18-17 Segment 2: Curing Chronic Sinusitis

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Common colds, allergies, and sinus infections have similar symptoms that make it very difficult to identify which malady a person is suffering from. However, for some people who constantly feel sick, knowing what their symptoms mean could allow them to receive better healthcare. So, how can you tell the difference between a cold, allergies, and a sinus infection?

Dr. Lisa Liberatore, an otolaryngologist specializing in sinus and sleep issues at Totum Health, New York, explains the differences between these three maladies. If a patient has body aches, fevers, and other systemic symptoms, she states that these are not usually symptoms of allergies and can be indicative of an infection. Along with these symptoms, Dr. Liberatore explains that the longevity of the symptoms can further indicate if the infection is viral or bacterial. Some infections can start off as viral, but once seven to ten days pass, a patient may begin to have fits of heavy coughing or notice yellow or green mucus. Dr. Liberatore says that this is an indication that the infection has become bacterial. Despite being a bacterial infection, antibiotics tend to do little to help the patient. The best way to get over a cold or cold-like symptoms is often to just wait out the course of the infection, consume lots of fluids, and get lots of rest.

But, for some people, these cold-like symptoms never seem to go away. Dr. Liberatore explains that if the cold lasts for a long time, or tends to progress to something worse, that can be an indication of a structural problem. This structural problem is related to chronic sinusitis which affects a person’s quality of life tremendously, causing symptoms such as severe nasal congestion to lack of productivity. Dr. Liberatore states that many primary care physicians often provide their patients with two treatment options–antibiotics or surgery. However, she explains that there are many smaller treatments present today that can provide relief to the patient without having to undergo an intense surgery.

Guest:

  • Dr. Lisa Liberatore, otolaryngologist specializing in sinus and sleep issues at Totum Health, New York

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18-13 Segment 2: Teaching Doctors To Listen

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We all know that doctors endure years and years of schooling and training in order to learn how to diagnose their patients and provide them with the best care. But, studies have shown that many doctors tend to miss details about other aspects of a patient’s life that can also have an affect on their wellbeing. Dr. Saul Jeremy Weiner, Professor of Medicine, Pediatrics & Medical Education at University of Illinois and co-author of Listening For What Matters: Avoiding Contextual Errors in Health Care, explains that patients will make important comments that do not necessarily pertain to their symptoms, but that this information is often overlooked despite being critical for a doctor to understand in order to provide the patient with an effective care plan. But, what is the overall impact of this on the patient?
Dr. Weiner and Dr. Alan Schwartz, Michael Reese Endowed Professor of Medical Education at University of Illinois, Chicago, and co-author, Listening For What Matters: Avoiding Contextual Errors in Health Care, have done their own research that has shown the effects of doctor’s that are too focused on the biomedical details in providing care for patients. Dr. Schwartz explains that the results of their research showed that doctors who address the patient’s personal life were able to provide a much more successful care plan for the patient. Furthermore, the study also showed that the cost of healthcare for the patient increased when the doctor was too concerned with the science of the diagnosis. In order to have the most successful outcome without increasing the cost of healthcare, doctors must address more than just the patient’s biomedical symptoms.

So, how can doctors learn to listen to their patients more efficiently? Dr. Weiner suggests using an approach commonly used in other industries: mystery shoppers. In the medical field, a mystery shopper is an unannounced standardized patient that is trained to go into a physician’s office and provide data to help identify problems–a tool that many doctors have found to be helpful in improving their practice. Dr. Schwartz states that by investing in improving contextual care doctor’s will be able to provide better care for their patients and decrease the cost of healthcare, too. However, all patients and employees in the medical field must be willing to undertake these methods and procedures in regular practice in order to improve the overall experience for everybody.

Guests:

  • Dr. Saul Jeremy Weiner, Professor of Medicine, Pediatrics & Medical Education at University of Illinois and co-author of Listening For What Matters: Avoiding Contextual Errors in Health Care
  • Dr. Alan Schwartz, Michael Reese Endowed Professor of Medical Education at University of Illinois, Chicago, and co-author of Listening For What Matters: Avoiding Contextual Errors in Health Care.

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18-09 Segment 2: Cyclic Vomiting Syndrome

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Vomiting is not a pleasurable experience for anybody, but most people do not suffer from it all that often. However, people with cyclic vomiting syndrome may experience this discomfort once or twice a month for 24 to 48 hours, and sometimes, even up to ten days. Kathleen Adams is the mother of a cyclic vomiting sufferer and the founder, President, and Research Liaison of Cyclic Vomiting Syndrome Association. She explains that her daughter began having episodes of vomiting as a baby that would last for two and a half to three days. She went undiagnosed for ten years, before finding a doctor who recognized her symptoms and was able to prescribe her medicine that helped decrease the severity of the episodes.

Due to the fact that this syndrome is not well known, many people do not know what to look for or how to prevent it. Dr. B Li, Professor of Pediatrics and Director of Cyclic Vomiting Program at the Medical College of Wisconsin, states that cyclic vomiting syndrome is defined as  recurrent spells of vomiting that can make individuals vomit to the point of dehydration, and even hinder their ability to walk and talk. She explains that these episodes can be triggered from stress, lack of sleep, prolonged fasting, and even exciting events. Although, it can sometimes be prevented if the patient or caregiver is able to identify the trigger that sets off an episode.

While there are ways to help prevent cyclic vomiting syndrome through medications and understanding what triggers an episode, it still remains difficult to treat. Dr. Li states that studies have sought to address how debilitating the syndrome is and it has been proven to impact the quality of life to the same degree as diseases such as Crohn’s disease. However, Dr. Katja Kovacic, pediatric gastroenterologist at the Children’s Hospital of Wisconsin, explains that most children eventually outgrow cyclic vomiting syndrome by adolescence. Unfortunately for many, it can evolve into other symptoms, such as migraine headaches. Despite being something a person may eventually outgrow, it is important to understand the impact the syndrome has on those who suffer from it as well as their caregivers.

Guests:

  • Kathleen Adams, mother of cyclic vomiting sufferer and the founder, President, and Research Liason of Cyclic Vomiting Syndrome Association
  • Dr. B Li, Professor of Pediatrics and Director of the Cyclic Vomiting Program at Medical College of Wisconsin
  • Dr. Katja Kovacic, pediatric gastroenterologist at Children’s Hospital of Wisconsin

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15-26 Segment 1: Bell’s Palsy

 

Synopsis: Bell’s palsy is a frightening malfunction in the nerve controlling half of the face that occurs for unknown reasons. Sufferers often think they’re having a stroke. While Bell’s palsy often resolves on its own, it can leave permanent effects. Experts and two people who’ve had the disorder discuss.

Host: Reed Pence. Guests: Mandy, Bell’s palsy patient; Dr. Steven Lewis, Professor and Associate Chairman, Department of Neurological Sciences, Rush University Medical Center; Dr. Lisa Ishii, Associate Professor of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine; Kerry Schrambeck, Bell’s palsy patient

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Click here for the transcript