Hypothalamic Obesity: How Hungry Do Patients Get?
A tumor on the hypothalamus, when removed, can cause unimaginable permanent hunger in the patient leading to extreme obesity.
Their hunger is so intense that food must be locked up, and the patient often requires continuous supervision to ensure they don’t eat themselves to a point of extreme sickness. (more…)
Causes of MILD vs. Severe Bilateral Ankle Swelling
Causes of MILD swelling or edema in both ankles are usually not as worrisome as the causes of severe edema in the ankles.
Have you noticed only mild swelling in your ankles?
Certainly, serious medical conditions such as congestive heart failure can cause only mild bilateral swelling in the ankles and lower legs.
But there are benign conditions that will never cause severe swelling.
If the bilateral swelling in your ankles has only been mild – and stabilized that way for a lengthy period of time – does this necessarily rule out a serious cause?
The answer is NO. There may still be a serious medical condition going on.
If you’re a 25-year-old athlete, the cause is far less likely to be congestive heart failure than if you’re a 50-year-old smoker who’s never been into exercising.
Causes of Mild Bilateral Swelling in the Ankles
“Dietary: excess consumption of salt, carbonated beverages or alcohol leads to salt and water retention in the bloodstream that diffuses into surrounding soft tissue,” says Jenepher Piper, a family practice nurse practitioner for Maryland Family Care for 25+ years and a former nurse with Home Care Nurse for Johns Hopkins Home Care.
“This occurs particularly in tissue that are subject to the effects of gravity: feet/ankles, hands/wrists.”
Lay off these beverages and cut down on the sodium/salt to see if this doesn’t make the edema go away. Most dietary salt comes from processed foods, not the salt shaker.
“Venous stasis (pooling of blood): prolonged standing, excess walking/running, elevated blood pressure, advanced age (all veins less competent), pregnancy (normal unless sudden and excessive), excessive heat,” says Piper. PMS and varicose veins can also be a cause.
The most serious cause in this second group is the elevated blood pressure.
High blood pressure is a leading risk factor for stroke and can cause other damage to the body.
Excessive heat can lead to life-threatening heat stroke, but presumably, you’re experiencing the puzzling though mild ankle swelling while indoors, and it’s there on a daily basis.
Prolonged sitting can also lead to this problem. Below is ankle edema from an extended flight.
James Heilman, MD, CreativeCommons
In fact, prolonged sitting on a daily basis can lead to all sorts of ailments.
“Medication side-effect: anti-inflammatories(NSAIDS), prednisone and some blood pressure medicines (e.g., calcium channel blockers),” says Piper.
Have a doctor check the swelling in your ankles. What kind of doctor?
See what both a primary care physician and a cardiologist say.
However, you’ll likely first be seen by a nurse; get the nurse’s perspective as well.
And if you have swelling in only one leg, rather than bilaterally, this can mean a dangerous blood clot.
Patients suffering from conditions such as coronary artery disease, obesity and diabetes turn to Nurse Practitioner Piper to help them best manage their overall health.
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.
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Top image: Shutterstock/Toa55
Top 3 Exercises to Prevent Back Pain from Shoveling Snow
I’m a 50-something woman and can shovel heavy wet snow like a beast and never feel back pain thanks to 3 exercises.
Not only have I been a personal trainer, but I’ve been lifting weights for years — and have done a lot of snow shoveling — so I’m going to strongly recommend the three best exercises for this “back wrenching” task.
The act of shoveling snow is actually a fusion of all three of these exercises. Before I go on, I need to emphasize the importance of proper form during snow shoveling.
When doing any kind of resistance-based activity, correct form is crucial – whether that activity is being performed in a gym to get stronger or build muscle, or whether the action is being done to clean something up or transport heavy objects.
Shoveling snow, especially the heavy wet kind of snow, involves cleaning up and transport of a heavy object.
The reason that so many people feel drained and suffer low back pain within minutes of shoveling snow is because of the resistance that’s being transferred to their low back.
However, intense burning in the thighs is also a typical complaint.
