Health Meditations

November: National Alzheimer's Disease Awareness Month

Alzheimer's disease develops slowly and causes changes in the brain long before there are obvious changes in a person's memory, thinking, use of words or behavior. The deterioration of the brain eventually affects the entire body.  Stages and changes the person will go through are outlined below.

Common Changes in Mild AD

• Loses spark or zest for life - does not start anything.
• Loses recent memory without a change in appearance or casual conversation.
• Loses judgment about money.
• Has difficulty with new learning and making new memories.
• Has trouble finding words - may substitute or make up words that sound like or mean something like the forgotten word.
• May stop talking to avoid making mistakes.
• Has shorter attention span and less motivation to stay with an activity.
• Easily loses way going to familiar places.
• Resists change or new things.
• Has trouble organizing and thinking logically.
• Asks repetitive questions.
• Withdraws, loses interest, is irritable, not as sensitive to others' feelings, uncharacteristically angry when frustrated or tired.
• Won't make decisions. For example, when asked what she wants to eat, says "I'll have what she is having."
• Takes longer to do routine chores and becomes upset if rushed or if something unexpected happens.
• Forgets to pay, pays too much, or forgets how to pay - may hand the checkout person a wallet instead of the correct amount of money.
• Forgets to eat, eats only one kind of food, or eats constantly.
• Loses or misplaces things by hiding them in odd places or forgets where things go, such as putting clothes in the dishwasher.
• Constantly checks, searches or hoards things of no value.

Common Changes in Moderate AD

• Changes in behavior, concern for appearance, hygiene, and sleep become more noticeable.
• Mixes up identity of people, such as thinking a son is a brother or that a wife is a stranger.
• Poor judgment creates safety issues when left alone - may wander and risk exposure, poisoning, falls, self-neglect or exploitation.
• Has trouble recognizing familiar people and own objects; may take things that belong to others.
• Continuously repeats stories, favorite words, statements, or motions like tearing tissues.
• Has restless, repetitive movements in late afternoon or evening, such as pacing, trying doorknobs, fingering draperies.
• Cannot organize thoughts or follow logical explanations.
• Has trouble following written notes or completing tasks.
• Makes up stories to fill in gaps in memory. For example might say, "Mama will come for me when she gets off work."
• May be able to read but cannot formulate the correct response to a written request.
• May accuse, threaten, curse, fidget or behave inappropriately, such as kicking, hitting, biting, screaming or grabbing.
• May become sloppy or forget manners.
• May see, hear, smell, or taste things that are not there.
• May accuse spouse of an affair or family members of stealing.
• Naps frequently or awakens at night believing it is time to go to work.
• Has more difficulty positioning the body to use the toilet or sit in a chair.
• May think mirror image is following him or television story is happening to her.
• Needs help finding the toilet, using the shower, remembering to drink, and dressing for the weather or occasion.
• Exhibits inappropriate sexual behavior, such as mistaking another individual for a spouse. Forgets what is private behavior, and may disrobe or masturbate in public.

Common Changes in Severe AD

• Doesn't recognize self or close family.
• Speaks in gibberish, is mute, or is difficult to understand.
• May refuse to eat, chokes, or forgets to swallow.
• May repetitively cry out, pat or touch everything.
• Loses control of bowel and bladder.
• Loses weight and skin becomes thin and tears easily.
• May look uncomfortable or cry out when transferred or touched.
• Forgets how to walk or is too unsteady or weak to stand alone.
• May have seizures, frequent infections, falls.
• May groan, scream or mumble loudly.
• Sleeps more.
• Needs total assistance for all activities of daily living.

If someone you love is showing signs of Alzheimer's disease, get help ASAP. 

The content of this posting is based on information from the National Institute on Aging of the National Institutes of Health.

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Deborah White, MD, MBA

November: Pancreatic Cancer Awareness Month

Your pancreas is a gland located deep in your abdomen behind your stomach and in front of your spine. Your liver, intestine, and other organs surround your pancreas.  Your pancreas is about six inches long and is shaped like a flat pear. The widest part of your pancreas is the head, the middle section is the body, and the thinnest part is the tail.

Your pancreas makes insulin and other hormones. These hormones enter your bloodstream and travel throughout your body to regulate the use or storage of the energy that comes from food. For example, insulin helps control the amount of glucose your cells absorb from your blood stream.

Your pancreas also makes pancreatic juices containing enzymes that help digest food. Your pancreas releases these juices into a system of ducts leading to your common bile duct. The common bile duct empties into the duodenum, the first section of your small intestine.

