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It’s Colorectol Cancer Awareness Month –

March is Colorectal Cancer Month. While we’ve covered this top in the past, we thought it would be a good time remind those of you who are 50-75 years old to schedule your appointment for a screening. If you are younger than 50, but have a family history of the disease, then it’s important to talk to your doctor about your risks and when you should have your first screening.

What is colorectal cancer?
Colorectal cancer is a term that’s used for both colon cancer and rectal cancer. Like other types of cancer, colorectal cancer can spread to other parts of your body. The colon is the longest part of the large intestine, and the rectum is the bottom part of the large intestine.

Picture of the colon, the part of the large instestine attached to the rectum.

Am I at risk for colorectal cancer?
People over age 50 are at higher risk of developing colorectal cancer. Other risk factors are:

  • Polyps (growths) inside the colon
  • Family history of colorectal cancer
  • Smoking
  • Obesity
  • Not getting enough physical activity
  • Drinking too much alcohol
  • Health conditions, such as Crohn’s disease, which cause chronic inflammation (ongoing irritation) of the intestines

How often should I get screened?
Both men and women should get screened, but how often you get screened will depend on your risk for colorectal cancer. It will also depend on which screening test is used. There are different ways to test for colorectal cancer. Some tests are done every 1 to 2 years. Other tests are done every 5 to 10 years. You doctor can help you decide which test is right for you and how often to get screened. After the ag e of 75, most people can stop getting screened.

What to ask your doctor?

Visiting the doctor can be stressful and sometimes overwhelming, especially if you’re having anxiety about the appointment. So, writing down some questions ahead of time can help. You may also want to ask a family member or close friend to go with you to take notes. Here are some sample questions you can take with you to your appointment:

  • What is my personal risk for colorectal cancer?
  • When do you recommend that I start getting tested?
  • How often do I need to get tested?
  • What are the different types of screening tests for colorectal cancer?
  • Which screening test do you recommend? Why?
  • What’s involved in screening? How do I prepare?
  • Are there any dangers or side effects of screening?
  • How long will it take to get the results

What are the tests?
There are different kinds of tests used to screen for colorectal cancer.  Four tests are used to screen for colorectal cancer:

  • Fecal occult blood test
  • Sigmoidoscopy
  • Barium enema
  • Colonoscopy

Some tests you can do at home, such as a fecal occult blood test. Other tests, such as a colonoscopy, must be done in a clinic or hospital.

The day before the test, you may need to drink only clear liquids (like water or plain tea), and use laxatives to clean out your colon. Your doctor will tell you how to get ready for your test.

Some people find the tests for colorectal cancer to be uncomfortable. Most people agree that the benefits to their health outweigh the discomfort.

Get support.
If you are nervous about getting a colorectal cancer test, get support.

  • Ask a family member or friend to go with you.
  • Talk with people you know who have been screened to learn what to expect.

What about cost?
Most insurance plans now cover colorectal screenings, and depending on your insurance, you may be able to get tested at no cost to you. Talk with your insurance company to find out about your coverage.

Take control – act early.
If you act early, you have a good chance of preventing colorectal cancer or finding it when it can be treated more easily.

  • If your doctor finds polyps inside your colon during testing, these growths can be removed before they become cancer.
  • If you find out you have cancer after you get tested, you can take steps to treat it right away.

 

Source: U.S. Department of Health & Human Services

Vertigo: Beyond the Dizziness

You may have seen Roy Williams, men’s basketball coach for the UNC Tarheels, collapse during a game a few weeks ago. There was a lot of initial speculation about his condition, but he later confirmed that he has vertigo.

Vertigo is a form of dizziness. It’s a helpless feeling of a sense that everything around you is spinning. And if you’ve ever experienced it, it can be absolutely debilitating. When you experience vertigo, you get a sensation of disorientation or motion. Think of it as being motion sick, but you’re not moving. Dizziness can be accompanied by nausea or vomiting, sweating, or abnormal eye movements. Some people have had symptoms that include hearing loss, ringing in the ears, weakness, difficulty seeing, decreased level of consciousness, and difficulty walking. Symptoms can last from minutes to hours, and symptoms can be chronic or episodic.

What causes vertigo?

Vertigo can be the result of sudden head movements, inflammation within the inner ear due to ear infection, tumors, Miniere’s disease, decreased blood flow to the brain, head trauma and neck injury, pregnancy, migraine headaches, complications from diabetes, or multiple sclerosis.

