Friday, April 29, 2016

Medical FACT OR FICTION

Today's Health Tip will explore the validity of several medical issues that are commonly bandied about.  After reading each statement, decide whether it is true or false and then read on to learn more about the topic.

1. "Reading, sewing or doing other close work in dim light can damage your eyes."
In a survey on the topic, 71% of those polled had the misconception that eye damage would occur from reading under dim light.  Additionally, 66% erroneously thought that sitting too close to a television set would cause eye damage.  Reading in dim light can cause eye fatigue, but it will not cause eye damage.  When you think about it, for hundreds of years, people have been reading and working under dim light, such as oil or kerosene lamps.  While it is certainly preferable to perform these tasks with good lighting, aside from the fatigue that it creates, it does not do permanent damage.

2.  "Eating grilled meat can cause cancer."
Eating meat grilled well done or burned has been linked to several types of cancer, including colon and pancreatic.  The longer meat cooks at high temperatures, the greater the buildup of cancer-causing compounds called heterocyclic amines (HCAs)  This increased  risk of cancer is n
ot confined to grilled foods but is associated with pan-fried meats at high temperatures also.  Grilled vegetables, even well-done, do not appear to pose the same risk as overcooked meat.  You may be able to reduce your risk by precooking meats in the oven or microwave, and then finishing them on the grill for just a few minutes.

3.  "Eating chocolate will give you acne" 
This one has been debated back and forth for years.  Previously it was believed that acne development was related to factors such as hormones, heredity, and stress. Food, including chocolate, was not thought to cause it.  More recent research has found that people eating a diet with a low glycemic load (less sugar, higher fiber, etc.) were found to have healthier skin than those whose diet contained higher amounts of sugar.  This has led organizations, such as the American Academy of Dermatology, to recommend avoiding food with a high glycemic index (white bread, pasta, white rice, etc.) if acne is a concern.

4.  "Cracking your knuckles will give you arthritis."
There is no evidence that cracking knuckles causes damage, such as arthritis, to finger joints.  There is one report in the medical literature, however, of long-standing knuckle cracking resulting in injury to ligaments that support the finger joints. Additionally, people who habitually crack their knuckles have been found to have reduced grip strength as compared to people who did not crack their knuckles.
 
5.  "Undergoing anesthesia will cause your hair to fall out" 
The great majority of people undergoing general anesthesia notice no effect on hair growth or loss. There are two situations, however, in which receiving anesthesia may cause hair loss. The first is known as "pressure alopecia"--- hair loss in a specific area due to scalp pressure from the head lying in one position during prolonged anesthesia or postoperative recovery. The second is a condition known as "telogen effluvium".  This results in a more diffuse thinning of the hair on the scalp and is primarily seen following stressful events such as undergoing surgery, receiving general anesthesia or experiencing an illness with high fever.
That's all for this edition of Medical Fact and Fiction.  I hope that you found this entertaining as well as educational.  Stay tuned for the next episode.

Article Sources:
Safeguarding your sight, Harvard Health Publications
Chemicals in Meat Cooked at High Temperatures and Cancer Risk, National Cancer Institute
Acne, American Academy of Dermatology
Will Joint Cracking Cause Osteoarthritis?, WebMD
Hidden Causes of Hair Loss, WebMD

Content last reviewed by our Medical Director on 4-27-2016

Friday, April 22, 2016

Heartburn or Heart Attack?

Around six million people go to the emergency department each year with chest pain.  In many cases, the determination has to be made as to whether the chest pain is due to a relatively minor condition or to a life-threatening process.  Often this means making the distinction between heartburn (a gastrointestinal condition) and angina or heart attack (heart-related conditions), since these can all present with similar symptoms.

Heartburn, also called acid indigestion, is experienced by as many as 60 million Americans at least once a month. Heartburn is the most common symptom of gastroesophageal reflux (GERD), a disorder in which stomach acid "backs up" into the esophagus, the tube-like structure that connects the mouth to the stomach. Symptoms result when harsh stomach juices come in contact with delicate lining of the esophagus.  The most common features of heartburn are:
  • A painful, burning sensation just below the breastbone or ribs
     
  • Pain that develops after eating or upon reclining
     
  • Improvement in symptoms when taking antacids or "acid blockers"
     
  • A sour or bitter taste in the mouth and belching  
Angina is a symptom of coronary heart disease that occurs when the heart muscle is not being supplied with enough oxygen-carrying blood. It is usually described as a pressure or squeezing discomfort in the chest. This discomfort can also be felt in the arms (usually left), neck, or jaw.   A heart attack (myocardial infarction) occurs when blood flow to the heart is interrupted due to complete blockage of a coronary artery. This results in death of heart muscle. The pain caused during a heart attack or from a severe heartburn episode is sometimes so similar that sophisticated equipment may be required to tell them apart. The following are symptoms typical for heart attack:
  • Chest discomfort in the center of the chest that lasts for more than a few minutes, or goes away and comes back. The discomfort can feel like uncomfortable pressure, squeezing, fullness, or pain.
     
  • Discomfort in other areas of the upper body including one or both arms, the back, neck, jaw, or stomach.
     
  • Shortness of breath, often occurring along with chest discomfort.
     