Pancreatic Cancer Risk Factors

No one knows the exact causes of pancreatic cancer. However, people with certain risk factors are more likely than others to develop pancreatic cancer. A risk factor is anything that increases a person's chance of developing a disease.

Pancreatic cancer risk factors include:

Age -- The likelihood of developing pancreatic cancer increases with age. Most pancreatic cancers occur in people over the age of 60.

Smoking -- Cigarette smokers are two or three times more likely than non-smokers to develop pancreatic cancer.

Diabetes -- Pancreatic cancer occurs more often in people who have diabetes than in people who do not.

Being male -- More men than women are diagnosed with pancreatic cancer.

Being African American -- African Americans are more likely than Asians, Latinos, or Caucasians to get pancreatic cancer.

Family history -- The risk for developing pancreatic cancer triples if a person's mother, father, sister, or brother had the disease. Also, a family history of colon or ovarian cancer increases the risk of pancreatic cancer.

Chronic pancreatitis -- Chronic pancreatitis is a painful prolonged inflammation of the pancreas. Some evidence suggests that chronic pancreatitis may increase the risk of pancreatic cancer.

Chemical exposure and lifestyle -- Other studies suggest that exposure to certain chemicals in the workplace or eating foods high in fat may increase the chance of getting pancreatic cancer.

Most people with known risk factors do not get pancreatic cancer. On the other hand, many who do get the disease have none of these factors. If you think you may be at risk for pancreatic cancer should, speak with your doctor.

Symptoms

Pancreatic cancer is sometimes called a "silent disease" because early pancreatic cancer often does not cause symptoms. But, as the cancer grows, symptoms may include:

• Pain in the upper abdomen or upper back
• Yellow skin and eyes, and dark urine from jaundice
• Weakness
• Loss of appetite
• Nausea and vomiting
• Weight loss

These symptoms are not sure signs of pancreatic cancer. Other problems could also cause these symptoms. Only a doctor can diagnose the cause of a person's symptoms. If you have these symptoms, see your doctor so that your doctor can identify and treat any problem as early as possible.

The content of this posting is based on information from the National Cancer Institute of the National Institutes of Health.

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Deborah White, MD, MBA

November: Lung Cancer Awareness Month

November is Lung Cancer Awareness Month.  Smoking causes lung cancer.  Lung cancer is the most common cause of cancer death among women in the United States.  Breast cancer is more common, but most of the time women survive breast cancer.  Victims of lung cancer die most of the time.  If you smoke, you literally set fire to hundreds if not thousands of dollars each year as you slowly poison yourself.  If you smoke around other people, you are poisoning them too.  If you smoke, the odds are stacked against you.  If you smoke, Quit!

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Deborah White, MD, MBA

November: Diabetes Month

November is:

• American Diabetes Month
• Diabetic Eye Disease Month
• Foot Health Issues Related to Diabetes Awareness Month

Diabetes deserves all this attention because diabetes is a total body insult.  Diabetes damages the nerves and blood vessels throughout your body.  So it puts every part of you at risk, including your brain, your heart, your kidneys, your eyes and your feet.

Protecting your body from the ravages of diabetes is as simple as ABC:

A for the A1C test.
The A1C Test shows you what your blood glucose has been over the last three months.  The A1C goal for most people is below 7.  High blood glucose levels can damage your heart, kidneys, feet, and eyes.

B for Blood pressure.
The goal for most people is 130/80 or less.
If you blood pressure is too high, it increases your risk of heart attack, stroke, and kidney disease.

C for Cholesterol.
The LDL (bad cholesterol) goal for most people is less than 100.
The HDL (good cholesterol) goal for most people is above 40.

LDL or "bad" cholesterol can build up and clog your blood vessels. It can cause a heart attack or a stroke. HDL or "good" cholesterol helps unclog your blood vessels.

To control your ABCs, you must know your numbers.

• Ask your doctor what your A1C is.
• Ask your doctor what your blood pressure is.
• Ask your doctor what your cholesterol numbers are.
• Ask your doctor what your ABC numbers should be.

To control your ABCs, you must take action.

• Write down all your ABC numbers.
• Ask what you can do to reach your ABC goals.
• Take your medication as directed.
• Make the right lifestyle choices to achieve your ABC goals.

The content of this posting is based on information from the National Institutes of Health.

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Deborah White, MD, MBA

October: "Talk About Prescriptions" Month

It's important for you to take prescription medication as your doctor has prescribed it.  It's equally important for you to understand why you are taking medication and what medication you are taking.  So talk to your doctor about your prescriptions.  If you have prescription medication from more than one physician, it's important for all of your doctors to know about all of your medications.

