting with others and participating in activities.<br /><br />The light therapy is similar to what is used for people with Seasonal Affective Disorder - patients are exposed to bright light for an hour or so in the morning. <br /><br />For the study at the University of California, Alzheimer's patients were divided into three groups: One got only morning light therapy, one got both morning light therapy plus melatonin at bedtime, and the third group didn't have any special treatment.<br /><br />It was found that only the group receiving both light therapy and melatonin improved in their daytime alertness. <br /><br />Since light therapy alone did not show an effect, it is unclear whether it provided any benefit to the group that received melatonin, or whether melatonin alone was responsible for the improvement. Further research needs to be done to clarify this.<br /><br />Many Alzheimer's patients are recalcitrant when it comes to taking pills and other medications. My mother-in-law is relatively good about this but sometimes she hides a pill in her mouth and spits it out when no one's looking, the same way my cat does when I give him a pill. The solution has been to crush pills in applesauce and have her consume them that way, which works as long as she's in the mood for applesauce.<br /><br />Last summer, however, <a href="http://www.fda.gov/consumer/updates/exelonpatch080307.html">the FDA approved an Alzheimer's medication that is delivered in a patch</a>. The medication, Exelon, is a drug for treating mild to moderate Alzheimer's Disease that has already been approved in the form of a capsule and an oral solution. It works similarly to Aricept, another commonly prescribed drug used for Alzheimer's Disease. <br /><br />The patch, which can be applied to the back, chest or upper arm, delivers the drug in a steady dosage throughout 24 hours, after which it must be replaced with a new one. <br /><br />A study showed patients using the patch had fewer side effects than with the capsule version of the drug.<br /><br />Further research continues constantly, so if you have a loved one with this disease or are worried about getting it yourself, don't be discouraged. If you are interested in learning more, please check the <a href="http://www.ninds.nih.gov/disorders/dementias/detail_dementia.htm#1033419213">National Institute of Neurologic Disorders</a> website.<br /><br />UPDATE: In doing some further research, I discovered that there have been studies that show <a href="http://www.medscape.com/viewarticle/568812">Perispinal etanercept (Enbrel, Amgen), an anticytokine therapy that targets excess tumor necrosis factor - alpha (TNF-α) - in the brain, has been shown to produce almost immediate cognitive and behavioral improvement</a> in a patient with moderate Alzheimer's Disease.<br /><br />The therapy, which has already been approved for use in rheumatoid arthritis, reduces neurological inflammation. It is administered via a once-a-week injection into the cerebro-spinal system. Full research article is available at <a href="http://www.jneuroinflammation.com/content/5/1/2">this site</a>.<br /><br />Further research must be done, but this seems to be a promising therapy.Mauigirlhttp://www.blogger.com/profile/15529827915262851910noreply@blogger.com14tag:blogger.com,1999:blog-726388883619960935.post-61487446779725422782008-03-22T20:20:00.000-07:002008-03-22T20:27:15.409-07:00Medical SabbaticalHello fellow hypochondriacs! I just wanted to pop in and apologize for my long absence. I had been intending to write another information-laden post about, of all things, appendix cancer. (Yes, there is such a thing - and a friend of mine was recently diagnosed with it.) But I haven't had enough time and energy recently. (Do you think there's something wrong with me?) <br /><br />I still want to write about that cancer, but was sidetracked for the entire month of February due to some family issues. Then I was on vacation for two and a half weeks, and have just gotten back into the swing of things. In addition, politics, my other obsession, has been taking up what time I have had for blogging, on my other site, <a href="http://www.mauigirlsmeanderings.blogspot.com">Mauigirl's Meanderings.</a><br /><br />I think to get back to my medical calling over here, I will write some shorter posts about recent medical developments before writing the long post. I hope to have something up in the next day or two!<br /><br />In the meantime, no, that hacking cough you have is NOT lung cancer. It's from the dry heat in your house. Or the pollen that I hear is already blowing around out there despite the fact that every tree in my area is still starkly naked. <br /><br />Of course, if the cough doesn't go away please do get it checked out...Just because you're a hypochondriac doesn't mean you don't have a fatal disease!Mauigirlhttp://www.blogger.com/profile/15529827915262851910noreply@blogger.com1tag:blogger.com,1999:blog-726388883619960935.post-77237140428105312342008-01-05T20:03:00.000-08:002008-01-06T08:09:44.867-08:00Colon CancerUnfortunately, many of the subjects I choose to write about in Medicana are driven by the diagnosis of someone I know with the condition in question.<br /><br />In the case of colon cancer, I am sorry to report that a friend of mine was just diagnosed with it. I don't yet know all the details, but her symptoms led to an initial diagnosis of some type of ovarian tumor, based on an ultrasound and an MRI. Once surgery was performed, it was discovered the tumor was actually colon cancer that had spread to the ovaries - not a good scenario.<br /><br />I do not yet know the staging of her cancer since all the tests have not come back yet, but I thought I'd do the research on colon cancer now so there would be plenty of information available once she finds out more.<br /><br />I am posting this information in hopes that my research may help discover new treatments or information that may help her and her family as they work with her doctors to find the right treatment for her cancer, and help anyone else who may have been diagnosed with this disease.<br /><br /><strong>Colon Cancer - What is it?</strong><br /><br />Colon cancer, more generally known as colorectal cancer, is any cancer affecting the colon or rectum. The colon is the large intestine and the rectum the last six inches of the large intestine.<br /><br />Colon cancer usually begins as small, noncancerous clump of cells called adenomatous polyps. Eventually these polyps can become colon cancers.<br /><br />Because polyps usually cause few symptoms, or in many cases, no symptoms at all, it is important for people to get screened for colon cancer once they reach middle age; usually 50, unless there are risk factors in the family, in which case screening should start earlier.<br /><br />There are three types of polyps:<br /><br />- <strong>Adenomas:</strong> These are likely to turn into cancer.<br />- <strong>Hyperplastic polyps:</strong> These rarely turn into cancer.<br />- <strong>Inflammatory polyps:</strong> These can follow a flare-up of ulcerative colitis, and can turn cancerous, which is why ulcerative colitis is a risk factor for colon cancer.<br /><br />Most colon cancers are adenocarcinomas (cancers that begin in cells that make and release mucus and other fluids).<br /><br /><strong>What Are the Symptoms of Colon Cancer?</strong><br /><br />Often there are no symptoms that show up for colon cancer in its early stages. The symptoms to watch out for are:<br /><br />- Any change in bowel habits, including diarrhea or constipation or a change in the consistency of your stool that lasts more than a week or two. Narrowing of the stool is another symptom.<br />- Rectal bleeding or blood in your stool<br />- Persistent abdominal discomfort, such as cramps, gas or pain<br />- Abdominal pain with a bowel movement<br />- A feeling that your bowel doesn't empty completely, or feeling full or bloated<br />- Unexplained anemia<br />- Weakness or fatigue<br />- Unexplained weight loss<br /><br />According to Medicinenet.com (link below), colon cancer may be present for several years before symptoms develop. Symptoms vary according to where in the large bowel the tumor is located. The right colon has plenty of room, and cancers of the right colon can grow to large sizes before they cause any symptoms. Usually right-sided cancers cause anemia due to the slow loss of blood over a long period of time, which can lead to fatigue, weakness and shortness of breath. Because the left colon is narrower than the right colon, cancers of the left colon are more apt to cause partial or complete bowel obstruction.<br /><br /><strong>What Are the Causes and Risk Factors for Colon Cancer?</strong><br /><br />There are a number of factors that put a person at higher risk for colon cancer:<br /><br /><strong>Age:</strong> About 90 percent of people diagnosed with colon cancer are older than 50. Only about 10% of colon cancer cases occur in younger people.<br /><br /><strong>A personal history of colorectal cancer or polyps:</strong> Naturally it makes sense that if a person has already had colon cancer they would have a risk of colon cancer again in the future. However, people who have had a history of adenomatous polyps also have a higher likelihood of getting colon cancer and will need regular screening.<br /><br /><strong>Inflammatory bowel disease/conditions:</strong> Chronic conditions such as ulcerative colitis and Crohn's disease can increase the risk of colon cancer.<br /><br /><strong>Genetics: </strong>Inherited syndromes passed through the family can increase the risk of colon cancer. Inherited conditions account for only about 5 percent of all colon cancers.<br /><br />One such genetic condition is called familial adenomatous polyposis (FAP), which is a rare disorder that causes thousands of polyps to develop in the lining of the colon and rectum. People with untreated FAP have >90% chance of developing colon cancer by age 45.<br /><br />Hereditary nonpolyposis colorectal cancer (HNPCC), which is also called Lynch syndrome, is more common than FAP. Sufferers of Lynch syndrome also tend to develop colon cancer at an early age. Both FAP and HNPCC can be detected through genetic testing.<br /><br />Certain HNPCC patients are also at risk of developing uterine cancer, stomach cancer, ovarian cancer, and cancers of the ureters (the tubes that connect the kidneys to the bladder), and the biliary tract (the ducts that drain bile from the liver to the intestines).<br /><br />MYH polyposis syndrome is another, recently discovered, hereditary colon cancer syndrome. Affected people tend to develop 10-100 polyps starting at around 40 years of age, and are at high risk of developing colon cancer.<br /><br />According to Medicinenet.com, <span style="color:#000099;">"Among first-degree relatives of colon cancer patients, the lifetime risk of developing colon cancer is 18% (a threefold increase over the general population in the United States).<br /><br />Even though family history of colon cancer is an important risk factor, majority (80%) of colon cancers occur sporadically in patients with no family history of colon cancer. Approximately 20% of cancers are associated with a family history of colon cancer. And 5 % of colon cancers are due to hereditary colon cancer syndromes. Hereditary colon cancer syndromes are disorders where affected family members have inherited cancer-causing genetic defects from one or both of the parents."<br /></span><br /><strong>Family history of colon cancer and colon polyps:</strong> If a person has a parent, brother or sister or a child with colon cancer, this too is a risk factor. This may be a hereditary connection or it might be due to mutual exposure to an environmental toxin, diet or lifestyle that leads to the condition.<br /><br /><strong>Diet:</strong> Colon cancer and rectal cancer may be associated with a diet low in fiber and high in fat and calories. It is believed that the breakdown products of fat metabolism lead to the formation of cancer-causing chemicals. Some studies have found an increased risk of colon cancer in people who eat diets high in red meat and processed meats. Lack of fruits and vegetables may be part of the picture, since increased consumption of these foods seems to have a protective effect against colon cancer.<br /><br /><strong>Lack of exercise:</strong> If a person is inactive, they are more likely to develop colon cancer, possibly by causing waste to stay in the colon longer.<br /><br /><strong>Diabetes:</strong> People with diabetes and insulin resistance may have an increased risk of colon cancer. Just one more reason to try to avoid diabetes; it seems to be implicated in so many other diseases.<br /><br /><strong>Obesity:</strong> People who are obese have an increased risk of colon cancer and an increased risk of dying of colon cancer when compared with people considered normal weight. Of course, obesity also may be associated with a high fat diet, sedentary lifestyle, and diabetes, so it may all be connected.<br /><br /><strong>Smoking:</strong> People who smoke cigarettes may have an increased risk of getting colon cancer - and of dying of it.<br /><br /><strong>Heavy Use of Alcohol:</strong> Heavy drinking may increase the risk of colon cancer.<br /><br /><strong>Growth hormone disorder:</strong> Acromegaly, an uncommon disorder that causes an excess of growth hormone in the body, may increase the risk of colon polyps and colon cancer. (Sounds to me as if the use of human growth hormone by sports figures might not be a good idea).<br /><br /><strong>Previous radiation therapy for cancer:</strong> Radiation therapy directed at the abdomen to treat previous cancers may increase the risk of colon cancer.<br /><br /><strong>How Is It Diagnosed?</strong><br /><br />There are a number of screening methodologies available to find colon cancer before it is advanced enough to cause symptoms - and at a stage where it is most curable.<br /><br />Unfortunately, none of them are very appealing to people, which is why many people avoid the whole subject. This is tragic, since when caught early, colon cancer is very curable. In fact, some of the screening methods actually prevent it from developing in the first place by removing polyps before they have a chance to go bad.<br /><br />The following are the screening techniques currently used to detect colon cancer:<br /><br />- <strong>Fecal occult blood test:</strong> This is a fancy way of saying it's a test to detect hidden (occult) blood in the stool. It can be done in the doctor's office, or by using a kit at home. If blood is detected, the doctor would then order more tests to find out the cause. Blood in the stool does not always mean cancer; it can be caused by a polyp that has not yet become cancerous, certain foods or medications (such as aspirin), or hemmorrhoids. A negative test for occult blood is not a guarantee of no cancer, either: Not all cancers bleed, and some only bleed occasionally, so they can be missed. This test, however, is least invasive and more apt to be performed willingly by the patient. A digital rectal exam may also be performed to check for growths or blood in the lower part of the rectum.<br /><br />- <strong>Flexible Sigmoidoscopy:</strong> For this test, the lower colon must be cleaned out ahead of time, usually through an enema; the sigmoidoscopy is usually done in the doctor's office, where the doctor examines the last two feet (1/3) of the colon for polyps or other anomalies, using a slender, flexible lighted tube. The colon is inflated with air to enable the doctor to examine the colon. The drawback to this test is that since it only examines part of the colon, polyps or growths farther up will not be detected. I had one of these once after I'd noticed blood in my stool (it turned out to be hemmorrhoids).<br /><br />- <strong>Barium Enema:</strong> In this test, barium is inserted into the cleaned colon, with or without air added. Barium is a contrast dye that enables the doctor to see irregularities along the colon walls through X-ray examination. Sometimes a flexible sigmoidoscopy is done as well. The barium enema is not able to identify small cancers and small polyps. A colonoscopy is usually recommended if suspicious lesions are sighted in the barium enema test, since no sampling is possible during this test.<br /><br />- <strong>Colonoscopy:</strong> The gold standard of colon cancer screening, the colonoscopy enables the physician to examine the full length of the colon with a flexible lighted tube, similar to the one used in sigmoidoscopy, with a video camera and monitor attached. The colon must be thoroughly cleaned out ahead of time; the patient must consume a laxative solution the night before. The beauty of the colonoscopy is that the doctor is able to remove polyps or other suspicious growths with the colonoscope, and find out whether they are cancerous. As mentioned previously, removal of the polyps can actually prevent cancer since they will no longer have the opportunity to develop into cancer once they are removed. Patients are under sedation during this procedure so there is no discomfort; most people do not remember the experience due to new medications that are used. If nothing suspicious is found during the colonoscopy, patients are advised to have another one in 7-10 years.<br /><br />I had a colonoscopy at age 47, since both of my parents have had polyps. I didn't feel a thing and felt fine afterwards. I am due for another this year and you can be sure I'm going to get it.<br /><br />- <strong>Virtual Colonoscopy:</strong> Although many insurance companies do not yet cover this method, it is becoming more popular since it is not invasive. The patient cleans the colon ahead of time, similar to preparation for the standard colonoscopy, but instead the procedure is a simple computerized tomography (CT) scan. There is no sedation, no recovery needed; and no risk of perforating the colon. However, the colon does need to be filled with air, which is uncomfortable. Virtual colonoscopy is not as good as the real thing in finding very small polyps or flat lesions on the wall of the colon. In addition,if anything is seen on the scan, the patient would still need a standard colonoscopy to follow up, since there is no way to sample anything suspicious that is seen.<br /><br />All of the invasive methods carry some risk of perforating the colon; however, the benefits of screening far outweigh the risks.<br /><br />If a person presents to the doctor with actual symptoms, rather than just needing a routine screening, usually a colonoscopy would be ordered so as to enable the physician to take biopsies of anything that is found. When it is less clear that the symptoms are colon-related, MRIs, CT scans or ultrasounds may be ordered first.<br /><br />If cancer is diagnosed, the next step is staging. The first step may be to have a CT scan of the abdomen and a chest X-ray to make sure nothing has spread yet.<br /><br /><strong>How Is Colon Cancer Treated?</strong><br /><br />Surgery is the first line of treatment for colon cancer. It is important to remove as much of the cancer as possible, and also to remove lymph nodes in the abdomen to help stage the cancer and prevent it from spreading.<br /><br />Depending on how much of the colon is affected, the patient may need to have more or less of it removed. In some cases the entire colon has to be removed; in others, just a section - and in some cases, only the cancerous polyp needs to be taken out.<br /><br />During surgery, the tumor, a small piece of the surrounding healthy colon, and adjacent lymph nodes are removed. The surgeon then reconnects the healthy sections of the bowel. Recent studies have indicated that the more lymph nodes removed at the time of surgery, the better the prognosis.<br /><br />If the cancer is in the right or left side of the colon but above the rectum, usually a resection of the colon will work. If the rectum or anal sphincter is involved, it may be necessary for the patient to have a colostomy bag; he or she can no longer defecate and stool goes into the bag instead.<br /><br />According to EMedicineHealth.com, in the case of early cancers, sometimes there is no further treatment, just follow-up:<br /><br /><span style="color:#000099;">"Once your cancerous colon has been removed and you receive any other treatment recommended by your cancer care team, you will see your gastroenterologist or cancer specialist (oncologist) regularly for follow-up visits. These visits will allow your team to see if the cancer has spread and to detect newly formed cancers.<br /><br />These follow-up visits should include, at minimum, the following:<br /><br />Colonoscopy within 3 months after your surgery.<br />Colonoscopy 1 year after surgery and every 3 years after that.<br />Test for occult (hidden) blood in your stool every year, followed by colonoscopy if the test result is positive.<br /><br />A screening tool—measurement of carcinoembryonic antigen (CEA) level—is available to test for cancer recurrence following cancer surgery.<br /><br />CEA is a protein normally found in trace amounts in your bloodstream but is present in increased amounts in people with colon cancer. It is referred to as a tumor marker.<br /><br />Blood CEA levels should be measured before colon cancer surgery and then at intervals of 2-3 months.<br /><br />Increasing levels of serum CEA may indicate that colon cancer has come back and that you should seek further evaluation.<br /><br />Once you have had several blood tests with negative results, you probably don't need to continue the tests indefinitely. However, no one is sure how long you should continue to have the tests."<br /></span><br />Colon cancer, as mentioned before, is staged based on how much it has spread. If it is not caught early, further treatment is needed.<br /><br /><strong>What Are the Stages of Colon Cancer?</strong><br /><br />There are a number of ways to stage colon cancer; there is a simple Stage I-IV method, but the more complex way to stage cancer is to divide up the various aspects of it into the tumor itself, the lymph node involvement, and whether or not it has spread (metastasized). From the Oncology Channel (link below), here is the breakout of these details:<br /><br /><span style="color:#000099;"><span style="color:#000099;">"<strong>TNM Staging System (Tumor, Node, Metastasis) </strong><br /><br /><strong>Tumor </strong><br /><strong>T1: </strong>Tumor invades submucosa.<br /><strong>T2:</strong> Tumor invades muscularis propria.