Otolaryngology

Making the Connection

Why do otolaryngologists specialize in these three particular areas? Most specialists

limit themselves to one body part or system. Ophthalmologists focus only on eyes.

Cardiologists make their living off of hearts. ENT doctors get three body areas on which

to focus their expertise.

The reason is actually quite simple. The three are all connected. The ear is connected to the nose and throat via the auditory (or Eustachian) tube while the nasal and sinus passages drain directly into the throat via the pharynx. That’s why you get a sore throat when your nose drips and why a cold often turns into an ear or sinus infection. It’s also why people with allergies are much more likely to suffer from chronic ear infections and sinusitis than people without. Given that, it should come as no surprise that ENT docs are some of the busiest specialists around. Just consider the numbers:
&bull Hearing loss affects one in 10 people. We’re not just talking about older people, either. The increasing noisiness
of modern life, including earblowing concerts and too-loud MP3 players means that even people in their 30s and 40s are saying, &ldquo What?&rdquo a bit more often than they’d like. In fact, an estimated one in eight children and teens already show signs of hearing loss. Noise isn’t the only risk factor for hearing loss, either. Quit smoking and you could reduce your risk of hearing loss nearly 200 percent. Even eating a healthy diet filled with antioxidantrich fruits and vegetables could reduce your risk.
&bull Over 35 million people a year have allergies. These numbers are increasing due to environmental changes that affect our immune system. Some say we’ve simply become &ldquo too clean,&rdquo so our immune system overreacts to every foreign object it encounters, even if it’s just a speck of pollen. Allergies are far from benign, however. People with allergies are three times more likely to develop asthma. There’s even some evidence that a history of allergies might increase the risk of Parkinson’s disease.
&bull More than 30 million adults in the United States get sinusitis each year. The costs of the disease&mdash inflammation of the sinuses&mdash exceeds more than $3 billion a year when you figure in all the doctor and emergency room visits, medications, tests and procedures. And that doesn’t even count days missed from work because of illness.
&bull Eighty to ninety percent of children have at least one ear infection by the time they turn three. Put another way, ear infections are the reason behind one in three doctor visits during the first five years of life. Chronic ear infections in children can lead to speech, language and cognitive impairments, as well as hearing, motor and balance loss.
While hearing loss, allergies and chronic sinus infections might be the first things that pop into your mind when you think about an ENT doctor, their expertise extends far beyond those two areas. Having trouble talking or swallowing? Feeling dizzy when you stand up? Hear a buzzing in your ears? It might be time to call an ENT. Was your child born with a cleft palate? Need her tonsils out? She’ll likely see an ENT doctor. For these doctors do more than just peer down your throat and write prescriptions. They are also surgeons, removing sinus polyps, inserting ear tubes and cochlear implants, and operating on thyroid and head and neck cancers. Some even do facial and reconstructive surgery, including nose jobs and face lifts. All of which is a roundabout way of telling you that there is much more to ENT than what you’ll read in this special section. Nonetheless, we’ve tried to highlight some of the more common areas that ENT doctors address, both from a treatment and a preventive perspective. You’ll read about the very latest in hearing aids (hint: forget everything you thought you knew about hearing aids when you read this story), the role of cochlear implants in restoring hearing to adults, and about lifestyle and other non-medical approaches you can take to keep your nose and sinuses healthy. Because, bottom line, if you can’t smell it, hear it, or taste it, you’re missing out on a big part of what makes life special.

Diet and exercise can reduce the risk of becoming diabetic by more than a third, says a new study by the Nat’l Institute of Diabetes and Digestive and Kidney Diseases. Overweight study participants who cut calorie and fat intake and exercised at least 30 minutes 5 days a week cut their risk of getting diabetes by 34% vs. people who didn’t change their lifestyle. People over 60 got even more dramatic results, cutting their risk of diabetes during the study period by about half.

*DIANE G HEATLEY, MD
Pediatric Otolaryngology
University of Wisconsin
School of Medicine and
Public Health:

Saline nasal washing helps keep the nose healthy. The nose warms, humidifies and filters the air we
breathe every day. When healthy, it does a good job of filtering, but an unhealthy nose can’t function
efficiently.
The nose and sinuses produce a quart of mucus every day. When this thickens, the cilia have a hard
time moving the mucus blanket. It can then become infected, leading to nasal congestion, drainage,
post-nasal drip, cough, headache, bad breath and fatigue.
Saline nasal wash with a Neti Pot or squeeze bottle thins the mucus to &ldquo clean the filter&rdquo that is your
nose. Saline use has been shown to diminish the number of days a person suffers from respiratory
symptoms, such as cold or flu, and relieve symptoms of nasal allergy. Saline nasal mist is a great alternative
for infants, young children, and others who find a true nasal wash to be unpleasant.

