“POPPING THE QUESTION” – What to do to feel your best?

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feel your best

At this point our medical Q&A’s are coming to an end. Hopefully, they will help you to know a smidgen of what you should know, like what to do to feel your best. It’s important to know how to take care of yourself and understand how your body ticks. (And keeps ticking.)

WHAT IS NEUROPATHY?

“Pain something or other?”

BOY, THAT HURTS

How about a lot of pain for a lot of people for a lot of different reasons?

Neuropathy is a term that refers to general diseases or malfunctions of the nerves. Nerves at any location in the body can be damaged from injury, disease, infections and even vitamin deficiencies.

Neuropathy is the term used to describe a problem with the nerves, usually the “peripheral nerves” as opposed to the ‘central nervous system’ (the brain and spinal cord).

Peripheral neuropathy is common.

It is estimated that upwards of 20 million Americans suffer from this illness.

It can occur at any age, but is more common among older adults.

A 1999 survey found that 8-9% of Medicare recipients have peripheral neuropathy as their primary or secondary diagnosis. The annual cost to Medicare exceeds $3.5 billion.

OUCH!

The symptoms of neuropathy cover a wide range, from disturbing to debilitating. Here are some examples:

Sensory Neuropathy

  • Tingling and numbness
  • Pins and needles and hypersensitivity
  • Increased pain or the loss of ability to feel pain
  • Loss of ability to detect changes in heat and cold
  • Loss of co-ordination and proprioception
  • Burning, stabbing, lancing, boring or shooting pains – which may be worse at night
  • Skin, hair or nail changes
  • Foot and leg ulcers, infection and gangrene

Motor Neuropathy

  • Muscle weakness – causing unsteadiness and difficulty performing small movements such as buttoning a shirt
  • Muscle wasting
  • Muscle twitching and cramps
  • Muscle paralysis

Autonomic Neuropathy

  • Dizziness and fainting (because of sudden changes in blood pressure)
  • Racing heart
  • Reduction in sweating
  • Inability to tolerate heat
  • Loss of control over the bladder function leading to incontinence or retention of urine
  • Bloating, constipation or diarrhea
  • Difficulties in achieving or maintaining an erection

Neuropathy can also exist without the cause being possible to diagnose, which doctors call ‘idiopathic. Approximately 30% of neuropathies are ‘idiopathic’, or of an unknown cause.

COULD THIS BE ME?

Nearly 40 drugs and illnesses are known to cause neuropathy.

  • Diabetes – the commonest cause of chronic peripheral neuropathy. High blood sugar levels in people with poorly controlled diabetes damage nerves
  • B12 or folate vitamin deficiencies can cause nerve damage and peripheral neuropathy
  • Drugs – such as some chemotherapy medication and medicines used to treat HIV can cause damage to peripheral nerves
  • Poisons (toxins) – insecticides and solvents can cause peripheral nerve damage
  • Cancers – peripheral neuropathy can occur in people with some cancer E.G: lymphoma and multiple myeloloma
  • Alcohol excess – high alcohol levels in the body cause nerve damage
  • Chronic kidney disease – if the kidneys are not functioning normally, an imbalance of salts and chemicals can cause peripheral neuropathy
  • Chronic liver disease
  • Injuries – broken bones and tight plaster casts can put pressure directly on the nerves.
  • Infections – damage can be caused to peripheral nerves by some infections including shingles HIV infection and Lyme disease
  • Guillain-Barré syndrome is the name given to a specific type of peripheral neuropathy triggered by infection
  • Connective tissue diseases –rheumatoid arthritis, Sjögren’s syndrome and systemic lupus erythematosus.
  • Certain inflammatory conditions – conditions including sarcoidosis and coeliac disease can also cause peripheral neuropathy.
  • Hereditary diseases –Charcot-Marie-Tooth syndrome and Friedreich’s ataxia (So many diseases, so little knowledge they even exist.)

COULDN’T HURT

Fortunately, there are different types of treatments:

Epilepsy drugs like Neurontin, Lyrica and Tegatrol

Antidepressant drugs like Cymbalta, Effexor, Elavil, Norpramin, and Tofrinal

Oxycodone, and other opioid painkillers which in fact, can be actual killers when used to extremes

Lifestyle and dietary changes, drinking plenty of water, and training exercises

Even wearing clothing that causes less irritation

Other complementary therapies like massage, acupuncture and vitamin therapy

 

WHAT IS THE DIFFERENCE BETWEEN CYSTS, GROWTHS, TUMORS AND POLYPS?

“They all scare me.”

WHAT’S IN A NAME

First thought: Fear. Big time. It has to be cancer!  The big “C”.

Well, calm yourself. Yes, of course, you’d be concerned about being diagnosed with any of the above, but let’s walk through the realities.

