Health

National Household Drug Survey-Ministry of Health

February 24, 2017

The Ministry of Health, in collaboration with other government agencies, is currently dispatching a team of persons into various communities throughout The Bahamas to conduct a national household drug survey during the months of February and March 2017...

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Rheumatoid arthritis is more than just a joint disease

February 21, 2017

At it's most basic, the average person would describe rheumatoid arthritis (RA) as joint pain, but the disease is not purely joint disease and goes beyond that. It's a painful and destructive joint disease that can cause deformity in the hands, affect the heart, eyes and lungs, and even shorten a person's life span. Further, patients with prolonged inflammation can develop insulin-resistance, a risk factor for diabetes, according to rheumatologist and internal medicine specialist Dr. K. Neil Parker.
While Dr. Parker said arthritis is a common disease, he said since he has returned home to practice, he's seen quite a few cases of Bahamians with dramatic cases of arthritis.
The good news is that RA can be treated safely, effectively and affordably, but diagnosis must be made as early as possible, and treatment began to control the condition to ensure the best outcome for patients.
"Rheumatoid arthritis is an autoimmune disease. This is a condition where the body attacks itself. The body fails to recognize a part of itself as friendly and basically attacks it," said Dr. Parker at the most recent Doctors Hospital Distinguished Lecture Series. "That component in rheumatoid arthritis is the synovium of the joint, a particular component of the joint lining, and that causes inflammation, it causes pain and it causes the arthritis of rheumatoid arthritis."
It's a disease that affects approximately one percent of the world's population. About 0.5 percent of the population will develop rheumatoid arthritis on an annual basis, he added.
Dr. Parker said it's a disease primarily of middle-aged to elderly people, even though some young patients can get it. The peak age in females is between 40 to 60 years, with males tending to be a bit older. He said there's a slight female predominance, and twice as many females as males have it.
The slight female predominance in RA is thought to be related to the hormonal axis (hypothalamic pituitary adrenal axis). He said the disease is also associated with tragic or serious life events which can also have a hormonal component to them.

Impact of Rheumatoid arthritis
"Beyond it being a joint disease, it's a disease that increases the risk of coronary artery disease, or atherosclerosis, which drives not only coronary artery disease, but strokes. It also increases the need for surgeries -- it's a disease that causes disability, loss of productivity. It can really affect quality of life, and can actually shorten your life as well and increase your mortality."
The rheumatologist and internal medicine specialist said rheumatoid arthritis can be familial, but that it's not 100 percent a genetic disease.
"There is interplay like most conditions between the genes and the environment -- evidenced by the fact that if you have identical twins, if one twin has it, there is a 15 to 30 percent chance that the other twin will develop it; if you have non-identical twins, there is about a five percent chance that the other twin will develop it. The best-established gene that's associated with rheumatoid arthritis is the HLA-DRB1 gene and that really increases the risk of rheumatoid arthritis in individuals who have it."
The best-established environmental risk factor for rheumatoid arthritis is smoking, according to the doctor. When you smoke, it causes an activation of an enzyme in the lungs that produces proteins which the body makes the antibodies to.
"Smoking will increase your risk factor about two-fold. And if you have the genetic predisposition, combine that with smoking, and your risk for rheumatoid arthritis goes up to about 40-fold compared to the general population."
The risk improves after you stop smoking, but he said it takes about 10 years for a person's risk of rheumatoid arthritis to go down to approach that of the non-smoking population.
In addition to smoking there are some viruses that are associated with rheumatoid arthritis, but he noted that there is no definitive proof, or the mechanism isn't well established.
"It is believed that certain infections, if you get them, while your body responds to them it produces antibodies that cross react with your joints, and can trigger rheumatoid arthritis. We call that molecular mimicry. And there is also an association of gum disease with rheumatoid arthritis -- so all of this 'feeds' into the fact that there is interplay between your genetic risks and the environment."
Dr. Parker said in the rheumatology world there is excitement surrounding the makeup of bugs in the stomach that potentially predispose a person to autoimmune diseases like RA. It's research that he says is ongoing, but that a person basically has to have some susceptibility to have RA. And then once you get to modification of your gene from a risk factor like smoking, to bugs in your stomach, or the bugs in your gums, this leads to alteration of the genes.
"The body begins to produce antibodies against itself which leads to the arthritis, and also the other associated problems that go along with rheumatoid arthritis like the vascular disease, potential metabolic syndrome; increased inflammation can produce insulin resistance which drives diabetes as well," he said.
A person's immune system (innate and adaptive) allows a person to fight off infections and to stay healthy. He said the immune system is involved in RA, and that the cells develop the propensity to attack the joints, and begin to develop proteins that further the attack.
One of the most significant markers of RA is erosion of the bones, and that, he said, occurs early in the disease, which is why it's imperative to diagnose the condition early and treat it aggressively and appropriately; he said bony erosions are driven by cells that "eat" through the lining of the bone and actually go into the marrow as well.
"We go from having a nice healthy joint, healthy cartilage and fluid -- then the rheumatoid arthritis starts, the synovium gets angry, it produces inflammation, cartilage begins to get destroyed, as the cartilage wears away, you get fibrous tissue developing in the joint, and eventually the bones fuse, and you get the fusion of the joint itself. So you go from having a nice normal joint to a totally fused and destroyed joint."

How do you know if you have rheumatoid arthritis?
Dr. Parker said RA generally has an insidious onset over weeks to months.
"You have the joint pain, you have stiffness, some patients can have fever, some patients can have fatigue and this develops and progresses over months. There are some patients that get very sick, very fast, but that tends to be the minority. And there are some patients who just develop joint pain in one or a few joints that go away -- we call that palindromic rheumatism and about half of these patients will go on to develop rheumatoid arthritis."
There are differences between RA and osteoarthritis. Regular osteoarthritis, the doctor said, is a wear and tear disease. In addition to the significant inflammation in rheumatoid arthritis, RA affects a different subset of joints.
"Rheumatoid arthritis tends to be a symmetrical disease within the joint and outside the joint. In addition to the pain, a significant proponent of rheumatoid arthritis is stiffness. This stiffness you can get with regular osteoarthritis, but with rheumatoid arthritis, the stiffness tends to last for an hour or more. Patients usually take a long time to get going. If they sit down, if they stop moving, the joint becomes stiff, and it takes a long time for the joint to loosen up. As they get going the stiffness resolves. You can also experience pain in the feet, in addition to the wrist and hands, and the ball of the foot. Early in the disease the neck stiffness has to do with ligamental inflammation. Rheumatoid arthritis tends to affect the upper neck, but not the lower back."
Dr. Parker said RA is not just a joint disease, but a whole body disease. He said patients can develop rheumatoid nodules to pressure points at the elbows and fingers that tend to be firm and tender. He said the lungs and eyes can also get involved, and patients can get secondary Sjojgren's syndrome, and a lot of patients will end up with dry eyes and dry mouth if the joint is not treated, and end up with extensive joint damage.
"In addition to the joint damage, you can get deformities. There are certain classical deformities -- swan neck deformity, boutonniere deformity, and also deviation of the fingers to the outside of the hand away from the thumb. They tend not to be reversible when they occur, however treatment would prevent those things from happening."
Extra-articular manifestation, he said, can be seen in about half of the patients with RA. Patients also can be anemic and have enlarged lymph nodes. He said RA is also associated with increased risk of lymphoma, not necessarily being related to the treatment, but some of the treatments can increase risk for cancer as well. Specific syndromes patients can see are enlarged spleens, and low white cell counts.
Up to 30 percent of patients with lung disease can have RA. They can have interstitial disease, or fibrosis of the lungs, as well as involvement of the pleura.
"Lung involvement is the third leading cause of death in patients with rheumatoid arthritis, behind infection and cardiovascular disease. In addition to involvement in the lungs, you can get involvement or inflammation in the lining of the heart and that would present with chest pain when you breathe in. You can also get accelerated atherosclerosis with rheumatoid arthritis. Patients can also present with pain in the eye, blurred vision, redness in the eye --rheumatoid arthritis can affect multiple layers in the eye, giving you various different presentations."