*NEIL SCHACHTER, MD
Author of Life and Breath:

Most people are well aware of air pollution in our outdoor environment. What is less known is
the problem of indoor air pollution in our homes, schools and workplace. In fact, the Environmental
Protection Agency (EPA) estimates that air quality is two to five times worse indoors than outdoors.
The key to maintaining healthy levels of indoor air quality is the right form of ventilation, which
helps balance outdoor air pollutants like pollen and dust against the build-up of gases, irritants and
allergens that occur naturally in the home. Simple steps to improve ventilation like running the air
conditioner in warm months can help remove pollutants and gases that are dissolved in the humid
air. Also, using a high performance filter to help remove particulate matter, mold spores and pollen
can make a difference. Avoid using cleaning products that release volatile organic compounds, which
can cause tiny airways to constrict.

*STEVE RAMOS
Certified Home Inspector:

According to the Center for Disease Control (CDC), air pollution in the home can be made worse
by poor ventilation as well as high heat and humidity levels. Sometimes, improving your indoor air
quality is as simple as improving your homes ventilation system. Many homes are already outfitted
with a forced air heating and cooling system that circulates the air. While standard fiberglass filters
were originally designed to protect the equipment, they don’t provide much improvement toward
home air quality. High performance filters help protect equipment and help reduce indoor allergens
like mold spores, dust mite debris, pet dander and particles that can carry bacteria and viruses by
capturing them from the air that passes through the filter. Look for an electrostatically charge filter
to help capture more micro particles (.01 to 3 microns) than an ordinary fiberglass filter and change it
regularly, according to manufacturer directions for maximum efficiency.

*PEER LAURITSEN
President
Oticon, Inc:

At Oticon, our goal is always to put the needs of people with hearing loss first. As the first company
to introduce Bluetooth connectivity to the hearing instruments, we recognized the potential for high
speed, broadband wireless signal processing to address the most common listening challenges for
people with hearing loss. Powered by our proprietary RISE platform, two hearing instruments are now
able to communicate wirelessly with each other, processing sounds as a single unit. This is similar to
the way the brain normally processes sound from two ears to support the proper interpretation of
speech and other sounds in the environment. The result is a unique spatial awareness that makes it
possible for hearing instrument users to more easily focus on conversations while &ldquo cancelling out&rdquo
background noises. With the wireless connectivity built into Oticon hearing instruments, people with
hearing loss can also stream sound directly from cell phones to their hearing devices. The new ConnectLine
system, the first and only system of wireless connectivity solutions that connects seamlessly
to TV and landline phones, allows users to enjoy high quality audio streaming seamlessly through their
hearing instruments at their own preferred volume and without the delay experienced with off-theshelf
Bluetooth transmitters.

Breathe Easier
With alternative approaches
Even in our technologically advanced society there are natural remedies and alternatives. Some treatment options for respiratory conditions that used to be considered on the margins of allopathic medicine such as nasal irrigation are today considered mainstream.

To learn what is most likely to work in the alternative realm, we turned to naturopath Joshua Leavitt, ND,
of Whole Health Natural Family Practice in Hamden, CT. What, we asked, does he use for patients with allergies, sinus infections and other respiratory conditions? Here’s what he recommends.

Allergan. This pharmaceutical grade
petroleum jelly is rubbed on the inside
of the nostrils where it catches airborne
pathogens and helps prevent respiratory
infections. One study found it slashed
symptoms of allergic rhinitis (i.e., hay fever)
by 60 percent with no adverse effects.

Nettles. Dr. Leavitt often prescribes nettle
tea or nettle capsules for people with
allergies, asthma or other inflammatorybased
respiratory conditions. He recommends
brewing six to eight cups at a time
and sipping on it throughout the day, preferably
sweetened with a local honey produced
during the season in which allergies
are worst. One of the few published studies
on nettles found 300 mg of freeze-dried
nettles twice a day improved symptoms in
people with allergic rhinitis about as well
as their normal medication.

N-acetylcysteine (NAC). This amino
acid supplement was originally investigated
in people with cystic fibrosis. Studies
find it works well at thinning the thick,
heavy mucus common during colds and
sinusitis. Dr. Leavitt recommends 600 mg a
day, four times a day before meals.

Salt inhalation. The roots of this therapy
date back to Hippocrates, who had
congested patients inhale the steam from
boiling saltwater. In more recent times,
people in Eastern Europe sit in salt caves
and breath the air to clear their congestion.
For those of us without a nearby salt cave,
there are salt pipes. The salt is contained
in the bottom of the ceramic inhaler. You
breathe in the air emanating form the top
for 20 minutes at a time. Two studies in the
New England Journal of Medicine found that
inhaling a salt-water mist could reduce the
pus and infection found in the lungs of
people with cystic fibrosis, an often-fatal,
genetic respiratory disease.

