Sample Articles: June - August 2005

CAN YOU HEAR ME NOW?

By Lesa Gaudreau, BC-HIS, ACA

A SELF-CHECK FOR YOUR HEARING

1. Do you sometimes feel people are mumbling or not speaking clearly?
2. Do you often ask people to repeat themselves?
3. Do you have trouble hearing when there is background noise?
4. Do you have trouble understanding women and children?
5. Do you experience difficulty following dialog in the theater or on TV?
6. Do people complain that you turn the television volume up too loud?
7. Is it hard for you to follow a conversation when two or more people talk at once?
8. Do you have trouble hearing on the telephone?
9. Do you sometimes find it difficult to understand a speaker at a public meeting or religious service?

About 1/3 of people over 65 and up to 1/2 of those over 75 have significant hearing loss. Indeed, hearing loss is the second most common disability, behind back pain, in the U.S. And, as our environment becomes louder, hearing loss is becoming more prominent.

But, because it is usually gradual, you may not notice a problem. It has been established that hearing loss can lead to disruption in relationships and eventually social isolation. Hearing impaired individuals may stop attending their place of worship or associating with friends. This can be avoided, however, by rehabilitating the hearing loss with medical treatment or hearing aids.

If you found yourself identifying with the self-test, the next step is to visit a licensed audiologist or hearing aid specialist - a professional who provides care and sells hearing aids - to determine what kind of correction is needed. If it is a sensorineural hearing loss, commonly described as nerve damage, the specialist can custom-fit the device and provide follow-up care. Follow-up care is important because a poorly adjusted hearing aid can be uncomfortable or can even physically damage the ear.

The wrong amplification may make sounds unnatural and louder...not clearer. A hearing aid is only as good as the professional who evaluates the patient. Choosing the right amplification, fitting the hearing aid and, perhaps more importantly, a professional who offers training and follow-up care is key to being successful in wearing the device.

Because of the cost, people are searching for ways to save money to correct their hearing loss. With the cost of a custom hearing aid ranging from $1,000 to $2,000, many people are turning to the Internet to shop for savings.

A very important fact to remember... purchasing online bypasses the medical evaluation required by the FDA and the custom services needed to fit the device to your specific needs. What the Internet is useful for is researching information of the manufacturer, the kind of hearing aids on the market, new technology, return policy and warranty.

You can get information from corporate websites: Self Help for Hard of Hearing People www.shhh.org and the Better Business Bureau www.bbb.org Be good to yourself! If you do have a hearing loss, you should talk with your hearing care professional and follow his/her advice. You will notice an overall important improvement in the quality of your life.

Adapted from Hearing Journal & AARP 2005. For more information or questions on this article, hearing problems or concerns, please call Lesa at (480) 443-9119 at Abbott Hearing Centers or visit www.abbotthearing.com

-------------------------------------------------------------

Live Without Limits!

By Barbara Feth, HEALTHSOUTH

Embracing Technology
New Hope for Persons following Stroke

There is new hope for improved function and recovery following stroke—thanks to government support of research into rehab technology and motor learning.

For years, we have known that the brain damage from stroke is permanent, but that patients still had some potential for recovery. New imaging technology lets us “see the brain” during task performance, leading to two exciting new discoveries:

1. Adjacent parts of the brain can “take over” function of a damaged brain to a degree

2. Some latent capabilities of the brain can become activated with training, so that one structure of the brain can “take over” some function of another structure

In order for these exciting events (called brain plasticity) to occur, we need the following ingredients:

1. There has to be a lot of practice; hours and hours a day

2. The affected limb needs to be “forced” to be used

3. The practiced movement needs to have meaning—something the patient WANTS to do

Some new technologies that have been developed can help patients to recover function by helping patients to learn to perform new activities in therapy sessions, to encourage use of a low functioning arm or leg, and to record home compliance and progress in a way that therapists can monitor.

A few of these new technologies are: Visipitch™ and Parrot Software™: Used by speech pathologists to re-train speech, cognitive function, and voice. Some software programs can be downloaded for home use. New technologies for recording voice and practice sessions at home are being developed. Electric Stimulation:

The Bioness 200™ is a wrist splint with embedded electrodes; enabling a paralyzed hand to function.

VitalStim™ is an electric stimulation therapy to help patients regain the ability to swallow.

SaeboFlex™ Wrist Splint: A splint with springs that “open” a hand that is closed because of abnormal tone or paralysis. Comes with a very nice home exercise station.

All of these technologies are available in various clinics throughout the Phoenix area. For more information about the contents of this column or rehabilitation technology available at HealthSouth Scottsdale Rehabilitation Hospital, please call 480-551-5471.

Barbara Feth, PT, MBA, is the Director of Clinical and Marketing Services at HealthSouth Scottsdale Rehabilitation Hospital.

