Should I take steroids for my chronic sinus infections?

Posted June 12, 2013, 2:00 am

I have chronic sinusitis and nasal polyps. My specialist suggested trying oral corticosteroids. What do you think?

“Steroids” is short for anti-inflammatory hormones called corticosteroids, and “oral” means steroids taken in pill form. I think a short course of five to seven days of oral steroids is worth a try. That’s particularly true if your sinusitis isn’t getting any better. My colleague, Neil Bhattacharyya, an ear, nose and throat doctor and professor at Harvard Medical School, agrees. Much of what I say below is based on his advice.

As you know, sinusitis is an inflammation of the mucous membranes that line the sinuses. It often causes headaches and an uncomfortable feeling of pressure in the face. (I’ve put an illustration of how sinusitis works below.)

Sinusitis is inflammation of the mucous membranes that line the sinuses.

Chronic inflammation in the membranes of your nose and sinuses can cause fleshy growths called polyps. Not all cases of chronic sinusitis result in polyps, but when they form, polyps can block your nasal passages and sinuses. This makes breathing more difficult and can diminish your sense of smell. Polyps also make it easier for infections to start in your sinuses.

I assume you’ve tried the usual techniques for dealing with sinusitis: inhaling steam, taking extra-long showers, drinking lots of water and sleeping with your head elevated. A course of antibiotics is also often appropriate if there are clear signs of bacterial infection in your sinuses (such as green or brown discharge when you blow your nose, a fever and a rotten feeling).

Once sinusitis becomes chronic, the inflammation can take on a life of its own. Corticosteroids become an important treatment option, as they have anti-inflammatory effects.

The first type of steroid to try is one that can be inhaled into the nose. Inhaled steroids deliver the medicine directly to the inflamed tissues that need to be quieted. However, polyps can block the passage of the inhaled steroids to some of the inflamed areas.

If inhaled steroids don’t do the job, it’s worth considering a brief course of steroids in pill form. Taking an oral steroid such as prednisone for a week or so reduces the size of the polyps a little and decreases overall inflammation in the nose. Shrinking polyps and reducing inflammation allow the topical steroid to reach its target and be more effective.

The reason I and many doctors hold off on using steroids in pill form is that the medicine travels in the blood, exposing the whole body to the medication. (In contrast, topical steroids expose only the nose and sinuses.) Side effects are more likely from oral steroids than from inhaled steroids; they may include elevated pressure in the eyes (glaucoma), increased blood pressure and mood swings. But in my experience, a short course of oral steroids, such as what I’m recommending here, rarely produces serious side effects.

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Drop 10 With SELF: Keep the Weight Off While Away

Need a little extra inspiration? Meet our Drop 10 Blogger, Danielle. She's lost 10 pounds (and counting!) in her first five weeks on the plan. Follow along with Danielle every week as she shares her experience.

OMG, you guys! I'm down three more pounds, even though I was away for the majority of the week. It feels great to know I can make healthy food decisions on the go with Drop 10 and easily work out even when I'm away from home.

So, my idea came from a Cali woman I met at said work conference -- she had a similar story to mine. Two years ago, she had dropped 55 pounds, and has kept the weight off ever since. And get this -- she's a marathon runner now, who is seriously dedicated to her healthy lifestyle. I found that really encouraging; it's not always easy to find someone who's been in my shoes.

And not only did my new BFF inspire me, she got me to sweat, too -- we visited the hotel's fitness center (pictured) together during the conference. It felt SO good to be back on the treadmill after a few days burning the midnight oil at the office. And then, at the end of my cardio routine, she asked me to do a serious strength-training and toning workout with her -- and although it looked intense (it was the Jillian Michaels' 30-Day Shred DVD), I was up for the challenge. I was practically sweating buckets while doing my crunches. My new BFF? Total champ. She took me out of my comfort zone and motivated me to continue until the end. And here I am, after a work trip, three pounds lighter -- and still motivated.