Testing, diagnosis and treatment
Diagnosing RA, or any inflammatory arthritis, Dr. Parker said can be difficult to distinguish from gout as a result, and an important component of diagnosing the condition is to actually remove fluid and send it to the lab for analysis.
But he advised that making a diagnosis is important because diagnosing the condition and treating it early prevents the damage.
"It's a clinical diagnosis, so there are a number of factors you want to take into consideration -- the number of joints, and the size of the joints is important in determining if you have rheumatoid arthritis. Larger joints tend not to be as specific. The more joints you have and the more small joints [in your hands and fingers] you have, the more likely it is you have rheumatoid arthritis. The antibodies, while not being necessary, significantly increase your risk of having rheumatoid arthritis. If you have inflammatory markers in your blood, whether they're positive or negative, that increases your risk of having rheumatoid arthritis."
If you have symptoms for more than six weeks, he said that's considered chronic arthritis, which again increases the risk.
The 2010 American College of Rheumatology and the European League Against Rheumatism's classification for rheumatoid arthritis lists 10 components that comprise arthritis. To have a RA diagnosis, the doctor said a patient would have to score at least six or more out of the 10 of the components to be clinically diagnosed with RA.
Dr. Parker said treatment could be thought of as two components -- treatment of the pain, and stopping the condition. They utilize disease-modifying anti-rheumatoid drugs to stop or arrest the progress of the disease.
"You want to employ the drugs within the first three to six months of diagnosis to give yourself the best chance of arresting the destruction of the joint. A number of patients will not be able to be controlled with simple oral medications and there are multiple biologic medications that can be used to treat the rheumatoid arthritis. So it really becomes a matter of what the patient responds to, and escalating the care overtime. Generally, patients are assessed every three months after they're stable to determine the effectiveness of the treatment."
To determine if treatment is effective, Dr. Parker said they have a number of disease activity scores that incorporate the patient's perception of pain -- the number of tender joints they have, the number of swollen joints, and their blood work in terms of markers of information to determine whether or not the patient's disease is controlled.
In addition to early and aggressive treatment, he said they treat to remission or low disease activity.
"When treating patients for rheumatoid arthritis, we use a joint count as well as the patient's assessment of how painful they are, along with their markers for inflammation. We actually calculate a score. When treating patients for rheumatoid arthritis we generally count the shoulders, the elbows, the joints and hands and the number of tender and swollen joints they have in addition to their blood work and how they feel and calculate a literal score, and use them from visit to visit to track how the patient is progressing."
If a person scores less than 2.6 they are considered to be in remission. And Dr. Parker said ideally, that's where they want to get a patient, but if not, low disease activity of 2.6 to 3.2 is acceptable.
For a patient to be considered in clinical remission at least five of the following -- morning stiffness of not more than 15 minutes, no fatigue, no joint pain, no joint tenderness or pain on motion, no soft tissue swelling in joints or tendon sheaths -- must be present for at least two consecutive months.
He said medical professionals could determine if a patient is at risk for aggressive disease if the following are present -- younger age of onset, the more joints involved, poor functional status, whether they have extra-articular features, whether they have rheumatoid nodules, whether or not their antibodies are positive, and if they have co-morbid cardiovascular disease. If they have the indicators, he said an aggressive course and intensive treatment is needed.

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Rechargeable hearing aids are the trend of the future

February 21, 2017

For those who wear hearing aids, one of the more notable complaints is the constant change of batteries that must take place on a regular basis for optimum hearing aid performance. Depending upon the size of the hearing aid and the degree of hearing loss, a hearing aid user may have to replace batteries as frequently as every four days to two weeks. And although replacing the battery is an easy fix for most, for many, particularly the elderly, who may suffer from dexterity issues, arthritis, and an array of other conditions, changing a tiny hearing aid battery can be extremely challenging. Remember, the smaller the hearing aid, the tinier the battery.
Furthermore, in this age of electronic devices -- cell phones, tablets and computers, where everything is a simple charge and go, and where we easily read an indicator that tells us when a charge is needed, more and more hearing aid users are looking for hearing aids that offer the same ease of use. On average, a hearing aid user may change as many as 100 zinc air batteries over a period of one year if using a pair of digital hearing aids. To them, it is often an inconvenience to change their hearing aid batteries so frequently. As a matter of fact, to those with dexterity loss, it is a painful task to endure and they may have to depend on others to do it for them. It can also be extremely frustrating when a hearing aid battery dies while listening to something important and a new battery must be quickly found. Over the years hearing aid manufacturers have been listening and are now manufacturing rechargeable hearing aids that give hearing aid users more options, flexibility, ease of use, and peace of mind.

About rechargeable hearing aids
There are two main types of rechargeable hearing aids, each using a different type of rechargeable battery:
o Hearing aids using replaceable rechargeable batteries: This type of rechargeable hearing aid comes with a battery that only needs to be replaced about once a year. The user places the hearing aids or rechargeable batteries into its charger when not in use, usually at night while sleeping. The hearing aids or batteries are then charged overnight and in turn offer a full day of listening the next day.
o Hearing aids using built-in rechargeable batteries: This type of rechargeable hearing aid option comes with a built-in rechargeable battery. With this type of rechargeable hearing aid, the hearing aids are placed into the charger overnight to offer a full 24-hour day of listening once removed from the charger. The best part of this rechargeable hearing aid is the hearing aid user does not have to worry about changing the battery because it is built into the hearing aid. Just charge and go.

