A short anatomy lesson
Our inner ear, or cochlea, has thousands of cellular components called hair cells. These cells act as biological amplifiers when the sound arriving at our ear is soft. That is, they pump up and down at the same frequency as the sound entering our ear making it more intense. This allows us to hear very soft sounds.
These same cochlear cells which amplify soft sounds can also contract and dampen the loud sounds which enter our ear. This prevents the ear from being over driven and this, in turn, prevents distortion.
So what happens if these cells are gradually damaged so that they no longer work properly? The simple answer is ...
I was traveling last week. After the stewardess pointed out the exits, the broad shouldered gentleman stuffed into the seat next to the seat I was stuffed into, decided to make some small talk. “What kind of work do you do?”
“I am an oncologist,” I said, and prepared myself for what I knew was coming next. There are only two responses to “I am an oncologist.” The first is, “what’s that?” (The word oncology is code. In the 60s it was politically incorrect to say “cancer”. Even today, patients and clinicians stumble around the word, preferring terms like malignancy, neoplasm, tumor, or just lump. Cancer care was entering the dawn of an era where not everyone was going to die and was soon to become a new specialty, so the word “oncology” was coined to avoid saying the “C word.” But when someone doesn’t know the code word you have to be direct. “I am a cancer doctor.”)
If the second question isn’t asked first, it is asked next. It isn’t really said like a question, it’s more like a statement with a question mark. Sometimes the statement is one of wonderment, but as often as not it is pity. “Why did you decide to be a cancer doctor?”
Cancer is a fascinating disease. It is the closest thing, in this life, that we will get to immortality. Take cancer cells, put them in a test tube and take care of them right and those cells can be grown forever. Take our normal cells and care for them the same way and they will be dead in two weeks. We do research on cells harvested from cancer patients 20 years ago. Besides being mortal our normal cells respect the space of other cells ...
The holiday season is the perfect time to give back to the ones we love, our community, and those who have yet to enter our lives. For many of us, small, simple acts of kindness are easiest to introduce in our efforts to give back, especially when we are busy getting back to work or school in the new year. Thankfully, giving back doesn’t mean you have to give up a huge amount of your time!
One unique way to make a huge impact in our community is by using your hands, heart, and brain, together—to knit! The Swedish Cancer Institute (SCI) has been lucky enough to have the support of community members near and far who have donated thousands of knitted hats for patients undergoing cancer treatment. These donations come at prime time during the holiday season but act as gifts all year long!
During chemotherapy, many patients experience hair loss. With the loss of hair, many patients experience low self-confidence, heightened sensitivity to fabric and weather conditions, and limited flexible income to purchase headwear.
With the support from our patients, caregivers and community, the SCI has been able to provide free knitted hats to patients undergoing treatment for over nine years. Knitting hats is fast, and provides both literal and figurative warmth directly to patients at a time when they may feel most vulnerable during their treatment. If you’re an experienced knitter, or someone who wishes to learn how to knit, or would love to knit for a cause, join a Knit for Life group at either the SCI First Hill or Issaquah campus.
This network of volunteers uses knitting as a healing experience to enhance the lives of cancer patients, their family members and caregivers during treatment and recovery. The group provides a supportive environment for beginners and experienced knitters. All knitting materials are provided ...
In 2012, Washington passed legislation to legalize marijuana use for people 21 and over. While still illegal for those under 21, it is important to understand how this might affect adolescents and children.
Facts about marijuana and teens:
- In a 2009 national study, 32.8% of 12th graders had used marijuana in the last year, and 20.6% within the last month.
- One in eight adolescents who start using marijuana by age 14 become dependent.
- When prolonged marijuana use starts in the teen years it is linked to a significant drop in IQ points - and the decrease is irreparable.
- Marijuana can affect memory and concentration, cause or exacerbate depression/anxiety/hallucinations, and negatively affect asthma and other chronic lung diseases.
- Marijuana is much more potent now than in the past. In 2012 the average concentration of THC in marijuana was 15% (compared to just 4% in the 1980s).
- Harmful effects occur whether marijuana is smoked, ingested, or vaporized. “Edibles” are becoming more popular, and present unique risks. It may take longer to feel the effects when ingested rather than smoked - this often leads to users consuming more than intended and experiencing severe side effects.
