Quitting Smoking, Tobacco and Nicotine

John R. Bennett, MD
801-328-2522

1255 East 3900 South #301, Millcreek, Utah 84124
756 East 12200 South, Draper, Utah 84020
22 South 900 East, Salt Lake City, Utah 84102

Updated 03/22/2018

Quitting Smoking, Tobacco and Nicotine

Congratulations on considering quitting smoking (or chewing or vaping)! Giving up nicotine will be one of the best things you ever do for yourself. Quitting is very hard. The average person tries to quit eight times before they succeed. Never quit trying to quit. Know that some day soon you will be a nonsmoker (nonchewer, nonvaper). Go ahead and get mad at the tobacco and the tobacco companies! Tobacco is robbing you of your health, your money, your youth, your good looks, and ultimately, your life. Think of tobacco as a dear friend, a friend you love being with, but a dear friend that is trying to kill you. It is time to say goodbye to tobacco.

The most important factor in quitting tobacco is deciding to quit. Get mad, and get motivated. Don’t let yourself grow much older before you quit. Stay young and healthy and good-looking as long as you can, and quitting nicotine and tobacco is the best way to do that. If your partner uses nicotine, talk to them about quitting with you. It is far easier to quit with someone else, and it is far harder to quit if your partner keeps using nicotine.

It is easier to quit if you aren’t consuming as much nicotine, so start by cutting back on how much you smoke, chew, or vape. When you have cut way back and are ready to quit, pick a quit date, and tell everybody. Make it a public event so you have lots of support. When you are heading out for an evening with friends, remind them that you are now a nonsmoker, and if they are nice friends, they will support you! As you are quitting, you will often not be in a very good mood for a month or so, so tell everybody to be understanding! It is common to get in a disagreement at home or at work when you are trying to quit, and you will want to go have a smoke. Don’t fall for that – that is just the nicotine addiction taking advantage of a weak moment! Think about when you like to smoke or chew, and try to replace the smoking with something else. If you smoke in the car, have candy or gum to distract you. If you smoke in the morning, have a piece of toast in your hand instead. You can still enjoy a drink with friends in the evening, but remind them to help you to not smoke with that drink!

There are many aids to assist you giving up nicotine, and you may want to try these, especially if you have already failed to quit several times. Check out SmokefreeTXT, QuitGuide app, 1-800-QUIT-NOW (1-800-784-8669), or 1-877-44U-QUIT (1-877-448-7848). Stay busy when you are quitting to distract you from your cravings- exercise, take a walk, chew gum or hard candy, keep your hands busy, drink lots of water, relax with deep breathing, go to a movie, spend time with nonsmoking friends, and go to a restaurant. Avoid smoking triggers- throw away your cigarettes, lighters, and ash trays, avoid caffeine (which can make you jittery), get plenty of rest and eat healthy, change your routine. Stay positive and reward your successes. Get help. Various devices are available to you. Nicotine patches have a 14% success rate of smoking cessation at 6 months. Zyban pills have a 30% smoking cessation at 6 months. Adding nicotine patches to Zyban increases smoking cessation to 35% at 6 months. Chantix pills have a success rate of 70% at 3 months, and 44% at 12 months. Some people like to use e-cigs to help them stop smoking, but be careful, as many people then just continue smoking and add vaping, and can actually increase their nicotine intake. E-cigs are probably less dangerous than smoking as you aren’t getting the tar and many other dangerous chemicals, but you are getting ten times the amounts of formaldehyde and acetaldehyde, both of which cause cancer. Although e-cigs aren’t as dangerous as smoking, they are still very bad for you. Other more helpful devices to help you quit smoking are gum, lozenges, and inhalers that don’t heat or vaporize the nicotine.

Nicotine exposure is very harmful to healing after surgery. Nicotine causes small blood vessels to spasm, and these are the small blood vessels that ‘knit’ wounded tissue back together after surgery. People who smoke, vape, chew, or take nicotine after surgery have much higher complication rates such as infection, wounds re-opening, and deep ugly scars. Do not use nicotine for three weeks before and three weeks after surgery, especially surgery on thin delicate tissue, such as nasal and facial surgery. If you find you are unable to stop using nicotine before your surgery, please cancel the surgery and reschedule for a later date when you can quit using nicotine, particularly elective surgery such as septoplasty and rhinoplasty.