Benefits of rechargeable hearing aids
More features: Rechargeable hearing aids mean greater battery life with a steady power supply. This means more features of the new digital hearing aids can be used before a charge is needed. With regular batteries, the battery drain is significantly more when additional features are used resulting in the use of more batteries over a shorter time.
Easy to use: Rechargeable hearing aids mean batteries are much easier to deal with, and in some cases, not necessary to deal with at all. For elderly hearing aid wearers, those who have arthritis, or those with difficulty manipulating small objects, rechargeable hearing aids make hearing aid use even more enjoyable.
Less stress: Rechargeable hearing aids mean no more worrying about a battery going dead during an important listening event. No more fussing around to buy hearing aid batteries, and no more inconvenience of changing batteries every week. The handiness of only changing batteries once a year, or not at all, makes rechargeable hearing aids a far better, stress free option for hearing aid users.
Cost savings: The average life of a hearing aid is about five years. During this time, a hearing aid user may spend as much as $500 on batteries for a set of hearing aids. On the other hand, rechargeable hearing aid batteries cost about $350 for the same time frame. Use of rechargeable hearing aids will soon become the future trend.

o For further information on any hearing-related disorder, please contact Dr. Deborah Nubirth, doctor of audiology, in New Providence at Comprehensive Family Medical Clinic, Poinciana Drive at 356-2276 or 677-6627 or 351-7902 in Grand Bahama; or email dnubirth@yahoo.com.

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Regional nurses excelling at specialized training at UWI second cohort to start in May

February 21, 2017

The first cohort of Caribbean nurses undergoing specialist training to care for children with cancer and blood disorders have all successfully completed the first semester.
Thirteen nurses from The Bahamas, Barbados, Jamaica, Trinidad and Tobago and St. Vincent and the Grenadines, enrolled in a specialized one-year nursing training program at the University of the West Indies (UWI) School of Nursing (UWISoN) in El Dorado, Trinidad and Tobago last September.
The training is part of a partnership with SickKids-Caribbean Initiative and is being funded by the FirstCaribbean International Comtrust Foundation, the charitable arm of regional bank, CIBC FirstCaribbean. The nurses successfully completed their first semester in the Paediatric Haematology/Oncology Nursing Program.
The 13-week semester consisted of online learning, in-class learning at UWISoN and clinical practicum at the Eric Williams Medical Sciences Complex (EWMSC).
They focused on building foundational knowledge and skills in general paediatric nursing and specialty knowledge and skills in paediatric oncology nursing care. The students started Semester 2 on December 5, 2016 with five weeks of online learning. In-class learning began on February 6, 2017, and will be complemented by six weeks of clinical practicum both at EWMSC and at their home institution, culminating in a final twelve-week internship component at their home institutions.
The second cohort of students will begin the program in May 2017 and will also include nurses from St. Lucia.
CIBC FirstCaribbean's partnership with SickKids Foundation extends from the signing of a memorandum of understanding in Barbados in 2013 when the bank pledged to provide $1,000,000 over a seven-year period to train medical professionals specializing in the care of pediatric patients affected by cancer or blood disorders such as sickle cell disease. The partnership is being undertaken in collaboration with the UWI.
SickKids Foundation is a charity registered in the Caribbean to do, among other things, fund training for Caribbean medical professionals as part of the SickKids-Caribbean Initiative (SCI) through the Centre for Global Child Health at The Hospital for Sick Children (SickKids) in Toronto, Canada.
"CIBC FirstCaribbean is delighted at the progress of the participants in the training program," said Debra King, director of corporate communications at the bank and trustee of the FirstCaribbean International ComTrust Foundation Ltd. "We have every confidence that they will all successfully complete this vital training which will greatly increase their capacity to care for some of the region's most vulnerable children."
The overall objective of the SickKids-Caribbean Initiative is to enhance the care of children in the region who are affected by cancer and blood disorders, and ultimately increase the survival rates. The five-year plan that was developed by SickKids in association with their Caribbean partners addresses the region's gaps in capacity to advance diagnosis and the treatment of pediatric cancer and blood disorders.
It also aims to create awareness throughout the region of childhood cancers and blood disorders.

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The bump that can develop from wearing pumps

February 21, 2017

Pump bumps are painful, swollen bumps behind the heel, where the shoe rubs against the back of the ankle. It usually affects young women in their 20s and 30s who love to wear high heel shoes. The official name for this bump is Haglund's deformity, which is extra bone growing on the back of the heel bone. The soft tissue near the Achilles tendon becomes irritated when this bone rubs against shoes.
The rigid backs of pump-style shoes cause pressure that aggravates the enlargement when walking. The shape of the calcaneus (heel bone) and persons with high-arches, a tight Achilles tendon, and a tendency to walk on the outside of the heel, are at higher risk for developing a pump bump.
Haglund's deformity can occur in one or both feet. The primary symptom of Haglund's deformity is pain at the back of the heel, especially in the area where the Achilles tendon attaches to the heel bone. Over time the tissues over the boney bump thicken causing a callus to form. This area becomes inflamed while wearing shoes. The bursa on the back of the heel may become red, swollen and inflamed causing bursitis.
You can prevent Haglund's deformity by wearing appropriate shoes, avoiding shoes with a rigid heel back, using arch supports or orthotic devices recommended by the podiatrist, performing stretching exercises to prevent the Achilles tendon from getting tightened, and avoid running on hard surfaces and running uphill.

Diagnosis and treatments
The podiatrist will diagnose the problem starting with a complete history and physical examination. Usually the bump is obvious and easily seen on the back of the heel. X-rays will be taken so the podiatrist can see the shape of the calcaneus and to make sure there is no other cause for your heel pain.
Non-surgical treatment of Haglund's deformity is aimed at reducing the inflammation of the bursa. While these methods can help the pain and inflammation, they will not shrink the bony enlargement of the heel bone.
The primary cause of the problem is wearing shoes that press on the back of the heel. One easy way to remove the pressure from the back of the heel is to wear shoes with no back, such as clogs. If you must wear shoes with backs, heel pads placed over the back of the heel may give some relief. Staying out of shoes as much as possible will usually reduce the inflammation and the bursitis due to Haglund's deformity.
If the pain continues, see a podiatrist who will treat the condition. Oral non-steroidal anti-inflammatory drugs (NSAIDs) may be recommended to reduce the pain and inflammation. Ice can be applied to inflamed area to reduce swelling. Use ice for 20 minutes and then wait at least 40 minutes before icing again several times a day. Stretching exercises help relieve tension from the Achilles tendon and increase its flexibility. Heel lifts placed inside the shoe can also decrease the pressure on the heel. Ultrasound and other therapies can help to reduce inflammation. Insoles or orthotics (custom arch supports) help control the motion in the foot and relieve some pain.
If these strategies do not solve the problem, surgery may be needed. The surgical procedures designed to treat Haglund's deformity cut off a part of the heel bone to reduce the enlargement on the back of the heel. This will decrease the pressure from the shoe and prevent the pain. Over time, the thickened tissues will shrink back to near normal size if the pressure is removed.

o For more information email foothealth242@gmail.com or visit www.apma.org. To see a podiatrist visit Bahamas Foot Centre on Rosetta Street, telephone 325-2996, or Bahamas Surgical Associates Centre, Albury Lane, telephone 394-5820, or Lucayan Medical Centre on East Sunrise Highway, Freeport, Grand Bahama, telephone 373-7400.

