Inflammation: if you follow health news, you probably hear about it often. When is inflammation helpful? How can it be harmful? What steps can you take to tone it down? What is inflammation and how does it affect your body?If you’re not familiar with the term, inflammation refers to an immune system reaction to an infection or injury. In those instances, inflammation is a beneficial sign that your body is fighting to repair itself by sending in an army of healing white blood cells. As the injury heals or the illness is brought under control, inflammation subsides. You’ve probably seen this happen with a minor ankle sprain: the initial swelling disappears within days as the injury heals. But inflammation also occurs without serving any healthful purpose, such as when you experience chronic stress, have an autoimmune disorder, or obesity. And instead of solving a problem and receding, inflammation like this can last over a period of time, damaging the body and potentially leading to health problems like arthritis, heart disease, Alzheimer’s disease, depression, and cancer. This is why inflammation has taken center stage in recent years, and why strategies aimed at reducing it are so popular. Many of these anti-inflammation recommendations relate to your diet. Can changes in your diet reduce unhelpful inflammation in your body?The truth is, there are still many unknowns regarding diet and its connection to inflammation and disease. What is clear is that having a healthy diet can help improve overall health and longevity. There is also some evidence to support the notion that eating a host of nutritious foods can reduce inflammation. For example, people who eat lots of fruits and vegetables tend to have lower levels of a substance called C-reactive protein, a marker of inflammation inside the body. In addition, some research has found a link between diets heavy in foods that promote inflammation and a higher risk of certain health problems. For example, a study in Journal of the American College of Cardiology found that people who consumed pro-inflammatory foods, including red and processed meat, refined carbohydrates, and sugar-laden beverages, were more likely to develop cardiovascular disease than those who regularly reached for anti-inflammatory foods, such as leafy greens, beans, and tea. It may be too soon to draw a direct line between the food you eat and levels of inflammation in your body. Fortunately, the foods that appear to reduce inflammation also tend to be good for you for other reasons. So, focusing on eating these foods can likely benefit your body in more than one way. 5 food swaps to help fight inflammationA complete overhaul of your diet is challenging, so experts advise making smaller changes over time. Trying a series of simple swaps may add up to better health in the long term. Below are five substitutions you can use to help reduce the number of inflammation-promoting foods in your diet.
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As many people know, inflammatory bowel disease (IBD) is a complex condition affecting the intestine, which is the part of the digestive tract that helps digest food and remove water, salt, and waste. But you might not know this: in recent years in the US, IBD is being diagnosed more often among people who are Black, Hispanic/Latinx, East and Southeast Asian, or from other minority groups than it was in past decades. Is this a true rise in cases? Is IBD underrecognized in minority populations? While we don’t have all the answers yet, exploring health disparities in IBD and explaining its symptoms may encourage more people to get the health care they need. What is IBD?IBD is a chronic inflammatory condition in the intestine that may steadily progress, or repeatedly flare up (relapse) and calm down (remit). The two main types of IBD are ulcerative colitis (UC) and Crohn’s disease (CD):
What do we know about IBD among minority groups?Traditionally, IBD has been thought of as a disease that largely affects people who are white. For every 100,000 individuals, IBD occurs in about 10 Hispanic/Latinx individuals, 25 Black individuals, and 70 non-Hispanic white individuals, according to estimates published in 2014. However, more recently we’ve observed an increase in IBD among other racial and ethnic groups in the US and across the world. Is inflammatory bowel disease underrecognized in minority groups?Some experts believe that IBD might be underrecognized or underappreciated in minority populations, which might lead to delays in diagnoses. A delayed diagnosis could mean longer periods of untreated inflammation, which also increases risk for complications, such as
