Archive for the 'health' Category

One Ounce That Does a Lot

The thyroid gland is about two inches long and about one inch wide. It sits at the base of the neck, straddling the windpipe. It weighs about an ounce. When your healthcare provider encircles your neck with her hands and asks you to swallow, she is checking the size of your thyroid.

The thyroid’s main job is to control metabolism by secreting hormones.  If you, an adult, have too much thyroid hormone (hyperthyroidism) you will lose weight. If you have too little (hypothyroidism), you will gain weight. But that’s not all. Thyroid hormones have a strong influence on the nervous system, which influences everything. In turn, a change in the nervous system affects the thyroid.  Together, the thyroid and the pituitary in your brain function like the heating/cooling system in your home. For example, if the temperature in your home falls below a preset minimum on your thermostat, the furnace will start and send heat around your house until the preset temperature is reached. Then, once again responding to the temperature on the thermostat, the furnace will stop sending heat. What does all this mean for the way you feel and behave?

If your thyroid gland isn’t functioning properly it will not respond to the pituitary. The level of thyroid hormone in your blood stream will remain the same or drop further.  You may feel tired or not mentally sharp. If this persists, you may feel depressed or moody. You may have difficulty sleeping, in spite of feeling tired and sleepy. Physically, you may begin gaining weight, no matter how little you eat or how much you exercise. Meanwhile, your pituitary is frantically sending out thyroid stimulating hormone (TSH).  If this goes on long enough – the pituitary in overdrive – it may result in enlargement of the pituitary. But most people never reach this stage.  They generally feel sick enough to consult a healthcare provider.

On the other hand, if your thyroid keeps sending out thyroid hormone no matter how little TSH there is in your blood, your symptoms will be different. Emotionally you may feel anxious for no reason or more anxious for the reasons you do have. There’s some evidence that prolonged stress increases your risk for hyperthyroidism. You may be irritable or have difficulty concentrating. You may have difficulty sleeping, just as with low thyroid.  Physically you will begin to lose weight, no matter how many carbs you pile on. You might notice your heart racing, often greater than 100 beats per minute. Your hands may tremble. Eventually your thyroid will enlarge and you will feel or see the enlargement at the base of your neck. But, once again, most people have consulted a healthcare provider before this occurs.

Bottom line? That little gland in your neck is powerful. It can cause both physical and emotional/mental symptoms. The mind and the body are connected. They are both part of us. It may be only one that is causing your symptoms. But always suspect both, not just one, when you aren’t feeling well.


Depression and the Holidays

A great deal has been written about the topic of depression during the holiday season. I’m not going to rehash that. Today’s blog is more of a personal reflection on my professional experiences with depression among the elderly and individuals needing long-term care.

In one of my positions as a psychologist, I “covered” skilled nursing facilities. That’s the newer term for nursing homes. Today’s skilled nursing facility (SNF) is unlike the nursing home or old people’s home of the past. A SNF has both “patients” in the traditional sense, that is, individuals who are recovering from a medical or surgical illness, and non-patients. The non-patients are long-term residents or clients: the younger physically disabled, the frail elderly, and the mentally disabled. Each SNF is somewhat like a small town without children. There are town officials (registered and licensed practical nurses), town employees (certified nursing assistants, dietary workers, physical, occupational and speech therapists), citizens in no official capacity (clients or patients), county or state officials (owners, physicians), and visiting dignitaries (medical and psychological specialty consultants). What makes the SNF unlike a real small town, however, is that only the citizens actually live in the town. Everyone else is an out-of-towner with lives separate from the townies.

Now for the holidays. The holidays are everywhere: TV, SNF décor, the conversations of the out-of-towners. There are more visiting dignitaries, the ones who come once a year and sing or dance or give out small gender neutral and politically correct gifts. All, absolutely all, of the dignitaries mean well. They want to bring cheer and happiness to the townies. But they, too, go home.

The townies? Well, they are left with their memories and thoughts. Remember that year that Santa left his footprints in the ashes? Oh. No one but me is left to remember. Remember sliding down that big hill behind the school? I remember the feeling. But my body can no longer feel the experience or any, for that matter. Remember – no, I’d rather not. My mom drank and my dad scowled. Remember. No, I can no longer remember. What are the holidays? Where is everyone?