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Walk down a new street

February 21, 2017

I always remember, that when I was younger I'd arrive in a completely new town or city, wherever in the world it happened to be -- in Europe, North America, the Caribbean, the Far East or Australia -- I'd make it a point to explore different parts of the city or town each day so that I could get a real feel, so to speak, of the city or town and its people. Or as the title of today's article simply puts it, I'd walk down a new street every day. Well my friend, as you travel the road of life always looking for the proverbial success city, I suggest that you do likewise. In other words, you constantly keep on exploring new ways, new avenues to advance to the destination of your choice.
In a nutshell, when one street does not lead you to where you want to be, you don't throw your arms up in the air and quit trying to pursue your dreams, reach your goals and objectives. Oh no, on the contrary, you keep on trying something new, something different, until you eventually make it and arrive at your chosen destination. I guess in the end it's all about expectation, trying to find an avenue that will automatically end in success as you find exactly what you're looking for.
Yes indeed, today's lesson is all about exploring different avenues for succeeding in life and thus finally assisting you in arriving at a destination where you feel really comfortable, thus experiencing the great success you've been seeking.
You see -- if you really want to be successful, you have to be prepared to experiment a whole lot to find out what works for you. Don't forget, [Thomas] Edison had to fail some 10,000 times before he finally perfected the electric light bulb. Likewise we all have to experiment trying new ways in which to achieve the success we seek. If one way doesn't work, don't quit, but simply walk down a new street and believe me you'll eventually arrive at your chosen destination.

o Think about it!
Visit my website at: www.dpaulreilly.com.
Listen to "Time to Think" the radio program on STAR 106.5 FM at 8:55 a.m. & 6:20 p.m.

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CIBC FirstCaribbean Donates to Diabetes Support Group
CIBC FirstCaribbean Donates to Diabetes Support Group

February 14, 2017

A life-saving diabetic device was recently donated to a local Diabetes association. CIBC FirstCaribbean International Bank donated a Dexcom Continuous...

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The reality of caregiver syndrome (stress)

February 13, 2017

You do everything you can in taking care of a chronically ill dependent to the point where you neglect your own emotional and physical health. You find yourself exhausted, angry, filled with rage or guilt -- this is known as caregiver syndrome (caregiver stress). It is a condition of exhaustion, anger, rage or guilt that results from unrelieved caring for a chronically ill dependent. This oftentimes creates a degree of what is referred to as "caregiver stress" which includes social isolation, possible loss of income, lack of sleep, mental exhaustion and general fatigue. The risk of getting this syndrome is highest when caring for an individual with behavioral difficulties such as faecal incontinence, memory issues, sleep problems, wandering, and aggressive behavior by the person receiving care.
Caregiver syndrome (stress) is real, and caused by the overwhelming duty of caring for a disabled or chronically ill person, according to Family Medicine Specialist Dr. Patrick Whitfield.
"The stress on the caretaker is caused by an increased stress hormone level for an extended period of time. This results in increased blood pressure, heart rate and lack of sleep, eventually resulting in generalized fatigue, and in some cases depression," said Dr. Whitfield.
The person in declining health isn't the only one suffering. Caregivers also suffer the grief of a declining loved one, which attributes to a depressive-exhaustive state development, and a deteriorating emotional and mental health, says Dr. Whitfield.
"Double-duty caregivers are those already working in the healthcare field who feel obligated to also care for their loved ones at home," he said. "This over-exhaustion and constant caregiving role can cause an increase in physical and mental health deterioration. It is actually being thought that a part of the stress of being a caregiver is from how they feel about the job. In other words if a caregiver does not like or want to be a caregiver, they will inflict more stress on themselves by accepting the role."
The doctor said that daily, hundreds of older people -- 65 years of age or older -- are managing basic health and functioning needs with the help of family caregivers, and that it is becoming increasingly common that many younger Bahamians are requiring the same level of assistance as a result of trauma and strokes.
The result of care given to elders varies across the socioeconomic spectrum that subsequently impacts a person's quality of life in their end stage. In the absence of the financial capacity to employ the necessary caregivers, Dr. Whitfield said care for a loved one has to be assumed by family members. He said it commonly results in one relative assuming the role, with little, if any, assistance rendered by other relatives.
Family caregivers he said are typically close family members, partners, friends or neighbors who tend to provide help because of a personal relationship rather than financial compensation. Oftentimes, he said this leads to loss of income and social isolation of primary family caregivers.
Tasks caregivers may engage in could extend beyond just looking after a person, and include arranging and attending medical appointments, participation in routine and high-stakes treatment decisions, coordination of care and services, help with daily tasks such as dressing and bathing, managing medicines, obtaining and overseeing the use of medical equipment such as oxygen tanks, handling bills, and banking.
The doctor said that older caregivers are not the only ones who put their health and well-being at risk. And that Baby Boomers who have assumed the caregiver role for their parents while simultaneously juggling work and raising adolescent children, face an increased risk for depression, chronic illness and a possible decline in quality of life.
"Challenges are exacerbated when caregivers are in poor health themselves, and don't have a choice about assuming the caregiving role because no one else is available and willing."
He said many family caregivers most often are also employed, and work in low-wage jobs with limited flexibility in their work schedules. They too then develop medical issues due to their unhealthy lifestyle -- sleep deprivation, poor eating habits, failure to exercise, failure to stay in bed when ill, and failure to make medical appointments for themselves.
"As our rates of cancer, strokes, heart disease, high blood pressure, dementia and diabetes continues to escalate, we can expect that many persons currently in their 60s can expect to have substantial care needs, which are defined as having dementia or needing assistance with two or more self-care activities -- eating, bathing, dressing, toileting, or getting in or out of bed," said the family medicine specialist.
Greater rates of childlessness, smaller and more geographically dispersed families, income levels and increasing participation of older women in the labor force pose threats to the availability of family caregivers to meet the needs of the growing number of older Bahamians, according to the doctor.
With advances in medicine having extended life expectancy, that in turn he said has resulted in the duration, complexity and technical difficulty of care required by older adults and delivered by family caregivers.
He also said healthcare professionals also do not typically assess family caregivers' knowledge, understanding, or proficiency in the tasks they are expected to perform at home.
"Family caregivers describe learning how to provide care by trial and error, and being fearful of making a mistake that will cause harm."
In an effort to minimize caregiver stress, the doctor's prescription includes the caregiver taking time for themselves, recognizing and knowing their limit, sticking to a routine, asking for help, getting enough sleep, learning about sundowning and how to cope with it, and ensuring that caring for a loved one is a team effort.

