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Jaundice in newborn babies

As a new parent, you’re understandably eager and excited to leave the hospital and settle into your new routine with your baby. Sometimes, that routine is delayed due to the baby’s blood test confirming hyperbilirubinemia, also known as jaundice.

Jaundice in newborns is caused by an excess of red blood cells. Jaundice is seen as a yellow color to the skin, appearing first at the head (skin and sclera – or “whites of the eyes”) then progressing to the feet. As it decreases, it lessens in reverse. Before birth, the placenta removes bilirubin from the baby’s system; after birth, the baby’s liver takes over. In breast-fed babies, an imbalance between mother’s milk supply and baby’s feeding can lead to a higher-than-expected bili level. In addition to ensuring the baby is feeding well and having enough wet/stool diapers, phototherapy or “bili lights” may be needed. Bili lights help speed up the process by breaking down the bilirubin in the skin.

For phototherapy, your baby will be ...

Troubles swallowing food or liquids – what does it mean?

Dysphagia refers to the sensation of food or liquid being delayed or hindered from the mouth to the stomach.  This abnormality is increasingly recognized as an important concern that requires attention and study.  There are many causes of impaired swallowing, which are categorized into two types, mechanical, a structural barrier to food bolus movement, and motility disorders, involving abnormal muscle movement.  There are also two major anatomical sites, oropharyngeal and esophageal. 
 
Oropharyngeal dysphagia is related to problems with the initiation of the swallows and clearing the food bolus from the mouth to the esophagus.  This usually occurs within a second of swallowing and you may feel that you cannot initiate a swallow or food hangs up in the neck region.  A test that is commonly used to evaluate this is a modified barium swallow or videofluoroscopic swallowing study.  This study provides critical information on inability or excessive delay in initiation of swallowing, unintentional inhalation of food, unintentional expulsion of food from the nose or mouth, and/or abnormal retention of food in the back of the throat after swallowing.  Most ...

January 25 essential tremor seminar

If you or someone you care about shakes a lot—it could be essential tremor (ET) or another movement disorder. Essential tremor is a disorder affecting approximately 10 million Americans. This progressive neurological condition can cause the hands, head, voice, legs or trunk of the body to shake and can cause significant disability. It is often confused with Parkinson’s disease or dystonia. Because of stereotypes and lack of awareness, many people with ET never seek medical care, though most would benefit from treatment.
 
In an upcoming event, Dr. Ryder Gwinn will explain the causes, diagnosis,  research and treatment options for essential tremor.
 
Date: Saturday, January 25
Time: Check-in 9:30am/Program 10am-Noon
Location: Bellevue Hilton, 300 112 Ave SE, Bellevue, WA
 
There is no charge for the event but please note, parking in the Bellevue Hilton lot is $5.

Registration is required - call 888-387-3667 or visit www.essentialtremor.org/seminars

 

 
 

How to manage tinnitus (when your ears are ringing)

Almost all individuals experience ”transient ear noises” which is the intermittent sensation of ringing (lasting less than 5 minutes), typically in one ear. At times this sensation is accompanied by a sensation of fullness or a momentary change in hearing. When this change is brief, it is a normal phenomenon.  If it lasts longer than 5 minutes twice week, you should be evaluated for tinnitus.

What should I do when my ear(s) start ringing? 

The first step is a comprehensive hearing evaluation by an audiologist.  Tinnitus can be caused by a variety of auditory disorders and a complete audiology evaluation will confirm and/or rule out many of these conditions.  Pending the hearing test results, you may be referred to an otolaryngologist (sometimes referred to as an ENT or an Ear, Nose and Throat physician) or other health care providers.  The otolaryngologist will further investigate your tinnitus for possible medical causes. 

It is normal for tinnitus to occasionally change in the pitch and intensity; however, significant and prolonged changes in tinnitus (increased loudness or tinnitus that is one-sided) should be (re)evaluated.   Tinnitus that is present in one ear (unilateral) or pulsatile will always require an otolaryngology evaluation after the hearing evaluation.  Tinnitus that is accompanied by a sudden hearing loss is considered an emergent condition and individuals should be evaluated by an audiologist and otolaryngologist as soon as possible.

How can I manage my tinnitus?

Tinnitus can evoke ...

What causes constipation and how is it treated?

People often fear the worst about constipation.  Constipation is very common and only rarely signifies something serious.  Just because the average person has a bowel movement daily doesn’t mean you have to—if normal for you is every 3, 5, or 7 days that is okay so long as it’s not adversely affecting your life. In many cases, people with constipation struggle with it all their lives and are looking to be certain nothing more serious is going on and for a way to treat their symptoms.  Even in people with relatively new onset of constipation, there usually is a simple solution.  It is certainly reasonable to have your constipation assessed but in the absence of other warning signs for more serious disease, additional testing related to constipation is not always essential.

What are the causes of constipation?

Colonic inertia

  • Most cases of constipation are caused by colonic inertia, which is simply a slow moving colon.  Different people are made differently, and the muscles and nerves that are supposed to act in concert to push stool along just work a little slower in people with constipation.  In such cases, if we could look at the colon under the microscope it would look normal but if we took an x-ray of how quickly it pushed stool through, it would on average move things along more slowly.

Pelvic floor dysfunction

  • If ...

Is the FODMAP diet right for you?

FODMAPs is an acronym, coined by two Australian researchers, that refers to Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols.  These are small chain sugars, fibers, and sugar alcohols that are poorly digested by humans, but are easily digested by the bacteria in your intestine and colon.  When the bacteria consume FODMAPs, they produce gas, which leads to symptoms of gas, bloating, abdominal discomfort, and changes in bowel movements.  The FODMAP diet is used to alleviate the impact these types of foods have on your gastrointestinal tract. 

A diet low in FODMAPs food was designed to help minimize symptoms in individuals that suffer from irritable bowel syndrome (IBS) and functional bloating.  You should discuss your symptoms with your physician prior to starting this diet since other gastrointestinal related disorders need to be excluded first (i.e., celiac disease, thyroid disease, inflammatory bowel disease, and others). 

If a diet low in FODMAP is recommended for you ...

Tips for reducing hot flashes for women with breast cancer

Hot flashes are the most common complaint from women going through menopause. And for women who are breast cancer patients, the problem is often more acute. Surgery, chemotherapy and estrogen blocking medications can bring on hot flashes or make them worse if you already have them. And for women who must discontinue hormone replacement therapy, the instant onset of hot flashes and night sweats can severely impact quality of life.

Fortunately, there are several strategies you can easily and safely employ to decrease the severity and frequency of hot flashes and night sweats. Everything I recommend here is non-estrogenic so while it is generally safe for breast cancer patients and survivors, you should always check with your oncologist before trying any new supplement.

First, a few notes on diet. I recently had a patient who stopped eating refined sugars for general health reasons, and her hot flashes nearly disappeared. Your mileage may vary on this one but there are clear health benefits from lowering sugar intake, so it may be worth a try. You might also try ...

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