Lead Exposure Could Increase Your Risk of Glaucoma

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POAG develops when the inner-eye fluid, called aqueous humor, does not drain properly. Gradually, eye pressure builds to dangerous levels and can cause optic nerve damage and permanent vision loss. This eye condition is complicated because it is incurable, and vision loss is permanent and irreversible.

For years, researchers have linked glaucoma to a combination of risk factors including age, heredity, medication and health history. This study is unique because it suggests your environment could affect glaucoma risk.

Bone Lead Levels Affect Glaucoma Risk

Oxidative stress can elevate eye pressure and damage the optic nerve. Sung Kyun Park, an environmental health scientist at the University of Michigan, led a study on lead exposure and oxidative stress. Park wanted to learn whether chronic lead exposure affected glaucoma risk.

Because blood tests only measure recent exposure to lead, they were inadequate to analyze long-term contact with lead. Park decided to measure lead levels in the knee and leg bones because bones store lead for decades.

Park analyzed patella and tibia lead levels from a subset of participants in the VA Normative Aging Study, a study that has followed 2,280 men since 1963. The research team tracked ophthalmologic and bone lead level data on 634 men and identified 44 new cases of primary open-angle glaucoma (POAG).

Park estimates POAG risk was about “five times higher with a 10-fold increase in patella lead and about three times higher with a 10-fold increase in tibia lead” (EHP).

Although this research found strong evidence linking long-term lead exposure and POAG, Park needs to conduct further studies. He wants to examine the effects of other metals on POAG, as well as exposure at an early age.

Know Your Glaucoma Risk

According to the Glaucoma Research Foundation, more than three million Americans have glaucoma, but only half are aware they have the disease. It is imperative that you know your own risk for glaucoma. You are at higher risk for glaucoma if you are:

  • 45 years of age or older
  • African American
  • Nearsighted
  • Farsighted
  • Diabetic
  • Taking steroids (orally, injected or eye drops)

You can learn more by taking our Glaucoma Risk Assessment. In only a minute, you can find out whether you are at elevated risk for vision loss.

Finally, you can take active steps to preserve your eye health by exercising regularly and eating a diet high in fruits, vegetables, whole grains and lean proteins. Annual comprehensive eye exams with your ophthalmologist are essential to evaluate your eye health and overall wellness. If it has been over a year since your last appointment, call your ophthalmologist to schedule a check-up.

Hip Shape May Predict Total Hip Replacement

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Hip shape predicted the likelihood of whether patients needed total hip replacements in a recent study presented at the World Congress on Osteoarthritis.

Laura Laslet, Ph.D., is a musculoskeletal epidemiologist at the University of Tasmania in Hobart, Australia, who focuses on osteoarthritic pain. Dr. Laslet and a group of colleagues sought to identify risk factors that anticipated total hip replacement. Although hip pain and hip osteoarthritis are two main predictors for hip replacement, they are not the only indicators. Hip anatomy plays a significant role as well.

Hip Anatomy and Hip Dysplasia

The hip is the largest ball and socket joint in the body. Hip bone parameters, such as decreasing acetabular coverage, were among factors that predicted total hip replacement. The acetabulum, located in the pelvis, is the socket structure of the hip joint. The top part of the thigh bone called the femoral head is the ball. In a healthy hip, the femoral head fits securely into the acetabulum and rotates freely in the cartilage lining.

If the acetabulum does not fully cover the femoral head, the hip joint can become dislocated or partially dislocated. This is known as hip dysplasia. Dr. Laslet found that patients who had decreasing acetabular coverage had a higher risk of total hip replacement.

Risk Factors for Total Hip Replacement

Between 2002 and 2016, Dr. Laslet and her team analyzed 1,100 participants from 50 to 80 years of age from the Tasmanian Older Adult Cohort (TASOAC) Study. The team examined pelvic X-rays, bone density scans, MRIs and hip shape parameters. They looked at data from 40 patients who underwent hip replacements and 762 patients who did not. Patients were compared to others of the same gender, age and BMI.

