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Systemic Signs and Symptoms

Systemic signs and symptoms are those that affect you in a general or overall way. Common systemic signs and symptoms of vasculitis are:

  • Fever
  • Loss of appetite
  • Weight loss
  • Fatigue (tiredness)
  • General aches and pains

Organ- or Body System-Specific Signs and Symptoms

Vasculitis can affect specific organs and body systems, causing a range of signs and symptoms.

Skin

If vasculitis affects your skin, you may notice skin changes. For example, you may have purple or red spots or bumps, clusters of small dots, splotches, bruises, or hives. Your skin also may itch.

Joints

If vasculitis affects your joints, you may ache or develop arthritis in one or more joints.

Lungs

If vasculitis affects your lungs, you may feel short of breath. You may even cough up blood. The results from a chest x ray may show signs that suggest pneumonia, even though that may not be what you have.

Gastrointestinal Tract

If vasculitis affects your gastrointestinal tract, you may get ulcers (sores) in your mouth or have stomach pain.

In severe cases, blood flow to the intestines can be blocked. This can cause the wall of the intestines to weaken and possibly rupture (burst). A rupture can lead to serious problems or even death.

Sinuses, Nose, Throat, and Ears

If vasculitis affects your sinuses, nose, throat, and ears, you may have sinus or chronic (ongoing) middle ear infections. Other symptoms include ulcers in the nose and, in some cases, hearing loss.

Eyes

If vasculitis affects your eyes, you may develop red, itchy, burning eyes. Your eyes also may become sensitive to light, and your vision may blur. Rarely, certain types of vasculitis may cause blindness.

Brain

If vasculitis affects your brain, symptoms may include headaches, problems thinking clearly, changes in mental function, or stroke-like symptoms, such as muscle weakness and paralysis (an inability to move).

Nerves

If vasculitis affects your nerves, you may have numbness, tingling, and weakness in various parts of your body. You also may have a loss of feeling or strength in your hands and feet and shooting pains in your arms and legs.

If the need to go the emergency room suddenly arises, your first instinct is likely to be a phone call to 911—not to wonder how much an emergency room visit may cost you. And in an emergency, getting the right care, and getting it fast, should be the focus.

“If you’re having a heart attack, you’re not going to ask if the doctor treating you takes your insurance,” says Karen Pollitz, a senior fellow at the Kaiser Family Foundation.

But be aware: That potentially lifesaving trip to the emergency room may have a high price tag attached to it. A Kaiser-New York Times survey of insured and uninsured people who had difficulty paying medical bills found that ER bills accounted for the largest portion of what they owed.

Going to a hospital that takes your insurance may not prevent you from getting unexpected big bills. Here’s why: About two-thirds of emergency room doctors are independent contractors, who may not be in your insurance plan, according to the American College of Emergency Physicians. And any out-of-network doctor or laboratory may later bill you for whatever your insurance doesn’t cover, a practice called balance billing. “There can be a whole cast of providers involved, some you never even meet, who send you a bill,” says Pollitz.

In addition, if the ambulance company that transports you to the emergency room doesn’t take your insurance, your out-of-network costs could be over $2,000, depending on factors such as where you live and the level of care you receive before you get to the hospital. A breathing tube, for example, may bump up the price. And if your insurer doesn’t consider the ambulance ride essential, you may be on the hook for even more money

You can’t completely protect yourself from these kinds of surprising medical bills, and you never want to put cost concerns ahead of getting care during an emergency.

Overview

To understand COPD, it helps to understand how the lungs work. The air that you breathe goes down your windpipe into tubes in your lungs called bronchial (BRONG-ke-al) tubes or airways.

Within the lungs, your bronchial tubes branch into thousands of smaller, thinner tubes called bronchioles (BRONG-ke-ols). These tubes end in bunches of tiny round air sacs called alveoli (al-VEE-uhl-eye).

Small blood vessels called capillaries (KAP-ih-lare-ees) run through the walls of the air sacs. When air reaches the air sacs, oxygen passes through the air sac walls into the blood in the capillaries. At the same time, carbon dioxide (a waste gas) moves from the capillaries into the air sacs. This process is called gas exchange.

The airways and air sacs are elastic (stretchy). When you breathe in, each air sac fills up with air like a small balloon. When you breathe out, the air sacs deflate and the air goes out.

In COPD, less air flows in and out of the airways because of one or more of the following:

  • The airways and air sacs lose their elastic quality.
  • The walls between many of the air sacs are destroyed.
  • The walls of the airways become thick and inflamed.
  • The airways make more mucus than usual, which can clog them.

In the United States, the term “COPD” includes two main conditions—emphysema (em-fih-SE-ma) and chronic bronchitis (bron-KI-tis). (Note: The Health Topics article about bronchitis discusses both acute and chronic bronchitis.)