One study looked at people receiving health care who had two symptoms suggestive of IBD: iron deficiency anemia (a low red blood count) and diarrhea. The researchers found that certain groups were less likely to receive an appropriate workup to find out why they had these particular symptoms. Those who were Black or publicly insured were less likely to receive the appropriate workup, compared with those who were white or privately insured. These findings further support the hypothesis that IBD might be underrecognized in minority populations. What do we currently know about health disparities in IBD?Preventable differences — called health disparities — in health and well-being are seen among people with inflammatory bowel disease. These disparities may be due to a range of factors affecting certain groups, including inequities in the social determinants of health, unconscious biases of medical providers, barriers to care, and differences in the complex genetic and environmental driving forces of IBD that haven’t been sufficiently studied. Black patients who have IBD experience higher rates of emergency department use — and, in one study, higher rates of hospitalization, possibly because they are less likely to receive regular care from a gastroenterology specialist. Further, while the hospitalization rate in white patients with IBD has decreased, it remains unchanged for Black patients. Additional research shows that Black patients with Crohn’s disease are less likely to be in remission, more likely to undergo surgery, and more likely to experience complications after surgery. Socioeconomic status matters, too: lower income is linked with a higher risk of severe disease, IBD-related hospitalizations, ICU stays, and death. Another study reports that approximately 14% of Americans with IBD are food insecure. Further, it links food insecurity with inability to take prescribed medications because of cost and difficulty paying medical bills. What symptoms may be signs of inflammatory bowel disease?A variety of symptoms may be signs of inflammatory bowel disease:
If you have any of these symptoms — especially if you notice blood in your stool — talk to your healthcare provider. After a medical history and exam, the next steps may be further evaluation with a colonoscopy to look at the bowel, and/or an upper endoscopy to look at the upper part of the digestive system. Imaging studies may also be necessary. This evaluation will help your health provider diagnose IBD or another health problem causing similar symptoms. Getting effective treatment makes a differenceFortunately, ulcerative colitis and Crohn’s disease are both treatable conditions. Our goal in treating IBD is stable remission to stop or ease symptoms and ensure a high quality of life. Everyone with IBD can attain this with good care. Treatment may include medicine taken by mouth or given as infusions, dietary changes, surgery, or a combination of these. It’s important to find the right treatment and monitoring plan for each person early in the course of their illness. I assure my IBD patients that we will work together to find the best and safest treatment options for them. IBD care requires a team approach, which might include a primary care doctor, gastroenterologist, pharmacist, surgeon, dietitian, and other health providers. If you have IBD, you’re the central member and captain of the team; as providers we are just coaches. It is important that you feel heard, understood, and empowered as you navigate life with IBD. Follow me on Twitter @AdjoaGIMD The post Is IBD an underrecognized health problem in minority groups? appeared first on Harvard Health Blog. from https://ift.tt/3vOw0dU Check out https://drpandatv.blogspot.com/ If you’ve learned that your newborn or young child has sickle cell disease, you — and other family members and friends — may have many questions. These days, most cases of sickle cell disease in the US are diagnosed through newborn screening. It’s important to make the diagnosis early, so that babies can be started on penicillin (or another antibiotic) to prevent infection. Getting connected early to a pediatrician for primary care — and to specialists in blood disorders who can work closely with the child as they grow, and with their families — can help prevent complications of the disease. The basicsHemoglobin is the part of the red blood cell that carries oxygen. In sickle cell disease, the hemoglobin can change the rounded shape of red blood cells into a C-shape that is crooked, like the tool called a sickle. When that happens, the cells get sticky and can clog up small blood vessels. It also makes the red cells more fragile and likely to break apart, causing anemia. Millions of people around the world have sickle cell disease, or SCD. In the US, the Centers for Disease Control and Prevention (CDC) estimate it affects about 100,000 people. It occurs in about one out of 365 Black or African American births, and one out of 16,300 Hispanic American births. Is SCD a genetic disease?Yes. All of us have two genes that decide what kind of hemoglobin we have, one from each parent. People with sickle cell disease have two copies of the sickle gene, inherited from both parents. If someone has one copy, they have “sickle cell trait,” meaning that they are a carrier of the gene. Sickle cell trait is common, affecting one in 13 Black children. While there are some problems associated with sickle cell trait, people with sickle cell trait are generally healthy; in fact, they are thought to be less likely to develop severe cases of malaria, which is why the disease was thought to have evolved in people from areas around the equator where malaria is common. There are other kinds of genetic hemoglobin diseases, such as thalassemia or hemoglobin C. Sometimes people are born with one sickle gene and one