<br /><strong>T3:</strong> Tumor invades through the muscularis propria into the subserosa, or into the pericolic or perirectal tissues.<br /><br /><span style="color:#000000;">(NOTE: these are all fancy words for the various layers of the intestinal wall). </span><br /><br /><strong>T4:</strong> Tumor directly invades other organs or structures, and/or perforates.<br /><br /><strong>Node </strong><br /><br /><strong>N0:</strong> No regional lymph node metastasis.<br /><strong>N1:</strong> Metastasis in 1 to 3 regional lymph nodes.<br /><strong>N2:</strong> Metastasis in 4 or more regional lymph nodes.<br /><br /><strong>Metastasis </strong></span></span><br /><span style="color:#000099;"><span style="color:#000099;"><strong></strong><br /><strong>M0:</strong> No distant metastasis.<br /><strong>M1</strong> Distant metastasis present.<br /><br /><strong>Stage Groupings</strong><br /><br /><strong>Stage I:</strong> T1 N0 M0; T2 N0 M0<br />Cancer has begun to spread, but is still in the inner lining.<br /><br /><strong>Stage II: </strong>T3 N0 M0; T4 N0 M0<br />Cancer has spread to other organs near the colon or rectum. It has not reached lymph nodes.<br /><br /><strong>Stage III:</strong> any T, N1-2, M0<br />Cancer has spread to lymph nodes, but has not been carried to distant parts of the body.<br /><br /><strong>Stage IV: </strong>any T, any N, M1<br />Cancer has been carried through the lymph system to distant parts of the body. This is known as metastasis. The most likely organs to experience metastasis from colorectal cancer are the lungs and liver."</span><br /></span><br />Treatment may include chemotherapy, radiation, or both. According to Oncology Channel, the following regimens are frequently used:<br /><br /><span style="color:#000099;">"Chemotherapy is often used as a first-line treatment for metastatic colorectal cancer to destroy cancer cells that have metastasized (spread). It also may be used prior to surgery (called neoadjuvant therapy) to shrink the tumor, may be administered following surgery (called adjuvant therapy), and may be combined with biological therapy (also called immunotherapy) and radiation therapy.<br /><br />Newer combinations of chemotherapy drugs, such as FOLFOX (5-fluorouracil [5-FU], leucovorin, and oxaliplatin [Eloxatin®]) and FOFIRI (5-fluorouracil [5-FU], leucovorin, and irinotecan [Camptosar®]) may be used to prevent recurrence following surgery or to shrink the tumor prior to surgery.<br /><br />A combination of chemotherapy drugs (5-fluorouracil [5-FU], leucovorin, and irinotecan [CPT11]), administered intravenously, is standard treatment for metastatic colorectal cancer. Side effects include diarrhea, mouth irritation (mucositis), low white blood cell count (e.g., neutropenia), and hair loss (alopecia).<br /><br />Colorectal cancer with liver metastasis also may be treated using floxuridine (FUDR®) administered intra-arterially (i.e., through an artery). Side effects include nausea, vomiting, diarrhea, and inflammation of the intestine (enteritis).<br /><br />In addition to chemotherapy drugs, blocking agents (e.g., cetuximab [Erbitux®]) may also be used to treat metastatic colorectal cancer. These drugs prevent cancer cell receptors from receiving factors (e.g., epidermal growth factor) that cause cell growth, cell division, and additional metastasis. Blocking agents target specific cells so they usually do not cause systemic side effects. Side effects of these drugs include allergic reactions (e.g., difficulty breathing, hives, low blood pressure, rash).<br /><br />Bevacizumab (Avastin®) may also be used to treat advanced colorectal cancer. This medication prevents new blood vessels, which are necessary for tumor growth, from forming. It does not affect normal tissues that already have an established blood supply. Side effects include blood clots and high blood pressure, which can be controlled with medication. </span><br /></span></span><br /><span style="color:#000000;">(NOTE: Avastin is one of a new class of drugs called </span><a href="http://www.mayoclinic.com/health/angiogenesis/CA00079"><span style="color:#cc0000;">angiogenesis inhibitors</span></a><span style="color:#000099;"><span style="color:#000000;"> and they have shown to be quite effective against colon cancer.)<br /></span><br />Panitumumab (Vectibix™) is the first entirely human monoclonal antibody approved by the Food and Drug Administration (FDA) to treat patients with metastatic colorectal cancer following chemotherapy. This medication is administered intravenously once every 2 weeks.<br /><br /><strong>Immunotherapy </strong><br /><br />Immunotherapy, or biological therapy, attempts to stimulate the immune system to fight disease and protect the body from side effects of chemotherapy. Immunotherapy agents that may be used to treat colorectal cancer include bacilli Calmette-Guerin (BCG) and levamisole (Ergamisol®).<br /><br />Immunotherapy may cause flu-like side effects such as the following:<br /><br />Chills<br />Diarrhea<br />Fever<br />Loss of appetite<br />Muscle aches and weakness<br />Nausea and vomiting<br /><br /><strong>Radiation Therapy </strong><br /><br />Radiation therapy uses high energy x-rays to destroy cancer cells and shrink tumors. External beam radiation (i.e., radiation from a machine outside the body) may be used in addition to surgery to treat colorectal cancer (called adjuvant therapy). It also may be used to relieve symptoms (called palliative treatment) in patients with metastatic colorectal cancer.<br /><br />Side effects include fatigue, hair loss, reddened skin, and swelling (edema). Medicines and other treatments can reduce the intensity of the side effects. As with other cancer treatments, the incidence of side effects varies with patient health and the exact nature of the treatment.<br /><br /><strong>Follow-up Treatment </strong><br /><br />Follow-up care is recommended for colorectal cancer patients to ensure that recurrent or metastatic disease is detected as soon as possible. Patients should undergo regular physical examinations, fecal occult blood tests, colonoscopies, CT scans, and chest x-rays.<br /><br /><strong>Prognosis </strong><br /><br />Prognosis depends on the stage of the disease and the overall health of the patient. Overall, colorectal cancer patients have a 5-year survival rate of about 61%. The 5-year survival rate is about 92% when the disease is treated before it has spread (metastasized); 64% when the cancer has spread to nearby organs or lymph nodes; and 7% when it has spread to other parts of the body (e.g., liver, lungs)."</span><br /><br />Depending on the severity of the disease, some patients may want to try to get into clinical trials. If you have been diagnosed with advanced colon cancer and you are located near a major cancer center, it is possible trials are being held of treatments that are not yet generally available to patients that may be more effective than current methods.<br /><br />Clinical trials can be found on-line in a number of places. Please see below for some links.<br /><br /><a href="http://bethesdatrials.cancer.gov/colorectal/index.aspx">http://bethesdatrials.cancer.gov/colorectal/index.aspx</a><br /><a href="http://www.mdanderson.org/patients_public/clinical_trials/?Referrer=Google&KW=Cancer_Research&gclid=CObv_IKH4ZACFShsGgodSzLZYA">http://www.mdanderson.org/patients_public/clinical_trials/?Referrer=Google&KW=Cancer_Research&gclid=CObv_IKH4ZACFShsGgodSzLZYA</a><br /><a href="http://www.fightcolorectalcancer.org/patients/clinicaltrials/index.htm">http://www.fightcolorectalcancer.org/patients/clinicaltrials/index.htm</a><br /><a href="http://www.mskcc.org/mskcc/html/14075.cfm">http://www.mskcc.org/mskcc/html/14075.cfm</a><br /><a href="http://www.ccalliance.org/patient/clinical/clinical.html">http://www.ccalliance.org/patient/clinical/clinical.html</a><br /><a href="http://clinicaltrials.gov/ct/search?term=colon+cancer">http://clinicaltrials.gov/ct/search?term=colon+cancer</a><br /><a href="http://www.mayoclinic.org/colon-cancer/clintrials.html">http://www.mayoclinic.org/colon-cancer/clintrials.html</a><br /><a href="http://www.nlm.nih.gov/medlineplus/colorectalcancer.html#cat27">http://www.nlm.nih.gov/medlineplus/colorectalcancer.html#cat27</a><br /><br />Be sure to check out the trials available before starting any treatment; always get a second opinion on your treatment before committing to something. For one thing, clinical trials don't always accept patients who have already had other treatments first.<br /><br />Please note, although these trials are usually "double blind" trials (that is, patients and physicians don't know which patients are getting the experimental treatment), those who do not get the new treatment are given the current accepted treatment for the cancer, so no one gets a placebo.<br /><br /><strong>Will You Get It?</strong><br /><br />You could, especially if you have any of the risk factors above. Colorectal cancer is the fourth most common cancer in the United States and the second leading cause of cancer death. A person at age 50 has about a 5 percent lifetime risk of being diagnosed with colorectal cancer and a 2.5 percent chance of dying from it.<br /><br />Most people will not get it if they get screened at the recommended times. Unfortunately, people younger than 50 who have no other risk factors can get it too, and they are younger than the recommended age to start screening.<br /><br />So any time you notice anything unusual about the way your body feels or how you feel overall, be sure to go to the doctor and get checked out.<br /><br />And if you do find out you have cancer, always go to experts for your treatment. Get more than one opinion. Go to a major cancer center. I may sound like a broken record, but I'd rather be repetitive than not get the message across. Your life may depend upon it.<br /><br /><strong>Sources: </strong><br /><a href="http://www.medicinenet.com/colon_cancer/article.htm">http://www.medicinenet.com/colon_cancer/article.htm</a>: Medicinenet.com<br /><a href="http://www.mayoclinic.com/health/colon-cancer/DS00035">http://www.mayoclinic.com/health/colon-cancer/DS00035</a>: The Mayo Clinic<br /><a href="http://www.cancer.gov/cancertopics/types/colon-and-rectal"><span style="color:#cc0000;">http://www.cancer.gov/cancertopics/types/colon-and-rectal</span></a>: Cancer.gov<br /><a href="http://www.emedicinehealth.com/colon_cancer/article_em.htm">http://www.emedicinehealth.com/colon_cancer/article_em.htm</a>: EMedicineHealth.com<br /><a href="http://www.oncologychannel.com/coloncancer/staging.shtml">http://www.oncologychannel.com/coloncancer/staging.shtml</a>: Oncology Channel<br /><a href="http://www.ahrq.gov/clinic/3rduspstf/colorectal/colorr.htm">http://www.ahrq.gov/clinic/3rduspstf/colorectal/colorr.htm</a><br /><br /><strong>For more information/treatments:</strong><br /><a href="http://www.mdanderson.org/diseases/Colorectal/?gclid=CPKkh6fp4JACFRuhFQodBTLrXA">http://www.mdanderson.org/diseases/Colorectal/?gclid=CPKkh6fp4JACFRuhFQodBTLrXA</a>: M.D. Anderson<br /><a href="http://www.mskcc.org/mskcc/html/5789.cfm">http://www.mskcc.org/mskcc/html/5789.cfm</a>: Memorial Sloan Kettering<br /><a href="http://www.nlm.nih.gov/medlineplus/ency/article/000262.htm">http://www.nlm.nih.gov/medlineplus/ency/article/000262.htm</a>: National Institutes of HealthMauigirlhttp://www.blogger.com/profile/15529827915262851910noreply@blogger.com10tag:blogger.com,1999:blog-726388883619960935.post-12600094723857508912007-12-13T23:00:00.000-08:002008-02-06T18:47:26.817-08:00Prostate CancerI've known several people who have been diagnosed with prostate cancer, which is not surprising given that this is a common cancer among men, and I am now at that age that my male friends are in the likely age range to develop it.<br /><br />Luckily, prostate cancer, when found early, is highly curable and in most cases not that aggressive. It is said more men die with prostate cancer than of it.<br /><br /><strong>What is Prostate Cancer?</strong><br /><br />As it is described in nearly every website on the subject, the prostate is a "walnut-sized gland" located under the bladder and in front of the rectum.<br /><br />Helpfully, the <a href="http://www.cancer.org/docroot/CRI/content/CRI_2_4_1X_What_is_prostate_cancer_36.asp?sitearea=">American Cancer Society</a> also explains that only men have one, which, if you didn't already know this, is good information to have if you're a woman - this means if you are a female hypochondriac it's one cancer you don't have to worry about. (Don't worry, you have several other female-only cancers to choose from that men don't have to worry about, so don't get too smug).<br /><br />According to the American Cancer Society, over 99% of prostate cancers develop from the "gland cells," which make the fluid that is added to the semen. The cancer arising from this type of cell is called "adenocarcinoma."<br /><br />Other types of cancer that can start in the prostate gland include sarcomas, small cell carcinomas, and transitional cell carcinomas. Because these other types of prostate cancer are so rare, this post will just focus on adenocarcinoma.<br /><br />Overall, prostate cancer tends to be slow-growing, and autopsy studies show that many older men who died of other diseases also had prostate cancer. The studies indicate that 70% to 90% of the men had cancer in their prostate by age 80, but in many cases neither they nor their doctors even knew they had it.<br /><br /><strong>How Is It Diagnosed?</strong><br /><br />In the past, men frequently didn't receive a diagnosis until symptoms showed up, by which time it often was too late. Now there are methods available that can diagnose prostate cancer at a much earlier stage. From the <a href="http://www.mayoclinic.com/health/prostate-cancer/DS00043/DSECTION=6">Mayo Clinic website</a>: the following screening tests are used today:<br /><br /><span style="color:#000099;"><em><strong>Digital rectal exam (DRE</strong>). During a DRE, your doctor inserts a gloved, lubricated finger into your rectum to examine your prostate, which is adjacent to the rectum. If your doctor finds any abnormalities in the texture, shape or size of your gland, you may need more tests.</em><br /><br /></span><em><span style="color:#000099;"><strong>Prostate-specific antigen (PSA) test</strong>. A blood sample is drawn from a vein and analyzed for PSA, a substance that's naturally produced by your prostate gland to help liquefy semen. It's normal for a small amount of PSA to enter your bloodstream. However, if a higher than normal level is found, it may be an indication of prostate infection, inflammation, enlargement or cancer.</span><br /><br /></em><a href="http://www.mskcc.org/mskcc/html/1818.cfm">Memorial Sloan Kettering</a> recommends the following criteria in interpreting PSA tests:<br /><br /><em><span style="color:#003300;"><span style="color:#006600;">"To balance the influence of age on PSA levels, the following age-specific PSA level cut-offs should be considered:<br /><br />Greater than or equal to 2.5 ng/mL for men up to age 49<br />Greater than or equal to 3.5 ng/mL for men aged 50 to 59<br />Greater than or equal to 4.0 ng/mL for men aged 60 and older.<br /><br />Men with values outside their age-allowed targets should be considered as candidates for prostate biopsy.<br /><br />For those men being screened for PSA velocity, a PSA velocity of greater than or equal to 0.75 ng/mL per year should necessitate a prostate biopsy -- even if the PSA level is in the normal range."</span><br /></span><br /></em>There are differences of opinion among experts about PSA testing. The American Cancer Society recommends that both the PSA and DRE should be offered annually, beginning at age 50, to men who have at least a 10-year life expectancy. However, men at high risk, which includes African American men and men with a strong family history of close relatives diagnosed at an early age, should begin testing at age 45.<br /><br />Experts in favor of regular screening believe that finding and treating prostate cancer early offers men more treatment options with potentially fewer side effects. Those who recommend against regular screening feel that because most prostate cancers grow so slowly, the side effects of treatment would likely outweigh any benefit that might be derived from detecting the cancer at a stage when it is unlikely to cause problems. Although the jury is out on this one, given that two of my friends discovered their cancers solely through an abnormal PSA test, I tend to believe in testing.<br /><br />The following tests are used to diagnose prostate cancer if the initial DRE and PSA tests raise a red flag. (From the Mayo Clinic site):<br /><br /><em><span style="color:#000099;"><strong>"Transrectal ultrasound</strong>. If other tests raise concerns, your doctor may use transrectal ultrasound to further evaluate your prostate. A small probe, about the size and shape of a cigar, is inserted into your rectum. The probe uses sound waves to get a picture of your prostate gland.<br /><br /><strong>Prostate biopsy</strong>. If initial test results suggest prostate cancer, your doctor may recommend a prostate biopsy. During a biopsy, small tissue samples are taken and analyzed to determine if cancer cells are present.<br /><br />To do a biopsy, your doctor inserts an ultrasound probe into your rectum. Guided by images from the probe, your doctor identifies any suspicious areas. Then a fine, hollow needle is aimed at these areas of your prostate. A spring propels the needle into your prostate gland and retrieves a very thin section of tissue."<br /></span><br /></em>The biopsy could show either no cancer, precancerous or cancerous cells.<br /><br />It is believed that prostate cancer begins with a pre-cancerous condition called "prostatic intraepithelial neoplasia" or PIN. Almost half of all men have this condition by the time they reach 50. Under a microscope, the gland cells with PIN appear changed, but not invasive. They can be low-grade (almost normal) or high-grade (more abnormal).<br /><br />Doctors recommend that men with high-grade PIN be watched carefully and a repeat biopsy may be necessary.<br /><br />Another type of precancerous condition that may be found is "atypical small acinar proliferation," or ASAP, sometimes known as "atypia." It just means there are some possibly cancerous cells showing up in the biopsy, but not enough to be sure. If ASAP is found, there's about a 40% to 50% chance that cancer is also present in the prostate, which means it's best to get a repeat biopsy within a few months. You might think of "ASAP" as meaning "get another biopsy ASAP!"<br /><a></a><br />If the cells that are evaluated turn out to be cancer, then there may be more tests ordered to understand how advanced the cancer is, if there is a possibility cancer may have spread (from the Mayo Clinic website):<br /><br /><em><span style="color:#000099;"><strong>"Bone scan</strong>. A bone scan takes a picture of your skeleton in order to determine whether cancer has spread to the bone. Prostate cancer can spread to any bones in your body, not just those closest to your prostate, such as your pelvis or lower spine.<br /><br /><strong>Ultrasound.</strong> Ultrasound not only can help indicate if cancer is present, but also may reveal whether the disease has spread to nearby tissues. </span></em><br /><em><span style="color:#000099;"><br /><strong>Computerized tomography (CT) scan</strong>. A CT scan produces cross-sectional images of your body. CT scans can identify enlarged lymph nodes or abnormalities in other organs, but they can't determine whether these problems are due to cancer. Therefore, CT scans are most useful when combined with other tests.<br /><br /><strong>Magnetic resonance imaging (MRI). </strong>This type of imaging produces detailed, cross-sectional images of your body using magnets and radio waves. An MRI can help detect evidence of the possible spread of cancer to lymph nodes and bones. </span></em><br /><em><span style="color:#000099;"><br /><strong>Lymph node biopsy</strong>. If enlarged lymph nodes are found by a CT scan or an MRI, a lymph node biopsy can determine whether cancer has spread to nearby lymph nodes. During the procedure, some of the nodes near your prostate are removed and examined under a microscope to determine if cancerous cells are present."</span><br /><br /></em>Once a cancer is identified and necessary tests are done, Grading and Staging can be performed. These evaluations help you and the doctor decide on your treatment.<br /><br /><strong>Grading</strong><br /><br />Grading is the process by which cancer cells are evaluated in terms of how aggressive they may be. The most common cancer grading scale runs from 1 to 5, with 1 being the least aggressive form of cancer.<br /><br />The pathologist then assigns scores to the cancer, called Gleason scores. The Gleason score adds the grades of the two most aggressive types of cancer cells found in the tissue, so scoring may range from 2 (non-aggressive cancer) to 10 (very aggressive cancer).<br /><br /><strong>Staging</strong><br /><br />The next step is called staging, which determines if or how far the cancer has spread:<br /><br /><strong>Stage I</strong>. Signifies very early cancer that's confined to a microscopic area; it cannot be felt by the doctor.<br /><br /><strong>Stage II</strong>. The cancer can be felt, but it remains confined to your prostate gland.<br /><br /><strong>Stage III</strong>. Cancer has spread beyond the prostate to the seminal vesicles or other nearby tissues.<br /><br /><strong>Stage IV</strong>. The cancer has spread to lymph nodes, bones, lungs or other organs.<br /><br /><strong>What Symptoms Can Prostate Cancer Cause</strong>?<br /><br />Although early prostate cancer doesn't cause any noticeable symptoms, eventually it can cause the following:<br /><br />-Dull pain in your lower pelvic area<br />-Urgency of urination<br />-Difficulty starting urination<br />-Painful urination<br />-Weak or intermittent urine flow;dribbling<br />-A feeling that your bladder doesn't empty<br />-Frequent urination, especially at night<br />-Blood in the urine<br />-Painful ejaculation<br />-General pain in the lower back, hips or upper thighs<br />-Loss of appetite and weight<br />-Bone pain<br /><br />Please don't panic if you do have some of these symptoms, as there are other conditions that can cause them. One of the most common is BPH, or benign prostatic hyperplasia. This is a harmless enlargement of the prostate caused by changes in the body's hormone levels. In older men, the inner part of the prostate around the urethra may continue to grow, and eventually cause problems leading to symptoms such as frequent urination, difficulty urinating, urination during the night, etc. Although this is a benign condition, it is important to get symptoms checked out and make sure that they aren't caused by cancer. BPH can be treated with medications, or if it is more severe, a surgical procedure called a <a href="http://www.mayoclinic.com/health/turp/BP00018">TURP</a> can solve the problem.