Podcasts

Nose Issues [Show Notes]

 in Podcasts  tagged allergies / blood pressure / blood thinner / cancer / congestion / deviated septum / episode / hypertrophy / infection / nose bleed / polyps / smell / smoking / viruses by

Nose issues that cause your breathing to fail

  • Congestion from allergies, viruses, or infections.
  • Deviated septum – the septum (the bone that separates the nasal cavity and divides your nostrils) can get crooked and change the size and access of the nostrils or nasal cavity.  Can be from trauma, or may gradually get crooked from chronic pressure.
  • Turbinate Hypertrophy – over-growth of tissue covering the turbinates (tissue-covered bones that add warmth and moisture to the air you breathe). This can lead to snoring.  May be treated by steroid nasal sprays or surgery to remove extra tissue.
  • Nasal Polyps – uneven overgrowth of mucus membranes (symptoms may be runny nose, post-nasal drip, stuffiness).  They are not cancerous.  Treated by snipping them out.
  • Sinus cancer – a single growing tumor that causes bulging, either around the eye, face, or mouth.

Nose issues that cause your smelling to fail

  • Age
  • Deviated septum (see above)
  • Polyps (see above)
  • Chronic sinus infections – the smelling sensors are inflamed or covered with mucus so much that they become damaged or less sensitive.
  • Smoking – smoke and toxins can damage smelling receptors in your nose.  Also, the receptors become so clogged up with smoke and tobacco molecules that there’s no room for other molecules to be detected.  This can be temporary or permanent.

Nosebleeds

  • In kids, this is usually from trauma (either bumps and bonks or picking).  Can also be caused by dry air in the wintertime (use vaseline in the nostrils).
  •  In adults, can be from hypertension (high blood pressure) or chronic use of blood thinners.

PSA: Treatment for a nosebleed:  DO NOT tip your head backwards!!!!!  It makes you swallow that blood!  THAT’S GROSS!!  Proper treatment:  pinch the nose and tip the head forward.  This allows a clot to form and clots stop the bleeding.

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Smell [Show Notes]

 in Podcasts  tagged emotions / episode / evaporation / limbic system / memories / olfactory / smell / volatile by

Smell Basics

Air goes in your nose and flows over the smell sensors.

Your nose and sinus cavities act as a resonating chamber for your voice.  That’s why you sound funny when you hold your nose or when your nose is stopped up from a cold or allergies.  This is important in talking and singing.

What makes something smell?

Volatile molecules evaporate at normal temperatures and pressures, so actually molecules of the thing are in the air and available to go in your nose.  Don’t think about this too hard….

The smelling sensors are on the roof of the nasal cavity –> olfactory receptors (olfactory is the fancy word for smelling).  The molecules fit into the receptors like a key in a key hole.  Our brain likes to categorize things, and so certain compounds have similar structures and get lumped together (“smells like eggs” but you know it’s not real eggs).

The olfactory receptors send the signals to the olfactory bulb (which is the area in the brain that translates all the smells and allows you to identify a smell).  It’s not a very long trip….

The olfactory bulb is a part of the limbic system (the emotion center).  this is why smell is more strongly connected to emotions and memory – even stronger than sight and sound.

Smell Tidbits

If you go to the perfume counter at a department stores, you’ll find that they all start smelling the same.  The perfume department will have coffee beans because it helps clean out the receptors.

Coffee-scented, caffeinated perfume <– free idea!!

Inflammation and mucus congestion blocked off the receptors.

No concrete evidence of why pregnant women get a “super smeller” during pregnancy.

One rogue molecule won’t make you smell something.

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Nose Anatomy [Show Notes]

 in Podcasts  tagged anatomy / athletics / breathing / cartilage / episode / mouth-breathing / nose / sinuses / Sleep / smell by

Nose Basics

Your nose is responsible for breathing and smelling.  These things work better when it isn’t stopped up.

The part of your nose that you can see and touch is cartilage covered in skin.  There is bone above it, beside your nose, below it, and right in the middle (inside your head).  Part of the cartilage is stiff and hold shape, other parts of cartilage are soft for flexibility.