Image Credit: Courtesy of Author

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Health Tip: Don't Ignore Pacemaker Issues

(HealthDay News) -- If you have an irregular heartbeat, a pacemaker can help restore your heart to its natural rhythm and help the heart continue to pump blood to the rest of the body.

But once the device is implanted, you shouldn't just "set it and forget it," experts say. The National Heart Lung and Blood Institute says these potential problems can affect a pacemaker:

Interference with the pacemaker's electrical signal caused by other devices, such as cellphones, microwave ovens or high-tension electrical wiring.Broken or dislodged wires.Failing or weakened battery.Progression of heart disease.

-- Diana Kohnle
Copyright © 2013 HealthDay. All rights reserved.

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Short Strolls After Meals May Lower Diabetes Risk

Walking 15 minutes three times a day was better for blood sugar levels than one 45-minute walk, small study found

By Kathleen Doheny

HealthDay Reporter

WEDNESDAY, June 12 (HealthDay News) -- Older adults at risk for getting diabetes who took a 15-minute walk after every meal improved their blood sugar levels, a new study shows.

Three short walks after eating worked better to control blood sugar levels than one 45-minute walk in the morning or evening, said lead researcher Loretta DiPietro, chairwoman of the George Washington University School of Public Health and Health Services in Washington, D.C.

"More importantly, the post-meal walking was significantly better than the other two exercise prescriptions at lowering the post-dinner glucose level," DiPietro added.

The after-dinner period is an especially vulnerable time for older people at risk of diabetes, DiPietro said. Insulin production decreases, and they may go to bed with extremely high blood glucose levels, increasing their chances of diabetes.

About 79 million Americans are at risk for type 2 diabetes, in which the body doesn't make enough insulin or doesn't use it effectively. Being overweight and sedentary increases the risk. DiPietro's new research, although tested in only 10 people, suggests that brief walks can lower that risk if they are taken at the right times.

The study did not, however, prove that it was the walks causing the improved blood sugar levels.

"This is among the first studies to really address the timing of the exercise with regard to its benefit for blood sugar control," she said. In the study, the walks began a half hour after finishing each meal.

The research is published June 12 in the journal Diabetes Care.

For the study, DiPietro and her colleagues asked the 10 older adults, who were 70 years old on average, to complete three different exercise routines spaced four weeks apart. At the study's start, the men and women had fasting blood sugar levels of between 105 and 125 milligrams per deciliter. A fasting blood glucose level of 70 to 100 is considered normal, according to the U.S. National Institutes of Health.

The men and women stayed at the research facility and were supervised closely. Their blood sugar levels were monitored the entire 48 hours.

On the first day, the men and women did not exercise. On the second day, they did, and those blood sugar levels were compared to those on the first day.

The men and women were classified as obese, on average, with a body-mass index (BMI) of 30. The men and women walked on a treadmill at a speed of about three miles an hour (a 20-minute mile, which DiPietro described as the lower end of moderate).

The walks after meals reduced the 24-hour glucose levels the most when comparing the sedentary day with the exercise day.

A 45-minute morning walk was next best.

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Velvet Vejnovic, Fashion Journalism Student

I would describe my style as minimal with statement pieces. Today I'm wearing Converse trainers, Primark trousers and a Monki T-Shirt. The bag is from Topshop. I like to look at street style for outfit inspirations and my style icon is the Swedish blogger Elin Kling. I'm not really into designer clothes, I believe it's not where something is from that matters but how you put it together.

Photographed by Suzanne Middlemass.

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Working out to loose weight - Requesting expert guidance please.

Hi CC peeps,

Please guide me :-)

Height/weight/Age/Gender : 153 cm/72 Kg/35/Female

Work : 8 am to 5 Pm.

Diet : 1200 calories per day, 8 glasses of water.

Work out : (Since past 3 days, with personal trainer, 1 Hour morning , 2 Hour evening , total 3 hours per day)

Day type 1 : 60 Min elliptical + 60 Min elliptical ?? + 60 Min floor exercise and weights.

