7 medical breakthroughs that could change your life

Posted: Friday, June 20, 2008
Technology is revolutionizing the world of healthcare even as you read this. These are seven cutting-edge breakthroughs that are changing the way hospitals and health centers throughout the Hudson Valley diagnose and treat their patients.

1. Breast cancer
The newest technology dedicated to fighting and diagnosing breast cancer is digital mammography. Introduced about four years ago, it has now become the standard of care throughout the country. “The great thing about digital mammography is that it gives us greater visualization and flexibility,” says Laurie Wadsworth, imaging director at DRA Imaging of Fishkill and Poughkeepsie. “It allows us see through dense areas while still seeing the skin line.”

Not only does digital mammography give the technician a more in-depth and efficient way to survey the breast, but it is also more comfortable for the patient than a regular mammography. The compression varies more and the pull is less frequent.

Along with digital mammography is also what is called Computer Aided Detection (CAD) which, according to Laurie Wadsworth, gives the technician “another set of eyes.” If the technician misses a trouble area, the computer can highlight that area and call it back to the technician’s attention.

2. Sleep apnea
Sleep apnea affects more than 12 million Americans, according to the National Institute of Health. Although it is most common in overweight males over forty, many women are also suffering, says Barbra Chatr-aryamontri M.D., sleep lab director at Northern Dutchess Hospital in Rhinebeck.

The American Sleep Apnea Association (ASAA) explains that people who suffer from sleep apnea stop breathing several times throughout the night and often for a minute or longer. The ASAA adds that “with each apnea event, the brain briefly arouses people in order for them to resume breathing, but consequently sleep is extremely fragmented and of poor quality.” The ASAA states that left untreated, sleep apnea can cause high blood pressure, obesity, headaches, memory problems, and even impotency.

Dr. Chatr-aryamontri says that in treating sleep apnea, “the gold standard is a continuous positive airway pressure mask” which sends continuous pressurized air via the mask into the patient’s mouth to keep the airways open during sleep.
However, this mask can be uncomfortable for some patients. New masks are less invasive, with softer head gear and straps.

Dr. Chatr-aryamontri adds that “within the last year a machine has been developed with a flex feature that addresses both central and obstructive sleep apnea. This flex feature decreases the air pressure to the patient which allows him or her to breathe much more easily.”

A big change in treating sleep apnea is that now Medicare and Medicaid, along with some insurance companies, have agreed to pay up to 80 percent of the cost of a dental appliance, which is a very effective treatment. This dental appliance, Dr. Chatr-aryamontri says, “is a nocturnal retainer that displaces the jaw forward a little and pulls the tongue with it so that the airway remains open.”

Although the masks and appliances are a much more popular and less invasive option to help fight sleep apnea, sufferers can get surgery, but they must consult their own ear, nose, throat doctor and be a good candidate. A mild case can be improved with a UPPP (Uvulopalatopharyngoplasty) surgery that puts pillar implants in the patient’s soft palate to harden it.

A moderate to severe case can be downgraded with surgery so that masks can be worn less frequently. There is also major reconstructive surgery that remodels both the airways and the jaw, but a patient must meet all of the special requirements to be a candidate, Dr. Chatro-aryamontri says.

3. Alzheimer’s disease
All of the treatments that are currently FDA approved and used by patients are working wonders for Alzheimer’s disease and its symptoms. While she adamantly supports many existing Alzheimer’s treatments, Elaine Sproat of the Poughkeepsie chapter of the Alzheimer’s Association says “hope is on the horizon,” with numerous treatments currently undergoing clinical trials (there are more than 25 clinical studies in New York State alone).

While existing drugs and treatments effectively treat Alzheimer’s symptoms, those awaiting approval by the FDA following clinical study hope to change the course of the disease itself, Sproat explains.
One such drug is Etanercept. Commonly used to treat several forms of arthritis, Etanercept, has just recently been tested in Alzheimer’s patients and has shown promising results.

According to Scientific Daily, TNF (tumor necrosis factor-alpha) regulates the transmission of neural impulses in the brain, and studies show that when TNF is elevated, as in Alzheimer’s patients, it interferes with the regulation. After an injection of Etanercept (an anti-TNF) in the spine, patients have shown tremendous improvements in minutes. Etanercept is currently FDA approved only for arthritis patients.

4. Cataract surgery
Over the past few years cataract surgery has come a long way. “Now, only hours after surgery, patients can get up and function, can see better immediately, can do the jitterbug within the day – the benefit is entirely the patient’s,” says Satish Modi, MD, of Seeta Eye Center in Poughkeepsie.

Surgeons remove the cataract using a two millimeter incision to the eye and replace the natural lens with an implant, explains Dr. Modi. Improving on the standard crystal lens that gives reasonable distance vision but little near vision (75 percent of patients who receive a crystal lens must wear reading glasses) are three new premier implants for cataract patients: restor, rezoom, and toric.

The restor lens is best for patients who do a lot of up close work, such as reading or sewing. The rezoom lens is better for patients who need better distance or median distance sight, such as working on the computer. People who receive rezoom implants usually need reading glasses for up-close work.

