Category: Health

By Sarah Keitt, as told to Hallie Levine

I’ve lived with inflammatory bowel disease since 1990, when I was diagnosed with ulcerative colitis. Thankfully, my symptoms resolved with surgery, but about 6 years ago I began to experience a recurrence of frequent abdominal pain and diarrhea. I suffered for years, until this past December, when I was finally diagnosed with Crohn’s.

While I’ve started to get my life back, it hasn’t been easy, especially when it comes to my relationships.

Coping With Isolation

My Crohn’s symptoms started right around the time my kids were about to enter middle school. I had spent years being involved in everything from their classrooms to their sports games. But all that ended when I got sick.

I couldn’t go to my kids’ soccer matches, or meet other moms for coffee, because I couldn’t be away from a bathroom for that long. I developed severe anemia due to bleeding in my GI tract. I became so weak I could barely walk. All of a sudden, I found myself homebound, barely able to walk up and down stairs.

Still, I didn’t feel comfortable confiding in anyone except Geordie, my husband. Bloody diarrhea isn’t exactly cocktail-hour conversation. My family and close friends knew I was anemic, but I always tried to put my best face forward when I talked to them.

I have other chronic health conditions, including ulcerative colitis and multiple sclerosis, but I’d never thought of myself as disabled before. Now I did, and it was so depressing. It took so much energy and strength just to get through the day, while other mothers around me lived normal lives. I felt so lonely.

I wasn’t the only one who put on a brave face. It was agonizingly hard on my two kids, Lucy, now 17, and Theo, now 15.

My children had a lot of worries that they didn’t always vocalize. Over the next several years, I was in and out of the hospital for blood transfusions and surgeries, and it was very scary for them. They never asked a lot of questions. It was always just, “Mom’s not feeling well,” or “Mom’s tired.” They knew to run upstairs when I needed something, because it was hard for me to navigate stairs.

It really impacted our ability to do things as a family. We took them to an amusement park once and I couldn’t walk because I was so weak. We got a wheelchair, and I could tell from their faces how hard it was for them to see me in it. They were older by then, too — in middle school and high school. I don’t know what I would have done if they were younger.

Finding Support Is Key

In my case, it’s my husband, Geordie. When we met, he knew I had both multiple sclerosis and ulcerative colitis, even though I appeared perfectly healthy on the outside. But he realized there was always a chance both of these diseases could flare up, and he was prepared for that.

Neither of us expected the Crohn’s disease. But he has been a rock. He spends every day trying to make sure I have everything I need and that I get the right care. I know it’s been a drain on him, but he’s never once complained.

This past December, I had a surgery known as an ileostomy, where they removed my colon and replaced it with an ostomy bag, a pouch worn on the outside of my body to collect waste. It’s hard not to be self-conscious, but Geordie has been incredibly supportive. He always reassures me that he still finds me attractive and that he’s so grateful for it, because it’s allowed me to get my life back. I wouldn’t trade my husband for the world.

I also have a small but strong network of support beyond Geordie. I found a couple of online support groups specific to ileostomy and Crohn’s disease, and I have a good group of local friends whom I can turn to for help.

It was hard to cope with people during the COVID-19 pandemic. The medications I take to treat all my conditions suppress my immune system, which means I didn’t mount a response to the COVID-19 vaccine. I’ve been made fun of for wearing a mask, and had to deal with people who just don’t seem to understand that COVID could kill me if I got sick. It’s terrifying and sad when you are told to your face that you don’t matter.

Why It’s Important to Be Open

My ileostomy has allowed me to begin to return to normality. I feel a lot stronger, and have a lot more energy. I ran for local office, something I could not have done 6 years ago. I look forward to going to my kids’ soccer games and rock climbing meets, something I couldn’t do just a couple years ago.

But I’ll be honest. Walking around with an ostomy bag does a number on your self-confidence. I cover it under clothing, but it still is a small bulge under a sweater or dress. When I talk to people sometimes, I wonder if they look at it and are confused about what it is.

The hardest part of an ostomy bag is when I have to change it in public. When you open it, it smells, and there’s no way to spray that odor away. Occasionally, it’s leaked onto my clothing when I’m out, and I’ve had to stop whatever I’m doing to make an emergency trip to Walmart for a new shirt.

