Health & Wellness 2017 by Northern Virginia Daily

October 2017

Health Education What are biologic medicines?

Solving the Puzzle

Myths and misconceptions about autism spectrum disorder

Snore Relief Breathing easier about CPAP treatment

Health & Wellness - October 2017

What are biologic medicines?

resource Everyday Health, when biologics are made, a specific gene is isolated and inserted into the host cellĘźs DNA, where it will become permanent. The cell follows the instructions of the gene and how it was programmed and becomes a specifically functioning cell. This one reprogrammed cell is combined with others that have been made the same way.

relatively recent wave of medications has provided significant advances in treating a wide range of illnesses, particularly those that are linked to auto-immune dysfunction or chronic ailments. Many people may be prescribed a biologic response modifier medicine at some point in their lives, and those who understand when and why such medications are prescribed may find such knowledge calms their nerves and reduces any confusion they might have about their conditions.

medicines has come to market over the last decade or so. These medications are manufactured through biotechnology and are complex proteins, sugars, nucleic acids, or a combination of these substances that are created from living cells. Cells may include yeast, bacteria or a widely used cell called CHO, which originated from hamsters in China. The U.S. Food & Drug Administration says biologics are often at the forefront of biomedical research and are continually evolving.

What are biologic response modifiers?

Why biologics are different

How biologics work

Unlike traditional medicines, which are largely made from chemical components that follow a strict recipe for manufacture, many biologics are complex mixtures that are not easily replicated. According to the

According to WebMD, biologics are designed to inhibit specific components of the immune system that may cause a symptom of a disease. For example, in the treatment of rheumatoid arthritis, the medication

Biologics are derived from animal products. First-generation biologic products included things like vaccines and blood components. However, a newer wave of biologic

The entire process of biologic manufacturing is complex, requiring stateof-the-art knowledge. It also requires entirely new biotechnology facilities and laboratories that employ topnotch scientists. These factors combine to contribute to the generally high price tag of biologic medications.

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would suppress inflammation, which is a central feature of the disease. Biologics target specific parts of the immune system rather than broadly treating the body. Diseases that may be treated by biologics include rheumatoid arthritis, CrohnĘźs disease, ulcerative colitis, psoriasis/psoriatic arthritis, multiple sclerosis, and even certain cancers.

Side effects of biologic medicines Because most biologics are administered intravenously, injection-site irritation can be a common side effect. Biologics also carry a risk of infection. According to the Cochrane Database of Systematic Reviews, because biologics target the immune system, there is a risk for serious infection or disease. Biologic medicines continue to evolve and can be used to treat a variety of medical conditions for which no other treatments are available or effective.

The Northern Virginia Daily

Health & Wellness - October 2017

Minimize dark circles under the eyes

acoon eyes may be a side effect of forgetting to remove mascara and other eye makeup before retiring for bed. In such instances, dark eye circles are easily remedied with cleaning pads. For those whose dark circles canʼt be swept away with soap and water, dark, puffy eyes can be a cause for embarrassment or concern.

Dark circles under the eyes may be a byproduct of various circumstances. Getting to the root of the problem can help women (and men) look more awake and fresh.

Accept genetics Genetics may be the biggest culprit in undereye circles. Some people simply inherit fair or thin skin around the eyes. This can make blood that pools in these areas (from stretched or broken capillaries) more visible. While a person cannot change his or her skin tone, gently washing oneʼs face — paying careful attention to the sensitive eye area — can help reduce damage. Also, getting more sleep can increase circulation to this area and prevent blood pooling.

Treat allergies and sinus issues

of dark circles. To remedy this, try to reduce fluid pooling in the face. Sleep elevated on a few pillows so that fluid flows away from the eyes. Reduce consumption of alcohol and salty foods, which can exacerbate fluid retention. Cool compresses can be used to massage fluid gently away from the eyes as well.

Apply sunscreen Dark circles may result from pigmentation changes that occur after exposure to the sun or some other type of UV light. Individuals who apply sunscreen on their faces, including around their eyes, may be able to reduce or prevent pigment changes.

