November 2nd, 2011 by ChristopherChangMD in Opinion, Research
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I read with astonishment that a class of cancer drugs known as VEGF Inhibitors (ie, Avastin and Erbitux) used to treat colorectal, lung, breast, and kidney cancers can also be used to potentially treat a type of chronic ear infection known as glue ear… at least in theory and in mice. Glue ear is when an individual suffers from repetitive ear infections or upper respiratory infections to the point where the fluid in the ear turns into a maple syrup consistency. It’s thick, sticky and tough to get rid of with standard antibiotic medications. Standard treatment to address glue ear is placement of ear tubes to allow ventilation and drainage of the ear as well as antibiotic/steroid ear drops.
British researchers using the mouse model have determined that Read more »
*This blog post was originally published at Fauquier ENT Blog*
December 26th, 2010 by Toni Brayer, M.D. in Better Health Network, Health Tips, News, Research
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We now have another condition that may be prevented by eating a healthy diet, exercising, and abstaining from smoking: Age-related macular degeneration (AMD).
Macular degeneration causes a loss of central vision and makes it difficult to recognize faces and read small print. The macula degenerates with age and severe macular degeneration causes blindness. Treatment is costly and doesn’t work very well.
A new study published in the Archives of Ophthalmology looked at 1,313 women aged 55 to 74 years. They reviewed their diet and exercise habits. Eating a “healthy diet” meant 3.5 servings of fruit and vegetables, 2.3 servings of dairy, 2.7 ounces of meet and 3.5 servings of grain a day. Exercise habits and smoking history were also monitored. Read more »
*This blog post was originally published at EverythingHealth*
December 27th, 2008 by Dr. Val Jones in True Stories
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Fortunately for me, my recent brush with the healthcare system was not as frightening as Dr. Dappen’s (he blogs here every Wednesday and recently had a mild heart attack). However, it was provided me with some amusing blog fodder.
Last week I was minding my own business, planning to purchase a new batch of contact lenses from a local optometrist, when I was required (under threat of withholding my lenses) to undergo a vision exam. Much to my disappointment, my right eye was not behaving itself, and refused to correct to 20/20 despite a good deal of lens fiddling on the part of the doctor. A slit lamp retinal evaluation followed, and the optometrist concluded that my right eye’s macula “looked like an 85-year-old’s.”
Well, that was not the most welcome of observations. I asked for the differential diagnosis (being that I’m quite a few years away from 85) and wondered how I’d developed macular degernation. He suggested that it could also be a “central serous” which is (apparently) a stress-related swelling of the macula that requires no treatment and usually resolves on its own.
“So basically you’re saying that my eye could be ‘bugging out’ because of stress.” I said. “And you’d like me to see an ophthalmologist just in case it’s something worse and equally untreatable?”
“Right.”
So I made an appointment with a local ophthalmologist – one of the few working on Christmas Eve – and was sorry to have him confirm that there was indeed something wrong with my retina. He even ordered an eye angiogram (I didn’t know those existed, but it makes perfect sense) and I was injected with a vegetable dye. Photographs were taken through my dilated pupils at regular intervals as the dye wound its way through my retinal vasculature.
“It’s not a central serous.” He said with a serious tone. “And you can see the macular defect here on this photograph.”
“So my right eye is like an 85-year-old’s?” I asked, wondering how I’d been so fortunate to have one part of my body on the aging fast-track.
“Well, not exactly. I think it’s unlikely to be age-related macular degeneration. You probably have retinal thinning caused by your nearsightedness.”
“You mean all that straining to see the chalk board wore out my retina?”
“No. What I mean is that your eye is supposed to be shaped like a baseball, but yours is an egg shape. So your retina is stretched thin and is starting to wear in your macula area.”
“Well can you suck out some of the vitreous gel and shape my egg back into a baseball?”
“No. Unfortunately that doesn’t work.”
“How do you know?”
“The Russians tried it in the 1960s.”
“Ok, well how do I take some of the tension off my stretched out retina?”
“You can’t.”
“Well if I lose weight or eat carrots or exercise, or stop wearing contacts, or get lasik… would any of that help?”
“No.”
“So there’s nothing I can do to prevent further damage, and nothing to repair or treat it.”
“Right.”
Pause.
“I don’t like this condition.”
“Well, you’ll have to come and see me once a year so I can monitor the progression. Sometimes the body responds to the retinal damage by growing blood vessels in the area, and that can cause further visual deficits. But we can zap those new vessels with a laser and decrease the damage.”
“So my eye might overgrow with blood vessels like weeds in a garden.”
“It might. But it also may stay exactly the same for the rest of your life.”
“Well, the uncertainty is anxiety-provoking.”
“I’ll see you in a year. You’ll probably be fine. Don’t worry. Oh, and if you see any ‘floaters’ or flashes of light, come in to see me immediately.”
“What would that indicate?”
“A retinal tear that would need laser therapy right away. People with thin retinas can have spontaneous tears. Just keep that in mind.”
“Um… ok.” I said, smiling feebly.
So here I am, with one wonky eye, not knowing if it will get worse or remain the same indefinitely. There’s nothing I can do but watch the progression once a year with an ophthalmologist. Like so many patients, I’m in a gray zone where prognostication is a challenge and reversal of disease is not possible. I have one 85- year-old eye. May it bring me wisdom, courage, and more empathy for patients.
