Archive for April 2nd, 2009

BULGING, BOTH EYES: DESCRIPTION AND POSSIBLE MEDICAL PROBLEMS

Thursday, April 2nd, 2009

If both of your eyes appear to bulge from their sockets, causing a pop-eyed appearance, you may already be aware that you have a thyroid problem known as Graves’ disease, a kind of hyperthyroidism. If only one eye is bulging, it may be due to a tumor behind the eye (see “Bulging, One Eye” below for more information). Hyperthyroidism is a condition in which the thyroid gland produces too much thyroxine, a hormone that helps to regulate growth in the body; the condition often results in weight loss and nervousness, and it primarily affects women in midlife. Graves’ disease occurs when an excessively large amount of the hormone is produced; this may cause some parts of the body to grow, including the tissue behind the eyes, causing the eyes to bulge out. In addition to bulging eyes, your eyes may also water frequently and be extrasensitive to light, and your eyesight may be blurry and distorted.

If your eyes start to bulge and you are not aware that you have a thyroid problem, your doctor will probably suggest the possibility when she takes a look at your eyes. Though bulging eyes by themselves are not harmful to your health, the underlying thyroid condition can decrease your quality of life. Fortunately, however, if you begin to treat Graves’ disease when you first notice that your eyes begin to bulge, both your eye condition and your thyroid condition will clear up completely.

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NERVOUSNESS

Thursday, April 2nd, 2009

Description and Possible Medical Problems

Even though it’s an old-fashioned term, you may have recently heard someone refer to someone as a “nervous Nellie.” As is the case with anxiety, everyone gets nervous at some point, but there are always those who take it to extremes.

Also like anxiety, nervousness can get to the point where it prevents people from functioning normally and begins to interfere with their interpersonal relationships. In fact, nervousness is often linked with anxiety. In most cases, nervousness is a manifestation of stress, problems at home or work, or simply the travails of modern life. It can also result from working too hard and feeling overwhelmed.

In a few cases, however, if you are chronically nervous and also begin to lose weight unintentionally, you may have a thyroid disease.

Treatment

Once your doctor rules out the possibility of thyroid disease, she will suggest that you try some behavioral changes to reduce your nervousness, including exercise, cutting out or down on caffeine, and/or counseling. Sometimes a short vacation or day off is all that’s needed.

If your nervousness is interfering with your life and these methods don’t work, your doctor may prescribe an antianxiety medication or sedative such as Valium, Xanax, or BuSpar. Your doctor will determine your dosage based on factors such as your age, weight, and sex and will lean towards giving you a smaller dose than is customary to help prevent the medication from becoming habit forming. In the case of BuSpar, it takes a week or two of daily doses until it starts to work, and it doesn’t seem to cause dependency like the other antianxiety medications and sedatives.

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BODY SIGNAL ALERT/DIZZINESS WITH VOMITING, HEADACHE, NUMBNESS AROUND THE MOUTH

Thursday, April 2nd, 2009

Description and Possible Medical Problems

If you feel dizzy no matter if you’re moving around or sitting still and the dizziness is accompanied by vomiting, headache, loss of speech, numbness around the mouth, and/or loss of the use of one of your limbs, you should see your doctor immediately. Your dizziness may be caused by a problem in the brain, not your inner ear. In addition to the dizziness and other symptoms, you may have trouble walking.

These are all signs of a small stroke or a tumor. Arteriosclerosis, or narrowing of the arteries, often reduces the amount of blood that reaches the brain, which can cause these symptoms. A tumor can grow to the point where it begins to press on an artery, which cuts off the blood going to the brain.

Treatment

Your doctor will take your complete health history and do a complete physical, which will include an evaluation of your neurological system with a CAT scan or MRI scan to check for a possible old or new stroke, an echocardiogram to check for any heart irregularities or clots, or a carotid Doppler test, which measures the flow of blood from the neck to the brain.

