disease

Bad Breath – Episode 114

 in Podcasts  tagged bad breath / dentist / Diabetes / disease / dry mouth / food / halitosis / liver kidney / oral health / reflux / smoking by

A cartoon of two guys. One with black hair and blue shirt is laughing with a green cloud of bad breath. The green cloud of bad breath has surrounded the second guy with brown hair, goatee, and brown shirt. The second guy is grimacing with crossed eyes at the smell.

Bad Breath Basics

Halitosis, aka bad breath, can have many causes.  Some bad breath you can prevent with the choices you make, but some bad breath can be a sign of a more serious issue or disease.

Oral Health

You should brush your teeth for at least 2 minutes twice a day, including the surface of your tongue, then rinse your mouth with an antibacterial mouthwash.  Follow one of your brushing sessions with a good flossing.  This allows you to get any food debris and bacteria build-up out of the way on a daily basis.

You should see your dentist twice a year for a deep cleaning and a check-up on your overall oral health.  Your dentist will be able to help you with bad breath issues that may stem from more complicated issues like cavities, gum disease, poorly-fitting dentures, or thrush.

Dry mouth, whether due to your natural biology, medication side effects, or mouth-breathing, can lead to bad breath due to the imbalance of bacteria growth.

Your Choices

Smoking and other tobacco products can make your breath smell bad even when you are not actively using it.

The foods you eat also affect the status of your breath.  The compounds that cause eaten and digested foods to smell contain sulfur-based compounds.  These include broccoli, cabbage, brussel sprouts, onions and garlic, coffee, and fish.  The funny thing about these smelly compounds is that they can actually make your WHOLE BODY smell (including your breath as well as other exiting air) until they have passed all the way out of your body!

Diseases

Infections, such as bronchitis, pneumonia, and sinusitis, can lead to distinctive bad breath.  Postnasal drip can lead to bad breath as well.  Pharyngeal diverticula that trap old food bits can make your breath smell, as well as tonsil stones that are calcified debris trapped by the tonsils.  Bad breath can also be indicative of acid reflux or GERD.

Certain diseases that have telltale breath smells include diabetes, liver disease, and kidney disease.

People with diabetes are at risk of a medical emergency known as Diabetic Ketoacidosis, in which a lack of insulin renders the body’s cells unable to use the available sugar.  The body starts burning fatty acids for energy and the waste product is ketones.  Ketones cause the body to become very acidic.  This leads to a rapid transfer of water (extracellular fluid rushes into the blood to try and neutralize and dilute the ketones and then the kidneys rapidly try to flush out the acidic fluid through the urine) which can lead to fatal dehydration.  Clinicians are taught that people experiencing ketoacidosis may have fruity-smelling breath or breath that smells like acetone or nail polish remover.

People with liver disease may have breath that smells musty or like a mildewing basement.  And people with kidney disease may have breath that smells fishy or like urine or ammonia.  Ammonia is a typical by-product that is released in urine.  Someone with kidney disease may not be able to filter out the ammonia compounds effectively.  Therefore, the ammonia compounds will circulate in the blood.

Call Back

Brush your tongue – Tastebuds
Tonsil stones – Tonsils
Pharyngeal diverticula – Dysphagia

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Tongue Issues – Episode 106

 in Podcasts  tagged congenital / degenerative / disease / hairy tongue / infection / issues / strawberry / tongue by

Born With…

Ankyloglossia is also known as a tongue tie.  It is a result of a short frenulum.  This issue is easily corrected if it interferes with eating and talking.

Macroglossia is am abnormally large tongue.  This is one of the visible characteristics of Down’s Syndrome.  It is described as the tongue looks and feels to be bigger than space in the mouth.

Infected With…

Strawberry tongue

The tongue can appear extremely red and papillae are swollen to look like seeds on a strawberry.  This is a symptom of several conditions.

  • Kawasaki Disease is a rare but serious childhood disease.  The blood vessels become inflamed, and this includes the blood vessels in the tongue, making it appear red.
  • Scarlet Fever is caused by the same bacteria as strep throat.  The infection goes from being just in the throat to the bacteria toxins spreading in the bloodstream.
  • Toxic Shock Syndrome is when the bacteria called Staph aureus (yes, this is the staph that lives on your skin and can cause wound infections) gets into the bloodstream.  This is a medical emergency and needs to be treated immediately.

Hairy Tongue

White hairy tongue appears as patches on the sides of the tongue.  It can happen when someone who is immunocompromised gets the Epstein-Barr Virus. (Epstein-Barr is a virus that causes mild childhood illness or a disease we know as Mono when teens and adults.)

Black hairy tongue is a little more obscure with several possible root causes.

  • Smoking, excessive coffee or tea consumption, excessive alcohol consumption, or soft diet can lead to the inability to shed dead skin cells.
  • Antibiotic overuse leads to overgrowth of fungus or bacteria.
  • Overuse of peroxide-based mouthwash causes oxidation and discoloration of the skin cells.

