Can Unilateral Tinnitus of Acoustic Neuroma Seem Bilateral?
Should you exclude acoustic neuroma as the cause of your tinnitus if the “ringing” is in both ears?
Ninety-five percent of acoustic neuroma patients have the tumor in only one ear.
The remaining five percent have a tumor in both ears (bilateral).
The remaining five percent of patients with tumors in both ears have a genetic disorder called neurofibromatosis 2.
If you have NF2, you probably already know it, as most patients begin developing signs by their teens or early 20s.
So let’s talk about AN in a non-NF2 person; the tumor will be unilateral. Often, tinnitus is the first symptom.
When a patient reports unilateral tinnitus to a doctor, the doctor should take special note of this as being suspicious for an acoustic neuroma.
Though very rare (2,000-3,000 diagnoses yearly in the U.S.), an acoustic neuroma needs to be ruled out in cases of unilateral tinnitus.
The vast majority of unilateral tinnitus is NOT caused by an acoustic neuroma – which is benign and slow growing.
A person with tinnitus that seemingly comes from both ears may feel a sense of strong relief due to the following thought process:
“This can’t possibly be an acoustic neuroma because I hear the tinnitus in BOTH ears!
Whew! Here I am, fearing I have some kind of TUMOR that might need radiation treatment or whose surgical removal might cause permanent hearing loss – but thank God, these things affect only one ear.”
I was reading some posts on an AN site by patients; they were describing their initial symptoms related to these noncancerous masses.
What got my attention was a post by a woman who said that her tinnitus, before the surgical removal of her acoustic neuroma, had been in BOTH ears – and she did not have the NF2 genetic disorder.
You may think, How is that possible, both ears?
I posed this question to Brandon Isaacson, MD, F.A.C.S., Department of Otolaryngology – Head and Neck Surgery, UT Southwestern Medical Center, Dallas, TX.
Dr. Isaacson explains, “Tinnitus is most commonly perceived on the same side as the tumor but can occur in both ears.
“The hearing pathways crossing in the brainstem is the likely mechanism why it can be perceived in both ears.”
So there you have it. You are not automatically off the hook from an acoustic neuroma just because the tinnitus is bilateral.
Dr. Isaacson’s
research interests include cochlear implants, endoscopic ear surgery and acoustic neuroma. His clinical interests include all aspects of otology and neurotology, with a special focus on skull base surgery.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
.
Top image: Shutterstock/Florida Chuck
Source: cancer.net/cancer-types/neurofibromatosis-type-2/cineurofibromatosis-type-2printer
Can Cymbalta Cure Irritable Bowel Syndrome ?
Cymbalta is sometimes prescribed off-label for patients who suffer from IBS.
And some patients swear that Cymbalta has cured them of their irritable bowel syndrome.
But what’s really going on here?
“Unfortunately, IBS is a chronic disorder for many patients,” begins Dr. Brian Lacy, MD, of Dartmouth Hitchcock Med Center, who specializes in functional disorders of the gastrointestinal tract and author of “Making Sense of IBS.”
Cymbalta Cannot Cure IBS Despite what Happy Patients Claim
“There is no medication currently available that can cure IBS,” says Dr. Lacy. “Cymbalta is approved by the FDA for the treatment of depression.
“Although no medical studies have evaluated Cymbalta (duloxetine) for the treatment of IBS, some health care providers use this medication off-label to improve symptoms of abdominal pain.
“Other medications are FDA approved for the treatment of IBS symptoms, and two in particular may help abdominal pain.”
Relief of symptoms, or symptom management, is not the same as a cure.
Dr. Lacy recommends for those suffering with constipation due to IBS a medication called LINZESS.
LINZESS may dramatically improve both constipation and abdominal pain,” he says.
Other patients suffer from diarrhea rather than constipation, and for those individuals, Dr. Lacy recommends Viberzi (eluxadoline).
“It may improve both symptoms. Both of these medications require a prescription, so please make sure that you discuss these with your health care provider to determine if one of these might improve your IBS symptoms.”
