Sarcoidosis:
Queries and Responses
Tenth Annual Conference and Town
Meeting
Drs. Ganesh Raghu and Doug Paauw
If a person has one form of
Sarcoidosis,
might they develop another form?
A: Dr. Paauw – In general, if a person
has one type of skin sarcoidosis, like lupus pernio, Hutchinson’s plaque or
scar sarcoid, that is the type that is usually seen. One exception is of an
individual who has lupus pernio and later receives a scar, then scar
sarcoidosis can develop in that scar.
Can Sarcoidosis involve bone and
muscles?
A: Dr. Raghu - By definition, Sarcoidosis
is a disorder of unknown cause that can involve multiple systems, including
tissues and organs. Therefore bones and muscles can be affected. Ninety percent
of those with Sarcoidosis will have lung and thoracic lymph node involvement.
Only 3-5% of those with Sarcoidosis have bone and muscle involvement. Bone
lesions can occur in the outer lining of the bone, in areas of the skull, the
distal phalanx of the fingers and the toes.
When muscles are affected, they become
weak, but do not cause pain. An example of weakness in the muscles is when the
diaphragm, an important muscle in the breathing process, is affected. If
granulomatous tissue develops in the specific area of the spinal cord, which
controls the diaphragm, that muscle can become paralyzed, severely compromising
the function of breathing.
Do pulmonary hypertension and
pulmonary fibrosis
relate to Sarcoidosis?
A: Dr. Paauw– The pressure in the pulmonary vessels
of the lungs is usually a low pressure system. Pulmonary hypertension (PHT)
occurs when the lungs start to shrink or get destroyed by pulmonary fibrosis.
This results in the small blood vessels of the lungs also being destroyed and
pressure in the system rising. This is very hard on the heart, because the
heart is used to pumping blood into the lungs with no pressure against it. With
PHT, there is a lot of pressure. Consequently, the heart can enlarge.
The
symptoms that a person with PHT would have are the same as the type of symptoms
that one with pulmonary fibrosis would have: i.e. a lot of trouble breathing,
especially while walking. The other symptom some people would experience is
chest pain. But, chest pain can be present with pulmonary fibrosis, or be a
complication of other physical ailments.
What are the symptoms of Sarcoid
involvement
in the joints and ligaments?
A: Dr. Raghu – When joints are involved, there
is pain, which is called arthralgia. When there is inflammation, as defined by
a particular type of cell invasion, which leads to erosion in the joint spaces,
that is called arthritis. Arthralgia means pain in the joints. Arthritis means
inflammation of the joints. One will not have arthritis when there is
arthralgia and one will always have pain when there is arthritis.
Arthritis is associated with
Sarcoidosis. The majority of the people with Sarcoidosis will have non-specific
aches and pains; but those will not be specifically associated with active
inflammation. Only 15-20% of the patients with Sarcoidosis will have arthritis.
A problem is that symptoms, that mimic rheumatoid arthritis (RA) without having
the serological (blood) antibodies and the skeletal manifestations of RA, are
identified as arthralgia. Ligaments are not specifically involved with
Sarcoidosis.
Can fatigue upon awakening and/or
throughout the day, be related to
pulmonary fibrosis (PF) and reduced oxygen in the body, or to Sarcoidosis?
A: Dr. Paauw – Usually it depends on whether the situation is being
treated with oxygen or not. If the person has been using supplemental oxygen
during sleep and oxygen levels are O.K., it would not be expected that they
would be extremely fatigued upon awakening. Some people, as they progress
through the day and exert themselves more, without receiving any supplemental
oxygen, or receive an inadequate amount of oxygen, can get more tired with
increased exertion. Certainly the increased fatigue with exercise is a
concerning symptom for some physical ailments.
I’ve heard about peripheral nerve
damage caused by Sarcoidosis
and its “electro-shock feeling”. Can you address that?
A: Dr. Raghu – Neuro-Sarcoidosis -involving the
nerves – is one of the most difficult and challenging problems of Sarcoidosis.
Since we have not yet identified the etiology (cause) of Sarcoidosis, it is
unclear why certain nerves become involved. The large cranial nerves are more
likely to be affected. The 7th cranial nerve, which controls the
facial muscles and those of the mouth, lips, eyebrows and cheeks, is commonly
involved. The nerve’s involvement can become suddenly evident and will produce
the symptoms of Bell’s palsy. It is an acute syndrome. Less involved are the
small nerves which produce the neuropathy of diabetes.
