Archive | September 2024

QUOTE FOR MONDAY:

“When we are born, our arteries are clear and healthy. They carry blood, oxygen, and nutrients from our hearts to every part of our bodies. They are the channels of life.

But when our low-density lipoprotein (LDL) cholesterol gets too high, it damages and clogs those arteries which results in cardiovascular disease.

You’ve likely heard of LDL as the “bad cholesterol.” That’s because it’s the single biggest cause of the cardiovascular disease atherosclerosis. When there is too much LDL cholesterol in the bloodstream, it penetrates and irritates the walls of the arteries causing inflammation, plaque and blockages. As long as LDL levels remain high, this process continues and leads to heart attacks, strokes, or peripheral artery disease. 

September is Cholesterol Education Month, so it’s an important time of year to discuss the role of LDL cholesterol in heart disease.

In 2020 alone, approximately 700,000 people died from heart disease in the U.S. It remains the number one killer in America and around much of the world. The easiest way to prevent this is to know your cholesterol numbers and keeping them out of the danger zone.”

Family Heart Foundation (https://familyheart.org/cholesterol-is-key?gad_source=1&gclid=EAIaIQobChMI68_t4sLHiAMVXTIIBR1rghlqEAAYAiAAEgIBovD_BwE)

 

Part II Cholesterol Month: risk factors, what high cholesterol puts you at risk for and how to prevent this from happening!!

  VS

 

Modifiable Risk Factors putting you at risk for high cholesterol that can put you at risk for heart disease are:

High B/P, Diabetes, Low HDL=good cholesterol, High LDL=bad cholesterol, smoking, eating foods high in SATURATED FAT & CHOLESTEROL, harmful use of alcohol, and lack of any activity in your life (your regular routine doesn’t count like work unless your in a job severely active like construction building homes for example 5 days or week or a personal work out trainer 4 to 5 days week).

MAYO CLINIC states Factors Increasing your BAD Cholesterol:

  • Poor diet. Eating saturated fat, found in animal products, and trans fats, found in some commercially baked cookies and crackers and microwave popcorn, can raise your cholesterol level. Foods that are high in cholesterol, such as red meat and full-fat dairy products, will also increase your cholesterol.
  • Obesity.
  • Lack of exercise. Exercise helps boost your body’s HDL, or “good,” cholesterol while increasing the size of the particles that make up your LDL, or “bad,” cholesterol, which makes it less harmful.
  • Smoking.
  • Age. Because your body’s chemistry changes as you age, your risk of high cholesterol climbs. For instance, as you age, your liver becomes less able to remove LDL cholesterol.
  • Diabetes. High blood sugar contributes to higher levels of a dangerous cholesterol called very-low-density lipoprotein (VLDL) and lower HDL cholesterol. High blood sugar also damages the lining of your arteries.

Non-modifiable Risk Factors=4 types only which are factors we can’t control:

1-Heredity (The higher the risk is when the heredity is closer to you in your family tree=Nuclear family–mom, dad, and siblings).

2-Age (Men aged 45y/o or older & Women aged 55 y/o or older)

3-Gender (It may affect your risk, for years heart disease was considered a man’s disease but we now know that heart disease is the leading cause of death for women as well as men. Although men tend to develop coronary artery disease earlier in life, after age 65 the risk of heart disease for both genders is equal.)

4-Race (Heart disease is higher among African Americans, Mexican Americans, American Indians, native Hawaiians, and some Asian Americans compared to Caucasians).

Your body needs cholesterol to build healthy cells, but high levels of cholesterol can increase your risk of heart disease. With high cholesterol, you can develop fatty deposits in your blood vessels. Eventually, these deposits grow, making it difficult for enough blood to flow through your arteries.
High cholesterol can cause:

Too much cholesterol (LDL cholesterol) puts you at risk for heart disease and stroke, two leading causes of death in the United States. High cholesterol has no signs or symptoms, so the only way to know if you have it is to get your cholesterol checked.

WHAT DOES ALL THIS MEAN?  To make this short & simple, from continuous high cholesterol over time, especially with history in your nuclear family puts you at risk for ATHERO-SCLEROSIS = Blockage In Arteries.  This puts at you at risk for a heart attack, stroke (Based on oxygen blocked by high cholesterol causing lack of oxygenated blood (nutrients) to the heart or brain due to high cholesterol build up in arteries supplying the heart and brain.  This is a high risk for MI & CVA).