gene for a different hemoglobin problem. The severity of their condition depends on the particular hemoglobin combination. Currently, there is no cure for sickle cell disease or the other genetic hemoglobin diseases, except for bone marrow transplant or stem cell transplant. What health issues could SCD cause?When sickle cells clog up blood vessels, it can lead to pain and damage to organs or tissues due to lack of blood flow. When coupled with the effects of anemia, this means that babies and children with sickle cell disease are more likely to have complications from infections, such as pneumonia; vision problems; blood clots; and breathing problems. Children with sickle cell disease can also get swelling of the spleen if sickled cells get stuck there. How can you help your child live a healthy life as they grow?Children with sickle cell disease and their families can work together to help prevent complications by taking these steps:
Also, see this helpful toolkit created by the CDC and the American Society of Hematology. It explains common complications of sickle cell disease and steps to take for better health. Being closely connected to medical care is crucial, because the sooner complications are diagnosed, the sooner and more successfully they are treated. There are also treatments such as hydroxyurea that can help prevent complications in the first place. Children with sickle cell disease should regularly see their primary care pediatrician and their specialist, whether they are having symptoms or not, so that they can work together to help live the healthiest life possible. Follow me on Twitter @drClaire The post Sickle cell disease in newborns and children: What families should know and do appeared first on Harvard Health Blog. from https://ift.tt/3b8zpfv Check out https://drpandatv.blogspot.com/ Vaccines have been heralded as a key measure to slow the COVID-19 pandemic and one day bring it to an end. Every day, millions of American adults are receiving one of the authorized vaccines proven highly effective at preventing severe illness that might otherwise lead to hospitalizations and deaths. In the US, most people over 65 have now been fully vaccinated, protecting the most vulnerable in our population. As an infectious disease specialist, my responses to the questions below are based on what we know so far about infection and vaccines in children and teens. We’ll need to continue filling in gaps as research is done and our understanding evolves. What do we know about how COVID-19 affects children and teens?Most COVID-19 infections in children are mild or cause no obvious symptoms. However, a small percentage of infected children
Over 400 children have died from COVID-19 infection. That’s greater than the number of childhood deaths during the deadliest flu season in the past two decades. Vaccinating children to prevent these outcomes is one of the most important reasons driving vaccine studies in children. Further, vaccinating children will be critical to achieving a population-wide level of immunity — herd immunity — sufficient to slow the emergence of dangerous variants and bring an end to the pandemic. What do we know so far about COVID-19 vaccines in teens?
As states expand eligibility for COVID-19 vaccines, teens 16 and older can receive the appropriate vaccine through the same sources adults have had access to so far. Available vaccine sites may vary by state and where you receive health care. Check the searchable map on VaccineFinder, or your state board of health. Vaccine research done so far, or now underway, includes the following:
What about COVID-19 vaccine trials for younger children?
All of these steps will take some time so that they can be done without cutting any corners on safety. The earliest vaccines will likely be available for younger children is late 2021, or perhaps early in 2022. What is not yet known about COVID-19 vaccines in children and teens?
The post COVID-19 vaccines for children and teens: What we do — and don’t — know appeared first on Harvard Health Blog. from https://ift.tt/3xP0s9u Check out https://drpandatv.blogspot.com/ While the COVID-19 pandemic is not over by any means, more people are getting vaccinated, and restrictions are gradually lifting. After too much time spent inactive and indoors, what better way to move your body and enjoy nature than by taking a hike? In many ways, hiking is the ideal antidote to a global pandemic, as it can heal both body and soul. Enjoy the benefits of a hike
