The Pharmacist Answers Podcast

Avenleigh wants to know what is in our vitamins and why do we take them, so she asks the pharmacist!

Laryngitis Laryngitis, known as inflammation of the larynx, is the most common cause of hoarseness and voice loss.  It is very common in viral infections, such as a cold, flu, or adenovirus.  Acute laryngitis is caused by an illness, while chronic laryngitis may be a secondary symptom of another problem like acid reflux, smoking, or severe thrush. There is a lot of advice that goes around about what can "cure" laryngitis or get rid of hoarseness.  Hydration is always key.  Some of the other advice is more anecdotal.  But above all, whatever you do for a hoarse voice, DO NOT WHISPER! Laryngopharyngeal Reflux Disease (LPRD) LRPD is a condition where stomach acid refluxes into and burns the vocal cords.  It may or may not accompany GERD.  It causes intermittent to chronic hoarseness, swallowing troubles, throat pain, or a constant sensation that something is stuck in your throat. Misuse and Overuse Misuse of your voice is defined as the inefficient use of your voice.  It may stem from poor posture, poor breath support, or poor hydration.  Overuse of your voice is defined as excessively loud or prolonged use of your voice. Lesions Vocal cord lesions are benign growths on the vocal cords that interfere with normal vibration. These can result from repeatedly prolonged periods of misuse or overuse.  They will cause chronic hoarseness or sporadic voice-silencing.  They come in three varieties and are all treatable:  nodules, polyps, and cysts. Nodules require vocal rest and voice therapy and training to help make sure they don't happen again.  Polyps and cysts require micro-surgery where the growth is removed, and then rest and therapy and training will follow. Hemorrhage If you have a sudden loss of voice after yelling, then it is possible a hemorrhage occurred.  A hemorrhage is when blood vessels in the surface of the vocal cord burst and fill it with blood.  COMPLETE REST is required until the blood is reabsorbed by the body. Paresis and Paralysis Paresis is the fancy word for weakness.  Vocal weakness can occur during a viral infection or after neck or throat surgery.  It can be temporary and strength will return on its own after a recovery period, or it can be permanent.  Prolonged or permanent vocal weakness can be improved somewhat through therapy and training. Paralysis, on the other hand, is neurologically based, whether damage happened in the area of the brain that controls the voice and supporting structures, or the nerves in and around the larynx are damaged.  This can also be temporary or permanent and is generally one-sided. Symptoms of a weakened or paralyzed vocal cord include noisy breathing - like something is hanging in the way of the air flow.  And breathy talking - like when someone is trying to use their "sexy" voice and there's more air making noise than vocal vibrations.  There is a surgical repair process that involves taking the working vocal fold and stretching it over so when it activates, it will still come in contact with the unmoving vocal fold. Callbacks Voice Thrush - Mouth Issues Connect with me Support us on Patreon Give us your Feedback Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits: Up In My Jam (All Of A Sudden) by - Kubbi https://soundcloud.com/kubbiCreative Commons — Attribution-ShareAlike 3.0 Unported— CC BY-SA 3.0 http://creativecommons.org/licenses/b...Music provided by Audio Library https://youtu.be/tDexBj46oNI

Notes coming soon!

Gag Reflex Basics The official name of your gag reflex is the pharyngeal reflex or laryngeal spasm.  Trigger points for the gag reflex can be found on the roof of the mouth, back of the tongue, in the tonsil area, the uvula, and the back of the throat.  The purpose of this reflex is to prevent objects from entering the throat that did not first progress through the normal swallowing process.  It also helps prevent choking. Gag Reflex Progress When the reflex is triggered, the soft palate raises to close off the nasal passage.  Then the pharyngeal muscles contract on both sides to try and force whatever made it too far down back up into the mouth.  If the input is strong enough, it can also trigger vomiting (this is how vomiting is induced in eating disorders such a bulimia). Do you Gag? One in three people lacks a gag reflex, which means rather large things can enter their throats without triggering a reflex.  This is possibly how sword-swallowing got its start. The other side of this coin is someone with a hypersensitive gag.  They can have trouble swallowing large pills and large bites of food.  Dentist visits and even neckties can trigger this unpleasant reflex.  It can be a part of a larger issue, such as Sensory Processing Disorder or Autism.  Or it can be a preconditioned issue due to a previous experience.  In either case, speech or occupational therapy can be done and will include desensitizing areas of the mouth to touch. Other Protective Reflexes The Reflexive Pharyngeal Swallow is a triggered swallow that clears the pharynx of residue.  The glottis will close and allow the pharynx to move stuff to the digestive tract.  This is a protective mechanism to keep stuff out of the airways. Phayngoglottal Closure Reflex happens when the glottis closes inside the larynx without the continuation of a swallow. Phango-Upper Esophageal Sphincter Contractile Reflex occurs during any type of reflux from the stomach.  While some stomach contents may make it past the lower esophageal sphincter, so the upper one prevents it reaching into the throat and mouth. Bottom Line All of these reflexes are protective to prevent choking or improper ingesting of things.  They can be damaged to different degrees during head trauma or stroke.  But surprisingly, smoking causes the most damage to the protective reflexes on the pharynx. Callbacks Swallowing Mouth Parts Connect with me Support us on Patreon Give us your Feedback Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits: Up In My Jam (All Of A Sudden) by - Kubbi https://soundcloud.com/kubbiCreative Commons — Attribution-ShareAlike 3.0 Unported— CC BY-SA 3.0 http://creativecommons.org/licenses/b...Music provided by Audio Library https://youtu.be/tDexBj46oNI

Bad Breath Basics Halitosis, aka bad breath, can have many causes.  Some bad breath you can prevent with the choices you make, but some bad breath can be a sign of a more serious issue or disease. Oral Health You should brush your teeth for at least 2 minutes twice a day, including the surface of your tongue, then rinse your mouth with an antibacterial mouthwash.  Follow one of your brushing sessions with a good flossing.  This allows you to get any food debris and bacteria build-up out of the way on a daily basis. You should see your dentist twice a year for a deep cleaning and a check-up on your overall oral health.  Your dentist will be able to help you with bad breath issues that may stem from more complicated issues like cavities, gum disease, poorly-fitting dentures, or thrush. Dry mouth, whether due to your natural biology, medication side effects, or mouth-breathing, can lead to bad breath due to the imbalance of bacteria growth. Your Choices Smoking and other tobacco products can make your breath smell bad even when you are not actively using it. The foods you eat also affect the status of your breath.  The compounds that cause eaten and digested foods to smell contain sulfur-based compounds.  These include broccoli, cabbage, brussel sprouts, onions and garlic, coffee, and fish.  The funny thing about these smelly compounds is that they can actually make your WHOLE BODY smell (including your breath as well as other exiting air) until they have passed all the way out of your body!  Diseases Infections, such as bronchitis, pneumonia, and sinusitis, can lead to distinctive bad breath.  Postnasal drip can lead to bad breath as well.  Pharyngeal diverticula that trap old food bits can make your breath smell, as well as tonsil stones that are calcified debris trapped by the tonsils.  Bad breath can also be indicative of acid reflux or GERD. Certain diseases that have telltale breath smells include diabetes, liver disease, and kidney disease.  People with diabetes are at risk of a medical emergency known as Diabetic Ketoacidosis, in which a lack of insulin renders the body's cells unable to use the available sugar.  The body starts burning fatty acids for energy and the waste product is ketones.  Ketones cause the body to become very acidic.  This leads to a rapid transfer of water (extracellular fluid rushes into the blood to try and neutralize and dilute the ketones and then the kidneys rapidly try to flush out the acidic fluid through the urine) which can lead to fatal dehydration.  Clinicians are taught that people experiencing ketoacidosis may have fruity-smelling breath or breath that smells like acetone or nail polish remover. People with liver disease may have breath that smells musty or like a mildewing basement.  And people with kidney disease may have breath that smells fishy or like urine or ammonia.  Ammonia is a typical by-product that is released in urine.  Someone with kidney disease may not be able to filter out the ammonia compounds effectively.  Therefore, the ammonia compounds will circulate in the blood. Call Back Brush your tongue - Tastebuds Tonsil stones - Tonsils Pharyngeal diverticula - Dysphagia Connect with me Support us on Patreon Give us your Feedback Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits: Up In My Jam (All Of A Sudden) by - Kubbi https://soundcloud.com/kubbiCreative Commons — Attribution-ShareAlike 3.0 Unported— CC BY-SA 3.0 http://creativecommons.org/licenses/b...Music provided by Audio Library https://youtu.be/tDexBj46oNI

Dysphagia Basics Having difficulty swallowing or the inability to swallow is known as dysphagia. Symptoms of dysphagia include: Pain while swallowing The sensation of food stuck in the throat or chest Drooling Hoarseness Regurgitation Reflux Unexpected weight loss Choking, coughing, or gagging when swallowing Taking tiny bites Dysphagia by Phase There are several conditions that can affect each phase of the swallowing process. Oral Phase Dysphagia during the oral phase, or voluntary phase, can be caused by neurological conditions like Multiple Sclerosis, Muscular Dystrophy, advanced Parkinson's.  Brain damage caused by trauma or stroke can also cause trouble swallowing in adults. Dysphagia in Kids Babies start out nursing or feeding through a bottle and their swallowing mechanism is reversed.  A reverse swallow is when the tongue is thrust forward or out of the mouth to open the throat and allow food or drink down the esophagus.  As children learn to eat solid food and drink from a cup, the swallowing procedure changes. Children can also have trouble swallowing, but the root causes are completely different.  Premature birth, low birth weight, cleft lip or palate, and tongue or lip ties can lead to swallowing issues if not corrected with therapy.  These issues can cause swallowing issues with the reverse mechanism as well as make it difficult to convert to a regular swallow.  Children with low muscle tone are also more likely to stick with the reverse swallow because it is easier. Pharyngeal Phase Pharyngeal diverticula are pouches that form in the mucous membrane above the esophagus.  These pouches can collect food particles that don't get swallowed.  This can cause bad breath, as well as coughing, and constant throat-clearing because it feels like something is stuck in the throat. Esophageal Phase There are several swallowing issues that stem from the esophagus and esophageal phase. Achalasia is an issue where the sphincter that opens into the stomach doesn't relax to allow food to pass through.  This can cause pressure in the chest and may possibly lead to regurgitation if it persists. Diffuse spasms happen when the peristalsis rhythm of the esophagus muscles is poorly coordinated. Stricture is also known as a narrowed esophagus.  It can be a result of injury and scarring from GERD. An esophageal ring is when a thin area of the lower esophagus is narrowed.  This is also a result of scar tissue from chronic GERD.  The scar tissue from acid damage tends to be less flexible which can cause pain. Eosinophilic esophagitis is the overpopulation of eosinophils in the esophageal lining due to food allergies.  Eosinophils are a type of white blood cells that show up in very specific situations - parasitic infections, cancer, or allergies. Dysphagia Risk The risk of dysphagia increases with age, mostly because the risk of the conditions that cause dysphagia increases with age as well.  And while dysphagia can be very uncomfortable, the biggest concern is with the risk of aspiration, or breathing food or drink into the lungs, that leads to pneumonia. Call Back Swallowing Muscle Tone discussion - Accordion in Your Brain Connect with me Support us on Patreon Give us your Feedback Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits: Up In My Jam (All Of A Sudden) by - Kubbi https://soundcloud.com/kubbiCreative Commons — Attribution-ShareAlike 3.0 Unported— CC BY-SA 3.0 http://creativecommons.org/licenses/b...Music provided by Audio Library https://youtu.be/tDexBj46oNI