Tips to minimize caregiver stress
Take time for you: It's easy to get burned out when you're caring for a loved one -- whether it's a special-needs child, a spouse with chronic illness, or a frail older person. Taking time for yourself everyday -- even just a few minutes if you can get relief, is one way to help you recharge. Slip out for a 20-minute walk, go to the movies, or pursue any hobby you love. Reducing your stress will make you a better caregiver.
Know your limits: You can't provide good care if you feel overwhelmed and stressed out. Make a list of all the tasks you need to do in a week, including dressing and bathing a loved one, rides, cooking and household chores. Brainstorm which ones someone else might be able to do. Learn when to say no, and set boundaries so you can take charge of your family and yourself.
Stick to a routine: A daily routine can be a lifesaver. It can help you feel in control rather than stressed. It lets your loved one know what to expect. That's good for people with dementia. It provides a sense of security and helps them maintain their abilities.
Ask for help: Even a few hours "off duty" can help you recharge. Make a list of family, friends, or neighbors you can call when you need a break. If finances allow, hire a home health aide.
Get enough sleep: Most caregivers who say their own health has gotten worse, blame loss of sleep. If your loved one sleeps during the day, but is awake much of the night, try to take a nap during the day. You may need to hire someone, or ask a friend or relative to stay with your relative overnight so you can get a good night's sleep.
Cope with sundowning: People with dementia can become confused or agitated in the evening. Planning for it can help them and lower your stress. Set up activities early in the day, and serve an early dinner. Turn the lights up in the evening. Check with a doctor about any physical or sleep problems that may be making the problem worse.
Make it a team effort: Hold regular family meetings to discuss the latest medical news, daily caregiving tasks, financial concerns, and your need for support. Include everyone who cares for your loved one, including paid helpers. Include distant family members in the meeting with a telephone conversation on speaker, or online video chat. Follow up with a written agreement and a calendar of tasks.

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Assistive devices for the hearing impaired

February 13, 2017

Although hearing aids are the most common form of technology used by those who are deaf and hard of hearing, there are numerous other assistive technologies available to help people with hearing loss live even more independently. In most cases, these assistive devices are used in addition to hearing aids and enhance the auditory environment and everyday life of persons with hearing loss. Below are some of the more popular assistive devices used by people with a hearing loss.
Types of assistive device
Wake-up alarm signaler: These are usually portable alarm clocks that make a loud booming noise, flashes a built-in strobe light, or vibrates the pillow to awaken the sleeping individual who is unable to hear a regular alarm clock.
Doorbell signaler: One part attaches to a lamp in the house and the other outside the door. It works with or without an existing doorbell system. When the doorbell signaler button outside the door is pressed, the lamp inside the house flashes to let the hearing-impaired person know that someone is at the door.
Telephone signaler device: Is used to alert the hearing-impaired person when the phone is ringing. It usually transmits a signal from the telephone to a receiver located in the house or office that causes a lamp to flash when the phone is ringing. Some models attach to the side of the telephone to flash and/or amplify the sound of the phone when it rings.
Portable phone amplifier: This is a portable, battery operated, amplifying device for those who struggle to hear what is being said when talking on the phone. It fits over the listening end of the phone and has an adjustable volume control so that it can be made as loud as needed.
Amplified telephone: Is different from the portable phone amplifier. This is an actual phone with a built-in amplifier, tone selector, and extremely loud ringer. In many cases the volume can be adjusted up to 55 decibels allowing the hearing-impaired person to better hear telephone conversations.
Baby cry signaler: Alerts hearing impaired parents to the sounds of their baby, in most cases, by causing a lamp to flash. This device is so sensitive it can usually pick up the softest sounds the baby makes and send out a signal.
Smoke alarm/carbon monoxide detector: Can be purchased as a single unit of one or the other, or as a combo set. The device usually features a built-in strobe light and a loud booming noise that alerts the deaf or hard-of-hearing that the smoke alarm has been activated, or that carbon monoxide has reached dangerous levels.
Weather alert: Is an actual radio that gives alerts about upcoming or dangerous weather conditions. It can be used alone or with optional alerting accessories.
Audio induction loop system: Improves the intelligibility of the sound coming directly into the hearing aid by using a magnetic field. This method greatly reduces background noise, competing sounds, reverberations and other acoustic distortions thereby improving the clarity of the speech sounds entering the hearing aids. The system consists of a microphone, an amplifier, and a physical loop of cable or cables placed around a designated area, room or building. Other types, like individual neck loops, are also available. To pick up the signals, the wearer must have his/her hearing aids in the "T" (telecoil) position and must be seated within the "looped" area. This device is great for watching TV or when attending meetings. It is often found in airports and theaters.
FM system: This is a wireless system that transmits sound via radio waves. The speaker wears a compact transmitter and microphone while the hearing impaired listener wears a portable receiver that is normally attached to his/her hearing aids. Alternatively, it may also have a headphone, neck loop or other accessories attached to it. This system can be used both indoors or outdoors and is great for group meetings, conferences, church settings, and classroom environments.
Infrared system: This is a wireless system used indoors only, to transmit sounds via infrared light beams. The receiver must be in the direct line of sight of the light beam from the transmitter. The infrared system is often used in homes to improve TV listening, but can also be found in churches, theaters and auditoriums. The transmitter is attached to the sound source while the listener wears a receiver headset with a volume control on it. Once the sound is received he/she then adjusts the volume to meet his/her hearing needs.
Personal amplification system: A personal amplification system is a small portable amplifier that can be used indoors or outdoors. It often comes with headphones or earbuds and is used to amplify one-on-one conversational speech or TV listening.
Closed captioning: Is the ability for text to be displayed on a television, video screen, or other visual device to provide additional or interpretive information to those who are hearing-impaired. "Closed" means it is hidden until activated. However, not all TV's -- particularly older models -- have the closed captioning decoder or decoder chip built into the TV. Check your user's manual for closed caption information.
Subtitles for the deaf and hard of hearing (SDH): SDH and standard subtitling are both very similar. However, SDH is written specifically for the hearing impaired viewer who may or may not be able to hear the audio of the movie being watched. SDH therefore adds information about the background sounds and who is speaking in addition to translating the script.
You should consider an assistive listening device if:
o You have trouble hearing people talking on the phone.
o You have trouble following a conversation when more than one person is talking at the same time.
o Your family complains that the TV is too loud.
o You strain to hear conversational speech.
o You have trouble hearing in noisy environments.
o You live alone and cannot hear when someone is at the door.
o You are unable to hear the regular smoke/carbon monoxide detector.
o You cannot hear your regular alarm clock.
o You misunderstand what people say.

o For further information on any hearing-related disorder, please contact Dr. Deborah Nubirth, doctor of audiology, in New Providence at Comprehensive Family Medical Clinic, Poinciana Drive at 356-2276 or 677-6627 or 351-7902 in Grand Bahama; or email dnubirth@yahoo.com.