Function Lost

Motor Neuron Disease occurs in the later stages of ALS or Lou Gerig’s Disease when the nerves and muscles of the tongue for speech and swallowing become affected.

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Chameleons of the Art, Science, and Business of Healthcare

 in Blog  tagged compliance / disease / expert / healthcare / insurance / medicine / professional by

The Healthcare Professional and The Expert

A perception that has stuck around despite the rapidly changing world around us is that “if my doctor said it, then that’s what I should do”. Doctors are listed among the most trusted professionals in America (3rd to nurses and pharmacists). Everyone knows that medical professionals take this oath where they promise to help and not to hurt. Society trusts them to do just that in all their interactions. So why not do everything they say because their intention is to help me? They studied medicine for 17 years to become a doctor so they REALLY know their stuff, right?

And it’s true.  Medical professionals of all kinds study their brains out to earn the status of “expert” in their field. Then they continue to study and learn for the rest of their lives to keep up with the changes in their industry. Another thing the oath they take says is that “medicine is an art as well as a science”. Science tells us what appears to be best for “most”, the art comes in when we figure out what’s best for YOU.

Art? Science? Healthcare Business!

Thanks to this industry we’ve built called “health insurance”, the idea of helping but not hurting is no longer an art or a science. It’s a business venture. Before the Affordable Healthcare Act (ACA, ObamaCare), insurances could look at people applying for coverage as “investments”.  That is why women of childbearing age had more expensive premiums for the same type of coverage as their husbands. They evaluated the risk of that woman having a baby, and the insurance has to pay for it was an expensive risk. I remember when Ken and I first got married and he looked at putting me on his insurance. His premium for himself was $170/month, to add me increased the premium to $650/month. It is also why people with pre-existing conditions were denied coverage because the risk to cover them was too expensive. The removal of this level of discrimination and dehumanization of healthcare has been one of the positive aspects of the ACA. But it’s not completely gone…
Healthcare companies may not be able to deny coverage of the person due to age, gender, or illness, but they still approach healthcare as a business and not as science. As new drugs are developed and studies are published to show which ones are superior to the previous treatment standards, insurance companies are SLOOOOOW at adapting. They know the new medications are more expensive and have a lower Return on Investment (ROI). Thus for a long time, insurances preferred to pay for Warfarin (Coumadin, a blood thinner that required blood testing as frequently as once a week) over the new blood thinners that didn’t require testing and dosing adjustments.

Turning the Healthcare Titanic

It has also taken Insurance far too long to understand the cost-saving benefits of Preventative Care. If they pay for your vaccine, then they won’t have to pay the doctor or the hospital to treat you for a preventable disease and all the complications that go with it. The trade-off of paying for annual or bi-annual check-ups versus waiting until you have a heart attack to find out you had high cholesterol. Now there’s a multitude of problems to treat (and pay for). They’re finally getting a clue that they should pay for almost every contraception option (excluding OTCs) because birth control (even IUDs and implants) are cheaper than paying for a baby.
Trying to get the Compliance train rolling with insurances has been ridiculously hard. Compliance in Medicine means that you take 80% of your medicine when you’re supposed to and the way it’s intended. Many state Medicaid programs don’t allow members to use a program most pharmacies have that automatically refills prescriptions (Auto-Fill, Auto-Refills).  They actually think they’ll save money by waiting for the person to get severely ill or have a health emergency, rather than ensuring the person consistently takes the medication that is getting or keeping them well.

A Glimmer of Hope

Medicare, as well as a handful of other insurances, finally got a clue. They realized that allowing people to get three months of their medication at a time saves money.  Also, you’ve removed eight chances for someone to forget refills because they only visit the pharmacy four times a year.  This is the definition of improved compliance.

Be a Chameleon

Medical professionals still desire and strive to practice the art and the science of medicine. But most of our day, we find ourselves playing the part of a chameleon. We want insurances to understand that if they treat you as human, they actually save money. The biggest gap to close is the one where we want to help you stay well, rather than just take care of you when you’re sick.

Thrive with sleep [Show Notes]

 in Podcasts / Sleep  tagged disease / emotions / health / productivity / risk / Sleep / stress / wellness by

3 Areas Thrive When You Sleep

1. Productivity 

  • Memory
  • Attention span
  • Creativity

2. Health

  • Decreased risk for cardiac disease
  • Inflammatory chemicals are cleansed out
  • Weight management – certain metabolism processes only happen while you’re sleeping
  • Tissues heal and rebuild
  • Reaction time improves

3. Emotions

  • Stress hormones are removed from your system
  • Gives your serotonin production a break, so you get a fresh supply in the morning (Serotonin is your happy chemical)

The Bottom Line

The cells in your brain (neurons) run on electricity (aka the flow of positive and negative charges).  Sleep allows the electricity to reset, so it’s really to flow quickly and efficiently the next morning.  You live longer when you get enough sleep.

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