Rely on concealer Makeup can help counter the look of dark shadows and pigmentation According to Allergy & Asthma Care around the eyes. Use a shade that is opposite the color of the circles to of New York, allergies and other camouflage them. For example, use sinus issues can cause puffiness orange-yellow tones to combat blueand dark eye circles. Histamines, which are released when an allergen purple shading under the eyes. is present, can cause blood vessels Makeup artists also advise applying concealer in the shape of a triangle. to swell and inflame. Getting tested for seasonal allergies can help peo- That way a person is creating a light arrow that draws attention to the ple identify some possible triggers. bright part of her eyes. Alleviating allergy symptoms can Undereye circles and swelling can reduce the appearance of dark cirbe alleviated when people get to the cles in some cases. source of the problem. A combination of treating the sources and Reduce swelling masking the issue can help. In Undereye bags can cause shadows severe cases, individuals should visit to form and increase the appearance their dermatologists.

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Health & Wellness - October 2017

The Northern Virginia Daily

Safeguard your eyes against computer vision syndrome T echnology has simplified life in a myriad of ways. Thanks to their tablets and smartphones, many people now have a wealth of information at their disposal 24 hours a day, seven days week.

Computers, tablets and smartphones can now be seen just about everywhere, so itʼs no wonder that studies have shown that as much as 90 percent of computer users have reported symptoms of computer vision syndrome, or CVS. Sometimes referred to as “digital eye strain,” CVS is, according to the American Optometric Association, an umbrella term used to describe a group of eye and vision-related problems that result from prolonged computer use. Manhattan Vision Associates notes that such problems can arise in people who spend two or more hours daily in front of a screen, a qualifier that means just about anyone, from working professionals to children, is susceptible to CVS.

What are the symptoms of CVS? No two individuals are the same, and some people who spend significant amounts of time may never develop CVS. But those that do may experience the following symptoms. Eyestrain: When people spend ample time staring at screens, the muscles of their inner eyes can strain and tighten and cause eye irritation. This can result in fatigue and pain.

Blurred vision: Blurred vision can compromise a personʼs ability to see small details. That loss of sharpness can make it hard to focus on a screen for a significant amount of time. In addition, vision can blur as people go back and forth between their keyboards and screens or multiple screens, as many people do while simultaneously working on a computer and using their smartphones.

one of the ways the eyes replenish moisture.

Can CVS be prevented?

from the center of the screen. In addition, position the screen so it is between 20 and 28 inches from your eyes.

Avoid glare. Computer screens also should be positioned to avoid glare from lighting and windows. Draw blinds or drapes if sun is shining in on the screen, and opt for low wattage light bulbs in desk lamps. Take frequent breaks. The AOA recommend that Headaches: Many people develop headaches people alleviate digital eye strain by following the after staring at screens for prolonged periods of Blink more. Make a concerted effort to blink time. Thatʼs because the brightness and contrast 20-20-20 rule. This rule advises taking 20 second more throughout the day so your eyes remain as breaks to stare at something 20 feet away every of a screen can produce an indirect glare thatʼs moist as possible. 20 minutes. especially hard on the eyes. The average time people spend staring at Dry eyes: People do not blink as often when star- Reposition your computer screen. The AOA screens continues to rise, making CVS a legitiing at screens as they do when they are not look- notes that the optimal location for computer mate concern for adults and children alike. Learn ing at screens. As a result, people are vulnerable screens is between 15 and 20 degrees below eye more about CVS and how to prevent it at to dry eyes when staring at screens, as blinking is level, or about four to five inches, as measured www.aoa.org. While some people may be inclined to accept CVS as a side effect of living in the 21st century, there are ways to prevent CVS.

The Northern Virginia Daily

Health & Wellness - October 2017

Protect eyes from ultraviolet rays

hanks to increased awareness about the perils of exposure to ultraviolet rays and skin damage, a greater number of people routinely apply sunscreen before spending time outdoors. But while people take steps to prevent sunburns, skin cancer and premature aging, they may fail to consider that UV rays also can damage their eyes.

or skiing without proper eye protection. UVB rays cause photokeratitis, and these rays can burn the cornea, potentially causing pain and temporary vision loss.

