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Causes, symptoms and therapies

diet can also have an effect. Limiting salt and taking diuretics helps some people control the dizziness, and some sufferers claim that caffeine, chocolate and alcohol make their symptoms worse. If someone has the symptoms of Meniere’s disease, they should see a physician who specializes in the ear for an evaluation.

Help is available for ringing in the ears



QUESTION: What is Valley Fever?

ANSWER: Valley Fever is the nickname for coccidioidomycosis, the infection caused by the fungus Coccidioides. This fungus lives in the desert soil in the southwestern United States. It is also seen in northern Mexico and parts of Central and South America. People acquire Valley Fever by breathing the fungal spores from the air; there is no person-to-person spread. Over half the people infected with Valley Fever don’t have any symptoms at all. The majority of people with symptoms have one or more of the following: fever, night sweats, headache, muscle and joint aching, fatigue, rash, cough (often dry, without being able to cough up sputum), shortness of breath, or chest pain. For persons with severe or prolonged infection, fluconazole and itraconazole are the most commonly prescribed medications, but others can be used when an infection is difficult to treat. Since the body can often conquer the infection without treatment, many people do not need to be treated. However, for those who do require treatment, the treatment sometimes needs to continue for weeks, months or even longer. In 2009, 8,078 Maricopa County residents had coccidioidomycosis, which is the highest rate not just in Arizona, but in the entire United States. Pinal and Pima counties were second- and third-highest. JANIS E. BLAIR, M.D. IS AN INFECTIOUS DISEASES SPECIALIST AT MAYO CLINIC IN ARIZONA. SHE IS A MEMBER OF THE INFECTIOUS DISEASES SOCIETY OF AMERICA, THE AMERICAN COLLEGE OF PHYSICIANS AND THE AMERICAN MEDICAL ASSOCIATION.

Living Well a-z invites readers to submit questions to a panel of healthcare experts. The short questions and answers will offer readers a little more information about hot topics in medicine and refer you to other resources where you can learn more. Responses will also arm you with information so you know what to ask your own healthcare providers.

If you would like your question to be considered for the May 4 issue of Living Well a-z, please write to editor: Paula Hubbs Cohen or, c/o The Arizona Republic 200 E. Van Buren St., CA22 Phoenix, AZ 85004

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Several therapies


innitus, or ringing in the ears, is a condition that affects approximately 50 million adults. Of this number, about 12 million suffer from constant ringing and buzzing severe enough to negatively impact their daily lives. Robert Baber, a board-certified hearing instrument specialist and owner of Miracle-Ear Centers’ 21 Valley locations, said that the most common causes of tinnitus are noise exposure or head injury. “It can also be a side effect of medications,” he explained. “Because tinnitus can be a symptom of a more serious disorder, it is important to have it evaluated by your physician.” Edward Maznio, President of PurTone Hearing Centers LLC, said that for most people who struggle with tinnitus, noise exposure during their lifetime is the main culprit. He adds that the ringing often coincides with hearing loss in the high frequency ranges.

Robert Baber, owner of Miracle-Ear Centers' 21 Valley locations

Edward Maznio, President of PurTone Hearing Centers LLC

Varied effects

Baber said that tinnitus often directly affects a person’s thoughts, emotions, hearing and sleep. “Some people with tinnitus are annoyed, bothered, depressed, anxious or angry about it,” he said. Because tinnitus is so pervasive, he notes that people can become completely focused on it, and many sufferers report that it interferes with them getting to sleep.

Baber and Maznio both said there is no cure for tinnitus. However, there are several therapies that can be tried to help reduce the ringing sounds that are a hallmark of tinnitus. “Tinnitus Retraining Therapy (TRT) is a longer-term therapy for reducing the patient’s anxiety and awareness of the disturbances in their head,” Maznio said. “Another option is to use a hearing device or ambient-sound-maker that emits masking sounds. For many individuals, a hearing aid that is capable of amplifying ambient noise in the high frequencies, which are sounds their brain is currently missing, is also helpful.”

The bottom line is there is help for tinnitus

“I suggest if a person is suffering from tinnitus that they check with a physician who specializes in the ear,” said Baber. “Middle-ear tinnitus can be treated.”

FOOT-ASTIC Continued from page 3

can be treated with orthotics that have a very deep heel cup. Achilles tendinitis, caused by wearing shoes that are too short or by not stretching properly before a vigorous workout, can also be treated with arch supports. An arthritic foot responds well to shoes that have been modified with extra cushioning. “We want to create little ‘nests’ for the bones of the foot so there’s less pressure on the joints,” Orischak said.

Bunions, hammertoes and cold feet

Several additional foot problems are well-known to podiatrists, including bunions, hammertoes and cold feet. “A bunion is a structural deviation of bone or tissue around the great toe joint near the base of the big toe, and is often

treated with surgery. But first, a patient can try wearing a sandal, orthotics or a wider, deeper shoe to see if that helps with bunion pain,” Losi explained. “Hammertoes are caused by muscle imbalance and occur when the toes start to curl up and act like little hammers.” This condition may also require surgery for correction. “Cold feet can be caused by diabetes or poor circulation,” said Orischak. “A normal foot temperature is 86 degrees; a cold foot will present at about 73 degrees.” The treatment is a biochemically treated sock that can warm the foot an additional 13 degrees. According to Orischak, if the patient has a doctor’s prescription for this product, there is no sales tax. Both Losi and Orischak say patients with most foot problems shouldn’t wait to see a professional. “Get evaluated as soon as you can, before the problem gets worse,” Losi said.

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April Living Well Tinnitus:Causes, Symptoms and Therapies.

April Living Well Tinnitus:Causes, Symptoms and Therapies.