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Bad Breath – Episode 114

February 5, 2018 in Podcasts tagged bad breath / dentist / Diabetes / disease / dry mouth / food / halitosis / liver kidney / oral health / reflux / smoking by Cynthia Hendrix

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.

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

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Music Credits: Up In My Jam (All Of A Sudden) by – Kubbi https://soundcloud.com/kubbiCreative Commons — Attribution-ShareAlike 3.0 Unported— CC BY-SA 3.0 http://creativecommons.org/licenses/b…Music provided by Audio Library https://youtu.be/tDexBj46oNI

Dysphagia – Episode 113

January 29, 2018 in Podcasts tagged age / aspiration / babies / choking / coughing / difficulty / drink / dysphagia / esophageal / food / kids / oral / pharyngeal / phases / pneumonia / risk / swallowing / therapy by Cynthia Hendrix

Dysphagia Basics

Having difficulty swallowing or the inability to swallow is known as dysphagia.

Symptoms of dysphagia include:

Pain while swallowing
The sensation of food stuck in the throat or chest
Drooling
Hoarseness
Regurgitation
Reflux
Unexpected weight loss
Choking, coughing, or gagging when swallowing
Taking tiny bites

Dysphagia by Phase

There are several conditions that can affect each phase of the swallowing process.

Oral Phase

Dysphagia during the oral phase, or voluntary phase, can be caused by neurological conditions like Multiple Sclerosis, Muscular Dystrophy, advanced Parkinson’s. Brain damage caused by trauma or stroke can also cause trouble swallowing in adults.

Dysphagia in Kids

Babies start out nursing or feeding through a bottle and their swallowing mechanism is reversed. A reverse swallow is when the tongue is thrust forward or out of the mouth to open the throat and allow food or drink down the esophagus. As children learn to eat solid food and drink from a cup, the swallowing procedure changes. Children can also have trouble swallowing, but the root causes are completely different. Premature birth, low birth weight, cleft lip or palate, and tongue or lip ties can lead to swallowing issues if not corrected with therapy. These issues can cause swallowing issues with the reverse mechanism as well as make it difficult to convert to a regular swallow. Children with low muscle tone are also more likely to stick with the reverse swallow because it is easier.

Pharyngeal Phase

Pharyngeal diverticula are pouches that form in the mucous membrane above the esophagus. These pouches can collect food particles that don’t get swallowed. This can cause bad breath, as well as coughing, and constant throat-clearing because it feels like something is stuck in the throat.

Esophageal Phase

There are several swallowing issues that stem from the esophagus and esophageal phase.

Achalasia is an issue where the sphincter that opens into the stomach doesn’t relax to allow food to pass through. This can cause pressure in the chest and may possibly lead to regurgitation if it persists.
Diffuse spasms happen when the peristalsis rhythm of the esophagus muscles is poorly coordinated.
Stricture is also known as a narrowed esophagus. It can be a result of injury and scarring from GERD.
An esophageal ring is when a thin area of the lower esophagus is narrowed. This is also a result of scar tissue from chronic GERD. The scar tissue from acid damage tends to be less flexible which can cause pain.
Eosinophilic esophagitis is the overpopulation of eosinophils in the esophageal lining due to food allergies. Eosinophils are a type of white blood cells that show up in very specific situations – parasitic infections, cancer, or allergies.

Dysphagia Risk

The risk of dysphagia increases with age, mostly because the risk of the conditions that cause dysphagia increases with age as well. And while dysphagia can be very uncomfortable, the biggest concern is with the risk of aspiration, or breathing food or drink into the lungs, that leads to pneumonia.

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Swallowing
Muscle Tone discussion – Accordion in Your Brain

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Swallowing – Episode 112

January 22, 2018 in Podcasts tagged dentist / esophagus / food / mouth / reflex / saliva / Sleep / swallowing / teeth / throat / tongue by Cynthia Hendrix

A young child with no shirt and light brown hair against a blue sky is swallowing gulps of orange juice from a clear plastic bottle.

The 3 Phases of Swallowing

Oral Phase

This phase includes chewing and saliva mixing with the food to form a bolus (a little glob of mashed up food). Then the tongue moves the bolus towards the back of the mouth. The tongue starts by pressing against the hard palate behind the front teeth. Then the sides of the tongue raise up to also press against the hard palate inside the teeth. At this point, the bolus has nowhere to go except towards the back of the throat.

