|
Hopkins News For You
This is a service for our friends around the world from Johns Hopkins International. To receive reports, please send e-mail to patientnewsletter@jhmi.edu with the name of this e-newsletter.
April 2003
Soothing the Pain of Shingles
Turning off the Ringing of Tinnitus
A New Way to Treat Atrial Fibrillation
What is Carpal Tunnel Syndrome?
The Hidden Cancer
How are those New Year's Resolutions Going?
To Julio Montoya, Lima, Peru
Soothing the Pain of Shingles
The same herpes virus that causes chicken pox also causes shingles, a painful rash that sensitizes the body and turns the slightest touch into mind-numbing pain. Hopkins anesthesiologist Srinavasa Raja, M.D., who treats shingles patients, says: "When patients have this type of persistent pain, the body can become so sensitive that even contact with clothing is uncomfortable."
Antidepressants and opioid medications such as morphine are used to treat shingles. But studies conducted by Dr. Raja of patients who used both types of medications, found that a considerably higher proportion preferred opioids to antidepressants. Among patients who experienced pain relief, 52 percent used opioids versus 34 percent who took antidepressants.
Turning off the Ringing of Tinnitus
An estimated 15 percent of people worldwide suffer from tinnitus, nonstop ringing in the ears that for nearly a third of sufferers leads to depression, anxiety or chronic sleep deprivation. No cure exists but many tinnitus sufferers experience relief using white noise generators or hearing aids that create a light background noise that distracts the brain.
"Most treatments for tinnitus either trick the brain into thinking the sound isn't there, try to mask the sound out with other noises or teach the brain to ignore the sound," says Hopkins otolaryngologist Lawrence Lustig, M.D. "We know that people who wear hearing aids with hearing loss and tinnitus tend to have reduction in their tinnitus while they use their hearing aids and over time their tinnitus lessens. That effect can be lasting even if they take their hearing aids out for the night."
Dr. Lustig says new implants based on the same technology used for cochlear implants to restore hearing in some patients may help tinnitus patients who do not have a hearing problem. "There are very experimental treatments that are stimulating the inner ear with an electrode to see if it can help reset some of the signaling and reduce tinnitus in patients who are really bothered by it."
A New Way to Treat Atrial Fibrillation
Atrial fibrillation is a malady that causes the heart to race out of control. While medications and electrically shocking the heartbeat back to normal can control the condition, nothing could eliminate it. But Hopkins cardiologist Hugh Calkins, M.D., has begun using a new technique to treat atrial fibrillation that has cured 80 percent of his patients with intermittent atrial fibrillation and 50 percent of those with chronic atrial fibrillation.
Atrial fibrillation happens when the electrical signal that begins each beat in the heart's atrium is diverted from its normal pathway by muscular tissue in the veins connecting the heart and lungs. This causes the upper chambers of the heart to beat faster and faster, out of sync with the lower ventricles. A process called ablation uses radio-frequency energy to burn the area causing the problem and return the signal to normal. The secret to success, says Dr. Calkins, is knowing how to use MRI and a special catheter to target the disruptive tissues that cause the problem.
What is Carpal Tunnel Syndrome?
Carpal tunnel syndrome is a work-related injury many people experience from forceful and repetitive hand movements. The painful syndrome strikes when the tendons and nerves along the tight canal, or tunnel, at the base of the palm become swollen and the carpal tunnel is constricted or pinched, causing pain or numbness in the affected hand.
Mild cases can be treated by simply changing or avoiding activities that cause symptoms and taking frequent breaks from repetitive tasks. Your doctor may ask you to wear a wrist splint or wrist support, particularly at night, and may also recommend taking anti-inflammatory medication. If swelling persists, the next step may be trying cortisone injections or vitamin B6. Surgery is recommended when other treatments fail to relieve pressure on the median nerve located inside the carpal tunnel.
Usually, surgery results in immediate relief and patients can resume full normal activities within six weeks. The main risk of not having carpal tunnel surgery is that the median nerve may become permanently damaged and the thumb muscle may get smaller and become weak.
The Hidden Cancer
Sun exposure is synonymous with skin cancer, but one form of the disease prefers to do its work in the dark. It's called The Great Imitator, and left untreated it can kill. Cutaneous T-Cell Lymphoma, also called CTCL, is a slow growing skin cancer that can be difficult to spot. That's because the red, dry patches that mark the disease can be mistaken for eczema or psoriasis. However, unlike most skin cancers, CTCL cell growth may be inhibited by sunlight. That oddity, says Johns Hopkins Dermatologist Eric Vonderheid, can help clinicians make a CTCL diagnosis.
"One of the clues clinically is when you see persistent patches that are predominantly on non-sun exposed skin. So the bathing suit area, the flanks of the body, inner arms, inner thighs...these raise a flag that these are not eczema or psoriasis in the usual sense and should be investigated further." Vonderheid says that CTCL is relatively rare and can be easily cured as long as it hasn't spread from the skin to internal organs.
How are those New Year's Resolutions Going?
Many of us began the New Year with a list of lifestyle changes to help us regain or maintain good health. Here is a list of recommendations to help you achieve your goal:
1) If you smoke, stop;
2) Cut back on all forms of fried foods;
3) Eat 5 or more servings of both fruits and vegetables a day;
4) Drink at least 6 glasses of water per day;
5) Exercise for 30 minutes at least 3 times per week;
6) Eat high calorie foods sparingly;
7) Take 30 minutes a day to unwind and relax, read a book or meditate;
8) Calcium is a key ingredient of good health. Adults need 1000 mg/day, post menopausal women and men over age 65 need 1500 mg/day and teenagers need about 1200 mg/day;
9) Drink alcoholic beverages in moderation (or not at all);
10) Get regular check ups, including pap smears and mammograms, and monitor blood pressure, weight and cholesterol levels.
To Julio Montoya, Lima, Peru
Julio Montoya, of Lima, Peru, a former patient and a friend of the Latin America Division at Johns Hopkins International, is taking part in a marathon walk from Ecuador through Peru and ending in Chile. The 3000-km walk began April 7, the International Day of Health, in Mchala, Ecuador, and will end in the city of Iquique in northern Chile.
In a letter to Johns Hopkins International, Montoya, who received a leg prosthesis at Johns Hopkins, wrote: "I want to show to the world that young people with various handicaps who, for one reason or another, have beÿes radio-frequency energy to buren deprived of one or more parts of our bodies, are not marginalized and can function as any normal person can." We send our best wishes and admiration to Julio and all those who are accompanying him on this inspiring walk.
|