But whenever I feel embarrassed, I remind myself that the bag gives me back my freedom. I can eat what I want now, and be present for my husband and kids, because of it. Sure, no one wants to talk about bathroom habits, but if I let people know that I have to wear an ostomy bag because I have Crohn’s disease, I help give the condition more visibility. That doesn’t just help me — it helps everyone who lives with this condition.

By Michelle Pickens, as told to Danny Bonvissuto

As early as I can remember, I’ve had issues with my health. When I was little, I had severe constipation, nausea, vomiting, and food sensitivities.

As I got older, those symptoms transitioned into diarrhea, irregular bowel movements, and pain. I was always very fatigued and my immune system was weak: The second someone in my class had the cold or flu, I’d get it, too. Looking back, it was a sign.

From a mental perspective, my anxiety was high. What if I need to find a bathroom? What if I’m nauseous? Doctors would say, “Oh, you’ll grow out of it. It’s just your anxiety.”

Finally, a Diagnosis

After years of misdiagnosis, I was finally diagnosed with Crohn’s disease in 2015. I was 23 and had just finished up college while working full time. My symptoms were getting worse. I had a lot of vomiting and pain. The fatigue was at the point where it was difficult for me to work or even get out of bed some days.

It was so bad it pushed me to seek additional care. I took a couple months off, looked for another job, and went through all the doctor appointments it took to get the diagnosis.

There’s no blood test for Crohn’s. No way to prove what you’re feeling. Eventually I saw the right doctor, who did a test with a pill camera called a small bowel capsule. (This is a pill-sized camera that you swallow, allowing doctors to see inside your digestive system.) It tracked my intestines and was able to get into a blind spot where neither a colonoscopy nor endoscopy can see inflammation. 

It was such a relief to get the diagnosis because it made me feel like I wasn’t crazy. For so many years I knew something was wrong and couldn’t name it. I also felt hopeful. Once I knew what I was dealing with, I knew I could work to get to a better place.

Sharing My Story

In 2016, I started a blog called Crohnically Blonde as an outlet to connect with people as I go through the stages of dealing with Crohn’s. When I first started to share, there weren’t as many people talking about it.

I’ve been able to form relationships in an online community through shared experiences. I hope someone can see my story and feel that, if they’re at the beginning of their journey, there’s a way to get through.

Managing My Medication

At first, I was on a lot of medication that wasn’t working well and was a huge imposition on my schedule. Now I get infusions of an immunosuppressive drug every 7 weeks.

It means being away from my family and job for 4-5 hours, and managing child-care coverage during the treatment and the weekend after, because I feel almost flu-like. The extra help allows me to rest and fuel back up after the treatment.

I have the option to be on more medications to control my symptoms. But I try to shy away from those and manage it on my own because I don’t want to be on medicine for every single thing.

Before I had my son, I was more willing to try different medications. But while I was pregnant, I could barely be on any of the Crohn’s medicines. After I had him, it didn’t make sense to be reliant on them.

Crohn’s, Pregnancy, and Motherhood

Crohn’s affected me throughout my pregnancy. I got very sick in my third trimester because I went off my immunosuppressive drug to avoid passing any on to the baby. I ended up having to be induced early so I could get back on the medication as soon as possible.

My son, Maddox, is 1 now. Crohn’s changed my expectation of what I thought motherhood would be.

I’ve learned that I’d rather be present and able to enjoy him in the good moments than push it when I’m sick. It’s been difficult. But if I’m not well, I can’t be there for my child. I try to be with him as much as I can, but there are times when I need to step back and take an hourlong nap.

I have a great support system: My husband, mom, or mother-in-law can step in and help out for a little while, and when I feel better, I can be a better mom. There are also days when I don’t have accessible help. In those situations, I’ll do lower-key activities that I can enjoy with him but that aren’t physically demanding on me.

Schedule and Adjust

Right now I’m in a pretty good spot. I work from home now, as a recruiter for a tech company, and that makes a huge difference. A lot of my anxiety in the past was around being in an office and being sick. Now that I can work remotely, it’s such a game changer.

