The Daily Dose


If you have a medical problem, or something is bothering you or a member of your family, The Jackson County Times now has a local physician, Dr. John Spence, of the Panhandle Family Care Associates available to respond to your questions via e-mail.
Dear Dr. Spence,
What is Bell’s palsy?
Signed,
Lotta Drooping
Dear Lotta,
Bell’s palsy is an acute paralysis of the facial nerve that typically results in the fairly sudden onset of facial drooping on one side, as well as possible taste loss and inability to close the eye on that same side. It is unclear as to what is the cause of this entity, though many suggest it is viral in origin. It is cause for great distress as its symptoms closely mimic that of an acute stroke. Bell’s palsy affects roughly 20 to 30 people per 100,000 each year. Most of the time, full recovery of the paralysis occurs, but up to 30% can have residual symptoms, including facial weakness or pain.
The great debate has been how to treat these patients, as the literature has yielded conflicting results. A new study from the New England Journal of Medicine does shed light on the controversy. In the past, practitioners have used steroids, anti-viral medications like acyclovir, or both. The study consisted of 551 patients who were placed in one of four different treatment groups – acyclovir and placebo, steroid and placebo, steroid and acyclovir or placebo alone. After three and nine months analysis, those individuals in the steroid arm had a greater likelihood of making a full recovery. There was no benefit to adding the anti-viral agent acyclovir to the mix. In essence, if caught early enough (within the first 72 hours), steroids like prednisone are a valuable addition to treatment of Bell’s palsy.
Dear Dr. Spence,
I have tried nearly every diet on earth. What do you think is the best for me?
Signed,
Gotta Stuffless
Dear Gotta,
From the standpoint of weight loss, nearly all diets have been shown to be approximately equivalent after about one year. I have extolled the virtues of the Mediterranean diet for some time. Heavily based on fruits, vegetables, lean meats, red wine, olive oils, fish and nuts, the Mediterranean diet has been proven to reduce mortality in varying patient populations and may also result in a small degree of weight loss. The Lyon Heart Study looked at 300 patients adhering to the diet and showed a 73% risk reduction for heart attack and a 70% risk reduction in overall death (relative risks). Another Italian study showed similar, though not nearly as impressive, results as the Lyon study. The difficulty with adhering to this diet is the inherent cost. Certainly, fresh fruits and vegetables are more expensive than some canned and packaged products. Sometimes, cost can trump the long-term benefits of a healthier living.

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