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Love your feet

February 13, 2017

Aching feet is something that we often ignore. When it comes to our feet, at best we neglect them, sometimes we even torture them by standing, walking and running for long hours while wearing the wrong shoes. And even though our feet hurt, the next day we put on the same type of shoes and start the torture all over again. As we pause today to think of all the persons and things we love in our lives, think of your feet. Your feet deserve some love too.
Feet are located way down at the bottom of your legs, out of sight, and often, out of mind. It's easy to forget that your foot health is as important as the health of the rest of your body and mind. But your feet are very important to the functioning of your entire body. Your feet hold you up, take you places, and keep you balanced. Let's face it, if your face or some other part of the body was in pain, you'd do something or see a doctor pretty fast. But with the feet, we tend to wait and see -- often too long. Remember foot pain is not normal. It tells us something is wrong and that we need to see a podiatrist to find out what is wrong and to treat the problem.
The feet are praised as a masterpiece of art and science. They contain more nerve endings than any other part of our body and also contain 25 percent of all the bones in the body. On these amazing masterpieces we walk on average 65,000 miles in a lifetime (the equivalent of walking two-and-a-half times around the earth) often in ill-fitting shoes. Well, no wonder they hurt! Ill-fitting footwear can lead to corns, calluses, diabetic foot ulcers, bunions, foot pain and plantar fasciitis (inflammation that runs from the heel along the arch of the foot) as well as other symptoms elsewhere in the body including the back. Remember, when your feet hurt, you hurt all over.
It's time to pamper your tired feet and show them some extra TLC (tender loving care) and attention so they don't feel like they are the most abused, tortured and probably the most neglected part of the body. Pampering doesn't need to be expensive; there are alternative and reasonable ways. We want to stress that your feet are precious, they deserve to be loved and pampered too. The following are some ways to pamper your tired, aching feet.
Practice proper foot hygiene: Wash your feet every day and dry them properly, especially between the toes. Dry your feet completely before putting on socks and shoes to avoid fungal infections. Wear clean socks/hoses everyday and rotate the shoes you wear.
Wear the correct sized shoes: Not too tight and not too loose. Make sure your shoes are well made, supportive and fit properly with at least a finger's width of space beyond the end of your toes. This is to avoid getting corns, calluses, blisters, ulcers, ingrown toenails and other foot complaints. Wear the right shoes for the right sport.
Moisturize your feet while asleep: At night, before going to bed, apply moisturizers or your favorite foot oil and lotion. Wearing socks or booties can also help keep the moisturizer on your feet. It will help get rid of the dry, cracked heels and foot skin and help you achieve soft, smooth feet. If the feet are still dry and scaly, you may have a fungal infection that needs to be treated.
Foot spa and bath: One of the super-relaxing ways to pamper your feet is a foot spa. It can have a soothing effect on your feet after all the tiredness of the whole day. You can do it in the comfort of your own home or go to your favorite spa or salon for the dirt and dry skin to be scrubbed and washed away. At home you can put your feet in a basin of warm water with fragrant soap for 10 to 15 minutes, then use a foot file to scrub and exfoliate the dead skin; cut and file the nails. People with diabetes are strongly advised not to soak their feet, especially in hot water.
Foot massage: A relaxing foot massage stimulates the nerves in the feet and improves blood circulation. It helps eliminate stress, feels great and has many other therapeutic benefits. And, everyone loves a foot massage.
Your feet don't need to be super tired or in bad condition before you actually pamper them. Make it a habit. Pampering them is just like pampering your whole body and mind. On this day of love, just do it and enjoy!

o For more information email foothealth242@gmail.com or visit www.apma.org. To see a podiatrist visit Bahamas Foot Centre on Rosetta Street, telephone 325-2996, or Bahamas Surgical Associates Centre, Albury Lane, telephone 394-5820, or Lucayan Medical Centre on East Sunrise Highway, Freeport, Grand Bahama, telephone 373-7400.

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It costs nothing

February 13, 2017

I bet that many are wondering right now what the title of today's article, it costs nothing, refers to -- in fact some of the skeptics may be mumbling to themselves or saying to others, "Look man, in today's world nothing is free." Well my friend you're wrong, for, it costs nothing other than the actual effort to be kind to others. That's right, kindness costs nothing, but boy oh boy, it can work miracles in another's life who is perhaps hurting badly right now due to some very negative event taking place in their life.
To me kindness is linked to, and is an integral part of real love. In other words, when you profess to be a loving individual, well then, I believe it quite naturally follows that you'll be kind to those whom you profess to love so much. There's a saying which states, we always hurt the ones we love, the ones we shouldn't hurt at all. I wonder why?
If you really love someone, why on earth would you actually hurt them by being unkind when they're hurting and in need of your love and kindness? Actually, now that I think about it, bullies and control freaks are the ones who are consistently unkind to those who they profess to love. And of course, the reason they are like this is due to low self-esteem, a lack of self-love.
Yes indeed, it costs nothing to be kind and loving to others all the time, and if you appear to have a problem with this -- being loving and kind to one and all, I respectfully suggest that it may be time for you to receive some professional counseling to raise your level of self-esteem, self-love. Believe me, this could change your whole outlook on life.

o Think about it!
Visit my website at: www.dpaulreilly.com.
Listen to "Time to Think" the radio program on STAR 106.5 FM at 8:55 a.m. & 6:20 p.m.

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Sargento recalls cheeses amidst Listeria fears

February 13, 2017

The Bahamas Ministry of Health addressed a recent recall of various Sargento cheese products that may potentially be contaminated with Listeria Monday, February 13, 2017, via a Facebook post.

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Warning of 'immense' problems for NHI
Warning of 'immense' problems for NHI

February 10, 2017

AS the Christie administration faces a time crunch to implement the primary care phase of National Health Insurance before Bahamians head to the polls this year, the government is challenged by "immense" logistical problems because public facilities are not structurally sound, a high level NHI insider has told The Tribune...