But Crohn’s still affects my day-to-day. I have days where I’m feeling sick, and need to rest and change my plans so I’m home and not out somewhere.

No matter how planned-out I have my day or week, if I’m not feeling well that takes precedence. I like to be a very scheduled person. But I have to roll with the punches and have a plan B.

The biggest challenge is managing my sleep and stress. They’re both very influential in symptom flare-ups. I have to get at least 8 hours of sleep, no matter what. And I try to incorporate time to de-stress, like reading a book or relaxing at the end of the day.

Going to therapy helps offset stress as well, and is now part of my ingrained self-care schedule.

Social Life Strategies

My co-workers, family, and friends are very understanding. But that wasn’t the case at first. The more open I’ve been about Crohn’s, the more people understand that I’m not flaking out if I have to change plans; there’s an underlying reason.

I only have a certain amount of energy, so now I pick and choose. I know I need to work and be with my family, which means I have less energy to put into social situations.

I plan out what I’m comfortable doing, but have also become comfortable with changing plans. Even if I’m excited to go out to dinner with a friend, I don’t push it if I feel terrible that day.

Food in Flux

I’ve followed a gluten-free diet for years. I started with an elimination diet and realized that gluten was bothering me.

Other foods aren’t as black and white. I can eat a salad one day and it’s fine, and eat the same salad the next day and it makes me sick. I repeat the safe foods that don’t make me sick and stick to a general schedule of three meals a day that are pretty much all gluten free.

Sometimes the timing matters: I’ll wake up and feel nauseated and need a starchy food like dry cereal. If I’m going on a road trip, or have a big event, like a wedding, I plan it out and try to be careful about what I eat leading up to it because I don’t want to be sick. But it’s hard because you never really know. It’s kind of a gamble.

Flexibility Is Key

I’ve learned to be as flexible as possible. I never know what each day is going to bring, I just have to trust that my body is telling what it needs for that specific day. That’s my priority, and everything else can wait.

Oct. 21, 2022 – John Fetterman, Democratic candidate for Senate in Pennsylvania, is recovering well from a stroke he had in late spring, according to a medical report from his primary care doctor. 

In his evaluation of Fetterman, Clifford Chen, MD, concluded that “he has no work restrictions and can work full duty in public office.” Fetterman is currently lieutenant governor. 

But Chen also noted that the Senate candidate has exhibited symptoms of an auditory processing disorder that can cause hearing difficulties. While this means that Fetterman doesn’t always properly process words spoken aloud, his communication skills have reportedly improved significantly since his first speech therapy appointment. 

Fetterman had what’s known as an ischemic stroke, the most common type. Nearly 87% of all strokes are ischemic, meaning there is an artery blockage that prevents blood flow to the brain. 

Though we don’t have many more details about his stroke, Lee Schwamm, MD, a vascular neurologist at Massachusetts General Hospital in Boston says that, given his symptoms, it’s likely that Fetterman experienced a blockage in his middle cerebral artery. And if Fetterman is right-handed, Schwamm says, his language systems live in the left side of his brain, so the stroke would have been in the left-middle cerebral artery in particular. 

For recent interviews, Fetterman has relied on visual aids like a teleprompter and closed captioning, and plans to do the same for an upcoming debate against his opponent, Republican Mehmet Oz, who is a board-certified heart surgeon. Oz has been particularly vocal about Fetterman’s health in the wake of his stroke, going so far as to suggest that the candidate’s wife might have to serve as Senator in his place. 

But experts see that as a likely exaggeration.

“In general, patients who have a mild receptive language difficulty don’t have any change in IQ – their cognitive abilities are not altered,” says Gregory Albers, MD, neurologist and director of Stanford University’s Stroke Center. He added that, after a stroke, patients can have a recovery that lasts over a long period of time. 

“Although the most rapid recovery happens in the first few months, continued recovery is expected over many months,” Albers says. 

Schwamm says that a political debate – or any forum that requires more on-the-fly thinking and communication – will be the best measure of his abilities. But he doesn’t expect that Fetterman will function at his highest level of performance during a debate setting, which can be stressful for anyone, stroke or not. 