The 3 Phases of Swallowing Oral Phase This phase includes chewing and saliva mixing with the food to form a bolus (a little glob of mashed up food). Then the tongue moves the bolus towards the back of the mouth.  The tongue starts by pressing against the hard palate behind the front teeth.  Then the sides of the tongue raise up to also press against the hard palate inside the teeth.  At this point, the bolus has nowhere to go except towards the back of the throat. Pharyngeal Phase The vocal folds in the larynx close to keep food out. The larynx also moves up as the epiglottis covers it to seal off the airway. Then the soft palate and uvula move up and close off the nasal passage  So now there is only one way out. Esophageal Phase The bolus moves into the esophagus (because it is the only open path). The esophageal muscles contract from top to bottom (this waving, rhythmic muscle movement is called peristalsis) to push the bolus into the stomach. Swallowing Reflex There are sensory receptors in the pharynx and tongue that receive touch signals.  When they are touched by a bolus, the signals are sent to the brain stem and the return signal results in involuntary and automatic movements of the larynx and epiglottis.  This is a good thing since swallowing is a very rhythmic process and you want food and drink to continue going in the correct direction. This reflex cannot be triggered by sticking your finger in your throat.  You are more likely to trigger a gag reflex that way.  The voluntary steps of swallowing must be initiated before the involuntary portion of the process takes over. Weird Swallowing Scenarios How do you swallow with your mouth open? At the dentist, you are usually laying in the chair on your back and facing the ceiling.  There are at least three tools and two hands in your mouth.  Things in your mouth trigger saliva production.  Also, generally one of the tools the dentist is using is emitting water.  The natural reflex when you have to hold your mouth open for a long time is to bring the back of the tongue and the soft palate together.  This seals off the throat and allows you to still breathe through your nose.  The liquid in your mouth plus gravity creates a puddle at the seal of your tongue and soft palate.  Because the touch sensors to trigger your swallowing reflex are also in this area, it is likely you begin to panic because if they don't hurry and use the suctioning straw to remove the liquid, you're going to swallow! Do you swallow in your sleep? A study was done to find that the only times you swallow while sleeping is during arousal and during REM.  My logical deduction regarding why is that when you're aroused or in one of the more shallow phases of sleep, that is when you can voluntarily move - roll over, adjust the bedding, and swallow.  During REM sleep, most people will experience sleep paralysis, so whatever exciting things are happening in their brain, the body is not likely to act it out.  Because the brain cannot tell if a dream is real or imaginary, the feeling solicited can trigger hormones secretions and saliva production. Increased saliva, just like in the dentist scenario, can trigger swallowing. Connect with me Support us on Patreon Give us your Feedback Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits: Up In My Jam (All Of A Sudden) by - Kubbi https://soundcloud.com/kubbiCreative Commons — Attribution-ShareAlike 3.0 Unported— CC BY-SA 3.0 http://creativecommons.org/licenses/b...Music provided by Audio Library https://youtu.be/tDexBj46oNI

What is a Tonsillectomy? A Tonsillectomy is a surgical procedure to remove the tonsils.  Tonsil - immune system tissue in the back of the throat.  -Ectomy = to remove something from the body. Removing the tonsils may be required if chronic tonsilitis is a problem.  Chronic tonsilitis is defined as multiple infections in a row or an infection lasting 3 months or longer.  Severe snoring and sleep apnea may be another reason to remove the tonsils, for the purpose of opening up the airway. Adenoids Adenoids are another set of immune system glands in the back of the nasal cavity.  They can also swell during infections and interfere with breathing.  Depending on the severity of the infections or the risk of sleep apnea, these may also be removed in the same or a similar procedure. Tonsillectomy Methods Since general anesthesia is used in all methods to remove the tonsils, no eating is allowed before the procedure.  They also recommend no NSAIDs (non-steroidal anti-inflammatory drugs) are to be used before and after due to their ability to thin the blood and increase the risk of bleeding.  In general, a tonsillectomy will take between 30 and 60 minutes.  Recovery time afterward is estimated to be about two weeks. Scalpel This is the old school method of using a very sharp surgical knife to cut out the tonsil.  This method has the highest risk of bleeding. Cauterization This method involves a hot knife that separates the tonsil tissue from the throat.  The heat also closes off the blood vessels so bleeding is not as severe.  A downside is that the tissue has been burned, so I imagine the pain after this method is more severe. Ultrasonic Vibration Ultrasonic waves are sound waves that have a higher frequency than the human ear hears.  The waves cause a very rapid vibration and the energy of those waves is what causes the tissue to separate as well as the blood vessels to clot.  This is the newest method developed and seems to have the least bleeding and pain. After the Tonsillectomy The side effects of a tonsillectomy include swelling of the throat, as well as the face and jaw, bleeding, and infection.  To avoid the bleeding and infection, it is important to follow all the instructions given for the recovery period.  Because of the swelling, cold foods like ice cream and popsicles are popular because cold things reduce swelling.  Popsicles can also help with hydration because swallowing bigger sips or gulps of water can be painful the first few days.  Hot foods are not recommended because the heat can increase the pain or reinjure the surgical site.  And while ice cream is the most popular post-tonsillectomy food, any soft, non-abrasive foods are fine to eat. Why do adults have more issues than kids? Kids heal faster because they are still growing and developing.  Kids also have smaller body parts than adults - the tonsils are smaller and the blood vessels are smaller.  Smaller blood vessels clot and heal faster than larger ones.  This is even true between the different sized blood vessels in your own body.  And a factor no one wants to admit: adults are terrible at following directions and truly resting after a surgery or procedure.  Rest is the best thing for a healing body of any age or size. Strep Carriers Generally, when we think of severe tonsilitis that leads to a tonsillectomy, we think of strep throat.  A carrier is someone who carries the germ around with them but does not get sick from the germ (pertussis is another example). In 1998, a study found that 5-15% of school-aged children were asymptomatic carriers of strep.  This means they tested positive on a strep swab but had no symptoms of being sick.  This causes concern because it means that you can be sick with something else that causes vague symptoms like fever and sore throat but because the strep test is positive, antibiotics are prescribed when they might not be necessary (meaning that you were sick from a virus).  This study showed that providers and caregivers were unaware of the number of unnecessary antibiotics they were prescribing. Strep is eradicated from a carrier by an extensive treatment of antibiotics, or by removing the tonsils from the carrying family member as well as the tonsils of the chronically sick family member. #tonsillectomyforeveryone Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2851340/ Callback Facebook Memory: Episode 74 Sleep Hygiene All About Sleep Connect with me Support us on Patreon Give us your Feedback Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits: Up In My Jam (All Of A Sudden) by - Kubbi https://soundcloud.com/kubbiCreative Commons — Attribution-ShareAlike 3.0 Unported— CC BY-SA 3.0 http://creativecommons.org/licenses/b...Music provided by Audio Library https://youtu.be/tDexBj46oNI

Tonsils Basics Your tonsils can be found in the back of your throat.  You can open your mouth and look in the mirror and see them on each side of your mouth behind your teeth and tongue.  You can also feel them below your earlobes and behind your jaw bone. Tonsils are composed of lymph tissue since they are a part of your lymph system.  They store white blood cells that help you fight off infection.  Their activation during sickness is why they swell and get sore.  They are covered with the same mucosal membrane as the rest of the inside of your mouth.  This mucosa layer has pits and crevices called crypts.  These crypts increase the surface area of the mucosa that comes in contact with the lymph tissue and allows more opportunity for infectious material to be directly accessed by the immune system. Infectious Tonsil Issues Tonsillitis is the inflammation of the tonsils.  It can be classified as acute or chronic.  Acute tonsillitis is directly related to a viral or bacterial infection.  Chronic tonsillitis can be either a persistent, long-lasting infection or multiple consecutive acute episodes that can appear to be one long sickness. Swollen tonsils can cause simple activities such as swallowing, talking, and breathing very painful.  You can see your swollen tonsils when you look in the mirror.  They will appear red or possibly blistered. Mono, an infection caused in adolescents and adults by the Epstein-Barr virus, cause severe swelling in all the lymph nodes, including the tonsils.  This is one of the situations where your tonsils will be so inflamed, you can see the swelling on the outside of your face and neck.  Because such a large portion of your lymph system is involved, including your spleen, this is a serious sickness. Strep throat is probably the first infection you think about when you think of swollen tonsils.  The bacteria, streptococcus, infect the lining of the tonsils and throat.  This is why the doctor will swab your tonsils when they're testing for strep. Non-Infectious Tonsil Issues A non-infectious reason the tonsils will be large is a condition caused hypertrophic tonsils.  The tonsil tissue and/or mucosa overgrow and become oversized without any infection or immune activation being involved.  Overgrown tonsil tissue can lead to snoring or sleep apnea, and that's bad. Another non-infectious issue with your tonsils is called tonsilloliths or tonsil stones.  These stones happen when dead bacteria or food debris gets stuck in the crypts and they become calcified.  They cause a sensation many describe as a crumb stuck in your throat.   They can become quite large and can interfere with swallowing and eustachian tube function.  Because the eustachian tubes run from your eardrum into your throat, if the tonsil is swollen enough, it may close off the tube to the ear and cause ear pressure/pain.  Some tonsil stones are large enough to be visible and may have to be manually removed.  Lastly, due to the composition of the stones (dead bacteria and old food), frequent tonsil stones can be the cause of bad breath. There's no way to prevent tonsil stones 100%.  Good oral hygiene can certainly help reduce the frequency of stones, and can also help remove them quickly if they occur.  The most common way of trying to remove a tonsil stone involve coughing, clearing your throat, or hissing.  All three of these ways produce vibrations in the lining of the throat and mouth.  So along with the exhalation of these methods, hopefully, the result is the stone coming out of the tonsil and out of your mouth. PSA:  Please DO NOT scratch your tonsils with your fingernails to remove a tonsil stone! Callback Sleep Hygiene All About Sleep Connect with me Support us on Patreon Give us your Feedback Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits: Up In My Jam (All Of A Sudden) by - Kubbi https://soundcloud.com/kubbiCreative Commons — Attribution-ShareAlike 3.0 Unported— CC BY-SA 3.0 http://creativecommons.org/licenses/b...Music provided by Audio Library https://youtu.be/tDexBj46oNI

Glossary Aguesia: no taste Hypoguesia: reduced ability to taste (no the same as when taste changes due to changes in ability to smell) Dysgeusia: dysfunctional taste - bad, salty, rotten, or metallic taste (metallic is the most common). Causes for Change Chemotherapy and radiation for cancer causes taste changes because the taste buds are rapid-cycling cells and the goal of chemo and radiation is to kill fast-growing cells (cancer cells are definitely fast-growing). Head trauma or brain damage may damage the path of taste from the mouth to the brain. Conditions like GERD, diabetes, urinary retention, and dry mouth can cause dysgeusia.  Zinc deficiencies can too (in case you can't tell, zinc plays a big role in many processes in your mouth). Over 250 medications can causes changes in taste.  These include blood pressure medications, antibiotics, chemotherapy, asthma medications, and lithium.  Some of them are secreted in the saliva, so the change in taste is because you actually taste the medicine.  Other changes are because the medication disrupts or alters receptor or signal transport (i.e. ion transport - sodium, calcium, potassium, or chloride). My Own Metallic Taste I was taking generic Biaxin, AKA clarithromycin, for a sinus infection.  Clarithromycin is in a class of medication called macrolides.  Macrolides work on infections by disrupting the DNA-copying proteins in the bacteria.  They are known as bacteriostatic antibiotics, which means they stop the bacteria from growing and dividing, but do not kill them.  This allows your own immune system to get rid of the bacteria itself. Clarithromycin is excreted in your saliva at ~2.72 mg/L.  To get an idea of how small this amount is, it takes you 12-24 hours to produce 1 liter of saliva.  Only 3-7% of adults report metallic taste with clarithromycin. Connect with me Support us on Patreon Give us your Feedback Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits: Up In My Jam (All Of A Sudden) by - Kubbi https://soundcloud.com/kubbiCreative Commons — Attribution-ShareAlike 3.0 Unported— CC BY-SA 3.0 http://creativecommons.org/licenses/b...Music provided by Audio Library https://youtu.be/tDexBj46oNI

Review Smell plays a big part in your ability to taste.  The bumps on your tongue that you can see are actually papillae. 4 Types of Papillae Filiform Filiform papillae are the most numerous papillae and are arranged in regular rows running parallel to the median sulcus.  They are cone-shaped - either a single cone (like a volcano shape) or a frill of cones.  These papillae don't actually taste flavors but they do sense touch.  They work as cleaners, helping your tongue create friction with other parts of your mouth to loosen bits of food from the nooks and crannies. Foliate These papillae are located on the sides of the tongue near the back.  They are flat, leaf-like folds, and can be visible in some people.  These papillae contain taste buds for flavors. Fungiform These are mushroom-shaped.  They are scattered all over the tongue but seem to be more concentrated on the edges and tip of the tongue.  They contain taste buds for flavor as well as the sense of touch. Vallate (Circumvallate) These papillae are dome-shaped with a border.  The best description is that they appear as a circular fort with a mote around it and then a wall on the outside.  Or maybe they look like a bunch of "outie" belly buttons!  They are laid out on the back of the in a V-shaped pattern, pointing towards the back of the throat.  These papillae can be visible in some people, and they contain taste buds for flavors as well. Each papilla contains many taste buds.  They are called "buds" because, microscopically, they appear as unopened rosebuds. Taste buds have a swirl-like funnel with an opening in the middle that contains fluid. How You Taste You put food in your mouth. Your saliva dissolves bits of it to free up molecules.  The molecules that are mixed in your saliva wash into the funnels of each taste bud.  There, the molecules mix into the taste bud fluid and get swirled around to come in contact with as many taste sensors (nerves) as possible.  From here, the chemical signal changes into an electrical signal as the taste messages zoom into your brain.  In the brain, the signal is translated and identified - including details such as flavor, pain, temperature, texture, intensity, and smell (while your saliva mixes with some molecules, other molecules are released into the air as aromatics and contact the olfactory sensors in your nose). Taste Buds Map Truth The taste bud map that has been used for years in textbooks was created in 1901.  Even with all the things that we've learned about how taste buds work, where they're located, and what they look like, this map has never been re-written.  The original map identified four basic flavor categories: sweet, sour, salt, bitter.  Yet, just nine years later, the Japanese were able to identify "umami" - that savory flavor that doesn't quite fit into the other four.  Yet, the map still wasn't re-written.  Even now, scientists are learning and updating the database on what the tongue can taste and how - including categories like "fatty" and "metal" and even "water". So, while the taste buds are not grouped into sections based on the flavor they can taste, some taste buds may have a greater affinity or sensitivity to a certain type of flavor. It is estimated that we have about 2000-4000 tastebuds, and since the surface of the tongue is like your skin, the tastebuds recycle about every week or two.  This rapid and continuous recycling might be why it is acclaimed that your taste (preference and enjoyment from your taste buds) changes approximately every seven years. Conclusion Even though the tastebud categories are still too complicated to rewrite the map, I still plan to use my taste buds to their fullest potential.  Eat up! Resources I gathered some of my information from a PubMed article that is actively being updated by real scientists - How Does Our Sense of Taste Work? Callback Smell Connect with me Support us on Patreon Give us your Feedback Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits: Up In My Jam (All Of A Sudden) by - Kubbi https://soundcloud.com/kubbiCreative Commons — Attribution-ShareAlike 3.0 Unported— CC BY-SA 3.0 http://creativecommons.org/licenses/b...Music provided by Audio Library https://youtu.be/tDexBj46oNI

