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Monday, April 20, 2015
  • The joy of spring sports and yard work has resulted in a number of patients coming to see me complaining of sore shoulders and elbows. Many of these folks have been suffering from bursitis. Most people have heard of bursitis, but what is it really?

    Any time a medical term ends in "-itis," it indicates inflammation of the tissue or organ involved. In this case, bursitis is an inflammation of a bursa (pleural bursae or bursas). Bursa is Latin for purse, a very good descriptor of what it looks like - a small sac made of connective tissue.

    A bursa is lined with a synovial membrane that secretes fluid into the inside of the bursa. This turns the bursa in to a little pillow filled with a slippery liquid that helps cushion structures around it. It also allows these structures to glide more easily over each other. Here's a fun activity for the kids; make your own bursa by partially filling a small balloon with water. Then put an object like a book on top of it and roll it around on the table to get an idea of how bursae work.

     
  • The spring sports season, gardening and other outdoor chores are upon us. Weekend warriors will soon be doing all sorts of things to keep doctors who treat musculoskeletal injuries busy. I want to give everyone some pointers in treating those inevitable injuries.

    It's interesting to me how many people come to my office after suffering an injury and don't have any idea how to properly care for themselves. It's extremely important to treat injuries immediately to prevent additional damage and disability.

    When a musculoskeletal structure is injured, it starts a biochemical chain reaction to heal the injury. Injured cells release various messengers that start the healing process, but part of the process also results in pain and swelling. The intent of this inflammation is to get the injured person to immobilize the area so it can heal. However, for an athlete or anyone trying to get back to play or work as soon as possible, this can prolong the time it takes to get back to normal function.

    The goal of orthopedic and sports medicine is to promote healing of an injury, but 
  • It's once again time to run my annual column on allergies. Many of our readers will soon be cursing the annual return of allergy symptoms. The pollen levels in Indiana will be ramping up as spring (hopefully) approaches.

    Allergies are a major problem for many people. When allergy sufferers are asked about their quality of life, they generally rate allergies as more bothersome than heart disease and sometimes even cancer. There are many causes of allergies, but I want to focus on the seasonal type.

    Seasonal allergies are caused by pollen. Pollen actually contains the plant's male genetic material; it is somewhat analogous to sperm in animals. The goal of any organism is to spread its DNA as far and wide as possible. Pollen is the perfect vehicle to accomplish this task.

     
  • It won't be long before we'll be through flu season and will start seeing cases of Fifth Disease. The person or persons responsible for naming this illness didn't have much imagination. Rubella, measles, scarlet fever and roseola were already taken. Since it was the fifth illness described that also caused a skin rash or "exanthem," that's where it got its name. It's also known as "erythema infectiosum." 
  • Have you heard? Swimmer's ear can be a pain.
    I've seen a fair number of cases of swimmer's ear in the last few weeks. We tend to see more cases of this in hot, humid weather, but it can also be brought on by other conditions.

    The medical term for swimmer's ear is otitis externa, indicating inflammation of the external ear. This is in contrast to the more common otitis media, or inflammation of the middle ear (the part of the ear behind the ear drum).

    The number of people who suffer from swimmer's ear is about four per 1,000 per year, or about three to five percent of the population. It afflicts males and females in equal numbers and tends to present between seven and twelve years of age.

    A layer of wax or "cerumen" protects the external ear canal. There exists a delicate balance of too much or too little cerumen. If there is not enough present, the ear canal can dry out, crack and develop infection. If there is too much, the ear canal can become too moist. This leads to swelling and breakdown of the skin lining the canal.

     
  • Urinary tract infections (UTIs) account for about eight million visits to physicians each year in the United States. These infections are much more common in adults, particularly in women. Children account for 1 to 2 percent of all UTIs, but their infections are often more serious. About 40 percent of women and 12 percent of men have a UTI at some time in their lives.

    The urinary system or "tract" is composed of the kidneys, ureters, bladder and urethra. The kidneys filter waste products from the blood and produce urine that passes down the ureters to the bladder, where it is stored, before passing out the urethra. An infection can involve one or more parts of the urinary system. 
  • Snoring can certainly be annoying, but can be normal. I want to focus this week on a harmful condition that can be associated with snoring - sleep apnea.

    Sleep apnea is a condition where people have pauses in their breathing while sleeping. Most people have pauses to some degree, but people with sleep apnea have much longer pauses, sometimes up to 30 seconds. These long pauses cause the level of oxygen in the blood to drop and carbon dioxide to rise. This change in oxygen and carbon dioxide can be very hard on the body, especially the heart and lungs.

    There are two main types of sleep apnea - central and obstructive. Central sleep apnea is a problem with the brainstem that sends signals to the breathing muscles. It is not a very common cause of sleep apnea in adults; obstructive sleep apnea (OSA) is seen much more often.

     
  • One of our readers has asked that I write about fibromyalgia. This is a chronic neurosensory disorder that can cause debility and severely interfere with a person's ability to function.

    It usually presents in young or middle-aged women, affecting about nine times as many women as men. It is a frustrating condition for patients as well as physicians as it is poorly understood and current treatments are often minimally effective. 
  • I'm running through my list of suggested topics from readers, and this one goes out to a reader from Sheridan. It's a common problem, but one of those topics that doesn't usually come up in casual conversation.

    There are three common times in a person's life when constipation can become a problem. The first is during early childhood, the second when a person has decreased activity for some reason, and the last is during the elder years. Each type has different causes.

    First, I have to deliver yet another lesson in basic anatomy and physiology. When we eat, food travels through the following structures: mouth, esophagus, stomach, small intestine and finally, the large intestine. This journey is facilitated by peristalsis, a process where involuntary muscles in the wall of the digestive tract contract to move food from north to south. 
  • I continue to be amazed at the answers I get from ladies when I ask them to name the No. 1 killer of women. The overwhelming majority respond, "breast cancer." While breast cancer is the number one cancer killer of women, and is estimated to have claimed about 39,500 women last year, it is not the biggest threat women face. It's estimated that ten times that many women - 400,000 died of heart disease in the same year.

    Cardiovascular disease is arguably the most important women's health issue and is largely preventable. How can women be so unaware that they have a one in 31 chance of dying from breast cancer but a one in three chance of dying from heart disease? Could it be that breast cancer gets so much more coverage in the popular media? Is cancer generally more frightening? Is heart disease just plain boring to talk about?

     

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a division of Sagamore News Media

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