Steam inhalation. This low-tech approach
to clearing out your sinuses or
nasal congestion involves filling a pot with
water, adding a few drops of thyme or eucalyptus
essential oils (available in health
food stores), and heating the water to just
below a boil. Remove from the heat, lean
over the pot and cover your heat with a
towel, and breathe.

Sublingual immunotherapy. You
know about allergy shots, but do you know
about this non-shot option? It’s based on
the same theory as allergy shots: exposing
your immune system to larger and larger
amounts of the allergen to &ldquo train&rdquo your
immune system to tolerate it. While the
shots can take months or even years to
finally eradicate your allergies, sublingual
therapy, in which the allergen solution
is placed under the tongue, works much
faster and, studies suggest, may be safer.
Unfortunately, most insurance companies
don’t cover it.

Elderberry extract. When it comes to
preventing infections, Leavitt recommends
supplementing with elderberry extract, a
&ldquo top-notch antiviral &rdquo 4,000 to 6,000 IU of
vitamin D, important for immune function
and four grams a day of fish oil for its
anti-inflammatory effects.

Ten Steps to Indoor Air Quality
Think your house is clean? Consider this: The Environmental Protection Agency (EPA) finds that the air inside your house is dirtier than the air outside. Blame tighter construction techniques that enable fumes from paint, plastics and other synthetic materials used in our furniture and carpeting, toxins from cleaning products, pets, secondhand smoke, carbon monoxide, dust mites, and pet dander&mdash among other things&mdash to build up in our homes.

&ldquo With outdoor air there are regulations for the major pollutants,&rdquo said Neil Schachter, M.D., a New York City pulmonologist and author of the book Life and Breath, &ldquo but with the exception of cigarette smoke, we haven’t gotten a handle on our most common and long-lasting source of pollution, which is the indoor environment.&rdquo Whether pollutants in the indoor environment are irritants or allergens, he said, &ldquo Everyone is at risk.&rdquo Indeed, common symptoms resulting from indoor air pollution include eye, nose and throat irritation, headaches, skin irritation, shortness of breath or cough, and fatigue. Some of the most dangerous indoor toxins come from a relatively benign source: water. &ldquo I can’t tell you the number of people who come to me whose apartments or even homes have been water damaged,&rdquo said Dr. Schachter, &ldquo and that’s a recipe for disaster.&rdquo That’s because any type of dampness promotes the growth of living things like molds and fungi that contribute to bad reactions, he said. Another pollution pitfall is indoor carpeting. Even the EPA notes that carpet can act as &ldquo a sink for chemical and biological pollutants including pesticides, dust mites and fungi.&rdquo Anyone with any type of underlying respiratory problem, whether chronic
obstructive pulmonary disease (COPD), asthma, allergies or hay fever should assume that &ldquo unless you’re very careful, your home is going to be contributing to your problem,&rdquo Dr. Schachter said. The good news is that there are a number
of actions you can take to significantly reduce indoor air irritants and allergens.

For starters:
1. Use the right cleaning products. Products
that contain ammonia and chlorine
can irritate the respiratory tract,
causing watery eyes and sore throats
and even triggering coughing and
shortness of breath, said Dr. Schachter.
Choose milder yet effective cleaning
aids that use baking soda, vinegar, hydrogen
peroxide and citrus oils.
2. Add houseplants. Some common indoor
houseplants, such as bamboo
plants, English ivy and peace lilies, provide
a natural way to help fight rising
levels of indoor air pollution by absorbing
potentially harmful gases. They
work fast: a six-inch potted green plant
can clean a room of excess carbon dioxide
in eight hours.
3. Nix the carpeting. Instead, choose hardsurface
flooring like hardwood, tile or
laminate and opt for area rugs instead
of wall-to-wall carpeting. Once a year
send the rugs out for deep cleaning.
4. Use high-performance (HEPA) air filters
in vents. These filters capture particles
such as pollen, smoke, dust mite debris
and pet dander as air passes through
the filter. They only work if they’re
cleaned or changed regularly, however.
So put reminders on your calendar to
change them every three months, or at
the start of each season.
5. Turn up the air conditioning. Air conditioners
not only cool the air but can reduce
humidity levels, preventing mold
growth during warmer months.
6. Turn off the humidifier. This is a corollary
to the previous tip. Room air
humidifiers are moisture-generating
sources that serve as reservoirs for bacteria
and mold. Maintain your home’s
humidity between 30 and 50 percent
to prevent mold growth.
7. Ditch the shoes at the front door. That
way you won’t track outdoor pollutants
like pesticides, animal dander, mold
spores and pollen into your home.
8. Make some space. Increase airflow and
help control humidity levels by moving
furniture away from walls and opening
closet doors to air out what can be a
dank, smelly space.
9. Go for quality. Cheap vacuum bags can
stir up allergens when vacuuming so
use bags that contain a HEPA filter.
10. Use a fan. Showers, especially in smaller
bathrooms, can raise humidity levels
and create condensation on walls and
ceilings so install and use an exhaust
fan in the bathroom.