The study identified other risk factors for total hip replacement, such as:

  • WOMAC hip pain (self-administered questionnaire on perceived hip pain, stiffness and physical functions)
  • Bone marrow lesions (areas of bone impaction and bleeding caused by trauma)
  • Impingements (abnormal friction during hip movement that damages the joint)
  • Irregular shaped femoral head
  • Osteoarthritis

No other study has considered all these predictors in the same set of data, says Dr. Laslet.

“Combination of measures may allow us to improve models predicting risk of total hip replacement,” Laslet concluded. “All of these things can only help us in finding ways to prevent and treat osteoarthritis. We have shown in our data that age, sex and BMI did not predict total hip replacement independent of pain and hip osteoarthritis” (Healio).

Hip Treatment Reduces Risk of Other Injuries

If you are experiencing hip pain or reduced mobility, call an orthopaedist for a consultation. Limited hip flexibility can place more stress on other structures and can make them more susceptible to injury.

Ask Your Doctor for Cancer Screening Tests

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A recent study published in JAMA Network Open discovered primary care physicians (PCPs) are more likely to order cancer screening tests for patients with morning appointments rather than afternoon appointments. This is partly due to “decision fatigue,” the result of the summative burden of screening discussions in earlier appointments, and doctors falling behind as their shift progresses.

The study analyzed data from 33 primary care practices in New Jersey and Pennsylvania between 2014 and 2016. Clinicians ordered colon cancer screening tests for 37 percent of eligible patients with 8 a.m. appointments but only 23 percent of patients with later afternoon appointments.

Results were also consistent for breast cancer screenings. Doctors ordered mammograms for 64 percent of eligible patients with 8 a.m. appointments but only 48 percent of eligible patients with 5 p.m. appointments.

The study proposed three reasons why doctors suggested cancer screenings less often in the afternoon:

Decision Fatigue

Decision fatigue, defined as the depletion of self-control and active initiative, happens in every profession, and doctors are no exception. Doctors must make countless decisions regarding patients’ health. As the day goes on, physicians are more likely to forego a cancer screening discussion because they have already initiated these conversations earlier in the day.

Falling Behind in Scheduled Appointments

Appointments at the end of the afternoon tend to be shorter because doctors often are behind schedule. One way to abbreviate patient visits is to address the reason for the appointment only and delay the cancer screening discussion for next time.

Conserving Mental Energy

If morning patients decline cancer screenings, doctors may be less likely to suggest cancer screenings for patients with later appointments. The brain is very good at conserving energy, and meeting with resistance causes the brain to find more accessible pathways. In this case, the easier pathway would be to avoid suggesting the screening.

What kind of conclusions can we draw about doctors’ judgment during afternoon appointments? Are all afternoon appointments a waste of time? Not at all.

Perhaps we can view this data from a different angle. Decision fatigue can affect anyone of any age or profession, from a quarterback at the end of a game to a criminal judge, or even a mother of toddlers.

Making repeated healthcare decisions is exhausting, and doctors willingly carry a heavy yoke of responsibility. Deciphering symptoms, diagnosing illnesses and prescribing care erodes physical and mental energy as the day continues. Instead of passively relying on your doctor to suggest the preventive screenings and tests for which you are eligible, you can be proactive and do a little research for yourself.

Before your next well appointment, call your insurance company and ask what screenings and tests are recommended for your gender and age. You can also ask about whether you have met your deductible for the year and get an estimate for any out-of-pocket charges you may incur for the recommended screenings.

As an informed patient, you can make the most of your doctor appointment by:

  1. Bringing a list of recommended preventive screenings.
  2. Writing out any questions you may have.
  3. Asking your doctor’s recommendation regarding specific tests (colonoscopy vs. stool test).

Remember, you are the best advocate for your health, so don’t wait for your doctor to initiate the conversation about vital routine screenings. Bring up the subject yourself and be proactive about your care.

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Waldorf Endoscopy Center Staff give back to Special Olympics

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It was such a fulfilling and rewarding experience and during her time volunteering, she spoke with the Coordinator for the Sheriff’s Dept., Sgt. Gus Proctor about other ways to support the Special Olympics-the Torch Run was brought up. She then spoke with the staff on their interest and they decided to order t-shirts. Sgt. Proctor delivered them and the group photo was taken. 