Burning Mouth Syndrome Burning Mouth Syndrome is defined as a burning sensation with no underlying cause.  It may include dry mouth sensations with no true symptoms of dry mouth.  BMS is accompanied by unremitting burning or pain but no mucosal changes or signs of injury or swelling. 3 Categories Increases throughout the day after waking Stays the same morning, during the day, and at night Has no pattern Common Symptoms Bilateral pain of the tongue Chronic pain labeled as moderate to severe, or a 6-10 on the pain scale. Worsened by talking, stress, fatigue, or hot, spicy, or acidic foods. Subjective Descriptions Dry mouth Change in ability to taste Accompanied by a headache Decreased appetite Improved by cold foods or drinks Those who suffer from BMS may see temporary relief with topical analgesics (i.e. lidocaine or benzocaine) but see no improvement from systemic medications.  Fifty percent of the cases have no apparent cause but do have some correlation with depression.  This is a case of "the chicken or the egg".  Are people with depression more likely to have symptoms of BMS?  Or are people with BMS more likely to become depressed? Before someone can be said to have Burning Mouth Syndrome, many other issues must be ruled out. Deficiencies (iron, folate, B vitamins, zinc) Dry mouth Nerve damage Hypothyroidism Type 2 Diabetes Nocturnal habits (clenching, grinding, tongue-thrusting) Infection (thrush, herpes, HIV) A hiatal hernia (GERD) Medications (ACE inhibitors, anticholinergics) Myeloma (a blood cancer involving plasma cells) Pepto Lips Pepto-Bismol, aka Bismuth subsalicylate, has been used for decades for a variety of stomach complaints. Bismuth is a good binder of toxins, in a similar way that carbon is in activated charcoal.  And yes, bismuth is one of those elements on the periodic table.  Subsacylate activates into salicylic acid (related to aspirin) and works to decrease inflammation of the gastric lining. When bismuth binds with sulfur that is naturally in your saliva, it becomes bismuth sulfide, which has a black color and can stain your tongues and lips temporarily.  Pepto overuse is the obvious cause of black lips. Connect with me Support us on Patreon Give us your Feedback Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits: Up In My Jam (All Of A Sudden) by - Kubbi https://soundcloud.com/kubbiCreative Commons — Attribution-ShareAlike 3.0 Unported— CC BY-SA 3.0 http://creativecommons.org/licenses/b...Music provided by Audio Library https://youtu.be/tDexBj46oNI

Born With... Ankyloglossia is also known as a tongue tie.  It is a result of a short frenulum.  This issue is easily corrected if it interferes with eating and talking. Macroglossia is a large tongue.  This is one of the identifiable characteristics of Down's Syndrome.  It is described as the tongue appears to be bigger than space in the mouth. Infected With... Strawberry tongue The tongue can appear extremely red and papillae are swollen to look like seeds on a strawberry.  This is a symptom of several conditions. Kawasaki Disease is a rare but serious childhood inflammatory disease.  Because this involves the blood vessels becoming inflamed, the blood vessels in the tongue are also affected. Scarlet Fever is caused by the same bacteria is strep throat.  The infection goes from just being strep throat to being scarlet fever when the bacteria toxins spread in the bloodstream and cause widespread symptoms. Toxic Shock Syndrome is when the bacteria called as Staph aureus (yes, this is the staph that lives on your skin and can cause wound infections) gets into the bloodstream.  This is a medical emergency and needs to be treated immediately. Hairy Tongue White hairy tongue appears as patches on the sides of the tongue.  It can happen when someone who is immunocompromised gets the Epstein-Barr Virus. (Epstein-Barr is a virus that causes mild childhood illness or a disease we know as Mono when teens and adults.) Black hairy tongue is a little more obscure with a few possibilities of causes. Smoking, excessive coffee or tea consumption, excessive alcohol consumption, or soft diet - inability to shed dead skin cells Antibiotic overuse - overgrowth of fungus or bacteria Overuse of peroxide-based mouthwash - oxidation Function Lost Motor Neuron Disease occurs in the later stages of ALS or Lou Gerig's Disease, when the nerves and muscles of the tongue for speech and swallowing become affected. Connect with me Support us on Patreon Give us your Feedback Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits: Up In My Jam (All Of A Sudden) by - Kubbi https://soundcloud.com/kubbiCreative Commons — Attribution-ShareAlike 3.0 Unported— CC BY-SA 3.0 http://creativecommons.org/licenses/b...Music provided by Audio Library https://youtu.be/tDexBj46oNI

Tongue Basics Your tongue is made up of eight muscles.  This is why it is called a muscular organ.  It is the most important articulator in speech production. (A brief word dissection:  articulate means to communicate something clearly.  In medicine, articulate means to make a connection.  It all makes sense!) The tip is called the apex.  The crease down the middle is called the median lingual sulcus.  There is another crease at the back of your tongue and it is called the sulcus terminalis. Tongue Muscles The tongue has two types of muscles.  Extrinsic muscles attach to bones boarding the mouth.  Intrinsic muscles are completely contained inside the tongue borders. Extrinsic Muscles These muscles are responsible for moving your tongue front to back and side to side.  There are four of them and they are named for the facial bones that they are anchored to. The genioglossus muscle moves it forward so you can stick it out of your mouth. The Hyoglossus muscle pulls it back and presses it down. The Styloglossus muscle raises the sides of it during swallowing. The Palatoglossus muscle raises the back of it during swallowing.  It also presses the soft palate down and squeezes the palatoglossal arch inward during that same step of swallowing. Intrinsic Muscles These muscles are responsible for all the shapes and movements your tongue makes when you talk and eat. The superior longitudinal muscle covers the top side. The inferior longitudinal muscle covers the bottom side. The vertical muscle fibers are in the middle and connect the superior to the inferior muscles. The transverse muscle fibers start at the median sulcus and connect to the outer edges. The Tongue Has Skin?! The surface of your tongue is known as the masticatory mucosa, which basically means it's the surface that food comes in contact with.  The surface is made up of epithelial cells just like your skin.  The cells are keratinized (or filled with a toughening protein) so it is tough and does not get damaged by the wide variety of things we eat. Call Backs Wrinkly Brain Skin 101 Connect with me Support us on Patreon Give us your Feedback Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits: Up In My Jam (All Of A Sudden) by - Kubbi https://soundcloud.com/kubbiCreative Commons — Attribution-ShareAlike 3.0 Unported— CC BY-SA 3.0 http://creativecommons.org/licenses/b...Music provided by Audio Library https://youtu.be/tDexBj46oNI

Teething Teething is mostly known as the phase of babies growing their first teeth.  Eruption is when the tooth enamel shows through the gum tissue.  A baby's first teeth grow in between 6 months and 2 years old.  Before any of the teeth show, the gums can be swollen and bumpy.  These symptoms can cause fussiness, sleeplessness, drooling, decreased appetite, excessive chewing, and overall grumpiness.  A few controversial symptoms include fever, diarrhea, and rash. A fever less than 100.4*F can be indicative of inflammation going on, which can be true for some teething babies.  Diarrhea is blamed on excessive saliva ending up in the digestive tract (eh, many things can change the consistency of a baby's poop, especially in the early stages where they're only drinking milk or just learning to eat new foods).  A rash is a little more questionable, but can also be a result of inflammation going on. Treatments Treatments for teething babies include Infant's Tylenol or Infant's Ibuprofen (for children older than 6 months).  Other medications that used to be recommended for teething babies were Teething Tablets and Orajel.  An active ingredient in the Teething Tablets is Belladonna.  This medication can constrict blood vessels, which is good when there's inflammation (increased blood flow) to an area, but bad when baby's blood vessels are already tiny and they need to get blood to very important places (i.e. the brain).   The bottom line is that Belladonna can decrease the amount of blood, and therefore oxygen to a baby's brain, and the outcome can potentially be SIDS. This is also true of Benzocaine, the ingredient in Orajel.  Benzocaine is a topical numbing agent.  The key word here is topical.  It is not intended to circulate in the body.  The problem comes when you use a TOPICAL product in your mouth, you can't help but swallow some of it.  When Benzocaine is swallowed, it can cause a serious side effect that involved decreased oxygen in the blood.  Again, if oxygen doesn't get to important places in the baby's body, bad things can happen. PSA: NO Belladonna and NO Benzocaine for babies! Plaque Your teeth are covered in a biofilm that is mostly made up of bacteria. That bacteria can compromise the seal that is formed between healthy teeth and healthy gums.  If this seal is breached by bacteria, then infection and gum disease (gingivitis) can occur. Tartar Plaque can harden, and when it does, it becomes known as tartar.  Mouth bacteria eat the sugars in the food that gets stuck in the crevices of your teeth.  A waste product of this process is lactic acid, and lactic acid can actually dissolve enamel of your teeth.  Minor erosion can be repaired by your body.  The problem is that saliva cannot break through the plaque. Cavities Tooth decay is the result of long-term enamel erosion that can't be repaired by the body.  If the erosion is deep enough, it can expose the softer parts of the tooth to irritants and injury.  When this happens, the only way to repair and protect the tooth is to get a filling from your dentist. *womp womp* Discoloration Extrinsic stains are when substances change the tooth color from the outside. So this is how coffee, tea, wine, and tobacco can make the teeth yellow or brown.  Also, certain bacteria, excessive chlorophyll, or excess copper and nickel can make the teeth look green. Intrinsic stains are when the building blocks of teeth are altered and changes the color from the inside.  Tetracycline antibiotics have been a common treatment for acne in teenagers for quite a long time.  It is well-documented that these antibiotics can bind up free calcium in the body.  Therefore, it is not recommended for pregnant women or children younger than 8 years old to use these medications.  There are many cases of developing fetuses and children with quickly-developing teeth ending up with grey or brown teeth due to this missing calcium (remember, calcium built into the enamel is what makes it white). Injuries A chipped tooth is when a part of the enamel breaks away.  A fractured tooth is when a crack involves the enamel and the dentin.  An abscess is an infection in the gum around the tooth or in the accessible or exposed pulp of a tooth.  Luxation is a dislocated tooth, and may or may not include injury to the periodontal ligaments or jawbones. Dental Trauma Guidelines Connect with me Support us on Patreon Give us your Feedback Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits: Up In My Jam (All Of A Sudden) by - Kubbi https://soundcloud.com/kubbiCreative Commons — Attribution-ShareAlike 3.0 Unported— CC BY-SA 3.0 http://creativecommons.org/licenses/b...Music provided by Audio Library https://youtu.be/tDexBj46oNI

