Aug 26

Focusing on better vision

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Approximately half a million Australians are blind or vision impaired. Some 80% of vision loss is caused by just five conditions: age-related macular degeneration, cataract, refractive error, diabetes related retinopathy and glaucoma.

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Glaucoma is sometimes referred to as the “sneak thief” of sight because it gradually and permanently destroys side vision, often without being noticed.

There are several different forms of glaucoma. It is the name given to a group of eye diseases where the optic nerve at the back of the eye is damaged. The damage is caused when pressure in the eyeball rises due to a build up of fluid. This fluid build-up takes place either because too much fluid is formed or because the canals in the eye, which normally drain the fluid away, don’t work properly.

Unfortunately, glaucoma can’t be cured. Once there is damage to the nerve cells in the eye, repair is not possible. However, the serious consequences of glaucoma can be prevented if the condition is discovered soon enough; and early treatment, usually with eye drops to stabilise the pressure in the eye, can help avoid further loss of sight. As well, up to date information about glaucoma is available by way of the new Vision Impairment Fact Card available from pharmacies providing the Pharmaceutical Society’s Self Care health information.

Glaucoma is very much a family affair. If someone in your family has or had glaucoma you’re almost three times more likely to have glaucoma yourself. And that risk increases as you get older.

You are also at greater risk of getting glaucoma if you have diabetes or high blood pressure, if you are short-sighted or if you get migraine headaches.

In the early stages of glaucoma, most people experience no symptoms, even when losing their sight. Nevertheless, there are sometimes warning signs. Some people may notice a need to change their glasses more often, perhaps find it hard to see in dark rooms, lose wide vision, or have blurred sight.

So if your sight is hazy or blurred, or your eyes difficult to focus, it’s clearly important to see your optometrist or ophthalmologist for a check up.

The only way to prevent complete loss of vision is early detection and treatment.

The theme for the recent National Glaucoma Week was “Don’t lose your drivers licence to Glaucoma”.

National Executive Officer for Glaucoma Australia, Beverley Lindsell, said the theme was chosen because losing a driver’s licence generally led to major lifestyle issues related to mobility and independence. Licence loss can be a consequence of untreated glaucoma.

“Our major message is that all Australians aged 40 and over must have their eyes checked at least every two years by an optometrist or opthalmologist, more regularly if they have a family history of the condition, hypertension, diabetes or a former eye injury.”

Mrs Lindsell said research showed that drivers with moderate to severe glaucoma were six times more likely to be involved in an ‘at fault’ vehicle accident than those drivers not suffering from the condition.

If you have glaucoma and are using drops, make sure you know how your eye medicines work so as to get the most benefit from them. Ask your pharmacist for the Vision Impairment Self Care Fact Card; and there is some special information on glaucoma which your pharmacist can print out for you. It also gives some helpful hints on how eye drops should be applied.

For the location of the “Self Care” pharmacy nearest you, call the Pharmaceutical Society on 1300 369 772 or check out the Pharmaceutical Society website: www.psa.org.au

©2009 Pharmaceutical Society of Australia

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Aug 19

Can we KO BO?

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The word “phonograph” was the trade name applied to the device invented by Thomas Edison some 130 years ago for transmitting the spoken world by way of a needle scratching around the surface of a cylinder. It spawned the record player, itself long since superseded by the miniaturised music machines of today.

Edison is also credited with developing the electric light bulb into some form of practical illumination. And he famously shed light on the secret of his great success as an inventor with his much quoted (perhaps misquoted) statement: “It’s 10% inspiration and 90% perspiration.”

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That’s all well and good; but how do we cope with the sometimes unpleasant consequences of too much perspiration?

Hyperhidrosis is the fancy medical term used to describe excessive sweating. It’s happened to us all at some stage or another, usually when we over-exercise in hot conditions; but some people get extra sweaty in what seem to be the coolest weather and the calmest conditions.

Of course sweating occurs for a reason; it’s not just there to cause us embarrassment. The major function is the regulation of body temperature through the cooling effects of sweat evaporation. Well that’s what most sweat does.