Although each of these lenses improves a cataract patient’s sight tremendously, there are some side effects. Both of these lenses contain concentric rings in them to allow both near and far vision, but at night these rings can create circles of light (or ‘halos’) in the patient’s field of vision when looking directly at a street light or head light.

Neither the restor nor the rezoom lens corrects astigmatism. For that, Dr. Modi recommends the toric implant. The toric corrects the astigmatism and gives the patient either near or distance vision. Dr. Modi is hopeful that within the year patients will able to get both the toric and restor implant together so that the astigmatism will be corrected and the patient will be able to see up close without glasses.

“We are really serving as counselors and psychologists because we have to discuss with each patient what lens will fit their needs. If they hunt, or do needlepoint, or work all day on the computer, we need to find the best lens that works for their occupation and lifestyle,” Dr. Modi explains.

5. Diabetes
“Over the past five years there has been an explosion of new information on diabetes – probably more so than the twenty-five years before that,” says Beth Irish, a certified diabetes educator and dietician at Vassar Brothers Hospital in Poughkeepsie.

A cause for that explosion has been the inner relationships and connections researchers and scientists have been finding between different diseases as a result of the growth of genetics. New research may even show that Type 1 and 2 diabetes aren’t as different as what was once thought.
Michelle Muir from the Alzheimer’s Association explains that there may be a link between Type 2 diabetes and Alzheimer’s disease. “Compared to people without diabetes, more people with diabetes get dementia. And the most common dementia is Alzheimer’s disease.”

Just as there is no known cause for Alzheimer’s disease, doctors aren’t sure how Alzheimer’s and diabetes are connected either. What they do know, Muir says, is that “insulin resistance, high blood sugar or diabetes can harm the brain in several ways.”
Insulin resistance and Type 2 diabetes increase the risk of heart disease and stroke, which damage blood vessels, which then contributes to Alzheimer’s. Too much insulin can upset the chemical balance of the brain, which can trigger Alzheimer’s. And inflammation which is caused by high blood pressure, can also damage brain cells, Muir explains.

Numerous clinical trials are currently underway to determine whether Type 2 diabetes medication can help prevent or treat Alzheimer’s. And although “preventing Type 2 diabetes may not stop dementia,” Muir says, “preventing diabetes is a good idea in [and of] itself.”
Treatment for diabetes has become easier and more convenient. A new drug called Januvia treats diabetes without the side effect of weight gain. More and more, pharmacists are combining drugs to provide more thorough and fitting treatment. Insulin pens are growing in popularity as are insulin pumps.

Extremely popular are glucose monitors that measure blood sugar levels constantly throughout the day and tests, such as A1C, that diabetes patients can now take home and do on their own instead of visiting the doctor. “More and more diabetes treatments are fitting the lifestyles of the patients,” says Irish. “They are getting more basic and more successful, so that they become no big deal.”

6. Hearing loss
One of the newest treatments for hearing loss over the past couple of years has been bone anchored implants. Dr. Lori Biasotti A.U.D. of the Family Hearing Center in Fishkill explains that the implants, or what is also called trans ear bone conduction, work best for people who cannot hear in one ear but have normal hearing in the other.

“It’s very exciting because we only need to adjust the one ear rather than both, so it’s much more comfortable for the patient,” adds Dr. Biasotti. A bone conduction goes in the inner ear canal and re-directs the sound so the brain receives it in normal frequency.

With hearing loss that isn’t as severe, most patients prefer – and Dr. Biasotti recommends – an open ear fit, which lends a “free and comfortable feeling” to the patient. This is most common with high frequency hearing loss patients.
For the most severe hearing loss, Dr. Biasotti recommends the traditional, over the ear aid with a
custom mold.

7. Varicose veins
The newest and most minimally invasive treatment for varicose veins is Endo-venous Laser Treatment (EVLT) and was brought to the Hudson Valley about five years ago by Dr. Bryan Yen of DRA Imaging of Fishkill and Poughkeepsie. Varicose veins are caused by blood vessels that have pooled in one or more areas as a result of a faulty vein.

Kathleen Anduze R.N. C.R.N. of DRA Imaging explains that during EVLT a small laser catheter is inserted into the leg after the patient is given a local anesthetic and the heat from the laser seals the faulty vein. Because the vein is sealed, blood can no longer pool and, therefore, the bulging of the varicose vein is also stopped. The loss of that vein is inconsequential because the blood will naturally flow to other healthy veins.

“This procedure is exciting for many reasons,” Anduze says. “We do the procedure in our office. It only takes about an hour. Normally, it is covered by insurance. And the only recovery restrictions are that the patient cannot fly for a week and they have to wear a compression hose [or stocking]. If any pain occurs after the treatment, it’s usually only soreness for a few days that can be relieved with an over-the-counter pain reliever.”
Not only does the treatment relieve any pain or cramping but it also takes away the unsightly, bulging varicose vein.
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