The Salina Journal from Salina, Kansas on April 10, 2001 · Page 11
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The Salina Journal from Salina, Kansas · Page 11

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Salina, Kansas
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Tuesday, April 10, 2001
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Page 11
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TUESDAY APRIL 10, 2001 THE SAUNA JOURNAL Health CLASSIFIED / C2 SINUSITIS Clogged Cavity Repeated sinus infections can lead to chronic condition By KARA RHODES The Salina Journal At the first cough or sneeze, Joellyn Bishop would cringe. A chronic sinusitis sufferer, she Itnew a cold meant declining health and antibiotic prescriptions for weeks and sometimes even months. "I kept putting off surgery," Bishop said. She had the surgery in September. "My advice to people is: Don't put it off. My quality of life has definitely improved." Dr. Mark Bell, an ear, nose and throat specialist, said normally, mucus collecting in sinuses drains into nasal passages. But when sinus cavities become infected because of a cold, allergy attack or environmental pollu­ tions such as smoking, sinuses become inflamed, swell and can't drain. Bacteria breeds in the warm, wet and dark environment, and sinusitis results. Like a cold or allergy infection, sinusitis can go away without treatment such as that provided by antibiotics and humidifiers. But life can be miserable with the lingering side effects, which are often like that of a bad cold. Many people, struck by nasty headaches, facial pain, upper tooth pain, sore throat, nasal congestion, fever, fatigue or coughing, end up bedridden for days. Bell said the season for sinusitis peaks during winter- months because the dry air makes it hard for mucus to flow. But springtime, as the body adjusts to the increased pollen counts in the air, also can be a difficult time for the sinuses. "This part of the country is worse off because of seasonal changes," Bell said. TOM DORSEY / The Salina Journal Dr. Mark Bell demonstrates the Instruments used In endoscopic sinus surgery that can be used to relieve chronic sinusitis. The surgeon operates through the nostrils, and the procedure normally Is completed In about an hour. "That's bad for the nose." Clogged drainage system Sinuses are air-filled spaces in the skull behind the cheekbones, between the eye sockets and above the eyebrows. Like a bird's bones, facial and nasal bones are hollow, perhaps to keep the head lighter, Bell said. The fragile bones have narrow openings that drain into the nose. If the openings are blocked, a sinus infection occurs. The sinuses become inflamed, and mucus becomes thick and discolored. When the mucus thickens. more problems occur. Cilia, a minute hairlike substance that beats in rhythmic waves and lines the membranes throughout the nose and sinuses, is supposed to keep the mucus flowing. Since the body produces between two and four quarts of mucus a day that is swept down the back of the throat, the cilia has a big job. But if the mucus becomes thick or the cilia fails to work properly — smoking, asthma and viral infections contribute to keeping the cilia from working properly — a sinus infection can result be­ cause the mucus gets stopped up in the sinuses. If this happens often enough or isn't treated, chronic sinusitis can result because a sort of callus forms over the opening, and mucus is almost always backed up. At that point. Bell said, sinus surgery is an option. Once a terribly invasive surgery, today sinus surgery — while not painless — is considerably less problematic. Surgeons are able to enter the sinuses through the nostrils using small instruments guided by telescopes and open the sinuses by chipping away at the fragile bone at the openings. The outpatient procedure takes less than an hour for a normal case. Bell said. Bell's patient Bishop said the surgery has been a big life change for her "I've only had one cold, and I got over it with one dosage of antibiotics," she said. "I feel like my overall health has really improved." • Reporter Kara Rhodes call be reached at 823-6464, Ext. 167, or by e-mail at sjkrhodes@saljournal. com. Frontal sinus Ethmoid. sinus Maxiliary sinus Source: American Academy of Otolaryngology profile view Sphenoid Frontal sinus sinus Q: How common is sinusitis? A: More than 37 miilion Americans suffer from at least one episode of acute sinusitis each year. The prevalence of sinusitis has soared in the past decade due to increased pollution, urban sprawl and increased resistance to antibiotics. Q: What measures can be taken at home to relieve sinus pain? A: Warm moist air may alleviate congestion. A vaporizer or steam from a pan of boiled water are both recommended. Humidifiers should have a clear filter so bacteria and fungal spores aren't sprayed into the air. Warm compresses are also useful, and saline nose drops are safe for use at home. Q: What should one expect during the physical examination for sinusitis? A: At a specialist's office, the patient will receive a thorough ear, nose and throat exam. The physician will explore the facial features to see If there is swelling over the cheekbone. Other diagnostic tests may include a study of mucus culture, endoscopy. X-rays, allergy testing and a CT scan of the sinuses. Graphic by RICHAE HflORROW / The Salina Journal T ALCOHOLISM NIH to study treatment for alcoholics Federal agency will check effectiveness of different combinations of treatment By LAURAN NEERGAARD The Associated Press WASHINGTON — Marvin President tried to quit drinking for more than 10 years. Even a hospital detoxification program after he suffered serious liver damage didn't leave the South Carolina man sober for long. Half of alcoholics who undergo treatment relapse at least once, many repeatedly Now the government is fighting that grim statistic by launching a major nationwide study to see if novel combinations of therapies will better treat patients such as President — essentially hitting alcoholism with a one-two