Category: Educational

Psoriasis Explained

Psoriasis (pronounced Sor-eye-ah-sis) comes from the ancient Greek word psora — meaning itch. Psoriasis is a common, chronic skin disease. Its most prevalent form, plaque psoriasis, is characterized by raised, scaly patches of skin that can be itchy and painful. Psoriasis commonly occurs on the knees, elbows, trunk, and scalp, but it can also appear on the face or genitals. Since August is National Psoriasis Awareness month, we want to share information about it because it is often a misunderstood medical issue.

On white skin, psoriasis plaques appear as raised, red patches covered with a silvery white buildup of dead skin cells (scale). On skin of color, plaques may appear darker and thicker and a purple or grayish color, or darker brown.

Psoriasis tends to go through cycles, flaring for a few weeks or months, then subsiding for a while or going into remission. It can be limited to one or two patches that are hidden under clothing, or it can cover half to three-quarters of a person’s body. It is not contagious, but observers can confuse it with herpes or other transmissible skin diseases. This stigmatizes those with psoriasis, often resulting in anxiety or depression.

 Called the “Heartbreak of Psoriasis” in advertisements for medications, “these mood problems may go deeper than simply being unhappy about having an unsightly skin disease” says Dr. Suzanne Olbricht, associate professor of dermatology at Harvard Medical School. She explains that psoriasis is an inflammatory condition, and that “people with psoriasis are more likely to have other conditions linked to inflammation, including heart disease, diabetes, obesity, and inflammatory bowel diseases such as Crohn’s disease and ulcerative colitis.”

Risk Factors and Psoriasis Triggers

While it is an autoimmune disease, the exact cause of psoriasis is unknown. As in all autoimmune disorders, parts of the body’s immune system become overactive and attack normal tissues.

Research indicates that genetics and environmental factors play a role in psoriasis.  If your parent or parents have psoriasis, for example, your chances of developing it are greatly increased. About one-third of cases begin in childhood.

But anyone can develop psoriasis.  According to a 2021 JAMA Dermatology study, more than 7.5 million American adults have psoriasis.

High stress levels can make one more susceptible to psoriasis, because stress is known to affect the immune system. Smoking tobacco also increases the risk of developing psoriasis, and can increase its severity.

People who are more likely to develop psoriasis may be symptom free until the disease is activated.  According to the Mayo Clinic, common environmental ‘triggers’ include:

• Infections, like strep throat or skin infection
• Weather, especially cold and dryness
• Skin injuries: scrapes, cuts, bug bites, severe sunburn
• Smoking, and second-hand smoke exposure
• Heavy alcohol use
• Lithium, blood-pressure, and anti-malarial medications
• Rapid withdrawal of corticosteroids

Complications

About one-third of psoriasis sufferers develop psoriatic arthritis, causing pain, stiffness, and swelling of the joints. It can also occur in people without skin eruptions, especially if they have relatives with psoriasis. Since this condition can cause permanent joint destruction, it’s important to consult a rheumatologist to determine treatment.

Treatments

Treatment for psoriasis begins with a correct diagnosis by a dermatologist. In early stages, psoriatic lesions may be confused with other skin conditions. Depending on the severity of the disease, treatment may be as simple as topical creams or ointments, over-the-counter, or prescription.

Phototherapy treatments (exposing the skin to ultraviolet light) may be prescribed by a dermatologist. Light therapy can be tailored to small surface areas, like hands or feet, or to full body. To be effective, light therapy must be consistent.

Oral, systemic medications work throughout the body to treat moderate-to-severe psoriasis. They are also used by those for whom topical medications or light therapy are not effective.

Biologics are drugs administered by injection or infusion that target specific immune cells or proteins. Biologics present an option for people who do not respond to, or have had harmful side effects from other treatments.

In addition to these therapies, people with psoriasis can stay abreast of the latest research and coping strategies at the National Psoriasis Foundation’s website. The site includes a one-on-one peer support program, and an official online community of 90,000 people living with psoriasis and psoriatic arthritis.

Psoriasis is a medical issue that is often misinterpreted by those who experience it and by those who see it on others. Knowing the facts about it can help all of us deal with it a little more effectively.

The information in the above article is not intended nor implied to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

June is National Aphasia Awareness Month, yet few Americans even know what aphasia is. According to the National Aphasia Association, 2 million people in the United States have aphasia, but 84.5% of Americans state that they’ve never heard the term aphasia.

What is Aphasia?

