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WH - A Guide to Women's Health
WH - A Guide to Women's Health
Do You Have Dry Eyes?
You may be aware of many symptoms associated with menopause, but did you know that dry eyes is one of them?
Approximately 3.2 million women over age 50 are affected by chronic dry eye, a condition caused by insufficient tear production or excessive tear evaporation. Symptoms include dry, gritty, irritated or easily fatigued eyes and blurred vision. Although both sexes suffer from dry eye, the disease is two to three times more common among women (hormones are thought to play a role), and its risk increases with age. When it's left untreated, dry eye may lead to greater risk of infection or visual impairment.
Remedies for dry eye depend on its severity and underlying cause. The main options include artificial tears, prescription therapies—one of the latest increases tear production— and surgery.
If you have symptoms of dry eye, be sure to consult an eye doctor to find out why.
Sources: Society for Women's Health Research, www.healthfinder.gov, www.FocusOnDryEye.com
[back to top]Tablet Splitting 101
High prices have led many patients to search for ways to save money on prescription medications. One common cost-cutting measure is tablet splitting, a process in which higher-strength pills are sliced in half to attain the desired lower dose. This strategy pays off, so the logic goes, because there is often little price difference between, for example, 20 mg and 40 mg tablets of the same medication.
But medical experts say many factors should be taken into consideration before consumers take to tablet splitting: Some tablets are best sliced apart with a pill-splitting device, while others are OK to cut by hand. Some patients lack the strength or steadiness of hand to divide their own pills. And certain tablets, such as capsules, and critical-dose or controlled-release medications, shouldn't be split at all.
Your best bet? Consult your doctor and pharmacist to see whether tablet splitting makes sense for you.
Asthma: The Adult Version
Asthma may have a reputation as a childhood disease, but it can also develop in adulthood. When this chronic respiratory condition strikes after age 20, women are more likely than men to be affected, and some researchers think hormones play a role. (Some women first notice asthma symptoms before or during a pregnancy, while others develop asthmatic symptoms during menopause.)
Asthma is characterized by inflammation or obstruction of the bronchial tubes, the lungs' main air passages. When muscles of the bronchial tubes constrict, extra mucus is produced, which causes airways to narrow and results in symptoms such as wheezing, coughing and difficulty in breathing.
Adult-onset asthma is on the rise "and is a lot more common than people think,. says Kristina Kramer, M.D., a pulmonary critical care specialist on staff at John Muir Medical Center, Walnut Creek Campus. "People can suddenly develop asthma-like symptoms at any age, even in their 80s and 90s. Adult-onset asthma tends to present with a wider variety of chronic symptoms, even though they tend to be at lower levels than those experienced by people who've had asthma all their lives." The good news—asthma can be effectively managed even though there is no cure.
Medical science hasn't pinpointed the underlying cause of asthma, but experts have identified several factors that increase its risk. According to the Asthma and Allergy Foundation of America, nearly a third of adult-onset asthma cases are triggered by allergens, such as pollen, molds and animal dander. Other contributing factors include air pollutants, cigarette smoke, respiratory infections from a bad cold or flu and even obesity.
Adult-onset asthma can also be related to changes in the digestive system, says Dr. Kramer. "As people age, they gain weight and may develop gastroesophageal reflux disease [GERD]," a condition in which stomach acid backs up into the esophagus and causes wheezing. GERD can trigger asthma or exacerbate its symptoms, she adds.
Diagnosing asthma in adults can be tricky, says David Cook, M.D., an allergist on staff at John Muir Medical Center, Walnut Creek Campus. "Someone may come to my office with a chronic cough thinking it's asthma," he says, "but we need more sophisticated diagnostic tests to be certain." Generally speaking, doctors hone in on a diagnosis by ruling out other conditions, including chronic bronchitis and emphysema. Patients typically complete a medical history and a physical exam and take lung function tests to determine how much air moves in and out as they breathe.