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Mother and child

February 07, 2017

Many women will bear children, but not every female manages to create that special bond that can only exist between a mother and her child. And sometimes establishing a healthy relationship with a child is not always the easiest thing, even though many believe it should be, according to a family and relationship counselor.
While many mothers may have the best intentions, the love they may have shared with their child in the early years of their relationship can sometimes be strained or even completely lost over time, according to Camille Bullard, who spoke with The Nassau Guardian in an earlier interview. The counselor said the main cause of many poor relationships between mother and child is often the parent's inability to transition into the person their child needs at the various stages of their life: mother and youngster; mother and teen; and mother and adult.
"One cannot just decide to be fun and carefree one day and no-nonsense the next," said Bullard. "Consistency from early in the child's life is essential because it will establish the foundation for the future relationship a mother will have with her child. This means that whether it is your son or daughter, as a mother you have to be a firm yet loving authoritarian. This is a hard thing to balance as you don't want your child to fear you, but you also don't want to instinctively give in to their demands particularly when they are young. But the saying goes that you must bend the tree while it's young...and it couldn't be more true, especially when it comes to raising children today."
The most important thing for mothers to do she said is to always let their child know they are loved.
"Youngsters will not always understand or appreciate fully when they are shown love. They may know they are loved, but hearing it is just as important. If they know they have someone who loves them at home they are less likely to search for affection and love outside of the home," said Bullard.

Mother and youngster
Bullard said when a child is first born until he/she is pre-teen aged the mother is supposed to be the child's guardian, protector and guide. And that while it is important to be as loving and understanding as possible during these early years, a clearly defined line between parent and child is essential.
Setting boundaries for the child at this point she said will allow him or her to firmly trust in the parent and understand without a doubt the way things are meant to be.
"Allowing there to be a gray area at this stage should not happen because the child will keep pushing the boundaries, and upon seeing that there aren't any, will result in having a healthy and respectful relationship between mother and child more difficult."
Bullard said having a double standard could also plant the seed to ruin relationships between a mother and her children. Often times she said a mother can be strict with their daughters but leave their sons to their own devices; that they don't ensure that what works for one child goes for the other, and that this can leave a lasting impact later on in a child's life, particularly in how they regard the mother.
"All relationships should be based on trust, understanding, honesty and equality. Which means that although your child might be young, you should always treat the relationship professionally. You shouldn't favor one child over the other. It can cause unnecessary discord that can last well into adulthood. If you allow your sons to go about on their own, you are putting them at a disadvantage because they are still immature, and girls can resent you for not trusting them enough to do simple things they feel ready for."
In the relationship the therapist said there should also be repercussions for good and bad behavior. If a child does well she encourages mothers to praise them and to feel free to give hugs, kisses and show love because even if the child is two or three, she said it would stay in their subconscious that they are loved and that doing well is rewarded.
When children perform poorly she said that should also be highlighted so they know not to do it again. She said that does not mean that parents need to be harsh or quick-tempered with their child, but rather patient and provide the consistency needed for them to understand how to do a new task effortlessly.
"A mother can damage her relationship with her child by being harsh with him too often. The child learns early to be afraid of her, to lie to her to cover up failures or wrongdoings, to do whatever they can to not be around her because she is not a warm or inviting person," said the relationship counselor. "Even when you are angry as a mother it is essential to be gentle and firm with the child. Find a way to
establish that you are upset and disappointed, be it through punishment or talking to the child at length about what he did, but do not curse or row the child endlessly. This stunts the growth of the relationship."
Although parents want children to be obedient at an early age, it is just as important for them to allow children to learn to express themselves healthily when angry, sad or happy. She said this allows them to learn to be open later in life about how they feel and how to deal with negative feelings constructively.

Mother and teen
During the child's teenage years when they are seeking to become more independent and opinionated, Bullard said a mother is no longer meant to be the strict authoritarian, but instead supposed to be more of a guide.
"This is not to say to let children do what they want to. Rather as a teenager, a child has their own ideas and wants to explore in their own way. You are there to guide them as they venture out. You have to be that force that tells them no or go. You can't treat them the same way as you did when they were children, but you still have to be firm with them. They will want to go to parties or out to different places so you have to be there to teach them what makes a good choice from a bad one. You are there to teach them how to form their own ideas and even suffer the consequences at times," she said.
As children progress into adolescence, the counselor said mothers should start to get out of their child's way. She encourages mothers to allow their children to be individuals while still being strict so they don't lose their way. Holding tightly onto children at this stage compared to when they were children she said, will only frustrate the child and cause resentment towards a mother.
"This stage of your child's upbringing is about lessons and letting them taste life on their own at times, but still keeping a rein on them. But this is the time they want to prove themselves, and as a parent you should let them," said Bullard. "Trusting them to go to a party alone and behave in the way they were brought up is a risk, but as a parent you have to let them go at some point. Not trusting them can cause them to stay dependent on you for longer than necessary and for some it can become a bone of contention that they will not let go of even later in life."
The counselor said during the teenage years is also a good time to teach teens about delayed gratification. She said mothers may get away with saying yes or no to a request to children without explanation, but with a teen she said it's important to get them involved in decision-making.
"Sometimes it is necessary to let the child know honestly that the family is unable to cover the cost of an outing or trip they may want to go on. This may result in the child understanding and accepting the decision or even suggesting ways they could earn the money to be able to go, but some of them will take longer to fully grasp the concept."
No matter the child's response, Bullard said being honest with the child and giving them a glimpse of how he or she would be able to live in comfort is a conversation a mother should have with her child.
"Using this stage in the relationship to reveal the realities of life is a good idea. You can't let them assume money grows on trees and everything in life is free. You want to be open with them so they can be open with you."
She encouraged mothers to talk to their children about sex, money management, how they lived as a child and what they like and don't like. She said they're not being a friend to their children, but are showing them that they are human and that they understand, while at the same time preparing their children for the real world.
"If you don't use the teenage years wisely, when they are ready to leave home they will not be as ready as they should be," she said.