Ready to hike?Before you lace up your hiking boots, make sure you’re well prepared. After all, it’s probably been a while since you’ve been out in the world. Here are some tips. Work on your walking. If your walking endurance needs some work, begin a regular walking program in your neighborhood. Walk daily for 10 to 20 minutes, and wear a step counter to motivate you. Safety first. If you can’t hike with someone, let a friend or family member know where you will hike and for how long. Bring your cell phone and a local map, if needed. Apply sunscreen. Even if you mostly hike in the shade, you can still get sunburned. Always wear sunscreen with at least 30 SPF that blocks both types of ultraviolet rays — UVA and UVB —and a lip balm with sunscreen. Apply about 20 minutes before your hike, and then reapply every two hours. Protect against ticks. Ticks are common in the US and can spread serious illnesses, such as Lyme disease and Rocky Mountain spotted fever. Ticks are often found in wooded, bushy, or grassy areas. Wear light-colored clothes with long sleeves and long pants, if possible. Use insect repellent that is effective against ticks on exposed skin, clothes, and hiking gear. Do a thorough tick check after hiking. Know what to do if you find a tick on your body — and what signs suggest you might have been bitten by one, such as a rash or flulike symptoms. Contact your health provider right away for advice and appropriate treatment. Stay hydrated. Drink water before, during, and after your hike. Pay attention to your thirst (if you are thirsty, you are likely already dehydrated.) Set a timer on your phone or sports watch to remind you to drink at regular intervals. Watch the weather. If you are not sure about the forecast, wear layers that you can add or take off depending on the temperature. Carry a rolled-up windbreaker, rain jacket, or poncho in a backpack. Support yourself. Invest in hiking or trail shoes with good ankle support. Wear calf-length socks to protect your legs. Hiking with walking poles can help you navigate tricky terrain and support your knees. The post Happy trails: Take a hike, now appeared first on Harvard Health Blog. from https://ift.tt/3vL4mhV Check out https://drpandatv.blogspot.com/ In a recent blog post I discussed how beneficial sleep is for memory function. But sleep isn’t just good for your memory; it can actually reduce your risk of dementia — and death. Although it has been known for some time that individuals with dementia frequently have poor, fragmented sleep, two new studies suggest that if you don’t get enough sleep, you are at increased risk for dementia. Sleep six to eight hours each nightIn the first study, researchers at Harvard Medical School studied more than 2,800 individuals ages 65 and older participating in the National Health and Aging Trends Study to examine the relationship between their self-report of sleep characteristics in 2013 or 2014, and their development of dementia and/or death five years later. Researchers found that individuals who slept fewer than five hours per night were twice as likely to develop dementia, and twice as likely to die, compared to those who slept six to eight hours per night. This study controlled for demographic characteristics including age, marital status, race, education, health conditions, and body weight. In the second study, researchers in Europe (including France, the United Kingdom, the Netherlands, and Finland) examined data from almost 8,000 participants from a different study and found that consistently sleeping six hours or less at age 50, 60, and 70 was associated with a 30% increase in dementia risk compared to a normal sleep duration of seven hours. The mean age of dementia diagnosis was 77 years. This study controlled for sociodemographic, behavioral, cardiometabolic, and mental health factors, although most participants were white, better educated, and healthier than the general population. In addition, approximately half of the participants had their sleep duration measured objectively using a wearable accelerometer — a device that tracked their sleep using body movements — which confirmed the questionnaire data. Inadequate sleep in midlife may lead to dementiaWhat’s new here is that inadequate sleep in midlife raises one’s risk of dementia. There are many reasons for poor sleep in middle age: shift work, insomnia, caretaking responsibilities, anxiety, and pressing deadlines, just to name a few. Although not all of these are controllable, some are. For example, if you’re currently only sleeping four to five hours because you’re up late working every night, you might want to change your habits, otherwise you risk developing dementia by the time you retire! This relationship between sleep in midlife and dementia in late life is important not only from a clinical perspective, but also from a scientific one. It had always been a bit of a chicken-and-egg problem when trying to interpret the relationship between poor sleep and dementia. Was it really poor sleep that caused dementia, or just early dementia symptoms causing poor sleep? By looking at individuals who were initially studied in midlife — some as young as age 50 — we now have greater certainty that poor sleep can increase one’s risk of developing dementia 25 years or more in the future. Flush your brain while you sleepAlthough it is not totally understood why inadequate sleep increases your dementia risk, one possible reason relates to the deposition of the Alzheimer’s protein, beta amyloid. Beta amyloid is the protein that clusters and clumps together to form Alzheimer’s plaques. No one is completely certain what its normal function is, although there is increasing evidence it is involved in the brain’s defense against invading microorganisms. During the day, we all make some of this beta amyloid protein in the brain. When we sleep, however, brain cells and their connections actually shrink. This shrinking allows more space between the brain cells, so that beta amyloid and other