When shoveling, one must minimize the forces being absorbed by the low back. These erector spinae muscles are not designed for high force absorption.
Instead, they are stabilizers; their job is to stabilize the spine.
Correct Snow Shoveling Form
• Bend with the legs as much as possible.
• Keep back as upright as possible.
• As you go down to scoop and then raise your body to toss the snow, bend with the legs (mini squats) rather than pivot at the low back.
If your body is very well-trained with the deadlift, kettlebell swing and your favorite variety of squats, you will be able to effortlessly shovel snow – especially if you have good cardiorespiratory conditioning.
How to Do the Deadlift
• Stand over a barbell that’s on the floor.
• Keeping the lower back arched, back as upright as possible, bend at the legs and grab the bar with straight arms.
Freepik.com
• Depending on your body proportions, your back may be close to parallel by the time your hands reach the bar.
• However, make the necessary adjustments with your legs do that your shoulders are always ABOVE your hips.
• As you begin lifting, your hips should NEVER rise above shoulder level.
• Never round the back.
• Straighten your body, barbell in hands, arms straight, then lower it to the floor, reversing the movements that you used to lift the weight.
• Books have been written on proper deadlift form, and there are variations of positioning, but there are the basic bullet points to get your started.
How to Do a Kettlebell Swing
• Stand with feet shoulder width apart, holding the kettlebell with both hands, arms straight.
• Bend legs and swing kettlebell between legs, bending at your hips.
• Never round your back.
• Swing the kettlebell a little through your legs, then swing it upward, arms parallel to the floor.
• Repeat, controlling as much as possible the down-swing.
Shutterstock/The Faces
Freepik pressfoto
How to Do a Squat
• There are many variations.
• The rule for all variations is to never round the back!
• Keep the lower back arched.
• The two-legs-simultaneous squat need not go past parallel, meaning, butt lower than knees.
• However, go to at least parallel (thighs parallel to the floor). This is the half-squat position.
Depositphotos.com
• Never let your heels lose contact with the floor. This is a common mistake.
• If you can’t get parallel (two legs simultaneous) without feeling you’ll fall backwards, WIDEN your stance and slightly point your feet outward.
• Another common mistake is using too much weight, preventing the half-squat position.
It will take some time to become strong in all three of these exercises, which are truly the best for preventing pain from shoveling snow.
But if you begin these three exercises in the springtime, you’ll have all spring, summer and fall to get conditioned and strong for the next snow shoveling season.
I can go on and on regarding all sorts of nuances, such as how many times a week to do these three exercises, how many sets and repetitions, etc., but the topic of this post is the three best exercises for preventing pain and discomfort from snow shoveling.
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.
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Top image: Shutterstock/Chiyacat
Why Can Tinnitus Be Louder in One Ear than the Other?
Many tinnitus sufferers are aware that the noise is louder in one ear than the other, and/or is of a different frequency. (more…)
Intermittent Tinnitus, Comes and Goes: Causes and Solutions
Intermittent tinnitus is the typical tinnitus that affects millions, but instead of being continuous, it comes and goes, present on some days and absent on others.
This isn’t about that sudden, “brief piercing high frequency ringing (random neural firings) that goes away quickly and is not pathological,” says Rachel Raphael, M.A., CCC-A, an audiologist with ENT Baltimore.
Sooner or later everyone gets that: a sudden loud ringing in one ear that momentarily drowns out external noise.
The episode lasts well under half a minute and is also believed to be caused by a benign muscle spasm inside the ear.
So file that away, because this article deals with what seems to be the typical tinnitus that millions suffer from on a chronic basis, usually every minute of every day.
But what if you were to have this—only on some days? You have days of blessed silence, then days of tinnitus, with no pattern. And sometimes it’s intermittent WITHIN a given day.
“Will tomorrow be a tinnitus day or a silence day?” you ask at bedtime.
The tinnitus fluctuates in terms of presence and absence, and may fluctuate in terms of how loud or soft it is.