Granuloma can attack the myelin sheath – the
covering – on the outside of the nerves, which causes the non-specific symptoms
like tingling and pain. This feeling is then manifested as numbness, a
neuropathy like that of diabetes.
It is very hard to prove this particular
problem as being caused by Sarcoidosis. It could be multiple other causes, like
Vitamin B, or B6 deficiency. It could also be due to the presence of diabetes.
Sarcoidosis is a diagnosis of exclusion. In a known Sarcoidian, it is important
for the neurologist to distinguish the cause of the numbness and tingling.
Electrical studies, such as EMGs are conducted in such cases.
If the conclusion is that of Sarcoidosis,
then the challenge becomes what to do about it. If the decision is to treat,
how is it to be treated? The treatment
itself can become problematical. The patient’s overall health is an important
factor in preparing the treatment plan.
Even though corticosteroids are known to
have many side effects, prednisone is still the treatment of choice for
neuro-sarcoidosis. It is an extremely potent anti-inflammatory.
A recent development in the search for more
precise diagnostics regarding neuro-sarcoidosis is that the lymphocytes found
in fluid extracted in the course of a lumbar puncture (spinal tap) of a patient
with suspected neuro-sarcoidosis, can be analyzed in search of certain markers
of sarcoid-like activity.
What can be done about
Sarcoid-related arthritis?
A: Dr. Paauw – The most important factor to
help relieve the pain of arthritis without medication – especially if the
arthritis is in the knees and hips – is weight loss. Weight is a huge, huge
risk factor for the progression of arthritis. Anything that can be done to
reduce weight, is very, very important. The other is exercise and strengthening
the thigh muscles. It’s been proven that up to 50% of the pain in the legs can
be relieved by improving the quadriceps.
As far as medications, there are not a lot
of great prescription drugs that address the pain of wear and tear arthritis
(osteoarthritis). Some of you may be familiar with chondroitin and glucosamine.
They are natural products that may help a little with the pain and
theoretically may slow the progression of the disease. Clinically, they have
not proven effective in halting the disease’s progress. The most common drugs
used to alleviate some of the pain, are ibuprofen and the non-steroidal anti
inflammatory drugs (NSAIDs).
Is fibromyalgia a side-effect of
Sarcoidosis,
or is it a form of Sarcoidosis ?
A: Dr. Raghu – Fibro means fibrous (connective)
tissue; mya means muscle and algia means pain. So, pain involving muscles and
ligaments (fibrous tissue), if you will. Aches and pain do not come with
Sarcoidosis. Is fibromyalgia a specific disease, or is it a disorder? It is an important question.
The aches and pains which occur in patients
with fibromyalgia are so non-specific, that
unfortunately there is no gold standard of lab testing that one would
do. But, it is a real problem. Because clearly, certain people do have these
aches and pains at very specific points. One can touch and press on those
points and elicit reproducible aches and pains. That is called point
tenderness. It is considered as a very typical characteristic manifestation of
fibromyalgia.
Fibromyalgia is a diagnosis of exclusion,
just like Sarcoidosis is usually a diagnosis of exclusion. A certain percentage
of individuals with Sarcoidosis have those aches and pains.
Is it just a simple association or is it
simply a separate disease which occurs in the patient with Sarcoidosis? It is
unclear. An example of the latter is that of a Sarcoidian with diabetes. Is the
diabetes then associated with Sarcoidosis? Usually not. Therefore, the problem
of fibromyalgia occurring with
Sarcoidosis may simply be a coincidental situation. It then becomes a bit of a
psycho-social aspect of the situation.
Fibromyalgia is a true problem with its
aches and pains. Only one person can relate to those aches and pains … not the
patient’s physician, not the patient’s family members, only the patient. Only
she or he can tell how severe the pain is. There is no way that we can put a
number to the degree of the pain, because pain is a very subjective problem.
If
fibromyalgia is simply an association of Sarcoidosis, how can we then identify
the difference between Sarcoidosis causing the pain, which it can, or is
fibromyalgia the cause?
It can be very difficult for a physician to
determine if the aches and pains are truly aches and pains, or if they are
psychological pain. It would be easier to prove the existence and association
of aches and pains with Sarcoidosis if there were a test that could be
performed. The results could then guide the physician in monitoring the
progression of the condition and subsequently develop a treatment plan for
alleviating the aches and pains.