substances that accumulate during the day can be flushed away. So the theory is, if you don’t get enough sleep, your brain won’t have enough time to drain away beta amyloid and other substances. These substances then continue to accumulate, day after day, until they cause dementia. The good newsThe good news is that you can reduce your risk of developing dementia by getting adequate sleep. One study from researchers in Toronto and Chicago examined people who were at increased genetic risk of developing Alzheimer’s. They found that better sleep not only reduced the likelihood of developing clinical Alzheimer’s disease, but it also reduced the development of tangle pathology in the brain — another substance that accumulates in Alzheimer’s disease. The bottom lineSleep isn’t merely an annoying interruption between the important aspects of our waking lives. Just like eating right and exercising, sleep is absolutely essential for good brain health. These two new studies show that the harmful effects of inadequate sleep can start at age 50 (if not earlier), and they can lead to early dementia and death. But the good news is that you can reduce your risk of dementia by simply giving yourself six to eight hours of sleep each night. Try to avoid sleeping pills, as they don’t give you the deep sleep you need. If you’re having trouble sleeping, nonpharmacological approaches are best. The post Sleep well — and reduce your risk of dementia and death appeared first on Harvard Health Blog. from https://ift.tt/3vEtOFO Check out https://drpandatv.blogspot.com/ I have a confession: in late 2020, when the first COVID-19 vaccines were approved by the FDA, I was hesitant to get one myself. Despite working in public health and believing strongly in vaccines to keep our community healthy, I was anxious about putting something in my body that seemed so new. I thought: “What if the vaccine is dangerous?” “What about long-term side effects?” I am part of the LGBTQ+ community. Our history may help explain why I hesitated. Are LGBTQ+ people more hesitant to get the vaccine?In March a New York Times article reported that LGBTQ+ people are more hesitant to get the COVID-19 vaccine. A research study from the Human Rights Campaign reported mixed findings: while LGBTQ+ people overall are more likely to get vaccinated, certain subgroups, such as LGBTQ+ people of color and bisexual women, are less likely to get vaccinated. LGBTQ+ people have good reason to be hesitant about vaccines. Historically, this population has experienced — and continues to experience — discrimination in multiple settings, including in healthcare. At the same time, this population is more vulnerable to COVID-19 (see this study and an earlier blog post I wrote). LGBTQ+ people who are also people of color may be even more hesitant to get the COVID-19 vaccine, because of trauma and oppressions based on multiple intersecting marginalized identities that set the stage for mistrust in healthcare and medical research. We can include racism, transphobia, biphobia, and homophobia among such oppressions. Weighing the risks and benefits of the COVID-19 vaccineWhen I was trying to decide whether to get the vaccine, I began reading about the vaccine from trusted sources like the Centers for Disease Control and Prevention (CDC). I also talked to people I know and trust, like close friends, family members, and physician colleagues. I asked them: “Will you get the vaccine when it’s offered to you?” All of them gave me a resounding “yes!” Most shared this rationale: while we still don’t know about long-term side effects, this vaccine is similar to other vaccines that have been around for a while, and the benefits of getting vaccinated far outweigh the risks of getting seriously ill or even dying from COVID-19. When the vaccine was offered to me earlier this year, I booked my appointment immediately, without hesitation, and I haven’t looked back. As soon as I got the first shot, and certainly when I was fully vaccinated two weeks after my second shot, I felt a profound sense of relief. I also felt empowered about taking an important step toward keeping myself, my family, and my community safe from COVID-19. I now feel safer and freer in my daily life. I go into stores (wearing a mask) without feeling anxious, and I have been able to visit in-person with other fully vaccinated people, like my mom, without masks. If you are struggling to decide whether to get the COVID-19 vaccine, this decision-making grid may be helpful (note: auto-download). The grid walks you through the benefits and short-term and long-term risks of not getting the vaccine compared to getting the currently available vaccines. Why the vaccine is critical for LGBTQ+ communitiesNumerous “pandemics” have already wiped out large numbers of the LGBTQ+ community: HIV/AIDS, violence, suicide. In addition, the COVID-19 pandemic has already disproportionately harmed LGBTQ+ people (see this study and this report). LGBTQ+ seniors and people of color are at greatest risk for serious, possibly life-threatening illness from COVID-19. If each of us takes steps to get vaccinated, we can prevent more deaths and negative health outcomes in our communities. How can you empower yourself to get the COVID-19 vaccine?
