Archive for March, 2016

portrait of an young woman coughing with fist

Everyone has at one time or another experienced a common cold manifested by such symptoms as nasal and sinus congestion, runny nose, mild sore throat and cough.  This common infection may last from a few days to one to two weeks. It is always caused by a virus and therefore patience, and not antibiotics, is the main treatment.

Bronchitis can be thought of as any cough that is not caused by pneumonia or asthma.  The main symptom of bronchitis is a cough without a fever.  People with bronchitis usually just have a cough and do not feel particularly sick and are able to continue their normal daily activities.  One can expect coughing from bronchitis to last from one to three weeks. Again, this is a virus infection and antibiotics are usually not necessary. If a cough does last more than several weeks, or is associated with fever, it would be wise to visit your doctor.

Sinusitis is an infection of the sinuses which are air filled pockets around the nose in the skull.  This infection is usually preceded by a common cold.  It too is usually caused by a virus, but after lingering for one to two weeks may turn into a bacterial infection.  One of the key factors in determining the proper treatment for a sinus infection is the length of the symptoms.  If you have had a cold for one to two weeks and are experiencing pain or pressure in the sinuses along with yellow or green nasal mucus and perhaps a fever, then antibiotics may be helpful.

A sore throat is often a symptom of a cold, but can sometimes be a bacterial strep throat infection.  A good rule of thumb is that if a sore throat is associated with a bad head cold, and especially with a cough, it is usually caused by a virus and needs no prescribed treatment.  If however, one has a sore throat without cold symptoms or cough but does have a fever and a past history of prior strep infections, then the most likely culprit is the strep germ which needs to be treated with antibiotics. Strep is much more common in children than in adults.

Over the counter medications for adults can be helpful in alleviating the miserable symptoms of respiratory infections.  The following are the basic ingredients of all the myriad combinations of cold and flu drugs found on pharmacy shelves:

  • Acetaminophen (Tylenol) or ibuprofen (Advil) may be used to reduce fever and to alleviate aches and pains.
  • Pseudoephridine (Sudafed) is a decongestant to help relieve nasal and ear congestion.
  • Guaifenesin (Robitussin or Mucinex) is an expectorant to help loosen mucus. (Dinking lots of liquids may work just as well.)
  • Dextromethorphan is a cough suppressant which may help ease a persistent cough.

One may purchase a sinus rinsing system called Neil Med which can be found at all pharmacies. This is a natural treatment using a salt based solution to mildly flush out the sinuses helping to clear out the mucus as well as acting as a decongestant.  I have found this to be one of the very best treatments for bad colds and sinus infections.

See your doctor if you have a fever for more than 3-4 days or if your fever is 103 degrees or higher.  Your doctor will determine whether antibiotics are necessary to treat you.  At the very least, your doctor may prescribe medication which will help to alleviate your symptoms and make you feel more comfortable.

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Palliative and Hospice Care

There seems to be some confusion when it comes to understanding the difference between palliative care and hospice. They are both distinctive medical disciplines and often work together.

Hospice care comes into play when a patient has a terminal illness and all treatment options have been exhausted. It is really for those who have been determined to be in their last six months of life. The goal of hospice care is not to cure the underlying disease but to support the quality of life. Hospice care is usually provided by a team of health care professionals who maximize comfort for terminally ill patients while also addressing physical, social and spiritual needs.

Hospice care is most commonly provided at a patient’s home, with a family member typically serving as the primary caregiver, but, it is often available where ever the patient is, whether at hospitals, nursing homes or assisted living facilities. The hospice care team is usually available 24 hours a day, 7 days a week.

Palliative care is medical care based on the goal to relieve pain and suffering, reduce symptoms, ease stress, and mainly to improve a patient’s quality of life during a serious illness and is not limited to end of life issues. People who are actively being treated for a disease can receive palliative care at any stage of their illness whereas hospice is thought of as end of life care.

This is an important distinction because many people think of palliative care as end of life care and therefore is often not requested when it’s most needed and helpful. Recent studies are showing the benefits of beginning palliative care soon after the diagnosis of a serious illness or when an ongoing illness worsens.

The palliative care team works closely with the patient’s primary treating physician in caring for the patient. While the patient’s treating physicians may be trying to prolong life, palliative care’s goal is to maximize quality of life. It has been shown that palliative care can actually extend a patient’s life for a number of months.

Identifying and managing pain is one of the main priorities of any palliative care program. Cancer is the most common disease which needs adequate pain control usually with opiate drugs like oxycodone and morphine and its derivatives. Palliative care also seeks to improve many other troublesome sources of physical discomfort such as shortness of breath, constipation, and insomnia.

With the help of a social worker, palliative care also deals with psychological and social services both for the patients and their care givers, as well as helping with practical problems like coordinating doctors visits and even arranging transportation.

Our community is blessed to have a number of top notch palliative and hospice care providers. Talk with your physician for further information.

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Rare Disease Day

Kudos to state Senator Bill Monning who has introduced a resolution to the state Senate recognizing the last day of February as Rare Disease Day in California, coinciding with a similar national observance. This action should help to inform the public about the challenges faced by those living with rare diseases.

There are approximately 7,000 rare diseases that have been identified, which in reality, involve a very limited number of people. A rare disease is defined as one that affects less than 200,000 (and usually considerably less) people in the United States and where treatments and cures are equally rare, mostly because of lack of interest and funding.

I thought I would describe a few interesting sounding rare diseases from A to Z, most of which even I myself have never heard of (much less able to spell):

  • Aarskog syndrome is an extremely rare genetic disorder marked by stunted growth that may not become obvious until the child is about three years of age, facial abnormalities, musculoskeletal and genital defects, and mild intellectual disability.
  • Blue rubber bleb nevus syndrome (BRBNS) is a rare blood vessel disorder that affects the skin and internal organs of the body.
  • Dysplasia epiphysealis hemimelica, is a rare skeletal developmental disorder of childhood.
  • Fibrodysplasia ossificans progressiva (FOP) is a very rare inherited connective tissue disorder characterized by the abnormal development of bone in areas of the body where bone is not normally present, such as the ligaments, tendons, and skeletal muscles.
  • Keratosis follicularis spinulosa decalvans (KFSD) is a rare, inherited, skin disorder that affects men predominately and is characterized by hardening of the skin in various parts of the body.
  • Olivopontocerebellar atrophy (OPCA) has historically been used to describe a group of disorders that affect the central nervous system and cause a progressive deterioration of nerve cells in certain parts of the brain.
  • Paroxysmal nonkinesigenic dyskinesia (PKND) This group of neurological conditions is generally characterized by involuntary muscle contractions that force the body into abnormal, sometimes painful, movements and positions.
  • Trismus-Pseudocamptodactyly syndrome is a very rare inherited disorder characterized by the inability to completely open the mouth causing difficulty with chewing and/or the presence of abnormally short fingers.
  • Zollinger-Ellison syndrome (ZES) is characterized by the development of a tumor that secretes excessive levels of a hormone that stimulates production of acid by the stomach which can cause stomach ulcers or cancer. By the way, Dr.Ellison, who discovered this syndrome, was the chief professor of surgery during my days attending medical school at The Medical College of Wisconsin.

These are but a few interesting sounding rare diseases from which a limited number of people are afflicted. But for those unfortunate ones who are, and because of being so rare, treatments or cures are not easy to come by. Again, thanks to Senator Monning whose resolution could create a better awareness of rare diseases and increase desperately needed research.

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