<br /><br /><strong>What are the Risk Factors for Prostate Cancer?</strong><br /><br /><strong>Age</strong><br /><br />Age is the strongest risk factor for prostate cancer; the chance of getting it rises quickly over the age of 50. Two-thirds of prostate cancers are found in men over 65.<br /><br /><strong>Race/Ethnicity<br /></strong><br />Prostate cancer occurs more often in African-American men than in men of other races. African-American men are also more likely to be diagnosed at an advanced stage, and are more than twice as likely to die of prostate cancer as white men.<br /><br />Conversely, prostate cancer occurs less often in Hispanic, American Indian, and Asian/Pacific Island men than in non-Hispanic whites. It is not known why these differences occur. (See chart below from the CDC for a comparison).<br /><br /><div align="center"><strong>Prostate Cancer Death Rates by Race/Ethnicity in Men Aged 45 and Above</strong><br /><br /></div><p><img id="BLOGGER_PHOTO_ID_5143639132063815282" style="DISPLAY: block; MARGIN: 0px auto 10px; WIDTH: 474px; CURSOR: hand; HEIGHT: 263px; TEXT-ALIGN: center" height="216" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiWs3uoLSi22Bu8ggfvQdyhQ5UPkf8Zoz0zcQuFtVzft8UiZtKEWkv1qAAxQ_3t1soZt5_h8WQO8X9Q9gwUSqalhqY6z9iOa-upcd-PiP7aCXHYocXHmYNXEgozJL1oMn9MQD3nipxUE-F-/s400/deathrates.gif" width="393" border="0" /> <strong>Nationality<br /></strong><br />Prostate cancer is most common in North America, northwestern Europe, Australia, and on Caribbean islands. It is less common in Asia, Africa, Central America, and South America. Intensive screening in the more developed countries may account for some of this difference, but other factors, such as lifestyle differences (diet, etc.) may be important as well.<br /><br /><strong>Family History</strong><br /><br />Prostate cancer seems to run in some families, so there may be a genetic factor. Having a father or brother with prostate cancer more than doubles a man's risk of developing this disease. (The risk is higher for men with an affected brother than for those with an affected father.) The risk is much higher for men with several affected relatives, especially if their relatives were young at the time the cancer was found.<br /><br />Scientists have found several genes that seem to raise prostate cancer risk, but they probably account for only a small number of cases overall. Genetic testing for these genes is not yet available. </p><p>(One of my friends, who was diagnosed with prostate cancer through a routine PSA test, immediately called his brothers and told them to be checked - and a good thing, too. One of his brothers was also diagnosed with prostate cancer as a result of his warning.)<br /><br />Some inherited genes raise the risk for more than one type of cancer. For example, inherited mutations of the BRCA1 or BRCA2 genes, which lead to breast and ovarian cancers, may also increase prostate cancer risk in some men. So if there seems to be a pattern of women in a family with breast or ovarian cancer, the men in the family may be at a higher risk of prostate cancer and should be checked.</p><p><strong>Diet </strong><br /><br />A number of dietary factors may raise risk of prostate cancer. Men who eat a lot of red meat or high-fat dairy products appear to have a slightly higher chance of getting prostate cancer. These men also tend to eat fewer fruits and vegetables, so it is not clear whether it is the presence of the red meat and dairy or the absence of fruits and vegetables that is to blame. A diet high in fat also seems to be a risk factor.</p><p>Some studies have suggested that men who consume a lot of calcium may also have a slightly higher risk; this may be why dairy products are associated with a higher risk as well.</p><p><strong>Obesity<br /></strong><br />Although being obese does not seem to be linked with a higher risk of getting prostate cancer, several studies have found that obese men may be at greater risk for having more advanced prostate cancer and of dying from prostate cancer. The reasons for this are not clear, although it may be the connection with higher fat diets and higher fat levels in the body that does it. </p><p><strong>Infection and Inflammation of the Prostate<br /></strong><br />Some studies have suggested that prostatitis (inflammation of the prostate gland) may be linked to an increased risk of prostate cancer. Inflammation is often seen in samples of prostate tissue that also contain cancer. </p><p><strong>Can Prostate Cancer be prevented?</strong><br /><br />Eating more fruits and vegetables, particularly tomatoes, may confer some protection. Lycopene, a substance found in tomatoes, which is also available as a supplement, may help as well. One study has shown that pomegranate juice may be protective. Several other agents, including difluoromethylornithine (DFMO), isoflavonoids, selenium, and vitamins D and E have shown potential benefits in studies. Further studies are needed to confirm this.</p><p>A drug calle finasteride is being studied as a possible preventive agent, as it lowers testosterone levels, as this hormone is another factor in developing prostate cancer.</p><p><strong>How is Prostate Cancer Treated?</strong></p><p>Treatments options vary depending on the grade and stage of the cancer, the patient's age and overall life expectancy. Many factors must be taken into account, including the patient's own attitude toward the cancer. Some people just want to have the cancer removed, and are not as concernd with side effects, while others are more focused on their quality of life afterward. These concerns may result in different treatment choices even within the same stage of cancer. Following are some options recommended by the American Cancer Society. </p><p><strong>Stage I</strong></p><p>Since these prostate cancers are small and not aggressive, for elderly patients "watchful waiting" (by following PSA numbers) may be preferred. Other choices may be radiation therapy (either external beam therapy or the implantation of radioactive seeds (called brachytherapy).<br /><br />Men who are younger and healthy may consider watchful waiting, radical prostatectomy (complete surgical removal of the prostate), or radiation therapy (external beam or brachytherapy). </p><p><strong>Stage II</strong></p><p>Stage II cancers that are not treated with surgery or radiation are more likely to eventually spread and cause symptoms. However, for elderly men who have other health problems, watchful waiting may still be the best option if the cancer isn't causing symptoms. These men are still more likely to die of something else rather than prostate cancer. However, surgery or radiation therapy may also be options for them.</p><p>For younger men who are healthy overall, radical prostatectomy (often with removal of the pelvic lymph nodes) may be the preferred choice. This may be followed by external beam radiation if the cancer is found to have spread beyond the prostate at the time of surgery, or if the PSA level is still detectable several weeks after surgery. This may be either external beam radiation, brachytherapy, or a combination of both. Participation in a clinical trial may be considered in order to take advantage of newer treatments. For aggressive cancers (as measured by Gleason score and PSA level), hormone therapy (to block the production of testosterone) may be added.<br /><br /><strong>Stage III</strong></p><p>Stage III cancers have spread beyond the prostate gland but have not reached the bladder, rectum, lymph nodes, or distant organs. </p><p>Treatment options at this stage may include: </p><p>-external beam radiation plus hormone therapy<br />-hormone therapy only<br />-radical prostatectomy in selected cases (often with removal of the pelvic lymph nodes). This may be followed by radiation therapy.<br />-watchful waiting for older men whose cancer is causing no symptoms or for those who have another more serious illness<br />-taking part in a clinical trial of newer treatments </p><p><strong>Stage IV</strong></p><p>Stage IV cancers have already spread to the bladder, rectum, lymph nodes, or distant organs such as the bones. These cancers are not considered to be curable, but treatment can be palliative and prolong life.</p><p>Treatment options may include:<br />-hormone therapy<br />-external beam radiation plus hormone therapy (in selected cases)<br />-surgery (TURP) to relieve symptoms such as bleeding or urinary obstruction<br />-watchful waiting for older men whose cancer is causing no symptoms or for those who have another serious illness<br />-taking part in a clinical trial of newer treatments </p><p>If symptoms are not relieved by standard treatments and the cancer continues to grow and spread, chemotherapy may be considered. </p><p>Treatment of stage IV prostate cancer may also include treatments for relief of symptoms such as pain.</p><p>One of the people I knew who had prostate cancer was a friend's father, who was diagnosed when he was nearly 80. Given his age and other health problems, and the stage of his cancer (which must have been III or IV), he was treated with hormones only. He lived about 18 months after his diagnosis.</p><p>For more details on all of the types of treatments, please see <a href="http://www.mayoclinic.com/health/prostate-cancer/DS00043/DSECTION=8">the Mayo Clinic website.</a> </p><p><strong>What Happens Next?</strong></p><p>After prostatectomy, PSA levels are monitored to ensure the cancer is not returning. Since surgery removes the entire prostate, PSA levels should be undetectable afterward.</p><p>After radiation therapy, PSA is also monitored, but since the prostate has not been removed, the levels are not expected to be undetectable. A PSA that is rising on consecutive tests after treatment might indicate that cancer is still present.</p><p>For recurrent prostate cancer, the same treatments are available, depending on what has already been tried. If a patient has already had radiation treatment, for instance, then radiation treatment would not be an option if the cancer recurs. Surgery may still be an option, as is hormone therapy. For those whose cancer does not respond to hormone therapy, chemotherapy can extend life and reduce pain.</p><p>All treatments have side effects, varying from discomfort to impotence. It is important to understand the risks of these side effects before starting any treatment; be sure to discuss them with your doctor and make sure the doctor understands what your priorities are.</p><p>As with all cancers, when you are diagnosed, be sure to consult with various experts, including an oncologist and a radiation oncologist, as well as a surgeon, to truly understand your options. In addition be sure to consult with a major cancer center such as M.D. Anderson, Memorial Sloan Kettering, the Mayo Clinic, Johns Hopkins, or Dana Farber. </p><strong></strong><p><strong>Will You Get It?</strong><br /><br />According to the American Cancer Society, about 1 man in 6 will be diagnosed with prostate cancer during his lifetime, but the good news is, only 1 man in 35 will die of it. If you have some of the risk factors mentioned above, then just make sure to get regular checkups and even if you do get it, you will likely catch it early and be cured.</p><p>Over 90% of these cancers are now found while they are still confined to the prostate gland, making them highly curable. Five-year survival rates are now at 99% for these men; for those whose cancer has spread to distant parts of their body, only 1/3 survive 5 years. </p><p>Sources used for this article:</p><p><a href="http://www.cancer.org/docroot/CRI/CRI_2_3x.asp?dt=36">http://www.cancer.org/docroot/CRI/CRI_2_3x.asp?dt=36</a> (American Cancer Society)<a href="http://www.mskcc.org/mskcc/html/403.cfm">http://www.mskcc.org/mskcc/html/403.cfm</a> (Memorial Sloan Kettering)<a href="http://www.mayoclinic.com/health/prostate-cancer/DS00043">http://www.mayoclinic.com/health/prostate-cancer/DS00043</a> (Mayo Clinic)</p><p>Other excellent sources of detailed information, including the latest news and other resources on Prostate Cancer:</p><p><a href="http://www.nlm.nih.gov/medlineplus/prostatecancer.html">http://www.nlm.nih.gov/medlineplus/prostatecancer.html</a> (Medline Plus)<a href="http://www.cancer.gov/cancertopics/types/prostate">http://www.cancer.gov/cancertopics/types/prostate</a> (National Cancer Institute)<a href="http://www.prostatecancerfoundation.org/">http://www.prostatecancerfoundation.org/</a> (Prostate Cancer Foundation)<a href="http://www.webmd.com/prostate-cancer/default.htm">http://www.webmd.com/prostate-cancer/default.htm</a> (Web MD)</p>Mauigirlhttp://www.blogger.com/profile/15529827915262851910noreply@blogger.com1tag:blogger.com,1999:blog-726388883619960935.post-69943338759432396682007-12-01T19:49:00.000-08:002007-12-01T19:57:37.630-08:00Back AgainAfter posting every day for the month of November on my regular blog, <a href="http://www.mauigirlsmeanderings.blogspot.com">Mauigirl's Meanderings</a>, as part of <a href="http://www.nablopomo.com">NaBloPoMo</a>, it is finally over, and we can return to normal programming. <br /><br />In other words, I should have time to post on this blog again and give you all some new medical information. Many apologies for the long silence.<br /><br />I have not yet written the next post but have two topics pending that I intend to write about very soon. One will be on prostate cancer and the other on ovarian cancer. I've known several people with the former (one of whom was just diagnosed) and I know someone else with ovarian cancer, and would like to do research to understand more about what causes these cancers, learn how they are treated, and find out whether there are any new treatments being studied today.<br /><br />So, hang in there, and I'll be posting a real post shortly!Mauigirlhttp://www.blogger.com/profile/15529827915262851910noreply@blogger.com0tag:blogger.com,1999:blog-726388883619960935.post-53540583445289390902007-11-05T15:23:00.000-08:002007-11-06T12:48:36.924-08:00Be Careful When Searching the InternetAs a hypochondriac, I'm sure you have often searched the Internet for diseases and conditions that you fear you may have, or because you know someone who has something that you want to make sure you don't have.<br /><br />And, in this blog, I have often urged you to do your own research on diseases so you'll be knowledgeable.<br /><br />However, be careful. An <a href="http://searchenginewatch.com/showPage.html?page=3319441">article</a> I came across on the Internet, while not recent, is still worth reading, even several years later. The point of the article is to be cautious when you search for medical information on the Internet.<br /><br />The author refers to a study (whose link is now outdated, another problem with Internet research) that cited several problems with finding reliable health care information on the web:<br /><br /><em><span style="color:#000099;"><strong>"Two reasons have to do with the knowledge and skill of web users. Many consumers' ability to locate and evaluate health information online is hindered by access barriers for older, less well off, disabled, and non-English speaking Americans. Many people also lack critical thinking skills, having problems distinguishing credible health information from that which is not trustworthy.</strong><br /><br />The study also found problems with the web itself. <strong>Many web sites contain inaccurate, outdated or incomplete information.</strong> And of particular note, the study found that <strong>many consumers had a lack of knowledge about how search engines retrieve results, and didn't realize that paid placements listings can be featured prominently on search engine result pages without regard to quality</strong>."<br /><br /></span></em>In my experience with researching medical subjects on the Internet, I use the following "rules" when I search:<br /><ul><li><strong>Never use information from a site that is also a source to purchase an herbal or pharmaceutical product.</strong></li><li><strong>Always look for mainstream sites</strong> such as the ones listed down the side of this blog in order to do your primary research on a disease or condition, e.g., The CDC, The Mayo Clinic, Memorial Sloan-Kettering, National Institutes of Health, etc.</li><li><strong>Be sure to check the dates</strong> of the information you find. An article that may have been perfectly true several years ago may be hopelessly outdated now; some of these articles live forever on line.</li><li><strong>Before believing any information you find, be sure that it is consistent with the preponderance of data</strong> you find on the major medical sites. If you see some miraculous cure for something that is not mentioned elsewhere, take it with a large grain of salt.</li><li><strong>Whenever possible, if an article you find references a medical study,</strong> <strong>go to the original study to confirm the findings.</strong> Articles written for laypeople often "dumb down" the results of a study, or emphasize one aspect of it without covering the whole picture. <a href="http://www.ncbi.nlm.nih.gov/sites/entrez">Pub Med</a> is a good source to look up medical studies, or you can search for the name of the study on Google. Even if you don't understand all of the technical language, you can at least double check to make sure the gist of the original article was correct. </li><li><strong>Beware of quacks.</strong> If you find information on a doctor's site that you have no familiarity with, ignore information from that site unless it is backed up by the same data from a reliable source.</li><li><strong>Never rely solely on the Internet for your diagnosis or treatment. </strong>It should only be a tool to help you talk to your doctor when you go for your appointment. </li></ul><p>The Internet can be a very useful tool for those who use it wisely. You can learn what the latest treatment protocols are for your condition so you can ask your doctor about them, you can find clinical trials on line, you can learn to understand your disease or condition better, or you can look up your symptoms and find out what they may be caused by. </p><p>But be careful out there, as there is still a lot of uncharted territory.</p><p>The most important thing is to have a doctor you trust, who really listens to you when you tell them what is wrong.</p>Mauigirlhttp://www.blogger.com/profile/15529827915262851910noreply@blogger.com3tag:blogger.com,1999:blog-726388883619960935.post-32976685517527585962007-10-21T06:33:00.000-07:002007-10-21T07:23:01.434-07:00MRSA: A Plague for the 21st Century?Recent reports of <a href="http://www.washingtonpost.com/wp-dyn/content/article/2007/10/19/AR2007101902267.html">methicillin-resistant staphylococcus aureus (MRSA) spreading in schools</a> have no doubt been panicking hypochondriacs everywhere, especially since these infections can look like an ordinary boil (or even a nasty zit). This is bad if you’re a teenager and don’t know whether you have it or not.<br /><br />Before you hole up in your house and refuse to mingle with the general population, perhaps it would make sense to learn more about this “superbug” that is casting fear into the hearts of Americans everywhere.<br /><br /><strong>First of all, you may ask, what is <a href="http://www.textbookofbacteriology.net/staph.html">staphylococcus aureus</a>? </strong><br /><br />Usually fondly referred to by its nickname, “Staph,” it is a bacterium that can cause a number of different illnesses, from superficial skin infections to systemic illness that can be fatal. The germ is found almost anywhere on the skin and is usually harmless. However, once in your body it can cause havoc.<br /><br />I had a friend when I was young who got a staph infection from stepping on a tent stake, point-up (even now the mere idea of stepping on a tent stake gives me the horrors). She was hospitalized for over a week receiving intravenous antibiotics to quell the infection from staph germs that had gotten into her bloodstream. Luckily, being a strong, healthy 12-year-old, she recovered.<br /><br /><strong>So, what is <a href="http://www.medterms.com/script/main/art.asp?articlekey=24074">Methicillin</a>?</strong><br /><br />Methicillin is a synthetic type of penicillin that was developed in 1959, when many drugs had already developed resistance to the original penicillin. By 1961, staph germs resistant to the drug had already been discovered, and subsequently additional drugs were introduced to fight the resistant strains. As time went on, the wily staph germ became resistant to a number of drugs, not just Methicillin, although these resistant bugs are still generically known as “Methicillin Resistant Staphylococcus Aureus.”<br /><br />Currently the most resistant types of MRSA can only be attacked by what some call “the drug of last resort”: <a href="http://www.drugs.com/pro/vancomycin.html">Vancomycin.</a> When my father was hospitalized for depression in our local hospital a few years ago at age 88, he caught pneumonia while he was in the psychiatric ward. (It’s bad enough being depressed without getting pneumonia!). Because he caught it in the hospital, they immediately assumed the cause was a resistant bug and put him on I.V. Vancomycin. Thankfully, he recovered.<br /><br />(By the way, here is a great term for you: A disease or condition that occurs as a result of hospitalization is called a <a href="http://www.m-w.com/cgi-bin/dictionary?va=nosocomial">“nosocomial”</a> disease. It is kind of concerning to me that this happens so often that they have an official word for it. Just something to think about next time you’re hospitalized…)<br /><br />MRSA is actually very common, and while it is concerning, there is something much scarier out there: <a href="http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5126a1.htm">Vancomycin Resistant Staphyloccocus Areus, or VRSA</a>, which was first noted in the United States in a Michigan man in 2002. While still rare, and so far confined to people with chronic medical conditions (e.g., kidney failure) requiring catheterization or other invasive procedures, it is very concerning to know that MRSA is starting to become immune to Vancomycin. There are still a couple of other drugs that have been able to treat these very resistant bacteria, but unless science continues to develop new antibiotics, eventually these too will become ineffective.