The first thing to know is that they are all different entities:

CYSTS: Any abnormal fluid filled, bubble-like structure. Can be benign or malignant. More likely to be malignant (cancer) if not a simple bubble but has multiple internal walls and is “complex.”  A cyst, which is infected, is called an “abscess”

POLYPS: A usually nonmalignant growth or tumor protruding from the mucous lining of an organ such as the nose, ears, mouth, lungs, heart, stomach, intestines, urinary bladder, uterus, and cervix

GROWTHS: Any abnormal tissue that can increase or is increasing in size.  May be benign or malignant

TUMORS: Any mass or solid growth of cells.  May be malignant or benign.  Not leukemia, which is liquid. Benign tumors grow slowly and stay in one place. Skin moles and warts are examples

ENGLISH PLEASE

Words like “abnormal”, “benign”, “malignant” wreak havoc on anyone’s psyche. Sometimes you’re the one who notices something questionable on your body. Sometimes you’re totally unaware until your doctor sees something that comes up in a simple examination or tests. Oh brother…those doctors. They speak medical book bugaboo that sends your heart and head into a spin. “Huh?”
“Am I going to die? Be honest with me….”

To which he or she puts on their best iceberg clinical smile in an effort to reassure you. Which never helps. Fact is, doctors do a profoundly inadequate job in communicating. And most still have a lot of work to do with their skills. 

WAIT, THERE’S MORE

Take a deep breath here. Sometimes all it requires is a bandage to help it heal quickly. As if the four terms above aren’t enough to make you break out in a sweat, here are two more bumps in the medical road.

Lesion. Oh yeah, lesion. You’ve heard of it. But where does it fit into the fitful picture?

A lesion is a very general term meaning anything abnormal. A lesion can be used to describe a cut, an injury, warts, ulcers, or yes, a tumor. All tumors can be classified as lesions, but not all lesions are necessarily tumors. There can be various kinds of lesions in almost any part imaginable in the body

Here’s another one: nodules. Nodules are solid, elevated areas of tissue or fluid inside or under the skin with a diameter greater than 0.5 centimeters. Nodules may form on tendons and muscles in response to injury. The vocal cords may also develop nodules. Nodules are normally benign and often painless, although they can affect the functioning of the organ. Think Adele, Keith Urban, Sam Smith, Meghan Trainor, Steven Tyler and John Mayer to name a few. When nodules are on the vocal cords, you see a lot of singers canceling concerts. Touring takes a terrible toll on the vocal cords. But a little rest and they’re back. Good as new.

PASS ON PANIC

If you notice something, it could easily be nothing.

If your doctor notices something, it could also be nothing.

If there’s a question, there are tests.

Usually the results will be negative.

“Whew”.

When the results are inconclusive, there are further tests that can be done.

If it’s something malignant, it’s not a death sentence. There are more treatments with greater successes that ever before.

Don’t come to your own conclusions.

Remember, you’re not the doctor.

WHAT IS LUPUS?

“It’s…uh…something that occurs in the body, right?”

 

NO ONE’S IMMUNE

Lupus is a chronic, autoimmune disease that can damage any part of the body (skin, joints, and/or organs inside the body). Chronic means that the signs and symptoms tend to last longer than six weeks and often for many years.

In lupus, something goes wrong with your immune system, which is the part of the body that fights off viruses, bacteria, and germs (“foreign invaders,” like the flu). Normally our immune system produces proteins called antibodies that protect the body from these invaders. Autoimmune means your immune system cannot tell the difference between these foreign invaders and your body’s healthy tissues (“auto” means “self”) and creates autoantibodies that attack and destroy healthy tissue. These autoantibodies cause inflammation, pain, and damage in various parts of the body.

Lupus is also a disease of flares (the symptoms worsen and you feel ill) and remissions (the symptoms improve and you feel better).

Our research estimates that at least 1.5 million Americans have lupus. The actual number may be higher; however, there have been no large-scale studies to show the actual number of people in the U.S. living with lupus.

  • More than 16,000 new cases of lupus are reported annually across the country.
  • It is believed that 5 million people throughout the world have a form of lupus.
  • Lupus strikes mostly women of childbearing age (15-44). However, men, children, and teenagers develop lupus, too. Most people with lupus develop the disease between the ages of 15-44.
  • Women of color are two to three times more likely to develop lupus than Caucasians.
  • People of all races and ethnic groups can develop lupus.

