Constantly tuning into the news can feel stressful, and sometimes... inescapable. Even when you turn off your TV, you'll still find out what's going on - online, through friends, or through social media. So how can we find ways to be calm when it feels like we're constantly being bombarded?

On this episode of Health Matters, clinical psychologist Adam S. Anderson talks about how our bodies are wired to seek information, why negative, sensationalist news can feel addictive, and how we can adjust our relationship to the news by implementing healthy habits.

Find us online at Mayo Clinic Press for more health and wellness articles, podcasts and books.

Do you have feedback, questions or topic suggestions? Email us at mcppodcasts@mayo.edu.

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Awkward. Taboo. The stuff of juvenile comedy. That's how many people would describe hemorrhoids, if they even talk about them at all. And if the emotional discomfort isn't enough, they're also pretty physically uncomfortable.

But for something we don't talk about, a LOT of us experience them. One in two people will experience a hemorrhoid by the time they reach 50.

On this episode of Health Matters, gastroenterologist Dr. Sarah Umar — also known to her Mayo Clinic patients as the Queen of Hemorrhoids — joins us to answer all our burning questions about hemorrhoids.

Find us online at Mayo Clinic Press for more health and wellness articles, podcasts and books.

Do you have feedback, questions or topic suggestions? Email us at mcppodcasts@mayo.edu.

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When an infant starts experimenting with solid foods, their whole world expands. Like breast milk and formula, food is fuel for your body and a vehicle for love. But it is also a cornerstone of culture, defining a shared national identity. It provides entertainment and spreads joy. And it helps us understand the world and our place in it. On this episode of Ask the Mayo Mom, host Dr. Angela Mattke talks to Dr. Leslie Kummer, a primary care pediatrician with special interest in breastfeeding medicine, about beginning the weaning process, safely introducing kids to the wonderful world of food, and sharing the love.

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New cases of COVID-19 are down 90% from the peak, with under 75,000 new cases reported last week across the U.S. 

"What we're observing is a pretty dramatic suppression of cases," explains Dr. Gregory Poland, head of Mayo Clinic's Vaccine Research Group. "This is good news, but we need to be cautious."

Dr. Poland warns that there are still people who are vulnerable to COVID-19 infection, including people who are immunocompromised; children under 5 who cannot yet be protected by COVID-19 vaccination; and the more than 30% of the U.S. population that is not fully vaccinated against COVID-19, according to Mayo Clinic's COVID-19 tracking tool data.

"'I'm as weary of COVID-19 as everybody else," says Dr. Poland. "But we still need to take this seriously." 

On the Mayo Clinic Q&A podcast, Dr. Poland discusses the latest COVID-19 news, including new COVID-19 vaccines coming for approval; the latest on long COVID; and his recent commentary with his colleague, Dr. Richard Kennedy, a Mayo Clinic internist, on the need for more research infrastructure and research funding in order to maintain public confidence in vaccines.

Research disclosures for Dr. Gregory Poland.

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When it comes to the heart, it can be scary to seek care when you think you might be having a problem. Tests may be necessary to evaluate your heart, and the unfamiliar terminology associated with these tests can be confusing and intimidating. 

Understanding terms like EKG, echocardiogram, coronary angiogram or stress test may help alleviate the fear.

"Whenever we order these tests, we don't want you to have anxiety," says Dr. Christopher DeSimone, a Mayo Clinic cardiologist. "These tests are all done for a reason: to get you a diagnosis and to help you feel better. "

As American Heart Month wraps up, Dr. DeSimone joins the Mayo Clinic Q&A podcast to break down the terminology and explain what to expect during cardiac testing and evaluation.

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Skin cancer — the abnormal growth of skin cells — most often develops on skin exposed to the sun, but it also can occur on areas of skin not ordinarily exposed to sunlight. Skin cancer is the most common form of cancer in the U.S.

"And the incidence of skin cancer is rising," says Dr. Dawn Davis, a Mayo Clinic dermatologist.

The three major types of skin cancer are basal cell carcinoma, squamous cell carcinoma and melanoma. Early detection of skin cancer gives you the best chance for successful skin cancer treatment.

While it is common to have freckles and moles develop over time, it is important to know your skin and recognize when changes occur.