The nasal root (the bone that extends between your eyes) connected to the bridge of your nose (which is made of cartilage).  The tip is also called the lobe.  The wings are on each side of your nose that you can flare.  The nostrils is actually the holes.

There are 4 main sinus cavities

  1. Frontal sinuses = in your forehead, between your eyebrows
  2. Maxillary sinuses = run under your eyes, behind your cheeks
  3. Ethmoid sinus = right between your eyes, in the middle of your head, connected to your tear ducts
  4. Sphenoid sinus = under your sphenoid bone (in the middle of your head)

The sinus cavities are lined with mucous membranes that keep them moist and have lots of blood flow to them.  Their job is to warm and moisten the air you breathe in your nose before it goes into the lungs.  Your lungs don’t like cold air.

Mouth breathing is not very efficient. This is true in athletics as well as sleep.   But breathing out through your mouth can be useful because you can get a large amount of air out rather quickly and the lungs empty better.

You have a fast-flow and a slow-flow nostril – this has to help you perceive smell.  Sometimes almost as good as dogs.

The cartilage of your ears and nose never stop growing through your life.

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Ear Issues [Show Notes]

 in Podcasts  tagged ear / episode / flavanoids / hearing loss / infection / motion sickness / otitis media / tinnitus / vertigo by

PSA:  Please don’t stick things in your ear any larger than your elbow…and that includes your finger.

Review

Outer ear = the part that you can touch
Middle ear = the area being the ear drum
Inner ear = the cochlea and area responsible for your balance

3 common ear problems

  • Ear infections (otitis media)
  • Vertigo (and motion sickness)
  • Tinnitus (ringing in your ear)

Callback

*Ear wax

Ear Infections

The area behind your ear drum has air in it and that pressure is equalized through the eustachian tube.  If that area gets fluid in it, that fluid can grow bacteria and that leads to infection.  The natural motion of opening and closing your jaw helps massage the eustachian tubes and moves air in and out (like when you fly or drive in the mountains and you chew gum or yawn).

Cold and allergies can be the source of the fluid build up that leads to ear infection.  You may have decreased hearing, pain, decreased balance – infection can require antibiotics.

Vertigo

This is the sensation of spinning, dizziness, being off balance
The semi-circular canals are responsible for your balance.  If it get sloshed too much, or doesn’t level out exactly right, then the signals sent to the brain may translate to being off balance even though your body is upright.  The signal confusion is what can lead to nausea (it’s not actually happening in your stomach – at least not until you vomit!)
The fluid moving around in these canals are why kids can induce dizziness when they spin around in circles (think about the clothes in your washer during the spin cycle – they get pushed to the outside).
Medications  for vertigo are the same as some medications for nausea – plus they have drowsy side effects, so maybe you just sleep it off.
There are many suspected causes, but nothing definite or proven.

Tinnitus

Defined as ringing, buzzing, roaring, whooshing sound when nothing is actually making that noise.
Causes: hearing loss (either due to aging or exposure to loud noises); high blood pressure (pulsating); medications
One theory: the hairs in the cochlea are damaged so those frequencies of sound (usually high pitched sounds) can’t be picked up anymore; the brain fills in the gaps with “made up sound”.  This is NOT PROVEN!
High blood pressure can cause you to hear the blood pulsing through the blood vessels in your ears.

Medications that causing ringing in the ears

  • Aspirin (acute over-use)
  • Aminoglycosides (i.e. Gentamicin = antibiotic) – it has a small therapeutic window, too much can lead to ear damage, it stopped in time, permanent ear damage can be avoided
  • Quinine = usually asked for to help leg cramps, also medically prescribed to prevent malaria.  Can only be readily consumed by drinking tonic water.

Flavonoids are put in vitamins and advertised to help tinnitus.  Flavonoids are phytonutrients (nutrients you get from plants).  These nutrients can’t grow the hairs back in the cochlea.  Most of the vitamins and nutrients in the flavonoid vitamins have anti-oxidative properties, but I doubt that tinnitus is a major oxidation problem.

Audience Question

Can being slapped over time cause ringing in the ears?