Macular degeneration

According to the American Optometric Association, macular degeneration is a deterioration of the part of the retina that is responsible for Just as people protect their skin from the sun, so, sharp, central vision. In addition to UV rays, too, should they safeguard their eyes. Prevent chronic exposure to shorter-wavelength visible Blindness America warns that the sun is comblue and violet light can be harmful to the retina. prised of UVA and UVB rays. UVA rays may hurt The sun and many artificial light sources, such as central vision by damaging the macula, or a part LEDs and smartphones, emit blue light. Some of the retina at the back of the eye. UVB rays typ- blue light can be beneficial, but some can be ically affect the front part of the eye or the lens harmful to the eyes. Lenses that absorb harmful and cornea. The following are some common eye blue light or block it can prevent retinal damage. conditions that can be linked to exposure to UV Pterygium rays. Pterygium is a growth that forms on the outer porPhotokeratitis tion of the eye, or the cornea and conjunctiva. Excessive amounts of UV radiation over a short The World Health Organization says that properiod of time can cause photokeratitis, which is longed UV exposure can contribute to this condiequivalent to a sunburn of the eye. Photokeratitis tion. Pterygium may extend over the cornea and may occur after spending long hours at the beach reduce vision, requiring surgical removal.

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Cataracts UV exposure also can contribute to the formation of cataracts. Prevent Blindness America says a cataract is a clouding of the eyeʼs natural lens, the part of the eye that focuses the light people see.

Sun protection Sunglasses should completely cover the eyes, including the skin on the eyelids and under the eye, to provide adequate protection for the eyes. Wraparound frames will offer additional protection to those who spend a lot of time outdoors in bright sunlight. The AOA says sunglasses should also do the following. • Block out 99 to 100 percent of both UVA and UVB radiation. • Screen out between 75 and 90 percent of visible light. • Have lenses that are perfectly matched in color and free of distortion and imperfection. • Have lenses that are gray for proper color recognition.

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Health & Wellness - October 2017

Myths and misconceptions about autism spectrum disorder A utism spectrum disorder, or ASD, is a class of neurological conditions present from early childhood and is often identified through difficulty communicating, using language and understanding abstract concepts. The organization Autism Speaks says that an estimated one out of 42 boys and one in 189 girls are diagnosed with autism in the United States. Autism is now diagnosed in roughly one out of every 68 children in Canada, and has become the fastest growing and most commonly diagnosed neurological disorder in that country. ASD is estimated to affect tens of millions of people worldwide. But even though ASD is widely recog-

nized, studied and discussed, myths and misconceptions about the disorder continue to circulate. Shedding light on how ASD can help caregivers, peers and anyone who routinely interacts with individuals who fall on the spectrum.

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ize, but he or she may not know how revised in 2013. ASD is often perto facilitate these engagements. ceived through communication deficits that can include misinterpreted or nonverbal interactions. ASD does not produce Individuals also may have chalcarbon-copy symptoms lenges in bonding/friendship development. Characteristics of ASD can vary widely from person to person. One personĘźs limitations may not be presPeople with ASD can ent in another.

understand and express emotion

Although communication troubles may be present, those with ASD can and do feel emotions. But they may not be able to express these emotions the same way as others do. Also, just because someone has ASD is not a single disorder ASD doesnĘźt mean he or she is unable to understand the emotions Although autism and ASD are often used interchangeably, these names of others. Rather, the person may need firm and direct indications of do not define one specific disorder. how another person is feeling to ASD is now an umbrella term that includes autism, Asperger syndrome, understand. Reading body language or tone of voice alone may be inadepervasive developmental disorder, quate to someone with ASD. Schoolchildhood disintegrative disorder, and Rett syndrome, according to the aged children can learn from this, Diagnostic and Statistical Manual of recognizing that someone with ASD Mental Disorder, 5th edition (DSM-5) may want to have friends and social-

ASD is not just a childrenĘźs disease There is no cure for ASD, and symptoms may not be reversible, which means that autism is a lifelong condition. Children who are diagnosed will grow into young people and adults with autism. Many treatments and therapies are geared toward early intervention, but adults can benefit from continued work as well. Adults with ASD can be successful and live independent lives. Autism spectrum disorder is more prevalent than ever. However, despite the recognition of ASD, many people do not understand the nuances involved with a diagnosis.

