Great Smokies Medical Center of Asheville

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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.

A Time-Honored Tradition in Treating Hypothyroidism by Dr. Wilson

Monday, September 12th, 2005

The road one travels while treating hypothyroidism based on laboratory tests is strewn with potholes. Every doctor who treats hypothyroidism sees discrepancy when comparing blood test results with how the patient reports feeling. This failure to find an explanation for a patient’s symptoms may result in the physician determining that the patient has a psychosomatic illness.
Years ago, before blood tests and synthetic drugs were available, doctors relied on patients’ histories and physical exams to diagnose and treat them. If patients presented with symptoms and physical findings that fit the clinical picture of hypothyroidism, they would then be prescribed the only agent available at that time, whole glandular thyroid from pig (porcine) thyroid. This preparation, known as U. S. Armour Thyroid, contains mostly T4 as well as some T3.
A small but growing group of doctors have continued this tradition of listening to patients’ symptoms while carefully taking their history and performing a physical examination in addition to using blood tests. They have continued to treat hypothyroidism with natural, whole, desiccated glandular thyroid.
This natural time-tested approach more often results in improvement in mood and mental functioning–symptoms often not improved by the more commonly used prescription drugs.
An article in the New England Journal of Medicine reported research suggesting Synthroid use resulted in no improvement in 17 parameters measuring memory, mood, language, and learning. The use of Armour thyroid however, resulted in improvement in 6 of the 17 parameters. (NEJM 1999;340:424-429, 469-470.)

Laboratory Testing of Hypothyroidism

Monday, September 12th, 2005

Doctors have traditionally measured blood levels of thyroid stimulating hormone (TSH), T3 Uptake, Total T4 and Total T7 to both diagnose thyroid imbalances and monitor the effectiveness of thyroid hormone therapy regimens. The problem with this laboratory assessment is that most of the total T3 and T4 are bound to proteins that render them unavailable for use by the body.
Alternatively, doctors can measure Free T3 and Free T4 that reveal the parts of Total T3 and Total T4 that are not bound to proteins and are thus biologically active. These more sensitive tests enable a doctor to more accurately and safely customize dosing of T3 and T4 to optimize functioning of the patient.
We recommend having a TSH, Free T3, Free T4, and thyroid antibodies drawn as baseline to test for hypothyroidism. To monitor thyroid replacement therapy in a person taking thyroid hormone, the doctor can usually monitor with a simple free T3 or T4. The time of day that blood specimens are drawn is important. Have your thyroid blood level tests drawn about eight hours after taking your morning dose of thyroid, about 3:00 p.m. to 4:00 p.m. for most people. Thyroid medication should be taken upon waking and when fasting.

The Medical Treatment of Hypothyroidism by Dr. Wright

Monday, September 12th, 2005

Hypothyroidism is treated by replacing thyroid hormone in pill form. Most physicians use synthetic, bio-identical T4 (Synthroid, Levoxyl, or Unithroid). T4, so named because each molecule contains four molecules of iodine, is a mostly inactive precursor hormone that is made in the thyroid gland. Before it can be useful in the body, T4 has to be converted into triiodothyronine (T3), the biologically active form of the hormone that contains three iodine molecules. The conversion of T4 to T3 occurs outside of the thyroid gland in the body’s cells. For several reasons, including deficiency of zinc, copper, selenium, or iron, and excess cortisol (the adrenal stress hormone), many people can’t efficiently convert T4 to T3. For such a person, taking Synthroid, Levoxyl, or Unithroid will not likely result in improvement, as the body cannot convert synthetic T4 to T3 any better than it can convert its own natural T4 to T3. Unfortunately, in this situation, the blood tests that doctors routinely use to check thyroid status may be normal, which could cause a physician to miss the diagnosis. The patient all too often ends up with the symptoms of hypothyroidism and the doctor’s bill.
Cytomel is a synthetic prescription form of T3, while Thyrolar contains both synthetic T4 and T3.
Because deficient cortisol results in a speeding up of the conversion of the inactive T4 thyroid hormone to the active T3 form, failing to treat adrenal fatigue either before or at the same time hypothyroidism is being treated can result in the patient feeling jittery or anxious, and then wrongly thinking thyroid is bad for them. What may really need addressing is the cortisol deficiency.
Because symptoms of hypothyroidism are also symptoms of other general syndromes and specific diseases and doses required to treat an individual can change from time to time, I recommend regular ongoing monitoring of thyroid blood levels.

Signs and Symptoms of Hypothyroidism

Monday, September 12th, 2005

The following symptoms are associated with hypothyroidism:

Low body temperature
Slow to waken in the morning
Weight gain and difficulty losing weight
Depressed mood
Poor mental function
Constipation
Difficulty feeling warm, especially hands and feet
Dry skin
Orange discoloration of palms and soles
Goiter
Menstrual cycles irregularities

Thinning or disappearance of outer third of eyebrows
Edema (swelling) of face, tongue, ankles, and fingers
Dry, lusterless, coarse, brittle hair
Dry, brittle nails
Migraines
Hair loss
Slow or absent reflexes on physical exam
Personal history of high birth weight or family history of tuberculosis
Hoarseness
New onset of snoring
Increased cholesterol levels

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.

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