Dangers of Smoking

Cigarette smoking causes 480,000 deaths in the USA every year. This is nearly 1 in 5 deaths.

People that continue smoking have a 50% chance of dying of their tobacco.

Smoking causes more deaths each year than the following causes combined: illegal drug use, alcohol, motor vehicle accidents, HIV, and firearm-related incidents.

More than ten times as many Americans have died of smoking than have died in all of the wars fought by the United States.

Smoking causes 2-4 times the risk of heart attack, and 2-4 times the risk of stroke.

Smokers die 10-14 years earlier than nonsmokers.

Smoking causes 1/3 of all cancers, and causes over 90% of lung cancers.

More women die from lung cancer each year than die from breast cancer.

One in 14 women smoke during pregnancy. Smoking during pregnancy causes premature birth, triples the risk of sudden infant death syndrome (SIDS), and causes asthma and heart defects in children.

Smoking causes 80% of all deaths from COPD (emphysema).

One out of seven smokers will get lung cancer, and smoking increases your risk of getting lung cancer 25 times.

People who smoke fewer than 5 cigarettes a day still have increased heart disease and stroke.

Smoking can cause the following cancers: bladder, blood, cervix, colon and rectum, esophagus, kidney and ureter, larynx, liver, mouth and throat, pancreas, stomach, as well as trachea, bronchus, and lung.

Secondhand Smoke

There is no risk-free level of secondhand smoke. Secondhand smoke contains more than 7,000 chemicals, hundreds of which are toxic, and at least 70 of these chemicals cause cancer.

Since the 1964 Surgeon General’s Report alerting people to the dangers of smoking, 2.5 million adult nonsmokers have died of secondhand smoke.

In infants and children, secondhand smoke causes more frequent and severe asthma attacks, respiratory infections, ear infections, and Sudden Infant Death Syndrome (SIDS).

Secondhand smoke in adults causes coronary heart disease, stroke, and lung cancer.

Smoking during pregnancy results in more than 1,000 infant deaths annually.

Secondhand smoke causes nearly 34,000 premature deaths from heart disease each year in the US among nonsmokers.

Secondhand smoke causes 7,300 lung cancer deaths in nonsmokers each year in the US.

Secondhand smoke causes 8,000 deaths from stroke every year.

Secondhand smoke increases the risk of heart disease in nonsmokers 25-30%.

Secondhand smoke increases the risk of stroke in nonsmokers 20-30%.

Even brief exposure to secondhand smoke can damage the lining of blood vessels and cause platelets to stick, potentially causing a heart attack in susceptible individuals with heart disease.

Please do not allow anyone to ever smoke in your house or car, even if children and nonsmoking adults are not there at the time, because the dangerous chemicals linger.

What’s the good news?

Quitting smoking sharply drops your risk of heart attack within one year of quitting.

Your risk of stroke after quitting drops to the same risk of a nonsmoker in just 2-5 years.

Your risk of cancers of the mouth, throat, esophagus, and bladder drop by half within 5 years of quitting.

Ten years after quitting, your risk of lung cancer drops by half.

It is never too late to quit: 80 year-olds who quit smoking outlive other 80 year-olds who don’t quit smoking by 2-3 years.

Dangers of Chewing Tobacco

Smokeless tobacco has at least thirty chemicals that cause cancer.

Chewing tobacco causes cancers of the mouth, esophagus, and pancreas.

Chewing tobacco causes heart disease and stroke.

Chewing tobacco causes gum disease, tooth decay, and tooth loss.

Chewing tobacco absorbs more nicotine than cigarettes, potentially making it more addictive.

Those who chew tobacco (especially young people) are more likely to start smoking.

Pregnant women who chew tobacco have higher incidences of early birth and stillbirth; nicotine affects how the baby’s brain grows. Nicotine harms brain development if used below the age of 20.

Chewing tobacco can cause nicotine poisoning in children.

Dangers of Vaping

Vaping has up to ten times the levels of formaldehyde and acetaldehyde than smoking; both of these chemicals cause cancer. These are present even if the vaping has no nicotine.

Vaping with nicotine causes heart disease, strokes, birth defects, and poisoning.

Vaping reduces heart and lung function, and increases inflammation.

Vaping causes hypotension, seizure, chest pain, rapid heartbeat, disorientation, and congestive heart failure.

Vaping causes abdominal pain, headache, blurred vision, throat and mouth irritation, nausea, vomiting, and coughing.

