Older People with Hearing Loss at Risk for Depression

February 7th, 2019

Hearing-Loss

New research shows further evidence that older people with hearing loss have more symptoms of depression. The greater the hearing loss, the greater the risk, according to the data. These findings suggest that treatment of age-related hearing loss, which is underrecognized and undertreated among all elderly, could be one way to head off later-life depression.

People with hearing loss usually find communication difficult, which can lead to stress, fatigue and social isolation. And social isolation leads to depression, especially in older adults. But it wasn’t until recently that researchers were able to show that is was more of a problem than previously thought.

Many people older than 70 have at least mild hearing loss, but relatively few are diagnosed or treated. Hearing loss is the third-most occurring condition in older adults. Presbycusis, the most common form of hearing loss is associated with aging, occurs gradually. It is characterized by loss of the highest frequency consonant sounds and trouble understanding speech in the presence of background noise.

Between 25 and 40 percent of those over the age of 65 have hearing loss. Unfortunately, for the majority of older adults, hearing loss goes undetected and untreated. Only nine percent of internists recommend hearing tests to their older patients. And even with testing, only 25 percent of those whose hearing loss is treatable take action to get hearing devices.

“Hearing loss is easy to diagnose and treat, and treatment may be even more important if it can help ease or prevent depression,” said lead researcher Justin Golub.

Age-related hearing loss is known to raise the risk of other conditions, such as cognitive impairment and dementia. But there are few large studies trying to discover whether hearing loss may lead to depression in the elderly – particularly in Hispanics, a group in which depression may be underdiagnosed because of language and cultural barriers.

This researchers analyzed health data from 5,239 individuals over age 50 who were enrolled in the Hispanic Community Health Study/Study of Latinos. Each participant had an audiometric hearing test – an objective way to assess hearing loss – and was screened for depression.

They found that individuals with mild hearing loss were almost twice as likely to have clinically significant symptoms of depression than those with normal hearing. Individuals with severe hearing loss had over four times the odds of having depressive symptoms.

Because the research did not revisit the participants over time, it has limits. It couldn’t show that hearing loss caused depressive symptoms – just that there was an association at that point in time. Although the study focused on Hispanics, the results could be applied to anyone with age-related hearing loss. “In general, all older individuals should get their hearing tested and consider treatment,” says Golub.

 

The Underappreciated Neck: What’s inside

January 7th, 2019

neck8The neck tends to be one part of your body that works hard, but doesn’t get enough credit. It serves as a flexible connection between your head and the rest of your body and contains many nerves and blood vessels vital to your health and continued viability. Your neck contains numerous important structures, including:

Spinal cord. The cervical portion of your spinal cord is located in your neck. Your spinal cord sends messages through nerves from your brain to your body, and from your body back to your brain. The spinal cord stretches all the way down the length of your back.

Vertebrae, disks and ligaments. The vertebrae are bones that encase and protect your spinal cord. Intervertebral disks are located between each vertebra and help to absorb shock and allow your spine greater flexibility. Ligaments in your neck stabilize your vertebrae and help hold them in place.

Nerves. A network of nerves in your neck sends signals to your brain and body. When a vertebral disk places pressure on the nerves in your neck, you may experience neck pain. Many of the nerves in your neck stretch into your arms, which is why problems with the neck often lead to arm and shoulder symptoms, in addition to neck pain.

The Tubes. The pharynx is a hollow tube that connects your nose and throat to your esophagus and trachea. Your larynx, or voice box, sits just below your pharynx. It contains your vocal cords, which give you your voice. Your trachea is the tube that allows air to flow between your mouth, nose, and lungs. The esophagus provides a passageway for food and liquid to move from the mouth into the stomach.

Glands. The thyroid is an essential gland that is located in the front of the neck. It produces hormones that help regulate metabolism. The parathyroid glands are small glands adjacent to the thyroid gland. They release a critical hormone that helps control the amount of calcium in the blood. Lymph nodes are located in many parts of your body, including the neck. They help to drain impurities out of the body and contain infection-fighting blood cells.