Editor’s
Note:
The
synopsis of Dr. Paauw’s presentation at the 10th Conference on Sarcoidosis and
professional biography were published in the January/February 2003 issue of
Sarcoidosis Networking.
Dr. Raghu Comments on WASOG
Dr. Raghu
reported that at the recent meeting of WASOG (World Association of Sarcoidosis
and Other Granulomatous Disorders), an interesting observation was made
regarding Sarcoidosis. A small study was done in The Netherlands. Patients with
Sarcoidosis and having fibromyalgia-type aches and pains had random skin
biopsies taken from specific points of tenderness, as well as other sites. The
investigators found tiny nerve endings with inflammation and lymphocytes, which
is characteristic of Sarcoidosis. The results of the study demonstrated that in
those cases there were true lymphocytes involving the nerve endings. So, for the first time we have scientific
evidence with an explanation for the aches and pains.
Whether
prednisone or other drugs will decrease the cellular infiltrates [considered]
to be fibromyalgia is unclear.
It is
unfortunate that sarcoidologists [sarcoid specialists] don’t have a clear
explanation for the aches and pains that persons with fibromyalgia suffer, and
rheumatologist don’t yet have an understanding of fibromyalgia itself.
Although heart disease continues to be the
number one killer in the
Coronary artery disease, or blockage in
the arteries, is the most common form of heart disease. “The most frequent
symptom is chest pain, although pain can also occur in the neck, jaw or arms,”
says Patrick Reagan, M.D., a cardiologist at Virginia Mason,
During an exam, a physician can assess the
cause of the chest pain—the most common causes are cardiac, gastrointestinal or
musculoskeletal. If further diagnosis is needed, usually a cardiologist will
evaluate the patient with a stress test. The patient exercises on a treadmill
and the EKG (electrocardiogram) is monitored for signs that the heart muscle is
not receiving enough blood because of blockage in the coronary arteries.
Sometimes the treadmill is not accurate enough, especially in women, and more
sophisticated testing is necessary.
“The two most commonly used tests that
increase the accuracy of a diagnosis are the stress echo and the nuclear stress
test,” says Dr. Reagan.
Using test information, the cardiologist
can assess whether previous damage has occurred and whether a person is at risk
for developing a heart attack.
“If you are at risk for heart disease, you
can reduce your risk factors by quitting smoking, controlling your blood
pressure and lowering your cholesterol,” says Dr. Reagan. “The key is to reduce
your risk factors, be aware of the warning signs and seek proper medical
attention.”
For more information on The Heart
Institute at Virginia Mason, visit www.VirginiaMason.org/Heart
Source:
Virginia Mason Magazine, Winter 2003
Scientists
have sequenced the genome of a microbe that lives in the mouth and causes most
of the cavities in the world. The bacterium, streptococcus mutans,
sticks to the surface of teeth and subsists on a diverse group of
carbohydrates. While metabolizing sugar and other energy sources, the microbe
produces acid that causes cavities in teeth.
Source:
Genome News Network, Oct 2002
Your companions are like the
buttons on an elevator.
They will either take you up or
they will take you down.
Source:
God’s Little Instruction Book
WHAT’S YOUR FITNESS RATING?
The women in the
Find a step that’s about 12 inches high.
(If you don’t have a low bench or step around the house or neighborhood that
will work, your local sporting goods store should sell steps for aerobics that
you can use.) Grab a watch that has a
second hand, and practice stepping up on the bench in this pattern: right foot
up, left foot up, right foot down, left foot down. That counts as 1 step;
briefly practice this until you can smoothly do 8 in 20 seconds (that’s a
24-steps-per-minute pace).
Once you have the pattern and pace down,
do some stretches (calf, thigh, and hamstring), and wait 10 minutes or so until
you’re fully rested. Now you’re ready. The idea is to do 3 minutes of stepping on
the bench, then sit down in a chair and immediately count your pulse for a full
minute. The total at the end of a minute is your score. See where you rank in
the chart below.
|
|
|
Your Age |
|
|
|
|
|
|
26-35 |
36-45 |
46-55 |
56-65 |
|
Pulse
Rate |
Good |
<94 |
<98 |
<103 |
<105 |
|
|
Average |
94-111 |
98-112 |
103-118 |
105-120 |
|
|
Below
Average |
>111 |
>112 |
>118 |
>120 |
Strength:
Knee Push-Ups
Lie facedown, your feet resting on your toes,
with your palms flat on the floor at your chest. Keeping your knees on the
floor, contract your abdominals and slowly push up until your arms are
straight. Lower down to the starting position. Do as many push-ups as you can.
