Are early detection and treatment always best? – Harvard Health Blog

Throughout my medical career, I’ve heard statements like these:

Early detection offers the best chance of cure.

If you wait for symptoms, you’ve waited too long.

Knowledge is power, and the sooner you have the information, the better.

Over time, I’ve realized they are often untrue. Many health conditions go away on their own. In such cases, early testing may amount to wasted effort, time, and medical cost. Some testing is invasive and has a significant risk of complications. And minor abnormalities may lead to more testing. There’s also the anxiety of waiting for results, or learning you have an abnormality of uncertain importance that requires additional evaluation.

Why wait? Why not just test and treat right away?

Sometimes, the “cure” is the passage of time. That’s one reason many doctors will suggest watchful waiting rather than aggressive testing. Knowledge is only power if there’s something useful you can do with it. And many conditions aren’t worth knowing about or treating until they cause symptoms.

For these reasons, the American Board of Internal Medicine Foundation launched the Choosing Wisely campaign in 2012. Its mission is to encourage more selective, evidence-based testing and treatment, and to discourage unnecessary tests and care.

Six conditions for which early detection and treatment isn’t clearly helpful

  • Certain leukemias and lymphomas. While malignant, some leukemias and lymphomas may progress so slowly that the risks of treatment outweigh the benefits. For example, no therapy may be recommended for early-stage chronic lymphocytic leukemia that is causing no symptoms.
  • Sarcoidosis. This condition of unknown cause often causes enlarged lymph nodes and inflammation in a variety of organs. But when there are no symptoms, a normal physical examination, and normal results of routine testing, no treatment may be warranted.
  • Some types of prostate cancer. For men with prostate
Read More

Shingles of the eye can cause lasting vision impairment – Harvard Health Blog

Shingles, or herpes zoster, is a viral infection known for its characteristic painful, burning, or itchy rash. This rash appears along a particular affected nerve, for example in a band on one side of the chest or abdomen that extends around to the back. In fact, the name shingles comes from cingulum, the Latin word for girdle, belt, or sash.

Shingles is caused by reactivation of the varicella zoster virus, the virus that causes chickenpox. After the initial chickenpox infection resolves the virus lives on in nerves all over the body, but is kept in check by the immune system. The risk of shingles therefore increases with any process that can weaken the immune system, including age, illness, and immune-suppressing medications. About one million cases of shingles occur in the US each year.

Up to 20% of shingles episodes involve nerves of the head, where the infection can affect various parts of the eye, including the eyelid, the eye surface, and the deeper portions of the eye. Viral infection of the eye can cause pain, drainage, redness, and sensitivity to light. In some cases it can lead to vision impairment, including blindness.

Shingles in the front of the eye

Shingles can affect the cornea, the curved, transparent dome of tissue at the front of the eye. This is called keratitis, and it can occur as a complication of herpes zoster ophthalmicus (HZO), which refers to shingles with a rash that typically involves one side of the upper face, forehead, and scalp. More than half of patients with HZO may have keratitis.

If you have shingles involving the upper face, forehead, or scalp area, it is important to see an ophthalmologist for a formal eye examination, whether or not you notice any eye symptoms. Keratitis usually develops within one month

Read More

New dietary guidelines: Any changes for infants, children, and teens? – Harvard Health Blog

The United States Department of Agriculture (USDA) has published new dietary guidelines to help Americans get and stay healthier across all parts of the lifespan. Babies and toddlers are included for the first time, because the recommendations cover our full lifespan.

The guidelines are called “Make Every Bite Count.” If we want to get and stay healthy, we shouldn’t be eating foods that are basically empty calories — or worse, foods that actually do us harm.

Because foods can do us harm. Eating an unhealthy diet can lead to obesity, with the cardiovascular disease, diabetes, high blood pressure, and everything else obesity brings. It can lead to cancer, tooth decay, anemia, high blood pressure, weak bones, and so many other problems. The adage “you are what you eat” is remarkably true.

Why healthy eating is so important for children

Children are building bodies and habits they will carry with them for the rest of their lives. The track they get on when they are young is very often the one they stay on, and we want that to be a good track.

Right now, 40% of children are overweight or obese, and research shows that they are likely to stay that way or get worse. Since children rely on parents and caregivers for their food, this is on us. We literally have their lives in our hands.

Starting with infants and toddlers: First foods and responsive eating

For infants and toddlers, the recommendations include

  • feeding with breast milk whenever possible, ideally for at least the first six months of life. When that isn’t possible, infants should be fed iron-fortified infant formula.
  • vitamin D for infants that are entirely or mostly breastfed
  • responsive feeding: parents and caregivers are encouraged to pay attention to the cues babies give to us when they
Read More

3 simple strategies for stress relief – Harvard Health Blog

The last few months of any year, with deadlines and holidays, often create a harried pace. The beginning of a new year can give you a chance to exhale. But even if you experience a few serene days or weeks, tight shoulders and tension are never far off.

Family stress. Work stress. Daily life stress. Self-induced stress brought on by scrolling through the news. As it turns out, stress is almost impossible to avoid. So this year, instead of waiting for your most recent stressful patch to ebb, take a different approach. Teach yourself to stay grounded and calm — regardless of what’s going on around you.

Managing stress helps you stay healthier

It’s important to manage stress, because it’s not only emotionally taxing, but it’s also bad for your health. When you are under stress, the levels of a hormone called cortisol start to rise in your blood. Over time, chronic stress that results in higher than normal levels of cortisol can wreak havoc on your metabolism, spurring weight gain (particularly around your middle), and causing dangerous inflammation inside your body. It can affect your blood sugar levels, your blood pressure and heart, and even your memory.

Three simple strategies to counter stress

To lessen the effects of stress, try three simple strategies to help you reset.

Take a new approach. Much of life’s stress comes from how we view the various situations we encounter. For example, two people may take on the exact same task, but only one person may find it stressful. Some of this has to do with personality, but it also has to do with your inner narrative — how you frame things in your mind. Aim to change your perspective, and you can often reduce the number of stressors in your life.

Read More