If your doctor thinks you’ve had a stroke, he will prescribe treatment that includes a low-fat diet that is also low in sodium if your blood pressure is elevated, and one baby aspirin taken daily, which seems to inhibit the blood’s ability to clot, meaning that no obstructions to the flow of blood to the brain will develop. If your doctor believes you’ve had a series of persistent small strokes as shown by an MRI but that you may have not noticed, he may prescribe a medication called Ticlid, taken three times a day, which also helps keep the blood from clotting but is stronger than baby aspirin. If you are taking Ticlid, your doctor will want to monitor you with periodic blood tests, since the medication can sometimes cause your white blood cell count to decrease.

Another medication is Coumadin, which actually thins the blood and is only used in severe cases when aspirin and Ticlid are not strong enough to prevent the blood from clotting. If you are taking Coumadin and you also have an ulcer, you may need to take an antiulcer medication such as Carafate or Zantac to coat your stomach in order to protect it from the Coumadin. Also, you need to make sure your doctor monitors your health closely when you are taking Coumadin and call your doctor immediately if you notice that you are bleeding excessively from a small cut or notice blood in your stool or urine. All of these symptoms can be a sign of internal bleeding, which can be caused by the Coumadin.

If your doctor thinks you may have a brain tumor, see “Headache in the Morning, Made Worse by Sneezing, Coughing,” below, for a description of the condition and your treatment options.

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NEW AMERICAN MODEL OF HEALTH CARE PROVISION: THE SECOND GROUP

Thursday, April 2nd, 2009

You’ll recall that the second group, health care providers, includes both the hospital and the professional and nonprofessional employees in the health care system. In some ways, the goals of the health care provider run counter to those of the first group, the purchasers of health care. The hospitals want to keep their beds full, and the doctors and other providers want to have a full appointment book, while the insurance companies will tell them they can, but only if the visits are absolutely necessary—and they’ll ask for proof. In many cases, in fact, the insurance companies will have the final say. Then again, the development of high-tech surgical procedures that can be performed on an outpatient basis, noninvasive testing, and potent new antibiotics that are given by mouth, not intravenously, has drastically reduced the length of the average hospital stay. The insurance companies have also begun to reward hospitals for encouraging shorter hospital stays by making the longer stays less profitable for them than shorter ones are. The hospitals have also begun to attract their own loyal market by forming their own HMOs—either an on-site staff group or a group of primary care physicians and specialists in private practice who refer their patients to a specific hospital when necessary. Hospital networks will also begin to develop: one hospital in the network will specialize in high-risk pediatric care, for instance, while another hospital will focus on state-of-the-art cancer therapies. This benefits patients who join the hospital-based HMOs, since they can easily be moved to the network hospital that specializes in their particular problem.

But while hospitals will quickly snap into action, many of the physicians in this country will have a dilemma: there are too many specialists in this country, and in the age of health care reform it’s the primary care physicians who will be in demand. As a result, many specialists will either have to incorporate primary care into their practices or else eliminate their specialty altogether. In addition, U.S. medical schools will need to make primary care an attractive option for medical students.

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BODY SIGNALS: SPECIAL THOUGHTS FOR SPECIAL PEOPLE AND SITUATIONS

Thursday, April 2nd, 2009

Some of the Body Signals in the book address special health problems and concerns for readers over the age of 75 under the section “Special Mention for the Elderly”. This section follows the “Treatment” section and includes specific warnings about medications, treatments, and illnesses to which they may be especially prone. For instance, in Chapter 6, “Ears and Nose,” readers will learn that when an older person is affected with Ramsay Hunt syndrome, a form of shingles, an extremely painful condition called postherpetic neuralgia can sometimes occur. Readers are then provided with special information about the symptoms of this illness as well as how to minimize their discomfort.

Another section I’ve included in some of the entries is called “Tips and Precautions.” This section includes self-help treatments you can try at home before you see your doctor as well as certain preventive measures you can take to lower your chances of having the condition recur.

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