Sound travels through different parts of the hearing system to produce the ultimate sense of sound in the brain. People can hear when a sound wave stimulates the neurological component of the inner ear and takes the sound signals to the brain.

When there is a problem with the ear, human beings cannot hear, or hear garbled sounds. Hearing loss may have different reasons. There may be a tumor in the ear, a problem with the eardrum, the inner ear or the neurological structure. Different conditions can plague the hearing system and cause hearing loss. Some of these conditions can be serious and require medical intervention.

Let us discuss 3 such conditions where the intervention of an audiologist is a must.

Tinnitus and Vertigo

 Tinnitus is a medical term for a sense of ringing in the ears. It s annoying, to say the least. But more importantly, it could be a sign of hearing loss. This is why people need to see an audiologist if they have a sense of Tinnitus for a prolonged time. An audiologist can first diagnose the condition, and can then treat this problem with the help of specialized hearing aids.

 Vertigo and dizziness are the other two problems that result from a hearing system problem. It may create balance disorders. It is said that vertigo originates in the inner ear. Vertigo can also be treated with the help of physical therapy and medicine.

 Sudden Hearing Loss

 The human ear cannot hear sounds greater than 85 dB in intensity and 20,000 Hertz in tone. If the sound tone is less than 20 Hertz, then too the human ear is not able to hear anything. Between these two polarities, the human ear is able to catch all types of sounds. If human beings are exposed to sound waves of more than 85 dB in intensity, the ears may get damaged. In that case one may suffer from hearing loss. If a person has recently experienced huge changes in air pressure, exposed to blaring music or noise at close quarters, or had an accident causing loss of hearing, one needs to see an audiologist. The ears need to be assessed for trauma, if any, and treated quickly. However, hearing loss may have other reasons too such as reactions to medicines, head injury or some kind of illness that affects the hearing system. An audiologist would be able to make the right determination.

 Recurrent Ear Infections

This is common in children, but that does not mean that adults are immune to it. If there is chronic ear pain, difficulty in hearing along with drainage and fever or a feeling of pressure, an ear infection is most likely. Any doctor can detect an ear infection, however, if it is a recurrent one needs to see an audiologist. He has the wherewithal to evaluate the middle ear with different tests. A person may need treatment that only an audiologist can do.

There can be many situations in which a visit to an Audiologist is warranted; the above 3 are just a tip of the iceberg.

Audiologist - Why To Visit One?

In healthy individuals, the liver contains little or no fat. In overweight or obese people, gradual fat accumulation leads to significant liver disease. Interestingly, these individuals may be consuming minimal to no alcohol. So, alcohol, which is the main cause for liver damage, does not have a significant role to play.

The non-alcoholic fatty liver disease (NAFLD) has 4 significant stages as outlined below. It is a chronically progressive disease and may take years to reach the final stages of cirrhosis and fibrosis.

1. Simple fatty liver (steatosis): This is usually identified when diagnostic tests are done for some other suspected conditions. There are usually no symptoms obvious in this stage, other than the buildup of fat in the liver.

2. Non-alcoholic steatohepatitis (NASH): The second stage where the liver is inflamed to a greater extent due to fat accumulation.

3. Fibrosis: The next degree of inflammation where blood vessels may be narrowed leading to scarring in the liver with impaired liver functions.

4. Cirrhosis: This is the most severe stage that occurs due to years of cumulative inflammation. The liver shrinks in size, is scarred, and liver functions are markedly impaired and can also result in liver cancer.

Risk factors for NAFLD: The exact reason why a person develops NAFLD is not established, but some of the risk factors include

1. Obesity, with more weight concentrated around the abdomen

2. Type 2 diabetes

3. High blood pressure

4. High cholesterol levels

5. Age greater than 50

6. Smoking

Symptoms: This will depend on the stage in which it is identified. While there are no symptoms in the early stages, in some people there could be a dull, aching below the ribs, unexplained weight loss, weakness, and extreme tiredness. As it progresses to cirrhosis, there could be jaundice, fluid accumulation in the abdomen and feet, and itching of the skin.

Management: While there is no treatment aimed at curing the disease per se, there are ways to manage the symptoms, as noted below.

1. Weight loss: Reducing excess accumulated fat will help reverse symptoms and prevent further progression of the disease. A BMI of 18 to 26 is considered optimal.

2. Dietary changes: Modify your diet to a carbohydrates and protein rich and reduced fats and sugars. Increasing fiber through fruits and vegetables is highly recommended.

3. Exercise: Whatever your choice of workout, it will do wonders for NAFLD. Keep a target of an hour or two of moderate to intense exercise per day to reduce weight.

4. Smoking: This is another risk factor and can also help prevent other effects of NAFLD such as diabetes and heart disease.

