Learning the Signs That Lead to COPD

DEAR DR. ROACH: What signs and/or symptoms do you need for a doctor to determine whether you have chronic obstructive pulmonary disease (COPD)? -- R.K.

ANSWER: The diagnosis of COPD is suspected in people who are at risk for the disease and note one of two cardinal symptoms: cough or dyspnea. (A “symptom” is what a patient identifies by history, while a “sign” is noted on a physical exam. A cough can be both a symptom and a sign.) Dyspnea is usually described as shortness of breath, a sensation that a person can’t get enough air, like they have just run very fast. Some people with COPD may have very subtle symptoms.

Smoking is the biggest risk factor for COPD, but there are other causes, including other chemical exposures (industrial exposures and home cooking fires are less common now, but are historically important causes of COPD); scarring lung disease; and a genetic cause, a condition called alpha-1 antitrypsin deficiency.

The diagnosis is confirmed most often by tests of lung function, which are breathing tests to look at the physiology of the lung and its ability to exchange oxygen and carbon dioxide. Sometimes the diagnosis can be supported by an X-ray or CT scan, but pulmonary function testing is the best way to determine the severity of COPD.

We do have ways of slowing down lung decline in COPD, one way being smoking cessation for current smokers, but some of the medications we use also help reduce ongoing damage.

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DEAR DR. ROACH: Please help! Is it true that Trulicity may cause serious side effects, including thyroid tumors and cancer, as well as pancreatitis? -- J.R.

ANSWER: Dulaglutide (Trulicity), like semaglutide (Ozembic) and liraglutide (Victoza), are in a class of drugs called GLP-1 receptor agonists, which have several actions, such as increasing insulin release by the pancreas in response to meals. Initial studies on laboratory rats did show an increase in an unusual type of thyroid cancer, but studies have not yet shown an increased rate in humans. Still, people at an increased risk for this type of thyroid cancer (having a family history of medullary thyroid cancer or of multiple endocrine neoplasia, type 2A or 2B) are not recommended to take this medication. Similarly, there are reports of pancreatitis in people taking this medication, but it isn’t clear whether the medicine is responsible for the pancreatitis. It’s unwise to use this class of medication in people with a history of pancreatitis.

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Dr. Roach regrets that he is unable to answer individual questions, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu.

© 2023 North America Synd., Inc. All Rights Reserved

Summer health and beauty guidelines

Try tinted moisturizer. A carefree, breezy look often means not being weighed down by a lot of makeup. It may be possible to skip foundation and rely only on concealer to cover up small blemishes or alleviate dark circles under the eyes. Another option to try is tinted moisturizer, which can keep skin supple and offer a light amount of color to even out pigment. BB creams also can provide you with an all-in-one beauty product, as such creams frequently contain sunscreen, color tinting and anti-aging ingredients.

Do you have HEEL pain or ARCH pain?

HEEL SPUR SYNDROME/PLANTAR FASCIITIS is a common problem among people who are active. It starts as a dull intermittent pain in the heel and progresses to a sharp persistent pain. Classically, it is worse in the morning with the rst few steps, after sitting, after standing or after walking.

• Plantar fasciitis often begins with irritation and tearing of the brous band of tissue on the bottom of the foot, which may eventually result in the formation of a heel spur.

• Contributing factors: Flat pronated feet, high arched feet, poor shoe support, increased age, sudden weight increase, increased activity level, family tendency.

• 95% of our patients’ symptoms are resolved with conservative treatment, avoiding surgical intervention.

• We also o er surgical procedures with the best post op success rates using Endoscopic Plantar Fasciotomy techniques (minimal incisions and scarring; often back in a shoe in 1 week).

Advanced Podiatry Associates

Joseph Canzoneri, DPM

Benjamin Heddy, DPM

2 State Street, Batavia • 585-343-8150

Mon., urs., Fri. 8am-5pm; Tues. 11am-8pm. In-o ce Fluoroscan • Handicapped Accessible.

WHAT CAUSES DEPRESSION?

Althoughthecauseofdepressionremainsamystery,certaindistinguishing factors are common among those who have the condition. People with clinical depression appear to have physical changes in their brains. In addition, naturally occurring brain chemicals known as neurotransmitters likely play a role in depression. The Mayo Clinic states changes in the function and effect of these neurotransmitters and how they interact with neurocircuits involved in maintaining mood stability may play a significant role in depression and its treatment.

In addition to biological factors in the brain, hormones can impact rates of depression or even trigger it. These hormone shifts may be a leading reason why women have higher incidence rates of depression than men. Depression is more common in people whose blood relatives also have the condition. Therefore, those with a family history of depression may be more likely to get it than those without such a connection.

Nervous about getting a root canal?

You’re not alone. Many people avoid treatmentforapainfultoothoutof fear, but getting a root canal now may save your tooth from extraction later. The most common myth about root canals is that they are painful. Although this used to be the case, modern dentists are experts in pain management, and a modern root canal should not feel much different from having a cavity filled. A painful tooth is usually worse than the root canal itself. If you’ve heardthathavingarootcanalcanmake you more prone to future illnesses,this is also untrue. There is no scientific evidencelinkingrootcanalstodiseases elsewhere in the body.

We believe in staying on the leadingedge of dentistry,which is why we keep up-to-date on advanced techniques in root canals and other dental procedures, state-of-the-art materials, and the latest health studies and therapies to ensure all our patients receive the very best in dental health care. If you are looking for a family dentist who understands the needs of everyone in your family as individuals and patients,we welcome you to stop by BATAVIA FAMILY DENTAL, 6 Batavia City Centre, and get acquainted. We’re sure you’ll leave with a good feeling about our practice. For an appointment, please call 585.343.4246 www.bataviafamilydental.com

P.S. If you think it’s better to have a tooth extracted than it is to undergo a root canal, think again. Replacing a tooth can lead to more treatment timeandadditional treatments for neighboringteeth.