In fact there are two types of sweat glands: so-called eccrine and apocrine. The eccrine glands are distributed over the entire skin surface whereas the apocrine glands occur mainly in the armpits and the groin. The apocrine glands produce a more viscous secretion responsible for our “personal scent”.

Wherever on the body the sweat comes from it’s initially clean and fresh and without any unpleasant odour; but when it comes into contact with the normal skin bacteria, a not so pleasant smell is the result.

The management of body odour (BO) or bromhydrosis as it is known medically, depends chiefly on two factors – killing the bacteria on the body (or at least reducing their number) and keeping the affected area as dry as possible.

Sweaty, smelly feet are a particular problem. The moisture enclosed by shoes and socks can increase the risk of fungal infections; and the fungal infections can exacerbate the often already unpleasant odour which rises from floor level whenever the laces are loosened.

Oral malodour sounds so much more polite than halitosis; but it’s bad breath by any other name. Overnight the lack of the cleansing action of saliva allows the bacteria in the mouth to run riot, so waking up in the morning with dogs’ breath is not an unusual occurrence.

But this is most often transient and is easily rectified by having some breakfast, brushing the teeth and tongue, and rinsing the mouth with fresh water.

In people with persistent halitosis, poor oral hygiene is probably the problem, but other pre-disposing factors include mouth and gum disease, and a chronic reduction in the secretion of saliva. There are a number of medicines that cause dry mouth and a few others which could be a direct cause of bad breath. Ask your pharmacist for advice.

The cause of halitosis may not always originate in the mouth. Sometimes an upper respiratory tract or sinus infection could be the culprit. See your doctor if this is a possibility.

Meanwhile you could get some useful information on how to avoid those less than pleasant fragrances from pharmacies providing the Pharmaceutical Society’s Self Care health information. There are fact cards on Dry Mouth, Oral Health, Sinus Problems and Tinea, among many others. Check the website www.psa.org.au and click on Self Care Pharmacy Finder, for the nearest location.

©2009 Pharmaceutical Society of Australia

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Aug 12

Making the mouth a healthier place

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We expect our teeth to last a lifetime; however, it seems the standard of oral health care in Australia – especially in regional areas of Australia – leaves quite a bit to be desired.

Recent studies indicate that Australians have lower standards of oral health than almost any other developed country.

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In part, this problem is due to a shortage of skilled oral health care practitioners, but there are strategies that we can personally put into practice that will help prevent tooth decay and gum disease occurring – strategies that were highlighted during the recent National Dental Health Awareness Week.

The most common cause of oral health problems is plaque. Plaque is a thin, sticky film which builds up on the teeth. It is produced by a combination of saliva, bacteria and food. The bacteria ferment sugars in the food forming acids that erode the tooth enamel. Plaque also damages the gums as well.

The plaque can be removed by brushing and flossing, but it quickly reforms. When it stays on the teeth for longer that a few days, it hardens into tartar (or calculus) that acts a reservoir for bacteria. The tarter then needs to be removed by a dentist.

For some good tips on how to keep your teeth long term, and how to keep those tissues that support the teeth healthy as well, get hold of the Fact Card titled Oral Health. It’s available from pharmacies around Australia that provide the Pharmaceutical Society’s Self Care health information.

For a start, brush your teeth twice a day – morning and bedtime – with a soft toothbrush and a fluoride toothpaste. Take the time to brush carefully and gently along the tongue, or use a tongue cleaner, as bacteria can thrive on the tongue, too.

A low fluoride toothpaste is recommended for children aged 18 months to 6 years, and for children under the age of 18 months brushing without a paste is best.

To completely remove plaque and food from between the teeth we should also floss once a day (rinse thoroughly after flossing) or use interdental brushes. The appropriate flossing technique is detailed on the Oral Health card.

Healthy eating makes healthy teeth and gums. Avoid sweet sugary drinks and snacks; and if you do snack between meals, rinse the mouth with water afterwards. Smoking increases the risk of gum disease and oral cancer; so it’s another good reason to quit smoking. Smoking also contributes to dry mouth, itself a factor in causing teeth and gum disease.