The Northern Virginia Daily

Health & Wellness - October 2017

Treatments for Alzheimerʼs disease continue to evolve

lzheimerʼs disease is one of the most prevalent types of dementia in the world, affecting an estimated 35.6 million people all over the globe, and that number is expected to double in 20 years. The Alzheimerʼs Foundation of America estimates that as many as 5.1 million Americans may be living with Alzheimerʼs disease. Australian company Actinogen Medical says Alzheimerʼs is Australiaʼs second biggest killer. According to a 2012 study commissioned by the Alzheimerʼs Society of Canada, 747,000 Canadians were living with cognitive impairment, which included, but was not limited to, dementia. People with Alzheimerʼs disease and other types of dementia may experience a decline in mental function severe enough to reduce their ability to perform everyday activities. Some of the cognitive functions that may be impaired include memory, communication and language, ability to pay attention, reasoning and judgement, emotional control, and social behavior. There is no cure for Alzheimerʼs disease, nor is there an effective longterm way to prevent potential mental decline. However, that has not stopped scores of researchers and medical teams that continue to study the efficacy of different drugs and therapies. The following are some of the more promising options in the works.

into the brain.” Leukine has been successful in removing the plaque or amyloid along the outside of nerve cells in the brain of mice. Researchers do not know the exact mechanism for removal, but the drug is working and working quickly. Leukine also may be helping the brain repair itself. The Alzheimer's Association has donated $1 million toward financing the costs of the next phase of this trial.

Insulin Neurologists at Rush University Medical Center are testing a type of insulin that is inhaled through a nasal spray to see if it improves cognition and memory function in people with mild cognitive impairment. “There is growing evidence that insulin carries out multiple functions in the brain and that poor regulation of insulin may contribute to the development of Alzheimerʼs disease,” said Dr. Neelum Aggarwal, a neurologist at Rush and the lead investigator of the study. The 18-month clinical trial will study the nasal spray versus a placebo in 275 adults between the ages of 55 and 85.

Xanamem

Australian researchers at Actinogen Medical have begun trials of a new drug called Xanamem. More than 170 patients with mild dementia in Australia, the United States and the United Kingdom will take part in the placebo-controlled 12-week trial. The Leukine medicine blocks the stress hormone cortisol in order to improve mental A safety trial on the drug Leukine function for those with dementias. In already is underway at the Colorado 2015, an Edinburgh University study University Anschutz Medical Campus. of mice showed reducing cortisol in “We found so far that Leukine is safe the brain improved their memory and in people with Alzheimerʼs disease,” decreased the number of said Dr. Huntington Potter, the direc- Alzheimerʼs-associated amyloid tor of Alzheimerʼs research at the uni- plaques in the brain. versity. “That means it doesnʼt have Researchers continue to work as they the side effects that so many other seek a successful, long-term option Alzheimerʼs drugs have had, which for treating or preventing Alzheimerʼs are swelling in the brain and bleeding disease and other dementias.

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Health & Wellness - October 2017

Simple ways to alleviate back pain

ew health problems are as prevalent as back pain. The American Chiropractic Association says that 50 percent of working Americans admit to having back pain symptoms each year. Bone and Joint Health Canada states that as much as 80 percent of people experience back pain at least once in their lifetime. Back pain can be so significant that it results in a loss of function that impedes daily activities. In fact, according to the 2015 Global Burden of Disease report, back pain is the single leading cause of disability in most countries. Back pain can be a complex issue. According to data complied by TheGoodBody.com, only one in 10 people learns the primary cause of their pain. ThatĘźs because many things, including muscle sprains or joint irritation, can contribute to back pain. Other factors that may contribute to back pain include arthritis, stress, obesity, or diseases of the internal organs. Each of these issues can make it challenging to uncover the culprit behind back pain. Ruling out degenerative diseases can be a first step in treating back pain. Doctors also may ask their patients about their level of physical activity. Doctors may want to know if patients suffering back pain engage in activities involving repetitive movements to determine if their back pain can be traced to these activities. Some common factors contribute to back pain, and addressing these issues may bring about relief.