Additional resources
The post COVID-19 vaccines and the LGBTQ+ community appeared first on Harvard Health Blog. from https://ift.tt/2SlNGPH Check out https://drpandatv.blogspot.com/ Often, the skin can be a window to what is occurring inside your body. For women with polycystic ovarian syndrome, or PCOS, this this may mean acne, hair loss, excessive facial or body hair growth, dark patches on the skin, or any combination of these issues. What is PCOS?Skin and hair issues can be the most readily perceptible features of PCOS, and thus sometimes the reason for seeking medical care. However, features of PCOS also include menstrual irregularities, polycystic ovaries (when the ovaries develop multiple small follicles and do not regularly release eggs), obesity, and insulin resistance (when cells do not respond well to insulin). The cause of PCOS is not entirely understood, but scientific evidence points to hormonal imbalances, specifically excess testosterone (also known as hyperandrogenism) and insulin resistance. PCOS is the most common cause of infertility in women. The hormonal imbalances in PCOS disrupt the process of ovulation, and without ovulation pregnancy is not possible. PCOS exists on a spectrum, meaning not every woman with PCOS has the same signs and symptoms. Because of the variation in characteristics of this syndrome, it can be difficult to diagnose. How do I know if I have PCOS?There is no one specific test that can be used to diagnose PCOS, so a thoughtful and thorough workup, including lab tests and imaging, is needed. Lab tests typically involve measuring levels of various hormones, such as androgens. Imaging tests may include ultrasound of the ovaries. Seeking care from an experienced team, including primary care physicians, gynecologists, endocrinologists, and dermatologists, can establish the diagnosis. What are the skin manifestations of PCOS?PCOS-related acne often flares on the lower face, including the jawline, chin, and upper neck. Although not a hard and fast rule, these areas are considered to be a hormonal pattern for acne. Women with PCOS may notice that acne lesions are deeper, larger, and slower to resolve. Acne in PCOS usually worsens around the time of menstrual periods. Dermatologists often recommend the use of oral contraceptive pills or a medication called spironolactone to treat this type of acne. These treatments, when used in the right patients who have no contraindications to them, can be very helpful in clearing acne. Hirsutism, or excessive hair growth in places where hair is usually absent or minimal, is another dermatologic sign of PCOS. Common areas of hirsutism include the chin, neck, abdomen, chest, or back. On the scalp, however, balding or thinning of the hair can be seen. Both of these hair issues are driven by an excess of testosterone. Occasionally, another skin condition appears called acanthosis nigricans, which are dark, velvety areas of skin, usually in skin creases such as around the neck and underarms. This type of skin condition is also associated with insulin resistance, and may be due to stimulation of skin cells by insulin, causing them to overgrow. Treatment options and a tailored approachAlthough there is no cure for PCOS, there are many treatment options for managing various symptoms of this syndrome. The types of treatments used depend on a woman’s priorities and symptoms. For example, being at a healthy weight can lead to improvement of symptoms, so lifestyle modifications to nutrition and exercise may help. Hirsutism can be treated with laser hair removal or electrolysis. Some patients may try birth control pills to improve menstrual regularity. Metformin, a commonly used medication for diabetes, can be used to help improve the body’s response to insulin. Treatment planning is tailored to each person and depends on whether or not pregnancy is a short-term goal. Certain medications, including spironolactone and retinoids for acne, should be avoided if a woman is trying to become pregnant. The post Polycystic ovarian syndrome and the skin appeared first on Harvard Health Blog. from https://ift.tt/32WXtNR Check out https://drpandatv.blogspot.com/ Keeping your partner — or yourself — up at night with loud snoring? This might be more than a nuisance. About 25% of men and nearly 10% of women have obstructive sleep apnea (OSA), a serious sleep disorder characterized by explosive snores, grunts, and gasps. Tissue at the back of the throat temporarily obstructs the airway, leading to breathing pauses (apneas) throughout the night. Not only does OSA leave people tired and groggy, but it also puts them at risk for a host of health problems, including high blood pressure, depression, and heart disease. The most effective and best-studied treatment is positive airway pressure (PAP), a small bedside machine that blows air through a mask to prevent your airway from collapsing. But people with mild or moderate OSA sometimes find PAP challenging to use, and often wonder about alternatives. Dental devices (also known as oral appliances) are an option for some people. But do your homework before going this route, cautions Sogol Javaheri, MD, MPH, MA, a sleep specialist at Harvard-affiliated Brigham and Women’s Hospital. Who might benefit from a dental device for sleep apnea?