Brain and Mental Health

  • 1 Generational anxiety

According to a study published by the American Psychological Association, more young Americans experience mental health disorders than previous generations. The past decade has seen a significant increase in the number of teens and adolescents battling anxiety, depression and suicidal thoughts.

The increase is not seen among adults 26 years and older – pointing to a social shift within younger generations. No singular cause is identified, but theories include the increased use of electronic communications and digital media and a higher number of young people receiving and reporting treatment.

Psychiatrist Scott Moseman, medical director of the eating disorders program at Laureate Psychiatric Clinic and Hospital, says the increasing number of mental illnesses in youth is one reason why the Laureate Institute for Brain Research – not a part of the Saint Francis Health System but on Laureate’s grounds – studies the neural development of adolescent brains.

“In my practice, I see children daily who are told the world is not safe, and they are restricted from doing as many things independently,” he says. “I see far fewer teens getting jobs or even starting driving when they are 16, yet at the same time they have to decide on one competitive sport by age 9, make great grades, do activities and be constantly bombarded with comparative social stress 24 hours a day through social media.

“It gives them a mixed message, which leads to more stress on brains that are becoming less independently capable of handling the load.”

Laureate’s Adolescent Brain Cognitive Development Study is the largest of its kind to date – enrolling 10,000 children and following them from age 9-10 into early adulthood.

  • 2 Stress and its physiological impact

When stressed, the body releases adrenaline and cortisol, hormones that increase your heart rate, elevate blood pressure and prepare you to respond to a threat. This natural reaction helps on specific occasions, but chronic stress and anxiety degrade the body.

“Excessive stress and anxiety can quickly and directly impact us through headaches and gastrointestinal issues,” Moseman says. “Over time, stress can impact our immunity to infections, our cardiovascular system health and our ability to heal. Our brains and bodies are very much connected and the health of one is always dependent on the other.”

  • 3 Healthy state of mind

“Similar to diet and exercise programs, mental health upkeep needs to be matched to the individual’s needs,” Moseman says.

Take time to identify the causes of your stress, whether it’s from your own thoughts and actions or the result of your surroundings – then adjust.

“Practices of exercise, yoga, meditation, proper diet and surrounding yourself with a supportive collective of people can all be excellent for mental health, but every individual has to tailor their interventions to what works for them,” he says.

“Sometimes, people just need to learn how to say no, take on less things and have time to recharge with what provides them energy and solace.”

Common Cancers

1 Declining death rates

According to the American Cancer Society, the death rate from cancer in the United States has steadily declined the past 25 years.

“Patients with a diagnosis of cancer in 1950 had a 65 percent chance of dying from their disease,” says Robert S. Mannel, director of Stephenson Cancer Center in Oklahoma City. “By the mid-1970s, this had fallen to 50 percent. With continued reduction in the use of tobacco, coupled with advances in prevention, screening and treatment, we have seen this number further reduced to 35 percent.”

He attributes the decline to research and the pharmaceutical industry.

“There’s been an explosion of new therapies targeted to specific molecular pathways that are abnormal in cancer cells, leading to some dramatic changes in outcomes for certain cancers,” Mannel says. “In addition, major advances in unlocking the body’s immune system have opened up a whole new strategy for treating cancer.”

Juan C. Claros-Sorto, a breast surgical oncologist at Stephenson Cancer Center, says advancements in breast cancer management led to a 40 percent drop in mortality between 1989 and 2016.

“These include improvements in screening imaging technology with 3-D mammography, better medical treatments directed at tumor biology and, more recently, tumor genomics and immunotherapies to target specific cancer types/behaviors,” he says. 

2 Lung cancer

Lung cancer is the most fatal common cancer in both men and women, says Kevin Tulipana, chief of staff and director of hospital medicine at Cancer Treatment Centers of America in Tulsa.

“Lung cancer screenings have been shown to reduce mortality … nearly 20 percent, a substantial improvement,” he says. “Survival is also improving because of … advancements in treatment, such as immune therapy.”

Tulipana says high-risk individuals are men and women, 55 and older, who have 30 “pack-years” of smoking cigarettes, smoke now or have quit within 15 years.