Cochlear Implants: Not Just for Kids anymore
Cochlear implants, tiny, implantable devices that use electrical signals to restore partial hearing and were once reserved for children who were born deaf or lost their hearing at a very early age, have found a new audience.

Thanks to major advances in digital chip technology spurred by the exploding cell phone industry, today’s cochlear implants are small enough, cheap enough, and good enough to be used in adults&mdash no matter what the reason for their hearing loss. Add the fact that we’re no longer embarrassed to walk around with things sticking out of our ears (think Bluetooth receivers) and you have a perfect storm for the use of the implants in grownups. &ldquo The new implants are so sophisticated you can even understand and appreciate music,&rdquo said Harold C. Pillsbury, MD, who chairs the department of otolaryngology and head and neck surgery at the University of North Carolina School of Medicine in Chapel Hill. They are also covered by 90 percent of health insurance plans, including Medicare. Unlike hearing aids, which make sounds louder and clearer, cochlear implants stimulate the auditory nerve to replace hearing function lost by the cochlea, the auditory chamber of the inner year. In adults, that loss may stem from toxic medications such as chemotherapy, infections, or, most commonly, presbycusis, i.e., age-related hearing loss. Cochlear implants consist of two parts. The external component contains a microphone to pick up sounds connected by a thin cord to a sound processor, which organizes the sounds. A transmitter coil sends the sounds via radio waves to the implant, which is surgically embedded under the skin behind the ear. It contains the receiver and electrode system. The receiver converts the radio waves into an electrical signal which the electrodes use to stimulate fibers in the auditory nerve. Voila! Your brain registers those signals as sound and you &ldquo hear.&rdquo While older units were about the size of an iPod and had to be worn on a belt or in a pocket, some of today’s implants are tiny enough to be tucked behind the ear. Patients also often receive implants in both ears, said Dr. Pillsbury. &ldquo This allows you to hear the sound the same in both ears and determine where it’s coming from,&rdquo he said. It also improves the ability to hear voices in a noisy environment. People with some residual hearing may opt for Electric Acoustic Stimulation (EAS), composed of a hearing aid to amplify low tones and the cochlear implant to transmit high tones.Dr. Pillsbury, who implants more than
200 devices a year, envisions the day whenno one will be deaf or even hard of hearing.&ldquo There will be those who hear fine anddon’t even need hearing aids those who do well with hearing aids and those who need cochlear implants. But there won’t be anyone who can’t be helped by something.&rdquo Still, despite technology that enables wearers to program cochlear implants for specific environments (i.e., loud parties or quiet rooms), Dr. Pillsbury warns his patients not to expect miracles. Hearing with an implant &ldquo is never going to be perfect,&rdquo he said. But, he added, &ldquo It is getting better and better all the time.&rdquo Cochlear implants are not for everyone. Because they involve surgery performed
under general anesthesia, they are reserved only for those who don’t get the hearing quality they need with hearing aids. Otherwise, there are no restrictions, said Dr. Pillsbury. &ldquo I just gave them to a 92-year-old woman who couldn’t wait for them to be hooked up,&rdquo he said. She had to wait about two weeks, however, for her incision to heal before he could flip the switch and ask that all-important question: &ldquo Can you hear me now?&rdquo

News In Brief
THE AUDIOLOGY AWARENESS CAMPAIGN
Hearing loss is the third most chronic health problem in America. Untreated hearing loss negatively impacts income on-average up to $12,000. The Audiology Awareness Campaign is a not-for-profit foundation whose mission is to educate the public about the value of hearing healthcare. The foundation represents audiologists nationally to increase public awareness of hearing healthcare. To learn more about protecting your hearing and hearing loss, request a free consumer educational booklet entitled &ldquo Listen-UP America We Hear You&rdquo . For a free set of earplugs call 888-833-EARS(3277) or visit our website www.audiologyawareness.com. Not sure about your hearing? Take a free Online Hearing test, read consumer-friendly brochures about hearing loss and hearing aids, discover more about audiology services, post a question about hearing on &ldquo Ask an Audiologist, or &ldquo Find an Audiologist&rdquo in your area who offers professional services. For further information about the foundation contact Dr. Landau Goodman at [email protected].

How Well Do You Know Green It?

The Wall Street Journal – Monday, November 16, 2009

Technology has transformed the office, made it possible to communicate instantly around the globe and put the world’s art, music and books at our fingertips. Can it now help improve the environment? Technologists say yes, as they use computing power to save energy, reduce waste and produce power more efficiently. Try our quiz to see how well you know green IT.