Aphasia is a language disorder that occurs when someone experiences brain damage, such as a stroke. The brain has two halves or hemispheres. Language skills are carried out in the left half of the brain. Damage on that side may lead to language problems. Damage on the right side of the brain may cause other problems, like poor attention or memory issues.

Aphasia may make it hard for someone to understand, speak, read, or write. It does not make them less intelligent or cause problems with the way they think. Brain damage can also cause other problems along with aphasia. People may have muscle weakness in and around the mouth, called dysarthria. They may have trouble getting the muscles of the mouth to move the right way to say words. This is called apraxia. They can also experience associated swallowing problems, which is called dysphagia.

Signs of Aphasia

Aphasia can lead to a number of different problems. Someone may have trouble speaking, reading, and writing. People with aphasia may experience the following:

• Cannot think of the words they want to say
• Say the wrong word without realizing it
• Change the order of compound words
• Use words that sound like gibberish
• Have a hard time creating sentences
• Use single words rather than sentences
• Create sentences that include non-words and real words

Comprehension

People with Aphasia may experience the following:

• Not understand what others are saying
• Have trouble understanding conversations in groups
• Be unable to understand humor or sarcasm

Reading and Writing

People with Aphasia may experience the following:

• Difficulty reading and comprehending magazines, books, and computer screens
• Unable to spell and put words together to write complete sentences
• Difficulty using numbers or doing math such as counting

Causes of Aphasia

Aphasia is most often caused by a stroke (brain bleed) but can occur as a result of any type of brain damage. This includes a traumatic brain injury, brain tumors, and certain types of dementia.

Testing for Aphasia

People should see a doctor if they have trouble speaking or understanding what people say. A doctor will determine if there is a medical cause for the problem. A speech-language pathologist, or SLP, will test their speech and language skills. The SLP will test how well someone:

• Understands words, questions, directions, and stories
• Says words and sentences
• Reads and writes

Treatments for Aphasia

Many people who suffer from aphasia following a brain injury will find it most beneficial to work with a speech/language pathologist. This can be done individually or in a small group. Some people with aphasia find it helpful to join a support group because it is a way of connecting to others who are experiencing the same type of communication challenge.

Tips for Communicating with a Person Who Has Aphasia

These tips may make it easier for you to understand and talk with those with aphasia:

1. Make and keep eye contact
2. Watch body language
3. Talk in a quiet place
4. Keep your voice at a normal level
5. Keep the words simple but do use not baby talk
6. Use shorter sentences
7. Give them time to speak
8. Try using drawings, gestures, writing, and facial expressions
9. Ask them to draw, write, or point when having trouble talking
10. Ask “yes” and “no” questions

Aphasia is a difficult and frustrating disorder for those who have it – it’s also caused by some other medical issue which adds to its complexity. If someone you care about has aphasia, please be patient and kind. It will go a long way in helping them recover.

Other Resources

• Aphasia Hope
• National Aphasia Association
• American Stroke Association

 The information in the above article is not intended nor implied to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

October is national Physical Therapy month. As a provider of both inpatient short-term rehabilitation and outpatient rehabilitation services, The Osborn knows the importance of physical therapy (PT) following an injury, accident, or surgery. Just as importantly, physical therapy can also help older adults retain their independence, whether they are managing a long-term illness or just want to improve their strength and mobility. Let’s take a look at how physical therapy helps older adults stay healthy and safe.

According to marketreach.com, physical therapy in the United States constitutes a $34.5 billion industry and the need for PT continues to grow each year. The goal of physical therapy is to help restore and improve functionality, reduce pain, and increase mobility for endurance, stamina, and balance. The last of these is very important as we age because falls are more prevalent in older adults and often can have negative long term and life changing effects. Some falls are even fatal.  According to the Centers for Disease Control and Prevention, one out of four older adults will fall each year in the United States, making falls a public health concern, particularly among the aging population. Thirty million older adults fall each year—resulting in about 30,000 deaths. Each year, 3 million older adults are treated for a fall injury and can benefit from physical therapy.

Osteoporosis, which is a progressive bone disease characterized by a decrease in bone mass and density, can lead to an increased risk for fractures. It can also be the cause of falls as we age. Physical therapy and regular exercise can help reduce the negative effects of this condition.