"It's important to know what skin lesions you have," explains Dr. Davis. "Know what they look like, so that if they change, you can come to the dermatologist or health care provider for evaluation."

Melanoma is the most serious and deadly form of skin cancer. Dr. Davis says the "melanoma alphabet" can help with early detection:

• Asymmetry 
  Look for moles with irregular shape.
• Border 
  Look for moles with irregular, notched or scalloped borders.
• Changes in color 
  Look for growths with different or uneven colors.
• Diameter 
  Look for new growth of more than one-quarter of an inch in diameter.
• Evolving 
  Look for changes over time.

On the Mayo Clinic Q&A podcast, Dr. Davis discusses skin cancer detection and treatment. Dr. Davis also recommends steps to take to protect your skin including avoiding ultraviolet rays, and wearing sunscreen and protective clothing.

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For heart surgery patients, a cardiac reoperation or reintervention is sometimes needed. A reoperation is a second or subsequent surgery needed due to complications that develop over time.

People who require a second or even third heart surgery often fall in to three groups: 

1. Patients with aortic dissections 
   For patients with aortic dissections, emergency lifesaving surgery is performed initially. Then additional surgeries are often needed to repair the aorta.
2. Patients who receive tissue valves 
   Tissue valves typically last a decade before a reoperation is needed to replace the deteriorated valve.
3. Adults with congenital heart disease 
   Patients with congenital heart disease often have surgery as a newborn or infant. As they grow and age, additional operations may be necessary.

Cardiac reoperations are even more complex than first surgeries, due to scar tissue and other underlying conditions that develop. It is important to have a surgeon with a highly advanced set of surgical skills and techniques. Mayo Clinic surgeons perform more than 300 cardiac reoperations each year.

On the Mayo Clinic Q&A podcast, Dr. Alberto Pochettino, a Mayo Clinic cardiovascular surgeon, discusses cardiac reoperations and reinterventions.

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Thanks to significant advances in techniques and devices, minimally invasive procedures can be used to treat some congenital heart disease defects. Innovative procedures using catheters through blood vessels in the legs or neck allow interventional cardiologists to repair heart defects without surgically opening a child's chest. 

Specialists at Mayo Clinic's Center for Congenital Heart Disease use catheter-based procedures to treat some heart valve replacements and many other conditions, including tetralogy of Fallot, patent ductus arteriosus, patent foramen ovales, and atrial septal defects. 

On the Mayo Clinic Q&A podcast, Dr. Jason H. Anderson, a Mayo Clinic pediatric interventional cardiologist, joins Ask the Mayo Mom host Dr. Angela Mattke to discuss innovative procedures to treat congenital heart defects.

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As the U.S. moves beyond the omicron surge of the COVID-19 pandemic, key indicators are dropping.

"Both the acute indicators — number of cases — and the lagging indicators — hospitalizations and then deaths — are all dropping slowly, but they're surely dropping," says Dr. Gregory Poland, head of Mayo Clinic's Vaccine Research Group. 

Experts warn that caution is still needed to protect yourself in certain situations, including masking in crowded indoor settings and making sure you are up to date with your COVID-19 vaccinations and boosters.

While the latest surge wanes, COVID-19 research continues. 

On the Mayo Clinic Q&A podcast, Dr. Poland discusses the latest COVID-19 news, including a new study on the long-term effects of COVID-19 on the heart and why Pfizer is delaying the request for emergency use authorization of its COVID-19 vaccine for children under 5. 

Research disclosures for Dr. Gregory Poland.

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Thanks to research and treatment advances over the past few decades, most children diagnosed with cancer now live on to pursue full adult lives. To ensure that those children will one day have the option to become parents, families must consider the risk of infertility when deciding about cancer treatment.

Researchers and health care providers have made progress in minimizing the side effects of cancer treatment without reducing its effectiveness, allowing many cancer survivors to have children after spontaneous recovery of fertility. However, some cancers require rigorous treatment that almost always leads to permanent infertility. But there is hope for those families through fertility preservation.

Mayo Clinic's Fertility Preservation Program offers several options for fertility preservation, depending on the child's age, stage of puberty, diagnosis and proposed treatment plan. Both ovarian and testicular tissue cryopreservation is possible.