Types of Teeth Incisors: You have 4 on the top and 4 on the bottom.  Yes, it sounds like "scissors"; they are the teeth and cut and tear food (or the enemy?).  They are in the very front of your mouth. Canines:  You have 2 on the top and 2 on the bottom.  Yes, canine, like a dog; they are sharp and pointed.  These teeth are good for gripping and tearing.  Also known as cuspids (one point).  They are located at the "corners" of your teeth arch. Premolars: You have 4 on the top and 4 on the bottom.  These are permanent teeth only.  They have a flatter surface for crushing food.  Also known as bicuspids (two points). Molars: You have 6 on the top and 6 on the bottom.   They have large flattish surfaces for grinding up food.  Four of these molars are also known as your wisdom teeth. Parts of a Tooth Outside In Enamel: This is the part that you can see.  It is mostly made up of a crystalline structure of calcium phosphate, and that's what makes them look white.  Enamel all by itself can be very brittle. Dentin: This layer is made of a softer, yet still strong calcium-containing crystals.  This acts as a tough and supportive scaffold for enamel. *These two layers together are what make your teeth so hard and strong. Pulp: The soft connective tissue that contains the nerves and blood vessels that feed the tooth. Top to Bottom Crown: This is the part of the tooth that is above the gum line that you can see.  And since you can only see the outside of the tooth, when you look at your teeth, you only see enamel. Neck:  This is the enameled part of the tooth that is below the gum line. Root: The part of the tooth that is embedded in the jawbone and provides the openings for the nerves and blood vessels to run up into the pulp.  The roots are covered by a specialized bone structure called cementum (yes, it sounds like cement). *The roots are actually attached to the jawbone by periodontal ligaments. (Ligaments are connective tissue that connects bone to bone). Callback Feed Your Bones Connect with me Support us on Patreon Give us your Feedback Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits: Up In My Jam (All Of A Sudden) by - Kubbi https://soundcloud.com/kubbiCreative Commons — Attribution-ShareAlike 3.0 Unported— CC BY-SA 3.0 http://creativecommons.org/licenses/b...Music provided by Audio Library https://youtu.be/tDexBj46oNI

Mouth Issues Ulcers They are uncomfortable and mostly non-serious.  Also known as "canker sores".  Can take 2-3 weeks to completely heal.  Anything lasting over 3 weeks should be checked out by your doctor or dentist.  Ulcers can appear on the inside of the cheeks or lips, the roof of the mouth, or the tongue.  A minor ulcer versus a major ulcer is determined by the size of the sore and the layers of skin affected.  Any ulcer that is bleeding should be checked out despite the length of time.  The edges are red while the center can be yellow, white, or grey.  And they are PAINFUL!! Ulcers can be caused by acidic or spicy foods, braces, stress, hormones, and some medications (such as beta-blockers for blood pressure or NSAIDs).  Nutritional deficiencies can increase your risk of ulcers.  Malabsorption due to conditions like celiac or deficiencies in B-vitamins and iron are the most common culprits.  Also, decreased immunity can make the skin inside the mouth more prone to ulcer recurrence. Thrush This is a yeast infection the mouth caused by the overgrowth of Candida, known as oral candidiasis.  It appears as white patches on the inside of the cheeks, tongue, or roof of the mouth, and the spots cannot be scraped off.  Candida is normal in the body and is kept in balance by the rest of the body's normal flora.  Overgrowth can occur after antibiotic treatments, during times of decreased immunity due to treatments or disease states, or from inhaled steroid treatments. Thrush is treated with a topical antifungal that the doctor directs you to swish around in the mouth to coat the affected areas, usually Nystatin.  If yeast is wide-spread, a systemic antifungal will be used.  Probiotics are a great way to keep your normal flora in balance. Angular cheilitis (ky-ly-tis) Cheilitis = inflammation of the lips.  This is the cracking that can occur in the corners of your mouth.  Many sources will tell you this is caused by a vitamin deficiency - like B-vitamins, iron, and zinc.  Other times, it may be a wound caused by contact dermatitis from increases contact with the tongue or your hands, and then they may become infected with normal skin bacteria or other bacteria in saliva.  An infected wound is one that doesn't ever appear to heal.  Fungal infections, in the same way, cause the skin to crack open and appear overly dry and never-healing. Lie Bumps Transient Lingual Papillitis (swollen taste buds).  They can appear to be white or red, and they can be asymptomatic or very bothersome.  Not sure what exactly causes it.  Definitely NOT caused by lying.  *I used to think they were "lye bumps" as in sodium hydroxide that is a strong base and used to be popular as a detergent.* Cleft lip/palate A birth defect that has a strong genetic component, but also linked to environmental components that have not been pinpointed yet.  A cleft lip or palate is a result of parts of the mouth and face not fusing together during fetal development, and requires surgical correction after the baby is born.  The oral and nasal cavities are supposed to be separate and when they are not, it can increase the risk of sinus and ear infections.  Ear tubes are usually recommended. Even after repair, a child may require speech and occupational therapies to develop the muscles needed for normal speech and eating habits.  Many times, a follow-up surgery is required as the child grows, and many other types of mental support are needed. Bonus *Mouth Cancers: the most common cause of mouth cancers is tobacco use (smoking, chewing).  It can start out as something that appears minor like a mouth sore, but can develop quickly into something deadly.  In the end, it can result in large areas of the mouth having to be surgically removed.   Callback Probiotics Connect with me Support us on Patreon Give us your Feedback Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits: Up In My Jam (All Of A Sudden) by - Kubbi https://soundcloud.com/kubbiCreative Commons — Attribution-ShareAlike 3.0 Unported— CC BY-SA 3.0 http://creativecommons.org/licenses/b...Music provided by Audio Library https://youtu.be/tDexBj46oNI

Mouth Parts Lips:  They are red due to blood flow.  They have lots of nerve ending so they can be very sensitive.  Our lips are used to manipulate food as we eat and make sounds as part of our speech. * The Divot above the center of your upper lip is called the philtrum. Gums:  They are also known as the gingiva.  Even though they are wet and look fleshy, healthy gums are quite resilient. Teeth: They are used for chewing, and possibly as a tool.  Healthy teeth and gums seal together tightly to keep out invaders.  We will talk about teeth in a separate episode. Tongue:  It is a muscular organ made up of many muscles and nerve endings.  It just happens to be an organ that we can voluntarily move around.  We use our tongue to manipulate food and to make sounds for speech.  And, of course, it is covered in taste buds.  We will cover all of this in a separate episode. Hard Palate:  A flesh-covered bone that connects the upper teeth.  Our tongue will smash food against it when we eat and use to make certain sounds in speech. Soft Palate: It is a muscle behind the hard palate and it moves up to close off the nose when we swallow and sneeze.  It also interacts with the back of the tongue to make certain sounds when we talk. Palatoglossal arch:  It marks the front edge of the soft palate. Palatopharyngeal arch: It makes the back edge of the soft palate and the end of the "mouth". Salivary Glands Parotid glands: The largest salivary glands are located by your jaws, below your ears. Submandibular glands: They are located under the jaw and back molars Sublingual glands: They are located under the tongue, behind your chin. ~1000 of mini glands: They cover the buccal (cheek) tissue, soft palate, uvula, and tongue to keep everything moist.  This is what allows the inside of the mouth to be known as a mucous membrane. Sublingual papilla: This is the folds of skin under the tongue.  This area contains many blood vessels close to the surface.  Medicine development has learned this is a great place for medication absorption directly into the bloodstream. Palatine raphe (ray-fee): This is the seam down the middle of the hard palate. Frenula: Plural for frenulum.  These are folds of skin that connect one place to the other.  You have three: for your upper lip, lower lip, and tongue. Uvula: Latin for "small bunch of grapes".  It is attached to the soft palate and contains a gag reflex trigger.  It is also involved in snoring if it dries out.     Callback Sneezing Connect with me Support us on Patreon Give us your Feedback  Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits: Up In My Jam (All Of A Sudden) by - Kubbi https://soundcloud.com/kubbiCreative Commons — Attribution-ShareAlike 3.0 Unported— CC BY-SA 3.0 http://creativecommons.org/licenses/b...Music provided by Audio Library https://youtu.be/tDexBj46oNI

Post-Manifesto Tidbits This is the heart and soul of why I have produced this podcast for 100 episodes.  My Manifesto, if you will. The podcast is going to take a break for the summer to regroup and plan new and fun things! In the meantime, catch up on episodes you missed or re-listen to them all! If you want to stick close for sneak peaks of new adventures and the reboot, join the Pharmacist Answers Podcast Community on Facebook If you've enjoyed the first chapter of The Pharmacist Answers Podcast, please leave a rating and review on your favorite podcast app. The new home for show notes is intelleximed.com Thank you so much for letting me be in your ears each week. Connect with me Support us on Patreon *NEW* Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits:  “Radio Martini” Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0  http://creativecommons.org/licenses/by/3.0/

Sneezing is very forceful in your body. Review:  the inside of your nose is covered with mucous membranes, and that mucus traps up things so they don't get into your lungs. Some little particles float through the air and into your nose.  They will land on those mucous membranes and irritate it.  That irritation sends a signal to your sneeze center of your brainstem. *Callback:  Brainstem* The sneeze center sends out several signals.  One goes to your diaphragm to tell it to compress the lungs to force the air out.  Another signal goes to your tongue to have it direct the air through your nose.  The last signal goes to your eyes - it is really true, you can't sneeze with your eyes open. So your abs contract and your diaphragm forces your lungs to exhale, your tongue directs the air to go out your nose, so the mucus plus the things that irritated your nose flies out of your face. *Mythbusters sneezing* The proven statistics on sneezes is that they travel about 40 mph but only go about 20 feet. Holding in a sneeze can be painful and damaging.  By holding in all that air, you can rupture your eardrums, damage your tear ducts in your eyes, fracture your nasal cartilage or bones, or cause nose bleeds because of the blast against your sinus passages. There's so many tricks about trying to stop a sneeze - most of them involve counter-pressure on other spots on your face or body. The best advice for stopping a sneeze is to blow your nose to get out the irritants before the body blasts it out with a sneeze. You will never ever sneeze when you're sleeping.  So morning sneezing fits are normal for a lot of people.  This is because all the dust and stuff you breathe in while you're sleeping finally irritates your body.  So morning congestion and sneezing is normal to help clear all of that out. We're unsure why people will sneeze in other situations like sudden exposure to bright light or changes in air pressure or temperature.  Another unsual trigger is an over-full stomach.  Multiple people have reported they feel nauseous and once they sneeze, the sick feeling goes away.  I dunno.... If you do have to sneeze, make sure you cover your face.  Use the elbow technique! *Mythbusters hanky* Support us on Patreon *NEW* Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page "Radio Martini" Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0 http://creativecommons.org/licenses/by/3.0/

Nose issues that cause your breathing to fail Congestion from allergies, viruses, or infections. Deviated septum - the septum (the bone that separates the nasal cavity and divides your nostrils) can get crooked and change the size and access of the nostrils or nasal cavity.  Can be from trauma, or may gradually get crooked from chronic pressure. Turbinate Hypertrophy - over-growth of tissue covering the turbinates (tissue-covered bones that add warmth and moisture to the air you breathe). This can lead to snoring.  May be treated by steroid nasal sprays or surgery to remove extra tissue. Nasal Polyps - uneven overgrowth of mucus membranes (symptoms may be runny nose, post-nasal drip, stuffiness).  They are not cancerous.  Treated by snipping them out. Sinus cancer - a single growing tumor that causes bulging, either around the eye, face, or mouth. Nose issues that cause your smelling to fail Age Deviated septum (see above) Polyps (see above) Chronic sinus infections - the smelling sensors are inflamed or covered with mucus so much that they become damaged or less sensitive. Smoking - smoke and toxins can damage smelling receptors in your nose.  Also, the receptors become so clogged up with smoke and tobacco molecules that there's no room for other molecules to be detected.  This can be temporary or permanent. Nosebleeds In kids, this is usually from trauma (either bumps and bonks or picking).  Can also be caused by dry air in the wintertime (use vaseline in the nostrils).  In adults, can be from hypertension (high blood pressure) or chronic use of blood thinners. PSA: Treatment for a nosebleed:  DO NOT tip your head backwards!!!!!  It makes you swallow that blood!  THAT'S GROSS!!  Proper treatment:  pinch the nose and tip the head forward.  This allows a clot to form and clots stop the bleeding. Connect with me Support us on Patreon *NEW* Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits:  “Radio Martini” Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0  http://creativecommons.org/licenses/by/3.0/

Smell Basics Air goes in your nose and flows over the smell sensors. Your nose and sinus cavities act as a resonating chamber for your voice.  That's why you sound funny when you hold your nose or when your nose is stopped up from a cold or allergies.  This is important in talking and singing. What makes something smell? Volatile molecules evaporate at normal temperatures and pressures, so actually molecules of the thing are in the air and available to go in your nose.  Don't think about this too hard.... The smelling sensors are on the roof of the nasal cavity --> olfactory receptors (olfactory is the fancy word for smelling).  The molecules fit into the receptors like a key in a key hole.  Our brain likes to categorize things, and so certain compounds have similar structures and get lumped together ("smells like eggs" but you know it's not real eggs). The olfactory receptors send the signals to the olfactory bulb (which is the area in the brain that translates all the smells and allows you to identify a smell).  It's not a very long trip.... The olfactory bulb is a part of the limbic system (the emotion center).  this is why smell is more strongly connected to emotions and memory - even stronger than sight and sound. Smell Tidbits If you go to the perfume counter at a department stores, you'll find that they all start smelling the same.  The perfume department will have coffee beans because it helps clean out the receptors. Coffee-scented, caffeinated perfume