Each year the Charles County Sheriff’s Office sponsors several fundraising events in support of the Special Olympics of Maryland. One in particular is the a Law Enforcement Torch Run for Special Olympics which will take place June 6,2019 in LaPlata, Maryland, of which center staff will attend. The Run is 3.5 miles for runners or 3 miles for walkers. This is a family event that raises money for the Special Olympics and by purchasing the Torch shirts, the money raised will help Special Olympics of Maryland.

Esophageal Research Center Opens with Help from the Kardashians

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The Robert G. Kardashian Center for Esophageal Health is the newest addition to the UCLA Vatche and Tamar Manoukian Division of Digestive Diseases. The center is a collaboration of UCLA’s experts in gastroenterology, oncology, anesthesiology, surgery, pathology, radiology and pediatrics, all dedicated to the prevention, diagnosis and patient-centered treatment of esophageal diseases.

Robert Kardashian was a prominent businessman and lawyer from Los Angeles. He is most remembered for representing O.J. Simpson in his 1995 trial, and for being the father of Kim, Khloe, Rob and Kourtney who are on the television series Keeping Up with the Kardashians. Mr. Kardashian was diagnosed with esophageal cancer in July 2003 and died just two months later, at age 59.

Kim Kardashian West and her mother, Kris Jenner, along with other family members, attended the ribbon-cutting ceremony honoring her late father. After the event, Kim tweeted, “So proud to announce the Robert G Kardashian center for esophageal health being launched at UCLA. My wish is that other families can have more information and we can also focus on health and prevention.”

What is Esophageal Cancer?

Esophageal cancer begins when cells in the esophagus mutate and divide abnormally. This cancer is the sixth-leading cause of cancer death in the world because it is fast-growing, aggressive and has few symptoms.

Incidence of esophageal cancer and esophagus disorders has increased dramatically in the past decade. Risk factors include alcohol and tobacco use, obesity, poor nutrition and gastroesophageal reflux disease (GERD). Chronic acid reflux damages the lining of the esophagus and can cause a condition called dysplasia, which increases the risk for Barrett’ esophagus, a precursor to esophageal cancer.

How to Lower Your Risk for Esophageal Cancer

You can take proactive steps to lower your risk for esophageal cancer by adopting healthy lifestyle habits.

  1. Eat a well-balanced diet with lots of fruits, vegetables, whole grains, lean proteins and healthy fats.
  2. Limit your alcohol intake and drink only on special occasions.
  3. Quit smoking and do not use tobacco products.
  4. Visit your doctor annually for well visits.
  5. Say “yes” to all preventive screenings. Preventing disease is always more cost-effective than treating it.
  6. Call your doctor if you notice symptoms of an esophageal disorder which include heartburn, difficulty swallowing, indigestion, chest pain, persistent coughing, hoarseness, throat burning or weight loss.

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Cataract Prevention Begins with Nutrition

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One in six Americans over the age of 40 has a developing cataract. Age is the leading cause of cataracts, but the foods you eat play a significant role in cataract formation.

How to Prevent Cataracts Naturally

You can prevent or delay cataract formation by avoiding smoking, limiting alcohol and eating a nutrient-dense diet. Here are four foods that provide good nutrition for eye health and prevent cataracts naturally.

Eggs

Eggs contain high amounts of DHA (docosahexaenoic acid), an omega-3 fatty acid that is important for cell, muscle and nerve function. Research suggests omega-3 fatty acids may protect eyes against cataracts, dry eye syndrome and macular degeneration. Egg yolks contain lutein and zeaxanthin, two nutrients that protect eyes from the sun’s ultraviolet radiation.

Suggestion: Enjoy eggs scrambled, poached or sunny side up with a slice of whole grain toast in the morning. Top your salad with a hard-boiled egg. It is a great source of protein and a meat substitute.