1) Which of these roles for information and communications technology has the potential to yield the biggest reductions in greenhouse-gas emissions by 2030?
A. Retrofitting existing buildings
B. Designing new buildings for reduced emissions
C. Telecommuting and virtual meetings
D. E-commerce and replacing paper
Answer: D. According to a study by the World Wildlife Fund, a big increase in online shopping and in the use of electronic transactions and documents to replace paper bills and publications could eliminate nearly a billion tons of greenhouse gases a year from the environment. That’s about twice the reduction estimated to result from either making existing buildings more efficient or designing new buildings that constantly monitor and adjust air conditioning and heating to minimize waste. More telecommuting and virtual meetings would save about 160 million tons of emissions a year, it estimated.

2) Toyota Motor Sales cut energy use in its Torrance, Calif., data center by 10%. How did it manage that?
A. It stopped keeping track of dealer sales, shutting down four blade servers.
B. It moved all storage to an Amazon.com cloud-computing center.
C. It redirected air flow from air conditioners and separated intake and outflow ducts.
D. It planted heat-absorbing vegetation on the roof.
Answer: C. The Toyota Motor Corp. unit hired International Business Machines Corp. to analyze air flows in the building and their effect on temperature. Air flows can create uneven temperatures in a facility, which results in inefficient temperature control&mdash for instance, bringing hot spots down to the desired temperature takes more cooling than is necessary for the rest of the space. By changing the air-flow patterns, Toyota was able to cut its air-conditioning use.
3) Lithium-ion batteries are the most popular technology for laptops and cellphones, because they are light and long lasting. They also can be disposed of with little environmental impact. What country produces the most lithium?
A. Argentina
B. Bolivia
C. Chile
D. Denmark
Answer: C. Sociedad Quimica y Minera de Chile SA is the world’s largest lithium miner, with mines in Chile and in Argentina, the No. 2 producing country. Bolivia is considered a promising prospect for future development.

4) Match the product, service or initiative with the company that dreamed it up.
A. Dell 1. ecoMeter
B. CA 2. Plant a Tree
C. Lexmark 3. Eco Ultra Small
D. Lenovo 4. Eco-simulator
Answer: A-2. Dell Inc. will plant a tree for each corporate laptop sold under some sales plans. It says each tree will soak up enough carbon dioxide over its projected 70-year life to offset the carbon used in making and powering a computer.
B-1. CA Inc.’s ecoMeter is software that helps chief information officers visualize, monitor and manage the use of energy in data centers and other facilities.
C-4. Eco-simulator is Lexmark International Inc.’s online service that measures the environmental impact of a user’s printing.
D-3. Lenovo Group says its M58p Eco Ultra Small desktop contains 10% recycled plastic.

5) What is a zombie server?
A. One that causes so much trouble it is said to scare IT managers out of their wits.
B. One that is running but isn’t connected to any live data.
C. One that keeps running even though it has nothing to do.
D. A special server at Amazon.com that serves hit novels to teenage girls.
Answer: C. IT managers trying to understand why their data centers use so much electricity sometimes find that they have a number of servers that produce hardly any useful work. These servers sometimes were authorized for an ambitious sales campaign or other project that never achieved its goals but never was completely shut down. Such servers are good candidates for elimination, with their jobs to be taken up by other servers with computing power to spare. A study of four unidentified data centers by McKinsey and Co. discovered that 146 of 458 servers were running at less than 3% of capacity.

6) What is the fastest-growing source of energy consumption in data centers?
A. High-end servers
B. Midrange servers
C. Networking devices
D. Storage devices
Answer: D. According to the Environmental Protection Agency, storage devices’ consumption of electricity grew 191% between 2000 and 2006. Over that period, storage devices rose from consuming the least power in the four categories to the most, at 32.3% of energy usage.

7) What area of green technology is likely to offer IT veterans the most new job opportunities?
A. Smart grids
B. Solar-cell development
C. Engineering projects designed to fight global warming
D. Lithium battery development
Answer: A. A January 2009 report by Kema Inc., an energy consulting firm, estimated that in the U.S. alone, smart-grid development efforts could create up to 280,000 jobs directly by 2012. Jobs include installing smart meters in homes and designing software to manage the energy use of networks of homes and businesses more efficiently.
IT-networking skills match up neatly with smart-grid work, according to CleanEdge.com, a jobs Web site.

8) Match the high-tech company with the organization that ranked it No. 1 in some aspect of environmental responsibility.
A. Hewlett-Packard 1. Greenpeace
B. IBM 2. Newsweek
C. Intel 3. Environmental
Protection Agency
Answer: A-2. Hewlett-Packard Co. took the top spot in Newsweek’s 2009 Green Rankings of the 500 largest companies in the U.S.
B-1. IBM was atop the &quot leaderboard&quot of Greenpeace’s CoolIT Challenge, due to &quot an extensive range of climate solutions and action to reduce its own emissions.&quot
C-3. The EPA said Intel Corp. was the biggest purchaser of renewable energy last year, accounting for 48% of its power.