"We hope the pediatric Fertility Preservation Program brings a lot of optimism for the future for these children," says Dr. Asma Chattha, chair of Pediatric Gynecology at Mayo Clinic. "They're obviously fighting an uphill battle. It's a very difficult time in their lives. But barring none, I've always found the conversation surrounding fertility preservation to be a source of hope for families." 

In recognition of International Childhood Cancer Day on Tuesday, Feb. 15, Dr. Chattha joins the Mayo Clinic Q&A Podcast to discuss what patients and their families should consider when making decisions related to fertility preservation, and the steps involved in the process.

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More than two full years of living in the COVID-19 pandemic has taken its toll on children and their families. During the most recent omicron surge, pediatric infection rates were particularly concerning for pediatricians across the country. 

Parents of children younger than 5 years of age are feeling especially concerned, as vaccines have not yet been approved in this age group. But that may change soon, as Pfizer has recently submitted a request to the Food and Drug Administration for emergency use authorization of its COVID-19 vaccine for kids 6 months to 5 years old.

Beyond the direct effects of COVID-19 infections on children are the psychosocial and mental health effects of the pandemic. Isolation and socioeconomic stressors on families affect children, too.

"One in 6 children has sought mental health services in the past two years," says is Dr. James Gaensbauer, a pediatric infectious diseases physician at Mayo Clinic Children’s Center. "The American Academy of Pediatrics has declared a mental health emergency during this pandemic."

Dr. Gaensbauer points out it is important for parents to keep an open dialogue and be empathetic with kids about their fears and anxieties. Resources are available to help families, including the Mayo Clinic Family Stress Resource Center. 

On the Mayo Clinic Q&A podcast, Dr. Gaensbauer joins Ask the Mayo Mom host Dr. Angela Mattke to discuss how children and their families have been affected by the COVID-19 pandemic. 

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Each February, Black History Month is celebrated to recognize the important role Black people have played in U.S. history. 

"Black history is American history, and everyone should celebrate our history 365 days a year," explains Dr. Folakemi Odedina, a Mayo Clinic prostate cancer scientist and global health equity researcher.

This year's theme for Black History Month is "Black Health and Wellness." This theme acknowledges the legacy of Black scholars and medical practitioners. 

"It is really about time that we focus on Black health and wellness because our community is disproportionately experiencing health disparities," says Dr. Odedina. "We have to recognize that there are multiple dimensions of wellness."

According to Dr. Odedina, dimensions of health and wellness include physical, mental, emotional, intellectual, spiritual and environmental, and social health. 

On the Mayo Clinic Q&A podcast, Dr. Odedina discusses the factors responsible for health disparities in the Black community and shares how her work supports health and wellness for Black people.

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Integrative medicine uses an approach to health care that includes practices not traditionally part of conventional medicine, such as herbs, acupuncture, massage, yoga and meditation. Integrative oncology incorporates these therapies into conventional cancer care.

Integrative oncology helps people with cancer feel better by reducing the fatigue, nausea, pain and anxiety and other symptoms that come with cancer and cancer treatment.

"Integrative oncology is a practice where we are using lifestyle medicine," explains Dr. Stacy D'Andre, a Mayo Clinic medical and integrative oncologist. "We combine all of these modalities to help our cancer patients, not only with the quality of life, but also to hopefully improve outcomes as well."

Focus on diet, exercise and sleep are important parts of integrative medicine, and can help patients during each stage of their journey. This includes managing symptoms and treatment side effects. 

"The great thing about this type of practice is that it really empowers the patient, and patients become very active in their care," says Dr. D'Andre. "And because they're the ones doing the work — they're working on their die and they're doing the exercise — we're just guiding them. These are things that they can do and they can control to improve their health and outcomes."

On the Mayo Clinic Q&A podcast, Dr. D'Andre explains how integrative oncology helps people with cancer and discusses integrative medicine research underway at Mayo Clinic.

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The retina is a thin layer of tissues, cells, and nerves that line the back wall inside the eye.  This layer has millions of light sensing cells that receive and organize visual information according to the Mayo Clinic.