Nose Basics Your nose is responsible for breathing and smelling.  These things work better when it isn't stopped up. The part of your nose that you can see and touch is cartilage covered in skin.  There is bone above it, beside your nose, below it, and right in the middle (inside your head).  Part of the cartilage is stiff and hold shape, other parts of cartilage are soft for flexibility. The nasal root (the bone that extends between your eyes) connected to the bridge of your nose (which is made of cartilage).  The tip is also called the lobe.  The wings are on each side of your nose that you can flare.  The nostrils is actually the holes. There are 4 main sinus cavities Frontal sinuses = in your forehead, between your eyebrows Maxillary sinuses = run under your eyes, behind your cheeks Ethmoid sinus = right between your eyes, in the middle of your head, connected to your tear ducts Sphenoid sinus = under your sphenoid bone (in the middle of your head) The sinus cavities are lined with mucous membranes that keep them moist and have lots of blood flow to them.  Their job is to warm and moisten the air you breathe in your nose before it goes into the lungs.  Your lungs don't like cold air. Mouth breathing is not very efficient. This is true in athletics as well as sleep.   But breathing out through your mouth can be useful because you can get a large amount of air out rather quickly and the lungs empty better. You have a fast-flow and a slow-flow nostril - this has to help you perceive smell.  Sometimes almost as good as dogs. The cartilage of your ears and nose never stop growing through your life. Connect with me Support us on Patreon *NEW* Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits:  “Radio Martini” Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0  http://creativecommons.org/licenses/by/3.0/

PSA:  Please don't stick things in your ear any larger than your elbow...and that includes your finger. Review Outer ear = the part that you can touch Middle ear = the area being the ear drum Inner ear = the cochlea and area responsible for your balance 3 common ear problems Ear infections (otitis media) Vertigo (and motion sickness) Tinnitus (ringing in your ear) Callback *Ear wax Ear Infections The area behind your ear drum has air in it and that pressure is equalized through the eustachian tube.  If that area gets fluid in it, that fluid can grow bacteria and that leads to infection.  The natural motion of opening and closing your jaw helps massage the eustachian tubes and moves air in and out (like when you fly or drive in the mountains and you chew gum or yawn). Cold and allergies can be the source of the fluid build up that leads to ear infection.  You may have decreased hearing, pain, decreased balance - infection can require antibiotics. Vertigo This is the sensation of spinning, dizziness, being off balance The semi-circular canals are responsible for your balance.  If it get sloshed too much, or doesn't level out exactly right, then the signals sent to the brain may translate to being off balance even though your body is upright.  The signal confusion is what can lead to nausea (it's not actually happening in your stomach - at least not until you vomit!) The fluid moving around in these canals are why kids can induce dizziness when they spin around in circles (think about the clothes in your washer during the spin cycle - they get pushed to the outside). Medications  for vertigo are the same as some medications for nausea - plus they have drowsy side effects, so maybe you just sleep it off. There are many suspected causes, but nothing definite or proven. Tinnitus Defined as ringing, buzzing, roaring, whooshing sound when nothing is actually making that noise. Causes: hearing loss (either due to aging or exposure to loud noises); high blood pressure (pulsating); medications One theory: the hairs in the cochlea are damaged so those frequencies of sound (usually high pitched sounds) can't be picked up anymore; the brain fills in the gaps with "made up sound".  This is NOT PROVEN! High blood pressure can cause you to hear the blood pulsing through the blood vessels in your ears. Medications that causing ringing in the ears Aspirin (acute over-use) Aminoglycosides (i.e. Gentamicin = antibiotic) - it has a small therapeutic window, too much can lead to ear damage, it stopped in time, permanent ear damage can be avoided Quinine = usually asked for to help leg cramps, also medically prescribed to prevent malaria.  Can only be readily consumed by drinking tonic water. Flavonoids are put in vitamins and advertised to help tinnitus.  Flavonoids are phytonutrients (nutrients you get from plants).  These nutrients can't grow the hairs back in the cochlea.  Most of the vitamins and nutrients in the flavonoid vitamins have anti-oxidative properties, but I doubt that tinnitus is a major oxidation problem. Audience Question Can being slapped over time cause ringing in the ears? Being bopped in the face and head can probably cause permanent damage to the structures on the inside and outside of your head.  Being hit in the side of the head can cause pressure build-up in the ear where the air causes the ear drum to rupture (like "boxing" the ears). Slaps to the face (like "you jerk!" kind of slaps) don't usually cause ear problems, but punches or slaps to the side of the head near or on the ears can possibly cause damage. Prevent ear problems: be nice to your ears! Connect with me Support us on Patreon *NEW* Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits:  “Radio Martini” Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0  http://creativecommons.org/licenses/by/3.0/

Ear Basics The auricle is the part of the ears you can see. It is made of cartilage (flexible tissue that doesn't have a large blood supply).  Everything else requires a tool for the doctor to see inside.  And the doctor can only see to the ear drum.  The stuff behind the ear drum isn't visible because of the membrane that blocks it.  The middle and inner ear are surrounded by your head bones. Science of Sound Sound is created when the air around us is compressed and then expands.  They move away from the source in circles (think radar or sonar or throwing a pebble in a pond). The ear canal directs the sound waves towards the ear drum. Sound gets translated in 2 main ways Identify the sound Identify if the sound has meaning Inside Your Ears The ear drum (tympanic membrane) vibrates according to the intensity of the sound and trigger the Hammer-Anvil-Stirrup cascade. The ear drum vibrates the handle of the Hammer (Malus bone - yes, it's a real bone). The Hammer bangs on the Anvil (Incus bone).   The Anvil has a tail that is connected to the Stirrup (Stapes bone). The Stirrup looks like the spurs on the back of boots.  It is connected to a membrane on the Cochlea and works like a plunger. All of these bones are surrounded by air and the pressure is controlled by the Eustachian tube.  This is the access point for ear infections or congestion due to allergies or a cold. The Cochlea is a bone full of fluid and lined with hairs and shaped like a spiraled sea shell.  The hairs pick up different frequencies of sound (sound wave frequency determines pitch).  If certain levels of hairs get damaged, then you will not be able to hear pitches in that range anymore.  If you unrolled the cochlea, it would be laid out low pitch to high pitch like a piano.  And these hairs are connected to the auditory nerves and turn sound signals into electrical signal to send it to your brain. Semicircular canals of the cochlea are little bone chambers full of fluid and they control balance.  This works like a leveling bubble to help you stay upright.  If it becomes dysfunctional, then it may trigger vertigo. The middle ear (the area behind the ear drum) is where most of the trouble happens - whether allergies causing stopped up ears, or colds leading to ear infections. Connect with me Support us on Patreon *NEW* Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits:  “Radio Martini” Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0  http://creativecommons.org/licenses/by/3.0/

Allergy Basics Anaphylaxis = an out of control allergic reaction that can be life-threatening if medical treatment is not sought immediately EpiPens are a first-step self-treatment in the case of a major allergic reaction or anaphylaxis. My Allergy Testing Experience I got 33 injections!! Allergy testing started with a serum test as a baseline - just to see how strongly my histamine reaction was. The injections are sub-dermal (under the dermis layer of the skin).  It's the same level if injection that a TB skin test is done (to see if you've been exposed to tuberculosis). The next step was a prick-test or scratch test - these plastic claw things that poke down in my forearms.  This test required me to sit completely still for 20 minutes.  COMPLETE TORTURE! Numbers 1-20 are plants (trees, grasses, flowers).  C = cat. D = dog (Good news - I'm not allergic to dogs!) M = skin mites (don't think about this one too hard). CL = cockroaches.  The other letters are household and common molds. The skin pricks on my forearm was a preliminary test to determine how much serum she was going to inject of each in my upper arms. The mites injection hurt the worse of all of them, but i had minimal reaction. Slowest tattoo EVAR! My Results One of my higher reactions was to Fescue (this is the type of grass that Ken grows on the farm as hay to feed the cows!) The one the nurse was most concerned about was Cocklebur. They didn't want me to wash the mold markings off until I go in for a delayed reading a few days later. The next step that they prefer you do is allergy shots - 2 years of weekly injections of what you're allergic to in hopes to desensitize you to those triggers.  NOPE!  Not doing it! Connect with me Support us on Patreon *NEW* Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits:  “Radio Martini” Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0  http://creativecommons.org/licenses/by/3.0/

Eye Conditions (not) in ABC Order Dry eye 48% of Americans over age 18 complain of dry eyes.  Caused by environment, genetics, health conditions, eye procedures, medications. There are 2 reasons for dry eye: Inflammation blocks the free flow of fluid through the eye. Tear duct insufficiency - the ducts and glands don't produce adequate moisture for the eye (can be solved by a tear duct stent) If a medication dries up another part of your body, then it has the potential to dry out your eyes (antihistamines, medications for overactive bladder) - these medications can also lead to constipation. Many of the common diseases that many Americans deal with can cause dry eye - hypertension (high blood pressure), diabetes, obesity. They light from electronic devices tricks your eyes into not blinking as often, therefore your eyes can dry out more easily (blinking is your eyes' remoisturizing process).  The solution is to give your eyes long breaks from electronic light , especially late at night before sleeping. Air conditions in hotels can make your eyes feel dry because they work to remove excess humidity from the air. Hormones, whether in pregnancy, menopause, or during the use of prescription birth control products, can cause changes in the moisture content of your eyes. The Solution: eye drops (either OTC or Rx) Presbyopia It means "old or elderly vision". Presby = elders Presbyterian church = the church's decision-maker was a group of people called Elders This seems to happen somewhere around age 40.  The lens of your eye loses some of its flexibility.  The lens has to be really curved to see up close, and then flattens out a bit to see far away.  So, if the flexibility decreases, it means it can't curve up enough to clearly see things up close. The solution: wear reading glasses. Stye It's an infected oil duct or hair follicle.  Looks like a zit.  **DO NOT TRY TO POP A STYE LIKE A ZIT!!**  They will usually clear out on their own in 6-7 days.  Not too troublesome other than being sore, swollen, and not pleasant to look at. The Solution: warm compress for 15-20 min, then take a shower or wash your face, then leave it alone!  Can use drops or an ointment to help lubricate the eye.  Worst cases will require antibiotic drops or ointment from the doctor. Corneal dystrophy A genetic condition that causes the accumulation of protein material build up in the layers of the cornea (recap: cornea = the very front layer of your eye that starts to focus the light into the eye).  If this fluid gets cloudy with junk, then your vision gets blurry. No other symptoms really except worsening vision.  A surgical procedure can be used to clear out the cloudy liquid, but no cure. This can lead to corneal erosion (where the layers of the cornea begin to separate = painful). Corneal erosion has to be corrected by surgery.  Erosion can also be a result of eye injury - either instant trauma or more gradual like an unhealed corneal abrasion (which can lead to ulceration and eventually erosion). Take care of your eyes and treat them nicely! Callback Sleep Connect with me Support us on Patreon *NEW* Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits:  “Radio Martini” Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0  http://creativecommons.org/licenses/by/3.0/

Eye Conditions in (not) ABC Order If something happens to your eyes that makes you want to ask the pharmacist if you should go to the doctor, the answer will most likely be "yes, go see a doctor."  Even at emergency rooms, they will treat you and make you comfortable but always tell you to follow up with your eye doctor. Photopsias This is seeing things that aren't really there, the visual cortex translates other sensations as "sight". Floaters: "shadows" that float around in your field of vision.  They *can* be a sign of a detaching retina, but that is usually not the case.  They are normal for most people. Inside your eyeball is a gel, called vitreous gel.  Throughout your life, that gel begins to liquify.  As it turns to liquid, it may have other bits of gel still floating in that liquid.  And you see "shadows" because they block light from reaching your retina.  Floaters may worsen with dehydration or exhaustion.  If you try to focus on them, they "float" away. Flashes: "seeing stars" - when the vitreous gel/liquid combo gets shook up and sloshed around (i.e. head trauma).  You can also get "flashes" with Digitalis toxicity (Digoxin is a medication derived from the Foxglove plant and developed for arrhythmias.)  This is a medication that the doctor will test your levels for to make sure toxicity doesn't happen. Waves: looks like radiating heat; caused by spasms of the blood vessels in your eyes.  This may be one explanation of the "aura" that comes before a migraine.  If it happens and no headache follows, it's caused an "ocular migraine". Glaucoma It is the 2nd leading cause of blindness in the US and around the world.  Glaucoma is known for increased pressure in your eyes.  The fluid around the eyes typically have adequate drainage so nutrients can flow in and waste can flow out.  If that drainage becomes inadequate, the pressure builds up and it can put pressure on the optic nerve (the nerve that connects from the retina to the brain).  It starts with decreasing peripheral vision, and can become "tunnel vision" where a person can only see right in the middle of their field of vision. Medications are eye drops that control pressure and help open up drainage pathways as much as possible.  It doesn't hurt, and it takes a while for the decreased peripheral vision to be noticeable.  It's not reversible, but it can be slowed with medication.  Eye doctors have a way to check the pressure in your eyes each time you get your eyes checked. (Macular Degeneration is the #1 cause of blindness in the US, Cataract is the #1 cause of blindness worldwide).   Nystagmus Pronounced nigh-stag-mus.  It is the involuntary rapid eye movement side to side.  Caused by a neurological issue, either related to the eye muscles and nerves or the inner ear (one cause a vertigo).  The shaking seems to be worse when a person looks straight at something or someone.  For someone dealing with nystagmus, they usually discover they can tilt or turn their head to make their eyes slightly off center where the shaking wills stop - this is called a "null point".  Strengthening eye muscles can help the shaking, but it still worsens with exhaustion or stress. This can be a result of a stroke, multiple sclerosis (autoimmune).  Dilantin is a medication for seizures, and is another medication that has to be regularly measured because too much can cause temporary nystagmus. Connect with me Support us on Patreon *NEW* Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits:  “Radio Martini” Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0  http://creativecommons.org/licenses/by/3.0/

