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to your Address Book or Safe List. Learn how here. | August 4, 2011 | |  |  | Hoarse? Vocal Cord Paralysis Could Be to Blame | | | Breakthrough in Retaining & Regaining Memory | | | Getting People to Open Up to You | | | Did You Know That You Can... | | | Herbal Paste Applied in Summer Eases Breathing in Winter | | | |  |  | |  | |
 | | Hoarse? Vocal Cord Paralysis Could Be to Blame Usually a hoarse, husky voice results from nothing more troublesome than overzealous cheering at a sporting event—but sometimes it signals a more serious problem called vocal cord paralysis. This condition involves the immobilization of one (or, rarely, both) of the vocal cords, which are bands of muscle tissue in the larynx (voice box). When a reader wrote to ask me about vocal cord paralysis, I contacted Seth M. Cohen, MD, MPH, an assistant professor of otolaryngology–head and neck surgery at the Duke Voice Care Center. Dr. Cohen explained that normally when a person speaks, the vocal cords close (coming together to touch) and as air from the lungs passes through, the vocal cords vibrate to produce sound. But if there is damage to either of the nerves that control the muscles of the voice box, the vocal cords cannot close properly. These nerves, called recurrent laryngeal nerves, begin in the brain and loop down into the chest on the left and about to the level of the collarbone on the right. Possible causes for nerve damage leading to vocal cord paralysis include viral infection... intubation (being put on a respirator)... various neurological problems... or cancer in the brain, thyroid, lung or other areas. Damage to a recurrent laryngeal nerve also may occur during surgery—for instance, if the nerve is accidentally stretched, cut or otherwise injured as the surgeon operates nearby on the heart, lung, thyroid gland or neck. According to Dr. Cohen, in about 18% to 20% of cases, doctors just don’t know why patients get paralyzed vocal cords. A hoarse, weak, breathy voice typically is the primary complaint of a person with vocal cord paralysis. Simply talking can be exhausting because the open vocal cords allow too much air to escape the lungs, so the person runs out of breath before he or she can finish a sentence. A patient also may have trouble swallowing because the open vocal cords allow food and drink to get into the windpipe. In addition, it may be difficult to grunt or to cough well enough to clear secretions, Dr. Cohen said. Anyone who experiences such symptoms should see an otolaryngologist (ear, nose and throat specialist). Referrals: American Academy of Otolaryngology–Head and Neck Surgery (www.ENTnet.org). Depending on the cause, vocal cord paralysis sometimes gets better on its own, but that can take up to a year. In the meantime, symptoms often are greatly improved with a procedure in which the doctor injects collagen or another filler material (such as Cymetra or Gelfoam) through the neck or mouth and into the affected vocal cord. This bulks up the paralyzed vocal cord, effectively pushing it over a bit toward the other vocal cord, allowing the two to touch and improving closure, Dr. Cohen explained. The procedure can be done in the office with topical anesthesia or in an operating room with general anesthesia. There are few if any side effects. Symptoms generally improve within several days. Effects last for two to six months, depending on the filler. By that time, proper nerve function may (or may not) have returned. A permanent option is to place an implant made of a malleable material behind the vocal cord. The implant acts like a tiny wedge or shim, repositioning the paralyzed vocal cord so that it can make contact with the other vocal cord. This procedure, done in an operating room under local anesthesia, involves making a small incision in the neck. There is usually some swelling for about a week afterward. Maximal improvement in voice and other symptoms develops within a month. Either procedure—injections or an implant—typically would be covered by insurance. Source: Seth M. Cohen, MD, MPH, is an assistant professor of otolaryngology–head and neck surgery at the Duke Voice Care Center in Durham, North Carolina. He specializes in voice, airway and swallowing problems, and has published numerous articles in medical journals. www.DukeVoiceCare.org
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 | | Breakthrough in Retaining & Regaining Memory In Henry V, Shakespeare said: "Old men forget; yet all shall be forgot, But he’ll remember with advantages what feats he did that day." With great sadness, I realized my dad was no longer remembering the feats he did on any particular day. For as long as I can remember, my dad would quote Shakespeare and challenge me to keep up with him. He also loved to tell stories and play memory games with me and his grandchildren. But at a certain point, his memory began to betray him, and it not only affected his memory but his mood and our relationship. This problem set me on quest and led to a remarkable discovery that saved my special relationship with my father and can now help anyone with memory problems... | |
