Great Smokies Medical Center of Asheville

Archive for the ‘Miscellaneous Conditions and Treatments’ Category

Is it a Cold or the Flu?

Thursday, October 20th, 2005

While a rhinovirus (a cold) is a minor respiratory illness that usually just inconveniences us, true influenza (the flu) is a serious respiratory illness.
Flu symptoms start one to four days after the virus enters the body. In adults, the flu is contagious for one day before symptoms occur and for three to seven days (as many as ten days in children) after the first symptoms appear.
Unlike a common cold, influenza causes high fevers, and severe headaches and body aches. The cough of influenza is hacking and severe compared to the cough associated with colds. People with colds commonly experience sore throats, sneezing, and stuffy noses, while people with influenza usually experience fatigue, weakness and exhaustion.
Complications of common colds include sinus infections and earaches, while complications of influenza are bronchitis and life-threatening pneumonia.

Natural Prevention & Treatment of Colds & Flu

Thursday, October 20th, 2005

Implementing the basics of prevention and treatment of colds and flu is simple and inexpensive. While there is no cure for viral infections, preventive measures can be effective and viruses’ adverse effects can be minimized by treatment. Following some simple recommendations can help you stay healthy this cold and flu season.
First and foremost, to help prevent getting the flu, wash your hands as needed throughout the day with a mild soap that doesn’t irritate your skin. Keep your hands away from your face (hand-to-face contact can result in transmission of disease to mucus membranes of your eyes, nose, or mouth). Avoid putting objects such as pens and pencils in your mouth. Viral illnesses are spread more easily in confined indoor environments such as airplanes, buses, malls, and elevators.
Reduce your susceptibility to or hasten your recovery from the flu by doing the following: If you feel you are getting sick, change your plans and stay home and rest. Drink plenty of water, eat a light diet (to spare your energy for healing and to aid detoxification), eliminate sugar intake, and do light activity around the house as tolerated. Making a pot of organic chicken soup (by stewing whole chickens with bones) and freezing it for use during winter illnesses may be wise.
Have a plan should you or a loved one come down with a cold or flu this winter. Early intervention may help shorten the course of your illness and help prevent complications. Do not give aspirin to a child or teenager with the flu to avoid a known adverse effect, Reye’s syndrome. Seek medical attention (especially for children under 5 years of age, the elderly, and immune compromised individuals) if fever, sweats, or weakness persist.

The Lymphatic System

Thursday, October 20th, 2005

If there is such a thing as the "Rodney Dangerfield" of body systems, it has to be the lymphatic system. The role of the lymphatic system in health is glossed over in medical school curriculums, passing the lips of most practicing physicians only when discussing disease (lymphedema, lymphadenitis, lymphoma), rarely receiving mention for its vital, health-promoting functions.
The lymphatic system consists of lymph fluid, vessels, valves, more than 400 nodes, two tonsils, the thymus gland and the spleen. About 10 percent of the fluid that passes through the tiniest blood vessels called capillaries becomes trapped in our tissues. This daily accumulation of about one-and-a-half liters of trapped fluid would be our demise if the lymphatic system did not collect it and return it to the circulatory system through lymphatic vessels. Most lymph is clear, with the exception of that absorbed from the small intestinal area. It is called chyme and is milky in color because of the fat molecules it contains.
Unlike the circulatory system that has a pump (the heart), lymph flows as a result of filtration pressure, breathing, gentle movement, and pulsation of neighboring blood vessels. Once mobilized, lymphatic fluid reenters the circulatory system by eventually draining into major veins located in the upper chest region. The largest lymphatic vessel in the body is the thoracic duct. It is located in the left chest/abdominal area, and most of the body’s lymph is funneled into it. The spleen is the largest lymph node or gland.
The lymphatic system is where front line immune activity occurs. Its circulating cells, notably white blood cells or lymphocytes, gather and flow in the lymphatic vessels. It is here that surveillance and destruction of foreign invaders such as bacteria and viruses occurs through antibody production and activity. Toxins are also removed from the body through lymphatic fluid. Though there are some rare genetic diseases of the lymphatic system, most people become aware of this body system through the experience of having a superficial swollen lymph node in their neck, armpit, or groin that accompanies an infection. This swelling is called lymphadenitis, a medical term for inflammation of a lymph node, and is usually a sign that the immune system is doing its job of recognizing and combating infection. A swelling of a limb called lymphedema results when the flow of lymph is impeded either through a birth defect or more often as a side effect of surgery, radiation or trauma. As many as 30 percent of women having a mastectomy will, for example, have lymphedema of the affected arm. Restricted lymph flow and accumulation of toxins in the breast can result from bras that are too tight.
Lymphoma is a malignant overproduction of white blood cells that may become apparent by the appearance of swelling in superficial lymph nodes in the neck or groin or an enlarged spleen. Not all cancers in lymph nodes are lymphomas. Cancer cells can migrate through the lymphatic system, resulting in non-primary lymph node cancers such as breast or colon cancer spreading to local or regional lymph nodes.
Because immunity and surveillance of cancer cells have their origins in the lymphatic system, further research in understanding the lymphatic system’s important functions may hold clues to more effective treatment of all cancers, autoimmune diseases, and overall immune function.
Tactics to facilitate good lymphatic flow and function include deep breathing from the diaphragm, gentle bouncing on a rebounder (small trampoline), stretching, dry brushing of the skin with a soft brush (always brushing toward the heart), exercise, and avoiding obesity. Don’t wear restrictive undergarments, clothing, or belts. Certified lymphatic massage therapists can gently assist the flow of stagnant lymphatic fluid. Check with your medical healthcare provider before starting any new treatment.

