Inhaled steroids (IS) for the treatment of asthma have become a standard in the U.S. and many countries around the world. They are an essential cornerstone in the management of persistent asthma. Adverse effects of IS are minimal, but a small percentage of patients may experience dysphonia (hoarseness, weakness or loss of voice), throat irritation, cough or candida overgrowth (oral thrush).
Many patients who have hoarseness related to IS describe a subtle onset which began months or years after starting the inhaler. There is increased risk of voice change with higher doses or strengths of inhaled steroid. It’s often very frustrating when you have established a good routine of daily inhalations and have reaped the rewards of good asthma control, but later learn the wonder drug is weakening your voice.
Studies have reported between 10-50% of patients on IS experience hoarseness, although package inserts only reflect a range of 1-8%. In my practice it always seems to be a singer,...
Let’s get rid of the word, stigma, once and for all. Every once in a blue moon, I feel the urge to sound off. Please indulge me:
As a word, “stigma” is an insult to the outrages inflicted upon our population. Its use - even by well-meaning people - only perpetuates our status as third-class citizens. A quick history lesson:
In the US, during the first decades of the twentieth century - in the name of the improvement of the human race, with the sanction of the Supreme Court - 30,000 individuals deemed mentally unfit were subjected to enforced sterilization.
In Hitler’s Germany, some 300,000 to 400,000 forced sterilizations were carried out. Then, beginning in 1939, a quarter million mentally and physically disabled people were gassed in special “euthanasia” centers.
We live in a more enlightened age, but the basic premise that we are not welcome as equals in society remains substantially unchallenged. We are no...
Over the years that I've served as CEO
of DBSA, many of you have expressed your frustration and concern with the way
consumers of mental health services are portrayed in the media. Why are we
always the axe murderers and thugs? What about the millions of us who do good things in the world?
Well, the Substance Abuse and Mental
Health Services Administration (SAMHSA), an agency of the U.S. Department of
Health and Human Services, has heard those frustrations and developed the Voice Awards . This
program, which began in 2005, provides
a unique opportunity to be at the forefront of a movement to reduce stigma associated
with mental health problems and promote recovery by acknowledging and
celebrating the efforts of entertainment professionals who have helped support
The Voice Awards recognize entertainment writers and producers
who incorporate dignified, respectful and accurate portrayals of individuals
with mental illnesses into film and television productions...
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