Some medications can also cause balance issues because they change the body’s equilibrium.  “Dizziness may be caused, or made worse, by taking a combination of drug products or by drinking alcohol with your medication,” says Barb Young, RPh, an editor at the American Society of Health-Systems Pharmacists during an interview with Consumer Reports. “Always tell your pharmacist all of the medications that you are taking or plan to take, including over the counter products or alcohol,” she notes. Certain classes of drugs are more likely to cause dizziness and they are antidepressants, anti-seizure, and certain high blood pressure medications. Always speak with your doctor or pharmacist about any drug that causes you to feel unsteady on your feet – chances are an effective substitute with less side effects will be available.”

Strength training and various exercises provided by a physical therapist can be tailored to the needs of each patient. Physical therapy for seniors has a variety of benefits which can include gaining strength and balance, as well as providing a renewed sense of confidence.  Physical therapy can give seniors back their independence and make daily tasks easier.

Working with a physical therapist for short-term or outpatient rehabilitation will not only reduce pain, but it will also help improve overall strength and ability and reduce the risk for injuries, helping you maintain a higher quality of life.

The information in the above article is not intended nor implied to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

September marks World Alzheimer’s Month – a time to raise global awareness about Alzheimer’s’ related dementia, its devastating impact on families, and its societal cost.

Since March of this year, our attention has been directed toward the COVID-19 pandemic and its impact on so many facets of our lives. Although it has claimed many lives worldwide, we hope COVID will be preventable in the future when a vaccine becomes available.

Not so with a perennial disease that afflicts 50 million people worldwide–Alzheimer’s—which is expected to rise to 152 million by 2050. Since Alzheimer’s Disease was identified in 1930, the cause remains unknown, no vaccine can prevent it, and no treatment has yet been found to stop its progression or the dementia that is caused by it.

This year, the confluence of dementia and COVID-19 has proven especially deadly.  

“People with dementia are being disproportionately impacted by this pandemic and are in danger of being forgotten.Now more than ever we need to talk about dementia,” says Paola Barbarino, CEO of Alzheimer’s Disease International (ADI).

Kate Swaffer, Chair, Co-Founder and CEO of ADI’s partner Dementia Alliance International, adds that “in 2020, the rest of the world suddenly experienced what people with dementia and their families experience on a daily basis after diagnosis, such as isolation, distancing (from many family and friends), fear, anxiety and stigma.”

ADI, a federation of 100 Alzheimer’s associations around the world, sponsors international conferences and surveys, and each year publishes the World Alzheimer’s report. The newly-released World Report for 2019 is based on global surveys about Attitudes to Dementia.

Surprising Findings

According to the report, two out of three people believe there is little understanding of dementia in their countries because misinformation and stigma surround dementia globally.  

Despite ongoing efforts to educate the public about dementia, misinformation still exists. ADI’s survey of 70,000 people from 155 countries showed that one-third of people believe dementia is part of normal aging, rather than a disease. Many people think they will develop dementia in their lifetime.

Another staggering fact revealed in the study: 62% of healthcare practitioners believe dementia is a part of normal aging.

In reaction to that finding, Barbarino said, “Our message that dementia is NOT a part of normal aging, but a disease, is loud and clear, but it is clearly not getting through. We must work much harder on this.”

Stigma Still Abounds

Along with working harder to ensure that Alzheimer’s is understood as a disease, reducing the stigma also needs work.

People in the early stages of dementia are often reluctant to seek help because of the stereotypes and prejudice they fear.  A 60-year old interviewed in this year’s report summed it up: “People tend to run when they learn you have dementia.”

Do you have questions about memory care? Take our free memory care assessment.

Denial and not seeking help early may lead to more negative outcomes for the person. This self-stigma leads to avoiding social interactions, and not benefitting from dementia-appropriate services.

Public stigma still abounds. In the words of other interviewees:

• I used to be active in a club, but now I’m a non-person.
• Doctors talk to my spouse about me while I am sitting right there.
• Some work colleagues do not contact me anymore.
• I feel I cannot contribute at family gatherings because people get annoyed or feel uncomfortable.
• My neighbors avoid me.

Stigma also extends to caregivers and families of people living with dementia.

By default, stigma has a negative impact on research and research participation that could lead to a treatment breakthrough. Improving awareness, and debunking myths that dementia is a normal part of aging, is critical.

We can all play a role in fighting dementia and its stigma by increasing our own understanding of the disease during World Alzheimer’s Month.

Click to read the World Alzheimer Report.

For information about Alzheimer’s support and education programs, please visit  https://www.alz.org         

Learn more about memory care at The Osborn.                                         

The information in the above article is not intended nor implied to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.