“A pack-year is defined by the number of packs smoked per day per year,” he says. “For example, a patient who smokes one pack per day for 30 years has a 30 pack-year history and a patient who smokes two packs [a] day for 15 years also has a 30 pack-year history.”

3 Colorectal cancer

Tulipana says screening for this cancer, in the average-risk patient, should begin at age 50 and is best done through a colonoscopy. A benefit of a colonoscopy is that polyps can be found and removed before they become cancerous.

4Prostate cancer

“Screening remains somewhat controversial in that prostate cancer is generally very slow-growing and found in older men who are likely to die with the disease rather than from the disease,” Tulipana says.

The recommendation to men, 55 and older with an average risk, is to discuss the pros and cons of prostate screening with a doctor. 

3d rendered illustration of a polyp removal

5 Breast cancer

There are varying guidelines on when to begin breast cancer screening, but the U.S. Preventive Services Task Force recommends average-risk women begin at age 50, but start the discussion with a doctor at age 40.

Tulipana says screenings before age 40 increase the possibility of over-diagnosis, but the earlier a cancer is found, the more likely it is to be successfully treated.

“Breast cancer, when found very early, has a five-year survival rate of 99 percent, but when found with distant disease – metastatic – this drops to 27 percent,” he says. “Screening, in the right population, can identify breast cancer in these early stages.” 

Ears, Nose and Throat

1 Head and neck cancer

Evan Moore, an otolaryngologist with Eastern Oklahoma Ear, Nose and Throat in Tulsa, says the most common type of cancer in the head and neck is squamous cell carcinoma.

“Traditionally, it was mostly attributed to a history of tobacco use and/or heavy alcohol consumption,” he says. “However, it’s also more frequently becoming associated with a chronic HPV [human papillomavirus] infection of the tonsil region – similar to links in cervical cancer.”

Symptoms may include a non-healing ulcer or lesion in the mouth, an enlarged tonsil, problems swallowing or hoarseness. Moore says many head and neck cancers can appear as painless masses, indicative of the disease spreading to surrounding lymph nodes. Treatments include surgery, radiation and/or chemotherapy, while prevention strategies include smoking cessation and limiting alcohol intake. Also, having an HPV vaccination should limit occurrence.

2 Hearing loss or difficulty

“Hearing loss in some [patients] is nerve damage that responds well to a traditional hearing aid,” Moore says. “Other types of hearing loss can be treated medically or surgically.”

Moore says the keys to preventing hearing loss are having proper protection around loud noises – whether at work or play – and getting treatment if you experience new hearing loss.

“Neglect of certain types of hearing loss can make the chance of a good recovery/outcome less likely,” he says. “When in doubt, get it checked out.”

3 Treatment

While you should always see your doctor if there’s a significant change in your health, Moore says these symptoms involving your ears, nose and throat should prompt immediate attention:

  • a new mass in or around the neck that’s present for more than two weeks;
  • hoarseness lasting more than a month, especially for a current or former smoker;
  • oral ulcers or lesions lasting more than two weeks;
  • sudden, unexplained hearing loss.

4 ENT health

Moore offers the following advice on caring for your ears, nose and throat:

  • Ears – Wear plugs or coverings when you’re around loud noises. Also, avoid ear swabs. “We often tell patients, ‘Nothing smaller in the ear than their elbow,’” he says. 
  • Nose – Manage allergy symptoms with medicine. “We often see patients with recurrent sinus problems who suffer more than they should due to poor compliance in treatment of their allergic rhinitis,” he says. “Remember, when it comes to allergy treatment, consistency is key.”
  • Throat – Don’t smoke. For adolescents, get the HPV vaccine.

Heart and Lungs

1 Heart disease and prevention

Richard Kacere, a cardiologist with Ascension Medical Group St. John Cardiology in Tulsa, says traditional risk factors for heart disease include hypertension, diabetes, obesity, high cholesterol and a family history of premature coronary disease.