Eye Conditions in ABC order Color blindness It doesn't mean that someone sees the world in black and white. It's technically labeled as Red-Green color blindness, which means the world is seen in shades of yellow. The cones in your eyes (a certain shaped cells in your retina) are built to pick up different wavelengths of  light (think ROYGBV).  So the cones that would pick up reds and greens are absent or broken. Found to be a Y-chromosome trait, so it is more prevalent in males. Rarely Blue-yellow color blindness is a thing. Conjunctivitis pink eye = inflammation of the conjunctiva conjunctiva = the layer that covers your whole eye 3 types: Viral: itching, watering, burning, light sensitivity, very contagious, lasts ~ 7 days Bacterial: green/brown discharge (aka "goo"), foreign-body sensation, contagious, can cause damage if untreated, requires antibiotic drop Allergic: triggered by allergens, histamine reaction, can accompany a larger, more general allergy reaction, anti-histamine eye drops can help Corneal abrasion A scratched or injured cornea.  Symptoms include redness, watering, light sensitivity, foreign-body sensation Can be dramatic or traumatic like being hit in the face or eye by something, or something as simple as rubbing an itchy eye or getting something out of their eye. * If you end up with something in your eye, the best option is to flush it out with water or saline Bacteria on your hands or the thing that scratched your eye can lead to a deeper infection, but most of the time, if you use caution, it will heal itself rather quickly. **Solution for light sensitivity:  wear sunglasses at night Detached retina When the retina detaches from the back of the eye.  Sounds awful but it doesn't hurt.  The retina a web of nerves in the back of your eye that sends signals to the brain. Closing curtain sensation is where part of the view of vision will become shadowed as the retina detaches gradually from one side to the other.  Floaters also show up if this is happening. (All floaters ARE NOT related to the retina.) Sudden detachment can be caused by head injuries or sudden intra-ocular pressure drops (the fluid pressure inside your eyeball).  This sudden detachment is experienced as a flash of light and then sudden darkness.  Sudden or gradual detachment requires immediate medical attention and can be repaired with surgery and medical intervention. Diabetic retinopathy do to chronic damage can lead to retina detachment.  *The risk of retina detachment occurring after an eye procedure (lasik surgery or cataracts surgery) is skewed for people with severe nearsightedness, possibly due to a genetic disposition of having a shorter retina. Audience Question Safe to use allergy eye drops long-term? Answer:  Sure!  The only problem is that chronic use can lead to your body not responding to the same med over and over as well.  So, to avoid this, swap between drops and allergy tabs - based on if you're experiencing "eye only" allergies or a wider allergy response that involves the sinuses too. Connect with me Support us on Patreon *NEW* Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits:  “Radio Martini” Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0  http://creativecommons.org/licenses/by/3.0/

Eye Conditions in ABC order Your eyes work together so that the line of focus for each eye cross, and that is your most in focus image.  So as your eyes make tiny adjustments, you can focus on things close up or far away. Amblyopia If you have a lazy eye, the muscles don't allow the eye to focus and coordinate with the strong eye.  This can lead to double vision or blurry vision.  I remember it because it sounds like "ambling" which can mean to meander or wander around.  Versions of this can be caused by torticollis, where a baby's head is tilted or twisted due to positioning in the womb.  The eye can either compensate for the difference or it'll just give up and let the dominant eye do all the work.  Correction of this issue usually involves patching the strong eye and making the weak eye do all the work.  The blurry or double vision can lead to headaches.  Overuse and fatigue (like long days at work) can make it worse. Astigmatism An astigmatism no a stigmatism.  It's an irregularly-shaped cornea; think baseball vs football.  A circular lens (baseball) focuses light to a single point.  A football-shaped lens focuses light to a line, so that makes the vision blurry.  This is why people with astigmatism will squint.  Squinting is a way for your eyes to manipulate the amount of light coming in and alter the shape of the eye to clear up the image of what they're looking at. Lasix procedures can correct astigmatism - the laser does micro-damage to the eye and it heals more circular in the eye. Blepharitis Inflammation of eye lids.  Can result in dry eye.  It can affect the outside (eye lashes side) or the inside (lubrication gland size).  This is NOT a stye.  Caused by a chronic build-up of bacteria, skin flakes, dried eye lubrication.  Some skin conditions can make a person more susceptible to blepharitis - Rosacea (overgrowth of skin bacteria), severe dermatitis, including psoriasis.  It's recommended to use really good eye hygiene before having a doctor intervene.  Using warm compresses to keep dried skin and "eye crusties" soft and glands open so they don't get clogged.  Using clean cotton swabs or clothes instead of your hands to touch or wipe things out of your eyes, so you don't transfer bacteria.  Doctor's can insert a catheter into the tear ducts to keep it open and less likely to keep it clogged.  There's not a cure to make it go away for good. Cataracts The lens of the eye gets cloudy due to proteins clumping up.  People have described trying to see with cataracts like trying to look through wax paper.  Risk of cataracts normally increases with age.  The risk for cataracts can be increased even more by chronic diseases (diabetes, high blood pressure), poor health habits (obesity, smoking, alcohol use), long-term use of certain medications (steroids, hormone replacement therapy).  The current treatment for cataracts is lens replacement.  The old treatment would be just removing the proteins, but depending on a person's longevity, they may get cataracts again in their lifetime. Connect with me Support us on Patreon *NEW* Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits:  “Radio Martini” Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0  http://creativecommons.org/licenses/by/3.0/

Remember: if a vitamin is good for one place in your body, it's probably good for a lot of places in your body.  It's a marketing ploy to call them eye vitamins. Eye Vitamins Thiamine (B-1): thiamine is used heavily in your liver, to help metabolize alcohol.  Most well-known deficiency in alcoholics.  Thiamine also helps nerves produce several neurotransmitters, as well as protects your nerves from inflammatory chemicals (the chemicals in your body that trigger swelling and pain).  You don't want inflammation in your optical nerves.  You also don't want the signals from your eyes to your brain and back to be slow. Folic acid:  important for pregnancy women and fetal development, deficiency can cause a type of anemia.  It's main job is to help make accurate copies of the DNA and RNA when cells are dividing and multiplying.  You don't want typos in your DNA!  This is important for your eyes because the cells of your eyes is because they are some of the fastest reproducing and dividing cells in your body. Omega-3 Fatty acids:  Beneficial for heart health, found in oils.  Oils in your body are lubricating.  Omega-3 fatty acids are building blocks for the cholesterol that is build into cell membranes that keep the fluid and slippery. The body also uses O3FA to produce the natural lubrication in your eye. N-Acetylcystine (NAC): an amino acid (building block of protein).  Glutathione - your body's naturally produced antioxidant.  NAC is used when the cells build and store glutathione.  Glutathione focuses mainly on oxygen-based free radicals. Alpha Lipoid Acid (ALA): another antioxidant.  Found in sources of natural oils - seeds and nuts. Lutein and Zeaxanthin: 2 nutrients that are found in red, orange, and yellow fruits and vegetables (and that actually cause them to be those colors in the first place).  Their main goal in your eyes are to prevent blue light damage.  Blue light is a short wavelength with a higher speed and energy than the lower colors of light.  This energetic light can damage cells in your eyes, so the orange nutrients blocks this energetic waves so you can still see the blue colors, but it's more chill and doesn't cause damage to the retina.  These nutrients concentrate in the macula. Connect with me Support us on Patreon *NEW* Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits:  “Radio Martini” Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0  http://creativecommons.org/licenses/by/3.0/  

*Disclaimer: most vitamins and minerals are good for ALL of your body. Eye Vitamins Vitamin C: helps make collagen, allows iron to be absorbed, and acts as a neurotransmitter co-factor (helps in the process of creating and sending messages). Vitamin E: antioxidant, it traps up free radicals so they don't damage cells in important organs. Beta-Carotene: a pre-cursor to Vitamin A (this happens in your liver). Vitamin A works with proteins in your eyes to create light-sensitive molecules to aid in color vision and seeing in dim light. Zinc: helps Vitamin A know where it's needed in the body and helps it get there. Selenium: helps the body absorb Vitamin E. Calcium: vital for muscle and nerve conduction (think electricity). No lone rangers here!   Many foods are fortified in modern countries and have vitamins added to them that may not be naturally occurring in the raw ingredients.  If you're eating a well balanced diet and still deficient in something, take a supplement of the thing you're deficient in, not a whole multi-vitamin.  If you're getting regular check-ups with your doctor, they should be testing for many things, including many vitamin levels, to check for deficiencies.   Being “tired” isn't always fixed by taking vitamins. Bonus Depending on what nutrient is missing to cause anemia, the red blood cells will have a certain appearance. Some vitamins are fat soluble. They hang out in your adipose tissue, and can cause problems if you get them in too large amounts. Connect with me Support us on Patreon *NEW* Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits:  “Radio Martini” Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0  http://creativecommons.org/licenses/by/3.0/  

Eyes Your eyes are more complex than any camera on the planet! Cornea:  a concave lens on the front of your eye that focuses light Iris:  the colored part, a diaphragm that controls how much light comes in (the pupil is the hole the light enters = equivalent to the aperture of a camera) Lens:  the "focuser", uses a process called accommodation to focus near to far and make the image as sharp and clear as possible Retina:  the sensor, and sends signals to the brain to translate light into an images The retina has 2 types of sensors: Rods - detect light intensity Cones - color differentiation Two special areas of the retina: Macula - right in the middle of the retina, they place that detects the most detail (that's why the center of your vision field is a clearer picture than the periphery) Fovea - the center of the macula, it contains cones (color sensors) only to aid in the translation of very fine details Support structures Extra-ocular muscles - allows your eyes to move around in their holes There are chambers of fluid that are between each structure of the eye, and that fluid helps hold nutrients that feed those parts, and remove waste Choroid:  the layer that holds all the blood vessels that feed the eyes Sclera:  the whites of your eyes, an outer coating that hold everything inside Conjuntiva:  the mucus membrane that attaches the sclera to the eyelids; produces liquid for lubrication and trapping invaders PSA Please don't vigorously rub or scratch your eyes, you could hurt them! Connect with me Support us on Patreon *NEW* Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits:  “Radio Martini” Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0  http://creativecommons.org/licenses/by/3.0/

Brainstem Basics Your brainstem is the most basic area of the brain.  The area of the brain that we have in common with almost all other levels of the animal kingdom.  It extends right into the spinal cord.  A lot of other whole body involuntary reflexes come from the spinal cord - that's another story for another day). 3 main parts Medulla oblongata - rhythm center (heart rate, breathing, swallowing, vomiting and coughing reflex) - they're all involuntary Pons (not ponds) - the bridge between the cerebellum hemispheres and other brain regions, helps coordinate the right side and left side of your body for complex activities Midbrain - sensory reflexes (also involuntary) - blinking, eye focusing, pupil dilation in response to light, visual and auditory startling reflex that kick-starts the "fight or flight cascade". Other eye focusing problems are not rooted in the midbrain. They are more likely rooted in the areas of the brain that control orbital muscles or in the areas that translate what your eyes are seeing, like a "lazy eye" or drifting eye or being cross-eyed.  There are therapies that doctors prescribe to try and strengthen the weak eye.  Blinking is usually a response to eye moisture. Connect with me Support us on Patreon *NEW* Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits:  “Radio Martini” Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0  http://creativecommons.org/licenses/by/3.0/