Day type 2 : 60 Min elliptical + 30 Min Cycling + 30 Min elliptical + 60 Min floor exercise, crunch, streach, weights

PS : My elliptical settings are ?(Cross ramp 5, resistance 9, 98 steps per minute). One hour in morning - one in evening - alternate days as above programme.

I have deficit of 1330 calories per day on average as per calorie count. I should have lost half KG after 3.5 days of workout. But it did not happen. Will I loose weight? When will I see a difference? Currently I am sore all over :-) even my boob muscles are sore .. dang!

Please help - and guide me - what can be done better?

Sherry.

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Pierce Brosnan out and about in LA

Well maybe you shouldn't be living HEEEEEEEEEEERRRE!* Still Brozza's best work, if we say so ourselves.

*If you don't have any idea what we're talking about, please watch this movie gem.

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question about muscle building and calories needed

i am at a healthy weight that I want to maintain but I am starting a heavy lifting regime so I can convert the fat into muscle. In order to do this successfully, do I need to be eating maintenance calories or a weight loss amount? Logically I would think it would be maintenance but I am not totally sure how this works.

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Brad Pitt at CinemaCon in Las Vegas

Whenever we see pics of Brad Pitt speaking, we can't help but wonder if he's reeling off that script from those Chanel ads. Alas, in this case, probably not, as he was introducing a film clip from his forthcoming zombie flick, World War Z, last night in Las Vegas. Inevitable.

CELEBRITY MANPUZELS

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Pesticide Exposure Linked to Changes in Fetal Movement: Study

Findings underscore need to protect developing brain, researcher says

By Robert Preidt

HealthDay Reporter

WEDNESDAY, June 12 (HealthDay News) -- A pregnant woman's exposure to environmental contaminants affects her unborn baby's heart rate and movement, a new study says.

"Both fetal motor activity and heart rate reveal how the fetus is maturing and give us a way to evaluate how exposures may be affecting the developing nervous system," study lead author Janet DiPietro, associate dean for research at the Johns Hopkins Bloomberg School of Public Health, said in a school news release.

The researchers analyzed blood samples from 50 high- and low-income pregnant women in and around Baltimore and found that they all had detectable levels of organochlorines, including DDT, PCBs and other pesticides that have been banned in the United States for more than 30 years.

High-income women had a greater concentration of chemicals than low-income women.

The blood samples were collected at 36 weeks of pregnancy, and measurements of fetal heart rate and movement also were taken at that time, according to the study, which was published online in the Journal of Exposure Science and Environmental Epidemiology.

The researchers found that higher levels of some common environmental pollutants were associated with more frequent and vigorous fetal movement. Some of the chemicals also were associated with fewer changes in fetal heart rate, which normally parallel fetal movements.

"Most studies of environmental contaminants and child development wait until children are much older to evaluate effects of things the mother may have been exposed to during pregnancy," DiPietro said. "Here we have observed effects in utero."

How the prenatal period sets the stage for later child development is a subject of tremendous interest, DiPietro said.

"These results show that the developing fetus is susceptible to environmental exposures and that we can detect this by measuring fetal neurobehavior," she said. "This is yet more evidence for the need to protect the vulnerable developing brain from effects of environmental contaminants both before and after birth."

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Breathing Problem Sometimes Misdiagnosed in Athletes

FRIDAY, April 12 (HealthDay News) -- A vocal cord problem that restricts athletes' breathing is often misdiagnosed as exercise-induced asthma, a small new study suggests.

Researchers looked at 46 college athletes who were newly diagnosed with paradoxical vocal fold motion disorder (PVFMD), a condition that can be brought on by stress, anxiety or increased exertion. It causes the vocal cords to constrict and obstruct breathing.

An estimated 5 percent of athletes have the vocal cord disorder, which can severely affect their performance, according to the researchers at the Ohio State University Medical Center.

"There isn't a lot in the literature about PVFMD in elite athletes, and our study shows that because of their high level of conditioning they may be more difficult to diagnose and treat than non-athletes," lead investigator Dr. Brad deSilva, residency program director for the department of otolaryngology--head and neck surgery, said in a medical center news release.