While the neck is connected to the spine, it is not as sheltered as the rest of the backbone. This means this slim structure is prone to problems. Neck pain generally arises from muscle strain. But since your neck is so complex, there can be other, more serious causes of neck pain. If you are having neck pain, it is important to see your doctor, especially if your neck pain is intense or persistent, or is accompanied by other worrisome symptoms such as fever, severe headache, or numbness or weakness in the arms or legs.

Most neck pain improves gradually with home treatment. Seek immediate care if severe neck pain results from an injury, such as a motor vehicle accident, diving accident or fall. Contact one of our doctors if your neck pain:

- Is severe
- Persists for several days without relief
- Spreads down arms or legs
- Is accompanied by headache, numbness, weakness or tingling

Learning Physical Balance Benefits Kids

December 15th, 2018

toddler-balanceFor some kids it comes naturally. Hopping on one foot, jumping rope and walking along a wall is second nature. For others it takes a little practice. But having good balance can be learned! It’s a function that can be improved with practice and is a skill worth having. Teaching your child good balance at an early age will set her up for better body awareness, coordination, and even concentration.

Physical balance is the foundation on which many other physical skills are built. Because kids are spending more time bent over computers and shouldering heavy backpacks, experts believe that their balance is becoming more challenged. Continuously hunching over a screen or carrying extra weight can affect posture and balance, which could lead to less coordination or even problems with gait.

The solution is … well … fun. Common games like hopscotch and tag promote balance. And kid-appropriate activities in yoga and Pilates can also help. There are also simple exercises families can do at home to boost stability.

Researchers are connecting balance to mental, not just physical, functioning. When kids stabilize themselves from an unstable pose, they learn how to focus faster and more efficiently. Kids with learning problems, who often have less than optimal balance, can particularly benefit from balance training. If you free up the mental capacity they are using to concentrate on balance, they have the mental resources to focus on other things.

Balance-Building Exercises for Children

Under One Year: Once your baby begins to sit up, let her grab your fingers and pull herself into a sitting position. Slowly move your hands toward her, just enough so that she begins to rely on her own sense of balance. If she begins to teeter, gently support her back into an upright position. Repeat as long as it is fun for her.

One to Three Years:
Boot Balancers:
Sit in a chair and have your child stand in front of you with his arms extended from his sides. Reach your hands underneath his arms (but don’t support his weight) so you can catch him if he loses his balance, and have him step up onto the tops of your shoes. Make a game of how long he can balance himself on your feet.

Stork Stands: Together with your child, stand straight with your feet shoulder-width apart, hands on hips. Stand on your left leg, bending the right leg slightly behind you. Hold this pose for two seconds, then slowly extend your right leg straight out and slightly in front of you without touching the ground. Hold for two seconds and repeat the exercise standing on the right leg, resting your opposite foot on your supporting leg if you need to rest. Once this feels easy, try extending your arms out in front of you or overhead. Playing Simon Says with your child, alternating as leader, can make this drill even more fun.

Three Years and Up:
Balance Beam Lunges: Have your child stand on a long board (a 2-by-4 is fine). She should place her left foot several feet forward on the beam and lunge down until her left thigh is parallel to the ground (her right knee will bend as she deepens the pose). After she holds this position as long as she can, have her repeat the move with the other leg. With practice, your child can lunge with her arms extended out from her sides. For a challenge, raise the board six inches by placing wood or cinder blocks under both ends.

Wheelbarrows: Have your child stand behind a basketball or large ball that will support her body weight and then place her hands, fingers pointing forward, on it. Keeping her feet planted, she should roll the ball forward, alternating hands. Once she rolls it as far from her feet as she can without losing balance, she should roll it back to its original position. Repeat as many times as she’s able.