From a logic standpoint, we can rule out impacted ear wax as a cause, as this is either there or it’s not.
Aging in the inner ear doesn’t come and go, either; once something in there begins aging, it doesn’t reverse and become youthful.
Stress has been implicated as a cause for some cases of tinnitus. Stress can be intermittent, or at least, its severity can fluctuate.
But let’s make the question even more vexing: What if someone experiences intermittent tinnitus, as I’ve described, but its first onset was NOT precipitated by any unusual degree or amount of mental stress?
And what if the new-onset tinnitus that comes and goes was not preceded by exposure to booming loud noise, medications or an illness?
And what if there’s no perceived new-onset hearing loss?
Well, let’s first look at stress-caused tinnitus and its solutions.
“I have found in my experience that those who suddenly develop tinnitus have undergone a stressful life change, such as an illness, hospitalization or loss of a loved one,” says Raphael.
“We know that stress plays a role in worsening tinnitus, and it is widely believed that relaxation/ yoga/meditation/deep breathing exercises can help to reduce tinnitus.
“We also recommend a healthy lifestyle which includes a full night’s sleep and reducing (not necessarily eliminating) stimulants such as caffeine, alcohol, nicotine, etc., to help reduce tinnitus. The key is moderation!”
Counseling/ reassurance, and avoiding silence (mild and neutral external sound sources such as white noise from a sound machine) as well as properly fitted hearing aids when appropriate also play a key role in reducing/helping brain to habituate tinnitus.”
HOW does stress cause tinnitus?
A report in Frontiers in Systems Neuroscience (Mazurek, et al, 2012) explains the possible mechanisms.
The explanations are very lengthy and highly technical, with too much information for me to efficiently summarize here.
So we’re left with the enigma of what precisely causes tinnitus (especially in both ears) that comes and goes.
And again, this does NOT refer to that loud piercing ringing that drowns out external sounds and lasts maybe 15 seconds – but rather, the typical high frequency tonal tinnitus that affects millions on a 24/7 basis.
Another Audiologist’s Take on Intermittent Tinnitus that Comes and Goes
“There are many causes to intermittent tinnitus,” begins Rivka Strom, AuD, CCC-A, Director of Audiology, Advanced Hearing NY Inc.
“Tinnitus is highly correlated to hearing loss, but not all individuals with hearing loss experience tinnitus.
“A change in hearing, middle ear infections or Eustachian tube dysfunction can often be a trigger for constant or chronic tinnitus.
“Allergies can be a trigger as well. Remember that tinnitus is typically not objective.
“Since it is a subjective phenomenon, it can be ‘heard’ when an individual is fearful and looking for it, when stressed, when in a quiet environment where there are no distractions.
“Awareness of tinnitus can be associated with conditions beyond hearing loss such as changes in biochemistry, new medications, anatomical abnormalities — and the perception of tinnitus can change based on how our bodies change and how we react to those changes.
“It can fluctuate based on one’s well-being and mental status. Stress and mood changes are key triggers for many of those who suffer from tinnitus.”
It may very well be (though certainly not proven) that mental stress takes the No. 1 spot for the cause of intermittent tinnitus that comes and goes.
Dr. Strom is a member of the American Speech Language and Hearing Association and has received several awards including Brooklyn College’s Excellence In Audiology Award.
Rachel A. Raphael specializes in clinical audiology and hearing aid dispensing. She helps in the diagnosis of hearing loss, tinnitus, dizziness and vestibular pathology in adults and children.
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/fizkes
Source: ncbi.nlm.nih.gov/pmc/articles/PMC3371598/
Can Tinnitus Be Higher Tone than What You Can Hear for Real?
Can a person hear a tinnitus (sine wave tone) at a higher frequency than what he can hear in real life?
So let’s look at it this way: Suppose a hearing test determines that you can only hear at 11,000 Hz, but the tinnitus that rings in your ears against your will matches a tone of 13,000. (more…)
A Slightly Numb Big Toe Can Be Caused by Diabetic Neuropathy
You may have diabetes and the numb feeling in your big toe can be caused by diabetes, but it may also have other causes unrelated to blood sugar levels.