  • Being bopped in the face and head can probably cause permanent damage to the structures on the inside and outside of your head.  Being hit in the side of the head can cause pressure build-up in the ear where the air causes the ear drum to rupture (like “boxing” the ears).
  • Slaps to the face (like “you jerk!” kind of slaps) don’t usually cause ear problems, but punches or slaps to the side of the head near or on the ears can possibly cause damage.

Prevent ear problems: be nice to your ears!

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Ear Anatomy [Show Notes]

 in Podcasts  tagged brain / cochlea / ear / ear drum / episode / frequency / pitch / sound / vertigo by

Ear Basics

The auricle is the part of the ears you can see. It is made of cartilage (flexible tissue that doesn’t have a large blood supply).  Everything else requires a tool for the doctor to see inside.  And the doctor can only see to the ear drum.  The stuff behind the ear drum isn’t visible because of the membrane that blocks it.  The middle and inner ear are surrounded by your head bones.

Science of Sound

Sound is created when the air around us is compressed and then expands.  They move away from the source in circles (think radar or sonar or throwing a pebble in a pond).

The ear canal directs the sound waves towards the ear drum.

Sound gets translated in 2 main ways

  1. Identify the sound
  2. Identify if the sound has meaning

Inside Your Ears

The ear drum (tympanic membrane) vibrates according to the intensity of the sound and trigger the Hammer-Anvil-Stirrup cascade.

  • The ear drum vibrates the handle of the Hammer (Malus bone – yes, it’s a real bone).
  • The Hammer bangs on the Anvil (Incus bone).
  • The Anvil has a tail that is connected to the Stirrup (Stapes bone).
  • The Stirrup looks like the spurs on the back of boots.  It is connected to a membrane on the Cochlea and works like a plunger.

All of these bones are surrounded by air and the pressure is controlled by the Eustachian tube.  This is the access point for ear infections or congestion due to allergies or a cold.

The Cochlea is a bone full of fluid and lined with hairs and shaped like a spiraled sea shell.  The hairs pick up different frequencies of sound (sound wave frequency determines pitch).  If certain levels of hairs get damaged, then you will not be able to hear pitches in that range anymore.  If you unrolled the cochlea, it would be laid out low pitch to high pitch like a piano.  And these hairs are connected to the auditory nerves and turn sound signals into electrical signal to send it to your brain.

Semicircular canals of the cochlea are little bone chambers full of fluid and they control balance.  This works like a leveling bubble to help you stay upright.  If it becomes dysfunctional, then it may trigger vertigo.

The middle ear (the area behind the ear drum) is where most of the trouble happens – whether allergies causing stopped up ears, or colds leading to ear infections.

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Allergy Testing Experience [Show Notes]

 in Podcasts  tagged allergy test / anaphylaxis / epipen / episode / flowers / hives / injections / itchy / mites / molds / plants / prick test / scratch test / shots / trees / weeds by

Allergy Basics

Anaphylaxis = an out of control allergic reaction that can be life-threatening if medical treatment is not sought immediately
EpiPens are a first-step self-treatment in the case of a major allergic reaction or anaphylaxis.

My Allergy Testing Experience

I got 33 injections!!

Allergy testing started with a serum test as a baseline – just to see how strongly my histamine reaction was.

The injections are sub-dermal (under the dermis layer of the skin).  It’s the same level if injection that a TB skin test is done (to see if you’ve been exposed to tuberculosis).

The next step was a prick-test or scratch test – these plastic claw things that poke down in my forearms.  This test required me to sit completely still for 20 minutes.  COMPLETE TORTURE!

A picture of my right forearm where the nurse performed my allergy testing prick testA picture of my left forearm where the nurse performed my allergy testing prick test

Numbers 1-20 are plants (trees, grasses, flowers).  C = cat. D = dog (Good news – I’m not allergic to dogs!) M = skin mites (don’t think about this one too hard). CL = cockroaches.  The other letters are household and common molds.

The skin pricks on my forearm was a preliminary test to determine how much serum she was going to inject of each in my upper arms. The mites injection hurt the worse of all of them, but i had minimal reaction.