On this Ask the Mayo Mom edition of the Q&A podcast, host Dr. Angela Mattke is joined by Dr. Brittni Scruggs, an ophthalmologist at Mayo Clinic Children’s Center. Dr. Scruggs is a physician, surgeon, and scientist with a research laboratory at Mayo Clinic studying gene therapy and stem cell therapy for retinal degenerations, including for children. 

She treats all ages, ranging from newborns to adults. Dr. Scruggs is a member of the national workgroup developing ACMG evidence-based guidelines for diagnosis and clinical management of inherited retinal diseases.
Dr. Mattke and Dr. Scruggs explore retinal issues in children and discuss eye safety and health. 

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A congenital heart defect means that a child was born with a problem in the structure of his or her heart.

Some congenital heart defects in children are simple and don't need treatment. Others are more complex and may require several surgeries performed over a period of several years.

Improvements in imaging, monitoring and surgical techniques have improved outcomes for pediatric heart surgery patients. 

A prenatal diagnosis is scary for parents, but support and care from the cardiology team continue through the child's life and on into adulthood. And support from others, including patient organizations, also helps.

"It can feel like you're alone, especially if the diagnosis is new," says Dr. Elizabeth Stephens, a pediatric cardiovascular surgeon at Mayo Clinic. "It can feel very daunting. But there are many families out there who are not just dealing with congenital heart disease, they're thriving with it. These kids are incredibly resilient."

On the Mayo Clinic Q&A podcast, Dr. Stephens joins Ask the Mayo Mom host Dr. Angela Mattke for a discussion on congenital heart defects and new treatment options.

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The number of new COVID-19 cases in the U.S. is dropping as the omicron wave wanes in many places, but some parts of the country lag behind.

"As a nation, it looks like we've kind of gotten to the peak and are now starting on the decline, but it's very uneven," explains Dr. Gregory Poland, head of Mayo Clinic's Vaccine Research Group. "That's what's happening in the big Northeast cities, and maybe in L.A., for example. But if you look at the rest of the nation, it's not clear that they have peaked yet."

And on the heels of the latest surge, a new omicron subvariant — BA.2 — is emerging. Early indications are that the new subvariant may be more transmissible, but it does not appear to cause more severe disease than the original omicron strain.

Mayo experts, including Dr. Poland, continue to urge COVID-19 vaccinations and boosters as the best defense against the latest variants. 

"By getting two doses of vaccine and a booster, or a dose of Johnson & Johnson and a booster, you move yourself into a category of maximal protection such that if you have a normal immune system, you are probably going to have trivial or even asymptomatic disease if you get infected with COVID-19," explains Dr. Poland. 

On the Mayo Clinic Q&A podcast, Dr. Poland discusses the latest information on COVID-19 and answers listener questions.

Research disclosures for Dr. Gregory Poland.

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Treatment advances have increased lymphoma survival rates. But life after treatment for lymphoma can be complicated. 

"It's a really good problem to have, if you will, on how to manage some of these short- and long-term effects of lymphoma treatment," explains Dr. Carrie Thompson, a Mayo Clinic hematologist. "As we effectively treat more and more patients, we have more and more patients surviving and more and more patients living with chronic lymphoma, as well."

Lymphoma is a cancer of the lymphatic system, part of the body's germ-fighting network, which includes the lymph nodes, spleen, thymus gland and bone marrow. Lymphoma can affect those and other organs throughout the body. 

Of the many types of lymphoma, the main subtypes are Hodgkin's lymphoma and non-Hodgkin's lymphoma. Lymphoma treatment is based on the type and stage of the disease, and the goal of treatment is to destroy as many cancer cells as possible and bring the disease into remission. 

Lymphoma survivors need to be monitored for cancer recurrence. Some lymphoma treatments, such as chemotherapy and radiation, can put patients at risk of developing a secondary cancer. 

"The No. 1 concern patients have is really the risk of relapse," says Dr. Thompson. "Once somebody has been through treatment, they certainly don't want to don't want to be faced with having to do that all over again. The fear of recurrence sometimes spills over to really being very appropriately vigilant about all health issues and finding that balance between watching for symptoms that may suggest recurrence versus living without uncertainty and a comfortable way to move forward from what's been a really challenging part of somebody's life."