Meniere’s disease is composed of symptoms including episodes of vertigo, ringing in the ears (tinnitus), and hearing loss. People with this condition have the abrupt onset of severe vertigo and fluctuating hearing loss as well as periods in which they do not experience any symptoms. The cause of Meniere’s disease is not fully understood but is thought to be due to viral infections of the inner ear, head injury, or allergies . While vertigo itself is not contagious, Miniere’s disease can be part of your heredity.

Diabetes has a number of complications and one of them is hardening of the arteries which can lead to lowered blood flow to the brain, causing vertigo symptoms.

Changes in hormones during pregnancy along with low blood sugar levels can cause pregnant women to feel dizziness or vertigo, especially during the first trimester. In the second trimester, dizziness or vertigo may be due to pressure on blood vessels from the expanding uterus. Later in pregnancy dizziness and vertigo may be caused by lying on the back, which allows the weight of the baby to press on a large vein (vena cava) that carries blood to the heart.

How do you treat vertigo?

Any signs and symptoms of vertigo should be evaluated by a doctor. The majority of cases of vertigo are harmless. Although vertigo can be debilitating, most causes are easily treated with prescription medications and sometimes over-the-counter medications. Have a doctor check any new signs and symptoms of vertigo to rule out rare, potentially serious, or life-threatening causes. The source of vertigo may be not the ears or balance system and it is very important to rule out other life-threatening causes first.

Commonly prescribed medications for vertigo include the following:

  • meclizine hydrochloride (Antivert)
  • scopolamine transdermal patch (Transderm-Scop)
  • promethazine hydrochloride (Phenergan)
  • metoclopramie (Reglan)bon
  • odansetron (Zofran)
  • diazepam (Valium)
  • lorazepan (Ativan)
  • clonazepam (Klonopin)
  • prednisone

Some over-the-counter (OTC) medications  may also be recommended by your doctor or pharmacist for vertigo, including:

  • diphenhydramine (Benadryl)
  • dimenhydrinate (Dramamine)
  • meclizine (Bonine)

These medications should be taken only as directed and under the supervision of a doctor. Many of these medications can cause drowsiness and should not be taken before driving or working. Talk to your pharmacist to make sure that none of these medications will be counteract other medications that you are taking.

Sometimes, if medications do not work, you may find relief with vestibular therapy through a physical therapist. Vestibular rehabilitation exercises consist of having the patient sit on the edge of a table and lie down to one side until the vertigo resolves itself followed by sitting up and lying down on the other side, again until the vertigo ceases. This is repeated until the vertigo no longer occurs. Another treatment method is called the particle repositioning maneuve. This treatment is based on the idea that the vertigo is caused by displacement of tiny stones in the balance center (vestibular system) of the inner ear. The head is repositioned to move the stones to their normal position. This maneuver is repeated until the abnormal eye movements are no longer visible.

How do you prevent vertigo?

You may be able to prevent some forms of vertigo by limiting sudden movements. For example, get up slowly from your bed or chair.
If you have other risk factors for stroke, controlling high blood pressure and  high cholesterol can help. Stop smoking, too.
Those with Meniere’s disease should limit salt in their diet.

If your balance is affected by vertigo, take precautions to prevent injuries from fall.

Heart Rate: Learn your rhythm

Most fitness buffs are aware of their heart rate and monitor it for their own edification. But even if you’re not an athlete, knowledge about your heart rate can help you monitor your fitness level — and it might even help you spot developing health problems. Your heart rate, or pulse, is the number of times your heart beats per minute. Normal heart rate varies from person to person and knowing yours can be an important heart-health gauge.

“Your heart is a muscle and just like strengthening other muscles by doing activities, you can do the same thing with your heart,” said Dr. Mary Ann Bauman, an internist at Integris Baptist Medical Center in Oklahoma City.

Knowledge about your heart rate can help you monitor your fitness level, and it may help you spot developing health problems if you are experiencing other symptoms.

“As you age, changes in the rate and regularity of your pulse can change and may signify a heart condition or other condition that needs to be addressed,” said Richard Stein, M.D., professor of medicine and cardiology at the New York University School of Medicine in New York City and a volunteer for the American Heart Association.

How do I find my heart rate?