Also, Schwamm, says, we have many senators and representatives who need assistive devices like canes or wheelchairs, are on medication for heart disease, or have some degree of dementia – but we don’t block them from political life or remove them for office for their health conditions. 

“Accommodation is not weakness, accommodation is a mechanism for leveling the playing field so that people can perform at their highest levels,” says Schwamm. “We have to embrace the fact that people process information differently, even if you’ve never had a stroke. What matters is the product of their work, not the method of their work.” 

Oct. 21, 2022 – Including how long a person sleeps in a heart health score was able to predict heart disease risk among older adults, results of a new study show. 

The study supports the American Heart Association’s recent decision to make sleep duration “an essential component for ideal heart and brain health.” 

“Sleep seems to be the first thing that people squeeze out of their schedules when they are busy, but making sleep a priority is vital for health and well-being,” says lead author Nour Makarem, PhD, of the Mailman School of Public Health at Columbia University in New York City.

The study is the first to show that sleep metrics matter in predicting heart health, she says. 

Makarem and her colleagues studied 1,920 people participating in a large sleep study. The average age was 69, and a bit more than half were women. The researchers used the data to test scores of heart health that included sleep as a measure versus the American Heart Association’s guidelines known as Life’s Simple 7, which does not include sleep as a data point. (The AHA recently added sleep to the guidelines and unveiled the new Life’s Simple 8.)

Over more than 4 years of follow-up, both the heart health score that included the LS7 plus sleep duration alone and the score that included the LS7 and various aspects of sleep health, such as sleep duration, sleep regularity, daytime sleeping, and sleep disorders, were able to predict future heart disease events such as heart attack, bypass surgery, or chest pain.

Study participants who scored highest on the LS7 and various versions of the sleep health scores had up to 80% lower odds of getting heart disease, according to the study, which was published in the Journal of the American Heart Association. 

Of note, participants with a short sleep duration had higher chances of having low sleep efficiency; that is, less than 85% of the time sleeping in bed after lights off, irregular sleep patterns, excessive daytime sleepiness, and sleep apnea. They also had a higher prevalence of overweight/obesity, type 2 diabetes, and high blood pressure.

Consistent Patterns

Good sleep hygiene is key for getting enough restful sleep, as well as for heart health, Makarem says. Good sleep hygiene includes setting a sleep schedule, your bedtime routine, and sleep environment for consistent sleeping patterns.

Her tips include:

Stick to a stable sleep schedule: Try to go to bed and wake up at the same time every day, including weekends, to avoid disrupting your body clock’s sleep-wake rhythm. 

• Use the hour before bedtime to relax and unwind – for example, by reading or taking a hot bath.  
• Optimize your sleep environment by making your bedroom comfortable, quiet, cool, and dark. Use heavy curtains or an eye mask to prevent light from interrupting your sleep, and avoid sources of bright light such as computers, TVs, and phones. 
• Drown out any noise by using earplugs or a white noise machine. 
• Avoid stimulants such as nicotine and caffeine, particularly close to bedtime.  

“Sleep isn’t your enemy; it’s your friend,” says American Heart Association volunteer expert Michael A. Grandner, PhD, of the University of Arizona College of Medicine. “People often sacrifice sleep to work more, but the data show that the people who are getting more sleep actually get more done at the end of the day because they’re more efficient and they get sick less and get injured less.”

Also, he says, if you think have a sleep disorder, talk to your doctor, and get it diagnosed and treated. “No sleep tips in the world are going to fix an untreated sleep disorder.”

“And if you’re in bed and you’re not asleep, get up,” he says. “Laying there awake actually creates the bed as an awake place and programs you to be awake in bed. If you’re in bed and you can’t sleep, don’t make things worse by staying in there.”

Most people with Crohn’s disease know all too well what a flare feels like. Symptoms like diarrhea, abdominal pain, nausea, and exhaustion can be uncomfortable and embarrassing. So it’s a relief when they disappear. But if you don’t have any symptoms, does that mean you’re in remission? 

The answer is more complicated than you might imagine. There are several types of remission. And “remission” tends to mean something different to patients than to their doctors, says Ariela Holmer, MD, a gastroenterologist with the NYU Langone Inflammatory Bowel Disease Center.