Broccoli

Broccoli is also a good source of lutein and zeaxanthin. These powerful antioxidants reduce inflammation and prevent cell damage from free radicals.

Suggestion: Steam, roast or saute broccoli with other vegetables for a healthy side dish. For maximum nutritional benefit, eat raw florets.

Green Tea

Green tea is minimally processed because it is made with unoxidized leaves. It is known to improve blood circulation and lower cholesterol due to its high polyphenol content. Polyphenols reduce inflammation and maintain cellular function.

Researchers from the University of Scranton discovered black and green tea lowered ocular glucose levels in rodents and reduced their cataract risk by 50 percent.

Suggestion: Drink green tea daily. Whether you prefer green tea hot or chilled, your eyes will be nourished by a healthy dose of antioxidants.

Oranges

Oranges are a rich source of vitamin C, an essential antioxidant for strong blood vessels in the eyes and other parts of the body. A study in the Journal of Nutrition found high levels of vitamin C reduced cataract risk by 64 percent.

Suggestion: Instead of drinking orange juice in the morning, eat a fresh orange. Fresh oranges have an additional nutritional benefit because they contain potassium, fiber, folate and calcium.

Spinach and Leafy Greens

Spinach, kale, chard and other leafy greens are high in lutein, which is related to vitamin A and beta carotene. These essential nutrients protect eye tissues from degenerative disease and sun damage. Leafy greens also contain iron, folate and vitamin K, which are essential for strong vision.

Suggestion: Buy organic leafy greens if possible. Organic greens often contain higher amounts of lutein.

Make an Appointment with Your Ophthalmologist

Eating a well-balanced, healthy diet will help prevent cataracts naturally and improve your overall wellness. Talk to your eye doctor about proper nutrition for eye health and safe ways to exercise. It is never too late to start good eating habits.

MidAtlantic Endoscopy Center Merges Two Locations Into One Convenient, State-Of-The-Art Facility

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Serving the community for more than 40 years, the physicians and staff are proud to open a new state-of-the-art endoscopy center located at 2112 Harrisburg Pike, 1st Floor, Suite 100, with a ribbon-cutting ceremony and open-house reception. The new center replaces two centers located within the Penn Medicine Lancaster General Health Suburban Out-Patient Pavilion with one convenient location, offering the same high quality of patient care in a new updated environment.  The group also has an Ephrata location at 4140 Oregon Pike.

A wide variety of procedures will be performed at the new center and include upper endoscopy, colonoscopy, esophageal dilation, polyp removal and hemorrhoid treatment. Screening for colon cancer via colonoscopy remains a focus.

“Colon cancer is a common and deadly disease, but it is preventable and treatable when detected early.  We must continue to spread the word that colonoscopy saves lives,” said Dr. Ameet N. Parikh, Medical Director of MidAtlantic Endoscopy Center and partner at Regional GI.  “It’s important that we continue to serve our community by making screening colonoscopy available to everyone.”

To schedule your colonoscopy or to learn more about when you should be screened, the group encourages you to contact your primary care physician or call Regional Gi directly at 717-869-4600.

The ribbon cutting will commence at 5:30 p.m. followed by an open house where guests will tour the new state-of-the-art facility, meet the physicians and enjoy refreshments.  Those interested in attending the event are asked to RSVP by emailing Connie Ream at cream@regionalgi.com.

More on Regional GI

The physicians of Regional GI provide high quality care for those with digestive diseases in the greater Lancaster area.   In addition to colon cancer screening and colonoscopy, their 23 board-certified physicians and 10 advanced practice providers have expertise in diagnosing and treating all of your digestive health needs.

For more information, please visit their website at www.regionalgi.com or www.MidAtlanticEndoscopyCenter.com.

Is Early Cataract Surgery Right for You?

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Benefits of Cataract Surgery

Cataracts are a natural result of aging, but they are reversible through surgery. This safe, routine procedure removes the clouded lens and replaces it with a clear, synthetic lens that restores your vision and is customized to your unique needs. There are numerous benefits of cataract surgery, such as:

  • Clear vision
  • Increased quality of life
  • Independence
  • Decreased risk of falls and fractures
  • Longer life expectancy

Average Age for Cataract Surgery

There is no minimum age for cataract surgery. You should have a cataract removed when your eye doctor recommends it.