Some townies get out of town to family from out of town. They bring back peace and, best of all, they bring back hope.

Hope – one of the criteria for happiness and a stalwart defense against depression.

So, my blog readers, I wish you hope in this crazy world. Please spare a thought in your busy days for those who have little or none of it.

Be Aware of COPD

COPD (chronic obstructive pulmonary disease) is the third leading cause of death in the United States, behind heart disease and cancer. Lung cancer is the #1 leading cause of cancer deaths in both men and women. More on that another day.

Smoking is the primary cause of lung cancer and COPD. It is one of the causes of heart disease. This blog is not going to be a diatribe against smoking. You all know it’s bad for you. You all know you should quit or not start. Enough said. Oh, as an aside, smoking marijuana is as bad for your lungs as is tobacco. Think twice before you smoke marijuana recreationally.

Dying from lung disease is very unpleasant. Yes, I’ve seen it. I’ll spare you the graphic details. Instead I’ll tell you what happens to the lungs in COPD and let you think about it.

First, a very brief anatomy lesson (with apologies to my anatomy professors). You have two lungs, one on each side of your heart in your chest cavity. The lung on the left side has two lobes and extends further down that the right lung, in order to make room for the heart, which tilts slightly to the left. The lung on the right has three lobes and does not tilt downward, in order to make room for the liver, which is below the diaphragm. Each lobe of the lungs is further divided into segments.

As you breathe, the air travels from your nose into your trachea, basically a tube in your throat. The trachea branches left and right into the left bronchus and the right bronchus (plural: bronchi), which divide into ever smaller tubes, called bronchioles. Imagine a tree with ever smaller branches. Each bronchiole ends in an air sac called an alveolus (plural: alveoli – I am so glad I took Latin in high school). This is where the air you breathe ends up.

Your blood vessels also get smaller and smaller as they enter the lungs. The smallest blood vessels, which should be full of gaseous waste products, transfer the waste into the alveoli and pick up oxygen from the alveoli. So, if your lungs are healthy, you breathe in oxygen and breathe out waste.

COPD is actually a pair of lung diseases: emphysema and chronic bronchitis. In emphysema, the walls of the alveoli have been damaged and either the alveoli can’t contract enough to expel the waste or the walls are too thick to go through the exchange process. In chronic bronchitis (-itis at the end of a word means inflammation), the irritated bronchial tree secretes mucus, lots of mucus. Eventually there is so much mucus that the individual with chronic bronchitis can’t expel it all. This interferes with breathing.

Both emphysema and chronic bronchitis progress slowly. But the end is an inability to breath, either because oxygen and waste can’t be exchanged or because there is an obstruction preventing breathing. Breathing is not only necessary for life. It is also necessary to perform the everyday tasks of life: eating, standing, dressing, brushing your teeth, even smiling and, of course, laughing.

There is no cure for COPD. The severity of the symptoms can wax and wane. It is not reversible. But life style changes and medications can make you feel better. Consult with your healthcare provider. Don’t smoke.

For more information:

A Well Kept Secret: Little Known Benefits

of colonoscopy:

#4. Several hours of deep, dreamless sleep

#3. Colonic cleansing (in the privacy of your own home!)

#2. Twenty-four hours of a clear liquid fast (without going to a spa!)

#1. Screening for colorectal cancer, the fourth most common cancer among American men and women.


Colorectal cancer is cancer of the colon (the large intestine) or rectum.  It is more common in persons over 50. Other risk factors include:


  • Polyps (growths that may become cancerous) in the colon or rectum
  • A diet high in fat
  • A family or personal history of colorectal cancer
  • Having Crohn’s Disease or ulcerative colitis.


Symptoms of colorectal cancer include:


  • Persistent abdominal pain or pressure
  • A change in bowel habits
  • Blood in the stool.


However, in the early stages, colorectal cancer often causes no symptoms.


Treatment for colorectal cancer depends on the stage and category (or sub-stage) of the cancer.  Stages vary from early, 0, to late, IV (Roman numeral 4).