“Patients focus on symptoms, because those are what cause decreased quality of life and disability and why they come to see us in the first place,” she says.

But to doctors, remission means that your small and large intestines are healthy so you can avoid complications, she says. There can be a disconnect between symptoms and what’s going on in your digestive tract.

“You can be walking around feeling fine and still have active disease that’s visible when we do an endoscopy or MRI,” she says.

Ultimately, she explains, having inflammation in your intestines is what leads to complications.

Crohn’s disease is often aggressive, Holmer says. If it’s not treated the right way, Crohn’s can lead to ulcers and holes in the wall of your intestines. You may develop strictures (narrowed areas in the intestine), as well as fistulas (abnormal channels that connect your intestines to another organ).

These complications often need to be repaired with surgery. Long-term inflammation in your intestines also raises the risk that you’ll get colon cancer.

The bottom line: Even if you don’t have symptoms, you’ll need testing to find out whether your disease is still active.

What Are the Types of Remission?

The definition of remission in Crohn’s disease has changed over the past few years. Most inflammatory bowel disease (IBD) experts use at least four different terms to describe the various types of remission.

Clinical remission. This is something you can identify on your own. It simply means that you don’t have any noticeable symptoms. 

Biochemical remission. This means you’re in remission according to lab tests, specifically blood tests and stool tests. Your gastroenterologist should do blood tests to monitor your level of C-reactive protein, an inflammatory substance, plus stool tests to check your level of another inflammatory substance called calprotectin. Ideally, both markers should be low for you to be in biochemical remission.

Endoscopic remission. Endoscopic remission means that when you get a lower endoscopy (a colonoscopy or sigmoidoscopy) your doctor sees no signs of inflammation, ulcers, or bleeding. That’s a very good sign that your disease is under control.

The International Organization for the Study of IBD recommends that doctors use endoscopic remission as the long-term treatment target for Crohn’s disease. In other words, the fact that you feel better isn’t enough. Doctors should keep tweaking your treatment until your intestines show proof that you really are better.

During your endoscopy, your doctor will probably also take small samples (biopsies) of your intestinal tissue to be analyzed. If no inflammation can be seen under a microscope, you’re said to be in histologic remission. (Histology refers to the microscopic examination of tissue.)

Deep remission. If you meet the definitions for both endoscopic and clinical remission, congratulations.  You’re in deep remission. Research has found that people with Crohn’s who reach deep remission soon after being diagnosed and stay there for at least a year are less likely to have advanced disease and complications later on.

How to Avoid Relapses

There’s no cure for Crohn’s disease. People who have it tend to go through periods of remission with  flares from time to time. Reaching deep remission should increase the chances that you’ll stay in remission longer — perhaps for many years. But other things also affect what your future with Crohn’s might look like, Holmer says.

Those include how old you were when were diagnosed. People diagnosed after age 30 usually fare better than those who’ve had Crohn’s since childhood. It also matters how much of your intestines has been affected by Crohn’s (less is better).

It also makes a difference whether you’ve had complications like ulcers, strictures, or fistulas. If you’ve had them before, you’re apt to have more complications in the future.

There’s no way to guarantee you’ll stay in remission. But you can tip the odds in your favor. Take your medications as your doctor directs. And see your gastroenterologist regularly — even if you feel fine.

“You should always stay in touch with your doctor and continue having your disease monitored with biochemical and endoscopic tests,” Holmer says.

“Some patients think, ‘OK, I’ve been in remission for 5 years, so I can stop seeing my doctor.’ Those are the ones that end up relapsing.”

Oct. 21, 2022 – This past Monday was the long-anticipated debut of over-the-counter hearing aids, the day they could be sold at stores, pharmacies, and online after the FDA signed off on these less expensive options that require no health care professional’s input. 

What could be simpler? Just pick up that hearing aid you’ve been needing on your next Walmart run.

