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Breastfeeding, Disease Modifying Therapies (DMTs), and Postpartum Relapse in Multiple Sclerosis

Women with multiple sclerosis (MS) have higher risk of relapse during the postpartum period.  Can exclusive breastfeeding alone prevent relapses? How soon after delivery should disease modifying therapies (DMTs) be reintroduced? Are any DMTs safe to take while breastfeeding? 
 
While disease modifying therapies (DMTs) have been shown generally to reduce relapse rates, none of them are indicated for use during pregnancy and lactation. Therefore, the question of when to restart DMTs postpartum remains a difficult one for physicians counseling MS patients who wish to breastfeed their children.
 
Trying to predict the risk of relapse for any one individual is very difficult. The risk factors for postpartum attacks include ...

How to deal with gas and bloating

We all have occasional gas, usually from something we have eaten, but many people feel that they pass too much gas or burp too frequently. Intestinal gas can result in abdominal pain, bloating and embarrassment.
 
The amount of gas produced by the body depends upon your diet and other factors. Most people with symptoms of excessive gas do not produce more gas than the average person, but are more aware of normal amounts of gas.
 
Where does the gas come from?

New products available for allergy treatment

For those with seasonal allergies, treatment can be as simple as an over-the-counter medication, but often requires more.  The good news is that there are a lot of options now. Some new products have been recently approved by the FDA to help individuals who are dealing with grass and ragweed allergies.

The treatment of nasal and eye symptoms from allergies includes antihistamines, nasal sprays and allergy shots.  Over the counter antihistamines include diphenhydramine (ex. Benadryl), loratadine (ex. Claritin), cetirizine (ex. Zyrtec), or fexofenadine (ex. Allegra).  Over the counter allergy eye drops are also available, such as ketotifen (ex.Zaditor).  Together, these help with itchy, sneezy, watery nose and eyes.  Nasal antihistamines are prescription and also help with these symptoms.  Nasal steroids help decrease congestion and postnasal drip.  

A long-standing solution ...

Screening for Abdominal Aortic Aneurysm (AAA)

Abdominal aortic aneurysm (AAA) occurs when a weak area in the aorta (the major blood vessel that sends blood through the body) dilates and quietly expands. The dilated area can rupture or leak. Often AAA is only discovered when it appears on an X-ray taken for some other reason – or when it ruptures.
 
AAA is the third leading cause of death in men ages 60 and older. Nearly 90 percent of the time, a ruptured AAA causes death, so it is important to discover and treat it early.
 
Risk factors include:

Why aren't my bowel habits normal?

Do you have irregular, uncomfortable, or distressing bowel habits? Irritable Bowel Syndrome (IBS) is the most common gastrointestinal condition affecting an estimated 15% of the general population.  It is most common among women aged 30 to 49 years old.

IBS is a chronic condition of the digestive system that is not generally associated with more concerning findings of anemia, weight loss, family history of colorectal cancer, inflammatory bowel disease, or celiac disease. Symptoms of IBS include abdominal discomfort, constipation and diarrhea. Despite extensive research, no common cause of IBS has been identified. Some theories include:

Spiders and Bees and Bugs, Oh My! Treating insect bites and stings

Another beautiful Seattle summer is just around the corner.  As we stare out windows and wait for our long days of sunshine to begin, know this – the bugs are doing the same thing!  Any day now all our biting, stinging, and pinching friends will begin to appear.  Make sure you prevent bites with insect repellants.  The American Academy of Pediatrics recommends using repellants containing 30% or less of DEET for all children older than 2 months of age.  But if a bite happens, arm yourself (and your medicine cabinet) with a treatment plan to get your kids back outside ASAP.
 
Treatment for ...

When do kids need antibiotics?

Winter can seem like one long continuous “sick day” for families - kids pick up frequent infections at school or daycare and pass them around to everyone at home.  Often it feels like by the time the illness has worked its way through the household, a new one has started!  Even for physicians, it can sometimes be difficult to distinguish between viral and bacterial infections.  Since antibiotics cannot treat viruses, they are often over-prescribed - which can lead to significant side effects in children and also contributes bacteria becoming resistant to existing medications.  In November 2013, the American Academy of Pediatrics released an updated guidance regarding antibiotic treatment, helping answer the frequently asked question about when kids need antibiotics.

Here's what you should know about antibiotics in these situations:

  • Ear infections ...
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