Viruses R Us

Thursday, October 20th, 2005

What we thought were answers have turned into questions when it comes to the topic of viruses. Any perceived borders between human DNA and viral DNA have become blurred, making it unclear if we "have a virus" or if viruses actually "have" us.
More than 3,500 viruses have been classified. Viruses are so tiny (about a thousand times smaller than bacteria) that they can only be seen with a special electron microscope. They vary in form from spherical or rod-shaped to structures resembling lunar landing modules.
Viruses are responsible for relatively harmless ailments such as the common cold, warts, and chicken pox, as well as more serious illnesses such as mono, measles, gastroenteritis, herpes, shingles, viral hepatitis, influenza, polio, West Nile, Hantavirus, SARS, Ebola, and HIV/AIDS. Viruses cause 10 percent of all cancers. The health of our animal friends is affected by viruses that result in diseases including feline leukemia, Parvo, rabies, and bird flu. Use good hygiene and preventive practices to avoid contracting disease from insects or other animals.
Scientists debate amongst themselves whether viruses are living or not. Most scientists agree that viruses exist in a gray area between life and inanimate matter. To be considered as "living," the simplest functioning unit of an organism (a cell) needs the capability to reproduce, eat, and die. Bacteria, human and plant cells, for example, meet this criteria as they all contain a nucleus with DNA that enables them to reproduce, they eat, and they die. Not so with viruses. They are simply genetic material (DNA or RNA) wearing a protein coat and don’t even have a nucleus. They don’t eat and can lie dormant, hovering between life and death for long periods of time. Living organisms must come to the assistance of these cleverly dependent viruses.
Without so much as a "howdy," viruses enter living cells and hijack their host’s cellular activity by inserting their own DNA into the host cell’s DNA, for the purpose of using host cells as their own private virus nursery. The host cell may die during "viral childbirth" or it may live to slowly produce more viruses for years. Viruses can lie dormant in their host’s cells for decades, patiently waiting for some triggering event that instructs them to start reproducing viral genetic material. Using a kind of "primitive intelligence" to cleverly alter the host cell’s genetic code, viruses can avoid being detected by their host’s immune system.
Viruses are simple-minded: all they want to do is reproduce. To accomplish this, they can gain entry into the human body through vectors including birds, pets, mosquitoes, rodents, bats, ticks, and can even hitch a ride inside bacteria. They can also enter the body through mucus membranes or a break or cut in our first line of defense against infection (the skin), through contact with contaminated surfaces such as drinking glasses, doorknobs, or when we inhale viral matter that is shed from another person’s sneeze. Viruses can invade a variety of body tissues including respiratory cells (influenza), nerve tissue (shingles), or circulating immune cells (HIV/AIDS). Body fluids including saliva, blood, semen, nasal secretions, vaginal secretions, and sputum can shed viruses.
The encroachment of humans into all previously remote areas of our planet through international travel increases the risks of exposure to and transmission of viruses. Ecological imbalances from overpopulation and chemical poisoning of our global environment decrease our immunity and encourage viral mutations. Viruses are highly adaptable and are continually reinventing themselves, making it difficult for epidemiologists (scientists who study all matters of public health) to track them and to accurately predict their impact on public health.
Through sequencing of genetic code made it possible by the Genome Project, it is indisputable that viral DNA has been part and parcel of human DNA throughout the history of mankind. Genetically speaking, Viruses R Us.