Several devices are now available, but the party isn’t in full swing yet, it appears. A quick spot check on Wednesday and Thursday at a Best Buy, CVS, Walmart, and Walgreens about 10 miles from downtown Los Angeles found no OTC hearing aid devices on the shelves, with store personnel suggesting a visit to their websites or to check other, larger stores. Many of the prices, listed online, are higher than earlier estimates of $300 to $500. And reading and understanding the product information can take some education.

Even so, hearing loss professionals – and probably countless spouses and friends tired of hearing “Huh?” – applaud the move, noting that this more affordable hearing help is sorely needed by many. About 37.5 million American adults report some trouble hearing, but only about one-fifth of people who could benefit from a hearing aid use one, the FDA says. Expense is a big reason, although the stigma of needing a hearing aid can play in, too. And device makers say by month’s end, more models will be in stores. 

Before shopping, here’s what to know and where to turn for help. 

Hearing Experts On Board

Hearing experts, including audiologists and doctors who are hearing specialists (ENTs or otolaryngologists), favor the option of OTC devices, if people don’t misjudge their hearing loss. 

“I think it’s great to have multiple pathways [to treat hearing loss],” says Catherine Palmer, PhD, director of audiology at the University of Pittsburgh Medical Center and chair of the American Academy of Audiology OTC Resources Task Force. “This is going to be a positive for some.”

Who Could Be Helped?

OTC hearing aids are not for severe hearing loss, and they aren’t meant for children. They work best and are meant for adults with mild to moderate hearing loss.  

“We know people aren’t accurate in judging their own hearing loss,” Palmer says. 

o decide how extreme your hearing loss is, experts say those with mild to moderate hearing loss  have trouble understanding conversation when in a group, in a place with background noise, or when they can’t see who’s talking. They may need to turn up the television or radio loud — at a high enough volume that other people notice it’s too loud. They may have trouble talking on the phone, and they may often ask others to repeat what they said.

But you need a hearing professional if you have trouble hearing in a quiet environment or can’t hear loud sounds such as cars or power tools.

Should you try those online hearing tests first? (Google “online hearing tests” and you get 241 million results.) Some experts say it can’t hurt, but others say they are unreliable and to get a test from a professional.

A few other red flags: If you have ear pain, pus, or blood coming from the ear, excess earwax, sudden hearing loss, or loss in one ear only, see a hearing professional. 

“You have to make sure there isn’t a medical cause for your hearing loss,” says Douglas Backous, MD, a neurotologist at Puget Sound ENT Proliance Surgeons in Seattle and president-elect of the American Academy of Otolaryngology – Head and Neck Surgery.  

OTC Hearing Aid Options

Some of the over-the-counter hearing aids are “self-fitting,” requiring an app or accessory that develops a program based on your responses to some signals; others have preset programs, a simpler option, and users can choose the best or switch back and forth between the programs.

Models include behind-the-ear, in-the-ear, and in-the-canal, depending on preference. Those who wear glasses might not prefer the behind-the-ear model, experts say. Those who want it as inconspicuous as possible may prefer in-the-canal.

Among the many OTC devices: 

• Lexie B1, Powered by Bose, is self-fitting and is $849.
• Eargo Max has four sound programs to switch back and forth to; $1,450.
• Jabra Enhance Plus has a variety of modes; $799.

Costs

The OTC devices are expected to cost about $200 to $1,000, compared to $5,000 and higher for prescription devices, according to the Consumer Healthcare Products Association, which counts device makers among its members.

OTC devices are unlikely to be covered by insurance, says Palmer, noting that the hearing industry is still fighting for more comprehensive coverage of prescription hearing aids.

More Smart Shopping:

Check the return policy for any device, says Anita Brikman, executive director of the Consumer Healthcare Products Association Educational Foundation, a nonprofit group. It should be listed on the labeling. She and others recommend at least 30 days. Some device makers offer much longer.

It may take time to get used to the device, and adjustments may be needed.

Check to see if companies offer more support, Brikman says, such as online help or a toll-free number, and check the hours they can be reached.

Several organizations offer online information about OTC hearing aids, including:

Buying online doesn’t rule out the need for an audiologist or ENT doctor. If an OTC device isn’t working properly, experts suggest taking it to an audiologist and asking for an adjustment. “Before you give up, go get a formal evaluation,” Backous says.