Vaping with nicotine below the age of 20 harms brain development.

Vaping is a gateway to smoking in young people and other nonsmokers.

Vaping has a poor track record of helping people quit smoking, and often leads to both smoking and vaping, ultimately increasing your nicotine intake.

Vaping often leads to putting off actually quitting smoking.

There is dramatic variability in e-cigarettes and their liquid ingredients, and the aerosol you inhale. You really don’t know how much nicotine, chemicals, and heavy metals you are getting.

Dangers of Marijuana

Marijuana has 33 carcinogens (and counting), and deposits 4 times as much tar as tobacco, as people inhale much more deeply and hold it longer.

In high doses, marijuana causes hallucinations, delusions, and psychosis.

Marijuana causes respiratory problems and heart attacks.

Marijuana affects brain development in young people. Marijuana impairs thinking, memory, learning functions, general knowledge, and verbal ability. Teens who smoke marijuana into adulthood lose an average of 8 IQ points. Teens who use marijuana have worse school performance, and ultimately have lower income, increased use of welfare, higher unemployment, higher rates of criminal behavior, and decreased satisfaction with life.

Marijuana increases anxiety, depression, and psychotic illness. It can cause temporary hallucinations and paranoia, and worsens symptoms in people with schizophrenia, as well as increasing the risk of developing schizophrenia. Marijuana has been linked to suicidal thoughts.

Marijuana causes dizziness, dry mouth, nausea, fatigue, somnolence, euphoria, intense nausea and vomiting, disorientation, drowsiness, confusion, loss of balance, and hallucinations.

In the short term, marijuana alters the senses, alters sense of time, changes mood, impairs body movement, impairs thinking and problem solving, and impairs memory.

Marijuana use in pregnancy causes lower birth weights, and increased risk of childhood brain and behavioral problems. Children who have been exposed to marijuana have problems with attention, memory, and problem-solving.

The amount of THC in marijuana has been rising steadily over the last several decades. People trying marijuana for the first time have much higher risks of toxicity, causing rapidly rising numbers of visits to the ER. Edible marijuana has much slower onset of symptoms, so people tend to eat a lot more of it to get high before they realize how much they have consumed, with dangerous results. Higher levels of THC also cause higher levels of addiction.

Marijuana is addictive in 9 to 30% of people who use it. Teens who use marijuana, however, are 4-7 times more likely to develop addiction to it.

Marijuana has only moderate evidence of being helpful with chronic pain and spasticity. There is low evidence that marijuana helps nausea, vomiting, weight gain in HIV, sleep disorders, hepatitis C, Crohn’s disease, Parkinson’s, and Tourettes. It has been found to be helpful for Dravet’s syndrome, a rare form of childhood epilepsy. It is not helpful for sickle cell disease, PTSD, psoriasis, and ALS. Multiple studies have found no reduction in opioid use in chronic pain sufferers when they also used marijuana, but a single recent study has shown reduced opioid usage. Other studies have shown increased opioid usage when also using marijuana.

SINUSITIS

John R. Bennett, MD
801-328-2522
1255 East 3900 South #301, Millcreek, Utah 84124
756 East 12200 South, Draper, Utah 84020 22 South 900 East, Salt Lake City, Utah 84102

Updated 7/4/17

SINUSITIS

Symptoms of sinusitis are sinus pressure, nasal congestion, thick discolored drainage anteriorly, and thick post-nasal drip. There is often a cough at night when the post-nasal drip is worse as you lay flat. Fevers typically are low, if any. Sinusitis generally isn’t very painful, but it may trigger a painful headache. Sinusitis feels a lot like a viral cold, but lasts longer. Our immune systems can usually get rid of a cold in a week or so, but the viral cold may trigger a bacterial infection. Any “cold” that lasts more than 7-10 days is probably a bacterial sinus infection. Anything that causes swelling in the nose may pinch off the sinus openings, causing the sinuses to fill with fluid and leading to infection. Viral colds, allergies, air irritants, and smoking are common irritants that trigger sinusitis. Our sinuses constantly secrete mucus, which drips down the back of our noses, cleaning our nasal passages and lubricating our throats. When this mucus gets stuck in our sinuses it quickly becomes a great place for bacteria to grow. Sinusitis is treated by first facilitating drainage, and second, sterilization with antibiotics if improved drainage isn’t enough to return the sinuses to good health.