Strengthen core muscles. Poor muscle tone, especially in the back and abdominal muscles, may result in back pain. Engaging in activities that strengthen the core can help strengthen the area, offering more support to the back. A doctor, physical therapist or fitness instructor may guide you in exercises, such as planks or abdominal crunches, that can strengthen the core. Get up and move. A sedentary lifestyle can be a major contributor to back pain. Nearly half of Americans who experience back pain are desk workers who spend the majority of their time sitting, according to the Centers for Disease Control and Prevention. Qi Spine, a clinic that gathered data from 1,300 people who said they deal with spine-related pain, found that half the participants with sedentary jobs had lower back pain. Standing, moving around and taking breaks from the desk can help alleviate pain. Lose weight. The spine is vulnerable to effects of obesity. Extra weight in the abdomen may pull the pelvis forward and strain the lower back, states the American Obesity Association. Losing weight can reduce that strain on the lower back, thereby reducing pain. Back pain is a frequent complaint and compels many people to visit their doctors. Exercise, maintaining a healthy weight and strengthening core muscles can go a long way toward keeping the back healthy and pain-free.

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Health & Wellness - October 2017

GRACIOUS SENIOR ASSISTED LIVING

Personalized medicine may be the future of healthcare

hen a person feels ill, his or her doctor may assess any symptoms and then prescribe a particular medication to treat or alleviate those symptoms. Doctors prescribe medications hoping to treat sickness, but sometimes prescriptions fall short, leaving some to wonder if prescription medications could be customized more for individual needs? The science is already here. Making specialized drugs is not a new concept. Prior to the rise of drug manufacturing companies, early pharmacists routinely customized ingredients. According to Professional Compounding Centers of America, customized medications are created through a process known as pharmacy compounding, which is defined as the art and science of preparing personalized medications for patients.

Specialized pharmacists take a practitionerʼs prescription and mix individual ingredients together in the exact dosage and strength required. Compounding may be done to change the form of the medication from a pill to a liquid or to remove a certain additive or ingredient, such as gluten, that might cause an allergic reaction. The American Pharmacists Association says that compounding also can be used to flavor a medication in an effort to make it more palatable.

Compounded drugs can be just as

safe as mass-produced prescriptions. And thanks to their tailor-made formulas, compounded medications also may help people avoid side effects and other adverse reactions. Compounding gives physicians flexibility in regard to how to best help their patients. Compounding is done in hospital pharmacies and other healthcare facilities. There also are thousands of community-based pharmacies in the United States that specialize in compounding services. Pharmacists in these facilities spend all of their time making special preparations. All pharmacists and pharmacies engaged in compounding are subject to oversight by both federal and state authorities. On November 27, 2013, Congress amended the Federal Food, Drug, and Cosmetic Act by enacting the Drug Quality and Security Act to ensure that compounded drugs are produced in accordance with applicable federal requirements. The National Association of Pharmacy Regulatory Authorities helps to oversee compounding in Canada. Preparations of products are subject to the Food and Drug Act and Regulations, Good Manufacturing Practice guidelines, and inspection by Health Canada. Pharmaceutical compounding may not be new, but it is increasingly relied on to create the best formulations for individual patients.

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Health & Wellness - October 2017

How to promote healthy kidneys

idney disease is a widespread issue made all the more disconcerting by the fact that many people are unaware they have it. According to the National Kidney Foundation, 26 million American adults have kidney disease, and most donʼt know it. And the problem of kidney disease is not exclusive to the United States, as the Canadian Kidney Foundation notes that the number of Canadians being treated for kidney failure has tripled over the last quarter century.

Healthy kidneys are something many people take for granted. But those who want to do everything they can to keep their kidneys healthy can consider the following tips, courtesy of the Cleveland Clinic.

biggest risk factors for kidney disease, and regular exercise can reduce a personʼs risk of both conditions. However, overexertion can strain the kidneys, so adults who exercise, especially novices who need to improve their conditioning, should avoid going too hard at the gym. Speak with a physician before taking vitamin supplements or herbal remedies. Vitamin supplements and herbal remedies have become very popular in the 21st century, but excessive supplementation can harm the kidneys. Discuss any supplements or herbals remedies with a physician before taking them.

