Hayfever and Sinus

Hay fever is the common name for an allergic reaction of the lining of the nose and sinuses. It is mostly triggered by breathing in pollens of cer tain grasses, weeds and trees. High pollen levels happen at certain times of the year, usually in spring and early summer. Some people have allergy symptoms the whole year round. This is usually due to an allergy to animal dander, moulds or horse-dust mite.

Sinus problems occur when the sinuses (the air spaces in the bones behind the nose) become inflamed and blocked. Many people’s sinus problems begin with an allergy, although sinus problems can be caused by an infection.

Signs & Symptoms

Hay fever
• Sneezing
• Runny nose (although it can be blocked)
• Itchy nose
• Puffy, itchy, watery and red eyes
• Tickling, burning throat
• Itchy or lumpy skin
• Shortness of breath or wheezing

Sinus
• Blocked nose and sinuses
• Pain, pressure and aching across the sinuses, around the cheeks, eyes and forehead, especially when bending forward.

Hay fever and sinus symptoms are often worse in the mornings or on windy days. Allergy symptoms can last for two or three weeks or for a few months during the hay fever season. If symptoms don’t go away after the usual hay fever season, you may have a perennial (year round) allergy. People who have “cold” symptoms all the time may actually have an allergy.

If you suffer from year-round symptoms:
• Keep pets outdoors.
• Remove carpets or place plastic covers over carpeted areas.
• Replace carpet areas with a hard surface e.g. lino, cork, tiles or slate.
• Enclose mattress, quilts and pillows in special zippered plastic covers.
• Wash bed linen in hot water and leave blankets in the sun for at least 4 hours

Gout

Gout is a type of arthritis. People who usually get gout usually have a high level of uric acid in their blood. Uric acid can form crystals in joints like the toes, knees and fingers, causing pain and swelling. People most likely to get gout are middle-aged men, and women after menopause. Gout could come on very quickly, often at night.

Signs & Symptoms
• A joint that suddenly becomes hot, red and swollen.
• Joints that are extremely painful and sensitive to touch – sometimes even the weight of a bed sheet can be too much.
• You may also feel sick, lose your appetite or have a temperature.

Risks

You may have a high level of uric acid if you:
• Have a family history of gout
• Drink too much alcohol
• Are overweight
• Eat foods that can increase the level of uric acid in your blood
• Have certain health problems. People who get gout attacks may also develop kidney problems later in life if their gout isn’t well controlled.

Stages of Gout
• A gout attack usually star ts in a single joint, often the big toe. Your ankle, foot, knee or hand may also be affected.
• Untreated, gout attacks last about a week. Some people get another attack soon after, but for others it may be months or years before another attack occurs.
• If you’ve had gout for many years, uric acid crystals may form small lumps (tophi) on your ears, toes, hands and elbows. Tophi are usually painless but over time can grow and may deform joints.
• If you don’t treat your gout correctly, the time betweenattacks can get shorter and more joints can be affected.

Eczema

What is Eczema?

An eczema victim’s skin not only becomes inflamed, but also usually develops a persistent itchiness – often with blisters that weep and then form dry scabs and crusts. Mostly it strikes during childhood and clears up after puberty and adolescence. However, many people are affected in later life especially housewives with an allergy to bleaches, detergents, wax polishes and so on, who get eczema on their hands.

The two most common forms are:
• Contact eczema: which develops in minutes and is caused by reactions to anything from rubber shoes to metal watchstraps.
• Atopic eczema: which usually affects people with a family history of asthma or hay fever, and can take months or years to develop, appearing at any time.

High Blood Pressure

Everyone has high blood pressure. Your heart, pushing the blood through the blood vessels, through your body, creates the pressure. Pressure is needed to get blood around your body. Your blood pressure can go up and down during the day, depending on what you are doing and how you are feeling. People have high blood pressure when their blood pressure is constantly higher than is needed, even when they are relaxed and sitting quietly. About 40% of people at
retiring age have high blood pressure.

People at Risk

You are at higher risk of having high blood pressure if you:
• Have other family members that have high blood pressure
• Are overweight, don’t exercise
• Have too much salt in your diet
• Take the oral contraceptive pill
• Take certain medicines
• Drink too much alcohol

If high blood pressure is not detected early enough and treated it can lead to:
• Stroke: a blood vessel supplying a part of the brain is blocked or leaks
• Heart attack: a narrowed blood supplying the heart is totally blocked
• Heart failure:- heart becomes exhausted and can’t keep the blood circulating
• Kidney damage
• Eye damage
• If you smoke, you are more likely to have these problems

Signs & Symptoms

Usually there are no symptoms of high blood pressure until the continued pressure damages certain organs. This can happen after years of having high blood pressure. Having your blood pressure checked every 1 – 2 years could detect high blood pressure before any damage is done.

When your blood pressure is measured, your reading will include two numbers eg. “120 over 80”. These refer to the systolic (“120”) and diastolic (“80”) blood pressure. Systolic blood pressure is the pressure inside the blood vessels when the heart pumps blood through the body. Diastolic blood pressure is the pressure inside the blood vessels in between heart beats, when the heart is resting.

