Health Care and Throat Nodules (Nodes)

Do you know anyone who has suffered from nodes or nodules on their vocal chords? Typically it comes from overuse of the throat and vocal chords by singers, public speakers and others who do a lot of talking or singing for a living. Many performers deal with it as part of their hazardous vocal needs. Sometimes it is called "Screamer's Voice."

According to the American Academy of Otolaryngology (AAO), the term vocal cord lesion refers to a group of noncancerous (benign), abnormal growths (lesions) within or along the covering of the vocal cord. Vocal cord lesions are one of the most common causes of voice problems and are generally seen in three forms; nodules (nodes), polyps, and cysts.

The AAO says that vocal cord nodules are also known as “calluses of the vocal fold.” They appear on both sides of the vocal cords, typically at the midpoint, and directly face each other. Like other calluses, these lesions often diminish or disappear when overuse of the area is stopped. More details are found at their site: http://www.entnet.org/content/nodules-polyps-and-cysts .

Nodules and polyps, according to the American Speech-Language-Hearing Association, cause similar symptoms:

·         Hoarseness

·         Breathiness

·         A "rough" voice

·         A "scratchy" voice

·         Harshness

·         Shooting pain from ear to ear

·         A "lump in the throat" sensation

·         Neck pain

·         Decreased pitch range

·         Voice and body fatigue

If you have experienced a hoarse voice for more than 2 to 3 weeks, you should see a physician. A thorough voice evaluation should include:

·         a physician's examination, preferably by an otolaryngologist (ear, nose, and throat doctor) who specializes in voice,

·         a voice evaluation by a speech-language pathologist (SLP), and

possibly a neurological examination.

The team will evaluate vocal quality, pitch, loudness, ability to sustain voicing, and other voice characteristics. An instrumental examination may take place that involves inserting an endoscope into the mouth or nose to look at the vocal cords and larynx in general. A stroboscope (flashing light) may be used to watch the vocal cords as they move. Much more detail on vocal nodes is located at this site: http://www.asha.org/public/speech/disorders/NodulesPolyps/ .

A doctor makes the diagnosis by examining the vocal cords with a mirror or a thin, flexible viewing tube (laryngoscopy), according to Merck Manuals. Sometimes the doctor removes a small piece of tissue for examination under a microscope (biopsy) to make sure the growth is not cancerous (malignant).

Treatment is to avoid whatever is irritating the voice box (larynx) and rest the voice. If abuse of the voice is the cause, voice therapy conducted by a speech therapist may be needed to teach the person how to speak or sing without straining the vocal cords. Most nodules and granulomas go away with this treatment.

Granulomas that do not go away can be removed surgically but tend to come back. Most polyps must be surgically removed to restore the person's normal voice. More info can be found at this website: https://www.merckmanuals.com/home/ear,-nose,-and-throat-disorders/mouth-and-throat-disorders/vocal-cord-polyps,-nodules,-and-granulomas .

According to the British Voice Association, if you have symptoms that suggest you may have vocal nodules:

·         Seek a medical opinion from a Laryngologist experienced with voice problems. The best solution is to ask your primary care doctor for a referral to a multidisciplinary voice clinic.

·         Whenever possible rest your voice and avoid speaking against noise, shouting or coughing violently.

·         Inhale steam to soothe irritated and swollen vocal folds.

·         Keep well hydrated and avoid inhaled irritants, such as smoke.

·         If you are a singer discuss suitable warm up exercises with your singing teacher and do not try to sing high and quiet – you will be doomed to disappointment until the nodules have resolved.

·         If your Laryngologist refers you to a speech and language therapist take up the option and work hard on the exercises you are given. Voice therapy is like physiotherapy or Pilates for the voice and may well be all you need to resolve the nodules.

·         If your Laryngologist suggests surgery, do not panic! It may well be the quickest and most effective way to deal with the problem. Ask your Laryngologist to explain exactly what they will do at surgery and why they feel it is the best treatment option. Discuss any worries you have openly.

·         Don't beat yourself up about it! Vocal nodules are not a crime or even necessarily the result of "bad technique". They are an injury, much as a marathon runner might sustain during training or a race.

Although vocal nodules remain a problem for professional voice users and may cause some cancelled shows, delays in training, a lot of hard work and inevitably some anxiety, they are very unlikely to herald the end of a career. More details are located at this site: http://www.britishvoiceassociation.org.uk/voice-information_vocal-nodules.htm .

Having nodules or nodes on your throat should not be taken lightly. Seek professional medical advice to help your situation. Your doctor can prescribe treatment or suggest more advanced options for care. Don’t continue to ignore the symptoms, and do what the doctor says!

Until next time.

Health Care and Diabetes

One of the most difficult health care management issues today is controlling the rise in cases of diabetes. Chronic disease management costs and care have increased substantially with the disease over the past decade.  The medical community has declared diabetes to be an epidemic within current society, and it appears to be getting worse each year.

However, in a sign that Americans may finally be turning the corner in the fight against diabetes -- and possibly obesity -- federal health statistics released this month show that the number of new cases of diabetes has dropped for the first time in decades and reported by HealthDay News. The decline wasn't sudden or dramatic. But, the number of new diabetes cases went from 1.7 million in 2009 to 1.4 million in 2014, according to the U.S. Centers for Disease Control and Prevention.