Quit smoking. Just as exercise benefits the body in myriad ways, smoking harms the body in Stay hydrated, but avoid overhydration. Many myriad ways. Smoking decreases the blood flow in the kidneys, decreasing their ability to function people are familiar with the benefits of drinking water each day, and adequate hydration definitely at optimal capacity. Smoking also increases a promotes healthy kidneys. But overhydrating has personʼs risk of high blood pressure and cancer not been proven to enhance kidney function. The of the kidneys. Cleveland Clinic recommends adults drink Eat healthy. A healthy diet decreases a personʼs between four and six glasses of water per day. risk for high blood pressure and diabetes. Exercise. Regular exercise benefits various parts Adhering to a healthy diet and controlling portion sizes can help control weight and blood pressure of the human body, including the kidneys. High and contribute to healthy kidneys as well. blood pressure and diabetes are two of the

Get screened. Adults who have been diagnosed with high blood pressure or diabetes should make sure their physicians screen for kidney dysfunction during routine appointments. Learn more about kidney disease at www.kidney.org.

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Health & Wellness - October 2017

Arthritis linked to another condition

psoriatic arthritis are crucial to relieving inflammation and preventing permanent joint damage.

eople who see dermatologists for the skin condition psoriasis should not take the presence of joint aches and pains lightly, as the two things might be connected. The National Psoriasis Foundation notes that psoriasis is a precursor to psoriatic arthritis in 30 percent of patients.

Symptoms Symptoms of psoriatic arthritis can develop gradually or quickly, and some symptoms can be severe. NPF indicates that common symptoms of psoriatic arthritis include

What is psoriatic arthritis? Psoriasis is an autoimmune condition that affects the rate of skin cell reproduction. People with psoriasis may experience redness, itchiness and raised bumps (plaques) of skin on various areas of their bodies. Psoriatic arthritis is a chronic form of arthritis that typically occurs in people with skin psoriasis, but also can be present in those without the skin condition, but particularly among those who have relatives with psoriasis. The American College of Rheumatology says that psoriatic arthritis typically affects the large joints, especially the lower extremities, distal joints of the

riatic arthritis is typically blood test negative. The diagnosis is typically made by a rheumatologist after reviewing a clinical history and performing a physical exam.

• morning stiffness and tiredness; • tenderness, pain and swelling over tendons; • swollen fingers and toes;

Doctors will need to assess symptoms before deciding on a course of treatment. Mild cases may respond to over-thecounter, nonsteroidal anti-inflammatory drugs, such as ibuprofen. However, antirheumatic drugs and newer biologic drugs may be prescribed to treat more aggressive cases of psoriatic arthritis.

• redness and pain in the eyes.

Corticosteroid injections can be useful for swollen joints, and surgery may be necessary to repair badly damaged joints.

Symptoms of psoriatic arthritis are similar to rheumatoid arthritis, gout and reactive arthritis. Doctors will rule out other symptoms that may be indicative of those conditions. The American College of Rheumatology also indicates that pso-

Individuals who suspect their arthritis may be linked to psoriasis can first speak with a dermatologist or primary care physician. The NPF also offers a screening tool at www.psoriasis.org/psa-screening.

• reduced range of motion; • nail changes, including pitting, and

fingers and toes and the back and sacroiliac joints of the pelvis. Early recognition, diagnosis and treatment of

Treatment

Health & Wellness - October 2017

The Northern Virginia Daily

Breathing easier about CPAP treatment

eople who routinely toss, turn, snore, and wake up feeling less than refreshed in the morning may have more to worry about than simply not getting a goodʼs night sleep. They may be experiencing a relatively common yet largely undiagnosed condition that can contribute to long-term risk for various diseases. Sleep disorders have become a significant health issue. Sleep apnea, which affects an estimated 22 million people in the United States, can contribute to difficulty sleeping. Sleep apnea causes periods defined by an inability to breathe. The American Sleep Apnea Association says sleep apnea comes in three types: obstructive, wherein a blockage of the airway is usually caused by the collapse of the tongue or soft palate; central, when the brain fails to signal muscles to breathe; and complex, which is a combination of the two conditions. Over time, sleep apnea can be a risk factor for heart attack, stroke, diabetes, and other serious conditions, says the Cleveland Clinic. That is why symptoms that may begin as mildly agitating snoring sessions should be brought to a doctorʼs attention. When sleep apnea is identified, one of the more successful treatments is widely referred to as “CPAP.”

usually confirmed by an overnight sleep study known as a polysomnogram, or PSG, conducted in a lab or at home. According to the American Sleep Apnea Society, a PSG is often followed by with a CPAP titration study.