For example, only 30 percent of the athletes in the study consistently experienced PVFMD symptoms, such as coughing during exercise.

"PVFMD symptoms can often mimic asthma, and as many as 40 percent of people with asthma also have PVFMD -- so it's typical for an athlete to get the asthma diagnosed correctly, but not the vocal cord dysfunction," study co-author Dr. Anna Marcinow, a senior resident in the otolaryngology program in the College of Medicine, said in the news release.

The researchers also assessed a number of treatments for the vocal cord disorder, ranging from biofeedback to Botox injections. Biofeedback is a technique that teaches people how to control their body's responses.

The investigators found that vocal cord retraining therapy helped reduce or eliminate breathing problems and allowed many athletes to stop using asthma inhalers.

"Because PVFMD can have both physical and emotional impacts, using tactics that help athletes gain a sense of control over their breathing can be really effective," Marcinow said. "Athletes may also need additional alternative forms of therapy such as biofeedback or intervention from a sports psychologist."

While the disorder often occurs in athletes who have recently intensified their activity and training, it can also occur in non-athletes who are starting a more demanding exercise program, the researchers noted.

The study was scheduled for presentation Friday at the annual meeting of the Triological Society, in Orlando, Fla. The data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

-- Robert Preidt
Copyright © 2013 HealthDay. All rights reserved. SOURCE: Ohio State University Medical Center, news release, April 12, 2013

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New Procedure May Shrink Enlarged Prostate Without Surgery

By Serena Gordon
HealthDay Reporter

MONDAY, April 15 (HealthDay News) -- Men who need treatment for an enlarged prostate may soon have a new nonsurgical option, a small, early study suggests.

Called prostatic artery embolization (PAE), the technique uses a catheter threaded into an artery in the leg. The catheter is guided to the artery that supplies blood to the prostate. Then, tiny beads are injected into the artery, which temporarily block the blood supply to the prostate.

The temporary loss of blood supply causes the prostate to shrink, relieving symptoms, according to study lead author Dr. Sandeep Bagla. What's more, the new treatment doesn't appear to have the same risk of serious complications, such as incontinence and impotence, that often accompany enlarged prostate treatment.

"This is fantastic news for the average man with benign prostatic hyperplasia. Many men decline current treatments because of the risks. But, for the average man, PAE is a no-brainer," said Bagla, an interventional radiologist at Inova Alexandria Hospital, in Virginia.

The procedure has only been available as part of Bagla's trial until recently, but he said some interventional radiologists have started doing prostatic artery embolization, and he expects the procedure will become more widely available by the end of the year.

Benign prostatic hyperplasia is the medical term for an enlarged prostate. An enlarged prostate is very common as men get older. As many as half of all men in their 60s will have an enlarged prostate, according to the U.S. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). By the time men are in their 70s and 80s, up to 90 percent have benign prostatic hyperplasia, according to the NIDDK.

Some men experience no symptoms, while others may feel the need to urinate frequently, but they have a weak urinary stream, the NIDDK says. There are a number of treatments available for benign prostatic hyperplasia, including medications and surgery.

Bagla said that interventional radiologists in Europe and South America have been using prostatic artery embolization, and that the current study is the first in the United States to test the procedure.

He and his colleagues hope to treat a total of 30 patients, but they're reporting on the results from the first 18 patients on Monday at the annual meeting of Society of Interventional Radiology, in New Orleans. The data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

For the study, the average age of the patients who underwent prostatic artery embolization was 67 years. None of the men had to be admitted to the hospital after the procedure.

Ninety-four percent of the men (17 of 18) had a significant decrease in their symptoms one month after surgery. And, none reported any major complications following the surgery.

Bagla said the exact cost of the new procedure is difficult to estimate right now, but prostatic artery embolization will be cheaper than most of the currently used procedures, he said, because there's no need for an operating room and overnight hospital stays. In addition, he said, because the new procedure doesn't appear to cause complications, that will save health care dollars as well.