Now it makes sense?  The answer to prevention or treatment of cardiac disease is changing or modifying your diet, if it’s unhealthy 100% or just partially. The answer includes exercise (from just walking or if you like working out, even better) and if needed medication but your doctor will decide. All these changes can modify your blood lipid profile=cholesterol control, which helps increasing your heart to a better tolerance with activity, stress and simply functioning. Recommended is going to a cardiologist for people diagnosed with heart conditions or your general practitioner with any illness/disease before making changes to help guide you towards the right choices. Your doctor can help you in determining which prevention or treatment plan is best for you.

Foods high in cholesterol=Fast foods, whole fat dairy products-milk/cheese/butter/mayonnaise/ bacon/processed deli meats/salad dressings and shortenings.

The key is to be living a healthy life. This consists of diet, exercise or activity and healthy habits learned and practiced routinely in your life that will help prevent or assist in treating cardiac disease. The better we treat ourselves regarding health the higher the odds we will live a longer   life. There is not just one food to eat or one type of exercise to do or one healthy habit to keep you healthy, there are choices. Wouldn’t you want less disease/illness for yourself and for others throughout the nation including the future generations?  It is all in change and that would be in your diet, activity getting increased and exercise balanced with rest.  Most importantly sticking to it regularly not doing these changes on occasion and that is all in how well you discipline yourself.

FOR MORE INFORMATION:

National Heart Lung and Blood Institute

P.O. Box 30105

Bethesda, MD 20824-0105

QUOTE FOR THE WEEKEND:

“Your cholesterol levels show how much cholesterol is circulating in your blood. Your HDL (“good” cholesterol) is the one number you want to be high (ideally above 60). Your LDL (“bad” cholesterol) should be below 100. Your total should be below 200. Talk with your provider about what your results mean for you and how to manage your cholesterol.

Your cholesterol levels are important because they help you know your risk for heart disease. Cholesterol is a type of lipid (fat) that helps your body perform many important functions. But too much cholesterol in your blood is harmful. It can enter your artery wall, damage its integrity and lead to atherosclerotic plaque (hardened deposits) forming.

Cholesterol travels through your blood silently. And it turns into plaque silently. Plaque buildup is like someone tiptoeing on a carpet. You might not see or notice its presence for a long time.”

Cleveland Clinic (https://my.clevelandclinic.org/health/articles/11920-cholesterol-numbers-what-do-they-mean)

Part I Cholesterol Month: What is cholesterol, its functions for the body, how its measured, what is good versus bad cholesterol?

 

What is cholesterol?

Cholesterol forms in the liver but we also get cholesterol through foods we eat too. It is a waxy substance that has many important functions in the body. It is part of various hormones, the makeup of the walls of your body’s cells, a component of bile, and many other purposes. How the body processes it is very complex. It joins with a protein and forms a package called lipoprotein. These lipoproteins carry cholesterol through the blood.

What is the functions of cholesterol in the body?

In our bodies, cholesterol serves three main purposes:
  • It aids in the production of sex hormones.
  • It’s a building block for human tissues.
  • It assists in bile production in the liver.
  • Its main function is to maintain the integrity and fluidity of cell membranes.  Cholesterol helps to regulate membrane fluidity over the range of physiological temperatures. to serve as a precursor for the synthesis of substances that are vital for the organism including steroid hormones, bile acids, and vitamin D.

How is cholesterol measured?

Cholesterol is measured in metric system units. The LDL’s (low density lipoproteins) have the bad cholesterol. LDL’s are the main source of blockage in the arteries. HDL’s (high density lipoproteins) have the good cholesterol. HDL’s help keep cholesterol from building up in the wall of the arteries.  Which most foods show on their labels how much LDL and HDL cholesterol is in a serving of the food your buying.  If it doesnt’t show the cholesterol levels on the label than don’t buy it unless its a treat once in awhile.

Through Cleveland Clinic they state the normal levels of cholesterol for total. HDL and LDL should be:

A HDL level for women 20 yrs old or higher should be 50mg/dl or greater.