Individuals who will require CPAP can choose among masks and equipment that According to the National Heart, Lung and meet the prescription and maximize comfort Blood Institute, CPAP, or continuous positive levels. Many people become accustomed to airway pressure, is a treatment that uses using CPAP devices right away, while others mild air pressure to keep breathing airways may need a month or more to transition. open. A CPAP machine includes a mask or Problems like uncomfortable masks or air other device that fits over the nose or nose leakage can be tweaked until users grow and mouth. The mask is connected to a comfortable. machine via a tube, through which humidiCPAP needs to be employed under the guidfied air is blown. ance of a sleep specialist. The mask and In cases of obstructive sleep apnea, or OSA, CPAP can reverse the complete blockages or narrowing of upper airways. When used correctly, CPAP may be the only treatment necessary to address OSA. Sleep apnea is

tube should be cleaned daily and be replaced when necessary for the treatment to work effectively. More information about sleep apnea and CPAP is available at www.amsleep.org.

The Northern Virginia Daily

Health & Wellness - October 2017

How common is carpal tunnel?

ncreased hours spent on computer keyboards and digital devices can put people at risk for a relatively common and oftentimes painful condition that affects mobility in the wrist. Carpal tunnel syndrome, or CTS, can cause numbness, pain and tingling in the hand or arm as a result of one of the major nerves of the hand — the median nerve — being compressed in the wrist. The American College of Rheumatology says that CTS may be the most common nerve disorder experienced today, affecting between four and 10 million people in the United States alone. Middle-aged to older individuals are more likely to develop CTS than younger persons, and females are diagnosed three times more frequently than males.

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nates in the neck and runs through the arm. The median nerve passes through the carpal tunnel at the wrist and goes into the hand, providing feeling to the palm side of the thumb and to the index, middle and part of the ring fingers (although not the little finger). It also controls some small muscles at the base of the thumb.

Symptoms of carpal tunnel

Weakness of the hand as well as tingling and numbness are the two most common symptoms of CTS. The numbness particularly affects four of the fingers. It can occur when holding a phone, book, newspaper or steering wheel or engaging in just about any activity that involves the hands. CTS also may wake a person up from sleep. What is the carpal tunnel? There are a number of other comThe carpal tunnel is a passage that pression issues that can occur in the forms in the wrist on the palm side of hand and arms, causing similar pain the hand. It is located just beneath and tingling in other areas. Ulnar the skin surface. The National nerve compression in the elbow can Institute of Neurological Disorders cause part of the ring finger and and Stroke says the carpal tunnel is pinky finger to tingle and may be a narrow, rigid passageway of ligaindicative of a different ailment. ment and bones. Eight small wrist Thatʼs why a professional diagnosis bones form three sides of the tunnel. must be sought when experiencing The width of the tunnel is only about symptoms related to CTS. an inch. Injury or inflammation to the tissues inside of the carpal tunnel When to see a doctor can shrink the space of the tunnel, If pain and tingling are affecting eventually pressing on the tendons activities and sleeping patterns, indiand the median nerve that runs viduals should see their doctors. through this narrow area. Various nonsurgical remedies and The role of the median nerve therapies may help. If left untreated, any condition that affects nerve funcWhen compression occurs in this tion may lead to permanent nerve area of the wrist, a key nerve is and muscle damage. affected. The median nerve origi-

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Saturday, October 28 | 9:00 am

NORTHERN SHENANDOAH VALLEY Museum of the Shenandoah Valley 901 Amherst Street, Winchester, VA

703.766.9025 samartey@alz.org

Health & Wellness - October 2017

The Northern Virginia Daily

Exploring dental crowns

any people visit their dentists and learn they have a tooth that requires a crown. In many instances, dental crowns are necessary for proper tooth care. Crowns were once widely referred to as “caps.” A crown is a permanent cover for a tooth that would otherwise require a very large filling after dental decay has been removed. Crowns also may be used to repair cracked or broken teeth so that extraction is not necessary. Sometimes crowns are used for cosmetic modifications or to hold a dental bridge in place. The crown itself can be made from different materials, like stainless steel, gold or metallic alloy, porcelain, porcelain fused to metal, and resin. A dentist will determine which material will work best depending on the application and tooth location.