Health Risks of Obesity

Monday, September 12th, 2005

If you need a dose of reality about the health risks associated with diabetes, check out this formidable list: Type 2 diabetes, gallbladder disease, high blood pressure, high cholesterol and lipids, sleep apnea, coronary artery disease, osteoarthritis of the knee, fatty liver disease, gastroesophageal reflux disease (GERD), gout, low back pain, impotence, and some cancers, notably breast, uterine, and colon. The risk for these health problems to occur with obesity are strongest before age 55, and after age 74, there is no longer an association between obesity and the aforementioned diseases.

Dying For a Good Night’s Sleep?

Monday, September 12th, 2005

Each night across America, an estimated 15 million people are, in effect, being asphyxiated in their own homes.
Obstructive sleep apnea (OSA) is a much more serious health problem than just the annoyance of snoring. When lying down to sleep at night, the airway can actually collapse or can become physically obstructed, resulting in a life and death struggle for oxygen. People afflicted with OSA may be unaware of their own apnea, but others in their households are not, as they may also become sleep deprived from long nights of their loved ones’ gasping respirations and physical restlessness.
Sleep apnea is defined as 10 or more episodes per hour of cessation of breathing in excess of four seconds. They must be accompanied by a four percent or greater decrease of oxygen levels in the blood and be followed by frequent awakenings in an attempt to breathe.
The body interprets the decreasing oxygen levels as an emergency and releases the stress hormone adrenalin to counter this perceived life-or-death situation. An excess of adrenalin contributes to high blood pressure, which is known to afflict about 50 percent of OSA sufferers. Failure of blood pressure to lower during sleep is a sign that high blood pressure may be caused by OSA.
Middle-aged men are more commonly afflicted than women of the same age, as are obese or overweight individuals. A neck circumference greater than 17 1/2 inches in men and 16 1/2 inches in women suggests risk for OSA.
Sleep apnea is associated with many health problems and can even be fatal, most likely from heart arrhythmias or motor vehicle accidents from driving while tired. Symptoms associated with sleep apnea include headaches on waking and dry mouth. The lack of deep, restorative sleep results in irritability, hallucinations, and inability to think clearly, which can lead to stressed relationships and poor job performance. Blood vessels in particular suffer under sub-optimal blood oxygen levels, contributing to angina, coronary artery disease, stroke and impotence. OSA can be aggravated by sleep deprivation, the use of alcohol, tobacco, and some drugs, and allergies that cause swelling of tissues in the nose and throat.
Sleep apnea is diagnosed by monitoring breathing cessation (apneic) events and lowered levels of blood oxygen (hypopneic) events in a sleep lab. For many, being wired, observed, and sleeping in an unfamiliar bed does not mimic a routine night of sleep. Years of research has revealed that the tone of small arteries (peripheral arterial tone) in the fingers directly correlates with apneic and hypopneic events. An FDA-approved computerized device is available at GSMC for at-home monitoring to diagnose OSA. Simply wearing a specialized glove that holds a tiny computer and two devices that are worn on the fingers allows monitoring of heart rate, respiration rate, and oxygen saturation.
Once diagnosed, sleep apnea is routinely treated by Continuous Positive Airway Pressure (CPAP), which delivers room air under pressure by a facial or nasal mask. CPAP can effectively address the lowered oxygen levels. However, more than 40 percent of people with OSA cannot tolerate CPAP and others will not use it due to the aggravation.
Since the symptoms of OSA are more severe when people sleep on their backs, simply strapping a tennis ball to the back can inexpensively and effectively train people to sleep on their sides, resulting in great improvement of milder cases of OSA. Other treatments for OSA include weight reduction, desensitization to allergies, and specialized mouth splints that open the airway by pulling the lower jaw forward. In severe cases that do not respond to medical intervention, surgery may be necessary to reduce the volume of tissue in the throat.