Slowest tattoo EVAR!
An image of my left upper arm where nurse injected allergens for my allergy testing, labeled with letters. An image of my right upper arm where nurse injected allergens for my allergy testing, labeled with letters.

My Results

One of my higher reactions was to Fescue (this is the type of grass that Ken grows on the farm as hay to feed the cows!)
The one the nurse was most concerned about was Cocklebur.

They didn’t want me to wash the mold markings off until I go in for a delayed reading a few days later.

The next step that they prefer you do is allergy shots – 2 years of weekly injections of what you’re allergic to in hopes to desensitize you to those triggers.  NOPE!  Not doing it!

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Eye Conditions 4 [Show Notes]

 in Podcasts  tagged corneal dystrophy / corneal erosion / dry eyes / electronics / episode / eyes / hormones / presbyopia / reading glasses / Sleep / stye by

Eye Conditions (not) in ABC Order

Dry eye

48% of Americans over age 18 complain of dry eyes.  Caused by environment, genetics, health conditions, eye procedures, medications.

There are 2 reasons for dry eye:

  1. Inflammation blocks the free flow of fluid through the eye.
  2. Tear duct insufficiency – the ducts and glands don’t produce adequate moisture for the eye (can be solved by a tear duct stent)

If a medication dries up another part of your body, then it has the potential to dry out your eyes (antihistamines, medications for overactive bladder) – these medications can also lead to constipation. Many of the common diseases that many Americans deal with can cause dry eye – hypertension (high blood pressure), diabetes, obesity.

They light from electronic devices tricks your eyes into not blinking as often, therefore your eyes can dry out more easily (blinking is your eyes’ remoisturizing process).  The solution is to give your eyes long breaks from electronic light , especially late at night before sleeping.

Air conditions in hotels can make your eyes feel dry because they work to remove excess humidity from the air.

Hormones, whether in pregnancy, menopause, or during the use of prescription birth control products, can cause changes in the moisture content of your eyes.

The Solution: eye drops (either OTC or Rx)

Presbyopia

It means “old or elderly vision”.
Presby = elders
Presbyterian church = the church’s decision-maker was a group of people called Elders

This seems to happen somewhere around age 40.  The lens of your eye loses some of its flexibility.  The lens has to be really curved to see up close, and then flattens out a bit to see far away.  So, if the flexibility decreases, it means it can’t curve up enough to clearly see things up close.

The solution: wear reading glasses.

Stye

It’s an infected oil duct or hair follicle.  Looks like a zit.  **DO NOT TRY TO POP A STYE LIKE A ZIT!!**  They will usually clear out on their own in 6-7 days.  Not too troublesome other than being sore, swollen, and not pleasant to look at.

The Solution: warm compress for 15-20 min, then take a shower or wash your face, then leave it alone!  Can use drops or an ointment to help lubricate the eye.  Worst cases will require antibiotic drops or ointment from the doctor.

Corneal dystrophy

A genetic condition that causes the accumulation of protein material build up in the layers of the cornea (recap: cornea = the very front layer of your eye that starts to focus the light into the eye).  If this fluid gets cloudy with junk, then your vision gets blurry. No other symptoms really except worsening vision.  A surgical procedure can be used to clear out the cloudy liquid, but no cure.

This can lead to corneal erosion (where the layers of the cornea begin to separate = painful). Corneal erosion has to be corrected by surgery.  Erosion can also be a result of eye injury – either instant trauma or more gradual like an unhealed corneal abrasion (which can lead to ulceration and eventually erosion).

Take care of your eyes and treat them nicely!

Callback

Sleep

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Eye Conditions 3 [Show Notes]

 in Podcasts  tagged digoxin / dilantin / episode / flashes / floaters / glaucoma / migraines / nystagmus / see stars by

Eye Conditions in (not) ABC Order

If something happens to your eyes that makes you want to ask the pharmacist if you should go to the doctor, the answer will most likely be “yes, go see a doctor.”  Even at emergency rooms, they will treat you and make you comfortable but always tell you to follow up with your eye doctor.

Photopsias

This is seeing things that aren’t really there, the visual cortex translates other sensations as “sight”.