The CDC report offers some encouraging indications that Americans may finally be adopting healthier lifestyles. For example, fewer whites are now being diagnosed with diabetes -- typically type 2 diabetes, by far the most common form of the disease. But, blacks and Hispanics haven't seen significant declines in diagnoses even though a downward trend is starting to emerge, the CDC report showed. Educated Americans also have seen improvements in diabetes diagnoses, while the less educated have only seen a flattening in the number of new cases, the report found.

Today, diabetes takes more lives than AIDS and breast cancer combined -- claiming the life of 1 American every 3 minutes. It is a leading cause of blindness, kidney failure, amputations, heart failure and stroke. Living with diabetes places an enormous emotional, physical and financial burden on the entire family. Annually, diabetes costs the American public more than $245 billion, according to the Diabetes Research Institute Foundation.

Just what is diabetes? To answer that, you first need to understand the role of insulin in your body. When you eat, your body turns food into sugars, or glucose. At that point, your pancreas is supposed to release insulin. Insulin serves as a “key” to open your cells, to allow the glucose to enter -- and allow you to use the glucose for energy.

But with diabetes, this system does not work. Several major things can go wrong – causing the onset of diabetes. Type 1 and type 2 diabetes are the most common forms of the disease, but there are also other kinds, such as gestational diabetes, which occurs during pregnancy, as well as other forms. Much more information about this disease is located at this site: http://www.diabetesresearch.org/what-is-diabetes .

According to the American Diabetes Association, the following symptoms of diabetes are typical. However, some people with type 2 diabetes have symptoms so mild that they go unnoticed. Common symptoms of diabetes include the following:

·         Urinating often

·         Feeling very thirsty

·         Feeling very hungry - even though you are eating

·         Extreme fatigue

·         Blurry vision

·         Cuts/bruises that are slow to heal

·         Weight loss - even though you are eating more (type 1)

·         Tingling, pain, or numbness in the hands/feet (type 2)

Early detection and treatment of diabetes can decrease the risk of developing the complications of diabetes. Significant material about this health care problem is found at this website: http://www.diabetes.org/ .

Metformin is the standby drug for millions of people with type 2 diabetes, but a new study finds that adding it to insulin therapy won't boost blood sugar control for overweight teens with type 1 diabetes, according to HealthDay News.

In type 1 diabetes, which comprises about 5 percent of diabetes cases, the body is unable to produce the insulin it needs. So, supplemental insulin is a must for people with the disease. The new study was led by Kellee Miller of the Jaeb Center for Health Research in Tampa, Fla. As her team explained, young people with type 1 diabetes are at even higher metabolic risk if they become overweight or obese, especially in adolescence.

That's because both obesity and puberty may cause the patient to require higher levels of supplemental insulin, complicating blood sugar control, the researchers said. However, prior studies of how Metformin might affect blood sugar control in teens with type 1 diabetes have been inconclusive, Miller's team noted. More details on this news is located at this website: https://www.nlm.nih.gov/medlineplus/news/fullstory_155990.html

Managing diabetes is a challenge every day. There are so many variables to keep in mind -- food, exercise, stress, general health, etc. -- that keeping blood sugar levels in the desired range is a constant balancing act.

Men and women whose underlying biological clock does not match the sleep hours imposed by modern work schedules have metabolic risk factors that may predispose them to a higher risk for type 2 diabetes and heart disease, according to a new study published online in November in the Journal of Clinical Endocrinology and Metabolism. 

The work is the first to link so-called "social jet lag" with increased metabolic risk in middle-aged adults. Social jet lag refers to the disconnect between a person's natural circadian rhythm and the restrictions placed on it by social and work obligations. So, even your work habits can affect the possibility of contracting diabetes.

According to eDocAmerica, recent statistics also indicate that people with type 2 diabetes mellitus have nearly twice the risk of developing Alzheimer's disease as people without diabetes. While the exact reason for this is still being investigated, several interesting findings connecting the two diseases have emerged.

The American Diabetes Association reports that in 2012, 29.1 million Americans, or 9.3% of the population had diabetes. Of these, 90 to 95% have Type 2 diabetes. While both Type 1 and Type 2 diabetes are characterized by high blood sugar, the mechanism for the development of each type is very different. Type 1 diabetes is considered to be an autoimmune disease in which the cells within the pancreas that produce insulin are destroyed, resulting in a deficiency of insulin.

Without insulin to move sugar from the bloodstream into the body's cells, blood sugar rises. Type 2 diabetes, on the other hand, is considered a disease of "lifestyle". Poor diet, inactivity, and obesity are major reasons for its development. In type 2 diabetes elevated blood sugar levels are initially due to the body's inability to use insulin effectively. This is known as "insulin resistance" and is associated with higher than normal insulin levels.

In addition to significantly increasing one's risk of heart attack and stroke, Type 2 diabetes mellitus is associated with a number of other medical complications including:

·         Blindness from diabetic retinopathy

·         Reduced blood flow in the feet and legs requiring amputations

·         Kidney failure

·         Nerve damage and ulcerations of the feet

If these problems weren't enough, add in the recent findings that Type 2 diabetes may also contribute to the development of Alzheimer's disease.  More details about this subject are located at this site: http://weeklyhealthtip.blogspot.com/2015/11/the-link-between-type-2-diabetes-and.html .

Diabetes is a disease that still is being researched on a daily basis, and new issues are discovered on a regular basis as to the cause and treatment of it. There are varying degrees of health care issues with the disease, and management of it is serious. If you or someone you know has diabetes or may be symptomatic, see your doctor for a medical protocol. Don’t ignore its affects on your life—it can be deadly if left untreated.

Until next time.