When the nose becomes congested and the sinuses become blocked, conservative measures can often get the sinuses draining, and sinusitis can be avoided. Two things have clearly been shown to get the sinuses draining again- nasal steroid sprays and salt water irrigations (flushes). Nasal steroid sprays such as Flonase (fluticasone), Nasacort (triamcinolone), and Rhinocort (budesonide) are available over-the-counter. These should be used daily, but they take several days to build up and become effective. They may be used for weeks, months, and possibly years, but will ultimately dry out the nose, cause nosebleeds, and may even contribute to cataract formation in the eyes over many years. Although fluticasone (Flonase) is the most popular and widely advertised of the three steroid sprays, it is the only one that is alcohol based, and it tends to dry out the nose more than the other two (especially here in Utah with our high dry desert air). Nasal flushes like Neti pot and Neil-med saline nasal rinses decongest the nose while physically removing debris from the nose, and do a great job getting the sinuses to drain. They should be used twice a day when the sinuses are symptomatic. They are squirted up each side of the nose, and they drain out the opposite side of the nose and also out of the mouth. Nasal rinses usually take several tries before you get used to them!

The following medications have not been clearly shown to help sinusitis despite many studies, so at best these are all optional. Over-the-counter nasal decongestants like Afrin and Neosynephrine work immediately and can be used several times a day but must be stopped after three days as they diminish blood flow in the nasal lining, damage the nasal lining after 3-5 days of use, cause rebound congestion when stopped, and can even cause a hole to form in the septum. Nasal saline mist spray every several hours (while awake) naturally decongests the nose, keeps the nose healthy and moist, and allows debris to drain out. Mucinex (guaifenesin) is an over-the-counter pill that thins mucus, allowing the sinuses to drain easier. Mucinex-D has Sudafed to also decongest, but as this keeps most people awake at night, consider using Mucinex-D in the morning, and plain Mucinex at night. Sudafed should be avoided by those with high blood pressure, heart rhythm irregularities, enlarged prostates, and people who don’t tolerate the feeling of anxiety that Sudafed can cause. Antihistamines should be avoided as they dry out and thicken the nasal mucus, which make it harder for our sinuses to drain. If allergies are suspected, an allergy test and treatment can be very helpful.

The first goal in helping our sinuses is to get them to drain, which is what the conservative measures do. If symptoms persist beyond 7-10 days, then you may need antibiotics. If you haven’t had any antibiotics for 6 months, you may do well with just high-dose Amoxicillin (for adults, 2000 mg twice a day for 5-10 days), but often more aggressive antibiotics are needed, such as high-dose Augmentin (Amoxicillin plus Clavulanic acid, 875 mg, PLUS another 1000mg of Amoxicillin twice a day) or Levaquin. A number of other antibiotics are often employed. A five-ten day course of antibiotics may be inadequate for curing sinusitis, so refills may be necessary. If no improvement is noticed, it may be wise to get a sinus CT. Some apparent sinusitis can actually be something else, such as a migraine or tension headache, allergic rhinitis, or even a deviated nasal septum pushing into the lateral nasal wall causing constant congestion, irritation, and drainage.

Chronic sinusitis is sinusitis that lasts more than three months. A sinus infection resistant to multiple antibiotics, or someone who has recurrent sinusitis (such as three bad episodes a year for three years, five episodes a year for two years) may need to consider sinus surgery. Endoscopic sinus surgery is performed through the nostrils. The natural sinus openings are enlarged to facilitate nasal drainage, making it harder for the sinuses to block off and get infected, and easier for nasal medications to penetrate into the sinuses. Someone who has had sinus surgery can use medicated rinses to put antibiotics and steroids directly into the sinuses, avoiding antibiotic and steroid pills, and their side effects. Sinus openings may scar down after surgery, requiring a revision surgery. Image guided sinus surgery allows the surgeon to see exactly where the instruments are during surgery, making the surgery safer, as sinus surgery is performed between the eyes and below the brain. Balloon sinuplasty uses catheters with balloons to safely enlarge sinus openings in certain situations, either in the clinic or in the OR.

The conservative measures described earlier will often stop sinusitis from getting started or from worsening, and should be regularly used by those with chronic and recurrent sinusitis.

Please call Dr. Bennett at 801-328-2522 if you have any questions, problems, or concerns.