  • Floaters: “shadows” that float around in your field of vision.  They *can* be a sign of a detaching retina, but that is usually not the case.  They are normal for most people.
    Inside your eyeball is a gel, called vitreous gel.  Throughout your life, that gel begins to liquify.  As it turns to liquid, it may have other bits of gel still floating in that liquid.  And you see “shadows” because they block light from reaching your retina.  Floaters may worsen with dehydration or exhaustion.  If you try to focus on them, they “float” away.
  • Flashes: “seeing stars” – when the vitreous gel/liquid combo gets shook up and sloshed around (i.e. head trauma).  You can also get “flashes” with Digitalis toxicity (Digoxin is a medication derived from the Foxglove plant and developed for arrhythmias.)  This is a medication that the doctor will test your levels for to make sure toxicity doesn’t happen.
  • Waves: looks like radiating heat; caused by spasms of the blood vessels in your eyes.  This may be one explanation of the “aura” that comes before a migraine.  If it happens and no headache follows, it’s caused an “ocular migraine”.

Glaucoma

It is the 2nd leading cause of blindness in the US and around the world.  Glaucoma is known for increased pressure in your eyes.  The fluid around the eyes typically have adequate drainage so nutrients can flow in and waste can flow out.  If that drainage becomes inadequate, the pressure builds up and it can put pressure on the optic nerve (the nerve that connects from the retina to the brain).  It starts with decreasing peripheral vision, and can become “tunnel vision” where a person can only see right in the middle of their field of vision. Medications are eye drops that control pressure and help open up drainage pathways as much as possible.  It doesn’t hurt, and it takes a while for the decreased peripheral vision to be noticeable.  It’s not reversible, but it can be slowed with medication.  Eye doctors have a way to check the pressure in your eyes each time you get your eyes checked.

(Macular Degeneration is the #1 cause of blindness in the US, Cataract is the #1 cause of blindness worldwide).

Nystagmus

Pronounced nigh-stag-mus.  It is the involuntary rapid eye movement side to side.  Caused by a neurological issue, either related to the eye muscles and nerves or the inner ear (one cause a vertigo).  The shaking seems to be worse when a person looks straight at something or someone.  For someone dealing with nystagmus, they usually discover they can tilt or turn their head to make their eyes slightly off center where the shaking wills stop – this is called a “null point”.  Strengthening eye muscles can help the shaking, but it still worsens with exhaustion or stress.

This can be a result of a stroke, multiple sclerosis (autoimmune).  Dilantin is a medication for seizures, and is another medication that has to be regularly measured because too much can cause temporary nystagmus.

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Eye Conditions 2 [Show Notes]

 in Podcasts  tagged allergy eye drops / color blind / conjunctivitis / corneal abrasion / detached retina / episode / floaters / pink eye by

Eye Conditions in ABC order

Color blindness

It doesn’t mean that someone sees the world in black and white.
It’s technically labeled as Red-Green color blindness, which means the world is seen in shades of yellow.
The cones in your eyes (a certain shaped cells in your retina) are built to pick up different wavelengths of  light (think ROYGBV).  So the cones that would pick up reds and greens are absent or broken.
Found to be a Y-chromosome trait, so it is more prevalent in males.
Rarely Blue-yellow color blindness is a thing.

Conjunctivitis

pink eye = inflammation of the conjunctiva
conjunctiva = the layer that covers your whole eye

3 types:

  1. Viral: itching, watering, burning, light sensitivity, very contagious, lasts ~ 7 days
  2. Bacterial: green/brown discharge (aka “goo”), foreign-body sensation, contagious, can cause damage if untreated, requires antibiotic drop
  3. Allergic: triggered by allergens, histamine reaction, can accompany a larger, more general allergy reaction, anti-histamine eye drops can help

Corneal abrasion

A scratched or injured cornea.  Symptoms include redness, watering, light sensitivity, foreign-body sensation
Can be dramatic or traumatic like being hit in the face or eye by something, or something as simple as rubbing an itchy eye or getting something out of their eye.
* If you end up with something in your eye, the best option is to flush it out with water or saline
Bacteria on your hands or the thing that scratched your eye can lead to a deeper infection, but most of the time, if you use caution, it will heal itself rather quickly.