9) What percentage of corporate PC users leave their computers on nights and weekends when they aren’t in use?
A. About half
B. Hardly anyone
C. About 25%
D. Almost everyone
Answer: A. According to the nonprofit Alliance to Save Energy, less than half of corporate PC users shut their computers down overnight, even though they aren’t using them. Turning them off would save an estimated 20 million tons of carbon-dioxide emissions a year&mdash roughly equivalent to the impact of four million cars.

10) What makes Windows 7 greener than Vista and other older Windows operating systems?
A. Microsoft prints the product manual on recycled paper.
B. It won’t run on high-energy microprocessors.
C. It reduces processor activity while the computer is idle.
D. It adjusts for intermittent power from wind turbines and solar panels.
Answer: C. It reduces background activity by electronically checking all connected devices at once and then going to sleep, rather than checking them at random times, which requires a central processor to be in operation almost constantly. It also reduces power consumption in other ways: It can be configured to stop searching for a network connection when a network cable isn’t plugged in. It suspends Bluetooth radio connectivity when it senses the Bluetooth device is in low-power mode. And it dims displays after shorter periods of inactivity than previous models.

Hearing Aids: The Future Is Now
Super Bowl winner and New York Giants defensive line coach Mike Waufle knows a lot about loud noise. The 54- year old is surrounded by roaring crowds every Sunday during football season. At practice he hears the crack of helmets and sharp clanking of weights. In the early 1970s as a U.S. Marine, his ears were assaulted by rifle shots and booming artillery that severely damaged his hearing.

&ldquo As a coach, I’m a teacher, so clear communication is really important. I was missing a lot of conversations and couldn’t always hear what my players or colleagues said. Hearing loss was also affecting my speech patterns. I tried all kinds of hearing aids but most ended up in a drawer.,&rdquo said Coach Waufle, who is one of the 35 million Americans with severe hearing loss. The solution to his problem was provided by the team’s ear, nose and throat consultant, Michael Scherl, M.D., with his audiology colleagues. Little more than two years ago, Dr. Scherl was involved in early trial work on a unique new hearing aid called Lyric. It was conceived in Silicon Valley to provide users benefits similar to extended wear contact lenses. Unlike conventional hearing aids that have external microphones and require weekly battery changes, Lyric rests deep in the ear canal. It is invisible, completely self-contained and approximately onehalf inch long. The flexible, foam-covered device rests a fraction of an inch from the eardrum to provide exemplary sound quality while making use of the ear’s natural anatomy to funnel sound. It can operate 24/7 for up to four months before having to be replaced by an audiologist. &ldquo Since getting Lyric, my quality of life has been so much better,&rdquo said Coach
Waufle. &ldquo For instance, the Giants have a large field house with horrible acoustics. Our head coach recently walked up behind me and I could hear every word he was saying. Before Lyric, that would not have been possible. No matter who you are or what you do, it’s really important to know what your boss&mdash or spouse&mdash is sharing with you. &ldquo Beyond that, the biggest change is I can now hear little things like a pencil on the paper when I’m writing, or a turn signal in my car. My daughter says it’s fun watching TV together because the sound isn’t blaring any more. There are so many things to appreciate that could have easily slipped away.&rdquo Although Lyric represents a unique advance in hearing aid design, technology is advancing elsewhere, too. &ldquo Bluetooth capabilities are being added to a host of new hearing aids,&rdquo said veteran audiologist Richard Kaner of Brooklyn Audiology Associates. &ldquo For instance, Oticon has a device called the Streamer&trade that users wear around the neck. It’s an interface between hearing aids and cell phones, land lines, television sets, MP3 players and computers.&rdquo Other leading manufacturers such as Phonak, Siemens and Bernafon also offer expanded connectivity options. Starkey has been a leader in volume adjustment. Users can touch the back of certain hearing aids to adjust volume, or use the touch pad of their cell phone or land line. Additionally, a number of manufacturers are improving speech understanding by transposing high frequencies to lower frequencies. Philadelphia audiologist Dr. Kathy Landau Goodman, Au.D., of Main Line Audiology agrees the future of hearing aids is extended wear devices like Lyric, and devices that can interface with other technologies such as cell phones. &ldquo The most striking thing for me these past 25 years has been the improvement in sound quality,&rdquo said Dr. Goodman. &ldquo Years ago, we didn’t have great technology. Now we do. One client recently said he feels like he’s gone from a horse and buggy to a luxury car.&rdquo If you or someone you know has difficulty hearing, contact a local audiologist who will partner with you to select an appropriate hearing technology. As Helen Keller wrote, &ldquo Blindness separates us from things but deafness separates us from people.&rdquo Author Dr. Paul Pessis, Au.D., is owner and director of North Shore Audio Vestibular Lab in Chicago, and past president of the American Academy of Audiology.