punch. Does a standard medication or an experimental pill work better, or do they work best added together? What about HD volunteep For Information on volunteering forthe study on alcoholism, call 1.866-80-STUDY. medication plus different types of psychotherapy? Is intense psychotherapy necessary or is a cheaper kind OK? The National Institutes of Health is hunting 1,375 volunteers to test the different treatment combinations, for free, at 11 universities around the country It's unlikely just one will be the magic bullet — but because no two people are alike, researchers hope to uncover combinations that particularly suit certain alcoholics' vulnerabilities so they get better help than they do today "The goal is to cure," said Dr. Enoch Cordis, director of the NIH's National Institute on Alcohol Abuse and Alco­ holism. "We can't do that yet. ... But every day a patient is abstinent and sober is a big step." Health officials estimate some 8 million Americans are alcoholics — they have strong cravings to drink, experience withdrawal and need increasing amounts to feel satisfied. Another 6 million abuse alcohol but aren't deemed physically dependent on it. Alcoholism is a disease, not a character weakness, that needs treatment by a doctor, specialists say Scientists are narrowing their hunt for genes that make people vulnerable to alcoholism, discoveries that promise to yield better medications. And brain-imaging studies of other disorders show behavior therapy, not just medications, can change brain patterns to ease illness — encouraging for the alcohol field. For today which treatments work best for which patient is where the NIH's Combine study comes in. To be tested are different combinations of: • Acamprosate, an experimental pill believed to ease withdrawal symptoms by normalizing abnormalities in two brain chemical systems. The drug is widely used in Europe; the Food and Drug Administration is considering whether to approve its use here. • Naltrexone, an older, FDA-approved drug that works on different brain circuitry, blocking chemicals that make alcoholics feel good after a drink. • Intensive cognitive/behavioral therapy teaching patients to manage cravings and unlearn habits that promote drinking — how they respond to certain stresses or situations. It also includes "motivational enhancement," counseling that stresses problem-solving techniques, and encourages joining a support group such as Alcoholics Anonymous. • "Light" behavior therapy Similar to what some primary care physicians do today, it encourages AA and offers limited counseling, mostly about drlnk- ing's dangers. T PRESCRIPTION DRUGS States tackle drug costs Drugmakers oppose state-by-state actions to reduce drug costs By ANDREW WELSH-MUGGINS The Associated Press COLUMBUS, Ohio — As Congress debates solutions to high prescription drug costs, more and more states are pushing ahead with plans to ease the burden, particularly on the elderly and needy That aggressive approach by the states is worrying drug- makers and pharmacists, who say a consistent, national solution is what's needed. Some advocates for senior citizens have misgivings as well, saying many of the state initiatives don't go far enough and are more political than practical. "The last thing we need is a growing patchwork quilt of differing and perhaps even conflicting state laws," said Jeff Trewhitt, spokesman for the Pharmaceutical Research and Manufacturers of America. "It really is a national problem that requires a national solution," Ohio is among 43 states considering plans this year to provide discounts, bulk purchasing or price regulation, according to the National Conference of State Legislatures. Twenty-, six states have some type of pharmaceutical assistance program. Ohio discount The Ohio bill would encourage pharmacies to join a privately managed program that would negotiate group discounts on prescriptions for senior citizens. Gov. Bob Taft, who backs the bill in a Legislature controlled by his fellow Republicans, modeled the idea after the state's Golden Buckeye Card, which provides discounts for the elderly and disabled at more than 23,000 businesses. The discounts would vary according to the price of the drug. They would cost pharmacies money, but help them compete for the business of more than 600,000 Ohioans eligible for the card, said Rob Wright, legislative liaison at the Department of Aging. The idea appeals to 80-year- old Mary Kline, who declined to pay for an $80 arthritis medication recently when she realized she couldn't afford it month after month. "I'm not going to take it unless I know it's a death-or-life matter," said Kline, a widow in northeast Ohio who lives on about $1,100 a month. Opponents say the bill is too limited and places an undue burden on pharmacists, whose profit margin is much narrower than that of drug manufacturers. And some such as Betsey Exline of the Seniors Taking Action, an advocacy group in southwest Ohio, say Ohio alone can't make a difference. She called the proposal "a wonderful piece of junk" that will help Taft politically but be too small of a discount to really matter. "It's got to come out of the federal government," said Exline, 68. "I can't see that the states can have that much clout," National effort The nation's bill for health care has risen to a record $1.2 trillion, with prescription drugs accounting for nearly 10 percent of the costs and expected to grab an even larger share of what Americans pay to get or stay healthy, new government estimates show. As passed by the US. House last month. President Bush's budget sets aside Medicare's projected 10-year, $393 billion surplus for some future overhaul. This includes $153 billion for prescription drug benefits. Republicans voted against a Democratic alternative that would also have doubled prescription drug spending but would have taken the money from Bush's tax cut. SUGGESTIONS? CALL BRET WALLACE, ASSISTANT EDITOR, AT 823-6363 OR 1-800-827-6363 OR E-iVIAIL AT 8jbwallace@8alJournal .com

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