Diseases & Conditions Archive

Macular Degeneration

Questions to Discuss with Your Doctor:

• Have you noticed a change in vision in one eye or both?
• Do you have trouble reading, even with reading glasses?
• Do you have difficulty seeing fine details?
• Do you see a gray patch in the middle of the words when you read?
• Do straight vertical lines appear "wiggly" when you look at them?
• Is your side or peripheral vision affected?
• Do you have diabetes?
• Do you smoke?
• Do you have a family history of macular degeneration?

Your Doctor Might Examine the Following Body Structures or Functions:

• The inside of your eye, using an ophthalmoscope (see p. 417)

Your Doctor Might Order the Following Lab Tests or Studies:

• Referral to an ophthalmologist (eye specialist) who will do a complete eye exam with drops to dilate your pupils.

Multiple Sclerosis

Questions to Discuss with Your Doctor:

• Do you have cloudy or double vision?
• Do you ever have eye pain or involuntary jumping of your vision?
• Do you have problems with clumsiness or poor coordination?
• Have you ever had numbness or tingling in your arms or legs? Tremors?
• Do you ever have hearing loss or vertigo?
• Do you have difficulty concentrating or problems with memory loss?
• Do you have any problems with bladder or bowel control?
• Do you have constipation?
• Do you have any family history of multiple sclerosis?
• Are you taking any medications?

Your Doctor Might Examine the Following Body Structures or Functions:

• Complete neurological exam focusing on reflexes, strength, gait, sensation, and vision

Your Doctor Might Order the Following Lab Tests or Studies:

• Lumbar puncture for removal and analysis of cerebrospinal fluid
• Magnetic Resonance Imaging (MRI)

When you think of risk factors for hearing loss, over-the-counter pain relievers probably aren't among them. But a Harvard study published in the American Journal of Epidemiology suggests that frequent use of ibuprofen (Advil, Motrin) or acetaminophen (Tylenol) may be an important contributor. In the study, women who took the pain relievers at least twice a week were more likely to experience hearing loss, and more frequent usage increased the risk by up to 24%. The findings are similar to a study of men and hearing loss, although aspirin was also found to contribute to risk in that study.

Researchers speculate that the pain relievers may be damaging the cochlea, the snail-shaped hearing mechanism in your inner ear. "Ibuprofen can reduce blood flow to the cochlea, which could result in cellular damage and cell death. Acetaminophen may deplete the antioxidant glutathione, which protects the cochlea from damage," says study author Dr. Sharon Curhan, instructor in medicine at Harvard Medical School.

Does this mean you should think twice before popping a pill for headache or back pain? These medicines do provide good pain relief for many people. "However, frequent use of these medications and use over long periods of time may increase the risk of hearing loss and may cause other adverse health effects. Therefore, it is important to take these medications mindfully and to limit their use as much as possible," says Dr. Curhan. As always, talk to your doctor before making any changes in your medication use.

To learn more about the things that can threaten your hearing, and what you can to do keep this sense sharp and clear, buy Hearing Loss: A guide to prevention and treatment, a Special Health Report from Harvard Medical School. 

Hard to detect and quick to spread, pancreatic cancer is among the deadliest of cancers. Scientists hope that genetic research will make it more like other cancers-a treatable disease. But even if it's caught while confined to the pancreas-and it rarely is-just 16% of patients are alive five years after the initial diagnosis. By comparison, the five-year survival rate for localized breast cancer is 86%. If the cancer has spread beyond the pancreas, the likelihood of living another five years is just 2%. Only the statistics for liver cancer are as grim.

Fortunately, pancreatic cancer is uncommon compared with other major cancers. About 50,000 new cases are diagnosed every year in the United States, in contrast to about 250,000 new cases of breast cancer, and 225,000 new cases of lung cancer. But because it's so untreatable, pancreatic cancer causes about 40,000 deaths each year. It is the 4^th leading cause of cancer death.

"Stay away from me! I don't want to get sick, too." Most of us have had to utter those words to a family member, friend, or colleague who was sneezing or coughing incessantly. But how do we know how great the chances of catching someone's cold or other illness really are? A medical review published in the New England Journal of Medicine tells us when to exercise concern over eight respiratory tract infections.

Interstitial cystitis is a chronic inflammation of the bladder that causes people to urinate -- sometimes painfully -- as often as 40, 50, or 60 times a day. Their quality of life, research suggests, resembles that of a person on kidney dialysis or suffering from chronic cancer pain. Not surprisingly, the condition is officially recognized as a disability.

There's no cure for interstitial cystitis, but many treatments offer some relief, either on their own or in combination.

Irritable bowel syndrome (IBS) is a chronic disorder characterized by recurrent bouts of constipation, diarrhea, or both, as well as abdominal pain, bloating, and gas. IBS is a functional disorder, which means that it's not attributable, as far as we know, to any underlying disease process or structural abnormality. It's thought to involve various, often interacting, factors — infection, faulty brain-gut communication, heightened pain sensitivity, hormones, allergies, and emotional stress.

The good news is that IBS doesn't increase the risk for more serious conditions, such as ulcerative colitis or colon cancer. On the other hand, a disorder resulting in (at best) annoying and (at worst) debilitating and worrisome symptoms with no known cause can be difficult to diagnose and treat, not to mention live with. Managing IBS typically involves some trial and error, which can be challenging for patients and clinicians alike. Various tests or procedures may be ordered to rule out other conditions. Many diverse therapies, not all of them proven, are used in treating the symptoms, including antibiotics, antispasmodics, antidepressants, dietary changes, relaxation techniques, and psychotherapy, as well as drugs to relieve constipation and diarrhea.

Dr. Robert S. Stern, chair of the Department of Dermatology at Harvard-affiliated Beth Israel Deaconess Medical Center , calls them "solar-phobes": people so concerned about getting skin cancer that they stay inside or cover every bit of skin. "They cover up like they were going out into the Arabian Desert ," he says. The marketing of ultrablocking sunscreens and special sun-protective clothing plays into these fears.

There's no getting around the fact that sunlight is hard on your skin. Age gets blamed for wrinkles and rough, dry skin. But the real culprit is a combination of age and sun that dermatologists call photoaging. The short UVB wavelengths that cause sunburn can also damage DNA and suppress the skin's immune system. The longer, more penetrating UVA wavelengths may create highly reactive oxygen molecules capable of damaging skin cell membranes and the DNA inside.

Fighting back against tiny allergens before they strike can help you avoid or reduce symptoms.

Image: iStock

The spring allergy season begins next month, and if you want to avoid symptoms, you must act now. "Pretreating allergies will lead to better control of symptoms, and maybe prevent symptoms from showing up," says Dr. Ahmad Sedaghat, an ear, nose, and throat specialist at Harvard-affiliated Massachusetts Eye and Ear Infirmary.

Automatic defenses

When spring allergens—typically pollen from oak, elm, birch, poplar, or maple trees, depending on where you live—float through the air and reach the nose, the body sometimes overreacts. Mast cells in the lining of the nose mistake the harmless tree particles for dangerous invaders, and summon help by releasing chemicals such as histamine and tryptase, which then recruit more immune system cells to the battle.

Most people with atrial fibrillation take anti-clotting drugs to prevent strokes. For those who cannot take these drugs because of a high risk of bleeding, a tiny, basket-like device implanted in the part of the heart that traps clots may be an alternative.