Dr. David Thomas Russell, DO

Treatment for most asthma patients involves three steps. Patients learn what their asthma triggers are and avoid them. They take a daily control medication, usually an inhaled corticosteroid, to reduce inflammation in the lungs. Also, they have rescue medication with them at all times to take in case of a severe attack. These quick-acting inhaled medications relax the muscles around the airways and allow the lungs to open up for air.

There is no cure for asthma, but with treatment it should not interfere with daily life and activities.

• Blacklegged (deer) ticks, which spread Lyme disease in the Northeastern, North -Central, and mid-Atlantic United States.
• Western blacklegged ticks, which spread Lyme disease in the Pacific and Coastal regions of the United States.
• A mother infected with Lyme disease may pass it onto a fetus.

As background, ticks lay on the tops of grass and brush, clutching onto leaves with their legs and with their arms outstretched. This formation is called "questing" and allows ticks to quickly latch onto passers-by. Within two hours of biting a person's skin, the tick slowly begins to feed from the blood of its host, which can transmit the bacteria that causes Lyme disease. This tick activity generally occurs seasonally and tick bites mostly occur during the springtime.

After being infected, people with Lyme disease may develop symptoms like fever, exhaustion, headache, joint aches, and skin rash, usually three to thirty days after the tick bite. Lyme disease is characterized by a particular skin rash called erythema migrans, which is an enlarged red rash that starts at the site of the tick bite and expands outwards. The rash is a strong indicator that someone has developed or is at risk of developing Lyme disease.

In the following few months, symptoms may worsen and progress to include:

• Facial palsy (facial droop)
• Headache and neck pain
• Arthritis
• Nerve pain and numbness
• Spinal and brain inflammation
• Abnormal heart rhythm (Lyme carditis)

Most cases of Lyme disease dissipate over a few months. Lyme disease may be cured by a course of oral antibiotics, such as amoxicillin or doxycycline. Other treatments may include:

• Nerve blocking drugs for pain, such as gabapentin
• Topical ointments for rashes

People can take action to prevent Lyme disease by exercising caution when in environments with ticks. Using insect repellant and wearing long socks and protecting clothing can help prevent tick bites. Outdoor enthusiasts should regularly perform "tick checks," evaluating their skin for small ticks, especially in areas where ticks may easily burrow. Showering within two hours of returning indoors also can reduce the likelihood of developing Lyme disease.

Hashimoto's is the leading cause of hypothyroidism, which is when the thyroid does not produce enough hormones to stimulate adequate metabolism. The condition is diagnosed by blood tests that measure TSH (thyroid stimulating hormone) and detect Hashimoto's antibodies. Symptoms of hypothyroidism include sluggish metabolism, inflammation, fatigue, weight gain, brittle hair, dry skin, and sensitivity to cold. To supplement impaired thyroid function, patients with Hashimoto's are typically prescribed synthetic thyroid hormone pills. Such patients may need to consume synthetic thyroids for the rest of their lives. Other treatments may include dietary changes, such as the avoidance of certain foods and medication to reduce inflammation. Frequent blood tests can inform patients if their TSH levels are within a normal range.

Grave's disease is most frequently the cause of hyperthyroidism, which is when the thyroid produces too many hormones, overstimulating one's metabolism. The condition is also diagnosed by blood tests that measure TSH and detect Grave's antibodies. Elevated heart rate, high blood pressure, sweating, bulging eyes, and weight loss are common symptoms of hyperthyroidism. Treatments for hyperthyroidism include oral radioactive iodine, which slowly shrinks the thyroid, slowing the production of excess thyroid hormone. Other anti-thyroid medications such as methimazole (Tapazole) also reduce the production of thyroid hormones. Blood pressure medications known as beta blockers can ease the increased heart rate caused by hyperthyroidism. If treatments are unsuccessful, patients may be prescribed a thyroidectomy, or surgery to remove part or all of the thyroid. Some patients with hyperthyroidism may require ophthalmological (eye medicine) treatments such as eye drops, prednisone, and surgery to reduce eye swelling and bulging.

Untreated thyroid disorders frequently lead to goiters or thyroid nodules. A thyroid goiter is a large lump that can be felt near the base of the neck and is made of swollen thyroid tissue or nodules (excess cell growth). Nodules and goiters are diagnosed by CT scan or ultrasound. Obstructive goiters can cause pain, coughing, and abnormal breathing. The most common cause of goiters is hyperthyroidism (overactive thyroid). However, Hashimoto's is also known to cause goiters or nodules. Goiters develop from continued damage from antibodies to the thyroid over time. At times, a goiter can result from a cancerous thyroid tumor. Most goiters and nodules are themselves benign.

The exact causes of thyroid cancer are unknown. People who develop thyroid cancer may or may not have another thyroid problem such as Hashimoto's or Grave's disease. Symptoms of thyroid cancer include a nodule that can be felt on the neck, hoarseness, difficulty swallowing, swelling in the neck, and neck and throat pain. CT and MRI scans are used to diagnose thyroid cancer. There are four types of thyroid cancer which vary in intensity. Thyroidectomy (thyroid removal surgery) is usually prescribed to treat thyroid cancer.

Thyroid problems are often long-term conditions that require some form of treatment. With regular monitoring and medication, many people with thyroid problems are able to lead active and fulfilling lives.