On the Mayo Clinic Q&A podcast, Dr. Thompson discusses what people can expect after treatment for lymphoma and how to achieve the best quality of life.

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Despite treatments that include medications, surgery and neurostimulation devices, many people with epilepsycontinue to have seizures. And the uncertainty of when a seizure could occur affects their quality of life. 

But what if these people could anticipate a seizure and take action? A recent Mayo Clinic study tested a technology to do just that. 

"One of the most disabling aspects of seizures is the unpredictability," says Dr. Benjamin Brinkmann, a Mayo Clinic epilepsy scientist. 

The study found patterns could be identified in patients who wore a special wristwatch, allowing about 30 minutes of warning before a seizure occurred. This worked well most of the time for five of six patients studied.

The next step is a larger research study and collecting more data.

"We are putting in for funding to do a larger study and we will spend some time and effort improving our algorithms," says Dr. Brinkmann. "One of the things in this new era that we live in with AI (artificial intelligence) and machine learning is that data is king. We really need to collect lots of data so we can train our algorithms to find these subtle signals."

On the Mayo Clinic Q&A podcast, Dr. Brinkmann discusses how seizure forecasting might help patients in the future.

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Testing for COVID-19 is a part of the strategy to end the pandemic. But understanding testing — different types of tests and how and when to use them — can be confusing. Lab-run polymerase chain reaction, or PCR, tests and at-home antigen tests each have a role.

"PCR tests are really sensitive, meaning we can detect really low levels of the virus in a sample," explains Dr. Matthew Binnicker, director of Clinical Virology at Mayo Clinic. "They're very specific, meaning we shouldn't get many false positive results with PCR tests."

At-home antigen tests use a nasal swab and can produce results in 15 minutes, but they also have an increased chance of false-negative results, depending on when you test. 

"At-home rapid antigen tests look for a viral protein in the patient sample," says Dr. Binnicker. "So they're quick and easy, but they also have some important limitations."

So if you're worried you might have COVID-19, what test should you take and when? 

On the Q&A podcast, Dr. Binnicker walks through various scenarios and makes testing recommendations for what to do if:

• You think you’ve been exposed but I don’t have symptoms.
• You have symptoms of COVID-19.
• You had COVID-19 and want to know if you're “in the clear” to return to work, school or activities.

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Nationwide, there is a trend in orthopedic surgery to move total joint arthroplasty, commonly known as joint replacement, from inpatient to outpatient surgery. Patients benefit from the shorter hospital stay, and they are more satisfied recovering in the comfort of their own home.

At Mayo Clinic, physicians from orthopedics and anesthesiology have been working together on this initiative as part of the OASIS project. Oasis stands for Orthopedic Surgery and Anesthesiology Surgical Improvements.

"This is a team approach to practice optimization," explains Dr. Hugh M. Smith, a Mayo Clinic anesthesiologist. "One of our first targets was to try to bring down that length of stay." 

A decade ago, a patient who had a knee replacement or hip replacement would likely stay in the hospital for a week, says Dr. Smith. Even four years ago, the average hospital stay was around four days. Now some patients are able to go home the same day.

"It's a patient satisfier," says Dr. Matthew Abdel, a Mayo Clinic orthopedic surgeon. "You recuperate with your family. You recuperate in your own home environment. You don't feel like you're institutionalized. You feel like you're a part of a well model of care, not a sick model."

On the Mayo Clinic Q&A podcast, Drs. Abdel and Smith discuss the OASIS project and outpatient arthroplasty.

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Chest wall deformities are structural abnormalities in the chest. While present since birth, chest wall deformities might not become noticeable until children hit their adolescent growth spurt. 

The most common chest wall deformity, pectus excavatum, is a sunken breastbone that can be repaired with surgery. Another deformity, pectus carinatum, causes the breastbone to protrude out. It is typically treated with bracing. A third, difficult-to-diagnose condition, is slipped rib syndrome. This occurs when cartilage grows abnormally and the ribs rub together, causing nerve pain. Medical and surgical options can be used to treat slipped rib syndrome.