Mother and adult
Adulthood, the stage of a mother's relationship with her child that lasts the longest and at which point a mother can finally be her child's friend. It is during this time that mothers are supposed to let go and watch their children soar. At this stage a mother's duty is not to be an interloper, but a guide only when asked, even though for mothers it is natural to want to continue to give advice and push the child. According to Bullard, this is no longer a mother's job. The counselor says that hopefully by this stage a child should have the right level of responsibility and stickability to leave home and make it on their own.
"You have given the child a minimum of 18 years of strictness and advice. It is up to them to do what they want to do. You can only suggest what may be best, but at this stage your advice is rarely wanted. Children will go through a stage in their adulthood when they will want to do things on their own completely and you should let them unless they are totally going in the wrong direction. Only then do you step in and try to make suggestions, but do not push. Your role now is to advise, guide and console."
The counselor said the best way for mothers to transition into this last phase is by seeing themselves as gardeners who have planted seeds, watered them, fertilized them, weeded them, and put posts in the ground to influence their upward growth. She said after all is said and done, at a certain point it is essential to just step back and let nature take its course.
"As a gardener one only looks back at the young tree as its roots deepen, but the time for constant care is over. Only in great drought or danger will the gardener water the now grown tree. But otherwise, it is up to the tree to find ways to keep standing tall. This is the same way with children who are grown. Mothers should step back and not intervene unless asked. And at this stage, if there are any bad feelings between mother and child it should be resolved. You both are adults and can try to understand each other more profoundly," said Bullard.
During adulthood she said the relationship is not about exerting authority, but about making repairs to a relationship that could not be repaired before.
"Being able to say sorry is something you won't feel bad about anymore because you can finally have another kind of relationship with your child. At this point it is still important to say 'I am here for you if you need help.' Still praise them for wanting to move and launch out on their own. Be an open ear and shoulder for them. You are now an advisor."
If families are still struggling to repair their relationship despite individual efforts, getting professional counseling, be it from a minister or a counselor, may be necessary, said Bullard.

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Hearing loss caused by ototoxicity

February 07, 2017

The Vestibular Disorders Association describes ototoxicity as ear poisoning (oto = ear, toxicity = poisoning), which results from exposure to drugs or chemicals that damage the inner ear or the vestibulo-cochlear nerve (the nerve sending balance and hearing information from the inner ear to the brain). Because the inner ear is involved in both hearing and balance, ototoxicity can result in disturbances of either or both of these senses.
Simply put, ototoxicity is the damage certain medications cause to the inner ear system resulting in hearing loss, ringing in the ear or problems with balance. When medications affect the ear and balance mechanisms, they are identified as ototoxic. There are currently over 200 medications that are considered ototoxic, both prescribed and over the counter. In many cases the damage to the hearing and balance is temporary and may reverse itself once the treatment is discontinued. Still, in many other cases, the damage is permanent, resulting in irreversible tinnitus, hearing loss and/or balance disorders.

Use of ototoxic medications
Nonetheless, despite the risk to the hearing and balance system, ototoxic medications are prescribed when necessary, to treat very serious illnesses or other life-threatening medical conditions like cancer, heart disease and various types of serious infections.

Signs and symptoms of ototoxicity
Ototoxic medications cause damage to the sensory cells of the inner ear that are related to our ability to hear precisely and to maintain proper balance. Signs and symptoms of ototoxicity include ringing in the ears, hearing loss and dizziness or vertigo.
o Ringing or buzzing noises (tinnitus) in the ear is usually the first sign that an ototoxic medication is affecting the inner ear mechanism.
o Hearing loss normally follows the tinnitus and typically occurs in both ears starting with the high frequencies. It may appear suddenly or it may be gradual. However, in most cases, the hearing loss is not noticed until you begin having difficulties understanding conversational speech.
o Ototoxic medications may also affect your balance. You may begin by feeling a bit unsteady on your feet, or you may feel like things around you are spinning.

Ototoxic medications
Some of the more common ototoxic drugs include aminoglycoside antibiotics such as gentamicin, kanamycin, neomycin, amikacin and streptomycin; loop diuretics such as furosemide, ethacrynic acid and bumetanide; platinum-based chemotherapy agents such as cisplatin; and salicylate pain relievers such as aspirin, used to treat heart conditions.
The precise workings of the mechanisms of the ear are essential for us to have accurate hearing and balance function. Hearing is one of our most critical senses, and without the capacity to hear, a patient's ability to interact with people and the environment becomes extremely compromised. The effects of ototoxic medications therefore not only affect hearing and balance, but can also affect quality of life. Not being able to hear the conversations of family, friends and loved ones, or even a physician may leave a patient feeling isolated and depressed. Constant dizziness may also cause a patient to stop participating in normal activities, as it makes something as simple as walking or driving difficult or impossible to accomplish.
If you or someone you know is taking an ototoxic medication or suffering from ototoxicity, speak to your doctor regarding the possible hearing-related side effects so that you know what to expect and what to look for. Have your hearing checked both before and during medical treatment of ototoxic medications. This gives a baseline of your hearing and helps with monitoring and identifying any changes to your hearing during treatment as quickly as possible. Do not discontinue taking your medication. Certain medications are vital to fighting specific infections or diseases and may have to be continued. Always consult your physician if you are having any concerns regarding your medication. Although researchers are trying to develop ways of protecting patients from ototoxicity, there is currently no protective strategy that has been approved.
To have your hearing monitored while taking ototoxic medications, contact an audiologist.

o For further information on any hearing-related disorder, please contact Dr. Deborah Nubirth, doctor of audiology, at 356-2276 or 677-6627 in New Providence at Comprehensive Family Medical Clinic, Poinciana Drive or 351-7902 in Grand Bahama; or email dnubirth@yahoo.com.

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Nurse Patricia Laing winning smiles and hugs land prize
Nurse Patricia Laing winning smiles and hugs land prize

February 02, 2017

THE first winner of the PHA Unsung Heroes Award is veteran nurse Patricia Laing, who health officials praised yesterday as a stellar practitioner for her years of committed and noteworthy excellence...

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PHA Unsung Heroes Awards to reward healthcare excellence
PHA Unsung Heroes Awards to reward healthcare excellence

February 02, 2017

AN AWARDS programme to recognise and reward excellence, care and compassion in the Bahamas health care system launched on Wednesday as part of a ground breaking public-private partnership between the Public Hospitals Authority (PHA) and the Tribune Media Group...

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NHI registration of physicians begins
NHI registration of physicians begins

February 01, 2017

GOVERNMENT officials yesterday announced the launch of National Health Insurance's primary care physician registration, which NHI senior officials said is a "critical milestone" that signals the "initiation" of the second phase of the government proposed scheme...

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Minister Johnson Signs Global Wellness Banner for "Yes to Wellness" Initiative

February 01, 2017

Saying "Yes to Wellness," Minister of Youth, Sports and Culture the Hon. Dr. Daniel signed a promotional Global Wellness Day - I Say Yes! banner on Monday at Pompey Square on behalf of the nation...

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25 Trained Clinical Nurses for Grand Bahama

January 31, 2017

Minister for Grand Bahama the Hon. Dr. Michael Darville applauded a new initiative that recently produced 25 Trained Clinical Nurses, graduates of a program that is the collaboration of the Public Hospitals Authority, the University of The Bahamas and the Ministry for Grand Bahama...

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