The Secret Life of Fat

Monday, September 12th, 2005

Who would have imagined that a seemingly passive slab of belly fat could turn on its accommodating host by deploying sophisticated biochemical weapons that undermine health?
Though this "Attack of the Killer Fat" sounds like the title of a low budget movie, understanding the concept may go a long way toward removing the stigma of a presumed deficit in motivation or character so often directed at obese individuals by leaner, although under-informed, people.
The vital role of fat in assuring survival of the species results in the body’s no-holds-barred tactics that are a formidable opponent for any strategy (e.g., a very low calorie diet) which opposes it, resulting in the body’s survival switch, in effect, becoming stuck in the "on" position, perpetuating a vicious cycle designed to maintain fat stores at all costs.
Researchers have found that adipocytes (fat cells) are part of a living, sophisticated organ (fat) that secretes powerful hormone-like chemicals which determine how we feel and function. Fat has important work to do . . . and it never sleeps.
Chemical signals are broadcast from their fatty bunker and enter the general circulation where they influence immune function, mood, energy production, appetite, reproduction and, in particular, inflammatory responses that can result in pain and chronic illness.
These chemical signals are emitted by fat cells and macrophages. Macrophages are specialized white blood cells that reside in tissues where they perform their job of walling off and cleaning up debris from infection, injury, and toxicity. They surround and "eat" the offending threat, secrete potent chemicals to destroy it, and promote healing. In addition to these life-sustaining, beneficial tasks, macrophages are also involved in harmful inflammatory processes when their response to injury or infection becomes out of proportion to the threat.
Macrophages are probably most notorious for their presence in plaque, that ticking time bomb in the walls of arteries. When the thin cap over plaque ruptures and the plaque spills into a coronary artery, macrophages in the plaque spew their inflammatory brew of chemicals into the blood stream causing a clot to form, resulting in a heart attack. (Heart disease is more accurately depicted by a model of inflammation than by the simplistic model of sludge accumulating in a pipe.—Ed.)
Inflammatory chemicals secreted by macrophages in fat may explain the well-known association of obesity with many diseases—hardening of the arteries, Type II diabetes, arthritis, high blood pressure, and most cancers.
Among the many chemicals secreted by fat cells and macrophages is the beneficial adiponectin, which enhances metabolism and burns fat. Adiponectin levels fall as obesity increases. Cytokines are another example of chemicals released by fat that increase the likelihood of clot formation, heart disease, insulin resistance, cancer, and other inflammatory states. Cytokine levels rise as obesity increases.
The study of obese mice by researchers at Columbia University determined that the fat of leaner mice contains only a few macrophages, while the fat of extremely obese mice is composed of a remarkable 40 to 50 percent macrophages. Researchers theorize that as obesity increases, overstuffed fat cells can burst, requiring even more macrophages to clean up the debris.
Pharmaceutical companies will likely be tripping over themselves to develop the first miracle drug on the block that targets and stops the inflammatory consequences associated with obesity.
But, don’t rush to be first in line at the pharmacy counter for these new drugs.
Because inflammation is essential to a healthy immune response, any drug that interferes with it will most certainly have undesirable side effects. Vioxx, the anti-inflammatory drug recently pulled off the market because of the increase of heart attacks and strokes in its users, not only intervened with the adverse effects of inflammation (resulting in pain relief), but also interfered with the critical immune-protective functions of macrophages (resulting in side effects).
The spare tire that hangs over the belts of 15 million obese Americans is a particularly obvious sign that predicts increased risk for inflammatory illnesses. However, even lean people can have visceral fat, the dangerous fat hidden in and around the abdominal organs that is associated with risk of heart disease and other inflammatory diseases.
What is the relevance of all this in the life of an obese person?
While some obese people have no obvious health problems, many others have a variety of inflammatory disorders that occur as a direct result of being fat, leaving them stuck in a vicious cycle of obesity, poor health, and a quality of life that defies the expression "fat and happy."
Can obese people with inflammatory disease regain their health? Since being fat results in inflammation, it is only fair that losing that same fat results in reduced inflammation.
However, it is no longer considered adequate to treat obesity with a simplistic "calories in, calories out" approach. Because we are each biochemically unique, no one diet will fit all. A focus including nutrient-dense foods (such as fish and colored vegetables) and excluding nutrient-deficient foods (such as sodas, processed foods, and sugar) forms the foundation of various successful diets.
Two simple blood tests that measure inflammation (hsCRP and fibrinogen) can help identify and monitor those at risk from obesity-driven inflammation. Researchers have found that these inflammatory markers decrease with reduction of body weight and waist girth attained by exercise and dietary changes.