A HDL level for men at 20 years old or older should be 40mg/dl or greater.

A LDL level for women or men at 20 years old or older should be less than 100mg/dl.

A total cholesterol level less than 200mg/dl is considered good. It represents the least risk of heart disease. Above that, your level is borderline high. If you are above 200 your level of cholesterol is high.

In our body we have cholesterol which is a type of fat. In certain foods is cholesterol depending on the food you buy. Your total cholesterol includes LDL (low-density lipoprotein) and HDL (high density lipoprotein) cholesterol. Let’s differentiate the two:

1.  LDL (low density lipoprotein) the bad cholesterol can build up in the arterial walls and form plaque in time.  What does this mean?

That build up in the arteries will reduce blood flow and increase your risk to heart disease, especially eating frequently the wrong foods with high and bad cholesterol over years (Example. coronary artery disease, high blood pressure, and eating like this for years can lead to a heart attack or from s/s arising scarring the person to go to the doctor and find out they have blockages & need surgery. The sign and symptoms arising scarring the person can range from chest pain, and can be radiating down the arms, sweating profusely, weakness/fatigue increases in your life, dizziness, you feel like you’re going to fall or actually due to the fatigue/weakness=low blood pressure due to the blockage or the heart just working too hard in doing its function since the cardiac output is decreased from the blockage) Take one of my dear friends who I have known almost 40 years who was a workaholic 10to14hr/7 days a week for at least 35 years and 2 years ago he had to undergo surgery for a coronary artery blockage bypass for 5 vessels blocked 80% to 100%. He should have been dead already due to a heart attach for such blockage but had a successful bypass done followed by long rehab and got better due to high cholesterol eating, smoking (that both play an impact in plaque & tar build up in the vessels) and he stopped but he also was obese by about 50lbs. and lost 30lbs due to better eating and less beer. This could have been prevented if he changed his diet, watched his weight, and quit smoking years ago but that takes discipline, making sacrifices is all within your hands to allow for healthy habits now (prevention) or later when problems occur (treatment), if caught in time. There is a way out of this happening to you.

2-HDL (high density lipoprotein) the good cholesterol it’s known as.  What does this mean?

Because it is thought to help remove bad cholesterol from the body; if you decide the right foods in the right portions that will have more HDL than LDL in them. Differentiating the 2, now another component to keep in mind is risk factors that can put you at risk for heart disease and your doctor will determine what additional risk factors you have putting you at risk for heart disease. These risk factors can be modifiable (controllable by individuals) or non-modifiable (non-controllable by individuals).  Stayed tune for Part II on cholesterol tomorrow covering all this!

 

QUOTE FOR FRIDAY:

“September is National Suicide Prevention Month – a time to remember the lives lost to suicide, acknowledge the millions more who have experienced suicidal thoughts, and the many individuals, families and communities that have been impacted by suicide. It’s also a time to raise awareness about suicide prevention and share messages of hope.

During September, and throughout the year, we can care about suicide prevention; connect to community, culture, data, and research; and collaborate with others to address this public health problem that has impacted millions of Americans.

EVERYONE can play a role in suicide prevention. Know the warning signs of suicide and #BeThe1To offer support. Seek help for yourself or others by calling or texting 988 or by chat.”

SAMHSA – Substance Abuse and Mental Health Administration

(https://www.samhsa.gov/newsroom/observances/suicide-prevention-month)

SUICIDE PREVENTION MONTH : TOPIC-DEPRESSION VERSUS ANGER

 

SUICIDE  suicide_warning_signsSUICIDE2badtimes

Depression Vs. Anger — What does it all mean and What do I do?

Getting the blues  or down in the dumps now and than in one thing but staying in the blues or down in the dumps just sinking deeper over a long period of time can be diagnosed as clinical depression. Clinical depression presents many forms and symptoms. It is not something just to be brushed off, assuming it will rectify itself in a while. One of the most common symptoms noted when a person suffers from clinical depression is anger. Whether it’s uncontrollable anger toward oneself or outward aggression toward others, it’s clinically proven that depression and anger run hand in hand.

Do you find yourself feeling angry more often than usual, or more often than not, depression could be to blame. Anger is a common symptom of depression, which can lurk beneath the surface of any man, woman, or child as well.