From Parenting Magazine

Say What? How to Treat Short-Term Laryngitis

November 15th, 2018

Screen Shot 2018-11-15 at 11.01.09 AMYou never really appreciate just how valuable your voice is … until you lose it. You can hear it coming – you may start to hear a bit of cracking or huskiness in your voice … and then croaking … until no sound comes out at all. Was it the enthusiastic cheering at your daughter’s soccer game that’s to blame? Or too much singing in the shower?

Laryngitis indicates a problem with your larynx (also called the voice box). Your larynx contains your vocal cords and is important for talking, breathing and swallowing. Inflammation or irritation from overuse or infection causes your vocal cords to swell and distorts the sounds that air carries over them – making your voice sound hoarse. If there is too much swelling you may not be able to make your voice heard at all.

Although it is annoying and can be painful, laryngitis usually isn’t serious. Laryngitis that lasts less than a few weeks is often caused by upper respiratory infection from a virus. Laryngitis caused by bacterial infection is actually quite rare.

Laryngitis usually gets better on its own. If you have hoarseness that doesn’t go away after a few weeks, make an appointment so that we can determine what is going on. Long-term (or chronic) laryngitis lasts longer than 3 weeks and can have various causes, such as allergies, smoking, acid reflux, exposure to toxins, post-nasal drip, alcohol, or more serious diseases.

One of the best ways to treat laryngitis, and certainly the simplest, is not talking – at all. Whispering does not actually rest your voice. In fact, it can actually agitate your vocal cords and make your hoarseness worse. If you have laryngitis, try communicating by writing or texting. You may also get some relief by using a cool mist humidifier and avoiding irritants like cigarette smoke. Antibiotics are only effective against infections caused by bacteria. Since almost all infections with laryngitis are caused by viruses, antibiotics likely won’t help.

Relief for Short-Term Laryngitis:

  • Breathe moist air. Use a cool-mist humidifier to keep the air in your home or office moist. Inhale steam from a bowl of hot water or a hot shower.
  • Rest your voice as much as possible. Avoid talking or singing too loudly or for too long. If you need to speak before large groups, use a microphone or megaphone.
  • Drink plenty of fluids to prevent dehydration (avoid alcohol and caffeine).
  • Moisten your throat. Try sucking on lozenges, gargling with salt water or chewing a piece of gum.
  • Avoid decongestants. These medications can dry out your throat.
  • Avoid whispering. This puts even more strain on your voice than normal speech does.

Eczema can Occur Anywhere – Even in Your Ears

October 20th, 2018

Screen Shot 2018-10-26 at 11.40.47 AMEczema is no walk in park. It’s an annoying and sometimes painful condition tied to the immune system. It causes inflamed, itchy, cracked, and rough patches of skin all over the body. Eczema affects almost one third of people on the United States – some will outgrow it, but others struggle with outbreaks their entire life.

To add insult to injury, eczema happens in places you might not expect … in the ears, for instance. Ear eczema can be an extremely irritating and at times painful condition. It can range from slight dryness of the outer ear to extensive skin loss and soreness, as well as infection of the external and internal parts of the ear. It can affect the entire ear, including the lobes, the ear opening, canal and the eardrum itself. It is important to focus on prevention and control as if left untreated, eczema or infection can spread outwards to the surrounding skin.

Eczema may appear as a result of exposure to something that causes an allergic reaction. Everyday items can cause outbreaks inside the ears – soaps, gels, earrings, hearing aids, earbuds or even wearing glasses. Objects you might try to use to clean or scratch the ear can also be problematic. Ear piercing does not cause eczema, but can lead to problems when you wear certain types of earrings or studs. If you have a nickel allergy, wear only hypoallergenic jewelry.