SYMPTOMS UP THE WAZOO

Symptoms of lupus vary, but some of the most common symptoms of lupus are:

  • Skin involvement occurs in up to 80% of patients.
  • Many patients experience the malar, or butterfly, red rash across the cheeks and nose during flares.
  • Two-thirds of people have photosensitivity
  • Many lupus patients suffer from anemia, or low blood count, as well
  • The most common symptom of lupus is extreme fatigue.
  • 70% of patients also report painful and swollen joints.
  • Many times lupus also triggers other autoimmune conditions such as Raynaud’s Phenomenon where fingertips and/or toes become pale or purple from the cold or stress
  • Lupus often times causes a “lupus fog” making it hard to think, focus and remember things.
  • Lupus patients are susceptible to depression and other mental conditions.
  • Lupus also tends to “bring along” other autoimmune diseases. While it has not been determined that lupus causes the other autoimmune conditions to develop, many lupus patients seem predisposed to multiple conditions such as: Fibromyalgia, Rheumatoid Arthritis, Antiphospholipid syndrome, Crohn’s Disease, Multiple Sclerosis and Sjögren’s syndrome
  • Symptoms may come and go. The times when a person is having symptoms are called flares, which can range from mild to severe. New symptoms may appear at any time.
  • No single factor is known to cause lupus. Research suggests that a combination of genetic, hormonal, environmental, and immune system factors may be behind it. Environmental factors, ranging from viral and bacterial infections to severe emotional stress or overexposure to sunlight, may play a role in provoking or triggering the disease. Certain drugs, such as the blood pressure drug hydralazine and the heart rhythm drug procainamide, may cause lupus-like symptoms. High estrogen levels resulting from pregnancy may aggravate lupus.

Symptoms are frequently confused with other conditions including arthritis, skin conditions and blood disease. Just talking about it is enough to cause a case of hyperventilation in anyone.

CLEARLY CLUELESS

Lupus is not contagious, not even through sexual contact. You cannot “catch” lupus from someone or “give” lupus to someone.

Lupus is not like or related to cancer. Cancer is a condition of malignant, abnormal tissues that grow rapidly and spread into surrounding tissues. Lupus is an autoimmune disease, as described above. However, some treatments for lupus may include immunosuppressant drugs that are also used in chemotherapy.

Lupus is not like or related to HIV (Human Immune Deficiency Virus) or AIDS (Acquired Immune Deficiency Syndrome). In HIV or AIDS, the immune system is underactive; in lupus, the immune system is overactive.

FORGET THE SILENT TREATMENT

Treatment of lupus can be broken down into self-care and managed-care. Self-care is about protecting your overall general health and well-being to help control your flares. Managed care involves partnering with your healthcare team to develop the right treatment plans and medications and following up with them periodically.

Lupus Self-Care & Treatment

  • Reduce Stress: Stress is a known trigger for lupus flares. Keeping yourself relaxed and eliminating unnecessary stress can help control flares
  • Maintain a Healthy Diet and Lifestyle
  • Exercise Regularly: It doesn’t need to be a 5 mile run every day. Something as simple as going for a walk can help tremendously
  • Rest: Fatigue is a huge factor with lupus patients. Some need 12 hours of sleep a night or taking periodical naps throughout the day
  • Avoid Ultraviolet and fluorescent light: UVA/UVB and fluorescents easily trigger flares
  • Use Sunscreen: Even when the sun’s rays are not at their peak, lupus patients can still feel the effects
  • Monitor other conditions such as blood pressure and cholesterol and diabetes

Managed Care Treatments

Managing Lupus can often require a team of doctors from a Primary Care Physician (PCP) to a Rheumatologist, who specializes in lupus management. It’s important that all your doctors work together and work with you to develop the right treatment plan.

Treatment may include drugs like nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin, ibuprofen and Aleve

In some cases, Prednisone can help. Even antimalarial drugs.

All of which can have serious side effects.

When none of these treatments work, chemotherapy is indicated.

THE CELEBRITY OF LUPUS

As we’ve said, anyone can get lupus. Anyone. Like Toni Braxton, Nick Cannon, Seal, Rapper Snoop Dogg’s daughter, and America’s much-missed legend Michael Jackson. Lady Gaga is also reporting that she was tested “borderline” positive for lupus.

Then there’s Selena Gomez. Selena Gomez is the queen of Instagram. The pop star is Instagram’s most followed person, with a whopping 89.2 million followers and counting (for some perspective: President Barack Obama only has 8 million Insta followers). But Selena has a secret she kept for 3 years. She suffers from lupus. When she took time off, the tabloids speculated she was in rehab for some sort of addiction.  But in reality, she was undergoing chemotherapy in a bid to fight the symptoms of the disease which has no cure. But she came back with the release of her second album Revival which ended up on several year-end lists of best albums. The record debuted at number one on the U.S. Billboard 200. But sadly, Selena Gomez, 24, has officially begun canceling dates on her Revival World Tour following her tragic announcement that her lupus has been affecting her ability to perform again. She even posted a message on Instagram, tearfully questioning what she will be doing with her life overall.

Just another example of the serious nature of the illness.

 

WHAT IS PSORIATIC ARTHRITIS?