Basics The blood brain barrier is the last layer of cells between what's in your blood and the extracellular fluid around your brain cells. You're born with it!  It's main job is filtration. 2 ways things get through the blood brain barrier: Passive diffusion: small, neutral molecules (water, gases, lipid-soluble) Active transport: glucose, amino acids, drugs (like a revolving door) Permeability: how easily something can pass through a layer without work Things that change permeability: Inflammation - stretches layer and makes holes bigger (meningitis, injury) Multiple sclerosis - an auto-immune disease that can degrade the BBB Alzheimer's - BBB becomes overwhelmed with antibodies and burns out *Scary Section* Rabies is a virus that is small and can get through the blood brain barrier but the immune system cells, antibodies from the vaccine, and medicines can't. HIV encephalopathy is caused when a mutation of the HIV gets into the brain and use brain cells to replicate (rather than the well-known T-cells of the immune system).  There is also a rare symptom of HIV called HIV-associated dementia. Callback microchimerisms - Pregnancy causes the permeability of many areas of the body to change, and this includes the BBB. Test Yourself Drugs that have central nervous system effects (good) or side effects (bad) cross the BBB.  See what you know of different medications and what job they're supposed to do and what negative side effects they cause and see if you can guess if they cross the BBB. Connect with me Support us on Patreon *NEW* Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits:  “Radio Martini” Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0  http://creativecommons.org/licenses/by/3.0/

*Sorry again for crying baby* Male DNA In The News The news reported that scientists had discovered a link between male DNA found in the brain of the women who gave birth to sons. Microchimerism = DNA fragment of another organism that incorporates into you This particular microchimerism involves the Y chromosome (because otherwise, you wouldn't know it was specifically male). Other documented microchimerism studies have reason to believe they may be beneficial - especially in a process called immuno-surveillance (when the immune system is patrolling around looking for things that don't belong there). The blood brain barrier is the last layer of cells between what's in your blood and your brain cells.  DNA fragments are small and can easily pass through the BBB, especially during pregnancy when membrane permeability (the penetrable-ness) has increased all throughout the body already. The primary resource written by the scientists that did the study of the female brains states that their findings were pretty much inconclusive - partly due to the small sample size of brains they had available.  And they couldn't study living people.  They were mostly trying to decide if this male microchimerism had a positive or negative effect on Alzheimer's risk.  The final conclusion - we dunno.  Another obstacle was that the complete health history of the samples they used was not known. Other sources have stated hypotheses regarding the number of children a woman has and the risk of early onset Alzheimer's. This issue with reporting on studies like these is that Alzheimer's has so many factors that may increase or decrease risk and science is pretty sure there's NOT just one thing that will cause or prevent someone from developing this disease. The only thing they could conclude is that microchimerisms are evolutionarily significant. Here's the primary journal article. Connect with me Support us on Patreon *NEW* Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits:  “Radio Martini” Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0  http://creativecommons.org/licenses/by/3.0/

Cerebellum Basics Your cerebellum is a separate part of your brain that sits under the occipital lobe.  It is responsible for unconscious motor functions, and is organized differently than the cerebrum.  It is packed tightly together in neat folds like an accordion.  And it has 3 lobes: Anterior (in the front) - it keeps the body visually "centered" and on balance, as well as moving the head or body to keep the eyes level with the horizon.  Alcoholism can cause damage to this area that results in a person being sober but still walking "drunk". Follcular-nodular (in the middle with nodules on it) - responsible for eye movement in response to motion.  It is responsible for correcting balance based on signals from the body rather than the eyes. This is how you know you're falling over when you have your eyes closed.  Also responsible for muscle tone (aka the passive contraction or "readiness" of a relaxed muscle). Posterior (in the back) - responsible for fine motor coordination and it turns off signals for involuntary movements. Purkinje cells are the main type of neuron in the cerebellum - SO BEAUTIFUL!! Connect with me Support us on Patreon *NEW* Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits:  “Radio Martini” Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0  http://creativecommons.org/licenses/by/3.0/

Occipital Lobe Review A brain lesion is a place in the brain that doesn't fire when it should or fires sporadically when it shouldn't.  Occipital lobe lesions can lead to hallucinations that range from amorphous to extremely detailed. Field blindness: a lesion causes the occipital lobe to not translate the information from one or more spots of the visual map (your whole view).  Blind spots (round) or visual cuts (lines). Photosensitivity seizures: seizures triggered by visual overstimulation.  Even though stereotypical in different forms of entertainment, these only accounts for about 10% of seizure triggers.  Seizures triggered by visual stimulation can range from mild to severe. Certain types of blindness can be rooted in translation problems in the brain, rather than reception problems in the eyeball. Lesions in the occipital-temporal-parietal junction: Color agnosia: can see the colors but can't recall the names; simplified colors (all greens appear to be the same green) Movement agnosia: think weeping angels (things only move to a new position when you're not looking at it) or moving items appear blurry Agraphia: unable to communicate in writin Connect with me Support us on Patreon *NEW* Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits:  “Radio Martini” Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0  http://creativecommons.org/licenses/by/3.0/

Occipital Lobe Basics The occipital lobe sits in the back of your head, it directly connects to your eyes. 2 Streams of messages that your eyes send to your occipital lobe. Ventral stream - translates "what" Dorsal stream - translates "where" and "how" It sends translated information to the necessary part of the brain to respond or react to what you saw.  This is how hand-eye coordination works (not just for athletes).  And, since so much of the information we receive is visual means that the occipital lobe doesn't do much else. **The following is complete speculation based on my experiences as a Mom.** Mom's get accused of having eyes in the back of their head - but my guess is that mom's gain a keener sense of spacial awareness regarding the things that are happening around you.  Also, mom's hearing become much more attuned to specific sounds (aka knowing their baby's voice from other baby voices) to the point of knowing the difference between the sound of crayons coloring on paper versus crayons coloring on a wall! If it hasn't been obvious, let me just say that no part of the brain acts and reacts all by itself.  Many of the complex activities we complete as humans involve many areas of the brain simultaneously or sequentially. Connect with me Support us on Patreon *NEW* Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits:  “Radio Martini” Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0  http://creativecommons.org/licenses/by/3.0/

Temporal Lobe Problems Temporal lobe lesions can lead to dyslexia. Receptive aphasia: can't receive or translate speech meaning Word deafness: words are only noise Temporal lobe lesions can also lead to deafness.  The ears are fine, but the wires that translate input as sound are damaged. (Possibly what happened to Helen Keller). Callbacks Meningitis  Brain Bleeds Big Words Prospoagnosia = facial blindness Chuck Close Clinical apathy: you forget how to feel Anterograde amnesia: can't make new memories Retrograde amnesia: can't recall past memories Situational amnesia: self-preservation from trauma Wernicke-Korsakoff Syndrome Vitamin B-1 (Thiamine) deficiency alcoholics careless vegetarian/vegan diets Lose ability to walk, talk, and remember Connect with me Support us on Patreon *NEW* Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits:  “Radio Martini” Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0  http://creativecommons.org/licenses/by/3.0/

Temporal Lobe Basics The temporal lobe is located on each side of your head by your ears.  It helps you process auditory input and identify sounds. There is a special area called Wernicke's area.  It helps identify the meaning behind speech and vocal tones.  This is different from Broca's area, which is just able to identify some sounds as being words. This is where your long-term memory lives, like facts and knowledge (declarative). Emotionally charged memories are also held in the temporal lobe, but they have a special connection to the amygdala (which is part of the limbic system).  These memories have a high level of detail, and usually can't be recalled without also recalling the emotion.  They also don't have a sense of time. Mind Games Memories in the temporal lobe can lead to déjà vu. The temporal lobe allows you to see a simple or incomplete image and fill in all sorts of details, whether it be the details of the image or a long train of connected memories. Connect with me Support us on Patreon *NEW* Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits:  “Radio Martini” Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0  http://creativecommons.org/licenses/by/3.0/

Sugar Basics Sugar in your blood = glucose Your body prefers glucose over any other sugar out there. -ose = sugar suffix GlucOSE FructOSE - fruit sugar SucrOSE - table sugar SucralOSE - Splenda Your body can turn any of these other sugars in to glucose.  It can actually turn other carbohydrates, and even non-sugar molecules into glucose if it really needs to.  This all happens in your liver... If you were in a long-term starvation or malnutrition situation, your body would circulate non-glucose energy sources to try to get energy, since the process of making glucose can be relatively slow.  This is because your body would prefer to live than die. Brain Food The brain is a picky eater, and refuses to utilize non-glucose sources of energy.  This is because your brain works A LOT!  And it doesn't have time to use inefficient sources of energy.  Therefore, it will hog the glucose from the rest of your body. Your skeletal muscles use glucose to do work.  This is why people with diabetes have to be extra cautious when they exercise. Extra glucose gets saved for those times when you're not eating.  It gets put in a really long chain called glycogen.  But getting the glucose back from the glycogen can be relatively slow. Recovering from an episode of low blood sugar takes time and requires rest (so you're not burning through the fuel as fast as you replenish it).  But it can also be emotionally stressful because you may be required to eat "unhealthy" amounts of sugary or carb-heavy foods to get back to normal. Energy Production Glucose has a very complex metabolism cycle - the Krebs cycle. One intermediate is glucose-6-phosphate (G6P) - there is a genetic mutation where a protein for this step doesn't do it's job very well.  If this step gets delayed or clogged up, then there is a detour metabolism step that leads to triglyceride production, when then leads to fat storage.  *womp womp*  (note: triglycerides are useful in the right amounts for cell repair)  This is also why eating large amounts of sugary plus fatty foods can lead to quick weight gain. The end result of this cycle is Adenosine Triphosphate (ATP).  It is super energetic when a phosphate piece is removed.  It's like the body's dynamite.  This is how a sugar high works - all the sugar leads to all the dynamite exploding at once, but then it takes a while for it to get replenished, and that's why you crash after a sugar-high. Low Blood Sugar is Bad To immediately recover from low blood sugar, you need simple sugar (orange juice, regular soda, sugar-full hard candy, glucose tabs or paste or gel).  To continue to recover, you need carbs plus something that will help it not absorb so fast (i.e. protein, healthy fats). If you ever look at the underside of your tongue, you can see the blood vessels really clearly because they're really close to the surface.  So if someone is unconscious due to low blood sugar, you can use a glucose tablet or gel under their tongue and it will absorb into the blood stream.  This is also how you can absorb sugar quickly from sugar-full gum. Low blood sugar can lead to emotional fluctuations (aka crabby and grouchy) and short-term memory loss (and not just because you passed out). Connect with me Support us on Patreon *NEW* Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits:  “Radio Martini” Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0  http://creativecommons.org/licenses/by/3.0/

Basics Brain lesion = a group of brain cells that look different from surrounding cells on a brain scan Dark lesions - an area where the brain cells are missing or an area where signal is not firing (damaged cells) Light lesions - an area where the signals are firing at the wrong times (like a shorted out wire). Seizure - when the brain fires the electricity at the wrong time. Lesions around the brain A lesion in the Parietal lobe could affect how the body translates sensations (i.e. pain).  These lesions are usually caused by injury or stroke. If there is a lesion in the optical lobe of the brain (the area that "sees" what your eyes are looking at), then the signals from the eyes may not come through, and therefore the parietal cannot help map what you were looking at once it's not there anymore. Sensory seizures - feeling things on you or touching you that aren't really there. (unsure if this is related to the auras that come before migraines).  No medication necessary. Extinction phenomenon:  thinking that a sensation stopped before it really did.  You body can't translate two messages of the same type at the same time.  Like when you try to locate the same place on each side of your body (i.e. making pigtails even). Some Big Words Dyslexia:  can be related to written language, spoken language, or any other message being translated as language Dysphasia or Aphasia:  mixed up or missing words Dyscalculia:  it's hard to math.  Difficulty estimating distances, spacial mapping, and time passage.  Dana White of A Slob Comes Clean talks about TPAD (Time Passage Awareness Disorder) Apraxia:  unable plan what you want your body to do in order to make your body do it.  The deeper the path the more "natural"  the action is. Muscle memory is just an extremely well-developed motor path, so that you can even not do that action for a while, and when you do it again, you don't have to "relearn" it. If this is caused by a stroke, therapy can help try and re-route the information. Apraxia can affect gross motor movements (large movements with your body) - aka global apraxia, or it can affect speech motor planning. Gerstmann Syndrome: no motor path to write, or math, or to feel and use your fingers as separate digits. Also involves a left-right mix up.  In adults, it's the results of a stroke.  In kids, they have not a clue. Therapy can help kids get past the motor issues, but not the mathing issues. Constructional apraxia:  know how blocks should fit together, but the brain can't make their body build it. Dressing apraxia: know how clothes should be worn and where it goes, but the brain can't make the body dress itself.  This shows up in dementia and Alzheimer's a lot. Amorphosynthesis - your brain is not aware of some part of your body.  Usually a symptom after as stroke. Another symptom of a stroke is when a person is unaware of one-half of their visual field.  So they will only write on one half of the paper (the half they can see) or read only one half of the page of a book. Anosognosia - a person is not aware that they have a disorder, disease, or disability.   This is not just denial.  The area of their brain that would recognize "I'm sick" or "I'm hurt" doesn't work. Connect with me Support us on Patreon *NEW* Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits:  “Radio Martini” Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0  http://creativecommons.org/licenses/by/3.0/