And even though it isn’t required before getting an OTC device, “It is still recommended that people get some sort of hearing test,” Brikman says. Insurance may cover the cost of the test.

Improved Hearing, Better Health

Hearing loss is linked with many ill effects on health, including less socializing because you miss out on conversations. Hearing loss can also boost the risk of falls.

But it’s also been linked with an increased risk of dementia. Recent research has found it is one of the top risk factors for dementia — and it can be changed.

What Aren’t OTC Hearing Aids

Googling “over the counter hearing aids” brings up a variety of devices, including personal sound amplification products or PSAPs. These are meant not for hearing loss, but to help boost the ability to hear certain sounds in certain situations, such as while bird-watching.

“These are regulated as consumer electronics, but not for hearing loss,” Brikman says.

Deciphering the FDA Terms, Device Labels

The FDA regulates OTC hearing aids as medical devices and requires OTC hearing aid makers to have a maximum output or volume on the devices to prevent injuries from boosting the sound too much. Devices must also have distortion control limits, noise limits, and limits on how quickly they process, amplify, and relay a sound. There are requirements on the range of frequencies and the insertion depth of the device. 

According to an FDA spokesperson, OTC hearing aids makers must register their facilities with the FDA, list their devices with the FDA, and have clearance or approval, as appropriate for the device type .

The new hearing aid category has been in the works since 2017, when the Over-the-Counter Hearing Aid Act of 2017 was passed as a rider on the FDA Reauthorization Act of 2017.  In July, President Joe Biden issued an executive order calling for the FDA to take steps to allow hearing aids to be sold over the counter and included a timeline for action. The rule establishing the OTC hearing aids became effective Oct. 17.

By Cara Murez and Robin Foster 

HealthDay Reporters

FRIDAY, Oct. 21, 2022 (HealthDay News) – In an unanimous vote on Thursday, a panel of U.S. vaccine experts recommended that COVID shots be added to the list of recommended vaccinations for children and adults.

Now it’s up to the U.S. Centers of Disease Control and Prevention to decide whether to follow the advice of its Advisory Committee on Immunization Practices.

Even if the agency does approve adding the shots to the schedule, it doesn’t amount to a vaccine mandate. State and local jurisdictions will still decide what vaccines are required for schools, NBC News reported.

“Moving COVID-19 to the recommended immunization schedule does not impact what vaccines are required for school entrance, if any,” said Dr. Nirav Shah, director of the Maine Center for Disease Control and Prevention. “Local control matters. And we honor that the decision around school entrance for vaccines rests where it did before, which is with the state level, the county level and at the municipal level, if it exists at all.”

“This discussion does not change that,” he told NBC News.

An example of local jurisdictions making their own choices includes the HPV vaccine, which has been on the immunization schedule since 2006. Only Puerto Rico, Rhode Island and Washington, D.C., actually require it for both girls and boys. Virginia requires the vaccine for girls, NBC News reported.

Despite having a recommended national vaccine schedule, vaccination rates for American children have dropped during the pandemic.

COVID cases are also declining among U.S. children, totally close to 28,000 last week, according to the American Academy of Pediatrics. It is the first time since early April that cases were under 30,000.

An advantage to having COVID-19 shots on the vaccine schedule is that insurance providers typically will cover recommended vaccines. Though federal dollars are still paying for those vaccines, that will eventually end, NBC News reported.

The COVID vaccines could also become a part of the federal Vaccines for Children program, which would provide them free to children covered by Medicaid.

“By adding it to the VFC program, it now makes these vaccines available to these uninsured and underinsured children,” said Dr. Julie Morita, executive vice president of the Robert Wood Johnson Foundation, former public health commissioner for Chicago and a former practicing pediatrician.

Morita called the schedule the “gold standard” for clinicians.

“I used to look every year, waiting for this vaccine schedule, to make sure I was following the best vaccination guidance available,” Morita told NBC News.

By Kalee Eichelberger, as told to Stephanie Watson

At one point in my life, I wanted to go to medical school and become a doctor. But because of my struggle with Crohn’s disease, I changed career paths entirely. The challenge of adjusting my diet to my disease led me to become a dietitian.