WASHINGTON&mdash A key Senate committee approved sweeping legislation that would give the Food and Drug Administration more power to police food safety and reorient its efforts toward preventing food contamination instead of reacting to outbreaks of food-borne illnesses.

The bill, passed unanimously, would give the FDA the power to set safety standards for fresh produce and make sure food companies take steps to prevent those outbreaks. The FDA would also be able to force companies to recall products and require them to keep better production records. It would also require more frequent inspections of food facilities, especially those handling risky foods.

The action by the Senate Committee on Health, Education, Labor and Pensions follows House passage of similar legislation in July. HELP Committee Chairman Tom Harkin (D., Iowa) said the timing of a vote by the full Senate vote will hinge on the chamber’s work on legislation overhauling the nation’s health care.

The food-safety legislation was crafted in response to a slew of large outbreaks linked to cookies, peanut butter, hot peppers, bagged spinach, lettuce and other foods. The outbreaks cost the industry billions of dollars as sales of related products plunged.

Lawmakers, the Obama administration and the food industry have been in agreement that the FDA needs more power and funding to regulate domestic and imported food, and inspect more facilities.

Despite the committee’s bipartisan vote, however, lawmakers disagree on some thorny issues, such as how to fund a bigger food-safety effort. While the House legislation would require most food companies to pay an annual $500 registration fee for each of their facilities, the Senate HELP Committee didn’t include such fees.

FDA Commissioner Margaret Hamburg has said the agency would need more money to conduct more food-safety inspections.

Mr. Harkin told reporters he may consider the fees after the Congressional Budget Office calculates the legislation’s price tag. But he said he doesn’t like charging companies fees. &quot If it’s for public protection, it’s something we all ought to pay for,&quot Mr. Harkin said.

Sen. Mike Enzi of Wyoming, the committee’s ranking Republican, was more explicit. &quot Asking a regulated industry to cough up for their own basic regulation is a tax, plain and simple. Not to mention a potential conflict of interest, as the public-health watchdog becomes ever more dependent on the industry it is supposed to be watching,&quot he said.

The Grocery Manufacturers Association, the trade group for the food and beverage industry, generally supports the fees, but it wants the FDA to be more specific about how the agency would use the money.

There are other disagreements. Mr. Enzi said he is concerned that the new mandates on the FDA, such as more-frequent inspections, may prove to be too burdensome to the agency, which was recently given authority to regulate tobacco products.

QandA Can Fructose Affect My Weight?

Obesity expert Louis J. Aronne, M.D., talks about the relationship of fructose, a type of sugar, to weight gain.

Q: What exactly is fructose?
A: Fructose is a type of sugar found in foods such as fruit. It is also added to sodas, juice blends, salad dressings, pasta sauce, and other foods, primarily in the form of high fructose corn syrup (HFCS). HFCS is about half fructose and half glucose (another type of sugar).

Q: How does fructose promote weight gain?
A: Unlike glucose, fructose may increase appetite. And research indicates that when it’s eaten before or with fat, that fat is more likely to be stored than burned. Consuming HFCS appears to cause resistance to leptin, a hormone that tells you brain how much fat is stored and signals the feelings of fullness. The problem is Americans are consuming more of such sugars, especially in sweetened beverages.

Q: Is white table sugar better for you than fructose-based sweeteners?
A: No. Like HFCS, table sugar is about half fructose and half glucose. Some studies have found it has similar effects on the body.

Q: How can you limit your intake of fructose?
A: If you drink soda or juice, have only an 8-ounce glass with ice in it. And limit intake of foods that have &ldquo high fructose corn syrup&rdquo on the label.

The Smile Factor
Can Gum Disease Boost Diabetes Risks?

You can make it harder to control your glucose levels if you neglect your teeth and gums – that we know. But now it appears that gum disease may contribute to the development of diabetes in the first place. According to Ryan T. Demmer, Ph.D., M.P.H., an associate research scientist in epidemiology at Columbia University, research has shown that &ldquo periodontal disease can precede the onset of type 2 diabetes.&rdquo In Diabetes Care, a study by Demmer and his colleagues looked at data on more than 9,000 people who were followed for 17 years. The researchers concluded that those who had moderate gum disease when they were first observed were twice as likely to be diagnosed with diabetes over the life of the study as those who had healthy gums. When gum disease was so bad that it caused substantial tooth loss, the risk of diabetes jumped by 70 percent. The takeaway? Conscientious dental care is imperative for anyone who is at risk for diabetes.