Temporomandibular Joint (TMJ) Disorder

John R. Bennett, MD
801-328-2522
1255 East 3900 South #301, Millcreek, Utah 84124
756 East 12200 South, Draper, Utah 84020 22 South 900 East, Salt Lake City, Utah 84102

Updated 7/4/17

Temporomandibular Joint (TMJ) Disorder

The TMJ, or jaw joints, become easily inflamed when over-used, typically from clenching one’s teeth when stressed, and grinding teeth while asleep. As the nerve to the jaw joints is the same nerve as to the ear, jaw pain and ear pain can become virtually indistinguishable. TMJ pain radiates into the ear, down the jaw and neck, and up into the scalp. There is often grinding and popping in the joints, or one or both joints can become less mobile as the individual protects the joint, often unconsciously. There is pain with yawning and chewing. Stress can often trigger the pain, or it can become chronic.

The first step to stopping the pain is stopping the contact of the teeth. The teeth should never touch unless you are chewing, and the teeth should just barely come together while chewing. To break the habit, you must start paying attention to the teeth. I recommend a quick mental check every hour to see if the teeth are touching, and teach yourself to relax the jaw, even as the lips are kept together. When you are feeling stress, check and see if the teeth are touching. It may take months to break the habit, but it is a habit that can be overcome. The lips should be closed, but the teeth should never touch.

While breaking the clenching habit, a soft diet should be used. No hard breads, no hard vegetables, no hard meats, and no gum. Eat only soft foods. Warm soaks to the area of the jaw joint, and massaging the surrounding muscles is helpful. Anti-inflammatories such as Motrin are helpful. Prescription muscle relaxants such as Flexeril help some people, but as they make most people very sleepy, they usually are only helpful at bedtime. Getting help for stress and anxiety often prove very helpful. Working with a Physical Therapist is very helpful.

If you wake up with ear/jaw pain, or your spouse has noticed you grinding your teeth at night, the only thing that helps this is a bite block. Cheap ones can be purchased at all drug stores. They tend to be bulky, but if they work for you, that may be all you need. Dentists and Oral Surgeons can also make a much nicer form-fitted bite block, but these can get expensive.

If these measures do not help you, and other causes of the pain have been ruled out, then a referral to an Oral Surgeon or Dentist who treats TMJ dysfunction is the next step.

Remember: the teeth should never touch! Please call Dr. Bennett at 801-328-2522 if you have any questions, problems, or concerns.

Laryngopharyngeal Reflux Disease

Laryngopharyngeal Reflux Disease

and Recommendations to Prevent Acid Reflux

Updated 7/4/17

What is Reflux?

When we eat something, the food reaches the stomach by traveling down the muscular tube called the esophagus. Once food reaches the stomach, the stomach adds acid and pepsin (a digestive enzyme) so that the food can be digested. The esophagus has two sphincters (bands of muscle fiber that close off the tube) that help keep the contents of the stomach where they belong. One sphincter is at the top of the esophagus (at the junction with the upper throat) and one is at the bottom of the esophagus (the junction with the stomach). The term REFLUX means “a backward return of flow”, and refers to the backward flow of stomach contents up through the sphincters and into the esophagus or throat.

What is GERD and what is LPRD?

Some people have an abnormal amount of reflux of stomach acid up through the lower sphincter and into the esophagus. This is referred to as GERD or Gastroesophageal Reflux Disease. If the reflux makes it all the way up through the upper sphincter and into the back of the throat it is called LPRD or Laryngopharyngeal Reflux Disease. The structures in the throat (pharynx, larynx, and trachea) are much more sensitive to stomach acid and digestive enzymes, so small amounts of reflux into the area can result in more damage.

Why Don’t I have heartburn of stomach problems?

This is a question that is often asked by people with LPRD. The fact is that only one third of patients with LPRD experience significant heartburn. Heartburn occurs when the tissue in the esophagus becomes irritated. Most of the reflux events that can cause damage happen without the patient ever knowing that they are occurring, and is called ‘silent’ reflux.

Common Symptoms of LPRD:

  • Hoarseness
  • Chronic (ongoing) cough
  • Frequent throat clearing
  • Burning, pain or sensation in the throat
  • Lump in the throat feeling
  • Problems while swallowing
  • Bad/bitter taste in mouth
  • Dry throat
  • Asthma-like symptoms
  • Referred ear pain
  • Post nasal drip
  • Singing: Difficulty with high notes, difficulty with soft notes, delayed onsets or decreased clarity.