It’s always best to consult the doctor if you think you may have eczema in the ears. A professional can give you effective treatment and help to prevent flare‐ups. Treatment of ear eczema will depend on the cause and type, but there are things that you can do at home to prevent outbreak and spread. You can gently wash the inside of your outer ear with water or an emollient wash. You can also use a damp cotton tip very gently in the bowl area of your ear, but do not insert it into the ear canal.  Never try to wash further into the ears – you may damage the skin of the ear canal. After washing, dry your ears thoroughly – using a warm (not hot) hair dryer. Avoid scratching the inside of your ears, especially with a foreign object – not only can these damage your ear canal skin or drum, but they can also set up an allergic reaction. The use of ear candles is not advised.

If you go swimming, use ear plugs. You can get custom‐made ear molds to fit your ears. Apply an emollient cream/ointment to treat dry skin around the  ears and in the entrance to the ear canals, and refined petroleum oil or sunflower oil for loosening ear wax (but consult first with a healthcare professional first). Using water is not recommended, nor are wax loosening products as they may encourage the buildup of debris and cause more inflammation and irritation.

Ear eczema can be an extremely irritating condition. Since it is difficult to see in the ears without special equipment, it is often hard to know what is going on in there, particularly in the case of young children. If ears become uncomfortable, don’t ignore it – it is always best to see your health care professional and get to the bottom of the itch.

Itchy Ears: Causes and Possible Solutions

September 26th, 2018

Screen Shot 2018-10-26 at 11.40.05 AMGot an itchy ear? It may be more than someone dropping some gossip behind your back, as the old wives tale goes. There are several reasons the ear canal (the tube that connect your outer ear to your eardrum) can become irritated or itchy. How to get relief depends on what’s making you scratch.

But be warned … no matter the cause, it’s never a good idea to stick an object in your ear. You could damage your inner ear, including the tiny bones that help you to hear.

Itchy ears might be caused by an earwax buildup. Even though wax is a natural way for your body to clean dead skin cells and dirt out of your ears, too much can make them itch. But don’t use a cotton swab to remove the wax, as it can act as a plunger, pushing the wax deeper inside where it can get stuck. Try instead over-the-counter ear drops to break up the wax. If that doesn’t help, make an appointment with one of our friendly doctors. They can use a special tool to safely remove built-up wax.

On the flip side, ears can also get itchy if they don’t have enough wax inside, so don’t clean out your ears too often!

Itchy ears can sometimes be a sign of an ear infection. When you have a cold, the flu, or allergies, the bacteria and viruses in your body can also infect your ear. But infections can also happen when you aren’t even sick. Swimmer’s ear occurs when water stays in your ear after spending time swimming. Too much moisture wears away the natural layer of defense against germs in your ear canal. To stop the itch, you’ll need to treat the infection. Some may go away on their own, but our doctors can also prescribe ear drops. You may need to take them a few times a day for a week. Other infections may need a course of antibiotics.

The skin in your ears is much like the skin on the rest of your body. Itchiness may be caused by eczema or psoriasis, as it affects the rest of your body. The skin inside your ears could be itching because of an allergic reaction. Products like hair spray or shampoo could cause a reaction to sensitive skin. Objects that contains certain metals (nickel), like earrings can cause irritation as well. Plastic, rubber, or metal objects your use near or inside your ears, such as earbuds or a hearing aids, can also cause a rash called contact dermatitis.

If you have a concern about itching in your ears, feel free to make an appointment to discuss the best way to resolve this irritating condition.

Gearing Up for Fall Allergy Season

August 4th, 2018

fall-allergiesIt’s August, and the pollen of spring and blooms of summer are finally beginning to fade. So how come you’re still sneezing? Fall allergies can trigger just as many symptoms as spring and summer, unfortunately. Ragweed is the biggest culprit – it starts to release pollen with cool nights and warm days in August, but can last into September and October. About 75% of people allergic to spring plants also have reactions to ragweed.

Mold is another fall trigger. Mold spores love wet spots outside, such as piles of damp leaves. Or your fall issue may be dust mites. They can get stirred into the air the first time you turn on your heat in the fall and trigger sneezes, wheezes, and runny noses. Mold and dust mites are common in schools, so returning to the classroom can trigger allergies for some kids.