Dr. Lacy combines his love of science, medicine and people to uncover the causes of symptoms like stomach pain, gas, bloating, diarrhea, constipation and regurgitation.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
.
Top image: Shutterstock/Twinsterphoto
Can a Digestive Problem Cause a Metal Taste in the Mouth ?
A metal taste in your mouth can be caused by a serious medical condition including cancer, but it can also be triggered by a disorder in your digestive tract.
“In the occasional patient, acid reflux (GERD) can cause the production of frothy secretions in the mouth; this is called waterbrash,” explains Dr. Brian Lacy, MD, of Dartmouth Hitchcock Med Center, who specializes in functional disorders of the gastrointestinal tract, and author of “Healing Heartburn.”
A metal taste in the mouth from a digestive issue?
Dr. Lacy says that this waterbrash “results from acid refluxing into the mouth and stimulating the salivary glands to make a bicarbonate-rich fluid.
“In some patients this may taste a little metallic. Otherwise, patients with IBS or chronic constipation are not more likely to report a metallic taste than others.”
So if you have irritable bowel syndrome or a benign chronic constipation, and you then begin experiencing this phantom taste sensation, you’d be wise to report it to your doctor.
Cancer as a cause is actually not likely, but not impossible: More causes of a metal taste in your mouth.
Dr. Lacy combines his love of science, medicine and people to uncover the causes of symptoms like stomach pain, gas, bloating, diarrhea, constipation and regurgitation.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
.
Top image: ©Lorra Garrick
Can a Long IBS Flare Mean Something Serious; Should You Worry?
Panic often sets in when a person’s IBS flare seems to be going on and on without any let-up. (more…)
Double Hip Replacement Guidelines for Walking on a Treadmill
If you’re recovering great from your double hip replacement and walking well without assistance, here are smart treadmill guidelines from a surgeon, even if you’ve never before used a treadmill. (more…)
Ribbon Stools Caused by IBS vs. by Colon Cancer: Comparison
Both colon cancer and IBS can cause stools to come out like ribbons.
We’ve all heard that thin flat bowel movements are something to be concerned about.
“Ribbon” or “pencil” shaped stools are almost always on symptom lists for colon cancer, which can affect adults of any age, though it’s far more common in men and women over 45.
But irritable bowel syndrome, too, can alter the shape of bowel movements to come out thin and long.
Ribbon Shaped Poops from IBS vs. Colon Cancer: Appearance Comparison
Patients are often concerned about the frequency, shape and texture of their bowel movements,” says Dr. Brian Lacy, MD, of Dartmouth Hitchcock Med Center, who specializes in functional disorders of the gastrointestinal tract and author of “Making Sense of IBS.”
What is a normal stool?
“It is important to first understand what is considered normal with regard to stool frequency,” begins Dr. Lacy.
“A large study performed years ago in Britain determined that the average range of bowel movements is three per day to three per week.
“Stool form can also range from loose to firmer. This depends on a number of factors, including diet, stress, exercise and medications.
Ribbon-like stools can occur in younger patients and generally represent strong contractions of the colon flattening out the stool.
Freepik.com
“In the absence of warning signs (low blood count, unintentional weight loss, evidence of blood in the stool or a family history of colon cancer in a first degree relative), the occasional occurrence of ribbon-like stools is usually nothing to be concerned about.
“However, in a patient who is older, or in a patient with warning signs as mentioned above, ribbon-like stools could mean something serious, such as a lesion in the colon.
“This should be discussed with your health care provider who can perform a careful abdominal and rectal exam and order tests as appropriate.”
Comparison of Appearance in the Toilet Bowl of Ribbon Stools from Colon Cancer and Those from Irritable Bowel Syndrome
“Spasm in the colon which can cause a ribbon like stool is common in IBS patients,” explains Dr. Lacy.
“But, the appearance may be the same as someone who has partial obstruction or who has colon cancer.
“However, someone with colon cancer likely has other symptoms (e.g., weight loss, anemia, blood in the stool).
“That is why those are considered warning signs and warrant evaluation and a colonoscopy.”