Prevention Strategies in Mainstream and Alternative Medicine

Monday, September 12th, 2005

Is the time-tested adage "An ounce of prevention is worth a pound of cure" relevant in the discussion of disease prevention? The answer is a loud and clear "Yes!"
Prevention in a mainstream medicine model includes accident prevention (e. g. wearing seat belts, preventing falls), screening elevated blood pressure and blood sugar, weight normalization, smoking cessation, regular exercise, vaccinations, avoiding excess alcohol, cancer screening (breast exams, mammograms, PAP smears, prostate exams, PSA tests, colonoscopies, skin checks), diabetes screening, avoiding excessive sun exposure and using sunscreens.
The word prevention is often used in the mainstream medical model when the term early intervention would be more accurate. For instance, mammograms do not prevent breast cancer and PSA tests do not prevent prostate cancer. Regardless, early diagnosis and intervention are critical to tip the odds toward successful treatment outcomes.
The discriminating consumer of healthcare is advised to keep an eye to the horizon for changes in these recommendations that may accomplish even earlier identification of disease more effectively and with less risk. For example, radiation exposure to the breast from annual mammograms can be greatly reduced by utilizing thermograms for breast cancer screening with occasional mammograms when indicated.
In contrast to the mainstream medical approach that uses knowledge of disease, holistically-oriented physicians use their knowledge of how the body naturally attains and maintains health (homeostasis) to develop health maintenance strategies that help promote the body’s optimal function as a means to prevent or delay the onset of disease.
What are the causes of disease from a natural, holistic viewpoint?
Any situation that results in abnormal function of the body’s cells has the potential, over time, to result in organic disease. Some of these causes cannot be modified, including certain genetic diseases such as Huntington’s Disease, Achondroplasia (dwarfism), Sickle Cell Anemia, etc. However, most genetic contributors to disease, though less well-known than these dramatic conditions, are genetic glitches that require environmental triggers to manifest health problems including heart disease, osteoporosis, and immune system-related problems. The risk from these glitches can be modified by targeted nutrient therapies.
Environmental, biological and metabolic triggers of disease include infections, infestations, malnutrition, toxins, emotional shock, injury, and stress.
In addition to using the mainstream medical model, prevention in a holistic medical model also includes assessment of: digestion (Are hydrochloric acid, digestive enzymes, and friendly gut bacteria deficient?), nutrient adequacy (Are nutrient deficiencies perpetuating symptoms?), toxic influences on health (Are chemicals and heavy metals interfering with optimal functioning?), detoxification capacity (Are environmental toxins interfering with normal function?), diet (Is the diet nutrient-dense or nutrient-sparse?), effects of chronic low-grade infections and infestations on immune health, hormonal deficiencies and imbalances, dental interferences to general health (Are dental material incompatibilities, cavitations or mercury amalgams obstructing health?), and the health consequences of trauma, emotions, and stress (Is your autonomic nervous system functioning on tilt?).
Disease prevention is best accomplished by defining and addressing contributors to disease, often accomplished through common-sense lifestyle and diet changes.