Our doctors can help find out what’s causing your watery, itchy eyes and runny nose. They’ll talk to you about your medical history and symptoms, and may recommend a skin test. To do this, the doctor will place a tiny amount of the allergen on your skin – usually on your back or forearm – and then prick or scratch the skin underneath. If you’re allergic to it, you’ll get a small, raised bump that itches like a mosquito bite. Sometimes a blood test may also be used to figure out a cause.

There are medications you can use to ease symptoms of allergies. Steroid nasal sprays can reduce inflammation in your nose. Antihistamines help stop sneezing, sniffling, and itching. Decongestants help relieve stuffiness and dry up the mucus in of your nose. Immunotherapy in the form of allergy shots or oral tablets or drops can also help you feel better. You can buy some allergy medications without a prescription, but talk to our doctors to make sure you get the right one.

To manage symptoms on your own try staying indoors with the doors and windows closed when pollen is at its peak (usually in the late morning or midday). Before you turn on your heat for the first time, clean your heating vents and change the filter. Bits of mold and other allergens can get trapped in the vents over the summer and will fill the air as soon as you start the furnace. Use a HEPA filter in your heating system to remove pollen, mold, and other particles from the air. Use a dehumidifier to keep your air at between 35% and 50% humidity, and consider wearing a mask when you rake leaves so you don’t breathe in mold spores.

Care for Your Ears During Summer Swimming

July 4th, 2018

swimmers-earThere is nothing like dunking yourself in cool water to avoid blistering summer heat. If you avoid swimming for fear of swimmer’s ear, a popsicle can only do so much to keep you cool. There are steps you can take while enjoying a summer swim to help your ears stay healthy while you stay cool and comfortable in the water.

First, pick your pool carefully. Avoid swimming in bodies of water that may be contaminated with bacteria. Check for regular cleaning and disinfecting schedules if using a public pool. Research pollution level warnings before planning a swim in local rivers, lakes or ponds.

They may not look cool, but wearing a swimming cap helps protect your ears from getting wet while you are swimming. It is important to put the swimming cap on properly with the ears completely covered. To put it on, stretch the swimming cap open. Lean forward and slide the cap on, slowly moving your hands downward as the cap slides onto your head. Once the swimming cap reaches your ears, remove your hands completely and tug the cap down until snug.

Or, wear ear plugs as an alternative to a swimming cap to prevent water from entering the outer ear canal. Ear plugs come in both disposable and reusable versions; people who do not have latex allergies should consider using reusable latex plugs. Just be sure not to push the plugs too deep into your ear.

When you are done swimming, dry your ears thoroughly. Tilt your head and pull your earlobes in different directions to help drain the water. Use a clean, soft towel to pat your outer ear, and tilt your head to the side to allow any water that has gotten into the inner ear to drain out. Or, use a blow dryer on its lowest setting. Hold it a foot out away from each ear for about 30 seconds. It is possible to buy over-the-counter eardrops to help dry up any leftover water. But don’t put eardrops in your ear if you have had any ear pain, ear surgery, or have a tear in your eardrum.

If you have pain or discomfort inside your ear or a pussy oozing from your ear after swimming, make an appointment so that we can help you get back on the pool floatie faster!

Kids’ poor nutrition could lead to later-life hearing loss

June 4th, 2018

8acd5da8376aa8d9333b7e4d0e9ff76fBlue popsicles, fruit snacks and pepperoni pizza may be rites of childhood … but they may not be great for long-term hearing. Poor nutrition in childhood can lead to an increased risk for developing health conditions – including  hearing loss, according to a study published in the American Journal of Clinical Nutrition. Researchers found that young adults who suffered from poor nutrition in early childhood were twice as likely to suffer hearing loss than their better-fed peers.

Researchers looked at the relationship between nutrition and hearing of 2,200 young adults in Nepal. They found that those who were too short or too thin for their age were twice as likely to show signs of hearing loss. The link from nutrition to hearing could occur a couple of ways. In the case of stunted growth, researchers suspect poor nutrition impedes inner ear development beginning in the womb. Being underweight, on the other hand, raises the risk for developing chronic ear infections.