Depressive disorders come in many different types, but each type has its own unique symptoms and treatments. Major depression, the most common type of a depressive disorder, is characterized by a combination of symptoms (see symptom list) that interfere with the ability to work, study, sleep, eat, and enjoy once pleasurable activities. Such a disabling episode of depression may occur only once but more commonly occurs several times in a lifetime. Mental health professionals use this checklist of specific symptoms to determine whether major depression exists or not. Depression is also rated by your diagnosing physician or mental health professional in terms of its severity — mild, moderate, or severe. Severe depression is the most serious type. A less severe type of depression, dysthymia, involves long-term, chronic symptoms that do not disable, but keep one from functioning well or from feeling good. Many people with dysthymia also experience major depressive episodes at some time in their lives. Another type of depression is experienced as a part of bipolar disorder, also called manic-depressive illness. Not nearly as prevalent as other forms of depressive disorders, bipolar disorder is characterized by cycling mood changes: severe highs (mania) and lows (depression). Sometimes the mood switches are dramatic and rapid, but most often they are gradual. When in the depressed cycle, an individual can have any or all of the symptoms of a depressive disorder. When in the manic cycle, the individual may be overactive, overtalkative, and have a great deal of energy. Mania often affects thinking, judgment, and social behavior in ways that cause serious problems and embarrassment. For example, the individual in a manic phase may feel elated, full of grand schemes that might range from unwise business decisions to romantic sprees

Risk Factors

Numerous risk factors can lead to feelings of depression and anger in an individual. Some of these risk factors include but are not limited to: loneliness, financial strain, unemployment, alcohol or drug abuse, marital or family problems, or lack of a social support network. Depression and anger can also be influenced by childhood trauma, or it can be hereditary.

Symptoms

Anger manifested with depression is no ordinary anger. It can be all-consuming feelings of anger and hatred against one’s self, others or the situation that is causing the depression. One of the first signs of depression in a teenager may be a sudden onset of uncontrollable anger. In turn, constant feelings of anger can also trigger a response of depression. Also noted with depression are a tendency to turn away from family and friends, poor performance at work or school, lack of motivation, feelings of guilt, insomnia and hopelessness

Symptoms of Depression

Not everyone who is depressed or manic experiences every symptom. Some people experience a few symptoms, some many. Severity of symptoms varies with individuals and also varies over time.

Depression

  • Persistent sad, anxious, or “empty” mood
  • Feelings of hopelessness, pessimism
  • Feelings of guilt, worthlessness, helplessness
  • Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex
  • Decreased energy, fatigue, being “slowed down”
  • Difficulty concentrating, remembering, or making decisions
  • Insomnia, early-morning awakening, or oversleeping
  • Appetite and/or weight loss or overeating and weight gain
  • Thoughts of death or suicide; suicide attempts
  • Restlessness, irritability
  • Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic painMania
  • Symptoms of Mania (for Bipolar Disorder)
  • Abnormal or excessive elation
  • Unusual irritability
  • Decreased need for sleep
  • Grandiose notions
  • Increased talking
  • Racing thoughts
  • Increased sexual desire
  • Markedly increased energy
  • Poor judgment
  • Inappropriate social behavior

Come back tomorrow for Part 2 on Depression Vs. Anger in Considerations/Treatment and Knowing the Key Factor in what makes us deal with depression, which also can help prevent suicide!!

QUOTE FOR THE THURSDAY:

“Multiple myeloma is a cancer that forms in a type of white blood cell called a plasma cell. Healthy plasma cells help fight infections by making proteins called antibodies. Antibodies find and attack germs.

In multiple myeloma, cancerous plasma cells build up in bone marrow. The bone marrow is the soft matter inside bones where blood cells are made. In the bone marrow, the cancer cells crowd out healthy blood cells. Rather than make helpful antibodies, the cancer cells make proteins that don’t work right. This leads to complications of multiple myeloma.

Multiple myeloma treatment isn’t always needed right away. If the multiple myeloma is slow growing and isn’t causing symptoms, close watching might be the first step. For people with multiple myeloma who need treatment, there are a number of ways to help control the disease.”