Certain factors like smoking and sun exposure can affect how rapidly a cataract develops. When you begin to experience cataract symptoms like blurry vision, double vision, decreased night vision or light sensitivity, it may be time to talk to your ophthalmologist about cataract surgery.

While there is no rush to schedule cataract surgery, you also do not need to delay the procedure. Your ophthalmologist will help monitor your cataract development and advise you when to schedule surgery.

Types of Cataract Surgery

Better technology means more choice in cataract surgery. You can still choose traditional cataract surgery, performed by a skilled surgeon using a handheld blade, or laser-assisted cataract surgery. This modern technique allows surgeons to use optical coherence tomography (OCT) to create a 3-D map of the eye. From the OCT map, the laser can create an incision at the exact location, depth and length to treat conditions like astigmatism.

Whether you choose traditional or laser-assisted cataract surgery, you will heal better if you are in excellent health. For this reason, you may want to consider early cataract surgery. Younger patients tend to heal faster because their cataracts are softer, their corneas are clearer and their pupils dilate easier (Review of Ophthalmology).

Best Lens for Cataract Surgery

An intraocular lens (IOL) is a clear, artificial lens that requires no care and becomes a permanent part of your eye. Your surgeon will recommend an IOL based on test results and your specific preferences. Today, there are dozens of customized IOLs that correct vision at one, two or multiple distances, as well as astigmatism and presbyopia.

Early cataract surgery can be a wise economic decision. You can feel confident choosing a multifocal premium lens because it will never need replacement, and you’ll enjoy clear vision for an extended period.

Call Your Ophthalmologist Today

Talk to your ophthalmologist about early cataract surgery. One procedure could offer a lifetime of clear vision.

Ambulatory Surgery Centers Produce Successful Results, Low Complications

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A recent study compared patient cost and outcomes for inpatient hip and knee replacement surgeries to those performed in an ambulatory surgery center. It found no increased risk of 90-day complication rates or readmission rates for patients who went home the same day compared to patients in a hospital.

Michael P. Ast, M.D., hip and knee replacement surgeon at Hospital for Special Surgery, conducted a study with colleagues, including Alvin C. Ong, M.D., at the Rothman Orthopedic Institute. Dr. Ong performed inpatient hip and knee replacement procedures at a university medical center, and Dr. Ast conducted similar procedures on an outpatient basis at a local ambulatory surgery center.

ASCs Produce Shorter Stays and Lower Infection Rates

The surgeons analyzed data from 126 patients in each group, based on similar procedure, sex, age, body mass and health assessment. The outpatient group had a much shorter average length of stay: 8:09 hours compared to 23:24 hours for the inpatient group. The ambulatory group also had a lower rate of infection at 2.4 percent, whereas the inpatient group was at 3.9 percent.

ASCs Offer Cost Savings

Most patients are concerned about hip and knee replacement surgery costs, but many are not aware that outpatient surgery is an option. Dr. Ong and Dr. Ast found the average cost of total joint replacement among patients at the local ASC was $11,677, about 40 percent less than the $19,361 average cost for the inpatient procedure at the university medical center. This data is consistent with a 2016 article in Orthopedic Reviews, which estimated patients would save 17.6 to 57.6 percent by scheduling an orthopedic procedure at an ASC instead of a hospital.

ASCs and the Future of Healthcare

Total joint replacement surgeries are expected to rise each year, but currently, only about five percent of total hip and total knee replacements occur at ASCs. By 2030, there will be an estimated 635,000 hip replacements and 1.28 million knee replacements. Choosing an ASC instead of a hospital has the potential to lower individual spending and affect the trajectory of the entire healthcare industry.

If you are in good health and are at low risk for heart disease, blood clots or post-surgical complications, you could be an excellent candidate for total joint replacement at an ambulatory surgery center. Ask your doctor for a list of in-network ambulatory surgery centers for your knee or hip replacement.