In emphysema, the walls between many of the air sacs are damaged. As a result, the air sacs lose their shape and become floppy. This damage also can destroy the walls of the air sacs, leading to fewer and larger air sacs instead of many tiny ones. If this happens, the amount of gas exchange in the lungs is reduced.

In chronic bronchitis, the lining of the airways is constantly irritated and inflamed. This causes the lining to thicken. Lots of thick mucus forms in the airways, making it hard to breathe.

Most people who have COPD have both emphysema and chronic bronchitis. Thus, the general term “COPD” is more accurate.

Outlook

COPD is a major cause of disability, and it’s the third leading cause of death in the United States. Currently, millions of people are diagnosed with COPD. Many more people may have the disease and not even know it.

COPD develops slowly. Symptoms often worsen over time and can limit your ability to do routine activities. Severe COPD may prevent you from doing even basic activities like walking, cooking, or taking care of yourself.

Most of the time, COPD is diagnosed in middle-aged or older adults. The disease isn’t passed from person to person—you can’t catch it from someone else.

COPD has no cure yet, and doctors don’t know how to reverse the damage to the airways and lungs. However, treatments and lifestyle changes can help you feel better, stay more active, and slow the progress of the disease.

There is a common misconception that if you suffer from acid reflux, you must be eating spicy foods, drinking martinis and smoking cigars on a regular basis.

This is not true, said Dr. Anish Sheth, a gastroenterologist and assistant professor of medicine at Yale University.

In fact, lifestyle factors may account only for occasional heartburn sufferers, he said.

A person who experiences acid reflux on an everyday basis is more likely to have an anatomical or medical condition.

1. Sphincter has low pressure

Acid reflux occurs when the acidic contents of the stomach pass up into the esophagus, and the sphincter muscle (the barrier between the two) has a defect, so it is unable to block the acid.

If the sphincter muscle has low pressure, it causes acid reflux.

“Some people just have a low pressure, and we don’t know why,” Sheth said. “Pregnancy can lower the pressure, as can blood pressure and depression medications. But, most of the time, we don’t know what causes it.”

For patients who suffer from a low-pressure sphincter, there is hope: a minimally invasive surgery known as fundoplication can provide relief.

2. Pregnancy

“Elevated progestin hormones cause the pressure of the sphincter to go down,” Sheth said. “And the increased pressure of the growing uterus predisposes the woman to acid reflux.”

The good news is that once the pregnancy is over, the symptoms of acid reflux are likely to disappear.

3. Hiatal hernia

A hiatal hernia is very common (at least 40 percent of Americans have them) and doesn’t necessarily cause acid reflux, Sheth said.

However, in a subgroup of patients with very severe reflux, a hiatal hernia – where the upper portion of the stomach moves upward into the chest – can cause acid to reflux, Sheth added.

Hiatal hernias can range in size from 1 to 4 centimeters. They can be repaired during fundoplication surgeries.

4. Gastroparesis

This is a disorder in which the stomach takes too long to empty its contents.

“Normally, the acid is produced and emptied into the small intestine, but if it sits in the stomach for longer, by sheer logic, it will come back up into the esophagus,” Sheth said.

5. Obesity

“Even though obesity is a lifestyle issue, it’s also something that can go overstated,” Sheth said.

“Obesity increases the pressure in the stomach area, so for people who don’t have the other medical causes, the sheer presence of obesity will cause them to have acid reflux.”

6. Bisphosphonates

This class of drugs prevents and treats osteoporosis in women and, occasionally, cause acid reflux in users.

“They stand out,” Sheth said. “They don’t necessarily cause reflux, but they can cause esophageal irritation, which can feel like heartburn.”

Sheth added it is always worth a quick review of any medication that you are taking long-term to see if acid reflux is one of its side effects.

7. Lifestyle

People who have heartburn “every now and then” may benefit from making lifestyle changes, Sheth said.

If they decrease their chocolate and/or caffeine intake (or other food or beverages that may irritate their symptoms), lose weight and stop smoking, they are likely to see a reduction in acid reflux symptoms, he said.

In draft voluntary guidelines issued Wednesday, the agency set both two-year and 10-year goals for lower sodium content in hundreds of processed and prepared foods. The aim is to reduce the risk of high blood pressure, heart disease and stroke among Americans, according to the FDA.

“Many Americans want to reduce sodium in their diets, but that’s hard to do when much of it is in everyday products we buy in stores and restaurants,” Health and Human Services Secretary Sylvia Burwell said in an FDA statement.

“Today’s announcement is about putting power back in the hands of consumers, so that they can better control how much salt is in the food they eat and improve their health,” she added.