Pharyngeal Phase

The vocal folds in the larynx close to keep food out. The larynx also moves up as the epiglottis covers it to seal off the airway. Then the soft palate and uvula move up and close off the nasal passage So now there is only one way out.

Esophageal Phase

The bolus moves into the esophagus (because it is the only open path). The esophageal muscles contract from top to bottom (this waving, rhythmic muscle movement is called peristalsis) to push the bolus into the stomach.

Swallowing Reflex

There are sensory receptors in the pharynx and tongue that receive touch signals. When they are touched by a bolus, the signals are sent to the brain stem and the return signal results in involuntary and automatic movements of the larynx and epiglottis. This is a good thing since swallowing is a very rhythmic process and you want food and drink to continue going in the correct direction.

This reflex cannot be triggered by sticking your finger in your throat. You are more likely to trigger a gag reflex that way. The voluntary steps of swallowing must be initiated before the involuntary portion of the process takes over.

Weird Swallowing Scenarios

How do you swallow with your mouth open?

At the dentist, you are usually laying in the chair on your back and facing the ceiling. There are at least three tools and two hands in your mouth. Things in your mouth trigger saliva production. Also, generally one of the tools the dentist is using is emitting water. The natural reflex when you have to hold your mouth open for a long time is to bring the back of the tongue and the soft palate together. This seals off the throat and allows you to still breathe through your nose. The liquid in your mouth plus gravity creates a puddle at the seal of your tongue and soft palate. Because the touch sensors to trigger your swallowing reflex are also in this area, it is likely you begin to panic because if they don’t hurry and use the suctioning straw to remove the liquid, you’re going to swallow!

Do you swallow in your sleep?

A study was done to find that the only times you swallow while sleeping is during arousal and during REM. My logical deduction regarding why is that when you’re aroused or in one of the more shallow phases of sleep, that is when you can voluntarily move – roll over, adjust the bedding, and swallow. During REM sleep, most people will experience sleep paralysis, so whatever exciting things are happening in their brain, the body is not likely to act it out. Because the brain cannot tell if a dream is real or imaginary, the feeling solicited can trigger hormones secretions and saliva production. Increased saliva, just like in the dentist scenario, can trigger swallowing.

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Taste Buds – Episode 108

November 27, 2017 in Podcasts tagged bitter / eat / flavors / food / salty / savory / science / smell / sour / sweet / taste buds / tongue / umami by Cynthia Hendrix

An image for your taste buds. A plate of bread and cheese with sliced salmon, a cup of yogurt with berries, a container of fancy crackers, a mug of black coffee, and a plate with red and black grapes, circular orange slices, and a half of grapefruit. It's all laid out on brown parchment paper on a table of raw wood planks.

Review

Smell plays a big part in your ability to taste. The bumps on your tongue that you can see are actually papillae.

4 Types of Papillae

Filiform

Filiform papillae are the most numerous papillae and are arranged in regular rows running parallel to the median sulcus. They are cone-shaped – either a single cone (like a volcano shape) or a frill of cones. These papillae don’t actually taste flavors but they do sense touch. They work as cleaners, helping your tongue create friction with other parts of your mouth to loosen bits of food from the nooks and crannies.

Foliate

These papillae are located on the sides of the tongue near the back. They are flat, leaf-like folds, and can be visible in some people. These papillae contain taste buds for flavors.

Fungiform

These are mushroom-shaped. They are scattered all over the tongue but seem to be more concentrated on the edges and tip of the tongue. They contain taste buds for flavor as well as the sense of touch.

Vallate (Circumvallate)

These papillae are dome-shaped with a border. The best description is that they appear as a circular fort with a mote around it and then a wall on the outside. Or maybe they look like a bunch of “outie” belly buttons! They are laid out on the back of the in a V-shaped pattern, pointing towards the back of the throat. These papillae can be visible in some people, and they contain taste buds for flavors as well.

Each papilla contains many taste buds. They are called “buds” because, microscopically, they appear as unopened rosebuds. Taste buds have a swirl-like funnel with an opening in the middle that contains fluid.

How You Taste

You put food in your mouth. Your saliva dissolves bits of it to free up molecules. The molecules that are mixed in your saliva wash into the funnels of each taste bud. There, the molecules mix into the taste bud fluid and get swirled around to come in contact with as many taste sensors (nerves) as possible. From here, the chemical signal changes into an electrical signal as the taste messages zoom into your brain. In the brain, the signal is translated and identified – including details such as flavor, pain, temperature, texture, intensity, and smell (while your saliva mixes with some molecules, other molecules are released into the air as aromatics and contact the olfactory sensors in your nose).