Neuropathy has causes other than diabetes, even though you may have seen ads for diabetic neuropathy. (more…)
Ears Get Cold Outside Jogging even in Warm Weather?
Do your ears always get cold outside even in 75 degree weather, especially if you’re hiking, jogging or even walking?
For some people, wearing a cap of some sort to keep the ears warm is necessary, even in what would be considered warm weather. (more…)
Conquer that Mad Racing Heart Every Time You Use a Staircase
So your heart pounds like a demon every time you walk up a flight of stairs?
First of all, make sure that a cardiologist finds nothing wrong with your heart.
The doctor must clear you for a form of exercise called interval training, because this will likely cure you of that frightening racing heart that occurs every time you go up a flight of stairs. (more…)
Can More Frequent Urination Be a Symptom of Perimenopause ?
You aren’t imagining it: There may very well be a link between perimenopause and more frequent urinating than usual, including those overnight trips to the bathroom.
How many voids per 24 hours define urinary frequency?
“Although there is no absolute number of daytime voids that is ‘abnormal,’ urinary frequency is typically defined as more than eight voids/24 hours,” says R. Mark Ellerkmann, MD, Director, The Urogynecology Center at Mercy Medical Center, Baltimore.
“However, many things can influence the degree of urinary frequency — how much one drinks, what one drinks, whether someone is on a diuretic, etc.”
So right off the bat, you may want to ask yourself if perimenopause has been making you consume more fluids, though thirst is not a symptom of perimenopause.
Overactive Bladder
Dr. Ellerkmann says that usually, complaints of urinary frequency come with additional symptoms:
• Urinary urgency (“sudden, compelling desire to pass urine which is difficult to defer”)
• Nocturia – getting up in the middle of the night to relieve oneself more than once
• Urge related
“The constellation of these symptoms provide for a clinical diagnosis we refer to as overactive bladder or OAB (defined as urgency, often with frequency and nocturia, with or without urge related urinary incontinence),” explains Dr. Ellerkmann.
Severity does increase with age, but perimenopause typically occurs in a woman’s 40s. Urge related incontinence is more common in women.
“Urge incontinence increases with age, from 17 percent of women older than 45 years to 27 percent of women older than 75 years of age.”
The Perimenopause and Urinary Frequency Connection
“Perimenopause is defined at that period of time leading up to menopause,” says Dr. Ellerkmann.
“Many physiological changes occur during the perimenopausal time period as levels of circulating hormones — estrogen, progesterone and testosterone — fluctuate and levels slowly decrease.
“The effects of estrogen on the urogenital tract are well-known, as these tissues (the vaginal and peri-urethral tissues/bladder) are very rich in estrogen receptors.
“As circulating estrogen levels decrease and become less consistent, vaginal and peri-urethral tissues become less well-lubricated; they become thinner and less elastic and less well-vascularized [stocked with blood vessels].
“It may be that the loss of estrogen can adversely affect the bladder, but whether the hormonal changes of perimenopause are directly related to symptoms of urinary frequency is difficult to say.”
Solutions to Increased Urinary Frequency from Perimenopause
Dr. Ellerkmann says that some studies support the use of supplemental vaginal estrogen cream in both periomenopausal and menopausal women to partially alleviate symptoms of overactive bladder.
Dr. Ellerkmann also explains, “Excluding organic causes that might cause overactive bladder symptoms (bladder cancers, stones, bladder prolapse, infections, foreign suture or mesh from urological surgery) or medications (diuretics) or behavior (excessive consumption of liquids), the most common inciting causes of urinary frequency and urgency are consumption of known dietary irritants — the most common of which are caffeinated beverages, tea, artificial sweeteners, carbonated beverages, citrus juices, tomatoes, chocolate, sodas.”
Dr. Ellerkmann
is board certified in both OB/GYN and female pelvic medicine and reconstructive surgery. He specializes in the treatment of urinary incontinence in women of all ages.
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.
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