(If you start bending at the waist, stop.) Your total is your score.
|
|
|
Your Age
|
|
|
|
|
|
|
20s |
30s |
40s |
50s |
|
Number
of |
Good |
>29 |
>26 |
>23 |
>30 |
|
|
Average |
15-19 |
13-26 |
11-23 |
7-20 |
|
|
Below
Average |
<15 |
<13 |
<11 |
<7 |
Flexibility:
Sit and Reach
Ask a family member or friend to help.
Warm up for five minutes (perhaps by walking briskly). Remove your shoes and
sit on the floor with your legs straight out in front of you. Point your toes
at the ceiling and ask your helper to place the 12-inch bench against your
feet. Hold your arms straight out in front of you, one hand over the other,
palms down, and fingers pointing at your toes. Now slowly bend from the waist
and extend your hands over the bench. Have the helper mark on the bench the
farthest point your fingertips reached, then measure how far past your feet the
mark is. (If you can’t reach the bench, have your assistant measure how many
inches you came to the step.)
|
All
Ages |
|
|
|
|
Excellent |
>6
¾” |
Good |
4
to 6 ¾” |
|
Average |
|
Below Average |
<-3” |
(Editorial
Note: Don’t take the numbers seriously;
just do the best you can. Any exercise you can do will be beneficial to
your overall health.)
Source:
Health Magazine, Nov/Dec 2000
10 Warning Signs of Caregiver
Stress
1. Denial – about the disease and its effect
on the person who’s been diagnosed. I know Mom’s going to get better.
2. Anger
– at the person with the rare, chronic or chronic progressive, disorder: that
no effective treatments or cures currently exist and that people don’t
understand what’s going on. If he
asks me that question one more time, I’m going to scream.
3. Social withdrawal – from friends and activities that
once brought pleasure. I don’t care
about getting together with neighbors anymore.
4. Anxiety – about facing another day and what
the future holds. What happens when
he needs more care than I can provide?
5. Depression – begins to break your spirit and
affects your ability to cope. I don’t
care anymore.
6. Exhaustion – makes it nearly impossible to
complete necessary daily tasks. I’m
too tired for this.
7. Sleeplessness – caused by a never ending list of
concerns. What if she wanders out of
the house or falls and hurts herself.
8. Irritability – leads to moodiness and triggers
negative responses and reactions. Leave
me alone!
9. Lack of concentration – makes it difficult to perform
familiar tasks. I was so busy, that I
forgot we had an appointment.
10. Health problems – begin to take their toll, both
mentally and physically. I can’t
remember the last time that I felt good.
Source: Alzheimer’s Disease and Related Disorders Assoc.,
Inc. Edited for Publication
Pass this on to a Caregiver you
know!
Edited
for publication
BEING FOOLED BY ‘FAT-FREE’ FOODS?
By Miranda Hitti
Are you trying
to slim down by eating fat-free foods? Hold on to your grocery list—those items
may not be as “guilt-free” as you think.!
Serving sizes may be smaller and more
calorie-dense than you expect, largely because manufacturers add sugar to make
up for the missing fat. In fact, you might not save many calories at all. While
reducing fat intake is often a healthy dietary goal, calories also count when
it comes to weight loss. Check out these calorie comparisons from the National
Heart, Lung and Blood Institute:
One
fat-free fig cookie has 70 calories, compared to 50 calories in the regular
version.
A
half cup of premium nonfat frozen yogurt weighs in at 190 calories—that’s 10
more than the same amount of regular ice cream.
Two
tablespoons of fat-free caramel topping packs 130 calories, the same as a
two-tablespoon dose of regular butterscotch caramel topping.
However, fat-free foods can be a boon, if
you know how to use them. Here are some tips from Sheah Rarback, a Miami-based
registered dietitian:
Read
nutrition information labels for portion size and calorie content.
Compare
fat-free versions of high-nutrient items such as milk.
Think
twice before buying foods like pastries or cakes. If you don’t normally eat the
regular version, you’ll add calories with the fat-free product.