“As you can see, the first four traditional risk factors are all lifestyle-related conditions,” he says. “Therefore, what we do with our feet and with our food makes a huge difference in whether … the last risk factor – family history/genetics – will manifest itself or not. People often blame genetics for their poor health outcomes when it’s the years of poor choices that really matter.”

Paying attention to what you eat is key in preventing the disease.

“Eating mostly whole foods that are plant-based has been proven to prevent and reverse heart disease,” Kacere says. “I often tell my patients, ‘Let’s turn off the faucet instead of just mopping up the floor.’”

Kacere says a heavy, meat-based diet is “very pro-inflammatory and degenerative.” Regular, simple exercise, along with a good diet, can produce positive results.

“Walk briskly for 30 to 45 minutes every day, and incorporate a wide variety of vegetables, fruits, unprocessed whole grains, legumes, seeds and omega-3-rich nuts into your daily life,” he says. “Minimize eating anything that has a face, foot or mother, and you will do well to reduce the risk of a preventable disease.”

2 An irregular heartbeat

According to the American Heart Association, the average heart beats – expands and contracts – 100,000 times a day, and pumps approximately 2,000 gallons of blood through the body in that time. It’s a rhythm that ensures your well-being. But if your heart beats too quickly, slowly or irregularly, you could have an arrhythmia.

“An arrhythmia is when the electrical signal of the heart does not follow the normal sequence of events and will usually have an erratic pattern,” says Jered Cook, a cardiologist with INTEGRIS Heart Hospital. “Symptoms could be anything from palpitations – feeling your heart racing – to light-headed feelings and even shortness of breath. Arrhythmia symptoms can overlap with symptoms some have with a heart attack, but typically there will not be a crushing chest pain that is usually associated with heart attacks.”

Cook says arrhythmias can affect people of all ages, but there are types of arrhythmias that affect certain ages more than others. For example, atrial fibrillation is the most common type of heart arrhythmia, and older adults have a higher risk of developing it. 

“Each arrhythmia is treated in an individualized way,” Cook says. “Some have a higher risk of causing stroke and require anticoagulation, some can be treated by slowing the heart rate with medicine, and others can be terminated and put back into regular rhythm with medication. For some, there are even procedures with catheters that can be done by specialists to help eliminate the arrhythmia.”

3 Lung problems

Chronic obstructive pulmonary disease (COPD) is common among Oklahomans because of their high prevalence of smoking, says Brent Brown, a pulmonologist with OU Medicine in Oklahoma City.

“COPD is likely to develop in up to one-third of smokers if they smoke long enough and heavily enough,” he says.

Smokers with COPD also increase their risk of lung cancer, but research shows that quitting smoking can slow the disease’s progression.

While those with asthma can often manage the disease with medication, Brown says even those with mild asthma can suffer a severe or fatal attack. If you have asthma, you should have an established physician and a plan for emergencies.

A commonly overlooked illness is sleep apnea, Brown says.

“People don’t ordinarily think of sleep apnea as a breathing or lung illness, but, because it drops oxygen levels in the blood, it can be very harmful to the body,” he says. “People who snore during sleep or have been observed to stop breathing during sleep are likely to have sleep apnea and should seek medical attention.”

5 Solutions

Brown says not smoking and avoiding smoke and dust help people reduce their chances of lung disease. He adds that some recent evidence indicates vaping may be harmful, too.

“Not only is smoke and dust from burned material dangerous, but the dusts from organic material like grain, hay and woodworking can lead to lung disease,” he says. “Exposure to mineral dust from grinding and polishing stone or exposure to asbestos in the remodeling or demolition of buildings can lead to serious lung diseases like asbestosis.”

When doing home-improvement projects, you should follow the warning labels on paints and chemicals.

“Some chemicals like diisocyanates found in polyurethane paint can lead to permanent asthma-like conditions,” Brown says.

4 Signs of lung disease

Brown recommends medical care if you have shortness of breath, including exercise-induced shortness of breath or episodes of shortness of breath when waking up. Other potential signs of lung disease include chronic coughing, coughing that brings up phlegm or blood, and swelling of the feet and lower legs.