Taste Buds Map Truth

The taste bud map that has been used for years in textbooks was created in 1901. Even with all the things that we’ve learned about how taste buds work, where they’re located, and what they look like, this map has never been re-written. The original map identified four basic flavor categories: sweet, sour, salt, bitter. Yet, just nine years later, the Japanese were able to identify “umami” – that savory flavor that doesn’t quite fit into the other four. Yet, the map still wasn’t re-written. Even now, scientists are learning and updating the database on what the tongue can taste and how – including categories like “fatty” and “metal” and even “water”.

So, while the taste buds are not grouped into sections based on the flavor they can taste, some taste buds may have a greater affinity or sensitivity to a certain type of flavor.

It is estimated that we have about 2000-4000 tastebuds, and since the surface of the tongue is like your skin, the tastebuds recycle about every week or two. This rapid and continuous recycling might be why it is acclaimed that your taste (preference and enjoyment from your taste buds) changes approximately every seven years.

Conclusion

Even though the tastebud categories are still too complicated to rewrite the map, I still plan to use my taste buds to their fullest potential. Eat up!

Resources

I gathered some of my information from a PubMed article that is actively being updated by real scientists – How Does Our Sense of Taste Work?

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Smell

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Special Episode #3: Meds & Blood Sugar

September 14, 2016 in Diabetes / Podcasts / Special Edition tagged blood sugar / Diabetes / dose / food / Hypoglycemia / interactions / JDRF / medication / T1D / timing by Cynthia Hendrix

People with chronic diseases don’t get holidays or vacations from their medication.

4 ways medication can affect blood sugar

Type of medication

The goal of the medication that people with diabetes take is to lower blood sugar – either by increasing insulin sensitivity, encouraging the pancreas to make more insulin, or to replace insulin that’s not naturally made anymore. Metformin is like insulin’s wingman; it helps make the cells ready for insulin when it comes by. So usually these medications (including insulin) will lower blood glucose no matter if you eat or not.

Timing of medication

Most of the medications should not be taken if a meal is going to be skipped.

Dose of medication

The more sugar you eat, the more insulin you need. The higher the blood sugar level, the higher the dose is needed. It needs to stay proportional. Any form of sugar you eat gets turns into glucose, the complexity of the sugar determines how fast it raises your blood sugar. Even diabetics are at risk for hypoglycemia. If one little thing gets out of whack, it can cause a drop in blood sugar and require a “rescue”. Favorite hypoglycemia rescue “go to” is orange juice (lots of simple sugars). Regular soda can be used, as well as hard candy or glucose tablets. NO DIET SODA – artificial sweeteners do not affect sugar enough. High blood sugar can cause coma, lower blood sugar can cause coma. Bottom line: Coma is bad.

Interaction with medication

Fluoroquinolones can causes changes in blood sugar control and require a person to check their levels and adjust their medicines more often. Steroids can also cause blood sugar to be more uncontrolled – this is true for acute (short term) use or chronic (long term – like autoimmune diseases) use. Beta blockers used for blood pressure control can mask the symptoms of low blood sugar because the symptoms are very similar. Symptoms of low blood pressure: tiredness, weakness, dizziness, shakiness, inability to focus. The only way to know which one you’re experiencing is to check your blood sugar and your blood pressure.

~~The Nashville chapter of JDRF is having their annual One Walk on September 24th.~~ Friend of the show and previous guest, Rachel Mayo has been #T1D for over 10 years and she is passionate about the cutting edge research and support JDRF provides for people and their families. Her goal is for her team to raise $5000, you can contribute!

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Music Credits: “Radio Martini” Kevin MacLeod (incompetech.com) Licensed under Creative Commons: By Attribution 3.0 http://creativecommons.org/licenses/by/3.0/

Feed You Bones [Show Notes]

January 11, 2016 in Podcasts tagged bones / calcium / diet / food / osteoporosis / recommendations / supplements / vitamin D by Cynthia H.

Basics

Calcium is a natural element (yep, one of those periodic table guys). Our teeth and our bones are made strong by it.

For most healthy adults, daily recommended amount is 1000 mg. For females approaching 50 years old, recommendation increases to 1200 mg to 15oo mg per day.