Only
eat fat-free foods you enjoy. Otherwise, it’s better to eat a little of a tasty
regular or low-fat dessert, instead.
Source:
Arthritis Today, Sept/Oct
2000
PROTOCOL NUMBER: 99-H-0057
The
National Heart, Lung and Blood Institute (NHLBI), of the National Institutes of
Health (NIH), is sponsoring a research study regarding the “Treatment of
Pulmonary Sarcoidosis with pentoxifylline (POF)”. The study will evaluate the
effectiveness of giving POF to patients with sarcoidosis currently taking
steroids. Researchers will compare the results between patients taking steroids
with POF and those patients taking steroids alone.
The NHLBI
is actively recruiting male and female candidates, between 18 and 70 years of
age, who are on corticosteroid therapy (i.e. prednisone).
Individuals with the documented diagnosis of pulmonary
fibrosis, with or without ocular (eye) involvement, and interested in learning
about the eligibility inclusion or exclusion criteria, should access the NIH
website at http://clinicalstudies.info.nih.gov/detail/A-1999-H-0057.html.
To contact the Patient Recruitment and Public Liaison Office in
BLOOD THINNERS, YOUR DIET AND
VITAMIN K
I’m
taking blood thinners. Why do I need to pay attention to my diet?
Many foods you eat have vitamin K in them,
and vitamin K helps your blood make clots.
Foods containing fat substitutes, such as
Olestra (
In addition, you may want to avoid herbal
teas that have tonka beans, melilot (sweet clover), or sweet woodruff in them.
Why should I stay on the same general diet every day?
Large changes in the amount of vitamin K
you eat may affect the way your Coumadin Crystalline (Warfarin Sodium Tablets,
USP) works. It is important for you to keep your diet consistent so the amount
of vitamin K you eat is also consistent. Please contact your healthcare
provider before making major changes to your diet. Tell your healthcare
provider if you change your diet because you are sick; or if your body will be
undergoing great stress such as surgery, pregnancy or a planned weight loss.
Should I avoid foods with a lot of Vit. K?
No. Just keep your diet consistent. Some
foods that are important to a healthy diet are high in vitamin K, like leafy,
green vegetables and some beans and peas.
Does cooking, freezing, or drying foods change how
much Vitamin K is in them?
There is little information about the
effects of cooking, freezing, or drying on the vitamin K content of foods. It
appears that the vitamin K content of cooked, frozen, or dried foods is about
the same as fresh foods.
Source:
A Patient’s Guide to Using COUMADIN, 2002, Bristol-Myers Squibb Co.
Edited
for publication.
Before you use any anticoagulant, tell your
doctor
if you have or have had any Vitamin C or K deficiency.
A
Golden Oldie ... BEATING THE BLUES WITH EXERCISE
Everyone runs out of energy now and then.
But there is a healthy way to keep energy and spirits up: Exercise.
Exercising doesn’t mean you have to run the Olympics or be a
weightlifter – it just means doing what is right for you, to help stay fit. A
short walk, going up or down stairs, even stretching – these are all things
that will not only help keep you in good shape but can also give you a boost of
energy when you’re feeling tired or run down.
Your doctor or nurse can help to give you
ideas about what sort of exercise or physical therapy is appropriate for you.
Source:
Coping With Pain Focus On Cancer, Vol 3, No 1, Winter 1993
AROUND THE COUNTRY
SUPPORT GROUPS
New Listings
Sarcoidosis Chapter
of Louisiana, meets every other month. Call Lori at: 504.454.4871
EVENTS
Annual Walk-A-Thon, in many areas coordinated by
National Sarcoidosis Society, Inc.
For information about this in your area, call 773.536.7754
I n
s p i r a t i o n C o r n e r
HOW TO MAKE
YOUR WORK EASY
By Dr. Norman Vincent Peale
1. Don’t
get the idea you are Atlas carrying the world on your shoulders. The world will
go on even without you. Don’t take yourself so seriously.
2. Tell
yourself that you like your work. Then it will become a pleasure, not drudgery.
Perhaps you do not need to change your job. Change yourself and your work will
seem different.
3. Plan
your work—work your plan. Lack of system produces that “I’m swamped” feeling.
4. Don’t
try to do everything at once. That is why time is spread out. Operate on that
wise advice from the Bible, “This one thing I do.”