In a colonoscopy a doctor uses a long, flexible tube with a camera at its end, called a colonoscope, to look inside the colon and rectum.
The procedure helps doctors check for inflammation, precancerous polyps and of course, colon cancer.
A colonoscopy is necessary for a diagnosis of IBS, because IBS is a diagnosis of exclusion.
Dr. Lacy combines his love of science, medicine and people to uncover the causes of symptoms like stomach pain, gas, bloating, diarrhea, constipation and regurgitation.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
.
Top image: Shutterstock/Juan Gaertner
IBS Chest Pain vs. Cardiac Chest Pain: Symptom Comparison
Your chest pain may be irritable bowel syndrome—you HOPE, since you’re also fearing it’s related to your heart.
If you have IBS and one day you get chest pain, this doesn’t mean it’s from your irritable bowel, yet it also doesn’t mean it’s from your heart, either (e.g., could be a muscle strain).
Just how much overlap is there between the symptoms of IBS and a heart problem?
If you’ve been diagnosed with IBS and have new-onset chest pain or some kind of aching in that area, then gee, this sure is scary, no matter how much you try to convince yourself, “It must be my IBS.”
The Courage to See a Cardiologist
“Chest pain is a common disorder that can affect men [and women] of all ages,” says Dr. Brian Lacy, MD, of Dartmouth Hitchcock Med Center, who specializes in functional disorders of the gastrointestinal tract and author of “Making Sense of IBS.”
“The first step in the diagnosis of chest pain is to determine whether it is cardiac in origin (from the heart) or from another organ system.
“This is obviously critical, as chest pain from the heart will be treated very differently than chest pain from chest wall muscles or the ribs.”
IBS Chest Pain Symptoms Compared to a Heart Problem
Dr. Lacy explains, “Chest pain that is cardiac in origin is often (but not always, and that’s the hooker here) associated with an elevated pulse (tachycardia), shortness of breath, diaphoresis (sweatiness) with pain that radiates from the chest into the neck and left arm.
“Chest pain that originates from the esophagus or stomach is usually underneath the sternum or in the epigastric region, does not radiate to the neck or left arm, and is unlikely to be associated with diaphoresis or shortness of breath.”
Note that both heart attack pain and gastroesophageal reflux disease (which originates from the esophagus) can cause pain in the back, but irritable bowel syndrome does not.
“IBS, which is often associated with spasms of the colon or small intestine, can cause chest pain in some individuals,” says Dr. Lacy.
“It is easy to understand how a patient with IBS, who has spasms in the colon or small intestine, might also have spasms in another part of the GI tract such as the esophagus.”
Cardiac Issue
Angina is chest pain resulting from insufficient blood flow in the heart, caused by obstructed coronary arteries.
Source: vecteezy.com
A key difference between angina chest pain and that from IBS is that, in the case of stable angina, the discomfort will arise only during physical exertion or periods of intense emotion.
Sometimes the exertion is merely that of walking up a single flight of stairs.
Pain in the chest from IBS will not come from physical exertion or be associated with exercise or highly charged emotions.
However, things get very tricky with unstable angina. In this case, the chest pain can come during sedentary periods, even during sleep, awakening the person.
Unstable angina that’s caused by clogged arteries is an urgent situation, meaning that a heart attack can occur at any time.
We don’t want to get to a point of, “Is it IBS or unstable angina?”
What about how these different chest pains feel?
The sensation that arises during a heart attack may be quite severe – more so than any pain stemming from irritable bowel syndrome or even angina.
However, not all heart attacks present with severe chest pain. The discomfort may only be mild or dull.
IBS chest pain will never be severe, crushing (like a heavy weight is there) or have a feeling of constriction or tightness.
But remember, not all heart attack or angina sensations have these features, either.
“One approach that many health care providers take to try to determine whether chest pain is cardiac in origin or from another organ system (such as the esophagus) is to ask the patient about risk factors for heart disease,” says Dr. Lacy.
“Thus, an obese man [or woman] in his 60s or 70s who smokes cigarettes, has diabetes, has high blood pressure and elevated cholesterol, is at a much higher risk to have heart disease than a man in his 30s who is lean, does not smoke and does not have diabetes, elevated cholesterol or high blood pressure.