The trick to supplementation is knowing that your body can only absorb 500 mg of elemental calcium at a time. So you gotta split it up. When you get it from your diet, then this is NBD because it will naturally be spread out between your meals and snacks.

These supplements always go with Vitamin D. Vitamin D is responsible for helping with calcium absorption. If you’re low on D (and more people are than might realize b/c very few jobs have you working out in the sun – and Vitamin D is synthesized and activated by UV exposure), calcium can’t be absorbed and used like it should.

2 types of OTC supplements

Calcium carbonate (Caltrate) – a base (also what makes up OTC antacid tablets [i.e. Tums] so a bonus if you have heartburn); requires the acid in your stomach to break out of the tablet for your body to use.
Calcium citrate (Citracal) – an acid; doesn’t require extra stomach acid to be absorbed. A good supplement for those who had gastric bypass, because the stomach has been shrunk and there are less acid pumps to break down medications that require acid to work. Bad for people with reflux or ulcers.

The labels can be tricky. It will say “600 mg Calcium Carbonate”, but you have to look for the hint of how much elemental calcium that is equal to. This is because your recommended daily dose is in milligrams of elemental calcium. So, doctors don’t always tell you that when they recommend it. Your calcium-rich foods are going to provide you with 250-300 mg of elemental calcium per serving (about 25% of your daily requirement).

Random dietary sources (between 6-20% of your daily requirement)

White Beans
Black-eyed Peas
Sardines (cuz you eat their bones?!)
Dried Figs
Bok Choy
Molasses
Kale
Turnip Greens
Almonds
Oranges
Sesame Seeds

Calcium-fortified foods

Instant Oatmeal
Mainstream orange juices
Soy products (because you’re using them instead of dairy and animal products)
Cheerios

Vitamin D helps your stomach absorb the calcium into the blood. And then in the blood, keeps the calcium from binding with other things, so it’s free when the body needs it in other places.

Unfortunately, pounding supplements is not going to reverse osteoporosis.

Recommended dose for kids

1 to 3 years old — 700 milligrams daily
4 to 8 years old — 1,000 milligrams daily
9 to 18 years old — 1,300 milligrams daily

Usually not hard for kids to get the right amount with their diet plus a vitamin. Babies don’t need supplementation since their main source of nutrition is milk (breast milk or formula).

Seasonal Affective Disorder – is partly due to a Vit D deficiency, because Vit D also helps with mood. The sun exposure is the best way to supply your body with Vit D. A bonus is that sunlight stimulates serotonin production in your brain which is also responsible for good mood.

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Sleep Hygiene

November 30, 2015 in Podcasts / Sleep tagged bed / emotions / environment / food / habits / hygiene / mindset / risk / Sleep by Cynthia H.

A Definition

Sleep Hygiene: how conducive your night time and bedtime habits are for restful sleep on a regular basis

Your body performs important processes while you sleep.

Risk of disease is increased when you don’t get enough sleep. Heart disease, diabetes, and stroke, just to name a few.

4 Areas of Sleep Hygiene

Environment
- dark (all of our light-emitting toys are bad for our sleep) – your body makes serotonin stimulated by light, and then melatonin when the light is gone.
- temperature – your body sleeps well when it’s cool, kind of like hibernation. Gotta get past REM sleep because REM sleep is not restful sleep
Habits
- no naps – recovery processes can be inefficient
- exercise (vigorous exercise during the day; slow & calming exercise late at night)
- getting adequate natural light – so your brain isn’t confused about which chemical it needs to make
- consistent routine – your brain likes predictable patterns
Consumption
- stimulants – caffeine, nicotine
- alcohol – initially makes you sleepy, but can disrupt sleep when the liver finishes processing it into sugar
- large meals – can cause indigestion which can disrupt sleep
- drastic dietary changes – fluctuating amounts of sugar in the blood stream or digestive discomfort
Mindset
- bed is for sleep – not a place for work or studying or eating
- avoid emotional stress – positive (i.e. excitement) or negative (i.e. anger)

Tidbits

CPAP machine – helps in sleep apnea, which is wear the body doesn’t get enough oxygen during sleep. Oxygen is needed for all sorts of processes. If the body can’t get the oxygen, then it probably isn’t using the nutrients and energy sources available, and it can lead to feeling awful, even after a night of sleep.

Nothing good comes from a lack of sleep.

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Music Credits: “Radio Martini” Kevin MacLeod (incompetech.com) Licensed under Creative Commons: By Attribution 3.0 http://creativecommons.org/licenses/by/3.0/