Diagnosis of LPRD:

The following signs seen by the patient are strong indicators of LPRD

  • Swollen, red, irritated arytenoids (structures at the back of the vocal cords)
  • Red, irritated vocal cords
  • Small laryngeal ulcers
  • Swelling of the vocal cords
  • Granulomas in the voice box
  • Evidence of hiatal hernia (may or may not be associated with reflux).
  • Significant laryngeal pathology of any type.

Testing for LPRD:

Esophageal endoscopy, Barium Esophagram, and a 24 hour pH probe monitoring are some of the tests that may be used to evaluate for LPRD. However, the reflux does not always show up in these tests, but is present enough to irritate the voice or throat. Often, a 3-6 month trial of a reflux medication, along with the following behavioral strategies, is the best test for LPRD.

Behavioral Strategies:

  1. Stress: Take significant steps to reduce your stress! Make time in your schedule to do activities that lower your stress level. Even moderate stress can dramatically increase the amount of reflux.
  2. Smoking: If you smoke, STOP! This dramatically causes reflux and many other damaging effects to your body.
  3. Tight Clothing: Avoid tight belts and other restrictive clothing.
  4. Body Weight: Being over weight can dramatically increase reflux. Try to maintain a healthy body weight.
  5. Exercise: Exercise regularly. However, avoid exercising immediately after eating. Do not lift heavy things after eating. Sit-ups and abdominal crunches can put pressure on your lower esophageal sphincter and worsen reflux.
  6. Nighttime Reflux: Recent studies have shown that LPRD often occurs during the day. However, if you experience some of your symptoms more in the morning, you may be having some reflux at night. Do not prop the body up with extra pillows. This may increase the reflux by kinking the stomach. Do elevate the head of your bed 4-6 inches with books, bricks, or boards to achieve a 10 degree slant. Or, purchase a foam wedge that is made specifically for this purpose. Your entire torso must be elevated from the hips up.
  7. Foods: You should pay close attention to how your system reacts to various foods. Each person will discover which foods cause an increase in reflux. The following foods have been shown to cause reflux in many people. It may be necessary to avoid of minimize some of the following foods.
    1. Spicy, acidic and tomato-based foods like Mexican or Italian food.
    2. Acidic fruit juices such as orange juice, grapefruit juice, cranberry juice etc..
    3. Fast foods and other high fat foods, especially fried foods.
    4. Caffeinated beverages (coffee, tea, soft drinks) and chocolate.
    5. Alcohol, peppermint, nuts.
    6. Carbonated beverages.
    7. Limit dairy product consumption, especially late at night. Dairy products digest slowly, which encourages acid reflux.
  8. Mealtime:
    1. Don’t gorge yourself at mealtime.
    2. Eat sensibly (moderate amount of foods)
    3. Eat meals three hours before bedtime
    4. Avoid bedtime snacks
    5. Drink at least 8 ounces of water each day, but do not drink too much before bedtime
    6. If you do eat a spicy meal, don’t have alcohol or caffeine with it. Instead, drink water.
    7. Learn to moderate the foods that may cause reflux. You don’t have to give up ice cream forever, but if you have heartburn when you eat it, don’t have a bowl of ice cream just before you go to bed. Learn what your body can and cannot handle.

Medications for LDRP:

  1. Take one dose (as recommended on the label) at meals and at bedtime of and over the counter antacid such as Tums or Mylanta. Tums has the added benefit of containing calcium.
  2. Medications such as H2 Blockers (Axid, Pepcid, Tagamet, Zantac), and Proton pump inhibitors (Prilosec [omeprazole], Prevacid, Aciphex, Protonix, or Nexium) may be prescribed or recommended by your physician. These medicines are usually taken for at least several weeks at a time, and often several months. If you need to take these medicines for longer periods of time, you will be referred to a Gastroenterologist. Prolonged use of reflux medicines has been linked to pneumonia, diarrhea with C. difficile bacteria, increased risks of fractures, and low levels of calcium, Vit B12, and magnesium.

About smell and taste

By Megan Evans

Stock Photo

How smell and taste are related:
Did you know that smell and taste are linked? Conditions such as a cold or rhinitis can reduce not only your sense of smell but taste. Luckily, most smell and taste disorders are only temporary. More serious problems that can distort or reduce the perception of taste and smell include head injuries, neurological disorders, and even dental conditions.