Test Your Knowledge of Nutritional and Herbal Medicine

Monday, September 12th, 2005

Have some fun while you learn about the power of natural therapies. Give yourself one point for each correctly answered question. Answers follow the questions.

1. Name two trace minerals important in forming healthy bones.
2. What mineral is approved for emergency intravenous use in treating a heart attack in progress?
3. What mineral has been shown to shorten the duration of a cold?
4. Which B vitamin causes the urine to become bright yellow in color?
5. Name the vitamin whose deficiency is associated with blindness.
6. What vitamin important for clot formation and bone formation is synthesized in the skin from sun exposure?
7. What nutrient has the greatest impact in treating periodontal disease?
8. What common essential mineral carries oxygen and can be elevated to toxic levels, particularly in men?
9. What B vitamin causes "flushing" and lowers cholesterol levels?
10. Which fat soluble vitamin plays an important role in heart health?
11. Name the amino acid that is a nutritional counterpart for Prozac and other SSRI drugs.
12.. What herb has been shown to improve both cognitive brain function and leg circulation?
13. What herb is routinely used to improve the symptoms of an enlarged prostate?
14. The deficiency of which vitamin can result in poor ability to remember dreams?
15. What nutritional oil is routinely used in the treatment of PMS?
16. Which vitamin is made by the liver of all mammals except fruit bats, guinea pigs and primates (including humans)?
17. What nutrient is depleted by use of cholesterol lowering (statin) drugs?
18. What common cooking herb is used to prevent clot formation and slow yeast growth?
19.What trace mineral is used to treat manic depressive (bipolar) disorder?
20. Name two herbs commonly used to boost immune function to help fight infections.
21. What phytonutrient in tomatoes is linked to prostate health?
22. The deficiency of what trace mineral affects thyroid function and contributes to prostate and breast cancer?
23. Name three primary anti-oxidant vitamins.
24. What B vitamin is most depleted in chronic alcoholism?
25. What vitamins are depleted by a diet high in sugar?
26. The deficiency of this nutrient during the first trimester of pregnancy is associated with neural tube defects such as spinal bifida in the fetus.
27. Name two nutrients used to address an abnormal Pap smear.
28. Name three minerals used to treat leg cramps.
29. Name an herb used to treat indigestion and to boost adrenal function?
30. What two trace minerals are most often supplemented to help regulate blood sugar levels?

ANSWERS:
1. Strontium, boron, silicon, chromium, manganese, or selenium
2. Magnesium
3. Zinc
4. Riboflavin (B2)
5. Vitamin A
6. Vitamin D
7. Coenzyme Q10
8. Iron
9. Niacin (B3)
10. Vitamin E
11. L-tryptophan
12. Gingko biloba
13. Saw Palmetto Berry
14. Pyridoxine (B6)
15. Evening Primrose Oil
16. Vitamin C
17. Coenzyme Q10
18. Garlic
19. Lithium
20. Astragalus and Echinacea
21. Lycopene
22. Iodine (or less so, selenium)
23. A, C, and E
24. Thiamine (B1)
25. All the B vitamins
26. Folic Acid
27. Folic Acid and Vitamin A
28. Calcium, magnesium, & potassium
29. Licorice or ginger
30. Vanadium and chromium

Scoring:
26-30 points: Go to the head of the class!
21-25 points: Very well informed!
15-20 points: You’re paying attention!
8-14 points: Good and keep on learning!
0- 7 points: Don’t quit your day job!

Prehypertension?

Monday, September 12th, 2005

In May 2003, the Journal of the American Medical Association (JAMA) reported new guidelines issued by the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC) to further decrease cardiovascular complications. A new category, prehypertension, is now defined as a BP of 120/80 to 139/89. Hypertension is defined as 140/90 or greater. The effect of doctors and patients acting on this narrowly defined category of prehypertension would likely be millions more prescriptions for drugs being written. The side effects of these drugs are much more likely to adversely affect health than a BP of 120/80. GSMC doctors think this new definition is enough to, well, give anyone high blood pressure. Get regular BP checks and get your healthcare from a physician who treats people and not numbers.

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