5. Get
a correct mental attitude, remembering that ease or difficulty in your work
depends upon how you think about it. Think it’s hard, and you will make it
hard. Think it’s easy and it will tend to become easy.
6. Become
thoroughly proficient in your work. “Knowledge is power” (over your job). It is
always easier to do a thing right.
7. Practice
being relaxed. Easy always does it. Don’t press or strain. Take it in your
stride.
8. Discipline
yourself not to put off until tomorrow what you can do today. Accumulations
make the job harder than it should be. Don’t drag yesterday’s burdens along
with you. Keep your work up to schedule.
9. At
the start of every day pray about your work. You will get some of your best
ideas that way.
10. Take
on the “unseen partner.” It’s surprising the load He will take off you. God is
as much at home in offices, factories, shops, as in churches. He knows more
about your business than you do. His help will make your work easy.
H - Honesty
E - Energy
A - Acceptance
L - Love
T - Trust
H - Hope
“By being
honest, building up energy, accepting and loving ourselves and others and by
developing trust, faith, and hope, we support the healing process in our body,
mind, heart and spirit. ... We change in an environment of love, not
criticism.”
Rev. Stan Hampson
CAN A SUPPLEMENT REALLY HELP DIETERS?
Pills and potions that promise to help
people get slimmer are a dime a dozen. The problem is, there’s little
scientific evidence that any of the supplements actually work.
One such supplement—conjugated linoleic
acid, or CLA—has been tested on humans, with promising results. Michael Pariza,
a microbiologist at the
The real deal CLA made a real difference.
After six months, all the subjects were about five pounds lighter. But the CLA
takers reported having an easier time staying on their diets and experienced
fewer hunger pangs. It was also noted that any weight the subjects did happen
to regain, during the common fluctuations of dieting, was mostly lean muscle
the others regained mostly fat. “This is a big difference, much more like what
happens when people exercise,”, says Pariza. “Their weight might not have
changed much, but they were slimmer.”
Researchers suspect that CLA works in
several ways. “It doesn’t make people lose body fat faster, but it does keep
little fat cells from getting larger,” Pariza says. The supplement also helped
people emotionally. When the participants were asked periodically how they
felt, the CLA users reported a significant improvement in mood and
concentration. “That’s important,” says Pariza, “after all, dieting is
stressful.
Source: Health Magazine, Nov/Dec 2000
Edited
for publication.
Thumbs Up
|
Thumbs Down
|
|
Cinnamon: Sweet news for diabetics. Adding
a little spice to your diet may help control blood sugar levels. |
Nasal
Dilators:
You know those nasal strips jocks wear? Well, scientists say they simply
don’t boost performance. |
|
Day
Care Centers:
Sure, kids who go there get colds more often. But it turns out they’re less
likely to develop asthma. |
Saw
Palmetto:
The herb might help some prostate problems. Too bad many brands contain
little of the active ingredient. |
|
Cooked
Carrots:
With veggies, folks think raw is better. Surprise: Steamed, mashed carrots
deliver more antioxidants. |
Tongue
Studs:
Fashion victims beware: Dental experts warn this piercing fad can be
downright dangerous. |
HOW TO
TREAT A NOSEBLEED
If you thought nosebleeds
were kid-stuff, think again. Sure, getting knocked in the noggin by a foul ball
can still spur a bleeder, but so can frigid temperatures, allergies, or
high-altitude vacations. If you get a gusher, here’s what to do:
1. Sit
down and tilt your head forward slightly. (Don’t lie down or tip your head
back. The blood may run down your throat, making you gag.)
2. Use
your thumb and index finger to pinch your nose closed just above the flare of
the nostrils for ten minutes. Don’t let go, even to check whether the blood’s
still oozing.
3. If
you’re still bleeding, pinch your nose for another ten-minute stint. Try
holding an ice pack against the bridge of your nose to constrict underlying
blood vessels.
4. Once
the bleeding has stopped, don’t blow your nose, strain, or bend over to lift
anything heavy—all of which can trigger an encore—for the next 12 hours.
If bleeding continues for more than 20
minutes, go to the emergency room. A doctor can stop the flow by applying a
topical sealant, such as silver nitrate. See your physician if you get
nosebleeds frequently. Although most are harmless, roughly one in ten signals
an underlying condition (i.e. high blood pressure, diabetes, or hardening of
the arteries).