  • Other symptoms may include breaking out in a cold sweat, nausea, or light-headedness.
 As with men, women's most common heart attack symptom is chest pain or discomfort. But instead of the classic chest discomfort women are somewhat more likely than men to experience certain "atypical" symptoms, particularly shortness of breath, nausea/vomiting, and back or jaw pain. An important distinguishing feature of coronary heart disease is that the discomfort often occurs with exertion or activity.  To confound things, however, heart attack as well as heartburn may occur after eating.  With severe chest pain, atypical symptoms suggestive of heart disease, or if chest pain is a new occurrence, it is best to leave the determination of the cause to the physician.

While a heart attack is a medical emergency, recurrent heartburn, particularly if associated with GERD is not entirely benign either. If left untreated, GERD can cause or contribute to a wide range of problems such as inflammation and ulcers of the esophagus (esophagitis). Some patients with esophagitis develop strictures (narrowing of the esophagus due to scar tissue) which can lead to problems swallowing food or pills. GERD can also contribute to asthma, pneumonia, hoarseness, chronic cough, abnormal functioning of larynx and dental problems. Medical attention should be sought if heartburn is associated with any of the following:
  • Persistent heartburn after taking the full course of prescription or OTC medications (e.g. Prilosec, Tagamet, others)
     
  • Severe hoarseness or wheezing
     
  • Painful swallowing, especially with solid foods or pills
     
  • Frequent nausea, vomiting or unanticipated weight loss
     
  • Heartburn occurring several times a week or for more than a year
If you have warning signs of a heart attack, do not try to decide for yourself what the problem is—seek immediate medical attention.  A heart attack is an emergency. Call 9-1-1 if you think you (or someone else) may be having a heart attack. Prompt treatment of a heart attack can help prevent or limit lasting damage to the heart and can prevent sudden death. Remember that although both conditions make reference to the "heart", one is primarily a painful nuisance whereas the other represents a true medical emergency.

Article sources:
"Gastroesophageal Reflux Disease (GERD) in Adults" from The National Institute of Diabetes and Digestive and Kidney Diseases
"Heart Attack" from Family Doctror.org
What are the Symptoms of a Heart Attack" from the National Heart, Lung, and Blood Institute

Reviewed on April 20, 2016 by our Medical Director

Friday, April 15, 2016

Dental X-rays, When and Why

X-rays done during dental visits have seemingly become a routine part of the examination. But did you know that the American Dental Association (ADA) in conjunction with the U.S. Food and Drug Administration (FDA) has developed guidelines for when and why they should be performed?
   
Why perform x-rays of teeth?   Dental x-rays can provide valuable information to help guide the dentist in providing the best care possible. Some of the advantages to the dentist as well as to patients include:
  • Being able to detect areas of decay that are not visible on oral examination
     
  • Identifying decay occurring beneath a filling
     
  • Finding bone loss due to gum disease
     
  • Revealing an abscess at the root of the tooth
     
  • Allowing certain dental problems to be addressed at an early stage
Types of dental x-rays.  The three most common types of dental x-rays are the bitewing, periapical and panoramic.  Of these, the bitewing is the one most often performed.  The bitewing is performed by having the patient bite down on a piece of plastic with x-ray film.  These x-rays are designed to primarily view the molars and specifically look for decay between the teeth. A periapical x-ray provides an image of the entire tooth from crown to root.  These are particularly useful when evaluating for a cyst or abscess. Panoramic x-rays provide a view of the upper and lower teeth in a single view.  This type is particularly useful in evaluating children's tooth development or for the emergence of wisdom teeth.

Key recommendations from the ADA/FDA regarding dental x-rays in adults:
  1. For new patients, an "individualized radiographic exam consisting of posterior bitewings with panoramic exam or posterior bitewings and selected periapical images", is considered to be appropriate.
     
  2. In a new patient with evidence of dental disease or a history of extensive dental treatment, a “full mouth intraoral radiographic exam is preferred.”
     
  3. For patients returning for dental evaluation, who have evidence of dental decay or who are at increased risk of developing cavities, a posterior bitewing exam at 6-18 month intervals" is recommended.
     
  4. In return patients with no evidence of dental decay and no increased risk of developing cavities, "posterior bitewing x-rays at 24-36 month intervals" are advised.
Factors related to an increased risk of developing dental disease. Everyone is at risk of developing tooth decay, but a number of factors increase the likelihood of developing dental caries (cavities) including:
  • Poor dental hygiene
     
  • Foods that stick to teeth for a long time such as milk or sweets.
     
  • Inadequate fluoride intake which is typically not present in bottled water.
     
  • Worn fillings or dental devices.
     
  • Dry mouth due to certain medical conditions, radiation to the head or neck, and taking medications that inhibit saliva production.

  • Younger or older individuals who are more prone to developing cavities
It should be noted that these are recommendations only, with the final decision on when and why to perform x-rays left up to the dentist's clinical judgement. These guidelines vary somewhat in children, adolescents or in adults who do not have teeth. The ADA/FDA guidelines also state that the dentist should have dental x-rays performed only after reviewing the patient's health history and completing a clinical examination.

Additionally, measures should be taken to minimize radiation exposure by limiting the number of images produced, using "fast" speed film, and providing patients with radiation-blocking aprons and collars when appropriate.

Sources for article:
The Selection of Patients for Dental Radiographic Examinations from the FDA and ADA
American Dental Association Oral Health Topics---X-rays

Reviewed on April 13, 2016 by our Medical Director