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What is Muscle Tension Dysphonia (MTD)?

Muscle tension dysphonia (MTD) is one of the more confounding and misunderstood conditions of the voice.  With this condition the vocal cords and supporting structures may be healthy but they are working too hard.  MTD is caused by the throat muscles being too tight and out of balance with the rest of the voice production system.  The person with MTD may feel that it takes more effort to talk and their voice gets worse the more they talk.  Many patients may feel a soreness of their neck, throat and often their shoulders. Sometimes MTD may develop in trying to compensate for a weak vocal fold or a vocal fold lesion.

MTD is characterized by the following:

  • Voice that sounds rough, hoarse, gravely, or raspy
  • Voice that sounds weak, breathy, airy, or is only a whisper
  • Voice that sounds strained, pressed, squeezed, tight, or tense
  • Voice that suddenly cuts out, breaks off, changes pitch, or fades away
  • Voice that “gives out” or becomes weaker the longer the voice is used
  • Pitch that is too high or too low
  • Difficulty singing notes that used to be easy
  • Pain or tension in the throat when speaking or singing
  • Feeling like the throat is tired when speaking or singing
  • Voice that may sound normal sometimes, such as during laughing or coughing

Once an otolaryngologist has examined you and diagnosed you with MTD, you will typically be referred to a speech pathologist for voice therapy.  In some cases there may be some underlying physical or emotional stress contributing to the dysphonia.  Our voices are very emotional instruments and help to convey a spectrum of emotions including happiness, sadness and anger.  “I’m all choked up” is more than just a figure of speech.  As such, you may ...

What is Pilonidal Disease?

Pilonidal disease is a subcutaneous skin infection that occurs in the upper half of the gluteal cleft (the tailbone area, and/or between the buttocks). 

Etiology

The term “Pilonidal” means nest of hairs.  Interestingly, in 50% of reported cases, there was not any hair found within the pilonidal abscess.  This is routinely the case for females.  Although hair can contribute, the most common cause of pilonidal disease is an exploded follicle called a pit, which is located in the gluteal cleft, or midline region (between the buttocks). 

Who is at risk for Pilonidal disease?

Pilonidal disease is only slightly more common in men than women, and is most likely to occur between the ages of 16 – 26, correlating with puberty.  It should be noted that pilonidal disease can develop in younger and older age groups.  Pilonidal disease occurs less in Asian and black populations.  Other risk factors of pilonidal disease include:

  • Obesity
  • Sedentary lifestyle
  • Individuals with more body hair
  • Occupations with prolonged sitting

Diagnosing Pilonidal Disease

Pilonidal disease, similar to a large pimple, can burst through the skin by itself or may need to be lanced or drained to let the infected fluid escape.  Pilonidal disease is classified into three stages:

Why do people get hemorrhoids?

Hemorrhoids are composed of blood vessels found in the internal and external anal area. Believe it or not, everyone is born with hemorrhoidal tissue. Although there are several theories regarding the function of hemorrhoids, many physicians believe that hemorrhoids help maintain fecal continence.

Why Do People Get Hemorrhoids?

When the blood vessels become enlarged (similar to varicose veins in the leg), hemorrhoids may begin to bleed, become swollen, and can be extremely painful.

There are several reasons why enlargement of these veins can occur. The most common reasons are thought to be related to straining and increased pressure on the abdomen, including:

  • Constipation
  • Prostate problems in men
  • Chronic cough
  • Dietary factors
  • Pregnancy

Should Hemorrhoids Be Treated?

If symptoms are mild or infrequent, then treatment may not be necessary. If symptoms are more severe, such as frequent pain, bleeding, itching, or, difficulty with hygiene, there are several treatment options available.

Treatment options will vary depending upon the size of the hemorrhoid and if it is internal or external. Common treatments include:

  • Sitz baths
  • Prescription medications
  • Rubber band ligation
  • Surgical removal

Most procedures can be completed in the physician’s office and take less than 30 minutes. If surgery is required, patients go home the same day.

Will Hemorrhoids Come Back After Treatment?

Following treatment, a recurrence is uncommon. If hemorrhoids do return, conservative therapy usually corrects the problem.