<br /><br />MRSA can be acquired in two ways: through exposure through the healthcare system, or through the community without direct contact with the healthcare system. I’ll address both types here:<br /><br /><strong>Healthcare-Associated MRSA:</strong><br /><br />According to the <a href="http://www.cdc.gov/ncidod/dhqp/ar_MRSA_spotlight_2006.html">CDC</a>:<br /><br /><em>“MRSA occurs most frequently among patients who undergo invasive medical procedures or who have weakened immune systems and are being treated in hospitals and healthcare facilities such as nursing homes and dialysis centers. MRSA in healthcare settings commonly causes serious and potentially life threatening infections, such as bloodstream infections, surgical site infections, or pneumonia.<br /><br />In addition to healthcare associated infections, MRSA can also infect people in the community at large, generally as skin infections that may look like pimples or boils and can be swollen, painful and have draining pus. These skin infections often occur in otherwise healthy people.”</em><br /><br />Hospitals have always been reservoirs of infection, even though healthcare providers have known for over a century that hand washing will cut down drastically on the spread of infection. However, CDC data show that the proportion of infections that are antimicrobial resistant has been growing. In 1974, MRSA infections accounted for two percent of the total number of staph infections; in 1995 it was 22%; in 2004 it was 63%.<br /><br />The good news is that disinfection and stringent attention to hygiene can cut back on the spread of these infections in the hospital or at clinics and other medical settings. See the CDC website for more information on the precautions recommended to prevent the spread of drug-resistant staph in the medical community.<br /><br /><strong>What about the Community-Associated MRSA?</strong><br /><br />This is the type that is getting all the bad press right now. The <a href="http://www.cdc.gov/ncidod/dhqp/ar_mrsa_ca.html">CDC definition of Community-Associated MRSA</a> is:<br /><br /><em>“MRSA infections that are acquired by persons who have not been recently (within the past year) hospitalized or had a medical procedure (such as dialysis, surgery, catheters) are known as CA-MRSA infections. Staph or MRSA infections in the community are usually manifested as skin infections, such as pimples and boils, and occur in otherwise healthy people.”</em><br /><br /><strong>What are the symptoms of MRSA?</strong><br /><br />According to <a href="http://www.medicinenet.com/mrsa_infection/article.htm">Medicinenet.com</a>,<br /><br /><em>“Most MRSA infections are skin infections that produce the following signs and symptoms:<br /><br /><strong>Cellulitis </strong>(infection of the skin or the fat and tissues that lie immediately beneath the skin, usually starting as small red bumps in the skin),<br /><br /><strong>Boils</strong> (pus-filled infections of hair follicles),<br /><br /><strong>Abscesses</strong> (collections of pus in under the skin),<br /><br /><strong>Sty</strong> (infection of eyelid gland),<br /><br /><strong>Carbuncles </strong>(infections larger than an abscess, usually with several openings to the skin), and<br /><br /><strong>Impetigo </strong>(a skin infection with pus-filled blisters).”</em><br /><br />However, MRSA can spread from the skin to almost any organ in the body, resulting in a severe, even life-threatening illness, particularly among those with lowered immunity.<br /><br />Symptoms to watch out for are:<br />-Fever<br />-Chills<br />-Low blood pressure<br />-Joint pain<br />-Severe headaches<br />-Rash over much of the body<br /><br /><strong>How is MRSA transmitted?</strong><br /><br />It is usually spread in one of two ways:<br /><br />One way is through physical contact with someone who is infected with, or a carrier of, MRSA. The second way is <em>“for people to physically contact MRSA on any objects such as door handles, floors, sinks, or towels that have been touched by an MRSA-infected person or carrier.<br /><br />Normal skin tissue in people usually does not allow MRSA infection to develop; however, if there are cuts, abrasions, or other skin flaws such as psoriasis (chronic skin disease with dry patches, redness, and scaly skin), MRSA may proliferate. Many otherwise healthy individuals, especially children and young adults, do not notice small skin imperfections or scrapes and may be lax in taking precautions about skin contacts. This is the likely reason MRSA outbreaks occur in diverse types of people such as school team players (like football players or wrestlers), dormitory residents, and armed-services personnel in constant close contact.”</em><br /><br /><strong>How is it diagnosed?</strong><br /><br />MRSA is easily identified through taking a sample of the skin, pus, blood or urine of an affected person and sending it to a lab to be cultured to see whether S. aureus is present. If the bacteria grow in the Petri dish in the lab, then they are exposed to antibiotics, including methicillin, to find out whether they are resistant. If so, then the patient is diagnosed as MRSA-infected. If someone is suspected as being a carrier, the same procedure is done, but by swabbing the skin or mucous membranes, not through a biopsy.<br /><br /><strong>How is it treated?</strong><br /><br />MRSA can still be treated with some antibiotics, including Vancomycin and others such as Linezolid. For MRSA carriers, mupirocin antibiotic cream can eliminate MRSA from mucous membrane colonization. The best way to proceed is to determine which antibiotic can kill the MRSA and use it alone or, more often, in combination with additional antibiotics. Since resistance can change quickly, antibiotic treatments may need to change also. It is extremely important for patients infected with MRSA to take the entire course of antibiotics that are prescribed, and not stop just because they feel better. This can lead to additional resistance.<br /><br />Patients infected in the community usually fare well; hospitalized patients, not so much. Since they are usually ill in the first place, being in the hospital, they are more likely to develop the serious forms of the illness. As reported by the <a href="http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=45809">Kaiser Foundation</a>, “As many as 1.2 million U.S. hospital patients are infected with methicillin-resistant staphylococcus aureus each year, nearly 10 times as many as previously estimated,” and the mortality rate is estimated to be between 4%-10%.<br /><br /><strong>How can you avoid getting MRSA?</strong><br /><br />Avoiding direct contact with skin, clothing, and any items that come in contact with either MRSA patients or MRSA carriers, or anyone you think might be one, is the best way to avoid MRSA infection. However, unless you want to become a germophobic recluse like Howard Hughes, this may not work very well.<br /><br />However, to minimize the possible spread of infection, people can treat and cover (for example, antiseptic cream and a Band-Aid) any skin breaks and use excellent hygiene practices (for example, hand washing with soap after personal contact or toilet use, washing clothes potentially in contact with MRSA patients or carriers, using disposable items when treating MRSA patients). Also, antiseptic solutions, such as Purell, and antiseptic wipes can be used to both clean hands and surfaces that may contact MRSA.<br /><br />Personally, I never go anywhere without my Purell. Maybe I’m a little paranoid, but anytime I have touched surfaces that I know many other people have touched, whether browsing in a store or using a handrail in a public place, as soon as I have an opportunity, out comes the Purell. Better safe than sorry is always my motto.<br /><br />In the hospitals, the CDC has found that use of alcohol gels can be more effective and result in more compliance than handwashing. See <a href="http://www.cdc.gov/ncidod/eid/vol7no2/weinstein.htm">this link</a> for a full analysis of improvements to hygiene and sanitation that can be made in the hospital setting.<br /><br /><strong>Will you get it?</strong><br /><br />Not if you’re careful. But if you get any kind of unusual skin infection or have a flulike illness in combination with a skin infection, get to a doctor and get treatment. The earlier this type of infection is caught, the better. Cellulitis in and of itself, whether caused by MRSA or just regular bacteria, can be very serious.<br /><br />The chart below shows the breakdown of who gets MRSA (more blacks than whites, higher rates of infection for the very young, teens and young adults, followed by a higher spike over age 50. About 58% of cases are associated with medical care within the past year; 27% start in the hospital, and just 13.8% are non-healthcare related.<br /><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgORdwfVq1AWlzxv1h3oyGg3S2wUoG549lIeC5w85CJjqPvIbYxIbhDSbC-z-aKJxp9SPpvYhT-gtIzCOclz5M6DzGpVdZQIf6YLUuIi9yhxu8ZDFn8WXNbfSL8bQXVVFSLJpm-tSLo4-jG/s1600-h/staph.jpg"><img id="BLOGGER_PHOTO_ID_5123787087263125026" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; WIDTH: 409px; CURSOR: hand; HEIGHT: 368px" height="424" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgORdwfVq1AWlzxv1h3oyGg3S2wUoG549lIeC5w85CJjqPvIbYxIbhDSbC-z-aKJxp9SPpvYhT-gtIzCOclz5M6DzGpVdZQIf6YLUuIi9yhxu8ZDFn8WXNbfSL8bQXVVFSLJpm-tSLo4-jG/s400/staph.jpg" width="502" border="0" /></a><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br />The biggest concern is that new antibiotics are not being developed as frequently as in the past; once staph becomes resistant to Vancomycin and the other last resort drugs, we may have no defense against the next superbug. One way to forestall the rise of resistant bacteria is for doctors not to overprescribe antibiotics for every little ailment. Often patients go to the doctor with a sore throat or some other malady and literally expect to be prescribed an antibiotic and are disappointed or annoyed if the doctor sends them away without one. Doctors need to explain to patients that not all illnesses are caused by bacteria and that antibiotics do not work on viruses. The other danger is patients who do not finish their course of antibiotics, which means that if not all of the bacteria are killed, the ones that are left are more apt to be resistant and reproduce themselves.<br /><br />Please see the links throughout this article for more detailed information on MRSA.Mauigirlhttp://www.blogger.com/profile/15529827915262851910noreply@blogger.com5tag:blogger.com,1999:blog-726388883619960935.post-64887297845468869302007-10-04T20:00:00.001-07:002007-10-04T20:32:53.387-07:00More on MisdiagnosesNot to belabor this subject, but CNN had <a href="http://www.cnn.com/2007/HEALTH/conditions/09/26/ep.misdiagnosed.diseases/index.html">another article</a> about misdiagnoses that I thought I would share with you. This article was about several of the most common illnesses or conditions that tend to be misdiagnosed. Here, briefly, are the five they list:<br /><br /><strong>1. Aortic dissection:</strong> This is when the aorta, the main artery leading from the heart to the rest of the body, actually tears. This is obviously catastrophic, since a complete tear results in massive blood loss. But sometimes this condition is hard to diagnose, as the pain or sensation the person feels can mimic other illnesses, or even something as simple as heartburn. <br /><br />I had a friend whose father died of this; the pain he felt was in his back, and he thought he had injured his spine or had a slipped disk. He went to a chiropracter for treatment. The chiropracter immediately realized something much more serious was going on, and called an ambulance, but by the time my friend's father was on the operating table, sadly it was too late.<br /><br /><strong>2. Cancer: </strong>In a Harvard study of malpractice claims in the U.S., cancer was the most misdiagnosed illness. <br /><br />In my previous post on oral cancer, the young chef with tongue cancer was initially misdiagnosed by his dentist. And I had a friend whose doctor kept treating her for bladder infections when all along what she had was bladder cancer. Sadly, her initial surgery did not keep the cancer at bay and she died of the disease 2-1/2 years after her diagnosis.<br /><br /><strong>3. Clogged arteries:</strong> Sometimes doctors tell patients they're short of breath because they're out of shape, when it's actually coronary artery disease. Chest pain can masquerade as heartburn or a pulled muscle. <br /><br /><strong>4. Heart attack:</strong> Heart attacks don't always have the "classic" symptom of severe chest pain. Sometimes the only signs of a heart attack are a feeling of pressure or fullness in the chest, nausea, tiredness or malaise. Pain can also occur in the jaw or left arm. In women, in particular, heart attacks are often misdiagnosed as women tend to have less typical symptoms of heart attack than men do. <br /><br /><strong>5. Infection:</strong> In the Harvard study, infection followed cancer as the most misdiagnosed condition. <br /><br />An example of this is, a friend's mother, who is a lung cancer survivor, had problems breathing after a trip to Eastern Europe. The doctor she was going to at the time thought she was having symptoms of a recurrence of cancer. As it turned out, she had an infection with <a href="http://www.medterms.com/script/main/art.asp?articlekey=25713">Mycobacterium avium</a>, which is an unusual type of infection.<br /><br />So how can you keep yourself from becoming a victim of misdiagnosis? <br /><br /><strong>1. Ask for more tests</strong> (Do your research and find out what tests are commonly prescribed for symptoms such as yours).<br /><br /><strong>2. Ask, "What else could my illness be?"</strong> (And of course, do your research so that you are aware of what other illnesses it could be, and can suggest them if your doctor does not).<br /><br /><strong>3. Don't assume no news is good news</strong>. This is very important; my friend with the bladder cancer had been receiving CT scans regularly as follow-ups to her cancer surgery. Apparently, she did not hear any results from the last one she had had, and somehow did not find out until 3 months later that the scan had showed enlarged lymph nodes in her abdomen. Who knows whether her outcome might have been different had she found this out sooner?<br /><br />This goes for all kinds of tests, including your yearly Pap test. If you had one and don't hear from your doctor, call him or her and ask if everything was OK. And ask for copies of your lab tests, and read them carefully. If something doesn't look right, call your doctor and ask about it.<br /><br /><strong>4. Assume your doctors don't talk to one another.</strong> Always tell each doctor you go to about anything going on with the other doctor: Any tests, any blood results, any scans, any symptoms. If you feel your doctors should be working together as a team, schedule a conference call.<br /><br /><strong>5. Be wary when your doctors work in shifts</strong> - be sure each one passes on information to the other. And whenever possible, try to always see the same doctor even in a practice that has a number of physicians. <br /><br />Sometimes you only get one chance to get your diagnosis right. Make sure you do everything that is in your own power to accomplish that.Mauigirlhttp://www.blogger.com/profile/15529827915262851910noreply@blogger.com2tag:blogger.com,1999:blog-726388883619960935.post-13861826460245792007-09-30T09:01:00.000-07:002007-10-01T18:34:40.106-07:00Oral CancerI thought it was about time I wrote about this subject – since I am an oral cancer survivor. Two and a half years ago, I was diagnosed with, of all things, tongue cancer. I didn’t even really know there was such a thing until it happened to me.<br /><br />As a hypochondriac, I feel I have always done a really good job of making sure to worry about all of the diseases and conditions with which I was likely – or not so likely - to be diagnosed.<br /><br />I worried about breast cancer, cervical cancer, AIDS, Chronic Fatigue Syndrome (bingo, had that), brain tumors, aneurysms, and more. But never had I even remotely worried about tongue cancer.<br /><br />And wouldn’t you know it, that was what I got? It just goes to show, you must constantly search for new, more obscure diseases to worry about, or else one will pop up that you hadn’t thought of. (I like to call it “preventive worrying.” If you worry about it, it won’t happen.)<br /><br />So, here is my story.<br /><br />In late January of 2005, I noticed a sore spot on the side of my tongue that was annoying me. At first glance I didn’t see anything, so I didn’t worry much. But it kept bothering me. Finally one day I carefully examined the side of my tongue with my glasses off (being highly nearsighted, this is as good as using a magnifying glass), and saw a tiny little indentation, like a canker sore when it first starts. Relieved, I started rinsing with Amosan, thinking it would be gone in a few days.<br /><br />I had recently been under a lot of stress - my father had just died - and I figured that it wasn’t unusual to get a canker sore after that.<br /><br />But about a week later it was still there, and it looked about the same, maybe a little whiter. I had a dentist appointment for a checkup and while I was there I asked him about it. He didn’t seem too worried, but said if it didn’t go away he’d send me to an oral surgeon.<br /><br />I was back the next week for a filling and when I told him the tiny spot was still there, he gave me the name and phone number of a nearby oral surgeon.<br /><br />The doctor was able to see me on March 4. When I went, the lesion was so tiny he couldn’t even see it until I pointed it out to him. A shot of Novocain, a quick cut, a few stitches, and it was gone.<br /><br />In the meantime, I had done all kinds of Internet research on tongue cancer, and had discovered to my dismay that tongue cancer was not a laughing matter. It only had an overall survival rate of around 80% even in early stages, and did not respond all that well to chemotherapy. So I was glad to have gotten rid of this thing. I assumed I was being my usual hypochondriacal self and that it would turn out to be nothing.<br /><br />Four days later I was supposed to go back to the surgeon to make sure the tongue was healing properly. It was snowing that afternoon, the tongue felt fine, and I figured maybe it wasn’t so important to go back. I called up and asked if I really had to go, given the weather. I was somewhat surprised when the nurse told me the doctor still wanted to see me.<br /><br />When I arrived, the doctor invited me into his office rather than the examining room, and that’s when I realized something was amiss. He informed me the biopsy had come back as cancer.<br /><br />To make a long story shorter, I didn’t mess around – I went to a surgeon at Memorial Sloan-Kettering who was recommended by my husband’s dentist, and on April 1 (no fooling), he took an additional chunk off the side of my tongue to make sure all of the cancer was gone.<br /><br />By this time I had also consulted an oncologist at Hackensack University Medical Center’s Cancer Center, who had sent me for an MRI and a CT scan, and done blood work, to ensure that the cancer hadn’t spread anywhere. (The surgeon at Sloan-Kettering had not sent me to an oncologist for additional screening, but I figured better safe than sorry - I always hedge my bets. So I found my own).<br /><br />I had also had the original biopsy sent to Sloan-Kettering at their request, where they did a more thorough examination that determined the depth of invasion by the lesion was less than a millimeter – barely a cancer at all. So by this time I was feeling better about my prognosis.<br /><br />The results of the surgery showed that the original biopsy had actually gotten all of the cancer, and the surgeon told me I needed no further treatment; just needed follow-up examinations with him every 3 months.<br /><br />Now it’s been 2-1/2 years and thankfully, no new cancers have popped up, nor have I had any spread of the original one. I am very lucky that I am a hypochondriac and didn’t wait too long to get the lesion taken off.<br /><br />Sadly, that doesn’t always happen for everyone. There was recently a <a href="http://online.wsj.com/public/article/SB118850654534013822-LAudtvjuhiNxuLTg6k1drOPbshw_20070929.html?mod=tff_main_tff_top">story in the Wall Street Journal</a> about a young 33-year-old chef who was diagnosed with Stage IV tongue cancer. He had had a similar experience to mine, but his dentist just gave him a mouth guard to wear at night, saying he must be unconsciously biting on his tongue, and the young man ignored the continued pain until it got so bad a year or so later that he had lost 10 lbs. and could hardly eat. He is currently undergoing radiation and chemo in hopes of not losing his tongue – or his life.<br /><br />So, with that introduction, I will now get into the details of what oral cancer is, what can cause it, what the treatments are, and whether you will get it.<br /><br /><strong>What Is Oral Cancer?</strong><br /><br />Oral cancer is a group of cancers affecting the mouth. It is part of a larger group of cancers known as “Head and Neck Cancers.” This article will concentrate on cancers of the mouth, specifically, the palate, gums, tongue and lips. Locations where oral cancer is commonly found are:<br /><br />- the lining inside the lips and cheeks (buccal mucosa)<br />- the floor of the mouth (under the tongue)<br />- the top of the mouth (hard palate)<br />- the small area behind the wisdom teeth<br /><br />The most common type of oral cancer is the type I had – squamous cell carcinoma. Over 90% of oral cancers are of this type. It arises in the skin cells, and can also occur on other parts of the body.<br /><br />According to the <a href="http://www.merck.com/mmhe/sec08/ch113/ch113d.html">Merck Manual</a>, about 40% of squamous cell carcinomas begin on the floor of the mouth or on the side or bottom of the tongue, like mine did, and another 40% occur on the lower lip. The rest of them start on the roof of the mouth or the tonsils.