Understanding your appointment(s) Crowns are typically installed in two appointments. The first appointment requires prep work so the tooth can hold the crown. This is typically a painless procedure, and one in which the dentist will anesthetize the tooth and gum tissue and then file down the tooth along the chewing surface and sides to make room for the crown covering. If the patient will return to the office tooth was decayed or insubstantial, the dentist may to have it checked for fit and have to “build up” the tooth instead of filing it down. then cemented into place. Again, these determinations are made by the dentist who has the expertise to gauge how much workable tooth is left. Full and Once the tooth has been prepared, an impression will be made of the bite area. Thatʼs because the permanent crown will be fabricated in a laboratory and the fit/color will need to be exact for comfort — and also to ensure that bacteria and food debris do not get caught between the crown and tooth. The final component is a temporary cap that will keep the prepared tooth clean. This is molded in the office and will be worn only until the custommade crown is ready. When the permanent crown is delivered, the

partial crowns A partial crown may be used if only a portion of the tooth needs to be covered. Dentists will often rely on full crowns to get maximum coverage and strength.

Cost factor Crowns can be expensive. According to the resource CostHelper, crowns can range from $500

to $3,000 depending on the material used and the patientʼs insurance coverage. Dental insurance may cover a predetermined percentage of the cost when the crown is medically necessary, but insurance may not cover anything if the procedure is only cosmetic. Itʼs always a good idea for patients to express their concerns and ask questions about crowns prior to starting the procedure. Understanding the potential out-of-pocket costs is essential as well. Dental crowns can last several years and represent the best way to salvage a tooth that is cracked or damaged.

The Northern Virginia Daily

Health & Wellness - October 2017

Signs of stress that must be addressed

he American Institute of Stress notes that various disorders, both emotional and physical, have been linked to stress. Such disorders include depression, stroke, hypertension, and anxiety, among others. In its 2015 Stress in AmericaTM survey, the American Psychological Association found that money, stress and family responsibilities are the three most common stressors. While the symptoms of stress are uncomfortable and potentially very dangerous, the APA notes that such indicators also serve as a warning from the body that it needs maintenance and extra care. The following are some of the ways the body might be telling adults to step back and make an effort to relieve stress. Headaches, muscle tension, neck or back pain: Some headaches or aches and pains might be mere nuisances or indicative of issues unrelated to stress. But when such symptoms are accompanied by stress, this could be the bodyĘźs way of alerting men and women that the stress is approaching unhealthy levels. The AIS notes that when a person is under stress, his or her muscles tense up. The contraction of these muscles for extended periods of time can trigger tension headaches and migraines, among other things. Chest pains and/or rapid heartbeat: Chest pains and rapid heartbeat may indicate various problems, including stress. This happens when the body is stressed because stress causes the nervous system to signal the adrenal glands to release hormones that make the heart beat faster and increase blood pressure. Difficulty falling or staying asleep: Men and women who are feeling stressed out and also experiencing difficulty falling asleep or staying asleep should consult their physicians about ways to alleviate that stress. When strategies to alleviate stress are successful, adults should be able to return to normal, healthy sleeping patterns. Increased frequency of colds: Stress can attack the bodyĘźs immune system, making it increasingly vulnerable to colds. The AIS also notes that a weakened immune system also makes the body more susceptible to additional viral disorders, including herpes, and autoimmune diseases such as rheumatoid arthritis and multiple sclerosis. Loss of appetite or overeating: Stress can affect the gastrointestinal system in various ways, including influencing appetite. While not all problems with appetite are indicative of a body that is overstressed, stress can prompt some people to eat much more than they normally do, while others may eat considerably less than they normally would. Diarrhea or constipation: Another indicator that stress is compromising the gastrointestinal system is diarrhea or constipation. Again, while these problems are not exclusive to sufferers of stress, when a person is under stress, this can affect which nutrients the body can successfully absorb and how quickly food is metabolized. This can cause some people to experience diarrhea, while others may be constipated.

Health & Wellness - October 2017

The Northern Virginia Daily

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