MAYO CLINIC (https://www.mayoclinic.org/diseases-conditions/multiple-myeloma/symptoms-causes/syc-20353378)

 

Myeloma Cancer

What is Multiple Myeloma?

Multiple myeloma is a cancer of plasma cells (B and T cells).  Multiple myeloma is a cancer of plasma cells. Normal plasma cells are found in the bone marrow and are an important part of the immune system.The immune system is made up of several types of cells that work together to fight infections and other diseases.

We stated yesterday myeloma is most often found in bone marrow. Remember normal plasma cells are found in the bone marrow & an important part of the immune system.

The immune system is made up of several types of cells that work together to fight infections and other diseases. Lymphocytes (lymph cells) are one of the main types of white blood cells in the immune system and include T cells and B cells. Lymphocytes are in many areas of the body, such as lymph nodes, the bone marrow, the intestines, and the bloodstream.

When B cells respond to an infection, they mature and change into plasma cells. Plasma cells make the antibodies (also called immunoglobulins) that help the body attack and kill germs.

When plasma cells become cancerous=cancer cells (intially made in the bone marrow than released in the blood), they multiply and begin to crowd out healthy cells and produce abnormal antibodies called M proteins.  This continues to to replicate till the body dies or some treatment takes over decreasing them by destroying them (Ex. Chemo) or possibly putting the patient in remission.

What are the major types of myeloma?

There are four major sub-types of myeloma. Diagnosis depends on how localized or spread out the cancer has become and where it originated. The most common form of myeloma is multiple myeloma. Over 90% of people with myeloma have multiple myeloma.

Multiple myeloma -This is the one we will be discussing in this topic.
Plasmacytoma
Localized myeloma
Extramedullary myelom
Multiple Myeloma Complications:

In multiple myeloma, the overgrowth of plasma cells in the bone marrow can crowd out normal blood-forming cells:

1-Leading to low cell counts=RBCs-low in iron/anemia, level of platelets in the become low (called thrombocytopenia)=increased bleeding and bruising & WBCs low called leukopenia=problems fighting infections.

2-Myeloma cells make a substance that tells the osteoclasts to speed up dissolving the bone. So old bone is broken down without new bone to replace it, making the bones painful, weak, thinning the bones and easy to break.

3-Abnormal plasma cells cannot protect the body from infections. As mentioned before, normal plasma cells produce antibodies that attack germs. In multiple myeloma, the myeloma cells crowd out the normal plasma cells, so that antibodies to fight the infection can’t be made. The antibody made by the myeloma cells does not help fight infections. That’s because the myeloma cells are just many copies of the same plasma cell – all making copies of the same exact (or monoclonal) antibody.

A monoclonal gammopathy is when plasma cells make too many copies of the same antibody. It is usually found on a routine blood test when looking for other conditions.In monoclonal gammopathy of undetermined significance (MGUS), abnormal plasma cells make many copies of the same antibody (called a monoclonal protein). However, these plasma cells do not form an actual tumor or mass and do not cause any of the problems seen in multiple myeloma. MGUS usually does not affect a person’s health. It doesn’t cause weak bones, high calcium levels, kidney problems, or low blood counts.

4-Myeloma cells make an antibody that can harm the kidneys, leading to kidney damage and even kidney failure.

Factors that may increase your risk of multiple myeloma include:

Increasing age. Your risk of multiple myeloma increases as you age, with most people diagnosed in their mid-60s.
Male sex. Men are more likely to develop the disease than are women.
Black race. Black people are about twice as likely to develop multiple myeloma as are white people.
Family history of multiple myeloma. If a brother, sister or parent has multiple myeloma, you have an increased risk of the disease.
Personal history of a monoclonal gammopathy of undetermined significance (MGUS). Every year 1 percent of the people with MGUS in the United States develop multiple myeloma.
Diagnosing Multiple Myeloma:
Blood tests. Laboratory analysis of your blood may reveal the M proteins produced by myeloma cells. Another abnormal protein produced by myeloma cells — called beta-2-microglobulin — may be detected in your blood and give your doctor clues about the aggressiveness of your myeloma.Additionally, blood tests to examine your kidney function, blood cell counts, calcium levels and uric acid levels can give your doctor clues about your diagnosis.
Urine tests. Analysis of your urine may show M proteins, which are referred to as Bence Jones proteins when they’re detected in urine.
Examination of your bone marrow. Your doctor may remove a sample of bone marrow for laboratory testing. The sample is collected with a long needle inserted into a bone (bone marrow aspiration and biopsy).In the lab, the sample is examined for myeloma cells. Specialized tests, such as fluorescence in situ hybridization (FISH) can analyze myeloma cells to understand their genetic abnormalities. Tests are also done to measure the rate at which the myeloma cells are dividing.
Imaging tests. Imaging tests may be recommended to detect bone problems associated with multiple myeloma. Tests may include an X-ray, MRI, CT or positron emission tomography (PET).