Kidney Stones

A kidney stone (or calculus) is a hard, gravel like mass, which forms in the kidney and may pass into the ureter (the tube linking the kidney with the bladder). Urine usually collects in the kidney before being excreted through the ureter into the bladder and out of the body through the urethra. In some people, certain substances in the urine are present at excessive levels. These substances form crystals, which gradually combine to create a stone.

Causes of a Kidney Stone
There are several types of kidney or urethral stones.The most common types of kidney stones are formed from calcium oxalate or phosphates. The reasons for the over production of one or more of these substances in the urine are often difficult to determine, but may be caused by a metabolic malfunction. This disorder is sometimes due to an overactive parathyroid gland. The gland’s over activity causes a build up of calcium in the urine. In addition to an excess of
a normal constituent of the urine, another cause of kidney stones is the presence of an abnormal constituent. This may be the result of certain rare inherited metabolic disorders. Kidney or urethral stones resulting from a urinary tract infection are quite rare. Bacteria act on the urea, which is contained in urine to produce stones, composed of calcium, magnesium and ammonium phosphate. Stones are quite common. In Australia, about 5,000 people a year have a kidney or urethral stone. This complaint occurs more frequently in men than in women and is more common among people over the age of 30. The problem is also likely to recur after treatment. About 60% of sufferers develop another stone.

Is a Kidney Stone dangerous?
If a stone causing an obstruction is left untreated for any length of time, it can lead to an infection of the urinary tract and inflammation of the kidney, which may result in damage and, very rarely kidney failure. However, a kidney stone is very unlikely to go undiagnosed because of the severe pain it causes.

Cystitis

Cystitis is an inflammation of the lining of the bladder. It results in the frequent urge to pass small amounts of urine, which can cause a burning or stinging sensation. The urine may have an unpleasant odour or may contain blood. It may also cause feelings of pain and tenderness in the lower part of the abdomen, and fever and chills may also be experienced.

Causes of Cystitis
Usually, the cause of cystitis is a bacterial infection, commonly from a bacterium called E.coli. Cystitis is more common in women than men because of their shorter urethra (the tube that carries urine from the bladder). This allows the transmission of bacteria to the inside of the bladder more easily. Anything that obstructs the flow of urine out of the bladder increases the risk of infection by encouraging urine to stagnate. For example, cystitis may occur more often in people who have a narrowed urethra due to previous infections. For men, the most likely cause of out flow obstruction is an enlarged prostrate gland, a
condition that is a common problem for elderly men.
Pressure on the bladder outlet, for example during pregnancy or from a contraceptive cap (diaphragm), also increases the risk of cystitis.

How is Cystitis diagnosed?
Cystitis is diagnosed by the symptoms and the test results of a urine sample, which is sent to a laboratory for examination. A culture is grown from the sample to identify the organism responsible.

Symptoms of Cystitis
• Pain, often with a burning, stinging sensation, when passing urine.
• Urge to frequently pass small amounts of urine, which may be cloudy, smell fishy or contain blood.
• Pain in lower abdomen.

Osteoporosis

What is Osteoporosis?
Osteoporosis is a chronic disease in which the bones progressively lose some of their calcium and other minerals, and therefore become brittle and fragile. People with advanced osteoporosis may suffer spontaneous fractures, especially of the ver tebrae (the bones of the spinal column). The spine becomes compressed, leading to shortened height and a deformed back-kyphosis (the so-called dowager’s hump). Fractures around the hip are also common.

What causes Osteoporosis?
With ageing, almost everyone experiences some loss of bone mass, but incidences of severe osteoporosis are more common among women than men. Asian and white Caucasian women who are fine-boned are more vulnerable than Afro-Caribbean women, who tend to have heavier bones. The underlying causes of osteoporosis are poorly understood. It is known that after the age of 35, the body creates less new bone and is less efficient in absorbing and storing calcium, resulting in the loss of about 1% of bone mass every year. Women are more likely to be affected as they have about 30% less bone mass than men. Oestrogen seems to be important in female bone metabolism because women lose bone mass at an accelerated rate during the first 5-10 years after the menopause. Other factors that contribute to osteoporosis include smoking, heavy alcohol use, and inactivity. People who are bedridden lose bone mass at an even higher rate than postmenopausal women.

Symptoms
• Loss of height and development of a dowager’s hump
• Fragile bones that break easily or spontaneously in severe cases
• Backache

How is Osteoporosis diagnosed?
X-rays and other tests to check bone density may be performed if you are in a high-risk group. Treatment may stop the progression of osteoporosis but cannot usually repair the damage already done.

Deafness

There are two major types of deafness: sensorineural, which is caused by interference with the inner ear’s ability to process sound; and conductive, caused by anything that prevents sound-waves from reaching the inner ear (such as ear wax). Sound waves are vibrations created in the air. The vibrations pass through the outer and middle portions of the ear into the inner ear. There are tiny hair like cells that line the cochlea (the bony, snail-shaped structure where hearing is received), transform the vibrations into nerve impulses. These pass along the auditory nerve to the brain for interpretation. Rarely, there may be damage to the auditory nerve from a brain tumor or other serious neurological disorder.