- Adults cannot “share” with teens - it is felony to provide marijuana to a minor.
What you can do as a parent:
- Start the conversation early - begin talking to your child about marijuana and other substances by about age 10.
- Set clear expectations that marijuana is like any other drug, and is illegal for anyone under 21. For example ...
The liver is a vital organ necessary for survival. It performs crucial functions including protein synthesis and detoxification. When excessive amounts of fat and lipids accumulate in the liver cells, this can lead to liver injury and cause a disease called fatty liver disease. Fatty liver disease is a serious diagnosis that has become one of the most common causes of abnormal liver function tests in the United States. Fatty liver disease is also referred to as Non Alcoholic Fatty Liver Disease or NAFLD. NAFLD is associated with other diseases which influence fat metabolism, such as type 2 diabetes.
Why is fatty liver disease important?
NAFLD is a single disease seen in both alcoholics and non-alcoholics, especially in those who are overweight. When a biopsy is taken of a fatty liver, features of liver injury and fat deposit in the liver may be seen. These findings are of crucial importance as fat accumulation may cause progressive inflammation of the liver over time. This is called steatohepatitis. Unfortunately, NAFLD may progress to cirrhosis. Cirrhosis is scarring of the liver, which may mean someone would later need ....
A cancer doctor is very familiar with the anxious and fearful grief that accompanies a diagnosis of cancer. We are less acquainted with the lonely and empty grief that is experienced by those left behind when our patients die. However, when I wear my hospice medical director hat, I am privy to those struggles, and knowing that the loss of someone close is particularly difficult during the holidays, I have chosen to divert from subjects I am more familiar with and rely on the experts at hospice to help me present a meaningful discourse on grief during the holiday season.
For the bereaved, the joyous holidays trigger emotions of great conflict. Every act of preparing for the holidays, once a time of cheer and anticipation, becomes another stabbing reminder of ones loss. The demands of family and friends, always a bit stressful around Thanksgiving, Hanukkah, Christmas, and New Year, now are overwhelming, both physically and emotionally. Traditions, designed to create love and family unity, now seem empty and may even create divisions among the grieving. Even successful celebration may bring on a deep surge of guilt for enjoying the holiday alone. And those who have no physical or emotional reserves left for thanksgiving or joy making, may feel great pressure to “get on with their life, and join in the fun.”
It has been suggested that the key word in grief is “permission.” The bereaved need permission from themselves, and from family and friends, to grieve as long as necessary and in any way that works, remembering that what works may not always be the same. It means permission to only do what you can. A turkey and all the trimmings may just be too much this year. Eating out may be perfect. Having someone else do dinner may be better yet.
Permission may also be needed to change some timeworn traditions. It must be recognized that ...
Congratulations! You just found out you are pregnant and so many things start going through your mind. When you’re not dry heaving or completely exhausted you start planning for your exciting future but in the back of your mind you wonder… how do I know everything is okay with my baby?
We are entering an exciting time in the field of obstetrics that involves less invasive and more accurate options for genetic testing in pregnancy. ACOG, the American College of Obstetrics and Gynecology, recommends that all women, regardless of maternal age, be offered prenatal testing for chromosomal abnormalities.
For quite sometime our options for this testing have been somewhat stagnant. We have offered noninvasive risk profiling that involves a mixture of blood tests and ultrasounds at various times in the first and second trimesters to help evaluate the baby’s risk for Down syndrome or other lethal chromosomal abnormalities. Depending on how these tests are processed, the sensitivity ranges from 80-95% with about a 5% false positive rate. They are fairly accurate at identifying babies at higher risk, but can have false positive results (meaning an abnormal result followed by more invasive testing that shows normal results but of course this causes a lot of worry for the patient).
Obviously we want to be able to offer testing that has a high rate of detection and a low rate of false positives. More invasive testing is often offered also. This testing involves removing a sample of placental cells called chorionic villus sampling, or removing a sample of fetal cells from the amniotic fluid called amniocentesis. These cells are then analyzed for chromosomal abnormalities. Although these invasive tests are the most accurate, they do carry a small risk of miscarriage or fetal loss.
Fortunately, new testing has come out on the market called cell free fetal DNA testing. This is ....
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