Dr. Tom Frieden, director of the U.S. Centers for Disease Control and Prevention, elaborated on the health risks salt poses during a Wednesday morning news conference on the proposed guidelines.

“Heart attack and stroke is the leading killer in the United States, and high blood pressure is a leading risk factor contributing to more than 1,000 deaths per day,” he said.

“There is a direct dose-response relationship between sodium and blood pressure,” Frieden added. “Reducing sodium intake reduces both blood pressure and cardiovascular disease.”

Americans’ average salt intake is about 3,400 milligrams (mg) a day, which is nearly 50 percent more than what experts recommend.

The voluntary targets are meant to reduce Americans’ daily salt intake to 3,000 mg in two years and 2,300 mg in the next decade, according to the FDA. The guidelines cover a wide swath of foods, from bread to cold cuts, cereals and snacks.

Some studies have estimated that lowering salt intake by about 40 percent over the next decade could save 500,000 lives and nearly $100 billion in health care costs in the United States.

“The totality of the scientific evidence supports sodium reduction from current intake levels,” said Susan Mayne, director of the FDA’s Center for Food Safety and Applied Nutrition.

Aspirin, also known as acetylsalicylic acid, is the oldest analgesic on the market. Aspirin is an NSAID (nonsteroidal anti-inflammatory drug). Because of its anti-inflammatory properties, it is often used to treat arthritis, toothaches, and other pains aggravated by inflammation. It is also used to treat minor body aches and pains, headaches, and reduce fevers. Aspirin has two major side effects. The first is that it can be stomach irritant. In fact, it can irritate any tissue it comes into contact with (thus chewing aspirin gum is not recommended because it can irritate the gums and mouth). Also, people who know they are allergic to salicylic acids in general are urged to avoid aspirin. But many who take aspirin, even on a regular basis, do not have stomach irritation.

You may be wondering why some people take aspirin regularly. Another big “side effect” of aspirin can actually be a benefit for many people. Aspirin thins out platelets, the cells responsible for blood clots. While clotting helps stop bleeding when you cut yourself, clots also play a big role in causing strokes and heart attacks when blood vessels are already partially blocked by cholesterol. Fewer platelets means smaller chance of heart attack or stroke, so health care providers often prescribe aspirin for this.

Ibuprofen (commonly branded as Advil or Motrin) is one of the newest analgesics, approved by the FDA in 1974. It may have some advantages over aspirin, depending on the type of pain you are experiencing. It appears to be slightly stronger (meaning you need less of it) to treat pain from soft tissue injuries and dental pain. In addition, it has been shown to be the most effective pain reliever for menstrual pains. In fact, here’s a tip: all of the pain relievers marketed exclusively for this purpose (e.g. Midol) contain ibuprofen, but they cost much more because they are marketed as a “high tech” pain reliever. Stick with generic ibuprofen for menstrual cramps. Ibuprofen can also be a stomach irritant, but this occurs much less commonly than with aspirin. Unlike aspirin, it has a very mild blood-thinning effect, so if you have conditions where loss of platelets would be a concern, ibuprofen is a better choice. There have been some concerns that ibuprofen can contribute to kidney damage, so those with kidney concerns should consult with a health care provider before taking it.

Acetaminophen (also known as paracetamol, and commonly branded as Tylenol or Excedrin) was introduced in 1955. It has about the same pain-relieving power as aspirin for pains not caused by inflammation, but is slightly less effective for inflammatory pain. This is because it doesn’t alleviate inflammation, and is probably not as effective with menstrual cramps as ibuprofen. Of all the analgesics, acetaminophen is the least likely to be a stomach irritant. However, taking more than 325mg of acetaminophen at a time, taking more than one type of medication that contains acetaminophen, or taking it with alcohol can lead to severe liver damage — which can require a liver transplant or even result in death.

Naproxen (Aleve) is another NSAID. It didn’t become available without a prescription in the U.S. until 1994. It is the most powerful pain reliever currently available without a prescription, but can cause even more gastrointestinal irritation than aspirin. As a result, it needs to be taken in fewer doses, and with lots of water.

Regardless of what pain reliever you might choose or is most appropriate,remember to follow the directions on the label — just like you would with prescription medications. Hopefully this helps clear up some of the confusion. You may want to check out the related Q&As for more info about analgesics.

Choose a sunscreen that has an SPF of 30 or higher, is water resistant, and provides broad-spectrum coverage, which means it protects you from UVA and UVB rays. Follow these helpful tips when selecting a sunscreen.

Apply sunscreen generously before going outdoors. It takes approximately 15 minutes for your skin to absorb the sunscreen and protect you. If you wait until you are in the sun to apply sunscreen, your skin is unprotected and can burn.