Categories include:

T: the extent of spread of the cancer through the wall of the colon (from 0 to 4)

N: how far the cancer has spread into the lymph nodes (from 0 to 2)

M: whether or not the cancer has spread to other organs (from 0 to 1).


Treatment may include one or more of the following:


  • Surgery
  • Radiation
  • Chemotherapy.


As with most cancers, the treatment and eventual outcome of colorectal cancer is easiest and best when it is caught early.


At age 50:

Have a stool test for occult (microscopic) blood. Repeat it yearly.

Have a colonoscopy and then repeat the colonoscopy as often as recommended by your healthcare professional.


The number one benefit of colonoscopy is screening for the fourth most common cancer among American men and women, colorectal cancer.



For more information:


National Digestive Diseases Information Clearinghouse




American Cancer Society

Think those Low-Fat Chips Are Healthy? Think Again

The CDC reports an updated look at an old study. This study, from 2005- 2006, reported that 29% of adults had hypertension (high blood pressure) and 28% of adults had prehypertension (blood pressure higher than normal but not yet high enough to be called high blood pressure). Hypertension is one of the leading contributors to heart disease and stroke.


Excessive salt intake is one of the major contributing factors in hypertension. People already at risk for hypertension should consume no more than 15oomg of salt per day.


Who are the people at risk? African Americans, all adults over 40 and those who already have hypertension. That’s 69.2% of the population. Adults in general should consume no more than 2300mg of salt per day. LINK


Processed foods of all kinds are high in salt. So, re-think those chips!


For more on diet see

Dietary Guidelines






Two recent articles in the New York Times were related to allergies. One brief article agreed that allergies to pollen may lead to food allergies. A longer article discussed an experimental treatment for peanut allergy.


An allergy is your body’s mistaken over-reaction to a common environmental or food source. The source of the allergic reaction is called an allergen or a trigger. Your body mistakenly responds to the allergen as if it were a threat. Your body tries to attack and destroy the allergen by producing antibodies. The antibodies trigger your body to produce histamine. The histamine causes your symptoms.


  • Symptoms may include:
  • A runny nose (rhinitis)
  • Itching (pruritus)
  • Hives (urticaria)
  • A rash
  • Inflammation, redness or swelling
  • Gastro-intestinal upsets such as diarrhea or vomiting


Angioedema is swelling of the tissues below the skin. It can be very serious when this occurs in your throat and mouth.


A severe and life-threatening allergic reaction is called anaphylaxis. This is a reaction that affects your whole body. It is a true emergency and requires immediate medical attention.


While allergy symptoms are cause by an allergen, the underlying cause is an over-sensitive immune system. This over-sensitivity is hereditary.


Allergies can be treated or controlled. The type of treatment depends on the specific allergy and its symptoms.


For more information about allergies see:



American Academy of Allergy Asthma and Immunology

Diabetes: Part VI – Summary

Diabetes, both Type 1 and Type 2, is a chronic disease that affects your whole body and, quite possibly, your mind.


Diabetes affects your weight (Diabetes: Part II).


Diabetes affects your skin (Diabetes: Part III).


Diabetes affects your nerves (Diabetes: Part IV).


Diabetes affects your heart (Diabetes: Part V).


Diabetes also affects your kidneys, your teeth, your sight and has been related to sleep apnea (More Than Just a Relationship Breaker).


In the United States, the economic cost of diabetes is $174 billion a year.


In 2006 diabetes was the seventh leading cause of death in the United States. People with diabetes have twice the risk of dying a people of similar age who do not have diabetes.


It’s estimated that 23.6 million people (or 7.8% of the population) have diabetes. In addition, data extrapolation suggests that at least 57 million American adults had prediabetes in 2007.


Prediabetes is a condition in which individuals have fasting blood sugar levels higher than normal (100 mg/dL), but not high enough to be classified as diabetes (200 mg/dL). People with prediabetes have an increased risk of developing type 2 diabetes, heart disease, and stroke.




Diabetes is a serious disease. Get checked for it. Prevent it or postpone it by leading a healthy lifestyle.


Health – it’s about prevention.


Today is American Diabetes Alert Day.

Mary Lou Bernardo, PhD, MSN


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