Thursday, November 11, 2010

Sinusitis

I came down with a cold Saturday a week-and-a-half ago. My nose was stuffed, my throat hurt and I felt a bit crappy. Fortunately, it didn't last long. By Monday, I could feel it lifting. But, all that mucus my body generated during the cold was stuck somewhere in my upper respiratory system, most likely my paranasal sinuses. As of Tuesday, I could barely speak and my throat hurt. Wednesday morning after taking a 12-hour Pseudoephedrine the previous night, I had bloody (not to mention green) mucus out of my mouth and nose; it cleared-up quickly, but it was my first hint that I had progressed to a sinus infection and past a plain cold.

My dad had gargled with salt water when I was a kid, so I gave that a try. I later learned that gargling with salt water can lessen congestion. My dad had an awful time with his sinuses when he was younger, once having to have surgery to clear out a serious sinus infection. His advice to me was to use a saline nasal spray and decongestant medicine to prevent a cold from becoming a sinus infection. That sounds like good advice to me. I used allergy medicines, like Cetirizine, and expectorants, like Guaifenesin. I think a regular decongestant would have done a better job of clearing out the mucus. Allergy medications are good at drying-out my upper respiratory tract, but don't clear out existing mucus. I think Guaifenesin was a mistake as I later realized it works best on chest congestion, which I didn't have. Here's hoping that the nasal spray plus decongestant recipe works better the next time I get a serious cold.

Wednesday, July 28, 2010

I am Vitamin D Deficient

My doctor recently tested me for Vitamin D among other things after I complained of minor gastrointestinal issues. A few months prior I had learned that my nummular eczema may be due to a Vitamin D deficiency. I had long wondered why the lesions were worse in the winter and all-but-disappeared in the summer. The Vitmain D test came back a bit below the "normal" range and my doctor recommended that I take a 1000 IU Vitamin D supplement.

I was pleasantly surprised to find a NYTimes article highlighting the scope of the Vitamin D problem. It seems to be quite widespread and serious; and not enough is being done to raise awareness and compensate for our lack of UVB exposure due to sunscreen and jobs and lifestyles which rarely take us outdoors during the peak exposure hours (10am-3pm).

I'm quite happy to have solved one more piece of the puzzle known as my body and I hope awareness continues to build. If you've never been tested for Vitamin D, consider asking your doctor to test you for it in your next visit.

Wednesday, July 14, 2010

Thyroid-stimulating hormone

I didn't even know I had a Thyroid-stimulating hormone (TSH) until I got test results from my doctor indicating that it may be lower than normal. I visited him about a month ago with gastrointestinal discomfort and unexpected weight loss. He ran a battery of tests including for TSH. My level was low, indicating that I may be producing too much thyroid hormones (thyroxine (T4) and triiodothyronine (T3)). I was worried that this might have been a result of me not getting enough iodoine because my wife and I eat most of our meals at home using Diamond Crystal Kosher Salt which does not contain iodine unlike table salts. My doctor said he'd expect the reverse since iodine is required to produce the thyroid hormones. So, if I were low on iodine, he'd expect low levels of thyroid hormones which would cause the Hypothalamus to produce more TSH and result in a high TSH test result. He did blood work today to do a full battery of thyroid tests. I'll report back when I find out the results.

Tuesday, July 13, 2010

Bye, Bye Biotene

Welp, I gave it a fair try. I've been using Biotene toothpaste and mouthwash for just under a month now. Since starting Biotene, I've had two canker sores on my lower-left lip. The first appeared after I ate hot, acidic food (pizza), so I gave Biotene a pass. The first has since gone away. But, when a second sore appeared, I wasn't willing to wait any longer. When using Trader Joe's peppermint toothpaste over the past 3-4 years (and eating a wide variety of foods), I've seen canker sores very rarely and never two in such close time proximity. I suspect that the problem is the detergent in the Biotene toothpaste (Isoceteth-20), but also wonder about the mouthwash, which contains propylene glycol. Propylene glycol is a possible cause of contact dermatitis.

Update 7/14: My remaining canker sore is almost completely healed 2 days after I switched from Biotene back to Trader Joe's toothpaste.