Use enough sunscreen. Most adults need at least one ounce of sunscreen, about the amount you can hold in your palm, to fully cover all exposed areas of your body. Rub the sunscreen thoroughly into your skin.

Apply sunscreen to all bare skin. Remember your neck, face, ears, tops of your feet and legs. For hard‐to‐reach areas like your back, ask someone to help you or use a spray sunscreen. If you have thinning hair, either apply sunscreen to your scalp or wear a wide‐brimmed hat. To protect your lips, apply a lip balm with a SPF of at least 15.

Reapply sunscreen at least every two hours to remain protected, or immediately after swimming or excessively sweating. People who get sunburned usually didn’t use enough sunscreen, didn’t reapply it after being in the sun, or used an expired product. Your skin is exposed to the sun’s harmful UV rays every time you go outside, even on cloudy days and in the winter. So whether you are on vacation or taking a brisk fall walk in your neighborhood, remember to use sunscreen. For more skin cancer prevention tips, see a board-certified dermatologist.

What Is Earwax Buildup?

Your ear canal produces a waxy oil called cerumen, which is more commonly known as earwax. This wax protects the ear from dust, foreign particles, and microorganisms. It also protects ear canal skin from irritation due to water. In normal circumstances, excess wax finds its way out of the canal and into the ear opening naturally and then is washed away.

When your glands make more earwax than is necessary, it may get hard and block the ear. When you clean your ears, you can accidentally push the wax deeper, causing a blockage. Wax buildup is a common reason for temporary hearing loss.

You should take great caution when trying to treat earwax buildup at home. If the problem persists, visit your doctor. Treatment is generally quick and painless, and hearing can be fully restored.

Heat exhaustion is one of the heat-related syndromes. Symptoms range in severity from mild heat cramps to heat exhaustion to potentially life-threatening heatstroke. Heat exhaustion can begin suddenly, usually after working or playing in the heat, perspiring heavily or being dehydrated.

Heat exhaustion signs and symptoms include:

  • Faintness or dizziness
  • Nausea or vomiting
  • Heavy sweating often accompanied by cold, clammy skin
  • Weak, rapid pulse
  • Pale or flushed face
  • Muscle cramps
  • Headache
  • Weakness or fatigue

If you suspect heat exhaustion

Untreated, heat exhaustion can lead to heatstroke, which is a life-threatening condition. If you suspect heat exhaustion, take these steps immediately:

  • Move the person out of the heat and into a shady or air-conditioned place.
  • Lay the person down and elevate the legs and feet slightly.
  • Remove tight or heavy clothing.
  • Have the person drink cool water or other nonalcoholic beverage without caffeine.
  • Cool the person by spraying or sponging with cool water and fanning.
  • Monitor the person carefully.

Call 911 or your local emergency number if the person’s condition deteriorates, especially if he or she experiences:

  • Fainting
  • Confusion
  • Seizures
  • Fever of 104 F (40 C) or greater

Cuts – Home Treatment

Minor cuts usually can be treated at home. If you do not have an increased chance of getting an infection, do not have other injuries, and do not need treatment by a doctor or a tetanus shot, you can clean and bandage a cut at home. Home treatment can help prevent infection and promote healing.

The American Red Cross recommends that everyone use blood and body fluid precautions with first aid treatment.

Treat bleeding

Stop the bleeding with direct pressure to the wound.

Nonprescription products are available to be applied to the skin to help stop mild bleeding of minor cuts, lacerations, or abrasions. Before you buy or use one, be sure to read the label carefully and follow the label’s instructions when you apply the product.

After you have stopped the bleeding, check your symptoms to determine if and when you need to see your doctor.

Clean the wound

Clean the wound as soon as possible to reduce the chance of infection, scarring, and tattooing of the skin from dirt left in the wound.

  • Remove large pieces of dirt or other debris from the wound with cleaned tweezers. Do not push the tweezers deeply into the wound.
  • Wash the wound for 5 minutes with large amounts of cool water and soap (mild dishwashing soap, such as Ivory, works well). Some nonprescription products are available for wound cleaning that numb the area so that cleaning doesn’t hurt as much. Be sure to read the product label for correct use.
  • Don’t use rubbing alcohol, hydrogen peroxide, iodine, or Mercurochrome, which can harm the tissue and slow healing.

 

Stitches, staples, or skin adhesives (also called liquid stitches)

Determine if your wound needs to be closed by a doctor with stitches, staples, or skin adhesives.

Your doctor will tell you how to take care of your stitches or staples and when to return to have them removed. Skin adhesives usually do not need to be removed, but your doctor may wish to see you to check on the wound. Be sure to carefully follow your doctor’s instructions. If you are unsure of how to care for your wound or have questions, call your doctor for instructions.

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