**Solution for light sensitivity:  wear sunglasses at night

Detached retina

When the retina detaches from the back of the eye.  Sounds awful but it doesn’t hurt.  The retina a web of nerves in the back of your eye that sends signals to the brain.

Closing curtain sensation is where part of the view of vision will become shadowed as the retina detaches gradually from one side to the other.  Floaters also show up if this is happening. (All floaters ARE NOT related to the retina.)

Sudden detachment can be caused by head injuries or sudden intra-ocular pressure drops (the fluid pressure inside your eyeball).  This sudden detachment is experienced as a flash of light and then sudden darkness.  Sudden or gradual detachment requires immediate medical attention and can be repaired with surgery and medical intervention.
Diabetic retinopathy do to chronic damage can lead to retina detachment.  *The risk of retina detachment occurring after an eye procedure (lasik surgery or cataracts surgery) is skewed for people with severe nearsightedness, possibly due to a genetic disposition of having a shorter retina.

Audience Question

Safe to use allergy eye drops long-term?
Answer:  Sure!  The only problem is that chronic use can lead to your body not responding to the same med over and over as well.  So, to avoid this, swap between drops and allergy tabs – based on if you’re experiencing “eye only” allergies or a wider allergy response that involves the sinuses too.

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Eye Conditions 1 [Show Notes]

 in Podcasts  tagged astigmatism / blepharitis / cataracts / double vision / episode / eye hygiene / eye lids / lasix / lazy eye / lens replacement / stye by

Eye Conditions in ABC order

Your eyes work together so that the line of focus for each eye cross, and that is your most in focus image.  So as your eyes make tiny adjustments, you can focus on things close up or far away.

Amblyopia

If you have a lazy eye, the muscles don’t allow the eye to focus and coordinate with the strong eye.  This can lead to double vision or blurry vision.  I remember it because it sounds like “ambling” which can mean to meander or wander around.  Versions of this can be caused by torticollis, where a baby’s head is tilted or twisted due to positioning in the womb.  The eye can either compensate for the difference or it’ll just give up and let the dominant eye do all the work.  Correction of this issue usually involves patching the strong eye and making the weak eye do all the work.  The blurry or double vision can lead to headaches.  Overuse and fatigue (like long days at work) can make it worse.

Astigmatism

An astigmatism no a stigmatism.  It’s an irregularly-shaped cornea; think baseball vs football.  A circular lens (baseball) focuses light to a single point.  A football-shaped lens focuses light to a line, so that makes the vision blurry.  This is why people with astigmatism will squint.  Squinting is a way for your eyes to manipulate the amount of light coming in and alter the shape of the eye to clear up the image of what they’re looking at.

Lasix procedures can correct astigmatism – the laser does micro-damage to the eye and it heals more circular in the eye.

Blepharitis

Inflammation of eye lids.  Can result in dry eye.  It can affect the outside (eye lashes side) or the inside (lubrication gland size).  This is NOT a stye.  Caused by a chronic build-up of bacteria, skin flakes, dried eye lubrication.  Some skin conditions can make a person more susceptible to blepharitis – Rosacea (overgrowth of skin bacteria), severe dermatitis, including psoriasis.  It’s recommended to use really good eye hygiene before having a doctor intervene.  Using warm compresses to keep dried skin and “eye crusties” soft and glands open so they don’t get clogged.  Using clean cotton swabs or clothes instead of your hands to touch or wipe things out of your eyes, so you don’t transfer bacteria.  Doctor’s can insert a catheter into the tear ducts to keep it open and less likely to keep it clogged.  There’s not a cure to make it go away for good.

Cataracts

The lens of the eye gets cloudy due to proteins clumping up.  People have described trying to see with cataracts like trying to look through wax paper.  Risk of cataracts normally increases with age.  The risk for cataracts can be increased even more by chronic diseases (diabetes, high blood pressure), poor health habits (obesity, smoking, alcohol use), long-term use of certain medications (steroids, hormone replacement therapy).  The current treatment for cataracts is lens replacement.  The old treatment would be just removing the proteins, but depending on a person’s longevity, they may get cataracts again in their lifetime.

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