<br /><br />Another type of cancer is called verrucous (warty) carcinoma, which appears as a white grooved surface on the lining of the mouth. This type of cancer rarely metastasizes (spreads to other parts of the body) and is considered to be of a low grade of malignancy. It makes up <a href="http://www.healthsystem.virginia.edu/uvahealth/adult_oralhlth/cancer.cfm">only about 5% of oral cancers</a>.<br /><br />Cancer can also arise in the salivary glands, but this is relatively rare. In addition, melanoma and Kaposi's sarcoma (an unusual cancer that is more common among AIDs patients) can also occur in the mouth.<br /><br /><strong>What Are the Symptoms of Oral Cancer?</strong><br /><br />Oral cancer often starts as mine did, with a sore place or little ulcer that looks like a canker sore. However, not all of them cause pain, which explains why a lot of oral cancers may not be found until they have already progressed. An oral cancer can begin with any of the following symptoms:<br /><br />Common symptoms or warnings of oral cancer can include:<br /><br />- Patches inside your mouth or on your lips that are white, a mixture of red and white, or red<br />- White patches (leukoplakia) are the most common. White patches sometimes become malignant.<br />- Mixed red and white patches (erythroleukoplakia) are more likely than white patches to become malignant.<br />- Red patches (erythroplakia) are brightly colored, smooth areas that often become malignant.<br />- A sore on your lip or in your mouth that won't heal (which is what I had)<br />- Bleeding in your mouth<br />- Loose teeth<br />- Difficulty or pain when swallowing<br />- Difficulty wearing dentures<br />- A lump in your neck<br />- An earache<br /><br />The earache is particularly of interest - it is called referred pain, when the pain that happens isn't where the problem lies. I had a pain like this toward the back of my jaw for ages before my cancer was diagnosed, and thought it was just a pain in my jaw from my mismatched bite. I also thought the very back of my tongue was rubbing on something. Turned out that it all came from the side of my tongue where the tiny ulcer eventually appeared, which was fairly close to the front of my tongue. Once it was removed, all pain left. So if you have some kind of pain in your mouth and can't put your finger on it - literally - explore different areas than you think it is; it may be referred pain.<br /><br />So, say you get some weird symptom in your mouth. Before panicking, you may ask yourself "Could it be anything else besides a life-threatening cancer?" because otherwise you may go into a full-scale hypochondriacal panic attack. The answer is, yes, there are a lot of other types of growths that can occur in the mouth that are totally benign, such as:<br /><br /><strong>Fibroma</strong>: a benign tumor consisting of fibrous connective tissues:<br /><br /><strong>Keratoacanthoma </strong>: a flesh-colored, fast-growing bump on the skin with a keratin plug in the center (keratin, the main component of the external layer of skin, hair, and nails, is a tough substance);<br /><br /><strong>Leiomyoma</strong>: a tumor of the smooth muscle, often found in the esophagus, small intestine, uterus, or stomach;<br /><br /><strong>Lipoma </strong>: a tumor made up of mature fat cells;<br /><br /><strong>Neurofibroma</strong>: a fibrous tumor consisting of nerve tissue;<br /><br /><strong>Papilloma</strong>: a tumor that resembles a wart, growing on the epithelium (the cells that form the skin and mucous membranes);<br /><br /><strong>Pyogenic granuloma</strong>: a small, round bump that often has an ulcerated surface;<br /><br /><strong>Rhabdomyoma</strong>: a striated-muscle tumor that may appear on the tongue, pharynx, uterus, vagina, or heart;<br /><br /><strong>Schwannoma</strong>: a single tumor that grows in the neurilemma (Schwann's sheath) of nerves; or<br /><br /><strong>Verruca form xanthoma</strong>: wart-shaped tumors<br /><br />If you see any kind of unusual symptom in your mouth that doesn't go away after a week or so, go to your dentist for an exam. If the symptom does not resolve within another week or so, even if your dentist does not seem concerned, don't ignore it. Make sure to get a biopsy or other definitive test to rule out cancer.<br /><br /><strong>What Causes Oral Cancer?</strong><br /><br />Oral cancer has a number of risk factors. It is highly associated with smoking and is more common in older people – hence, when I told my regular doctor that I had tongue cancer, she said in surprise, “But you’re not an older man who smokes!”<br /><br />Tobacco use (either smoking or chewing tobacco) is by far the biggest risk factor for oral cancer. However, alcohol use is another independent factor that can lead to oral cancer; naturally, more use is more risk. Combining alcohol with tobacco is even more risky.<br /><br />Constant irritation from dentures or a sharp tooth can also be a factor, as can overexposure to sun (for lip cancer). In some cases poor oral hygiene can be a cause, although this isn't that common in our modern society.<br /><br />Although as a precaution I stopped drinking alcohol after my diagnosis, I had also had a sharp tooth that may have been rubbing on my tongue. I've since had the dentist file it down. I will never know if that was the cause, or the alcohol consumption - or perhaps a combination of both.<br /><br />I miss my wine - I had my last drink on St. Patrick’s Day 2005. A nice glass of Chardonnay. Kendall Jackson. I can still taste it. It’s ironic, too, because red wine was usually my wine of choice. And I loved Guinness, so I don’t really know why I had that Chardonnay on St. Patrick’s Day. But that was what it was. And I don't dare take it up again, given that people who have had one oral cancer are at high risk for another. There's no sense in doing something that is known to increase that risk.<br /><br />Although oral cancer tends to be more common in men, in recent years women and younger people have been showing up with this cancer more frequently. Viruses such as the human papilloma virus (the same one that causes cervical cancer) may be a cause as well, which may account for more cases in younger non-smokers, according to the <a href="http://oralcancerfoundation.org/facts/index.htm">Oral Cancer Foundation</a>.<br /><br />At any rate, just because you may not fit into the typical oral cancer profile, don't assume you don't have it and make sure to get checked regularly for any abnormalities when you go to the dentist.<br /><br /><strong>How Is Oral Cancer Diagnosed?</strong><br /><br />To diagnosis oral cancer, in addition to a complete medical history and physical examination, your dentist may send you for a <strong>biopsy</strong>, wherein tissue samples are removed (with a needle or during surgery) for examination under a microscope; this is the most definitive method, and the one that diagnosed my cancer.<br /><br />There are some new methods of highlighting abnormal areas in the mouth that some dentists are now using as an overall screening method, wherein the patient rinses with a solution that causes unusual areas to show up under a special light.<br /><br />Sometimes a brush can be used on a suspicious patch of tissue to obtain cells for further examination.<br /><br />If cancer is diagnosed, the following methods may be used to ascertain whether it has spread, or how deep it may be:<br /><br /><strong>Computed tomography</strong> (CT or CAT scan) - uses radiation to obtain a very detailed view of tissues that do not show up on an ordinary X-ray;<br /><br /><strong>Ultrasonography </strong>- a diagnostic imaging technique which uses high-frequency sound waves to create an image;<br /><br /><strong>Magnetic resonance </strong>imaging (MRI) - another non-invasive procedure that produces views of an internal organ or structure, and is especially useful to observe the brain and spinal cord.<br /><br />Your doctor or dentist may also recommend fiberoptic examination of the throat and palate to ensure you don't have other lesions that are not visible through a regular oral exam.<br /><br />There are a number of other methods to determine the stage of the cancer; see this link for more information: <a href="http://oralcancerfoundation.org/diagnosis/index.htm">http://oralcancerfoundation.org/diagnosis/index.htm</a><br /><br />There are four stages of oral cancer, as described on the Oral Cancer Foundation website:<br /><br /><strong>Stage I </strong><br /><br />The cancer is less than 2 centimeters in size (about 1 inch), and has not spread to lymph nodes in the area (lymph nodes are small almond shaped structures that are found throughout the body which produce and store infection-fighting cells).<br /><br /><strong>Stage II </strong><br /><br />The cancer is more than 2 centimeters in size, but less than 4 centimeters (less than 2 inches), and has not spread to lymph nodes in the area.<br /><br /><strong>Stage III </strong><br /><br />Either of the following may be true: The cancer is more than 4 centimeters in size. The cancer is any size but has spread to only one lymph node on the same side of the neck as the cancer. The lymph node that contains cancer measures no more than 3 centimeters (just over one inch).<br /><br /><strong>Stage IV </strong><br /><br />Any of the following may be true: The cancer has spread to tissues around the lip and oral cavity. The lymph nodes in the area may or may not contain cancer. The cancer is any size and has spread to more than one lymph node on the same side of the neck as the cancer, to lymph nodes on one or both sides of the neck, or to any lymph node that measures more than 6 centimeters (over 2 inches). The cancer has spread to other parts of the body.<br /><br /><strong>Recurrent </strong><br /><br />Recurrent disease means that the cancer has come back (recurred) after it has been treated. It may come back in the lip and oral cavity or in another part of the body.<br /><br />There are also different "grades" of cancer, which mean differences in how aggressive the cancer may be. See the <a href="http://www.oralcancerfoundation.org/facts/stages_cancer.htm">Oral Cancer Foundation site</a> for more information on this.<br /><br />Depending on what stage and grade the cancer is, there are a number of available treatments.<br /><br /><strong>How Is Oral Cancer Treated?</strong><br /><br />For very early cancers, surgery is the first best choice for a full cure. However, for more advanced cancers, or those in a spot where surgery would cause a decrease in quality of life (affecting speech or taste), radiation can be a viable alternative. Here is a basic listing of the various treatments available, according to this source: <a href="http://www.healthsystem.virginia.edu/uvahealth/adult_oralhlth/cancer.cfm">http://www.healthsystem.virginia.edu/uvahealth/adult_oralhlth/cancer.cfm</a><br /><br /><strong>Surgery</strong><br /><br />Different surgery techniques are used to remove specific types of oral tumors, including:<br /><br />-Primary tumor resection - removal of the entire tumor and surrounding area of tissue<br /><br />-Mandible resection -removal of all or part of the jawbone<br />maxillectomy - removal of the tumor, including part or all of the hard palate (roof of the mouth), if bone is involved<br /><br />-Mohs' micrographic surgery - removal of the tumor in "slices" to minimize amount of normal tissue removed (may be considered when the cancer involves the lip)<br /><br />-Laryngectomy - removal of a large tumor of the tongue or oropharynx, which may involve removing the larynx (voice box)<br /><br />-Neck dissection - if cancer has spread to the lymph nodes in the neck, these lymph nodes may need to be removed as well.<br /><br /><strong>Radiation therapy </strong><br /><br />This is a treatment that uses high-energy rays that damage cancer cells and halts the spread of cancer. Radiation therapy is very localized, aimed at only the area where the cancer is present. Radiation therapy may be administered externally with a machine, or internally with radioactive materials.<br /><br /><strong>Chemotherapy </strong><br /><br />Chemotherapy uses medications that kill cancer cells. Chemotherapy has the ability to interfere with the cancer cell's replication. Chemotherapy may be used in combination with surgery and radiation therapy.<br /><br />The following more detailed listing of treatments is exerpted from this link: <a href="http://www.oralcancerfoundation.org/cdc/cdc_chapter6.htm">http://www.oralcancerfoundation.org/cdc/cdc_chapter6.htm</a><br /><br /><em>Most centers advocate surgical excision for early-stage primary disease of the lip, floor of mouth, oral tongue, alveolar ridge, retromolar trigone, hard palate, or buccal mucosa. The CO laser may also be used as a cutting tool in removing oral cavity cancers. In addition, this laser may be useful in removing dysplastic lesions without scarring the area significantly. However, clinicians must still observe the patient closely after the lesions are removed, as there is a significant likelihood of recurrence.<br /><br />Although radiotherapy [radiation] may work as well as surgery for early malignant lesions in several of these subsites, such as the floor of mouth, concern about complication rates has made surgery the choice for most of these lesions. However, more advanced primary tumors in any of these sites typically require a combination of surgery and radiotherapy. Advanced primary tumors adjacent to the mandible may require a rim mandibulectomy, and those tumors that frankly invade the mandible are treated with a segmental mandibulectomy. The plan for surgical resection must also include reconstructive options; reconstructive teams composed of head and neck surgeons, oral surgeons, and prosthodontists are most successful at achieving the best functional and cosmetic result.<br /><br />Most radiotherapy for carcinoma of the oral cavity uses an interstitial implant either alone or combined with external beam. For carcinoma of the oral tongue and buccal mucosa, the results of an interstitial implant alone or combined with external beam radiotherapy are generally better than those achieved with external beam radiotherapy alone.<br /><br />Recurrence rates vary by primary site and increase with increasing primary stage.<br /><br /></em>Because the effects of treatment may cause disfigurement and other difficult side effects, there is often a need for follow-up surgeries, prostheses to replace missing tissue, and other therapies. Support groups can be helpful for those trying to cope with these issues. When getting radiation treatment be sure to ask many questions ahead of time, as there are now drugs and other preventive measures that can be taken to minimize some of these effects (such as protecting the salivary glands from damage, which will help preserve the ability to produce saliva).<br /><br /><strong>What Is The Prognosis?</strong><br /><br />(exerpted from above link, continued)<br /><br /><em>For lesions on the floor of the mouth, 5-year cause-specific survival rates by stage are as follows: I: 90%, II: 80%, III: 70%, favorable IV: 40-50%, and unfavorable IV: 20%.<br /><br />Five-year cause-specific survival rates for oral tongue cancers by stage approximate the following: I and II: 70-80%, III: 40%, and IV: 15­-20%. </em><br /><br />These rates vary depending on where the patient is treated and how early the cancer was. My surgeon at Sloan-Kettering told me my chances of survival were above 90%.<br /><br />If you are diagnosed with an oral cancer, be sure to get at least two opinions before embarking on your treatment. Some doctors prefer surgery, some recommend radiation, and you will need to understand the pros and cons of both.<br /><br />I would also recommend, no matter where you live or end up actually having your treatment, be sure to at least have a consultation at a major cancer center such as Memorial Sloan-Kettering or M.D. Anderson (Texas). As Sloan-Kettering's motto goes, "Where you are treated first can make all the difference."<br /><br /><strong>Will You Get It?</strong><br /><br />The odds are against it. Mouth cancer in general struck a little over 10,000 people in the United States in 2004, which are odds of about 1 in 26,000. Tongue cancer was even rarer, 1 in 37,000, or just over 7,000 cases in the U.S. that year. Other sources cite slightly different statistics, but they all confirm that oral cancer, particularly tongue cancer, is a relatively rare cancer. (I was one of the "lucky" ones I guess - why can't I hit those odds when I'm playing the lottery?)<br /><br />While there are some experiments being done to identify preventive measures for oral cancer, so far the most important thing you can do to prevent this condition is to eat lots and lots of fruits and vegetables. And a <a href="http://medicine.osu.edu/article/index.cfm?ID=3408">recent study</a> found avocados in particular may be helpful.<br /><br />In conclusion, remember, just because the odds are against you having oral cancer, don't be complacent about it if you notice anything amiss in your mouth. Go to your dentist, and don't take any chances if something isn't going away, no matter what reassurances you may get. You only have one life to live and when early diagnosis is so important, time is of the essence.<br /><br />The following links were sources for this information and can provide many more details than were included above.<br /><br /><a href="http://www.cancer.gov/cancertopics/wyntk/ora">http://www.cancer.gov/cancertopics/wyntk/ora</a><br /><a href="http://www.oralcancerfoundation.org/">http://www.oralcancerfoundation.org/</a><br /><a href="http://www.nlm.nih.gov/medlineplus/oralcancer.html#cat11">http://www.nlm.nih.gov/medlineplus/oralcancer.html#cat11</a><br /><a href="http://www.medicinenet.com/oral_cancer/article.htm">http://www.medicinenet.com/oral_cancer/article.htm</a><br /><a href="http://www.healthsystem.virginia.edu/uvahealth/adult_oralhlth/cancer.cfm">http://www.healthsystem.virginia.edu/uvahealth/adult_oralhlth/cancer.cfm</a><br /><a href="http://www.merck.com/mmhe/sec08/ch113/ch113d.html#sec08-ch113-ch113d-136">http://www.merck.com/mmhe/sec08/ch113/ch113d.html#sec08-ch113-ch113d-136</a><br /><a href="http://www.wrongdiagnosis.com/o/oral_cancer/intro.htm">http://www.wrongdiagnosis.com/o/oral_cancer/intro.htm</a>Mauigirlhttp://www.blogger.com/profile/15529827915262851910noreply@blogger.com19tag:blogger.com,1999:blog-726388883619960935.post-85968724391950546822007-09-24T10:09:00.000-07:002007-09-24T12:17:09.416-07:00What If Your Doctor Is Wrong?CNN had an interesting, albeit concerning, article regarding misdiagnoses – which apparently happen all too often.<br /><br />As a hypochondriac, you are probably used to being told “Don’t worry, there’s nothing seriously wrong with you.” But if you are really worried about symptoms you are having, don’t take no for an answer. Your doctor could be missing something. If the doctor you are currently going to doesn’t listen to your symptoms or take them seriously, go somewhere else.<br /><br />By the same token, you may be all too ready to believe it if a doctor tells you that you have a serious illness. But if something tells you that it’s not likely that you have whatever it is he or she has diagnosed, then again, seek another opinion.<br /><br />You are the best judge of how you feel; if there is something about your health that is making you uneasy, don’t rest until you figure it out.<br /><br />This article has some alarming case studies. How would you like being told you had a rare form of lymphoma, but it turned out to be a benign fatty tumor?<br /><br /><a href="http://www.cnn.com/2007/HEALTH/09/19/ep.misdiagnoses/index.html">http://www.cnn.com/2007/HEALTH/09/19/ep.misdiagnoses/index.html</a><br /><br />The article has some good advice for all of us to follow when it comes to diagnoses, including the following recommendations (my comments in blue):<br /><br /><span style="font-family:arial;">Here, from from medical experts, are some red flags -- five reasons for suspecting your doctor might have made the wrong diagnosis. </span><br /><br /><span style="font-family:arial;"><strong>1. You don't get better with treatment</strong> </span><br /><br /><span style="font-family:arial;">Sometimes doctors stick to a diagnosis even when multiple treatments aren't working.<br />As vice president for loss prevention and patient safety at Harvard's Risk Management Foundation, Bob Hanscom remembers one particular lawsuit against Harvard doctors.<br /></span><br /><span style="font-family:arial;">A young woman complained of stomach and chest pain. Her doctor prescribed a medicine for gastric reflux. When it didn't work, a second doctor prescribed another drug for gastric reflux. It also didn't work. The woman ended up in the emergency room with acute pancreatitis, which eventually caused kidney failure.<br /></span><br /><span style="font-family:arial;">She survived but will be on dialysis the rest of her life.<br /></span><br /><span style="color:#6633ff;">So, if your doctor has prescribed something for you that usually works on a condition within a certain amount of time, be sure to do some research on your symptoms and see if they could be caused by something else, and bring this to the doctor’s attention rather than blindly continuing to accept medications for the same condition as you continue farther down the wrong diagnostic path.</span><br /><br /><span style="font-family:arial;"><strong>2. Your symptoms don't match your diagnosis</strong> </span><br /><br /><span style="font-family:arial;">This is where the Internet comes in. You don't have to be a medical professional to Google your diagnosis. </span><br /><br /><span style="font-family:arial;">For example, let's say a doctor diagnoses you with tendinitis. Looking it up, you can find out it usually lasts about six to 12 weeks, according to Dr. Saul Weingart, an internist and vice president for patient safety at Dana-Farber Cancer Institute in Boston, Massachusetts. </span><br /><br /><span style="font-family:arial;">If you're still in pain beyond that time, the doctor may have made the wrong diagnosis.</span><br /><br /><span style="color:#3333ff;">By the same token, if you Google your symptoms and find they don’t really match what has been diagnosed, but are a closer match with something else, again, bring it to your doctor’s attention. If you have the right doctor, he or she will not be offended by your suggestions or your research. If they are, then find another doctor.