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 | | Getting People to Open Up to You Judy Kuriansky, PhD Teachers College, Columbia University | Much research demonstrates the physical and psychological benefits of social support—not surprising since we all know from personal experience how good it feels to be close to others. On the road to establishing intimacy and building trust, an important step is sharing confidences... so when you’re hoping to deepen friendships, it helps to know how to encourage others to open up to you. | Be careful: Some people, in an effort to be friendly, inadvertently come across as pushy, prying or presumptuous—which drives others away. To get closer... Ask questions, but start gently. Most people like to talk about themselves, so asking questions is a welcome sign of interest—provided they are the right questions. Of course you know not to say anything as insensitive as "Has your husband ever cheated on you?" or as intrusive as "How much money have you saved for retirement?" But the boundary between interest and inquisition is not always so obvious. Helpful: Get a feel for the other person’s comfort zone by introducing the subject you want to talk about in a neutral way. For instance, to spark a conversation about marriage, you can ask, "Did you read that interesting article in yesterday’s paper about what makes a relationship last?" It also is reassuring to ask permission to delve deeper ("Is it OK if we confide in each other?") so your queries don’t come out of the blue... or to invite the other person to set limits ("I’m the type of woman who is open with close friends, so please let me know what you’re comfortable with"). Set an example, then be patient. If you are talking with someone who is shy or reserved, revealing something about yourself can help move the conversation to a more intimate level. Share a brief confidence, demonstrating your trust ("It’s hard to admit how insecure I feel whenever I speak in public, but I’m comfortable enough with you to be honest"). Then change the subject—and wait to see whether the other person returns to the more personal topic... or bring it up again yourself another day. Listen well. Suppose someone mentions an upsetting experience of hers (for instance, "I think the man I’m dating is seeing other women"). You may think that you are being empathetic if you share your own similar experience ("That happened to me when I was dating a man last year") or that you are being helpful if you offer definitive advice ("Dump the creep"). But in reality, such interruptions cut off the other person, making her feel more alone. So unless she asks you a direct question ("Has that ever happened to you?" or "What would you do?"), keep the focus on her by practicing active listening. Repeat the essence of what she said to show you heard, understood and care ("Oh, you have suspicions about the man you’re seeing")... respond empathically ("I can imagine that upset you")... and invite her to explore her experience further ("What makes you think that?" or "How do you feel about that?"). Prove that you can keep confidences. You may think that sharing a secret about someone else will build intimacy with a new friend ("You and your husband argue about money? Diane told me that she and her husband are having money troubles, too"). But this only makes the other person fear that you would similarly gossip about her. Instead: Saying, "I know other women who are having that problem, too," makes the same point generally (that she is not the only one) without breaking the trust that is so essential to true closeness. Source: Judy Kuriansky, PhD, is a clinical psychologist and sex therapist on the adjunct faculty of Teachers College, Columbia University in New York City. She is the author of five books, including The Complete Idiot’s Guide to a Healthy Relationship (Alpha), and is a columnist and advisory board member for HealthyWoman from Bottom Line. www.DrJudy.com
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| | | Herbal Paste Applied in Summer Eases Breathing in Winter For people with chronic obstructive pulmonary disease (COPD), an incurable condition characterized by chronic bronchitis and/or emphysema, winter often brings a worsening of symptoms such as coughing, wheezing, shortness of breath, fatigue and recurrent respiratory infections. Steroids help control symptoms but can have side effects... antibiotics fight infection but increase the risk for antibiotic resistance. So it was welcome news when a recent study provided scientific evidence of the effectiveness of a topical herbal remedy called Xiao Chuan paste (XCP), which has been used in China for more than 1,000 years to treat COPD and other breathing problems. Researchers randomly assigned COPD patients to receive either XCP or a placebo paste. As is traditional, the paste was applied to three specific pairs of acupuncture points on the back... the treatment was given four times during an eight-week period in July and August. Then participants were monitored from November through February. Results: Compared with patients who received the placebo, those who received XCP were significantly less likely to experience an exacerbation of symptoms requiring steroids, antibiotics and/or hospitalization... and they reported a significantly higher quality of life. The only side effect—a mild skin reaction that cleared up without treatment once XCP was discontinued—occurred in just 2% of users. XCP is made from herbs native to China, including Asarum heterotropoides, Ephedra vulgaris and Acorus gramineus Soland. Researchers theorize that the herbs have properties that affect immune regulation. You can learn more about XCP by consulting a practitioner of traditional Chinese medicine who is knowledgeable about herbal therapies. Referrals: National Certification Commission for Acupuncture and Oriental Medicine (www.nccaom.org) or American Association of Acupuncture and Oriental Medicine (www.aaaomonline.org). Source: Yongjun Bian, MD, is a clinical researcher in the respiratory department of Guang’anmen Hospital in Beijing, China, and a research fellow for a study of 125 COPD patients.
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 | |  Tamara Eberlein, the editor of HealthyWoman from Bottom Line, has been a health journalist for nearly three decades. An award-winning author or coauthor of four books, she is committed to helping other women in midlife and beyond live healthy, fulfilling lives. Her latest book is the updated, third edition of When You’re Expecting Twins, Triplets, or Quads (HarperCollins). She is also the "chief health adviser" to her husband of 26 years and three college-age children. | |  | | Bottom Line Publications | 281 Tresser Boulevard, 8th Floor | Stamford, CT 06901
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