Takeaway point Talk to the people at the practice at which you are wanting to start receiving care.  If the doctor is not available for a direct interview, the office manager may be able to answer questions regarding the practitioners and their style of communicating with patients and their approach to care. Connect with Emily You can contact Emily at WholeLifeWellness.co (CO not COM) - it is under construction. You can find out information about the Whole Foods Nutrition Challenge on her Facebook page: facebook.com/wholelifewellness3. Contact her at: https://www.facebook.com/wholelifewellness3 As promised - The 7-Day Whole Food Challenge - sign up for FREE!!! ***The next challenge starts January 9, 2017!*** ***Time Sensitive**** She's offering some AWESOME specials--good until November 30th! Here are the details (but be sure to watch the video for further explanations!): *One-on-one 6-month coaching program: $584.00 (a 41% discount from $990.00--in honor of my 41st birthday!) *The 'It's About Time! Wellness for Work' 60-Day course--a nitty-gritty and encouraging course focusing on being your best self for your best work and vocation (starting on Dec 5th): 194.00 *'Consistency 'Til Christmas'--a 25-day engaging group accountability experience--focusing on water, steps, veggies, and sleep--in order to stay healthy and focused during the holiday season (starting on Dec 1): $25 Connect with me Support us on Patreon *NEW* Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits:  “Radio Martini” Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0  http://creativecommons.org/licenses/by/3.0/

Parietal Lobe It sits in the top of your head Responsible for translating: touch, temperature, and pain. So does it tickle? Or hurt?  How does it hurt - throbbing, stabbing, sharp, dull? The way your body translates temperature is based on the relative temperature to the body part that is being touched. Proprioception - ability to know where you are in space relative to the other things around you That awkward moment  when you think the toilet is higher or closer that it really is and you almost fall. Hand-eye coordination - being able to see something that is moving and make your body to interact with it. Two-point discrimination - the body's ability to tell if it's being touched by one thing or two separate things.  Different parts of your body have different levels of sensitivity.  Large body parts have a larger distance than small body parts (fingers and tongue have the closest discrimination distance due to the number of sensors). Graphesthesia = writing feelings = being able to correctly translate letters or shapes drawn on your body without you looking. When someone says "I can see it in my head" - it's the area that can recall visual memories.  Remembering the last place you saw your keys or visualizing driving directions based on the landmarks you pass (which is the only way we give directions in the South).  So, when someone closes their eyes to try and remember something, they're trying to deactivate their eyes and activate the parietal lobe. Being able to identify a 3D object with your hands by touch only, and without your eyes.  This is also how Braille works, the dot patterns created to represent letters. Good info here and here about Braille activates the brain. Connect with me Support us on Patreon *NEW* Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits:  “Radio Martini” Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0  http://creativecommons.org/licenses/by/3.0/

Recap Frontal Lobe Motor cortex - voluntary muscle movements, including the muscles that control speech Language translation Prefrontal cortex - personality, judgment Dopamine The main chemical, or neurotransmitter, that functions in the frontal lobe is dopamine. Reward System and Addiction Dopamine is part of your brain's reward system. So think about when you get a Facebook notification.... dopamine is released in your brain, and your brain really likes how dopamine makes it feel.  Feels good!  So you're brain will help you pay more attention to the things that will get you more dopamine (that's why a 5-second Facebook glance can turn into 30 minutes).  This also means that dopamine is involved in your attention span. Some newer studies are looking at dopamine's effect on addiction.  The problem is that it requires increasing levels of "excitement" for your brain to receive the same level of dopamine as the very first time.  This is why people with devastating addictions end up on a downward spiral of ruin. Memories Dopamine is also involved in short-term memory, especially in complex or cascading tasks (where you have to remember a thing from Step A to complete Step B) in your prefrontal cortex. Diseases that take away short-term memory:  Dementia (general or Parkinson's-related), Alzheimers. Dopamine is being studied in how it related to dementia and Alzheimer's.  It's effects are already known in Parkinson's disease. To form memories, your brain has to access the same information over and over again (like a smooth, speedy highway).  A road only traveled once, is not easy to travel again, especially if there's a long period of time between trips down that road.  So in diseases that involve brain cell death, there becomes less and less routes to take to the same memory.  Thus, the older memories are the last to go because they have the most access routes. Planing Dopamine is responsible for your planning and motivation mechanisms.  If I make a plan and carry out the plan, the reward of dopamine is the outcome. A New Discovery They've discovered a genetic component that affects the shape of the dopamine receptors. These cells in your brain don't actually touch each other.  The terminals spit out dopamine, and it floats in the space and hopefully comes in contact with the next cell's dendrites.  The dendrites have dopamine-shaped keyholes, and the dopamine should fit in the keyholes perfectly.  But they have discovered that a genetic component affects the keyhole shapes, and this make be a root cause for schizophrenia and attention deficits. If you think about it, the classic symptoms of schizophrenia - paranoia, anxiety, hallucinations, split personalities - most things affected in your prefrontal cortex.  So if the dopamine receptors are "broken" in this area of your frontal lobe, you can see how there could be a dysfunction.  And this is produced at the genetic level.  Science is still learning about this... Stroke Strokes or brain injury in this area of your brain can affect personality. These parts of your brain don't grow back! Some issues related to the speech motor area of the brain (Broca's area).  Stuttering (clinically diagnosed) is a misfire in the motor planning part of speech.  Aphasia (loss of words) - part of you brain knows the word but you can't seem to get it out of your mouth.  Strokes in this area can cause some strange effects in the loss of words. Seizures There is also a type of epilepsy (seizures).  Seizures are a misfire or a short in the electrical signals of the brain.  Seizures in the frontal lobe can possibly affect memory (epilepsy-related amnesia).  Must be diagnosed by a neurologist. Story Time Back in the day, there was a guy named Pheneas Gage who worked on the railroad.  An accident involving dynamite and a railroad spike, led to a major head injury and an altered personality! We rub our forehead when we're trying to remember something because that's where our short-term memory is. #RealTalk Cynthia doesn't have that many Facebook friends! Connect with me Support us on Patreon *NEW* Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits:  “Radio Martini” Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0  http://creativecommons.org/licenses/by/3.0/

**Many apologies for the screaming baby*** Basics Frontal Lobe - in the front of the brain (behind your forehead) This is the area that contains your personality.  A stroke or brain injury or damage can alter someone's personality drastically. We take personality tests, but they are too basic to take such a complex part of you and put it in a quadrant or on a spectrum. This area of the brain is also well-connected to the limbic system (emotional center), and if those connections are broken through stroke or injury, then that causes personality changes too. Frontal Lobe Motor cortex: voluntary muscle movements = how you choose to move your body. Prefrontal cortex: personality, complex cognitive behavior, decision-making, social behavior, judgment (not existential judgement - but simple things like opposites) - if this gets damaged in adults (so less chance to relearn things as kids would), they don't sense the dread of the consequences of doing “bad” behaviors, thus they can live lifestyles that include sex, drugs, and crime. Broca's area (confirmed: he was French):  speech, language production, translation (not just audible language, but any type of symbol or gesture that would have meaning) stuttering and aphasia originate here * This area of the brain doesn't reach full development until almost 30 years old —> Insert rant here!! Story Time During the Heroic Era of medicine (not a well-named era) - they invented the Lobotomy - mainly trying to find a treatment for mental illnesses.  Society was ok with doctors experimenting on criminals in prison and patients who were put in asylums by their families. It did cause changes in the people, thus they claimed the “cured” them. Connect with me Support us on Patreon *NEW* Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits:  “Radio Martini” Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0  http://creativecommons.org/licenses/by/3.0/

Review Disease like Alzheimer's and dementia are grey matter issues - the creation and translation of messages are interrupted or dysfunctional.  White matter is like the power cords that are responsible for sending the signals. White matter diseases Hypomylenation - cells are created with a low amount of myelin; premature, chromosome-linked defects Cell Biology review:  animal cells have a membrane and a nucleus that holds all the DNA, and cytoplasm, and then all the organelles that have different jobs - just like a self-contained factory.  Some systems can be dysfunctional and the cell still live and replicate. Dysmylenation - neurodystrophy (a huge list based on what's broken) Lysosomes - stores enzymes for breakdown Perioxosomes - stores enzymes for energy metabolism Mitochondrial - dysfunction of energy usage Amino acid metabolism dysfunction Demylenation Inflammatory: Multiple Sclerosis = autoimmune disease.  The brain wants the body to do something but the message doesn't make it to the body, so the body doesn't move or has very jerky, irregular movements.  Tests for antibodies can identify MS.  Available treatment is mostly immune suppressants. Huntington's is a genetic disease that presents in the same way.  It has a very sad prognosis and presents in females starting between the ages of 30 and 50.  Thus they have already planned a life and possibly had kids who now may have the same disease.  Genetic testing can identify Huntington's. Viral - PML (Progressive Multifocal Leukoencephalopathy); J-virus a typical virus that may mutate and go dormant in the brain.  If the immune system is lowered drastically - due to suppression or immunodeficiency diseases, this virus will wake up and attack the myelin of the neurons. Acquired metabolism demyleniation (being exposed to chemicals) - “Chasing the Dragon” - refers to a technique used to keep melted pills from burning in a container (usually a spoon) while it's being heated by a flame from underneath and the vapors are inhaled.  Drug of choice: heroin.  **DON'T DO DRUGS** Hypoxic ischemic - loss of oxygen.  Examples:  asphyxiation, drowning, ischemic stroke. Mechanical - compression due to injury or swelling Call Back Migraines are not a white matter issue, they are a brain chemistry issue.  Learn more on the Headache episode Connect with me Support us on Patreon *NEW* Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits:  “Radio Martini” Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0  http://creativecommons.org/licenses/by/3.0/

Review Grey matter - neuron cell bodies that create and translate messages White matter - myelin-covered axons that transmits the messages across the brain Conditions that affect grey matter Dementia - memory starts to fail with age (due to the death of brain cells).  Newest formed memories get lost first (Last In First Out), and it progresses until the vital functions are lost. Alzheimer's - similar results as dementia, different cause. Bipolar - there is not a clear explanation, but the grey matter of someone who exhibits bipolar symptoms looks different on a brain scan from the grey matter of someone who doesn't. Amnesia - can be because the cells holding the information or memories have been injured or killed due to injury, or because the wires that would send the messages for recall have been damaged.  This can be caused by head injuries.  In traumatic experiences, amnesia is a self-preserving mechanism. Lewy- body dementia - a type of dementia that manifests in Parkinson's disease.  As a neuron cell dies, it fills up with protein and blocks message transmission.  These large clumps of protein-filled cells will show on a brain scan.  These buildups can lead to hallucinations - visual or auditory.  Also, affects memories, just like typical dementia does. Schizophrenia - stereotypical symptoms can be caused by changes in grey matter, but not the same as protein build-up.  And still a lot unknown about why. Your brain cells do not reproduce and replenish the way other cells (like your skin) do.  We do know that the brain can create new cells, but it is a very slow process that requires very specific conditions to be present.  But the new growth of brain cells is not fast enough to slow or reverse a disease. Connect with me Support us on Patreon *NEW* Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits:  “Radio Martini” Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0  http://creativecommons.org/licenses/by/3.0/

Brain Basics All brains are wrinkly.  Wrinkles in your brain are a good thing.  Wrinkles are biology's way of maximizing surface area while conserving space. The plateaus of the brain are called gyri (or a gyrus). The smaller, sunken in wrinkles are called sulci (or a sulcus).  Sunken in sulci - that's how I remember it. The larger canyons of the brain are called fissures.  These are the groves that separate the hemispheres and the lobes of the brain. Connect with me Support us on Patreon *NEW* Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits:  “Radio Martini” Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0  http://creativecommons.org/licenses/by/3.0/

Basic Brain Biology Your brain is made of cells.  Those cells are called neurons.  Neurons transmit signals in the form of electricity (aka .positive and negative charges).  One end of a neuron will build a signal or charge, and once it reaches a certain threshold, then a signal is send down the axons. Most of the cells in your body touch and transmit signals and pass chemicals through their membranes.  Neurons do not touch.  The terminals of one will get really really close to the dendrites of another. They're really good at the telephone game - mostly because the body tries to minimize the number of neurons involved in passing a signal. Axons are coated in myelin.  Myelin insulates the axon that helps the signal being sent travel faster, and prevents it from getting lost to something else touching it.  You want the signal to have to same strength when it reaches its destination as it did when it left its source. Parts of a neuron Dendrites: receives signals from previous neuron Cell body: contains the nucleus and creates and translates signals Axon: the "wire" that transmits signals Terminals: sends signals to the next neuron Grey matter - cell bodies, dendrites, and terminals White matter - axons wrapped in myelin Grey matter - information storage and translation White matter - information transmission Brain: grey matter is on the outside, white matter is on the inside Spinal cord:  grey matter is on the inside, white matter is on the outside. PS.  Grey?  Gray?  IDK!!! Connect with me Support us on Patreon *NEW* Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits:  “Radio Martini” Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0  http://creativecommons.org/licenses/by/3.0/