</span><br /><span style="color:#3333ff;"><br /></span><span style="font-family:arial;"><strong>3. Your diagnosis is based purely on a lab test</strong></span><br /></span><br /><span style="font-family:arial;">The reality is that labs make mistakes. In Torrey's case, she says two labs made mistakes. When lab results are the sole criteria for a diagnosis, that can be a red flag, says Torrey, who works as a patient advocate. Another red flag is when a diagnosis of a rare disease comes from a lab that doesn't specialize in that disease, Weingart says.</span><br /><br /><span style="color:#3333ff;">Recently my husband and I had our annual blood tests, which required fasting beforehand. When we got our results back, we found that the lab had mislabeled our condition as being non-fasting, so all of the comparison ranges were for non-fasting values. This could have resulted in our cholesterol and blood sugar readings being incorrectly diagnosed as being normal when they may have been too high. (Luckily that was not the case when we checked into it).</span><br /><span style="color:#3333ff;"></span><br /><span style="color:#3333ff;">Other tests can also be mixed up. I once had a misdiagnosis of severe heart failure based on a routine EKG that was run in my doctor’s office when I had complained of occasional palpitations. The doctor called me and told me he wanted me to take it easy over the weekend and not do anything strenuous, and that he’d want to put me in the hospital for tests on Monday. He later called back and apologized, saying my EKG had gotten mixed up with that of an elderly patient with an aortic aneurysm. </span><br /><br /><span style="color:#3333ff;">Again, this was an example of symptoms not matching the condition. Other than my minor palpitations (which turned out to be nothing to worry about), I had no symptoms of heart failure that would have matched the sobering diagnosis suggested by the EKG. Luckily my doctor was equally puzzled by this discrepancy, which made him double check the results – but not soon enough to avoid scaring the bejeesus out of me and my husband!</span><br /><span style="color:#3333ff;"><br /></span><strong><span style="font-family:arial;">4. Your doctor attributes common complaints to an uncommon ailment</span></strong><br /></span><br /><span style="font-family:arial;">Torrey says her doctor said her night sweats and hot flashes were caused by the extremely rare lymphoma. Actually, they were signs of menopause. </span><br /><span style="font-family:arial;"><br /></span><span style="font-family:lucida grande;color:#3333ff;">Can you imagine? Quite a big mistake there!</span><br /></span><br /><span style="color:#3333ff;">Obviously this doctor did not remember the old adage that is told to medical students: <strong><em>“If you hear hoof beats, think horses, not zebras.”</em></strong></span><br /><span style="color:#3333ff;"></span><br /><strong><span style="font-family:arial;">5. Your diagnosis usually involves a test you never received</span></strong><br /><strong></strong><br /><span style="font-family:arial;">This is where the Internet comes in handy again. If you find out a specific test can determine the diagnosis you've been given, but you were never given that test, that's a reason to head back to the doctor's office armed with questions.</span><br /><br /><span style="color:#3333ff;">Another thing to be wary of is going by the results of just one test, if a disease or condition is more accurately diagnosed with more than one. Lyme disease is a good example; a simple antibody test might show up positive, but a more extensive type of test is needed to more definitively diagnose the disease. And even then there is potential for misdiagnosis.</span><br /><span style="color:#3333ff;"></span><br /><span style="color:#000000;">So there you have it. While you shouldn't go by the motto of the old <strong>X-Files</strong> TV show, "Trust no one," at least follow the other old adage, "Trust, but verify."</span>Mauigirlhttp://www.blogger.com/profile/15529827915262851910noreply@blogger.com9tag:blogger.com,1999:blog-726388883619960935.post-32575815341268869152007-08-31T10:37:00.000-07:002007-08-31T11:33:22.024-07:00Stress Linked to Alzheimer's DiseaseA <a href="http://www.medicalnewstoday.com/articles/80820.php">recent article</a> reported in Medical News Today confirms what I have suspected for some time: stress apparently is a co-factor for memory loss associated with Alzheimer's Disease.<br /><br />A study being being published in the September 1st issue of <em>Biological Psychiatry </em>was designed to explore the relationship between mutations of the APOE gene (also called allele) and cortisol levels. It is known that the a4 variant of the APOE gene contributes to the risk for memory loss related to Alzheimer's Disease, as do high circulating levels of cortisol, associated with high stress levels.<br /><br />The article is "The Effects of Prolonged Stress and APOE Genotype on Memory and Cortisol in Older Adults" by Guerry M. Peavy, Kelly L. Lange, David P. Salmon, Thomas L. Patterson, Sherry Goldman, Anthony C. Gamst, Paul J. Mills, Srikrishna Khandrika and Douglas Galasko. It appears in <em>Biological Psychiatry</em>, Volume 62, Issue 5 (September 1, 2007), published by Elsevier. <br /><br />The <a href="http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_uids=17544378&dopt=AbstractPlus">study results</a> showed that "low-stress subjects performed better than high-stress subjects on delayed recall of stories, word lists, and visual designs. APOE-epsilon4-negative subjects obtained better scores than epsilon4-positive subjects on immediate and delayed recall of visual designs." <br /><br />The study also showed worse memory and higher cortisol concentrations in the high stress, epsilon4-positive group. The authors concluded that the findings indicate "prolonged exposure of older, nondemented individuals to stress in the presence of an epsilon4 allele leads to memory decline." They hope to do further studies to learn whether stress and this gene mutation interact to increase the risk of developing Alzheimer's disease in the first place.<br /><br />I was not surprised to read about this, as I have been aware of several cases of Alzheimer's Disease that seemed to come on rather suddenly after a highly stressful situation. The mother-in-law of a friend of mine, who seemed totally normal not long before her husband died, became almost completely demented by the end of the following year. My husband's grandmother didn't show any overt memory loss or signs of Alzheimer's until not long after her only son accidentally (we think) shot himself in the head and was stricken blind as a result. <br /><br />My father's mental state was pretty normal (other than his usual problems with depression) until a year or so after major heart surgery, which must have been stressful for both mind and body. I wonder to this day whether he would have been better off dying of heart failure at 86 rather than living to 92, with the last three years lived in an ever-increasing fog of memory loss, loss of skills, loss of comprehension, and loss of personality.<br /><br />My mother-in-law now seems to be in the middle stages of Alzheimer's Disease; but her forgetfulness started not long after her own mother died in the nursing home of complications from Alzheimer's Disease. My mother-in-law had been under tremendous stress for a number of years before her mother's death, when her mother was still living in a senior citzen's apartment building. She went there every day, made sure her mother ate, bathed her, brought her over to her own home to entertain her, dealt with her mother's temper tantrums as she worsened and showed personality changes, etc. Her mother died not that long after entering the nursing home because she broke her hip, which tipped her over the edge into incoherence after the hip was operated on. This was still more stress for my mother-in-law, who developed shingles at this time, another indication of the body's reaction to stress, which lowers the immune system response.<br /><br />While further studies are planned, it makes sense to me that if you have any Alzheimer's Disease in your family, that you should avoid stress as much as possible. While we don't know whether the development of AD can be prevented or delayed by reducing stress, it sure couldn't hurt. <br /><br />Of course, as a hypochondriac, you will probably now get stressed out worrying whether your stress levels are leading to early Alzheimer's Disease. This will be self-defeating, so go meditate or something! And a little yoga might help too.Mauigirlhttp://www.blogger.com/profile/15529827915262851910noreply@blogger.com11tag:blogger.com,1999:blog-726388883619960935.post-29631683269269637292007-08-24T14:30:00.000-07:002007-08-24T14:40:56.086-07:00An Award for Medicana<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi02Hc0pSGZJoP27sQgHcO-C8cTm9-FKD4fBJX0zl1aqqa7Ey1QeuM-TJrMJ2BMHvvjKr5jeuuXY-nqsL8BmTSH2W1sS4orEHuHenzW_oG0gnVkmGtClmVu24Sk7kK9PyhjErT4OnFG0Jen/s1600-h/creativeblogger.jpg"><img id="BLOGGER_PHOTO_ID_5102382948715521794" style="DISPLAY: block; MARGIN: 0px auto 10px; CURSOR: hand; TEXT-ALIGN: center" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi02Hc0pSGZJoP27sQgHcO-C8cTm9-FKD4fBJX0zl1aqqa7Ey1QeuM-TJrMJ2BMHvvjKr5jeuuXY-nqsL8BmTSH2W1sS4orEHuHenzW_oG0gnVkmGtClmVu24Sk7kK9PyhjErT4OnFG0Jen/s400/creativeblogger.jpg" border="0" /></a> Ruth of <a href="http://www.ruthjen.blogspot.com/">Me, My Life, My Garden</a> has awarded Medicana a "Creative Blogger" award, saying it is quite creative for someone to invent a blog for hypochondriacs! Thanks, Ruth!<br /><br />In case, as a hypochondriac, this worries you, she did not award it to me for making things up! I do indeed try to get the facts straight!<br /><br />I'll be passing this award on to other creative bloggers, but will do it from my other blog, <a href="http://www.mauigirlsmeanderings.blogspot.com/">Mauigirl's Meanderings</a>.<br /><br />A new medical post will be up soon!Mauigirlhttp://www.blogger.com/profile/15529827915262851910noreply@blogger.com2tag:blogger.com,1999:blog-726388883619960935.post-50466724854821528792007-08-18T06:00:00.000-07:002007-09-25T11:56:47.382-07:00When it Pays to be a HypochondriacFor all I poke fun of myself for being a hypochondriac, I believe hypochondria, in moderation, can actually be a very good thing, leading to a long and healthy life. Why? Because if you're the right type of hypochondriac, you go to the doctor when you have suspicious symptoms. And serious illnesses, caught early, are curable.<br /><br />Naturally, this can be carried to extremes, and we all know people who run to the doctor for every sniffle or scratch, and drive people crazy with their constant obsessing over their health. This can be unhealthy, by driving up stress levels and actually causing stress-related illnesses.<br /><br />So, as a hypochondriac, how do you know when you should worry, and when you should tell yourself to let it go?<br /><br />Luckily for us, MSN.com has published an article from the Mayo Clinic about <a href="http://health.msn.com/general/articlepage.aspx?cp-documentid=100167120&page=1">10 Symptoms Not to Ignore.</a> Following are their recommendations; I'll put my own comments in <span style="color:#000099;">blue. </span><br /><span style="color:#000099;"></span><br /><strong>1. Unexplained weight loss</strong><br />If you find you're losing excessive weight without intending to do so, see your doctor. Unintentional excessive weight loss is considered to be a loss of more than:<br /><br />5 percent of your weight within one month<br />10 percent of your weight within six to 12 months<br /><br />An unexplained drop in weight could be caused by a number of conditions, such as an overactive thyroid (hyperthyroidism), depression, liver disease, cancer or other noncancerous disorders, or disorders that interfere with how well your body absorbs nutrients (malabsorption disorders).<br /><br /><span style="color:#000099;">Heart disease is not mentioned as one of the causes of weight loss, but that is another reason people may lose weight for no reason. As my father progressed into heart failure in his mid-80's, he lost weight. He didn't seem to develop the edema (fluid retention/swelling) that some heart failure patients get, which can disguise the weight loss. His only issue was breathing difficulties at night.</span><br /><br /><span style="color:#000099;">Old age in general can result in weight loss, as people find it harder to chew, lose their appetite and sense of taste and smell, or live alone and don't feel like cooking. As mentioned in the previous post, it is important for the elderly to continue to keep up their nutrition, particularly protein. If they aren't willing or able to eat more, then nutritional substitutes such as Boost or Ensure can help keep up their caloric intake.</span><br /><p><span style="color:#000000;"><strong>2. Persistent fever</strong><br />If you have a normal immune system and you're not undergoing treatment, such as chemotherapy for cancer, a persistent low-grade fever — over 100.4 F — should be checked if it lasts for a week or more. If you have a fever with shaking chills, or a high fever — greater than 103 F — or if you're otherwise severely ill, see your doctor as soon as possible.</span></p><p><span style="color:#000000;">If you have an immune system problem or take immune-suppressing drugs, fever may not be a reliable warning sign and your primary doctor or oncologist can tell you what would signal a need for an evaluation.</span></p><p><span style="color:#000000;">Persistent fever can signal hidden infections, which could be anything from a urinary tract infection to tuberculosis. At other times, malignant conditions — such as lymphomas — cause prolonged or persistent fevers, as can some medications and conditions, and reactions to certain drugs.</span></p><p><span style="color:#000000;">Fever is common with treatable infections, such as urinary tract infections. But if a low-grade fever persists for more than two weeks, check with your doctor. Some underlying cancers can cause prolonged, persistent fever, as can tuberculosis and other disorders.</span></p><p><strong>3. Shortness of breath</strong><br />Feeling short of breath — beyond the typical stuffy nose or shortness of breath from exercise — could signal an underlying health problem. If you ever find that you're unable to get your breath or that you're gasping for air or wheezing, seek emergency medical care. </p><p>Feeling breathless with or without exertion or when reclining also is a symptom that needs to be medically evaluated without delay. <span style="color:#000099;">(This was one of the key symptoms my father had with his congestive heart failure.)</span></p><p>Causes for breathlessness may include chronic obstructive pulmonary disease, chronic bronchitis, asthma, heart problems, anxiety, panic attacks, pneumonia, a blood clot in the lung (pulmonary embolism), pulmonary fibrosis and pulmonary hypertension.</p><p><strong>4. Unexplained changes in bowel habits</strong><br />See your doctor if you have any of the following:<br />-Severe diarrhea lasting more than two days<br />-Mild diarrhea lasting a week<br />-Constipation that lasts for more than two weeks<br />-Unexplained urges to have a bowel movement<br />-Bloody diarrhea<br />-Black or tarry-colored stools</p><p>Changes in bowel habits may signal a bacterial infection — such as campylobacter or salmonella — or a viral or parasitic infection. Among other possible causes are inflammatory bowel disease and colon cancer.</p><p><span style="color:#000099;">Of course, as a hypochondriac, you will want to know as many possible causes as you can, so you'll have more to worry about and so you can help your doctor by figuring out what is wrong with you ahead of time and informing him or her of your diagnosis. </span></p><p><span style="color:#000099;">Other reasons for diarrhea or changes in bowel habits include celiac disease (or milder forms of gluten intolerance, where the body is sensitive to wheat products) and irritable bowel syndrome (IBS). </span></p><p><span style="color:#000099;">Bloody or black diarrhea may not even be a problem related to the bowels; the cause could be a bleeding ulcer in the stomach. This happened to my father-in-law a few years ago. He began having black diarrhea and feeling very weak. After he was taken to the emergency room he was diagnosed with a bleeding ulcer; luckily it stopped of its own accord and medication and diet were able to cure him. He's had no problems since.<br /><br />Bright red blood in the stool can be a symptom of something as simple as hemmorrhoids. But it is important to find out for sure by consulting your doctor.<br /></span></p><p><strong>5. Mental status changes</strong><br />Immediate medical evaluation is warranted if any of the following occur:<br />-Sudden or gradual confused thinking<br />-Disorientation<br />-Sudden aggressive behavior<br />-Hallucinations in someone who has never had them</p><p>Changes in behavior or thinking may be due to infection, head injury, stroke, low blood sugar or even medications, especially ones you've recently started taking.</p><p><span style="color:#000099;">Other causes can include a brain tumor or other lesions on the brain, or dementia from Alzheimer's or other similar diseases. Please see my previous posts on Alzheimer's and Brain Tumors for more information to scare yourself with.</span></p><p><strong>6. New or more severe headaches (especially if you're over age 50)</strong><br />Seek prompt medical attention if you experience:<br />-A sudden and severe headache, often called a thunderclap headache, because it comes on suddenly like a clap of thunder.<br />-A headache accompanied by a fever, stiff neck, rash, mental confusion, seizures, vision changes, weakness, numbness, speaking difficulties, scalp tenderness or pain with chewing.<br />-A headache that begins or worsens after a head injury.</p><p>These headache symptoms may be caused by stroke, blood vessel inflammation (arteritis), meningitis, brain tumor, aneurysm or bleeding on the brain after head trauma.</p><p><span style="color:#000099;">I have known, or known of, several fairly young people who have been the victims of brain aneurysms, where a weakened blood vessel bulges and eventually bursts. One, a man that worked at my company, was only 40. Another, the sister of a friend of mine, was 47. Sometimes an aneurysm is so catastrophic that there is nothing that can be done, as sadly was the case with them. But it can also cause symptoms before it actually bursts, and if the person realizes something is wrong and seeks medical help, surgery may be able to repair the vessel before it bursts.</span></p><p><strong>7. Short-term loss of vision, speaking or movement control</strong><br />If you have these signs and symptoms, minutes count. These are signs and symptoms of a possible stroke or transient ischemic attack (TIA). Seek immediate emergency medical care if you have any of the following:<br />-Sudden weakness or numbness of the face, arm or leg on one side of your body<br />-Sudden dimness, blurring or loss of vision<br />-Loss of speech, or trouble talking or understanding speech<br />-A thunderclap headache<br />-Sudden dizziness, unsteadiness or a fall</p><p><span style="color:#000099;">If at all possible, try to get to a hospital that specializes in treating strokes. (For more information, see my post on stroke).</span></p><p><strong>8. Flashes of light</strong><br />The sudden sensation of flashing lights may signal the beginning of retinal detachment. Immediate medical care may be needed to save vision in the affected eye.</p><p><span style="color:#000099;">Other less serious causes can be a detachment of the vitreous humor in the eye (the gel-like substance that fills the interior of the eye), or an ocular migraine. Naturally I have experienced both of these phenomena. </span></p><p><span style="color:#000099;">The detachment of the vitreous humor caused me to see a ringlike light when I looked into bright lights. In and of itself, the detachment of the vitreous humor is not necessarily dangerous; it often happens in nearsighted people as they age. It can lead to a retinal detachment, however, so it is important to have an ophthalmologist keep an eye on it (so to speak). It can leave the person with a lot of "floaters" in the affected eye for awhile but this effect dies down after about 6 months.</span></p><p><span style="color:#000099;">The ocular migraine (which apparently is similar to the "aura" that some migraine headache sufferers get when they're getting a migraine, but with the ocular migraine the person never actually gets the headache), can be a bit scary when it happens for the first time. An affected person suddenly becomes aware of a distinctive curved pattern of jagged white light. It starts strongly and then gradually diminishes. These episodes usually only last 15-20 minutes. When I first had one, I thought of retinal detachment, but then remembered a friend of mine had had ocular migraines when she was pregnant. When my symptoms went away after 10 or 15 minutes, I decided it must have been an ocular migraine. (Like me, she gets concerned about health-related issues, so she described her symptoms in detail to me at the time.) </span></p><p><span style="color:#000099;">We were on vacation when I had this little episode, so I waited a few days until we returned home and went to the ophthalmologist just to be sure everything was fine. I told him what happened and that I thought it was an ocular migraine, he agreed, and said "You'll have another."</span></p><p><span style="color:#000099;">Sure enough, I had several more episodes over the next year or so, but since then I haven't had any others. It's been several years since the last one.</span> </p><p><span style="color:#000099;">I'd like to add, unless you are an experienced hypochondriac like myself, I would highly recommend that if you have ANY kind of flashing lights, that you consult an ophthalmologist immediately. Don't try to figure out whether it's a vitreous humor detachment, ocular migraine, or detached retina. It's just nice to know that there are other reasons you may have flashing lights in your eye other than the detached retina, which would require laser surgery and could cause you to lose your vision if not treated promptly.