Global Warming With the Lid Off

The Wall Street Journal – Tuesday, November 24, 2009

‘The two MMs have been after the CRU station data for years. If they ever hear there is a Freedom of Information Act now in the U.K., I think I’ll delete the file rather than send to anyone. . . . We also have a data protection act, which I will hide behind.&quot

So apparently wrote Phil Jones, director of the University of East Anglia’s Climate Research Unit (CRU) and one of the world’s leading climate scientists, in a 2005 email to &quot Mike.&quot Judging by the email thread, this refers to Michael Mann, director of the Pennsylvania State University’s Earth System Science Center. We found this nugget among the more than 3,000 emails and documents released last week after CRU’s servers were hacked and messages among some of the world’s most influential climatologists were published on the Internet.

The &quot two MMs&quot are almost certainly Stephen McIntyre and Ross McKitrick, two Canadians who have devoted years to seeking the raw data and codes used in climate graphs and models, then fact-checking the published conclusions&mdash a painstaking task that strikes us as a public and scientific service. Mr. Jones did not return requests for comment and the university said it could not confirm that all the emails were authentic, though it acknowledged its servers were hacked.

Yet even a partial review of the emails is highly illuminating. In them, scientists appear to urge each other to present a &quot unified&quot view on the theory of man-made climate change while discussing the importance of the &quot common cause&quot to advise each other on how to smooth over data so as not to compromise the favored hypothesis to discuss ways to keep opposing views out of leading journals and to give tips on how to &quot hide the decline&quot of temperature in certain inconvenient data.

A satellite image of Tropical Storm Ida. Some climate researchers claim that an increase in tropical storms is proof of anthropogenic climate change.
Some of those mentioned in the emails have responded to our requests for comment by saying they must first chat with their lawyers. Others have offered legal threats and personal invective. Still others have said nothing at all. Those who have responded have insisted that the emails reveal nothing more than trivial data discrepancies and procedural debates.

Yet all of these nonresponses manage to underscore what may be the most revealing truth: That these scientists feel the public doesn’t have a right to know the basis for their climate-change predictions, even as their governments prepare staggeringly expensive legislation in response to them.

Consider the following note that appears to have been sent by Mr. Jones to Mr. Mann in May 2008: &quot Mike, Can you delete any emails you may have had with Keith re AR4? Keith will do likewise. . . . Can you also email Gene and get him to do the same?&quot AR4 is shorthand for the U.N.’s Intergovernmental Panel of Climate Change’s (IPCC) Fourth Assessment Report, presented in 2007 as the consensus view on how bad man-made climate change has supposedly become.

Read a Selection of the Emails
Climate Science and Candor
In another email that seems to have been sent in September 2007 to Eugene Wahl of the National Oceanic and Atmospheric Administration’s Paleoclimatology Program and to Caspar Ammann of the National Center for Atmospheric Research’s Climate and Global Dynamics Division, Mr. Jones writes: &quot [T]ry and change the Received date! Don’t give those skeptics something to amuse themselves with.&quot

When deleting, doctoring or withholding information didn’t work, Mr. Jones suggested an alternative in an August 2008 email to Gavin Schmidt of NASA’s Goddard Institute for Space Studies, copied to Mr. Mann. &quot The FOI [Freedom of Information] line we’re all using is this,&quot he wrote. &quot IPCC is exempt from any countries FOI&mdash the skeptics have been told this. Even though we . . . possibly hold relevant info the IPCC is not part of our remit (mission statement, aims etc) therefore we don’t have an obligation to pass it on.&quot

It also seems Mr. Mann and his friends weren’t averse to blacklisting scientists who disputed some of their contentions, or journals that published their work. &quot I think we have to stop considering ‘Climate Research’ as a legitimate peer-reviewed journal,&quot goes one email, apparently written by Mr. Mann to several recipients in March 2003. &quot Perhaps we should encourage our colleagues in the climate research community to no longer submit to, or cite papers in, this journal.&quot

Mr. Mann’s main beef was that the journal had published several articles challenging aspects of the anthropogenic theory of global warming.

For the record, when we’ve asked Mr. Mann in the past about the charge that he and his colleagues suppress opposing views, he has said he &quot won’t dignify that question with a response.&quot Regarding our most recent queries about the hacked emails, he says he &quot did not manipulate any data in any conceivable way,&quot but he otherwise refuses to answer specific questions. For the record, too, our purpose isn’t to gainsay the probity of Mr. Mann’s work, much less his right to remain silent.

However, we do now have hundreds of emails that give every appearance of testifying to concerted and coordinated efforts by leading climatologists to fit the data to their conclusions while attempting to silence and discredit their critics. In the department of inconvenient truths, this one surely deserves a closer look by the media, the U.S. Congress and other investigative bodies.