The best places to find your pulse are the:

  • wrists
  • inside of your elbow
  • side of your neck
  • top of the foot

How do I calculate my heart rate?

To get the most accurate reading, put your finger over your pulse and count the number of beats in 60 seconds.

Most commonly, maximum heart rate is calculated by subtracting your age from 220:

  • 220 – Age. For a 30-year-old person, for example: 220 – 30 = 190.

The target zone for a 30-year-old person would be between 50 and 85% of his or her maximum heart rate:

  • 50 percent level: 190 x 0.50 = 95 bpm
  • 85 percent level: 190 x 0.85 = 162 bpm

The formula for maximum heart rate works well for people under 40 but for older people it may overestimate their maximum heart rate, Bauman said. For older people, a better formula for the maximum heart rate is:

  • 208 – (0.75 x Age)

You can either manually calculate your heart rate during exercise or use heart rate monitors that wrap around the chest, or are included in sports watches and fitness devices.

Your resting heart rate is the heart pumping the lowest amount of blood you need because you’re not exercising. If you’re sitting or lying down and you’re calm, relaxed and aren’t ill, your heart rate is normally between 60 (beats per minute) and 100 (beats per minute), Stein said.

But a heart rate lower than 60 doesn’t necessarily signal a medical problem. It could be the result of taking a drug such as a beta blocker.

Beta-blockers are one of the most widely prescribed classes of drugs to treat hypertension (high blood pressure) and are a mainstay treatment of congestive heart failure. Beta-blockers work by blocking the effects of epinephrine and slowing the heart’s rate, thereby decreasing the heart’s demand for oxygen. Long-term use of beta-blockers helps manage chronic heart failure.

A lower heart rate is also common for people who get a lot of physical activity or are very athletic, Stein said. Active people often have lower heart rates because their heart muscle is in better condition and doesn’t need to work as hard to maintain a steady beat.

“Moderate physical activity doesn’t usually change the resting pulse much,” Stein said. “If you’re very fit, it could change to 40. A less active person might have a heart rate between 60 and 100,” he added. That’s because the heart muscle has to work harder to maintain bodily functions, making it higher.

Other factors that affect heart rate:

  • Air temperature: Higher humidity and temperatures cause the heart to pump a little more blood, so your pulse rate may increase, but usually no more than five to 10 beats a minute.
  • Body position: Resting, sitting or standing, your pulse is usually the same. Sometimes as you stand for the first 15 to 20 seconds, your pulse may go up a little bit, but after a couple of minutes it should settle down.
  • Emotions: If you’re stressed, anxious or “extraordinarily happy or sad” your emotions can raise your pulse.
  • Body size: Body size usually doesn’t usually change pulse. If you’re very obese, you might see a higher resting pulse than normal, but usually not more than 100.
  • Medication use: Meds that block your adrenaline (beta blockers) tend to slow your pulse, while too much thyroid medication or too high of a dosage will raise it.

When to call your doctor:

If you’re on a beta blocker to decrease your heart rate or to control a another abnormal rhythm, your doctor may ask you to monitor and log your heart rate. Keeping tabs on your heart rate can help your doctor determine whether to change the dosage or switch to a different medication.

A number of conditions can affect your heart rate. An arrhythmia causes the heart to beat too fast, too slow or with an irregular rhythm.

Tachycardia is generally considered to be a resting heart rate of over 100 beats per minute, according to the National Institutes of Health, and generally caused when electrical signals in the heart’s upper chambers fire abnormally. If the heart rate is closer to 150 bpm or higher, it is a condition known as supraventricular tachycardia (SVT). In SVT, your heart’s electrical system, which controls the heart rate, is out of whack. This generally requires medical attention.

Bradycardia is a condition where the heart rate is too low, typically less than 60 bpm. This can be the result of problems with the sinoatrial node, which acts as the pacemaker, or damage to the heart as a result of a heart attack or cardiovascular disease.

Although there’s a wide range of normal, an unusually high or low heart rate may indicate an underlying problem. Consult your doctor if your resting heart rate is consistently above 100 beats a minute (tachycardia) or if you’re not a trained athlete and your resting heart rate is below 60 beats a minute (bradycardia) — especially if you have other signs or symptoms, such as fainting, dizziness or shortness of breath.

“If your pulse is very low or if you have frequent episodes of unexplained fast heart rates, especially if they cause you to feel weak or dizzy or faint, tell your doctor, who can decide if it’s an emergency,” Stein said. “Your pulse is one tool to help get a picture of your health.