NAFLD is highly controllable with these changes and other damages can be reversed too.

What is Nonalcoholic Fatty Liver Disease (NAFLD)?

People suffering from pneumonia, postoperative partial or complete collapse of the lungs, chronic respiratory conditions like Chronic Obstructive Pulmonary Disease, Cystic Fibrosis etc as well as people suffering from neuromuscular diseases can get partial relief by respiratory physiotherapy. If a person is suffering from retained secretions, increased effort to breathe or volume loss, he or she may be referred to Respiratory Physiotherapy.

Respiratory Assessment Of The Patient

A Respiratory Physiotherapist will assess the condition of the patient with the help of Respiratory Assessment or Respiratory Examination. It includes:

Auscultation and review chest X-Ray

Interpreting arterial blood gasses test and blood tests

History of present illness

History of past illnesses

Details of cough, breathlessness, sputum, chest pain  

Other symptoms like headache, fever, CO2 retention, heart failure, peripheral oedema, shivering, palpitations, weight loss, Gastrointestinal Reflux Disease, vomiting and nausea etc.

Respiratory Physiotherapy Techniques -

After the Respiratory Assessment the doctor may prescribe the following:

Breathing Exercises

Exercises like Active Cycle Of Breathing Techniques can help in clearing phlegm. Since people in respiratory distress often produce more phlegm than normal, it is essential that this excess phlegm be removed. This can help the person breathe more freely. Removing the phlegm can also help prevent infections in the chest and reduce coughing. It is a set of exercises that together help in establishing breathing control, huffing and deep breathing.

Mobilisation

Early mobilization is one of the most important aspects of chest physiotherapy. It includes positioning, active and passive turning, cycling pedals, standing, stepping etc. 

Manual Techniques

The Physiotherapist may apply pressure on the chest to facilitate airway clearance while keeping the patient in gravity assisted phlegm drainage position. 

IPPB

It employs a device that helps patients take a deep breath, cough and clear lungs. The device offers short-term and intermittent mechanical ventilation of a positive pressure set by a physiotherapist. The device pushes a mixture of oxygen through a facemask.

Suction

Here too the physiotherapist uses a device to suck out excess mucus from the chest and facilitate breathing. Here the cough is stimulated by a catheter and phlegm is sucked out using another catheter.

MHI

It is the acronym for Manual Hyperinflation. This procedure is carried out by a Respiratory Physiotherapist to give volume to partially or completely collapsed lungs.

BiPAP or CPAP

The device delivers pressurized air into the patient's airways through a facemask. The pressure of air prevents collapse of the throat muscles and reduces airway obstructions. In essence, they allow patients to breathe more freely and regularly. 

Conclusion

Right Respiratory Assessment or Respiratory Examination is crucial to applying the right physiotherapy techniques. Right techniques may help patients breathe more freely and avoid respiratory infections. 

Know More About Respiratory Examination!

Cranial nerve palsy is one of the common culprits of causing double vision. This is all the more true for people above the age of 60. A person is more prone to cranial nerve palsy if he is suffering from high blood pressure and diabetes. This is the reason why this disease is more commonly known as diabetes palsy. Eventually, though they get better and the problem of double vision disappears.

Symptoms:

One weak cranial nerve leads to the weakness of other cranial nerves as well. In case the eyes fail to move together, chances are that the patient will have double or blurred vision. In case the sixth nerve gets affected, side to side double vision is encountered. For the 3rd and 4th nerve disturbance, there could be a vertical double vision. The lack of blood flow causes pain to the eye.

Possible Causes of Cranial Nerve Palsy?

Cranial nerve palsy can result from traumatic or congenital factors. They can also result from vascular diseases such as strokes, hypertension, diabetes, and aneurysms. It can also arise out of infections, increased intracranial pressure, migraines, and tumours. A patient's age and clinical findings help a doctor decide the right course of treatment.

Treatment:

There are no particular treatments which can speed up the recovery of cranial nerve palsy. In a case of pupil pain, doctors may prescribe anti-inflammatory drugs such as Motrin and Advil. They key to natural recovery is to ensure that the blood sugar and the blood pressure is diligently controlled. By patching the eyes, the problem of double vision can be resolved. They are typically worn over both the eyes. They are however known to slow down the process of recovery and strain the eye. There is no known exercise to fix this condition. Botulinum injections are sometimes used by doctors to straighten the eyes but the result of such a treatment greatly varies from person to person. Doctors mostly rely on watchful waiting until the phase passes within 6-8 weeks. Pain medications are recommended on a case to case basis.