October is Talk About Prescriptions Month.  It's a good time to:

Take full responsibility for being fully informed about the medications you take.  Know the purpose, the risks and the benefits of all the remedies you use, whether prescription or over-the-counter.  The benefits should always outweigh the risks.  If they don’t, speak with your physician about other options.

Take full responsibility for fully informing all of your doctors about all of the prescription and over-the-counter medications you take.  This includes any potions, lotions or concoctions you purchase at the health food store.  (Just because something is labeled "all natural" doesn't mean it's harmless.)

Take full responsibility for following your doctor's instructions.  When used properly, medication has the power to help you.  If misused, it has the power to harm you. 

If you receive a new prescription, before you fill it, ask questions!  If you don't know what to ask, here are some suggestions:

• Why do I need this medication?
• What are the benefits of taking this medication?
• What are the risks of taking this medication?
• What are the risks of not taking this medication?
• What is the medication called?  Is it generic or brand name?
• If there is a generic version, will the generic version be as effective as the brand name?
• How will this medication affect my medical condition?
• How long will it take for me to experience a change in my condition?
• What side effects does this medication have and how long will they take to occur?
• Will the side effects last the entire time that I take this medication?
• What should I do if I experience side effects?
• How much medication will I need to take and how often?
• What should I do if I miss a dose?
• How long will I have to take this medication?
• Should I take this medication before or after meals?
• If I must take this medication on an empty stomach, how long should I wait before I eat?
• Are there any prescription or over-the-counter medications I should avoid while taking this medication?
• How will this medication interact with medications or "natural" remedies I already use?
• Are there any foods or beverages I should avoid while taking this medication?
• Should I store this medication at room temperature or in the refrigerator?
• What lifestyle changes can I make to reduce or eliminate the need to take this medication?
• Will my insurance company pay for this medication?
• If I have to pay out of pocket, how much will this medication cost? 
• When will I see you again to see if this medication is working?

Talk to your doctor!  Talk to your pharmacist!  Talk about your prescriptions!

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Deborah White, MD, MBA

October: National Physical Therapy Month

Physical therapy is a discipline that involves evaluating, diagnosing, and treating musculoskeletal problems with the ultimate goal of restoring maximal functional independence.  Physical therapists seek to relieve pain, improve the body's movement and function, maintain cardiopulmonary function, restore, maintain and promote optimal physical function, and limit disabilities resulting from injury or disease.  If you have suffered a debilitating injury or illness, your treatment regimen may have included physical therapy.  October is National Physical Therapy Month.  If you know a physical therapist, thank them for the contribution they make to restoring and maintaining good health.

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Deborah White, MD, MBA

October: Sudden Infant Death Syndrome Awareness Month

Sudden Infant Death Syndrome (SIDS), also called Crib Death, is the sudden, unexplained death of an infant younger than one year old. Some people call SIDS "crib death" because many babies who die of SIDS are found in their cribs.

SIDS is the leading cause of death in children between one month and one year old. Most SIDS deaths occur when babies are between two months and four months old. Although health care professionals don't know what causes SIDS, they do know ways to reduce the risk. Here are ten tips for creating a safe sleep environment for your baby:

1. Always place your baby on his or her back to sleep, for naps and at night. The back sleep position is the safest, and every sleep time counts.

2. Place your baby on a firm sleep surface, such as on a safety-approved crib mattress, covered by a fitted sheet. Never place your baby to sleep on pillows, quilts, sheepskins, or other soft surfaces.
3. Keep soft objects, toys, and loose bedding out of your baby’s sleep area. Don’t use pillows, blankets, quilts, sheepskins, or pillow-like crib bumpers in your baby’s sleep area, and keep all objects away from your baby’s face.
4. Do not allow smoking around your baby. Don’t smoke before or after the birth of your baby, and don’t let others smoke around your baby.
5. Keep your baby’s sleep area close to, but separate from, where you and others sleep. Your baby should not sleep in a bed or on a couch or armchair with adults or other children, but he or she can sleep in the same room as you. If you bring your baby into bed with you to breastfeed, put him or her back in a separate sleep area, such as a bassinet, crib, cradle, or a bedside co-sleeper (infant bed that attaches to an adult bed) when finished.
6. Think about using a clean, dry pacifier when placing the infant down to sleep, but don’t force the baby to take it. (If you are breastfeeding your baby, wait until your child is one month old or is used to breastfeeding before using a pacifier.)
7. Do not let your baby overheat during sleep. Dress your baby in light sleep clothing, and keep the room at a temperature that is comfortable for an adult.
8. Avoid products that claim to reduce the risk of SIDS because most have not been tested for effectiveness or safety.
9. Do not use home monitors to reduce the risk of SIDS. If you have questions about using monitors for other conditions talk to your pediatrician.
10. Reduce the chance that flat spots will develop on your baby’s head: provide “Tummy Time” when your baby is awake and someone is watching; change the direction that your baby lies in the crib from one week to the next; and avoid too much time in car seats, carriers, and bouncers.