"This may become part of the armamentarium of treatments that can be offered for [benign prostatic hyperplasia]," said Dr. Art Rastinehad, director of interventional urologic oncology at North Shore-LIJ Health System in New Hyde Park, N.Y. He was not involved with the new study.

"This was a small series and a limited study to draw significant conclusions from. But, it's very exciting to see it evaluated and moving forward," he said.

Copyright © 2013 HealthDay. All rights reserved. SOURCES: Sandeep Bagla, M.D., interventional radiologist, Inova Alexandria Hospital, Alexandria, Va.; Art Rastinehad, D.O., director of interventional urologic oncology, North Shore-LIJ Health System, New Hyde Park, N.Y.; April 15, 2013, presentation, Society of Interventional Radiology annual meeting, New Orleans

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so bored of the gym!!

I've been going to the gym on and off for 3yrs now and I've actually begun to hate it, I dread going. Is this normal? I can't do the classes as there on at various times which don't fit in with work and home. I haven't seen a change in my body apart from getting fatter since driving last year :(( what should I do? Need help before I become massive and depressed

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Abigail Bergstorm, Editorial Assistant

My style is "Scandinavian inspired". Today, I'm wearing Dr Martin shoes, a COS dress and a H&M jacket. I bought the clutch in Primark, the sunglasses are from Monki and I found the necklace in a market. This summer I will be wearing a lot of white floaty dresses.

Photographed by Suzanne Middlemass.

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Restless Legs Syndrome Tied to Earlier Death Risk

Older men with condition have 39 percent increase in mortality, study suggests

By Serena Gordon

HealthDay Reporter

WEDNESDAY, June 12 (HealthDay News) -- Men with restless legs syndrome now have another health concern: New research has just linked the condition to an increased risk of dying early.

In a study of nearly 20,000 men, Harvard researchers found that men with restless legs syndrome had a 39 percent higher risk of an early death than did men without the condition.

"This study suggests that individuals with restless legs syndrome are more likely to die early than other people," said study author Dr. Xiang Gao, an assistant professor at Harvard Medical School and an associate epidemiologist at Brigham and Women's Hospital in Boston. "This association was independent of other known risk factors."

"[However], this is an observational study," Gao said of the findings, which were published online June 12 in the journal Neurology. "We can only see an association that suggests a possible causal relationship."

Restless legs syndrome is a common condition that causes people to feel an uncomfortable sensation in their legs when lying down, according to the U.S. National Institute of Neurological Disorders and Stroke (NINDS). The feeling may be a throbbing, pulling or creeping sensation. Restless legs syndrome makes it hard to fall asleep and stay asleep.

The exact cause of restless legs syndrome is unknown. It does seem to run in families, suggesting a genetic component to the condition, according to the NINDS. Restless legs syndrome has also been linked to some medical conditions, such as kidney disease and the nerve disorder peripheral neuropathy. It's also associated with the use of certain medications, and may occur during pregnancy.

Gao said many people with restless legs syndrome have low iron levels, and taking iron supplements often can alleviate the symptoms of restless legs syndrome. But, he cautioned, too much iron can be dangerous, so be sure to have your doctor check your iron levels before taking any supplements.

The current study included nearly 18,500 American men who were followed for eight years. At the start of the study, none of the men had diabetes, arthritis or kidney failure. The average age at the start of the study was 67.

Almost 4 percent (690 men) of the study group was diagnosed with restless legs syndrome. Men with restless legs syndrome were more likely to take antidepressant drugs and have high blood pressure, cardiovascular disease or Parkinson's disease. Not surprisingly, men with restless legs syndrome had more frequent complaints of insomnia.

During the study follow-up, nearly 2,800 men died.

When the researchers compared those with restless legs syndrome to those without, they found that men who had the condition were 39 percent more likely to die during the study period than men without the condition. When they controlled for factors such as body mass, lifestyle factors, chronic conditions and sleep duration, the mortality risk for men with restless legs syndrome dropped to 30 percent.

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