-------------------------------------------------------------

Sleep Better…Live Better

By James L. Gross D.O.
Scottsdale Sleep Disorders

Dr. Gross, I am a 62-year-old man who falls asleep in the daytime in inappropriate places and under inappropriate circumstances. I have almost been in two car accidents because of this problem. Should I see my physician or a sleep specialist?

Symptoms of excessive sleepiness in the daytime, severe enough to nearly cause car accidents, suggest the presence of a serious condition that requires immediate attention. Many older men have such symptoms. One common cause of such symptoms in an older man is sleep apnea. Many patients with this disorder remain undiagnosed. It is important to identify this condition early to prevent long-term adverse consequences. Fortunately, effective treatment is available for most patients suffering from this problem. To ensure that this condition is treated, you should see your primary care physician. He or she may suggest a consultation with a sleep specialist, who is in the best position to evaluate your condition by performing appropriate laboratory tests and suggesting optimal treatment.


Dr. Gross, my husband tells me that I keep moving my legs during sleep. In the daytime, I feel tired and irritable. I do not seem to have quality sleep at night. Do I have Restless Legs Syndrome (RLS)?

The symptoms described here suggest that the patient may have periodic limb movements in sleep (PLMS). In PLMS, certain kinds of movements affect mostly the legs but occasionally the arms; these movements occur in a periodic or semi periodic manner during sleep, mostly during non REM sleep.

The patient moves his or her legs in a periodic fashion, for perhaps an hour or so, and then stops moving. The movements recur intermittently throughout the night. During the dream stage of sleep (REM sleep), they generally stop.

The bed partner may be able to describe your movements, which usually include bending of the toes and foot upward, sometimes bending of the knees, and occasionally bending of the arms and forearms every 20 to 40 seconds (range of 5 to 90 seconds). During some of these movements, the patient may briefly wake up.

Although the PLMS patient may be unaware of this awakening, a sleep specialist can detect it by looking at the brain waves (EEG) during an overnight polysomnographic study. The brain wakes up briefly (3 to 14 seconds), causing the EEG to show a change from sleep to waking rhythms. If you briefly wake up in this manner repeatedly throughout the night, your sleep will not be consolidated.

The resulting poor quality of sleep will lead to daytime fatigue and sleepiness. Whether PLMS causes sleep disturbance, giving rise to daytime fatigue and tiredness, remains somewhat controversial.

At least 80 percent of patients with RLS have PLMS. In addition, PLMS may occur as an isolated condition or be associated with a variety of other medical and neurological illnesses, medications, or primary sleep disorders. In particular, some antidepressant medications may aggravate these movements.

Sometimes PLMS may occur in normal individuals, particularly elderly subjects. To ascertain whether the patient has RLS, the physician will first ask several questions to decide whether he or she meets the minimal criteria established by the International RLS study group and then perform a thorough physical examination.

For questions about this article or other sleep disorders call Dr. James Gross (480) 614-0588, e-mail vickigross@cox.net or visit www.myhealth.com/james_gross2

-------------------------------------------------------------

Secondhand Smoke Packs Heavy Toll...

By The American Heart Association

Secondhand Smoke Packs Heavy Toll;
Nearly As Significant As Smoking

Compelling scientific evidence is accumulating about the substantial and rapid impact on the heart and blood vessel system from exposure to secondhand smoke, according to a literature review reported in Circulation: Journal of the American Heart Association.

“ Despite the much lower dose that nonsmokers receive compared to smokers, secondhand smoke can have effects nearly as significant as active smoking,” said study author Stanton A. Glantz, Ph.D., a professor of medicine at the University of California, San Francisco.

In a meta-analysis of 29 studies, researchers reviewed the mechanistic effects of secondhand smoke on the cardiovascular system, emphasizing research published in the past decade.

They found that the dose of smoke delivered to an active smoker is at least 100 times the dose delivered to a passive smoker. Coronary heart disease risk in smokers increases about 80 percent compared to an approximately 30 percent increase in risk for passive smokers; meaning passive smoking has much larger effects on the cardiovascular system than would be expected, based on a comparison of the doses of toxins delivered to active and passive smokers, according to the study.

The impact of secondhand smoke on the general public is similar to, but larger than, the effects of outdoor air pollution on the cardiovascular system, the authors said.

On a population basis, the effects of secondhand smoke are rapid and large. “Even a little secondhand smoke is dangerous,” said Joaquin Barnoya, M.D., M.P.H., co-author of the study and who is director of cardiovascular research at Unidad de Cirugia Cardiovascular de Guatemala and assistant adjunct professor of epidemiology and biostatistics at the University of California, San Francisco.

“The effects on blood, blood vessels, and heart rhythm occur quickly, often within minutes.” The American Heart Association continues to support the rights of everyone to a smoke-free environment and supports legislation to require it. The Flight Attendant Medical Research Institute in Miami, Florida, funded the study.

For more information about the content of this article or other questions or information regarding heart disease or stroke, call the American Heart Association at 602-414-5353, 1-800-AHA-USA1 or visit:
www.americanheart.org or www.strokeassociation.org