Saliva (we normally secrete about 1.5 litres a day) assists speech, taste and swallowing and prepares food for digestion. A good flow of saliva also helps prevent tooth decay and protects against mouth and gum infections.

Saliva production commonly decreases with age, but apart from smoking, there are other factors which reduce the flow of saliva such as alcohol and caffeine containing drinks (they can be dehydrating), snoring and breathing through the mouth, and also certain medicines.

In fact medicines are the most common cause of dry mouth. If you’re suffering from chronic or continual dry mouth, check with your pharmacist to see if one or more medicines could be the cause. Of course, sometimes these medicines are essential, but there are ways to minimise the dryness. Special gels, sprays, toothpastes, gums and mouthwashes are available.

For more information on keeping your mouth, teeth and gums fresh and clean and disease free, check out the fact cards on Oral Health and Dry Mouth at one of the 1,650 Self Care pharmacies around Australia. For the nearest location go to the Pharmaceutical Society website www.psa.org.au and click on “Self Care Pharmacy Finder”.

©2009 Pharmaceutical Society of Australia

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Aug 05

Beating the curse of brittle bones

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Prevention of osteoporosis through attention to diet and exercise has once again been the focus of National Healthy Bones Week (2-8 August).

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Osteoporosis is the name given to the condition which can be quite simply described as brittle bones (literally the word osteoporosis means porous bones) – bones that break and crack more easily. All bones are at risk, but the most common fractures occur in the spine, the hip and the wrist.

Osteoporosis has been dubbed the ‘silent epidemic’ because signs and symptoms are difficult to identify until bones actually break. Even then the diagnosis is sometimes overlooked. All the more important, therefore, that we put in place procedures to prevent osteoporosis.

Building bone density during childhood and teenage years is especially important. It’s during this time, just before puberty that the body is most efficient at storing calcium and so establishing bone strength to last a lifetime.

Perhaps we think of our bones as being constantly solid structures, but in fact they are continually being renewed and strengthened in a cycle regulated by calcium, vitamin D and certain hormones. With age, this renewing process slows and bones can weaken.

Peak bone mass is achieved by our twenties, so it’s essential during the first two decades of life to have a diet containing plenty of calcium and to undertake plenty of regular weight bearing exercise.

Women have a higher risk of developing osteoporosis at an earlier age. This is because of hormonal charges following menopause. However, osteoporosis is certainly not just a women’s disease. While fractures from fragile bones are less common in men than women, when they do occur they are associated with more long term health problems and a greater likelihood of death.

In Australia one in two women and one in three men over the age of 60 will suffer a fracture due to osteoporosis.

Both lifestyle and genetic factors have a role in determining bone density and strength; and while we can’t do much about choosing our parents, we can address the issues of exercise and diet.

The recommended daily intake of calcium is about 1000mg for young adults, and for teenagers and older adults is about 1300mg. Three or four serves of dairy foods each day will generally achieve these aims. A serve is equivalent to a 250ml glass of milk, a 200g tub of yoghurt or two slices (about 40g) of cheese. Each serve provides approximately 300mg of calcium. Green leafy vegetables, nuts, cereals and legumes also contribute calcium to the diet, but in much smaller amounts than dairy foods.

Unfortunately, it seems that thousands of Australian children are missing out on important bone-building nutrients at school. A study last year showed that at lunchtime only 20% of children are eating cheese and only 6 or 7% are having milk or yoghurt. The study also revealed that 84% of primary school aged children were consuming fewer than the recommended three or more serves of dairy foods a day. Whether the school lunch is prepared at home or comes from the school canteen, there’s always a place for the cheese sandwich.

There are some even more interesting dairy rich snacks and meals for children and adults at the www.healthybones.com.au website.

For those of us who just can’t manage adequate calcium intake by way of our diet, there are appropriate calcium and vitamin D supplements available. Ask you pharmacist for more advice. And for the best osteoporosis prevention strategies check out the Osteoporosis Fact Card at pharmacies providing the Pharmaceutical Society’s Self Care health information. For the nearest location phone 1300 369 772 or go to www.psa.org.au and follow the link to Self Care Pharmacy Finder.

©2009 Pharmaceutical Society of Australia

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