My health issues started early. I had health issues all through middle school and high school — GI symptoms like abdominal pain, loose stools, nausea, and vomiting.

It took a little bit of time to put the pieces together and get diagnosed. I finally learned that I had Crohn’s disease in 2012, when I was 17 years old.

The next challenge was finding a treatment that worked for me. My insurance company made me go through step therapy, where I had to try cheaper medications and fail on them before getting to try more expensive ones. Eventually I started on a biologic drug, which suppresses the part of my immune system that is triggering inflammatory bowel disease (IBD) symptoms. That has worked for me.

Underweight and Malnourished

Early in my disease, I had a very hard time maintaining my nutritional status. The combination of symptoms like abdominal pain, nausea, and vomiting made it difficult to eat and keep food in me. And really, who wants to eat when it triggers pain and discomfort?

On top of that, my GI tract was so inflamed that it wasn’t properly absorbing nutrients. As a result, I was very underweight. I just couldn’t keep the weight on.

It was really challenging for me to find foods and a diet plan that worked for me and didn’t aggravate my symptoms. After what felt like endless attempts at changing my diet, I ended up so malnourished that I needed a feeding tube for a couple of years, plus a central line for IV fluids so I wouldn’t get dehydrated.

For a while I was being fed solely through a tube to give my inflamed GI tract a rest. But I was gradually able to wean myself off of it.

My saving grace was getting connected to a phenomenal dietitian who showed me the link between medicine and nutrition and helped me create a diet plan that worked for me and my disease. When I realized what an asset a dietitian can be to people with IBD, I decided to go back to school and get a second degree in dietetics.

Fine-Tuning My Diet

My dietitian had me walk through my diet in very specific detail, asking me to record a food log of what I ate and how I felt throughout the day. He helped me figure out which foods were triggering my symptoms and helped me pinpoint my specific nutritional needs.

Through the process of trial and error, I learned which foods weren’t working for me. One was high-fiber foods. Certain whole grains, nuts, and tough-to-chew fruits and vegetables with intact skins and seeds give me cramping and upset stomach. The lactose in dairy foods is also a problem for me, leaving me feeling bloated and uncomfortable.

I don’t necessarily have to cut these foods entirely, but I do have to be more careful with them. I can have dairy and some fiber, as long as I watch the quantity. It’s all about eating these foods in moderation and being aware of what else I’m eating throughout the day.

I’ve had to take supplements to fill in the nutritional gaps from cutting these foods from my diet and from my other disease-induced vitamin deficiencies. For example, I wasn’t getting enough vitamin D  when I cut back on dairy foods, so my gastroenterologist suggested I take a calcium/vitamin D supplement.

Overall, I still eat a pretty well-rounded diet, although it’s relatively bland. I avoid spicy and acidic foods because they can trigger my GI symptoms. If I eat any meat, it’s typically lean — nothing too fatty. And I don’t eat a whole lot of fried or processed foods.

When I do have fruits and vegetables I steam or boil them, rather than eating them raw. They’re easier to digest that way. And I avoid pulpy or seedy fruits.

What I’ve Learned

Living with Crohn’s disease has given me a lot of empathy toward the people I work with. Eating is such a social component of everyday life, and it can become so stressful when you have IBD as there is no one-size-fits-all approach. Diet is very individualistic. I try to be patient as we work to find the diet that’s right for them.

Having been on the receiving end of a feeding tube, I understand what a challenge it is to maintain nutritional status and what a big task it is to need nutritional support. I remember how much my dietitian at the time empowered me to take control over my health and nutrition. If I could be that advocate for just one of my patients, I can honestly say that I’m grateful for my IBD and for the journey it has  brought me on.

Thankfully, I’m in remission today. I feel very healthy. I’m really empowered by what I’ve learned throughout the years, both from working with a dietitian and being a dietitian.

It was a journey to get to where I am today, and I hope that more people can get to the same point. I’ve learned how important it is to do your research as someone with Crohn’s disease. There’s so much conflicting information on the internet about IBD and diet.

It’s always important to work with trained specialists like a gastroenterologist and dietitian. Rely on the them, but don’t be afraid to advocate for yourself. No one knows your body better than you do.