Once a diagnosis is confirmed, the doctor and patient can draw up an action plan that will allow the patient to help manage his or her asthma, including:
Medication. Asthma medications are often prescribed in combination, says Dr. Cook. Long-term control drugs minimize chronic symptoms and prevent attacks. Quick-relief medications control symptoms during an acute attack. FYI: In recommending drug regimens for female patients, including pregnant women, doctors are especially mindful of benefits and side effects. Certain drugs, for example, can increase the risk of developing osteoporosis.
Self-care. People with asthma are advised to take steps to control environmental triggers, such as minimizing indoor allergens, reducing outdoor activities when pollen counts are high and avoiding tobacco smoke.
Self-monitoring, quick action. Patients with asthma should regularly monitor lung function with a home peak flow meter and learn to recognize signs of an impending attack. If treated early, attacks are less likely to be severe.
Our Pulmonary Rehab ProgramJohn Muir Health's six-week Pulmonary Rehabilitation Program helps people with respiratory conditions, such as asthma, chronic bronchitis and emphysema, improve their quality of life and decrease hospital visits. Education, support tools and physical activities assist participants in meeting the daily challenges of living with a chronic lung disease. For more information or to register, call (925) 674-2351. |
Q&A: Combating Vascular Disease
Seniors often dismiss aches and pain in their limbs as a normal part of growing older but physicians warn against it. Such discomforts could be signs of peripheral artery disease (PAD), a common vascular condition that occurs in blood vessels outside the heart and affects 12 million people in the United States. To learn more about PAD, check the following Q&A, which is based on interviews with two experts on staff at John Muir Health: William Sweezer, M.D., a vascular surgeon, and Neil White, M.D., an interventional cardiologist with specific training in endovascular treatments of PAD.
What, exactly, is peripheral artery disease?
Dr. White: In peripheral artery disease, the buildup of fatty plaque made by cholesterol causes arteries to narrow so that blood flow slows down or stops. The laymen's term for the condition is "hardening of the arteries"; the precise medical term is atherosclerosis.
What are risk factors for this disease?
Dr. Sweezer: The same factors that increase the risk of having coronary artery disease also increase the risk of developing PAD. These include cigarette smoking, diabetes, high blood pressure, elevated cholesterol levels and a family history of PAD.
Having PAD should be a wake-up call for a patient because the diagnosis is associated with the risk of losing the function of the arm or leg, amputation or the possibility of having a stroke—all because of poor circulation. Dr. White: Both the incidence and prevalence of PAD are increasing in this country. That's because physicians are looking for it more and detecting it more often but also because not all patients are taking sufficient steps to be aware of their risks and minimize them. (For more info about some John Muir Health screenings, see sidebar below, "Get Your Screening Exams.")
What are signs and symptoms of PAD?
Dr. Sweezer: Symptoms are determined by the part of the body affected. For instance, if circulation to the legs is impaired, the first symptom one might experience is cramping of the legs from walking, which is only relieved by rest. If the arteries are severely blocked and circulation is totally inadequate, a person can actually develop gangrene in the legs or feet and may require an amputation. That's why it's so important to pay attention to early signs. If you have pain in the leg or thigh while walking, you should talk to a doctor to find out if it needs further evaluation. The good news about PAD is that if it's diagnosed early, it can be treated effectively.
How is PAD treated?
Dr. Sweezer: Once a person is diagnosed, we try to prevent the disease from advancing further by reducing risk factors. Patients may be put on certain medications to facilitate blood flow and reduce stress on arteries. If cholesterol levels are elevated, we advise dietary modifications. A statin agent may also be prescribed to bring down cholesterol. Exercise is another very important part of treatment— and so is smoking cessation. Dr. White: In some patients, an endovascular procedure is necessary to open up the arteries and improve blood flow, often with a combination of balloons or stents or cutting catheters that remove the plaque. If this is not successful, then bypass surgery would be the last resort. In general, endovascular treatments are as effective as surgical procedures. Patients typically prefer endovascular procedures because the hospital stay is usually shorter, there is a smaller incision and they experience less pain.
Get Your Screening ExamsFor information about cholesterol and glucose screenings offered by appointment every other month at John Muir Women's Health Center, call (925) 941-7965. |