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How our voices work, and what to do when a voice doesn't work

A voice is an amazing thing.

With our voice, we convey information, express emotion and provide entertainment. We each have our own unique vocal ‘fingerprint’ that allows our friends to recognize us when we call them on the phone. We rely on our voice to win a debate, negotiate a contract, reassure a frightened child, and to celebrate a victory. Our tone conveys honesty, anger, happiness and fear. A song can inspire a spectrum of emotions, and recall past memories.

So how does our voice work? And what do you do when it doesn’t work?

Voice is produced when air is pushed up from the lungs to the level of the vocal cords. The vocal cords vibrate, producing sound. The vocal cords tense, lengthen and stretch to produce different frequencies. The sound is then shaped by the upper airway to add resonance and articulation resulting in speech or song.

The vocal cords themselves are thin bands of tissue over muscle. They sit within a framework that has a complex nerve supply and multiple paired muscles that allow very nuanced changes in vibration of the vocal cords, well demonstrated in professional singers.

Subtle differences in vibration or movement can ...

Probiotics and our gut - what you should know

Did you know that the bacteria that live in our intestines account for over two pounds of our body weight? And that there are 10 times the number of bacterial cells in our body than human cells? Some bacteria play a beneficial role in a normal gastrointestinal (GI) tract and are known as probiotics.

Probiotics have a variety of functions in the GI tract including aiding the intestinal immune system and the intestinal nervous system, breaking our food into nutrients, blocking the bad bacteria, and promoting a healthy intestinal lining. With so many important tasks, it is no surprise that probiotics can be used to treat some common GI conditions. Though studies of probiotics are small with considerable variability, there is evidence supporting probiotic use for prevention of diarrhea caused by antibiotic use and treatment of infectious diarrhea, ulcerative colitis, clostridium difficile, and irritable bowel syndrome.

What you should know:

The U.S. FDA considers probiotics as dietary supplements, so their production is not tightly regulated and quality can vary widely. In addition, insurance companies do not cover probiotics, and the cost adds up quickly.

Should I ....

Information from Swedish on Multistate Fungal Meningitis Outbreak among Patients who Received Contaminated Steroid Injections

SEATTLE, Oct. 23, 2012 – The U.S. Food and Drug Administration (FDA) is investigating a multistate outbreak of fungal meningitis and joint infections. It appears the outbreak is due to the contamination of an injectable steroid medication called methylprednisolone acetate produced by the New England Compounding Center (NECC). Swedish has never carried the methylprednisolone acetate product produced by NECC.

Getting ready for flu season

Influenza (“flu”) season is unpredictable but usually starts in October each year and peaks around January or February. The Centers for Disease Control (CDC) currently recommends annual flu vaccination for all people older than 6 months. Getting vaccinated is particularly important if you or someone with whom you live has a chronic medical condition, like asthma or chronic obstructive pulmonary disease (COPD).

Here are some things I want you to know about influenza and vaccination:

First, influenza is a serious medical illness that can lead to hospitalization and even death. Annually, up to 200,000 people are hospitalized for influenza. Sadly, the H1N1 outbreak in the 2009 – 2010 flu season caused about 12,000 deaths.

Second, influenza vaccination is the best way to prevent you from getting the flu.

Third, you cannot get sick from getting the flu shot! Some people ...

Eliminating your risk for stroke

In the clinic, we work with stroke patients and their families to help them understand the risk of having a second stroke and what they can do to reduce their risk. Lifestyle and medical conditions determine your risk for a first, or second, stroke.

  • Do you have high blood pressure and/or high cholesterol?
  • Do you have diabetes?
  • Have you been diagnosed with atrial fibrillation?
  • Do you smoke?
  • Are you overweight?
  • Do you avoid exercise?
  • Has a close relative had a stroke?

If you answered yes to any of those questions, you’re at greater risk for having a stroke. If you’ve already had a stroke, your “yes” answers mean you’re more likely to have another one.

Your lifestyle can help you avoid a first or second stroke. And, because family history is a stroke risk factor, your entire family can benefit from a healthy way of life. Pledge to help each other stick to a routine that includes:

  • No smoking
  • Healthy eating
  • Regular exercise
  • Taking medications are directed
  • Losing weight if you are overweight or obese
  • Drinking alcohol only in moderation
  • Taking low-dose aspirin or a similar medicine (if recommended by your doctor)
  • Managing your blood sugar if you have diabetes.

What to do when Seattle gets hot

The area is heating up. The National Weather Service has announced an excessive heat watch for this Thursday and Friday, with temperatures that will rise into the low to mid 90s. When outside temperatures are very high, the danger for heat-related illnesses rises. Older adults, young children, and people with mental illness and chronic diseases are at particularly high risk.

Here are some safety tips to avoid overheating and things to consider for the weekend:

Stay cool:

  • Spend more time in air conditioned places. If you don't have air conditioning, consider visiting a mall, movie theater or other cool public places.

  • Cover windows that receive morning or afternoon sun.

  • Dress in lightweight clothing.

  • Check up on your elderly neighbors and relatives and encourage them to take these precautions, too.

Drink liquids:

  • Drink plenty of water; this is very important. Avoid drinks with caffeine, alcohol and large amounts of sugar because they can actually de-hydrate your body.

  • Have a beverage with you as much as possible, and sip or drink frequently. Don't wait until you're thirsty to drink.

If you go outside:

  • Limit the time you're in direct sunlight.

  • Do not leave infants, children, people with mobility challenges and pets in a parked car, even with the window rolled down.

  • Avoid or reduce doing activities that are tiring, or take a lot of energy.

  • Do outdoor activities in the cooler morning and evening hours.

  • Avoid sunburn. Use a sunscreen lotion with a high SPF (sun protection factor) rating.

  • Wear a hat or use an umbrella for shade.

What test is best for breast screening?

I often get asked why can’t a woman just get a breast MRI rather than a mammogram. The imaging tests that we do for breast cancer screening and evaluation of abnormalities have different strengths and weaknesses.

Mammograms are very useful as a screening tool. They can be done quickly and read efficiently by the breast radiologist. They have minimal radiation exposure. They can be done by a mobile coach in locations that are more convenient to patients. They are excellent for identifying abnormal calcium deposits within the breast tissue and for seeing disrupted tissue and masses. They may be less effective in women who have dense breast tissue but the digital techniques have helped some with that. 

Ultrasound is a great tool for evaluating a mass or tissue asymmetry found on mammograms. It can distinguish between a benign appearing solid mass, a fluid filled cyst, a mass that is suspicious for cancer, or normal appearing breast tissue. There is no radiation exposure. It is less reliable as a screening tool because it can be dependent on the skill of the physician or technologist doing the procedure. It is possible to miss abnormalities or to mis-interpret normal findings as abnormal. There are studies underway evaluating using an automated version of ultrasound as a screening test but the results are not conclusive and this is not considered ready for standard practice.

Breast MRI is a highly sensitive test that is very dependent on...

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