</span></p><p><strong>9. Feeling full after eating very little</strong><br />Feeling full sooner than normal after eating and having persistent nausea and vomiting that last more than a week are warning signs that should be checked by your doctor. There are many possible causes, including pancreatic cancer, stomach cancer and ovarian cancer.</p><p><span style="color:#000099;">Um, of course, there is one other possibility - you could be pregnant. If this is possible, buy a pregnancy test and check it out!</span></p><p><strong>10. Hot, red or swollen joint</strong><br />These warning signs may occur with a joint infection, which requires emergency care to save the joint and keep bacteria from spreading elsewhere. Other causes may include gout or certain types of arthritis such as rheumatoid arthritis.</p><p><span style="color:#000099;">A friend of ours had these symptoms and found it hard to get a diagnosis. The doctor finally decided it was gout. </span></p><p><span style="color:#000099;">Be sure to differentiate between swollen ankles or swollen joints, as swollen ankles could be fluid retention, which of course has its own separate list of possible causes, such as heart failure, liver disease, or just eating too much salt on a hot day. (I had swollen ankles once after having been on a plane the previous day and panicked thinking I had heart failure.)</span></p><p><span style="color:#000099;">This list is not complete, since it doesn't mention the <a href="http://www.uihealthcare.com/topics/cancer/canc4280.html">"7 Warning Signs of Cancer,"</a> which are:</p></span><p><span style="color:#000000;">-A change in bowel or bladder habits<br />-A sore that does not heal <span style="color:#000099;">(including mouth sores - don't just assume it's a canker sore!)</span><br />-Unusual bleeding or discharge from any place<br />-A lump in the breast or other parts of the body<br />-Chronic indigestion or difficulty in swallowing<br />-Obvious changes in a wart or mole <span style="color:#000099;">(or any mole that is irregular in shape or has various colors in it - see this link for more information: </span><a href="http://cancer.about.com/od/skincancermelanoma/p/abcdeskincancer.htm">http://cancer.about.com/od/skincancermelanoma/p/abcdeskincancer.htm</a>)<br />-Persistent coughing or hoarseness</span> </p>The "7 Warning Signs of Cancer" link also has another good symptoms list - for prostate and bladder symptoms.<br /><br />Now that you are thoroughly educated about symptoms that should be checked out, go forth and worry! Maybe you'd better make a doctor appointment right now just in case.Mauigirlhttp://www.blogger.com/profile/15529827915262851910noreply@blogger.com10tag:blogger.com,1999:blog-726388883619960935.post-10036185192371931622007-08-10T16:05:00.000-07:002007-08-10T16:22:39.263-07:00Keep Eating Protein as You AgeA recent <a href="http://www.news-medical.net/?id=28664">study by the University of Texas Medical Branch at Galveston</a> indicates that elderly people are just as able to synthesize muscle from protein as younger people are.<br /><br />The study compared the rate at which study participants built muscle protein after consuming a four-ounce serving of lean beef. Ten elderly volunteers were compared to ten younger volunteers, by analyzing blood and muscle samples during the five hours after the beef was consumed. Results showed that both groups increased muscle protein creation by +50%.<br /><br />Since people lose muscle mass as they age, it is good news to learn there is no reason they cannot continue to build new muscle as long as they eat protein. However, elderly people often do not eat enough protein due to various reasons (loss of chewing ability, cost, decline in appetite, etc.). This study shows it is very important to continue to include sources of protein in one's diet on a regular basis.<br /><br />This is particularly important for vegetarians, since their protein must come from other sources than meat, fish or poultry. Including soy, beans, and other protein sources in the diet is crucial.<br /><br />Of course, lack of exercise is another factor leading to loss of muscle mass in the elderly. As a Baby Boomer (or "Aging Baby Boomer" as they keep calling us now) I was excited to find out that eating meat, one of my favorite foods, might help me stave off loss of muscle tone. However, I guess I still have to exercise. There's never an easy solution, it seems.Mauigirlhttp://www.blogger.com/profile/15529827915262851910noreply@blogger.com8tag:blogger.com,1999:blog-726388883619960935.post-10136387541599456502007-07-31T17:48:00.000-07:002007-08-01T08:02:11.176-07:00Macular Degeneration<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgjvpYsZeZKslhG8x9QRYfkax0xhRb8NDxGzaNRIQwO2L3mqctAtYlt33trzyg5RWaSg6qURmlCaFIc4Mfak1-4P4B0-d9sIO3ZX5jdJoXr5EOPWRYV0tRgytMEWe6MF_yMGcQyZHmEYmAE/s1600-h/eye6.gif"><img id="BLOGGER_PHOTO_ID_5093554270642492802" style="DISPLAY: block; MARGIN: 0px auto 10px; CURSOR: hand; TEXT-ALIGN: center" height="188" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgjvpYsZeZKslhG8x9QRYfkax0xhRb8NDxGzaNRIQwO2L3mqctAtYlt33trzyg5RWaSg6qURmlCaFIc4Mfak1-4P4B0-d9sIO3ZX5jdJoXr5EOPWRYV0tRgytMEWe6MF_yMGcQyZHmEYmAE/s400/eye6.gif" width="283" border="0" /></a><br /><p>As the Baby Boomers age, more and more people will be diagnosed with the most common type of macular degeneration, age-related macular degeneration, or AMD.<br /><br />Macular degeneration is a type of vision loss caused by a detrioration of the macula, which is the part of your retina that controls your central vision.<br /><br />By the time I was old enough to really know my grandfather, he was already having problems with his sight. He was a lot older than my grandmother, so when I was 5 years old, he was 86. He could still see somewhat when I was that age, but by the time he died at age 94 he was virtually blind from a combination of macular degeneration and cataracts. He kept his wits about him till the end, and enjoyed listening to opera and the Mets on the radio. But I know he missed reading, which was a great love of his, and back then they had no books on tape.<br /><br />I have an elderly neighbor who started developing macular degeneration quite a few years ago. She is now 97 and can see very little; however, she still lives at home by herself and enjoys listening to books on tape. Like my grandfather, she had been an avid reader, so she is grateful for the tapes and says they "saved her life."<br /><br />Now both my mother and father-in-law have been diagnosed with this condition. They both have the less severe kind, the "dry" variety, and so far their daily activities have not been impacted. But I worry about the future. And of course, being both a hypochondriac and a realist (after all, it seems to run in my family, at least on my mother's side), I worry that I will get it as I age.<br /><br /><strong>What is macular degeneration?</strong><br /><br />There are two types of macular degeneration: The wet form and the dry form.<br /><br /><strong>Wet AMD</strong> is caused by the growth of abnormal blood vessels behind the retina, called choroidal neovasculization. They start to grow under the macula and, because they are poorly formed and fragile, often leak blood and fluid. This distorts the macula by lifting it from its normal position and quickly damages the structure, causing scarring. The wet type of AMD is considered advanced because the vision loss can happen quickly.<br /><br /><strong>Dry AMD</strong> happens when the light-sensitive cells in the macula slowly break down, gradually causing blurred central vision in the affected eye(s). Eventually, as less of the macula functions, central vision can be gradually lost.<br /><br /><strong>What are the symptoms?</strong><br /><br />For Wet AMD, symptoms develop rapidly, and can include:<br /><br />-Visual distortions; straight lines may appear wavy or crooked, things may look smaller or farther away than they should<br />-A decrease in central vision or a central blurry spot<br /><br />There is another type of Wet AMD where fluids leak behind the macula but there is no sign of abnormal blood vessel growth. This is called Retinal Pigment Epithelial Detachment. It progresses less rapidly than regular Wet AMD, but eventually does develop into the more severe form.<br /><br />For Dry AMD, symptoms appear more gradually. They can include:<br /><br />-Need for increasingly bright light when reading or doing close work<br />-Difficulty adapting to a darker place, such as when entering a restaurant after being outdoors in the brighter light.<br />-Increasing blurriness of printed words<br />-A decrease in the intensity or brightness of colors<br />-Difficulty recognizing faces<br />-Gradual increase in the haziness of your overall vision<br />-Blurred or blind spot in the center of your visual field<br /><br />One of the most common early signs of Dry AMD is the appearance of little yellow spots called "drusen" in the retina.<br /><br />Dry AMD has three stages, all of which may occur in one or both eyes:<br /><br /><strong>Early AMD.</strong> People with early AMD may have several small drusen or a few medium-sized drusen, with no signs of vision loss yet.<br /><br /><strong>Intermediate AMD</strong>. At this stage, there may be either many medium-sized drusen or one or more large drusen. At this point, there may be a blurred spot in the central vision and the patient may need brighter light for reading and other tasks.<br /><br /><strong>Advanced Dry AMD</strong>. At this stage, in addition to drusen, there will be a breakdown of light-sensitive cells and supporting tissue in the central retinal area. This can cause a blurred spot in the center of the vision. Over time, the blurred spot may get bigger and darker, making it hard to read or recognize faces.<br /><br />In either type of macular degeneration, the process may affect one or both eyes.<br /><br />In addition, there may be visual hallucinations as the eyesight deteriorates; this phenomenon is called Charles Bonnet Syndrome, and may include seeing geometric patterns, strange-looking faces, animals, and more.<br /><br />The dry form of AMD is much more common; among people with the early and intermediate stages of AMD, 85% have Dry AMD. However, all people who have the wet form started out with the dry form of the condition. Among those with advanced AMD, 2/3 have the wet form.<br /><br />In both types of AMD, it is thought that a breakdown in the waste removal system in the eye may obstruct the nutrient flow and result in either the cellular deterioration seen in Dry AMD or the growth of the abnormal blood vessels in the wet form.<br /><br /><strong>How is it diagnosed?</strong><br /><br />If you are having problems with your vision, consult an ophthalmologist. He (or she) will give you a thorough eye exam, in which he will look for the signs of drusen or mottled coloring in the retina. In addition, he may use an Amsler Grid to test your eyesight, to see whether lines look wavy or distorted.<br /><br />You may need to have an angiography, where dye is injected into your veins so that the doctor can see the blood vessels and pigmentation in the back of your eyes that might not be visible in an ordinary examination. There are two different types of dye that may be used - fluorescein or indocyanine green (ICG).<br /><br />Another test that may be conducted is Ocular Coherence Tomography, or OCT. This is a test that can indicate the thickness of the retina and identify the presence of abnormal fluid. It is non-invasive.<br /><br /><strong>How is it treated?</strong><br /><br />Most of the treatments available are for treating Wet AMD. Since this is the most severe form, it is important to stop the damage as quickly as possible, as it is usually not reversible.<br /><br />Treatments include:<br /><br /><strong>Photocoagulation:</strong> This is a laser treatment which seals off the abnormal blood vessels and keeps them from leaking further. It is best for treating blood vessels that are not directly under the center of the macula (called the fovea).<br /><br /><strong>Photodynamic Therapy:</strong> This treatment is mainly used for abnormal blood vessel growth under the fovea. It is a cold laser treatment that is used in conjunction with a light-sensitive drug (verteporfin, brand name Visudyne)which is injected into the bloodstream. It is concentrated in the abnormal blood vessels behind the fovea and when the laser hits them, the drug causes substances to be released that close off the blood vessels.<br /><br /><strong>Macular Translocation Surgery:</strong> Another treatment used for the area under the fovea is this type of surgery, in which a skilled surgeon detaches the retina, moves the fovea away from the abnormal blood vessels, removes the blood vessels, and reattaches the fovea over unaffected tissue. This is not commonly used.<br /><br />Another way to treat Wet AMD is through drugs called Anti-Vascular Endothelial Antivascular Growth Factor (Anti-VEGF) medications. They include:<br /><br />-<strong>Macugen</strong> (pegaptanib). It is injected into the vitreous fluid in the eye and helps stop the development of new abnormal blood vessels and prevents leaking of fluids.<br /><br />-<strong>Lucentis</strong> (ranibizumab) works in a similar way. In addition to preventing additional damage, Lucentis may also reverse existing damage.<br /><br />-<strong>Avastin </strong>(bevacizumab)is related to Lucentis but is not currently approved for macular degeneration. Since it is approved for colon and rectal cancer, doctors can use it off-label for other purposes, and it is believed it will work similarly to Lucentis on Wet AMD. Therefore, some doctors are using it for this condition.<br /><br />For Dry AMD, there are fewer treatments, but since it progresses so much more slowly, there is a good chance that those who are diagnosed with Dry AMD will continue to live normal lives for many years.<br /><br />Photocoagulation is being explored as a treatment for Dry AMD who have drusen. It is hoped that low-level laser treatments of the retina may cause regressen of the drusen and prevent vision loss. This treatment is being studied in a clinical trial.<br /><br />Other therapies being studied include the use of Kenalog, a steroid that reduces inflammation; and Rheophoresis, where the blood is removed from the body and filtered to take out harmful substances that may be impeding the flow of blood in the eye.<br /><br />One therapy that has been proven to delay the progress of Dry AMD in those affected is the "AREDS" (for Age-Related Eye Disease Study) supplement formula. This combination of nutrients was tested in a <a href="http://www.nei.nih.gov/news/pressreleases/101201.asp">national clinical trial</a> and found to be effective in preventing the progress of AMD among those who were at high risk of developing Advanced AMD. The supplement consisted of a specific combination of vitamin C, E, zinc, copper and beta carotene. It is available in drug stores. Some versions include lutein as well, which has been shown to be beneficial.<br /><br />If you are looking to prevent AMD, eating a lot of healthy foods full of antioxidants should be helpful. A recent study also indicated that increased consumption of fish high in Omega-3 fatty acids may also be protective.<br /><br />Be sure to wear sunglasses, don't smoke, and keep your blood pressure under control as well.<br /><br />If you have Dry AMD, you should have a comprehensive dilated eye exam at least once a year so that your eye doctor can monitor the condition. Because dry AMD can turn into wet AMD at any time, you should get an Amsler grid from your doctor and use it at home to evaluate your vision daily.<br /><br />If you have Wet AMD and your doctor advises treatment, don't waste any time in getting it. After laser surgery or photodynamic therapy, you will need frequent eye exams to detect any recurrence of leaking blood vessels.<br /><br />There are many aids for those who have vision loss, including magnifiers, automatic readers, large print books, books on tape, and various other ways to help those with vision loss to cope. And be sure to subscribe to a website newsletter that keeps you informed of new treatments.<br /><br /><strong>Will you get it?</strong><br /><br />You may, if you live long enough. Macular Degeneration is the leading cause of vision loss in those over 55. Risk factors include:<br /><br />The greatest risk factor is age. A large study found that people in middle-age have about a 2 percent risk of getting AMD, but this risk increases to nearly 30 percent in those over age 75.<br /><br />Other risk factors include:<br /><br /><strong>Smoking:</strong> Smoking may increase the risk of AMD.<br /><strong>Obesity:</strong> Research studies suggest a link between obesity and the progression of early and intermediate stage AMD to advanced AMD.<br /><strong>Race:</strong> Whites are much more likely to lose vision from AMD than African Americans.<br /><strong>Family history:</strong> Those with immediate family members who have AMD are at a higher risk of developing the disease.<br /><strong>Gender:</strong> Women appear to be at greater risk than men.<br /><br />Information for this post came from the following websites:<br /><br /><a href="http://www.mayoclinic.com/health/macular-degeneration/DS00284/DSECTION=1">http://www.mayoclinic.com/health/macular-degeneration/DS00284/DSECTION=1</a> <a href="http://www.nei.nih.gov/health/maculardegen/armd_facts.asp">http://www.nei.nih.gov/health/maculardegen/armd_facts.asp</a><br /><a href="http://www.macular.org/">http://www.macular.org/</a><br /><a href="http://www.macular-degeneration.org/home.htm">http://www.macular-degeneration.org/home.htm</a> </p><p>Please see these websites for further details on the disease.<br /><br />Another resource that may be helpful is this site:<br /><a href="http://www.amd.org/site/PageServer?pagename=homepage">http://www.amd.org/site/PageServer?pagename=homepage</a></p><p>The picture of the eye at the beginning of the article came from this site:<br /><a href="http://images.google.com/imgres?imgurl=http://www.retinaaustralia.com.au/images/eye6.gif&imgrefurl=http://www.retinaaustralia.com.au/RP.htm&amp;amp;amp;h=396&w=565&sz=16&hl=en&start=0&tbnid=kY7c9mTnGlIwzM:&amp;amp;amp;tbnh=94&tbnw=134&prev=/images%3Fq%3Deye%26gbv%3D2%26svnum%3D10%26hl%3Den%26sa%3DG">http://images.google.com/imgres?imgurl=http://www.retinaaustralia.com.au/images/eye6.gif&imgrefurl=http://www.retinaaustralia.com.au/RP.htm&amp;amp;amp;h=396&w=565&sz=16&hl=en&start=0&tbnid=kY7c9mTnGlIwzM:&amp;amp;amp;tbnh=94&tbnw=134&prev=/images%3Fq%3Deye%26gbv%3D2%26svnum%3D10%26hl%3Den%26sa%3DG</a></p>Mauigirlhttp://www.blogger.com/profile/15529827915262851910noreply@blogger.com5tag:blogger.com,1999:blog-726388883619960935.post-65237305982739240852007-07-12T09:31:00.000-07:002007-07-12T09:32:05.420-07:00Always read the fine print when it comes to medical studiesI happened to notice a headline today that clearly stated "Meditation Won't Boost Health - Study." The article was one of those short, consumer-friendly health-related articles written for the layman, on Yahoo Health.<br /><br />But if you read the whole article, it does not say meditation doesn't boost health. What it actually says is:<br /><br />"Some of the studies suggested that certain types of meditation could help reduce blood pressure and stress and that yoga and other practices increased verbal creativity and reduced heart rate, blood pressure and cholesterol in healthy people.<br /><br />However, the report authors said <strong>it isn't possible to draw any firm conclusions about the effects of meditation on health, because the existing studies are characterized by poor methodologies and other problems."</strong><br /><br />Anyone who just glanced at the headline would have said "Oh well, I can ditch those yoga classes I'm taking, they won't help me any." And they might be jettisoning a type of workout that truly has benefits for blood pressure or stress, all because of a poorly-written headline.<br /><br />Whenever you see an article citing a study, always read the fine print of the article and draw your own conclusions. Better yet, find a copy of the actual study on the internet and read it yourself. This is the only way to truly understand the research results.<br /><br />For the rest of the article, see this link:<br /><br /><a href="http://news.yahoo.com/s/hsn/20070712/hl_hsn/meditationwontboosthealthstudy">http://news.yahoo.com/s/hsn/20070712/hl_hsn/meditationwontboosthealthstudy</a><br /><br />A more complete article with a better headline appears in the Canadian press, here:<br /><br /><a href="http://www.expressnews.ualberta.ca/article.cfm?id=8572">http://www.expressnews.ualberta.ca/article.cfm?id=8572</a><br /><br />Just goes to show how the media can spin things with slight differences in words. This is something to keep in mind every time you read an article, and particularly on medical subjects.Mauigirlhttp://www.blogger.com/profile/15529827915262851910noreply@blogger.com4tag:blogger.com,1999:blog-726388883619960935.post-51080794272331077212007-07-01T08:25:00.001-07:002007-07-01T08:30:22.350-07:00Comments are welcome at MedicanaIn the course of checking my Sitemeter from time to time I notice a lot of people find this blog via Google. And often they are searching for symptoms that the blog doesn't address so I assume they move on to greener pastures.<br /><br />But sometimes I wish they would comment and ask their question, as I may be able to provide information on what they're looking for.<br /><br />Also, you readers may have more information about a subject than I have provided, or new treatments that I did not come across in my research. So please, feel free to comment and add to the knowledge!<br /><br />Please note I've added a new search bar to the right of the posts - it is specific to medical subjects. You may be able to learn more there about whatever you're looking for, without having to wade through non-pertinent information.Mauigirlhttp://www.blogger.com/profile/15529827915262851910noreply@blogger.com2tag:blogger.com,1999:blog-726388883619960935.post-71033581620312326852007-06-16T10:06:00.000-07:002007-06-30T10:40:22.592-07:00Chronic Fatigue Syndrome or Chronic Fatigue and Immune Dysfunction Syndrome (CFIDS)<p>Believe it or not, this too has been an illness I have experienced personally. There is no end to them! (Are you really a hypochondriac if you actually have real diseases? I personally have always loved the story of the hypochondriac who died and had his headstone inscribed "I TOLD you I was sick!")