Smell is perceived through the olfactory nerve and taste is perceived via chemoreceptors called gustatory receptor cells. Although the ability to taste and smell are separate senses, the interconnection between the two senses affect the overall perception of flavor. The reason the two senses are connected is because both are stimulated by the chemical makeup of a solution. For more information, visit: Perception of Taste

The perception of flavor:
There are five main tastes: salty, sour, sweet, bitter, and savory (Umami), while, there are many smells that can change the perception of taste. Even though there are five basic tastes, the scientific community recognizes two more taste groups: astringent and pungent. Green apples and grape skin can be described as astringent, whereas, onions and garlic would be categorized as pungent.

The nose knows:
Want to understand how smell affects taste? Take the peppermint oil test. The basis of the Peppermint Oil Test is to have volunteers identify the fruit they eat that is masked with a drop of peppermint oil versus fruit that is not masked with peppermint oil. Volunteers must be blindfolded and please check for food allergies prior to conducting this experiment. Many volunteers will not be able to distinguish the various fruit because the smell will be masked.

Another experiment to try is the Jelly Bean Experiment . Segregate the same flavors of Jelly Beans into different bags. Blindfold your volunteer. Then, have them smell the jelly bean prior to eating it to guess the flavor. Afterward, give them a glass of water to refresh their palate. Repeat with a different Jelly Bean flavor. Next, have them pinch their nose shut and eat the Jelly Bean. Do they recognize the flavor? Many people cannot recognize flavor without the accompanied smell. They will only be able to taste the substance, in this case, sugar.

Audiology for ringing in ears

Ringing in the Ears: New Guidelines from AAO-HNS

Whether it started with that rock concert that got a little too loud or the excruciating pop in the wood shop years ago, many of us have persistent ringing in the ears from time to time.

More than 50 million Americans suffer from tinnitus, or the perception of sound without an external source. Experts say it’s the most common service-related disability among U.S. military veterans. Yet many people remain unsure what can be done about it.

The nation’s largest group of ear, nose and throat specialists, the American Academy of Otolaryngology – Head and Neck Surgery, has come out with new guidelines for treating the condition, based on the latest research.

The group says many cases are minor or go away on their own, but about 20 percent of patients need some type of medical intervention.

A good place to begin is a targeted history and physical exam, which you can do with the specialists at the ENT Center of Utah. This may include a hearing test when it is appropriate. Patients who also suffer from hearing loss may benefit from a hearing aid evaluation.Most patients will learn that there are plenty of methods to handle the annoying condition.

The Academy recommends against routine scans and MRIs to diagnose the condition the guidelines discourage the use of medications such as antidepressants and anticonvulsants. Some tinnitus sufferers have found relief from natural supplements but the panel also recommended against dietary supplements such as Ginkgo biloba, melatonin and zinc, or the use of a technique called transcranial magnetic stimulation, which involves the use of magnetic fields to stimulate nerve cells in the brain.

The guidelines are neutral on the effects of acupuncture for treating tinnitus, neither recommending nor warning against this popular form of alternative medicine.

While it falls short of a cure, doctors say patients with persistent, bothersome tinnitus may benefit from learning about strategies for managing their condition, and from cognitive behavioral therapy to help them cope.

Thyroid image for the ENT Center of Utah

Has Thyroid Cancer Been Overdiagnosed in South Korea?

Just before the run of the century, the South Korean government began a national program of cancer screening about 15 years, including cancers of the breast, cervix, colon, stomach and liver. Doctors and hospitals added ultrasound scans for thyroid cancer for a small additional fee.

What they have discovered in the last 15 years has alarmed some specialists in the field. The incidence of thyroid cancer has increased by 15 times and surpassed lung, breast and colon cancers. Thyroid cancer is the most common cancer in the nation.

However, many thyroid cancers are slow growing and easy to treat. In fact, some studies have shown almost one-third of autopsies show that people have thyroid cancers that were undetected throughout their life and were not the cause of death. Occasionally the best response to a report of thyroid cancer is to do nothing after consulting with an expert ENT physician.

In the United States, doctors caution against extreme treatment of many thyroid cancers. Few people die of thyroid cancer. Specialists at the ENT Center can help diagnose thyroid cancer and the appropriate response to any screenings.

See a full report of this story in the New York Times.