After someone is diagnosed with cancer, doctors will try to figure out if it has spread, and if so, how far. This process is called staging (I,II,III,IV). The stage of a cancer describes how much cancer is in the body. It helps determine how serious the cancer is and how best to treat it.

Treatment:

1-Targeted therapy. Targeted drug treatment focuses on specific abnormalities within cancer cells that allow them to survive. Bortezomib (Velcade), carfilzomib (Kyprolis) and ixazomib (Ninlaro) are targeted drugs that block the action of a substance in myeloma cells that breaks down proteins. This action causes myeloma cells to die. Targeted-therapy drugs may be administered through a vein in your arm or in pill form.

Other targeted-therapy treatments include monoclonal antibody drugs that bind to the specific proteins present on myeloma cells, causing them to die.

2-Biological therapy. Biological therapy drugs use your body’s immune system to fight myeloma cells. The drugs thalidomide (Thalomid), lenalidomide (Revlimid) and pomalidomide (Pomalyst) enhance the immune system cells that identify and attack cancer cells. These medications are commonly taken in pill form.

3-Chemotherapy. Chemotherapy drugs kill fast-growing cells, including myeloma cells. Chemotherapy drugs can be given through a vein in your arm or taken in pill form. High doses of chemotherapy drugs are used before a bone marrow transplant.

4-Corticosteroids. Corticosteroids, such as prednisone and dexamethasone, regulate the immune system to control inflammation in the body. They are also active against myeloma cells. Corticosteroids can be taken in pill form or administered through a vein in your arm.

5-Bone marrow transplant. A bone marrow transplant, also known as a stem cell transplant, is a procedure to replace your diseased bone marrow with healthy bone marrow.

Before a bone marrow transplant, blood-forming stem cells are collected from your blood. You then receive high doses of chemotherapy to destroy your diseased bone marrow. Then your stem cells are infused into your body, where they travel to your bones and begin rebuilding your bone marrow.

6-Radiation therapy. This treatment uses beams of energy, such as X-rays and protons, to damage myeloma cells and stop their growth. Radiation therapy may be used to quickly shrink myeloma cells in a specific area — for instance, when a collection of abnormal plasma cells form a tumor (plasmacytoma) that’s causing pain or destroying a bone.

QUOTE FOR WEDNESDAY:

“An estimated 400,000 people were exposed to toxic contaminants, risk of physical injury, and physically and emotionally stressful conditions in the days, weeks, and months following the attacks. Responders who worked on the rescue, recovery, and relief efforts reported a range of illnesses soon after the attacks. Survivors who lived, worked, and attended school in Lower Manhattan, some who remained throughout and some who returned to their lives in the disaster area, started reporting illnesses as well. estimated 400,000 people were exposed to toxic contaminants, risk of physical injury, and physically and emotionally stressful conditions in the days, weeks, and months following the attacks. Responders who worked on the rescue, recovery, and relief efforts reported a range of illnesses soon after the attacks. Survivors who lived, worked, and attended school in Lower Manhattan, some who remained throughout and some who returned to their lives in the disaster area, started reporting illnesses as well.”

Centers for Disease Control and Prevention – CDC  (https://www.cdc.gov/wtc/exhibition/toxins-and-health-impacts.html)

Health Effects from 9/11 Disaster.