Wednesday, July 7, 2010

A Periodontist Visit

Today I went to see Dr. Jeffrey Freedman, a periodontist recommended to me by colleagues at work and Consumer's Checkbook. He was very nice and walked me through the current status of my gums and the possible actions which can be taken. He also gave me a little tour of my mouth and gums. My upper gums are in good shape. He noticed no bleeding, swelling or recession. My lower gums aren't bad. He identified two teeth with recession, the two first bicuspids. The recessions are 1 mm (left) and 2 mm (right). He told me about the different parts of the gum. The lower, soft tissue and the upper, firm tissue. Most of my front, lower teeth have lost their firm gum tissue, though my canines are still okay. My upper teeth still have a good amount of the firm gum tissue. He told me about three similar invasive approaches:

  1. transplant mouth roof surface skin on top of existing gum - he said this was the most traditional action and takes 10-12 days to fully recover
  2. transplant mouth roof underneath skin under existing gum - this increases bulk of the existing firm gum
  3. use cadaver skin under existing gum - same as #2 except using skin from a dead body
Dr. Freedman said that my current condition is mild and it would be perfectly reasonable to wait and observe. This is the option I chose. Slightly frustrating was the fact that he didn't think there was much I could do to prevent the problem from getting worse. He said to continue my usual brushing. He said to continue to use a very soft brush and to not press hard when brushing. He also suggested to not overthink teeth and gum care. I'm not sure I can do that :-)

I'm guessing I won't see tremendously different advice from another periodontist. I'm planning to see a different dentist for my next check-up. At least I'll get another opinion on whether I can do anything to help the situation. For now, I've eliminated sugary carbonated beverages (Coke), greatly reduced my acidic liquid consumption (black tea) and am trying a toothpaste and mouthwash that are supposedly good for dry mouth (my mouth dries out overnight). Dr. Freedman said I can't do anything to get the gum tissue to regrow, but I'd like to at least know what I can do to minimize gum loss.

Friday, June 25, 2010

Trader Joe's Peppermint Toothpaste

I felt that I should single-out this toothpaste because it single-handedely solved my canker sore problem. When I realized 4 years ago that my canker sores might have been caused by an ingredient in most toothpastes (sodium lauryl sulfate), I went searching for a toothpaste without SLS. Trader Joe's Peppermint toothpaste was the only one I found! Granted, I didn't do an exhaustive search. But, it is somewhat amazing the extent to which SLS infiltrates toothpaste ingredients. Even "natural" toothpastes, like Tom's of Maine, use SLS. TJ's toothpaste is baking soda (sodium bicarbonate) based and is apparently much gentler on the gums than normal toothpastes. I went from having 10+ painful canker sores per month (often multiple at the same time) to one mild sore every few months. It took about a year to see the full effect, though I saw a significant decrease in canker sores after a month.

Based on this post, I'm not alone in praising TJ's toothpaste.

Saturday, June 19, 2010

Losing my Gums

I've known for a while that I've had a mild case of receding gums. My dentist has always focused me on the usual brushing/flossing/fluoride. I first learned that this was a poor recommendation after discovering that it was the sodium lauryl sulfate (SLS) (a cheap detergent) in most brand-name toothpastes which was irritating my gums resulting in canker sores. At my latest checkup, I got a pretty serious scare---my lower gums had receded so far that my roots were exposed in places. I now realize that this is why they've been more sensitive than the other teeth, especially to hot and cold. What did my dentist recommend? More fluoride (and a visit to the periodontist). Somehow, I don't think more fluoride is going to help considering that I already brush twice daily with fluoride toothpaste. 'course, it turns out that sodium lauryl sulfate is a cause of receding gum according to Wikipedia. Why hasn't anyone sued the ADA and toothpaste manufacturers yet?

In addition to seeing a periodontist, I'm also quitting Coke (used to do 1 can/day) and seriously scaling back my tea drinking (was ~6 cups/day and I've learned that the tannin in tea translates to acidity which teeth and gums don't like). Besides sugar and acid, I'm guessing that such drinks lessen the opportunities for my saliva to protect and heal my teeth and gums. I've also learned that I probably have a minor case of dry mouth, which again means that I don't get as much of the natural protection from
saliva as one normally would. One thing I'll be trying is Biotene toothpaste, which adds enzymes to the mouth and doesn't contain SLS. One of the things I like about Biotene is that it contains Xylitol which has been show to reduce dental cavities.

Update 6/21/10: Biotene toothpaste does contain a detergent, Isoceteth-20.

Update 6/21/10: A peer of mine at work discovered that the cause of her gum recesion was nighttime teeth grinding at night. A teeth guard solved her problem.

Update 7/13/10: Biotene was a failure.