Digestive tract

1 A healthy system

Poor digestive health can significantly impact your well-being – and it’s not just about what you eat. Gastroenterologist Christian D. Clark with Adult Gastroenterology Associates in Tulsa says maintaining digestive health requires a multi-pronged approach of diet, exercise, rest and constant re-evaluation of your environment.

“This evaluation process would involve avoidance of excessiveness – [like] food [or] blue light from electronics – as well as avoidance of toxins, including tobacco and alcohol,” Clark says. “Further, keeping up with routine screening exams, including colonoscopy and upper endoscopy, are also vital.”

2 Common issues

Gastroenterologists treat myriad problems, ranging from heartburn, constipation and diarrhea to liver disease, pancreatitis and gallbladder issues. If you experience any notable change in your digestive health, you should seek medical attention, especially, Clark says, for the following: abdominal pain; bleeding from the gastrointestinal tract; a change in bowel habits (such as diarrhea, constipation or a change in stool consistency or color); chronic nausea and/or vomiting; difficulty or pain with swallowing; and weight loss.

4 Crohn’s disease and ulcerative colitis 

People with Crohn’s disease or ulcerative colitis may share symptoms, but distinct components within these inflammatory bowel diseases affect patient health and medical care differently.

Crohn’s disease

  • causes chronic inflammation of the gastrointestinal tract;
  • can affect any part of the gastrointestinal tract, from the mouth to the anus;
  • most commonly affects the end of the small bowel (the ileum) and the beginning of the colon;
  • can affect the entire thickness of the bowel wall;
  • has inflammation that can skip or leave normal areas between patches of diseased intestine.

Ulcerative Colitis

  • causes chronic inflammation in the large intestine (the colon) and results in ulcers forming along the colon’s lining;
  • affects only the colon and rectum;
  • affects the inner-most lining of the large intestine;
  • has inflammation that does not skip areas.

Source: Crohn’s & Colitis Foundation

Bones and Joints

1 Thrive by being active

Travis Small, an orthopedic surgeon with the Orthopaedic Center in Tulsa and the Center for Orthopaedic Reconstruction and Excellence in Jenks, says the most important preventive measure for healthy joints is maintaining a healthy weight.

“For every pound a person weighs, it places four pounds of stress on a knee or hip,” he says. “Maintaining an active lifestyle and an adequate diet of calcium and vitamin D are best preventive measures for bone health.”

Children should take in daily recommendations for vitamins and minerals, which lay a foundation for healthy bones when they become adults.

According to the International Osteoporosis Foundation, the skeletal system grows from birth and extends throughout the teenage years; it reaches maximum strength and size – peak bone mass – in early adulthood. An estimated 10 percent increase of peak bone mass in children reduces the risk of an osteoporotic fracture during adult life by 50 percent.

2 Osteoporosis and osteopenia

“Osteoporosis is a … common metabolic bone disease which primarily affects post-menopausal women – 25 percent of women over the age of 65,” Small says. “The current diagnostic test for this condition is a [dual-energy X-ray absorptiometry] scan, which utilizes radiographic images to classify between normal, osteopenia and osteoporosis.”

With osteopenia, bones have a lower density than normal. It can be a precursor to osteoporosis, but not everyone who has osteopenia develops osteoporosis.

“The best preventative measures for treatment are to maintain an active lifestyle and supplement your diet with calcium and vitamin D, which are easily obtained through dairy products such as milk, cheese and yogurt,” Small says. “It is also … beneficial to avoid smoking.”

He says several various medical treatments are available and approved by the Food and Drug Administration, including bisphosphonates and hormone replacement therapy, which should be prescribed by a medical specialists.

3 Technology

“Medically, the field of biologic treatments for joint care is … in its infancy,” Small says. “However, there is a significant amount of research utilizing genetics and cellular level treatments for the future.”

Small cites the increased number of computer- and robotic-assisted surgeries.

“The design and properties of materials used as implants [evolves] daily as a result of advances in technology through three-dimensional simulators and other computer-assisted technologies,” he says. “In … joint reconstruction, technology allows us to more accurately and precisely place knee and hip replacement components through less invasive means.” 

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