“There are different kinds of arthritis? You’re kidding me.”

A RASH DECISION

Psoriatic arthritis is a form of arthritis that affects some people who have psoriasis — a condition that features red patches of skin topped with silvery scales. Most people develop psoriasis first and are later diagnosed with psoriatic arthritis, but the joint problems can sometimes begin before skin lesions appear. it seems to run in families. One in 20 Americans who have psoriasis, usually between the ages of 30 and 50, also get psoriatic arthritis. As many as 40% of people with psoriatic arthritis have a family member with skin or joint problems.

JUST SWELL…

Joint pain, stiffness and swelling are the main symptoms of psoriatic arthritis. They can affect any part of your body, including your fingertips and spine, and can range from relatively mild to severe. In both psoriasis and psoriatic arthritis, disease flares may alternate with periods of remission.

Both psoriatic arthritis and psoriasis are chronic diseases that get worse over time, but you may have periods when your symptoms improve or go into remission alternating with times when symptoms become worse.

Psoriatic arthritis can affect joints on just one side or on both sides of your body. The signs and symptoms of psoriatic arthritis often resemble those of rheumatoid arthritis. Both diseases cause joints to become painful, swollen and warm to the touch.

However, psoriatic arthritis is more likely to also cause:

  • Swollen fingers and toes. Psoriatic arthritis can cause a painful, sausage-like swelling of your fingers and toes. You may also develop swelling and deformities in your hands and feet before having significant joint symptoms
  • Foot pain. Psoriatic arthritis can also cause pain at the points where tendons and ligaments attach to your bones — especially at the back of your heel (Achilles tendinitis) or in the sole of your foot (plantar fasciitis)
  • Lower back pain. Some people develop a condition called spondylitis as a result of psoriatic arthritis. Spondylitis mainly causes inflammation of the joints between the vertebrae of your spine and in the joints between your spine and pelvis

WORK IT

You treat psoriatic arthritis by controlling the inflammation. The way you do that depends on how severe it is and what works for you. You’ll probably need to take a medication, which could include a:

  • Nonsteroidal anti-inflammatory drug (NSAID)
  • Disease-modifying antirheumatic drug (DMARD)
  • Biologic drug
  • Enzyme inhibitor

Exercise is also important for you. It helps protect your joints by making the muscles around them stronger. Gentle, low-impact movement can lessen pain and expand your range of motion. Physical activity may help you relax, ease your stress, and sleep better, too.

Other ways to help manage psoriatic arthritis and protect your joints are:

  • Heat and cold therapy
  • Hands-on therapies, like massage, acupuncture, and acupressure
  • Splints
  • Assistive devices

There’s no cure for the condition, but newer medications can control it so well that it goes into remission, which means you have no symptoms. Which could help cure your fear.

FORE!

In 2010 Pro golfer Phil Mickelson announced that he was being treated for psoriatic arthritis. According to media reports, he first developed symptoms right before the U.S. Open, and the pain quickly became so intense that he couldn’t walk. Chalking the pain up to years of practicing for and playing pro golf, he figured it would pass. But when lab tests came back, he was diagnosed with the disease. Currently you probably see him on television talking about getting help with the hope of helping others with the illness.

WHAT IS THE BEST THING YOU CAN DO TO FEEL YOUR BEST?

“Tell me right now.”

THE ANSWER TO THIS ONE IS SIMPLE. IF YOU’RE FEELING LIKE SOMETHING IS GOING ON IN YOUR BODY THAT YOU HAVE NO ANSWER FOR, DR. STEPHEN A. GOLDSTEIN, M.D, F.A.C.S. AT DENVER HORMONE HEALTH, IS THE DOCTOR TO SEE. BECAUSE HORMONE IMBALANCE JUST MIGHT BE WHAT’S BOTHERING YOU. ONCE YOU’RE THERE, YOU’VE GOT HIS FULL ATTENTION. FEW HAVE THE KNOWLEDGE AND EXPERIENCE IN THE FIELD OF HORMONE REPLACEMENT THERAPY AS HE DOES. DETAILED EVALUATION OF YOUR SYMPTOMS AND SIMPLE TESTS WILL LET HIM ASSESS ANY ISSUES WITH YOUR HORMONE LEVELS THAT ARE LEAVING YOU FEELING LESS THAN YOUR BEST. AT THAT POINT HE WILL CREATE AN INDIVIDUALIZED TREATMENT PLAN THAT IS TAILORED JUST FOR YOU. AND YOU ALONE. GETTING YOUR HORMONES IN BALANCE IS THE BEST THING YOU CAN DO FOR YOURSELF.

AND SEEING DE. GOLDSTEIN IS THE BEST WAY TO DO THAT.

SO CALL FOR AN APPOINTMENT NOW.