 

HEALTH EFFECTS FROM SEPTEMBER 11 DISASTER

The world trade center (WTC) terrorist attact and its aftermath exposed hundreds of thousands of people to dust, debris, smoke and fumes.  I was one that went down that day as a volunteer RN to help out my country.  It was a sight I will never forget and thank God nothing like it has happened since including developing anything from being exposed to the environment of this disaster.  September 11, 2001, among rescue and clean up workers, office workers, building evacuees, and residents of lower Manhattan living down their have shown increased respiratory and other physical health problems, like developing cancers after this terrible terrorist tragedy.  Following is a outline of the most common conditions experienced by individuals exposed to the WTC attacks and their aftermath.  The types of conditions are:

Upper Airway Cough Syndrome:  Formerly named postnasal drip syndrome which is commonly caused by continuous irritation or infection of the sinuses and the nose either due to allergies or from environmental irritants.  The signs or symptoms that arise from this are cough, nasal congestion, postnasal drip and frequent need to clear the throat.

Asthma/Reactive Airways Dysfunction Syndrome:  Some people exposed to the WTC disaster area have developed asthma related to exposure to irritants (also called reactive airways dysfunction syndrome [RADS]).  Signs and symptoms include:  Shortness of Breath (SOB); chest tightness, wheezing, coughing, phlegm, possible triggering of symptoms by colds or seasonal allergies or exercise or fragrances or extremes of temperature or humidity, recurrent episodes of respiratory infections requiring antibiotic treatment.

GASTROESOPHAGEAL REFLUX DISEASE OR LARYNGOPHARYNGEAL REFLUX DISEASE:  Some people exposed to the WTC disaster developed this condition.  GERD results from the flow back or return (reflux) of stomach contents into the esophagus. LPRD results from the reflux of stomach contents into the voice box or throat.

Symptoms of GERD: Heartburn, acid regurgitation, upset stomach, cough made worse with meals or at night

Symptoms of LPRD: Hoarseness or other vocal changes, sore throat, cough, sensation of having a lump in the throat

Long-Term Physical Health Concerns

There has been increased concern about sarcoidosis and cancer among individuals who were highly exposed during the WTC disaster. The NYC Department of Health and Mental Hygiene, in conjunction with other programs, is closely monitoring these conditions in order to detect any increases in these diseases.

At this time, there is no evidence of an increased rate of cancer among individuals highly exposed to the WTC disaster. Increased rates of sarcoidosis have been documented among fire department personnel ( Izbicki G, Chavko R, Banauch, GI, et al. World Trade Center “Sarcoid-Like” Granulomatous Pulmonary Disease in New York City Fire Department Workers. Chest. 2007;3:131;1414-1423). Rates of sarcoidosis among other groups are currently under investigation.

Sarcoidosis is difficult to verify because NYC providers are not required by law to report sarcoidosis cases to the Health Department.  Based on New York City death certificate records over the   past 10 years, there have been an average of 32 sarcoidosis deaths per year, with the annual number remaining the same since the WTC attacks. During the   same period, there have been between 362 and 439 sarcoidosis-related hospitalizations per year in NYC (five per 100,000 people), with the annual   rate remaining the same since the disaster.

* Breathing in beryllium, other metal dust or fumes or moldy materials can cause lung disease, which may resemble sarcoidosis.

.Sarcoidosis

Sarcoidosis* is an auto-immune disease that can attack any organ   of the body, although it often starts in the lungs or lymph nodes. It mainly   affects people between 20 and 40 years of age, with African-Americans three  times more likely to develop the condition than Caucasians and women twice as   likely to develop it as men. While most sarcoidosis patients recover without treatment, less than one-third develop chronic debilitating sarcoidosis and  fewer than 5% die from the disease. The exact cause of sarcoidosis is unknown.

Sarcoidosis and World Trade Center (WTC) Dust Exposure

While studies have not definitively linked dust exposure from   the WTC disaster to new-onset sarcoidosis among exposed workers, the data   does suggest elevated levels of sarcoidosis among firefighters.

There have been a few reported sarcoidosis cases among rescue   workers that may be related to Ground Zero dust exposure. In May 2007, the New York City Chief Medical Examiner determined that dust exposure from the disaster contributed to a sarcoidosis death, based on published epidemiologic findings among exposed firefighters.

Cancers

The collapse and burning of the WTC and neighboring buildings   released a complex mixture of irritant dust, smoke and gases. The dust cloud   also contained heavy metals, as well as asbestos and other carcinogens. In   addition, smoke released from the fires contained hazardous and potentially   cancer-causing substances.