The ‘Bottom’ Line

You do not have to live with, or schedule your daily activities around your hemorrhoidal discomfort. Our goal is to help find treatment that is right for you.

If you have questions about hemorrhoids or treatment options, call the Swedish Colon & Rectal Clinic at 206-386-6600.

Why is it hard to swallow?

Many people suffer from difficulty swallowing (dysphagia) acutely or chronically. Difficulty with swallowing may be a result of a problem anywhere from the lips to the stomach. It may be identified by weight loss, coughing or choking when eating, delayed cough or regurgitation, or outright obstruction. This is more likely to be an issue after a stroke or in elderly and frail individuals. In the inpatient population, symptoms suggesting some level of dysphagia may be as high as 34%. So what do you do if you feel like your swallow isn’t quite right?

Tips for getting the most out of your inhalers

“Darn! My inhaler is out and I am going to have to call today, a Sunday, to get a refill…”

Spring is here! And that means asthma season is back, and with the nicer weather, pollen counts are high. Flowers are wonderful and the trees beautiful, but if you are like me, some of those plants have your number. The beautiful smells come with itchy eyes, sneezes, and for some, a serious amount of wheezing.

Patients are reaching for their inhalers more often, and sometimes getting into serious respiratory trouble, especially if their medication is running short. Inhalers are expensive, too, and so using them optimally is both financially and healthfully important.

Fortunately, a couple of tricks can really help maximize an asthma spray’s value.

The medication comes out fast and hard when you squeeze the canister, and it can be difficult to time your breath to inhale the dose well, plus with the energy of the release being so high, a lot of misted drug can zoom right out of your mouth. The trick is to use a ‘spacer’, and the simplest is a rolled up piece of paper, to about a one inch diameter. Tuck the sprayer in the far end, wrap your lips around the outside of the other end, and take your leisure squeezing and breathing! The tube holds the mist in place for a few seconds, letting you better coordinate your inhalation and improve substantially the amount of drug you get to where it is needed.

The second tip is to use a steroid inhaler daily if you need your rescue inhaler more than a few times a week. The rescue inhaler will become less effective the more you use it if you don’t directly treat the inflammation of the allergic response in your bronchial tubes with a low dose of cortisone type medication. The dose of the latter is small and will not cause harm to the rest of your system if used according to directions, but it will keep your rescue medication most beneficial!

What is Gastroenteritis?

This past week, Britain’s Queen Elizabeth II was hospitalized with a “stomach bug”. Gastroenteritis (also called the “stomach flu”) is the second most common illness in the United States. So, chances are good that your family has been affected by gastroenteritis already this year!

What are the symptoms of gastroenteritis?
Gastroenteritis is inflammation of the stomach and intestines causing symptoms of diarrhea, vomiting, cramping, and fever. If a person is not able to keep up with fluid losses from diarrhea and vomiting, then they can become dehydrated. Gastroenteritis occurs year-round and affects people of all ages. Those who are young, old, or have a suppressed immune system are more susceptible to severe gastroenteritis and to dehydration.

What causes gastroenteritis?
The majority of cases are caused by a viral infection (occasionally, a bacterial infection) transmitted through contact with another sick person or contaminated food/drink.

I have gastroenteritis, how can I feel better?
Rest and fluids! Staying hydrated is the most important step to controlling gastroenteritis. Some good options for staying hydrated include sports drinks or oral rehydration solutions (such as Pedialyte in drug and grocery stores).

I typically do not recommend any anti-diarrheal medications as this may even prolong the illness. In addition, antibiotic therapy is not helpful unless a specific bacterial cause is identified.

When should I call my doctor?
If you have questions or concerns you should always call your provider. However, things to watch for if you have gastroenteritis include:

How to have more good days with COPD (chronic obstructive pulmonary disease)

Patients who are well educated about their medical conditions and who use self-management plans created in collaboration with their doctors have better outcomes in a number of chronic medical conditions. Chronic obstructive pulmonary disease (COPD), which includes both chronic bronchitis and emphysema, is no exception. Patients who understand the disease process that causes COPD and who understand their treatment and management plans have fewer emergency room visits, fewer hospitalizations and fewer days with COPD-related symptoms.

If you are one of the 12 million people who know they have COPD, what can you do to have more days without COPD-related symptoms?

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