Lifestyle Changes:

Managing cranial nerve palsy can be difficult for a working person. It involves many lifestyle changes till the condition fully cares. Some of the suggestions given by an ophthalmologist include resting the eye as long as one can. Reading or working on a computer should be eschewed since it puts great pressure on the eyes. The eye should not be contacted with forehands in case there is too much pain. Other basic hygiene issues include taking the medicine time to time, cleaning the eye with fresh water two to three times a day, putting the eye drops on time as prescribed by the doctor.

How To Treat And Manage Cranial Nerve Palsy?

Urine is normally pale yellow or straw coloured. However, for various reasons, this can change. In fact, the change in the colour of urine is one of the first indications of a deeper underlying problem. This would also be one of the questions that the doctor would ask when suspecting any problem with the urinary tract, starting from infection to stones to cancer.

Hematuria is, therefore, a symptom and not a problem in itself. Some of the reasons for hematuria   presence of blood cells in the urine, producing a light pinkish urine, are listed below.

Urinary tract infections   starting from urethra all the way up to the kidneys

Glomerulonephritis

Kidney Stones-

Prostate enlargement

Tumours/cancers in the kidney, bladder, or prostate

Heavy exercises causing trauma to any of the internal urinary tract organs

Bleeding disorders

Certain medications

Appendicitis

Tuberculosis

As the disease progresses higher in the urinary tract, the severity of hematuria also increases. Though hematuria is a symptom in itself, there are some associated symptoms which are listed below-

Fever

Fatigue

Abdominal pain

Reduced appetite

Urge to urinate

Dysuria

Painful/burning urination

Feeling of incomplete emptying

Nocturnal urination (if prostate is enlarged)

Cloudy urine

Nausea, vomiting

Kidney pain (with stones especially)

Homeopathy believes in treating the person as a whole and not just the presenting symptoms. The doctor will ask a number of questions, some pertaining to unrelated organs, which will help them identify the reason for the hematuria. The treatment prescribed will be customised to the patient in question, but some of the common ingredients used in hematuria management are given below.

Hematuria from all causes can be managed with Terebinthina.

Bladder hematuria is better managed with Erigeron Canadense at 80% concentration while renal hematuria responds better to the same at 60% dilution.

Inflammatory hematuria can be reduced with Cantharis (80%)

Renal hematuria is better managed with Gossypium herbaceous (60%).

Renal colic with pain in the glans, groyne, and thighs responds well to Pereira brava.

Cocus cacti thrice a day is useful where there is itching of the urinary meatus along with the passing of red-coloured urine.

When there are small stones or sand particles in the urine along with pain at the end of the micturition process, Sarsaparilla thrice a day is known to be beneficial.

In some other people, Arnica Montana, Cantharis, phosphorus, and Hepar Sulphur are also used to relieve symptoms of hematuria.

As with any homeopathic treatment, the actual ingredient chosen would depend on the actual symptom that the patient presents with. Though these compounds are used, self-medication is not advisable. Talk to a specialized homeopath who will identify the right ingredient for a given clinical presentation.

Hematuria - Symptoms and Treatment


How To Prevent Jaundice

During monsoons, many people fall prey to Jaundice. Not to be taken lightly, jaundice can prove fatal if strict care is not taken. However there are ways to ensure that we don't fall sick with jaundice. The four main ways in which it spreads are.

1. Enlargement of liver
2. Loss of blood
3. Infection
4. A previous ailment which has left bacteria in the body

SYMPTOMS: Once can have jaundice any time of the year however one needs to be extremely careful during the months of monsoon. The symptoms of jaundice are.
1. Nails and eyes become yellow
2. Skin and urine change colour to yellow
3. Loss of appetite and irritability
4. Loss of taste
5. Nausea and vomiting
6. Tiredness and weakness
7. High temperature with shivering
8. Taste/tongue becomes bitter
9. Vision also becomes yellow
10. Stool changes colour to yellow or black
11. Heavy pulse and headache

DO’s & DON’Ts
Once diagnosed, patients have to be on strict bed rest with regulated medication on diets. They are advised to drink a lot of sugarcane juice, radish juice, glucose water, take ample rest and not do anything strenuous.

Fried and oily foods are strictly prohibited. Ghee, oil, butter or cream should not be consumed. Alongside, vegetables like okra arbi, brinjal and cauliflower should not be consumed. Alcohol, tobacco, tea, coffee and hot & spicy foods are not allowed.

What jaundice patients should eat are light and healthy foods that are easy to digest. Sugarcane juice, tomato juice, lime water, carrot juice, orange juice, and sweet lime juice should be given to the patient. The patient is allowed to drink only boiled water as resistance to infection is very low at this point of time.
 
Moong and masur dals should be included in the diet, along with lots of buttermilk, without any spices in it. It is very important to follow the diet plan as given by the doctor.

If you would like to consult with me privately, please click on 'Consult'.

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Monsoon Time Prevention For Jaundice: DO's & DONT's

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