Because of these exposures, there has been concern about the   possibility of increased cancer rates among WTC-exposed people. The NYC   Department of Health and Mental Hygiene, the Fire Department of New York and   other researchers are carefully monitoring cancer rates among highly exposed   people.

In 2007, the NYC Department of Health and Mental Hygiene brought together a panel of experts, including representatives from FDNY, the Mount Sinai School of Medicine, the New York State Department of Health and the National Institute for Occupational Safety and Health, to discuss the potential impact of the WTC disaster on cancer rates and mortality.

In 2010, after beginning the process of confirming cancer   diagnoses within their cohorts, the NYC Department of Health and Mental   Hygiene and FDNY co-chaired another conference of outside experts, including biostatisticians, environmental health scientists and cancer epidemiologists,   to help address the complex methodological questions associated with their   preliminary cancer investigations. The conference produced several   recommendations which are described in the 2010 WTC Medical Working group annual report.

Although cancer associated with specific exposures takes a long   time to develop, three early cancer studies based on verified diagnoses   within their cohorts through 2008 (the latest year for which data was   available when these analyses began) have been published:

  • FDNY found that nearly 9,000 firefighters with WTC exposure may be at greater risk for cancer than firefighters  who weren’t exposed.
  • The WTC Health Registry found small increases in rates of prostate cancer, thyroid cancer and multiple myeloma, a blood cancer, among nearly 34,000 WTC rescue and recovery workers in comparison to rates among New York State residents after adjusting for age, race/ethnicity and sex.
  • Prostate and thyroid cancer rates were higher than expected among nearly 21,000 rescue and recovery workers enrolled in the WTC Health Program in comparison to rates in New York, New Jersey, Connecticut and Pennsylvania where the majority  of workers lived.

Cancer analyses continue at FDNY, the WTC Health Registry and at   the Mount Sinai School of Medicine.

In 2012, the National Institute for Occupational Safety and Health  added many different types of cancers to the list of conditions that can be treated at the World Trade Center Health Program.

What the New York City  Health Department Is Doing:

Through the World Trade Center (WTC) Health Registry, the Health Department is conducting a cancer study that will help determine if cancer rates are higher among those exposed to the WTC disaster. Results of   the study will appear on this Web site and will be submitted to peer-reviewed scientific journals.

The Department is also conducting a broader public awareness campaign about cancer testing, and is working with its clinical partners to offer free cancer screenings. Identifying cancer early in the course of the disease reduces the risk of developing disability from cancer. Department efforts to reduce the rates of smoking among WTC disaster-exposed people also help reduce their risk for developing cancer and other diseases.

What You Can Do

Seek medical care.

If you were exposed to the WTC disaster and have developed symptoms or conditions you feel are related to this exposure, tell your doctor and bring the Clinical Guidelines for Physicians Treating Adults   Exposed to the WTC Disaster to   help your doctor diagnose and treat your symptoms. The Health Department also   released clinical guidelines  for   health care providers on how to treat children and adolescents exposed to the WTC disaster.

If you or your doctor believe that you require more specialized   care, you may be eligible for free treatment at a WTC   Center of Excellence or affiliated facility.

Practice preventive   health.

Whether or not you are currently experiencing symptoms, there   are things you can do to maintain your current health status, prevent   worsening of your health, and detect any new conditions. Suggested measures   include:

    1. If you smoke, quit! Tobacco is known to cause   cancer and make existing respiratory conditions worse. If you currently   smoke, there are programs in place to help you quit.
    2. Lead a healthy lifestyle by drinking alcohol   in moderation and avoiding more than moderate sun exposure. Increase physical   activity, keep your weight down and eat a healthful and nutritious diet.
    3. Have a physical exam every year that includes a   complete blood count (CBC). Be sure your exam includes all tests appropriate   for your sex and age, including cancer screenings.
    4. Avoid   risks at work and during leisure time. If you have any respiratory conditions  try to reduce your exposure to irritants such as dust, pollen, grass and   smoke both at home and at work. Consider giving up activities that expose you to irritants, and if activities cannot be avoided, wear personal protective   equipment to minimize exposure.