Symptoms & Signs of Deafness
• Decreasing ability to hear the radio or television at volumes that are comfortable to others.
• Difficulty in hearing in noisy situations, such as groups, family meals, etc.
• Social isolation, depression, and even confusional states in the elderly.

What causes Deafness?
Most sensorineural deafness is due to damage to the delicate hairs or nerve fibers in the cochlea. Gradual hearing loss due to cumulative damage occurs as a natural process beginning in childhood. However, a 30% loss in hair cells can be sustained without measurable hearing impairment.

The other common causes of sensorineural hearing loss are:
• Natural ageing process: one to six people over the age of 70 years need a hearing aid.
• Viral labyrinthitis: an infection in the inner ear.
• Excessive noise: This can be chronic exposure to loud music or other sounds, or short-term exposure to very loud noise.
• Medications that damage the tiny inner ear structures:
- Aspirin (temporar y), antibiotics, quinine and some
- diuretics (drugs that help remove excess water from the body) are the most common examples.
• Meniere’s disease: This causes dizziness and tinnitus (ringing in the ears) in addition to deafness.

These kinds of deafness are characterized by the patients mild to moderate loss of discrimination of speech.

Conductive Deafness may be the result of:
• Impacted earwax.
• Middle and outer ear infections: These are characterized by discharge and sometimes pain and always requires specialist medical attention.
• Otosclerosis: Here bones in the middle ear become fixed. This is a progressive disorder, beginning in young adults, and can be corrected by surgery.
• Perforated eardrum.

Mastitis

Mastitis is inflammation of the breast. It most commonly affects lactating (milk producing) women in the first two months following childbirth, and is usually due to infection. This form of the condition is also known as infective, acute, or puerperal mastitis. The affected area may become red, shiny, hot and painful, and pus may exude from the nipple. It may also become too painful to continue breastfeeding from the affected breast.

Causes of Mastitis
Mastitis is most often due to infection, usually by staphylococcal bacteria, which have entered through a cracked nipple that occurred as a result of breast-feeding. It may also be due to a blocked milk duct, which may happen if the breast is not emptied during a feed. This may cause a swollen, red, tender lump or inflamed area, due to a build up of milk behind the duct, which is then vulnerable to infection.
A type of mastitis may also occur as a result of changing hormone levels, especially in women aged in their thirties and for ties. Other, much rarer, causes of mastitis include; mumps, septicemia (blood poisoning), tuberculosis and the fungus-like bacterial disease called actinomycosis.These formonly a tiny percentage of mastitis cases.

Symptoms of Mastitis
• Localized, red, painful area in the breast
• Local hardness in the affected area
• Swelling of the breast
• Obvious increase in local heat
• Pus oozing from the nipple
• Sometimes-local glazing and thinning of the skin
• Sometimes-visible pus formation under the skin
• Fever
• Malaise (general upset)
How is Mastitis diagnosed?
Acute mastitis is diagnosed from the history (often of breast-feeding and cracked nipples), a discussion of the symptoms and a physical examination. For nursing mothers it is important to relieve engorgement (over filling with milk), which will make the condition even more painful, by expressing (extracting) the milk. This can be done naturally, by rhythmical squeezing of the breast, working from the outer part in towards the nipple, or by means of a breast
pump. If mastitis is not treated promptly, there is a risk that it will lead to a breast abscess (collection of pus), causing extreme pain in the breast and, possibly, fevers and chills.This will require surgery, in which the abscess is drained.

Is Mastitis dangerous?
Mastitis offers little or no risk to life, even if an abscess develops, but it can be painful if treatment is not started promptly.

Menopause

What is Menopause?
Technically the term menopause refers to the permanent ending of monthly periods, but in general use it often embraces the wide range of accompanying symptoms which make up the climacteric, or “change of life”. This phase of a woman’s life, when her ovaries stop producing eggs and her fertility declines and eventually ceases, may begin anywhere from the early for ties to the mid-fifties and usually takes two or three years. In a few women menstruation may stop suddenly with no previous change in the cycle, but in most women the menstrual cycle becomes irregular. Often periods become less heavy and occur further apart. However, they may occur more often, or follow the usual timing but with some missing altogether. Bleeding or spotting between normal periods, or after sexual intercourse, should always be discussed with your doctor – as should any bleeding that occurs a year or more after the last period.

During the menopause, the ovaries reduce and finally cease production of not only eggs but also of estrogen, the hormone that maintains the female reproductive function. Some estrogen is still made somewhere in the body, particularly beneath the layers of fat beneath the skin, so plumper women experience less effects.

Signs and Symptoms of Menopause
Loss of estrogen brings about such symptoms as:
• Hot flushes
• Sweating at night
• More frequent need to pass urine
• Uncomfortable lack of lubricating fluid in the vagina
• Anxiety
• Irritability
• Lack of concentration
• Insomnia
• Mood swings, and
• Depression.

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