Sources: American Heart Association,

Should you worry about the Zika virus?

 

Living in Southeastern North Carolina we don’t have a direct risk of the Zika virus…yet.

microcephaly-comparison pic_1453148243419_436989_ver1.0_640_360What do we know about the Zika virus?

  • It’s transmitted by the Aedes aegypti mosquito.
  • It has spread to at least 29 countries including the U.S.
  • It is connected to microcephaly (left), a neurological disorder that results in babies being born with abnormally small heads and severe developmental issues, and sometimes death.

About 1 in 5 people infected with Zika virus become ill (excluding the unborn children who can develop microcephaly).

The World Health Organization estimates that 3 million to 4 million people across the Americas will be infected with the virus in the next year. Those are staggering numbers.

How is Zika spread?

The Zika virus, transmitted by the aggressive Aedes aegypti mosquito, has spread to at least 29 countries. WHO estimates 3 million to 4 million people across the Americas will be infected with the virus in the next year. “As long as the mosquito keeps reproducing, each and every one of us is losing the battle against the mosquito,” Brazilian President Dilma Rousseff said recently. “We have to mobilize so we do not lose this battle.”

Last week, the CDC reported the first case of locally acquired Zika virus in the United States , but it was not from a mosquito bite. Instead it was passed via sex. In this particular case, the female patient had not traveled, but instead  had sex with someone who had recently returned from Venezuela and who was infected with the mosquito-borne virus.

“There have been isolated cases of Zika spread through blood transfusion or sexual contact and that’s not very surprising,” CDC Director Tom Frieden told CNN’s Dr. Sanjay Gupta. “The virus is in the blood for about a week. How long it would remain in the semen is something that needs to be studied, and we’re working on that now.”

What are the symptoms and how long does it last?

  • The most common symptoms of Zika are fever, rash, joint pain, or conjunctivitis (red eyes).
  • Other common symptoms include muscle pain and headache. The incubation period (the time from exposure to symptoms) for Zika virus disease is not known, but is likely to be a few days to a week.
  • The illness is usually mild with symptoms lasting for several days to a week.
  • People usually don’t get sick enough to go to the hospital, and they very rarely die of Zika.
  • Zika virus usually remains in the blood of an infected person for about a week but it can be found longer in some people.

What are the next steps?

If mosquitoes in the United States do become carriers, a model created by Toronto researchers found more than 63% of the U.S. population lives in areas where Zika virus might spread during seasonally warm months. A little more than 7% of Americans live in areas where the cold might not kill off the mosquito in the winter, leaving them vulnerable year-round.

If you have traveled to Central or South America and begin exhibiting symptoms of Zika, go to the doctor. Be sure to tell him or her if you have traveled to a location where Zike is known to be found. Special bloodwork may be required to determine if you have the virus.

The Centers for Disease Control and Prevention is warning pregnant women against travel to those areas; health officials in several of those countries are telling women to avoid pregnancy — in some cases for up to two years.

The U.S. Defense Department is offering voluntary relocation to pregnant employees and their beneficiaries who are stationed in affected areas.

Researchers are hard at work in laboratories around the world trying to create a Zika vaccine. Hopefully, a clinical trial for a Zika virus vaccine could begin this year, but it may be a few years before we have a vaccine.

Health officials are implementing traditional mosquito control techniques such as spraying pesticides and emptying standing water receptacles where mosquitoes breed. The CDC encourages homeowners, hotel owners and visitors to countries with Zika outbreaks also to eliminate any standing water they see, such as in outdoor buckets and flowerpots.

How do you treat Zika?

  • There is no vaccine to prevent or specific medicine to treat Zika infections.
  • Get plenty of rest.
  • Drink fluids to prevent dehydration.
  • Take medicine such as acetaminophen (Tylenol®) to relieve fever and pain.
  • Do not take aspirin and other non-steroidal anti-inflammatory drugs.
  • If you are taking medicine for another medical condition, talk to your healthcare provider before taking additional medication.
  • If you have Zika, prevent mosquito bites for the first week of your illness.
    • During the first week of infection, Zika virus can be found in the blood and passed from an infected person to a mosquito through mosquito bites.
    • An infected mosquito can then spread the virus to other people.

 

Sources: CDC and CNN