Source :Health magazine, Nov/Dec 2000
REPORT ON 2003 PIO MEETING
SNA Board VP, Marilyn Larson and Exec.
Dir., Dolores O’Leary, attended the 4th annual PIO (Public Interest
Organization) meeting on
Dr. Elias Zerhouni, Dir. Of NIH,
presented his vision for the future of the Division. His “Roadmap for Action”
includes Advocacy, Treatment and Science. Dr. Zerhouni stressed that in this
technological age, the many disciplines and groups supporting primary
investigators in each research study, need to be recognized.
He also addressed President Bush’s request
for 2% cuts in NIH’s budget for 2004. The Director emphasized the urgency for
advocacy from the public to deter the
implementation of such reductions, so that NIH can continue to conduct research
at its present level.
Dr. Richard Cannon, a Clinical Director
at NHLBI stated that the progress with stem cell research with cardiac
application may eventually negate the need
for bypass surgery. It was mentioned to attendees that stem cell
transplantation for lung tissue is in the very early stages.
A panel discussion of PIO leaders gave
an overview of how groups can be
instrumental in providing education and guidelines for physicians and
individuals affected by rare disorders.
Breakout sessions emphasized the
benefits of dialogue regarding research studies, between researchers and
support/advocacy groups.
Larson and O’Leary visited Congressional
offices to heighten awareness of the needs, concerns and issues of the
Sarcoidosis and Rare Diseases communities. The listing by Soc. Sec. of
Sarcoidosis as a disabling disease, and new Medicare regulations affecting
Sarcoidosis and other Rare Diseases were discussed.
Congressional Aides stressed the
importance of voters and constituents contacting their elected representatives concerning
budgetary issues and concerns affecting individuals with Sarcoidosis and other
Rare Diseases.
DO PETS PLAY A ROLE IN YOUR HEALTH?
In taking time for the things you
enjoy, don’t overlook the value of a pet.
A pet – whether it’s a dog, cat, goldfish
or iguana –can help you establish healthful habits or even benefit your health.
For example, research show that dog owners are more likely to walk regularly
than people who don’t have dogs. Other research suggests that pet owners may feel
less lonely or isolated, even if they live alone. Because social isolation is a
powerful risk factor for poor health, having a pet may help you live longer and
better.
Robert Sheeler, M.D., believes strongly in
the healthful impact pets can have on your life. Dr. Sheeler has a golden
retriever, named Ranger, and three cats. Having all of them around helps him
unwind after a long day at work, he says. In addition, the pets remind him and
his wife to get outside and enjoy the outdoors.
“They remind you to live in the moment,”
Dr. Sheeler says.
Edward Creagan, M.D., a cancer specialist,
also says pets have an important role in his life. He has one dog and a cat at
his home. “These creatures can bring a tremendous sense of peace and
tranquility,” Dr. Creagan says.
Pet ownership isn’t for everyone. But the
pleasure and companionship of an animal may be something to consider as one of
the steps to a healthier, longer life.
Editor’s
Note: There are now individual volunteers and organizations who
train and certify therapy
pets. The animals and their companions
then visit
nursing homes, hospitals
and homebound individuals.
EXERCISE
AND HYPERTENSION
By Judi
Sheppard Missett
We’ve known for some time that exercise helps
patients control hypertension, but recent studies reveal important nuances
regarding its effect on blood pressure and physical response to mental stress.
First, low-level aerobic activity appears
to reduce ambulatory systolic blood pressure as effectively as does
high-intensity exercise, according to a study published in the Journal of
Clinical Epidemiology. Study participants were divided into two groups. One
group exercised at 20 percent maximum work capacity, and the other group at 60
percent of maximum work capacity. Both groups experienced comparable benefits.
This is good news, considering that
low-intensity exercise may be safer for unsupervised patients and also may
increase compliance to a regular fitness program, as moderate physical activity
is easier to do.
Second, exercise and weight loss appear to
have a positive effect on cardiovascular responses during mental stress.
Researchers at Duke University in Durham, N.C.; the University of North
Carolina at Chapel Hill; and the University of Colorado gathered individuals
who were mildly to moderately overweight and had elevated blood pressure, and
split them into three treatment groups:
Aerobic
exercise (45 minutes of biking and walking three to four times a week at 70
percent to 85 percent of maximum heart rate)
Aerobic
exercise and a behavioral weight-loss program
No
intervention