<br /><br />In April of 1987 I was under stress at work and had to give a presentation to a group of people, something I had never done before. I was so nervous the night before that I hardly slept! A few days later I started to feel odd -- my throat and ears felt clogged, and I started to get a kind of sore throat that ached rather than hurt when I swallowed.<br /><br />Gradually I developed severe fatigue and a host of other symptoms, including sensitivity to smells and sounds, "brain fog," and pressure behind my eyes. When I say "fatigue" I mean the kind of fatigue that makes you so tired you want to cry. I'd come home from work and collapse in bed for a couple of hours before I could do a thing.<br /><br />I had read about Chronic Fatigue Syndrome in an article in a magazine called "Hippocrates," which described a mysterious outbreak of the syndrome in a town called Incline Village, in Nevada, back in 1984. So at least I knew what it could be when the symptoms arose, and did not immediately assume I was dying.<br /><br />Luckily, I went to a doctor who had also heard of Chronic Fatigue Syndrome, which was just becoming known at the the time, and he tested me for the Epstein-Barr virus. The test came back as positive, meaning the virus was showing signs of reactivation. Epstein-Barr is not the cause of this syndrome, but reactivation of the virus may be a marker for something going on in the body that affects the immune system. He also ruled out other possible causes like cancer and Lyme disease.<br /><br />At that time there was little to do but rest a lot and hope the symptoms subsided on their own. The doctor tried me on tricyclic antidepressants, which were supposed to help with sleep patterns, and a couple of other things. I was lucky; the symptoms gradually became more intermittent - a few bad days, then a few good days, and after about three years the good outweighed the bad and I gradually returned to normal. I was also lucky in that I never had to miss work because of the symptoms, unlike some sufferers with this disease.<br /><br />The history of Chronic Fatigue Syndrome is murky, because descriptions of these symptoms go back decades; even Florence Nightingale may have been a sufferer. It has masqueraded under various names and for many years doctors suspected it was psychological; possibly the result of depression.<br /><br />This is no longer the case; the Centers for Disease Control now consider CFS (now known as CFIDS - Chronic Fagigue and Immune Dysfunction Syndrome) a real disease and research is being done on it to understand the causes and possible treatments. In Europe, it is often called Myalgic Encephalitis, to take into account the joint/muscle pain and mental effects of the disorder and make it sound more like a disease than just being tired all the time.<br /><br />I am happy that I am now 100% back to my usual self and that being tired or achey nowadays is usually just because of my advancing middle-aged status! But for many people the nightmare never ended and they are still ill with a disease that many people still don't believe in. That alone is part of the frustration they go through. People are always saying "Are you sure you're sick? You look fine!"<br /><br /><strong>CFIDS: What is it?</strong><br /><br />Chronic Fatigue Syndrome (or Chronic Fatigue and Immune Dysfunction Syndrome, which is now its preferred name in the U.S.) is a constellation of various symptoms, the most important of which is severe fatigue.<br /><br /><strong>What Are the Symptoms?</strong><br /><br />The CDC defines Chronic Fatigue and Immune Dysfunction Syndrome as a combination of the following symptoms:<br /><br />Clinically evaluated, unexplained, persistent or relapsing chronic fatigue that is of new or definite onset (has not been lifelong); is not the result of ongoing exertion; is not substantially alleviated by rest; and results in substantial reduction in previous levels of occupational, educational, social, or personal activities<br /><br />The concurrent occurrence of four or more of the following symptoms, all of which must have persisted or recurred during 6 or more consecutive months of illness and must not have predated the fatigue:<br /><br />-Self-reported impairment in short-term memory or concentration severe enough to cause substantial reduction in previous levels of occupational, educational, social, or personal activities<br />-Tender cervical or axillary lymph nodes (swollen or painful lymph nodes in the neck or under arms)<br />-Muscle pain, multijoint pain without joint swelling or redness<br />-Headaches of a new type, pattern, or severity<br />-Unrefreshing sleep - waking up just as tired as when you went to bed<br />-Postexertional malaise lasting more than 24 hours (feeling crummy after exercise)<br /><br />The earlier, 1988, definition also included the following:<br /><br />Exclusion of other clinical conditions that may produce similar symptoms (e.g., malignancy, autoimmune disease, chronic psychiatric disease, and chronic inflammatory disease, among others), which would still be an important thing to do.<br /><br />Minor criteria:<br />-Mild fever<br />-Sore throat<br />-Unexplained generalized muscle weakness<br /><br />Since I had the muscle weakness intermittently (I remember once I discovered the muscles in my hands felt overused and weak after typing!), and definitely the "sore" throat (which was really more of an ache, and unlike any sore throat I'd ever had before), I thought it worth including these symptoms, which are definitely common in many CFIDS sufferers, even though the current definition seems to be de-emphasizing them.</p><p><strong>How Is It Diagnosed?</strong></p><p>CFIDS, as mentioned, masquerades as various other illnesses. So many of the tests that are ordered are actually tests for other diseases or conditions, to rule them out. Naturally a full battery of blood tests will be ordered; in addition to a full blood chemistry to rule out liver or kidney problems or anemia, you would be tested for thyroid abnormalities, diabetes, multiple sclerosis, rheumatoid arthritis, lupus, HIV, leukemia, lymphoma, Lyme disease, or anything else that could cause similar symptoms as CFIDS. The doctor should also order tests such as an EKG and/or echocardiogram to check your heart, since heart problems can cause fatigue.</p><p>Many patients show abnormal levels of hormones such as cortisol (the stress hormone). Testing is still being done to further understand the relationship between these hormone levels and CFIDS.</p><p>Fibromyalgia is a similar illness to CFIDS, but its symptoms veer more toward pain in the muscles and joints, with 18 specific "trigger points" on the body that cause pain when pressed. Fibromyalgia sufferers share many similar symptoms to CFIDS and there may be underlying commonalities between the syndromes. There are a number of organizations that are researching both illnesses since they overlap in many cases.</p><p>Depression is another factor that must be considered. Although people who are depressed often complain of fatigue and even physical symptoms that are similar to CFIDS, CFIDS often strikes people who have been perfectly happy and active before their symptoms began. However, there may naturally be a relationship between CFIDS and depression, since people who are suddenly incapacitated by fatigue and other symptoms would naturally become depressed. There may even be some overlapping causes of both, so while depression, when present, should be treated, its diagnosis should not exclude the diagnosis of CFIDS.</p><p>The Epstein-Barr test that my doctor performed was based on a popular theory back in the 1980's that the syndrome was caused by the Epstein-Barr virus, which is the virus responsible for mononucleosis, since so many patients were complaining of symptoms that were so similar to those of mono. Later research has shown that those with CFIDS show higher than normal levels of antibodies to many viruses, not just Epstein-Barr, and it is hypothesized that the symptoms are actually caused by a highly oversensitive immune system that is responding too strongly to many different stimuli, causing the flu-like symptoms that people experience, not by any one viral agent. So the Epstein-Barr test is no longer used as a diagnostic for CFIDS.</p><p>Tests to positively confirm CFIDS are still being explored. It may be useful to test for immunological dysfunction (serum immunoglobulins, or IgC subclasses), since if these show up then treatment with immunoglobulin replacement could be helpful. There is also something known as the "Tilt Table Test" which tends to be positive for CFIDS patients. In this test, patients are put on a table that is then tilted so that they are lying down and then tilted upright. In a study that was done, CFIDS patients had abnormal responses to this test, unlike the control population (<a href="http://www.nfra.net/LowBld_1.htm">http://www.nfra.net/LowBld_1.htm</a>), indicating they have a type of low blood pressure called "neurally mediated hypotension."</p><p>In severe cases of CFIDS, patients may show true signs of immunologic malfunctioning, such as yeast infections, shingles, and other opportunistic diseases.</p><p><strong>How is it treated?</strong></p><p>Naturally it will be important for anyone diagnosed with CFIDS to get a lot of rest and eat very nutritious food and perhaps even take vitamin supplements to ensure their bodies are getting what they need. It is also important to avoid stress, as may CFIDS patients exhibit abnormal levels of cortisol in their bodies, and stress can make symptoms of the illness worse. In addition, although mild exercise is encouraged, CFIDS patients should not overdo it or they will feel worse the next day.</p><p>Treatment mainly depends on the symptoms. Since <strong>sleep disturbances</strong> are common, many doctors prescribe a tricyclic antidepressant to help the patient achieve a good night's sleep, which often makes a big difference in how he or she feels on a day-to-day basis. More modern drugs such as Ambien may also be helpful but should be used with care. Over-the-counter products such as Tylenol PM or Benadryl may also help with restful sleep, as well as the hormone Melatonin (available in drug and health food stores).</p><p><strong>Pain</strong> can be treated with over-the-counter remedies such as Tylenol or Advil (or their generic equivalents). More severe pain can be treated with narcotics but this is not encouraged due to the addictive nature of these drugs. Alternative treatments such as biofeedback techniques or acupuncture can also be helpful.</p><p>On top of everything else, some CFIDS patients have <strong>Irritible Bowel Syndrome</strong>, which can cause bloating, gas, and diarrhea/constipation. Therapy for this condition includes antispasmodics, antidiarrheal and anti-anxiety medications. A high fiber diet should help too.</p><p>Problems with the body's <strong>immune system</strong> can be treated with immune regulators. such as Gamma globulin or a drug called Ampligen. Both are still undergoing testing and have shown variable results. </p><p><strong>"Brain fog" or cognitive dysfunction</strong> is one of the other key symptoms of the illness. Having problems with memory, finding words, and reasoning are just some of the neurological effects of the disease. The anticonvulsant, gabapentin (Neurontin) sometimes helps, although the exact way it works to help these symptoms is not fully understood. </p><p>Actual <strong>infections </strong>should be treated with the appropriate medications: antifungals for yeast infections, antibiotics for bacterial infections, antiviral medicines for viral infections such as Shingles, which is a reactivation of the chicken pox virus that shows up as painful blisters. </p><p>People with CFIDS often are unusually sensitive to medications so it's best to start with low doses and increase them gradually. </p><p><strong>Will you get it?</strong></p><p>You may. More than one million Americans have CFIDS (based on studies conducted by the Centers for Disease Control and Prevention and DePaul University) according to the CFIDS Association of America. Of these, as many as 90% of them are not even diagnosed and are therefore not getting treatment.</p><p>CFIDS can affect people of all age, racial, ethnic, and socioeconomic groups. It does seem to be more common in women, as research has shown it to be about four times as common in women (522/100,000) as men, similar to that of many autoimmune diseases, such as multiple sclerosis and lupus. Kids and teens can also get CFIDS.</p><p>For more information, be sure to check out these links, which is where a majority of this information came from. The CFIDS Association of America also has a lot of excellent links to scientific papers and other sources of information.</p><p><a href="http://www.cfids.org/default.asp">http://www.cfids.org/default.asp</a></p><p><a href="http://findarticles.com/p/articles/mi_m3225/is_n3_v45/ai_12026536">http://findarticles.com/p/articles/mi_m3225/is_n3_v45/ai_12026536</a></p><p><a href="http://www.cdc.gov/cfs/cfsdefinition.htm">http://www.cdc.gov/cfs/cfsdefinition.htm</a><br /></p><p></p>Mauigirlhttp://www.blogger.com/profile/15529827915262851910noreply@blogger.com2tag:blogger.com,1999:blog-726388883619960935.post-8106613148741949262007-06-14T09:07:00.001-07:002007-06-16T10:03:41.892-07:00Worry About the Right DiseasesCNN had a good article today about the odds of people getting some of the more obscure diseases such as Mad Cow Disease, compared to more common ones like heart disease and osteoporosis.<br /><br />Now, let's face it, as a hypochondriac, you probably spend a lot more time worrying about things like Mad Cow Disease than about osteoporosis. I admit it: I still worry about sausages I ate in Great Britain during the 1980's and wonder if eventually the Mad Cow prions are going to come home to roost! And I make a point of buying grass-fed beef at Whole Foods because I don't trust the USDA to inspect our meat properly.<br /><br />But, as an overweight middle-aged woman with high blood pressure, I am much more likely to suffer from heart disease and diabetes in the future rather than Mad Cow Disease. But do I exercise? No. Do I lose the 25 lbs. I should lose? No. The two most useful things I could do to protect my health, I don't do. But do I go to the doctor any time I get a weird symptom that I'm afraid is some much less likely disease? Absolutely. Do I order new dietetic supplements that purport to prevent various diseases that I probably won't get anyway? Of course. It's so easy to take a pill.<br /><br />The CNN article was a good wake-up call to remind us that we should focus on the proven things that we know can protect our health - exercising, achieving a healthy weight, and eating more fruits and vegetables - while of course still being vigilant about checking out new symptoms (did that mole really get bigger? Why am I so tired?) and getting our mammograms and colonoscopies regularly.<br /><br />The challenge is that exercising, losing weight, and eating more fruits and vegetables require planning and effort, and the benefits are not seen immediately. Preventing these diseases requires a long-term commitment and change in lifestyle. But if your goal in being a hypochondriac is to have a longer and healthier life, these are the things you should be doing to achieve the goal!<br /><br />Please see the link below for the full CNN article.<br /><a href="http://www.cnn.com/2007/HEALTH/06/14/healthmag.diseases/index.html">http://www.cnn.com/2007/HEALTH/06/14/healthmag.diseases/index.html</a>Mauigirlhttp://www.blogger.com/profile/15529827915262851910noreply@blogger.com5tag:blogger.com,1999:blog-726388883619960935.post-18862637615028120022007-05-28T09:01:00.000-07:002007-05-28T09:33:04.717-07:00Stroke is often undertreated<p>Hello friends,<br />I've been so busy recently that I haven't yet written my next major disease post, which will be on Chronic Fatigue Syndrome, or, as it is often known, Chronic Fatigue and Immune Dysfunction Syndrome (CFIDS). Stay tuned...<br /><br />In the meantime I was reading the New York Times today and there was a long article about strokes, and how so many patients are not treated with the drug, tPA, which could prevent much of the permanent damage that sadly often results from an ischemic (blockage type) stroke. First, strokes caused by bleeding must be ruled out before giving the drug, but many hospitals are not staffed or equipped to do this in a timely manner. Therefore the drug is often not given early enough or at all, to those who might have benefited from it. </p><p>Please see this link for the full article: <a href="http://www.nytimes.com/2007/05/28/health/28stroke.html?_r=1&hp&oref=slogin">http://www.nytimes.com/2007/05/28/health/28stroke.html?_r=1&hp&oref=slogin</a><br /><br />Signs of a stroke include:<br /><br />-Sudden numbness or weakness of the face, arm or leg, especially on one side of the body<br />-Sudden confusion, trouble speaking or understanding<br />-Sudden trouble seeing in one or both eyes<br />-Sudden trouble walking, dizziness, loss of balance or coordination<br />-Sudden, severe headache with no known cause body<br /><br />More information can be found here: <a href="http://www.americanheart.org/presenter.jhtml?identifier=4742">http://www.americanheart.org/presenter.jhtml?identifier=4742</a> </p><p>High blood pressure leads the list of risk factors for stroke. Other co-factors include a history of "transient ischemic attacks" (which cause temporary symptoms of stroke), high cholesterol, diabetes, cigarette smoking, artery disease (particularly the carotid artery, which is in the neck), heart disease or failure in general, atrial fibrillation (improper heart rhythm of the upper pumping chamber of the heart), sickle cell anemia, poor diet, obesity and inactivity. Alcohol and drug use are often associated with strokes as well. Most of these are under your control so you can take steps to prevent a stroke.</p><p>One of the points the article makes is to recognize the symptoms of a stroke and be sure to get treatment as quickly as possible. If there is a hospital that is accredited as a Primary Stroke Center, by all means try to go there, as they will have the equipment and expertise to treat you. </p><p>This handy website allows you to search within your area for the locations of Primary Stroke Centers. In addition, you can search for other specialties such as acute myocardial infarction (heart attack) and pneumonia, among others: <a href="http://www.jointcommission.org/certificationPrograms/disease-specificCare/DSCOrgs/">http://www.jointcommission.org/certificationPrograms/disease-specificCare/DSCOrgs/</a></p><p>I was interested to learn that the two hospitals that are considered Primary Stroke Centers in my region were both fairly close, and yet not the hospitals I might have initially tried to go to in the case of an emergency. This is good information to know for future reference!</p><p>One thing that struck me was that the woman profiled in the NY Times article, who did have a stroke, but luckily was treated properly for it, had blood pressure of 200 over 120 for five years and yet decided not to go on medication because she was "too young" (53) and figured she'd worry about it later. There are so many medications out there now that can treat high blood pressure, no one should delay in getting treatment for it. The earlier it is treated the less long-term damage it can do and the less the likelihood of it causing a stroke. Please see my previous post about high blood pressure for more information.</p>Mauigirlhttp://www.blogger.com/profile/15529827915262851910noreply@blogger.com0tag:blogger.com,1999:blog-726388883619960935.post-65751134756718605302007-05-19T11:31:00.001-07:002007-05-19T11:51:13.868-07:00Medical site for up-to-date medical articlesI just discovered <a href="http://www.mdlinx.com/InternalMDLinx/">MDLinx</a>, a website that provides scientific articles on many different diseases and conditions. <br /><br />If you are a serious hypochondriac, as I am, I'm sure you will have sufficient medical understanding to find this site very useful. You can search on various types of illness and read either the abstract of the study or the full report, depending on the level of your interest. Sometimes the full report will require a subscription to a medical journal, but even knowing a study exists may be of use, since you can refer your doctor to the study if you think it might help them with your condition.<br /><br />As a serious hypochondriac, I feel you, the patient, must be well-versed in your illness, or in the possible causes of your symptoms, before even going to the doctor. Doctors are so busy nowadays that many do not listen to their patients' symptoms carefully enough, and if you have one of those doctors, you want to be sure they test you for whatever you think you might have, because otherwise they might miss something! <br /><br />I am very fortunate in that I have found doctors who are willing to listen to me, and will actually address my concerns, by either explaining why something isn't necessary, or else agreeing that the concern is valid. But many people are not so lucky, and if you may be dealing with something serious or life-threatening, you don't want to take a chance with your health.<br /><br />Naturally there are some doctors that will not take kindly to your suggestions or questions. But I feel a good doctor would agree that "An educated consumer is their best customer" as the <a href="http://www.syms.com/">Syms</a> ad goes.Mauigirlhttp://www.blogger.com/profile/15529827915262851910noreply@blogger.com2tag:blogger.com,1999:blog-726388883619960935.post-21527864581999691422007-05-10T14:01:00.000-07:002007-05-10T14:04:19.774-07:00Another website for you to dwell onI came across this new website and had to share it with my fellow hypochondriacs and anyone who is interested in medical subjects and basic gossip. It is called <a href="http://whoissick.org/sickness/">"Who is sick?"</a><br /><br />The premise is that people can post their symptoms on this website, and they are then plotted on a map. So you can check out your own zip code area and find out whether there are a large number of people who are sick, and if so, what their symptoms are. So, if you see there are a huge number of people in your general area that are suffering from cough, fever and aches, you may think "Hmmm, lots of flu out there...maybe I should stay home!"<br /><br />I feel this could be a very useful tool. Enjoy!Mauigirlhttp://www.blogger.com/profile/15529827915262851910noreply@blogger.com0