“Conversely, a younger man [or woman] with known IBS and intermittent spasms and cramps of the intestinal tract is more likely to have a spastic disorder of the esophagus (and thus chest pain) than a man who does not have IBS.”
If you’re worried your chest pain might be heart related, it’s time to see a cardiologist, who may recommend a cardiac stress test.
Additionally, for those suffering from IBS-C/CIC, you may want to try LINZESS® , and for IBS-D, Viberzi®, as these are very effective medications recommended by Dr. Lacy.
Dr. Lacy combines his love of science, medicine and people to uncover the causes of symptoms like stomach pain, gas, bloating, diarrhea, constipation and regurgitation.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
.
Top image: Freepik.com
Why You Should Exercise 7 Days a Week
Exercising seven days a week is a good thing, not a bad thing.
Your ancient ancestors worked their butts off seven days a week, and that’s why you’re here!
Think of all the things that primitive hunter-gatherers (and even modern-day hunter-gatherers) had to do just to survive.
Benefits of Exercising Seven Days a Week
Daily structured exercise means greater fat-burning (yes, it will make a difference over time) and better fitness.
The analogy: Think of practicing the violin only five or six days a week, versus seven. Over time, that seventh day will make a difference.
What’s harmful is excessive sitting seven days a week, a product of a modern way of living, replete with technology that makes daily living increasingly easier.
If you lift weights, say, four times a week, and do cardio on the remaining three days, that’s perfectly fine.
If you lift weights three times a week and do cardio four times a week, that’s fine too.
Or, if your goals are oriented more towards non-strength training, it’s perfectly okay to lift weights twice a week but do cardio on those other five days.
Don’t let the naysayers (who spend two to four hours, seven days a week, plopped in front of the TV) trick you into thinking there’s something sinister about exercising every day.
Marketing campaigns for physique transformation programs usually advise taking one day off per week, to “rest.”
Just because this is recommended doesn’t mean it’s harmful to work out every single day.
This one day a week of rest is advised to increase adherence to the program.
Many doctors and even personal trainers will recommend this, if for no other reason, so you can just kick back and have fun.
If that’s what suits you, do it. But if you feel like something’s missing on that one day a week you’ve decided to forgo working out, then resume your workouts to seven days a week.
It will not harm you or sabotage your goals. If that’s what you thrive on, then go for it.
Guidelines for Exercising Seven Days/Week
This doesn’t mean that every single day should involve a prolonged and grueling, strenuous workout.
It also doesn’t mean that if you’re already lifting weights three times a week, that the seventh day should be a fourth weight training day. This actually wouldn’t be a smart idea.
You have many other options that don’t involve barbells and other lifting equipment.
That seventh day should be a light day, such as a leisurely hike, fun inline skating, walking on a treadmill while watching TV, practicing your karate forms, yoga, calisthenics or basic stretching.
Never target the same muscle groups two days in a row when it comes to strength training.
So your regimen might look like this:
Monday: Back/biceps
Tuesday: Step class
Wednesday: Chest/shoulders/triceps
Thursday: Martial arts
Friday: Legs (squats, lunges, machines)
Saturday: Running
Sunday: Yoga
So go ahead, exercise every single day if that’s what you’d like to do!
After all, with all the time you may be spending sitting at the computer, you’ve earned it.
Lorra Garrick is a former personal trainer certified through the American Council on Exercise. At Bally Total Fitness she trained women and men of all ages for fat loss, muscle building, fitness and improved health.
How to Get ER Attention for a Migraine
Do ER doctors avoid taking your migraine complaints seriously because perhaps they think you might be an opioid addict faking a headache?
Here’s how to get treated promptly and efficiently in the ER for all of your future severe migraine attacks. (more…)
Dry Scaly Skin Above Eyelids that Itches: Causes & Solutions
Itchy scaly and flaky skin above the eyelids—sometimes it even stings.
There are many causes, and the solution depends on the causes. The flaking and itchiness can seemingly come out of nowhere. (more…)