“These devices are supposed to reposition your jaw or tongue to open your upper airway. But they can be really uncomfortable and only work about half the time,” Dr. Javaheri says. It’s hard to predict who might benefit from using an oral device, and people with very mild OSA and few symptoms may not notice any difference. As a result, she generally doesn’t recommend them except for people with mild to moderate OSA or those with severe OSA who can’t tolerate PAP. Three main categories of dental devices for OSAMandibular advancement devices. Made of molded hard plastic, these devices snap over your lower and upper teeth, and also feature metal hinges and screws that can be tightened to push your lower jaw forward. Some dentists make custom mandibular advancement devices, but before you consider buying a custom device, be sure to ask whether your dentist has experience in sleep-related breathing disorders and is certified by the American Academy of Sleep Medicine. Some non-certified dentists simply take a mold of your teeth, send it to a company that makes the device, then sell it to you at a large markup — sometimes totaling $4,000 or more. What’s more, it’s unlikely to be covered by your dental or medical insurance if it’s used for snoring. Mouth guards. Similar to mandibular advancement devices, these devices also help reposition your lower jaw, although to a lesser degree. Some sleep physicians recommend SnoreRx, which you can purchase online for less than $100. Instead of starting with an impression of your teeth created by a dentist, you use what the company calls the “boil and bite” method. You place the device in a cup of boiling water for a minute and then bite down on the softened plastic so it molds to your teeth. Tongue-retaining devices. These devices consist of a soft plastic splint placed around your tongue that holds it forward and out of your mouth throughout the night. They tend to make your mouth very dry and can be quite uncomfortable. Most insurance plans at least partially cover these devices when used for OSA, but not if they’re used for simple snoring. Don’t be tempted to try one unless you’ve been formally diagnosed with OSA, says Dr. Javaheri. And even if you have OSA, be sure to call your insurance company so you understand how much is covered before you have a device made. The post Dental appliances for sleep apnea: Do they work? appeared first on Harvard Health Blog. from https://ift.tt/3nsVsm9 Check out https://drpandatv.blogspot.com/ No one likes getting stuck by a needle. Whether for a blood test, vaccination, or blood donation, needle sticks are something most people would prefer to avoid. Yet, judging only by schedules for routine vaccinations and tests, the average healthy person can expect at least 165 needle sticks over a lifetime. Get hospitalized? That might add dozens or even hundreds more. And the number of needle sticks experienced by people with diabetes, HIV, and some other illnesses hovers in the “don’t ask” range. For many, this may be more of an annoyance than a real problem. But if you have a strong fear of needles or aversion to the sight of blood, getting a vaccination or any other needle stick is a big deal. If this sounds like you, you may have trypanophobia. What is trypanophobia?Fittingly, the name combines the Greek term trypano — meaning puncturing or piercing — with phobia, meaning fear. This remarkably common condition is marked by irrational, extreme fear or aversion to blood or needles. It’s estimated that fear of needles affects up to 25% of adults, and may lead 16% of people in the US to skip vaccinations. Many people who strongly fear needle sticks may avoid doctors and medical care, so it’s likely that the magnitude of this problem is underestimated. Just to be clear: this phobia is not limited to people who are overly sensitive to pain or aren’t “tough enough.” It can affect anyone. The cause is often unknown, but a particularly traumatic experience during childhood medical illness may set the stage for some people. And there may be a genetic component. Researchers have found genes linked to fainting after needle sticks, and trypanophobia sometimes runs in families. What are the symptoms of this phobia?People with trypanophobia who are contemplating a needle stick may experience
How does being afraid of needles affect you?This fear can affect your
What can you do to cope with a fear of needles?There’s not much high-quality research regarding how best to treat trypanophobia. Still, experts suggest a number of options to help people cope with it.
Can therapy help?Seeing a mental health specialist may be helpful. He or she may recommend
The bottom lineIt’s natural to have an aversion to pain, even when you know it’s coming and even though it’s for a good reason. So, if you’re one of the millions fretting about getting a COVID-19 vaccine or a blood test or any other needle stick, know that you’re not alone, and that there are things you can do to improve the situation. Talk to your doctor about your fear and get help if you need it. Your quality of life, health, and longevity could depend on it. As for me, I’m going to do what I always do: avert my eyes and stare at that spot on the floor. Follow me on Twitter @RobShmerling The post Terrified of needles? That can affect your health appeared first on Harvard Health Blog. from https://ift.tt/2R61iO1 Check out https://drpandatv.blogspot.com/ |