The content of this posting is based on information from the National Institute of Child Health and Human Development of the National Institutes of Health.

If you have questions or concerns about SIDS, speak with your pediatrician.

Share the health.

Deborah White, MD, MBA

October: National Down Syndrome Awareness Month and National Spina Bifida Awareness Month

October is National Down Syndrome Awareness month.  It is also National Spina Bifida Awareness month.  Each of these conditions is a reminder of the importance of preconception care and early prenatal care.  If you are planning to conceive, see your doctor.  Learn about your risk factors based on your age, medical conditions and lifestyle habits.  Be as healthy as possible before you get pregnant.  Once you get pregnant, get into prenatal care ASAP.

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Deborah White, MD, MBA

October: National Domestic Violence Awareness Month

Domestic violence devastates the lives of women, men and children of every background and circumstance.  It turns a home from a safe haven into a hostile, hopelessness, and hateful environment.  If you are a victim of domestic violence, don't suffer in silence.  During Domestic Violence Awareness Month, commit to ending the violence in your home.  Call the National Domestic Violence Hotline: 1-800-799-SAFE.  If you know a victim of domestic violence, commit to ending the violence in your community.  Tell that victim about the National Domestic Violence Hotline: 1-800-799-SAFE.

Don't hide domestic violence and don't ignore it!

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Deborah White, MD, MBA

October: National Dental Hygiene Month

 October is National Dental Hygiene month.  But you should be aware of your oral hygiene every day, all year round.  Not just because you want to avoid having bad breath.  Avoiding bad breath is a benefit of good oral hygiene, but it's not the most important aspect.  Your oral health and your total health are connected. 

The condition of your body can be reflected in the condition of your mouth.  And the condition of your mouth can impact your total health.  Here are a few important connections between oral health and total health:

Oral Cancer.  Each year, nearly 30,000 new cases of oral cancer are diagnosed and almost 9,000 people die from the disease.  Oral cancer is more common than leukemia, skin melanoma, Hodgkin’s disease and cancers of the brain, liver, thyroid gland, stomach, ovaries and cervix. Curable in its early stages, it can be treated successfully in more than 90 percent of cases. However, if not detected early enough, it can spread to other parts of the body and become nearly impossible to treat.

Heart Disease. Numerous research studies have shown a link between heart disease and key bacteria in periodontal disease (gum disease). While research continues to explore the link, it is important to treat periodontal disease aggressively so its impact on heart disease can be reduced or eliminated.  Heart Disease is the number one killer among men and women.  It claims more victims than all forms of cancer and AIDS combined, the disease affects more than 58 million Americans each year, killing almost a million.

Diabetes. Approximately, 95 percent of Americans with diabetes also have periodontal disease (gum disease), due in part to an increased susceptibility to infections. Research has shown that people with periodontal disease have more difficulty controlling their blood sugar levels and periodontal disease can increase the risk of developing diabetes.  Diabetes the fourth leading cause of death among Americans and will result in
more than 169,000 deaths this year alone.

Lung Health. Respiratory conditions can be aggravated when bacteria from periodontal disease travel from the mouth to the lungs and lower respiratory system.

Babies. Studies have shown that mothers with periodontal disease are up to seven times more likely to deliver premature, low birth-weight babies.  Researchers believe that since periodontal disease is a bacterial infection, it may trigger an increase in labor-inducing body fluids, leading to premature delivery.

Other Connections. Signs and symptoms of osteoporosis, eating disorders, such as anorexia nervosa and bulimia, and HIV often appears in the mouth first and can be detected during a routine oral health exam.

Early detection by a dental hygienist can lead to aggressive treatment and the control of periodontal disease and prevention of many of its consequences.

Signs and symptoms of periodontal disease may include:

• Red, swollen, or tender gums
• Bleeding gums while brushing or flossing
• Loose or separating teeth
• Tooth loss
• Pus around the teeth and gums
• Pain when chewing
• A change in the way your teeth fit together when you bite
• A change in the fit of partials or dentures

In addition to helping patients understand the connection between oral health care and overall health, dental hygienists educate patients about proper oral hygiene and treat periodontal disease to prevent the condition from advancing and complicating other diseases.

For more information about proper oral health care, as well as brushing and flossing instructions, please ask your registered dental hygienist or your dentist.

The content of this posting is based on information from the American Dental Hygienists’ Association.

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Deborah White, MD, MBA