“Our findings should help elevate hearing loss as a still-neglected public health burden, and one that nutrition interventions in early childhood might help prevent,” Keith West Jr., principal investigator of the study said.

In the United States, poor nutrition early in life is often a result of food insecurity, or the inability of a family to afford enough food for all its members, said West. Just over 12 percent of American households were food insecure in 2016. Poor nutrition can also be a result of choice. Empty calories from added sugars and fats account for 40 percent of daily calories for children and adolescents age 2-18 years of age, according to Centers for Disease Control. Most youth in the U.S. do not meet daily fruit and vegetable recommendations or drink the recommended amount of water.

Modeling good health habits for your family can help your children and grandchildren develop healthy habits of their own and stave off hearing loss due to poor nutrition.  Eat a balanced diet, get the proper amount of exercise, protect your hearing from exposure to loud or excessive noise, and schedule regular checkups with one of our hearing professional.

For more on the research:
https://academic.oup.com/ajcn/article/107/2/268/4840587

Avoiding the Eight Most Common Food Allergy Triggers

May 6th, 2018

food_allergies1Food allergies are caused by your immune system. Your body misidentifies a harmless food as something that could make you sick and tries to protect you. When you eat something you’re allergic to, your immune system responds. You might get a mild skin rash or itchy eyes, or you could have a bigger reaction that leaves you gasping for breath. Food allergies can be serious, but you can take steps to manage them. One of the best things you can do is avoid your trigger foods.

Eight foods cause about 90% of food allergy reactions:

  • Milk (mostly in children)
  • Eggs
  • Peanuts
  • Tree nuts, like walnuts, almonds, pine nuts, brazil nuts, and pecans
  • Soy
  • Wheat and other grains with gluten, including barley, rye, and oats
  • Fish (mostly in adults)
  • Shellfish (mostly in adults)

Less common foods that may trigger allergies include:

  • Corn
  • Gelatin
  • Meat — beef, chicken, mutton, and pork
  • Seeds, often sesame, sunflower, and poppy
  • Spices, such as caraway, coriander, garlic, and mustard

An allergic reaction can happen within minutes of eating, or it may happen hours later.

Mild symptoms can be hard to tie to specific foods. You could get red, swollen, dry, or itchy skin rash, including hives or eczema. Or, you may experience a runny or stuffy nose, sneezing, or a slight, dry cough. Other symptoms can include itchy, watery, red eyes, itchy mouth or inside your ears, a funny taste in your mouth, or upset stomach, cramps, throwing up, or diarrhea.

Peanuts, nuts, fish, and shellfish more often cause severe reactions, although any food can. Symptoms include trouble breathing or swallowing, swollen lips, tongue, or throat, feeling weak, confused, or light-headed, or passing out, or experiencing chest pain or a weak, uneven heartbeat.

Because young children may not know how to describe what’s happening, they might say something like, “My mouth is tingling,” “My tongue feels heavy,” or “I’ve got a frog in my throat.” A hoarse or squeaky voice or slurring words are also signs of an allergic reaction in kids.

Sometimes symptoms affect your whole body and are so serious that they’re life-threatening. This kind of reaction is called anaphylaxis, and it’s a medical emergency. It usually happens a few minutes after you’ve eaten. If you have asthma as well as a food allergy, you’re more likely to have anaphylaxis. When you have a severe food allergy, you should carry injectable epinephrine (adrenaline). It can ease symptoms until you can get medical attention. Do not hesitate to use the epinephrine auto-injector ever if you are unsure your symptoms are caused by an allergy. The epinephrine could save your life.

For highly allergic people, even tiny amounts of a food (for example, 1/44,000 of a peanut kernel) can set off a reaction. Less sensitive people may be able to eat small amounts of their trigger food.