On the Mayo Clinic Q&A podcast, a special edition of "Ask the Mayo Mom" focuses on chest wall deformities in children. Dr. Angela Mattke a Mayo Clinic pediatrician and host of "Ask the Mayo Mom" is joined by Dr. Denise Klinkner, a pediatric surgeon and practice chair of the Division of Pediatric Surgery at Mayo Clinic, and Dr. Stephanie Polites, who is also a pediatric surgeon at Mayo Clinic Children’s Center.

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With the highly transmissible omicron variant spread across the U.S., it may seem inevitable that most people will get infected with COVID-19. But Mayo Clinic experts explain why it is important to continue to be vigilant and take measures to avoid COVID-19 infection. 

"One of the many negatives about saying, 'Well, I'll just go ahead and get infected and get it over with' is you can spread the virus to highly vulnerable people," says Dr. Gregory Poland, head of Mayo Clinic's Vaccine Research Group. "Parents, grandparents, people too young to be immunized, and people whose immune systems might not be working well are all at risk of more severe disease. While your case may be mild, theirs may not." 

Dr. Poland cautions that the sheer number of infections is stressing the health care system, and treatments for omicronare more limited than they were for the delta variant.

"The role of testing and of getting boosted is critical to our response to this, and remember, even though you might have mild disease, every time this virus infects somebody, it is the opportunity for further mutation." says Dr. Poland. 

Vaccination, boosting and masking are all necessary to prevent the spread of omicron.

"Your best chance of protecting yourself is to be fully vaccinated, wear a proper mask properly when in public, and to avoid crowded indoor settings," says Dr. Poland. 

On the Mayo Clinic Q&A podcast, Dr. Poland discusses the omicron surge and answers listener questions.

Research disclosures for Dr. Gregory Poland.

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Patient advocacy and support organizations play an important role for patients suffering with diseases or conditions. The goal of these groups is to connect members with others who may be in similar situations and locate resources to manage or treat their condition. But patients aren't the only ones who benefit from these connections. Physicians and researchers also can benefit from getting involved. 

"Taking care of patients is my passion," says Dr. A. Noelle Larson, a Mayo Clinic orthopedic surgeon. "So it really comes naturally to be interested and involved in my patients' lives."

Dr. Larson's clinical and research focus is scoliosis. She has become involved with Curvy Girls Scoliosis, a global support group. Two years ago, she attended their national meeting. Spending time with families and children affected by scoliosis gave Dr. Larson a new perspective.

"So often, our encounter in clinic is quite short, and you don't get a sense of the impact of what our treatment has on that child's overall life and well-being," explains Dr. Larson. "These patients know more about living with their condition than the physician does at some level."

Beyond the connections patients and physicians make, the medical community benefits in other ways, as well. Support groups can help organize and inform patients about clinical trials that can lead to innovation.

Dr. Larson has seen this in her own practice. Feedback from patients led to a Mayo Clinic study on vertebral body tether implant as a surgical alternative to fusing the spine.

"That partnership between the families, the patients, and the researchers and doctors, all working together is really critical," says Dr. Larson.  "If we really want to make new drugs, new devices, and new treatments, we all have to work together. Because at the end of the day, we all want to get to the same place, which is better care for patients." 

On the Mayo Clinic Q&A podcast, Dr. Larson discusses the role of advocacy groups and the patient-physician connection.

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Whether a chronic condition affects your quality of life, or you have bad habits you'd like to change, a health and wellness coach could help. At Mayo Clinic, wellness coaches are board-certified professionals trained to help patients develop skills and tools to improve their well-being. 

"When we're focusing on well-being, intention, accountability and commitment are all important concepts," says Dr. Moain Abu Dabrh, a Mayo Clinic integrative medicine physician and board-certified health and wellness coach. "What is our motivation to make this change? What is the outcome we desire? And then, an important step is to create accountability to making that change."

Health and wellness coaches partner with patients, using evidenced-based strategies to help them identify their vision to live their best life. 

"Health coaching is still a relatively new process, and it has been integrated into our practice because we believe that a patient's life is still a person's life," says Dr. Abu Dabrh. "We don't just focus on illness care. We need to look at the 360-degree view, including illness and wellness care."

On the Mayo Clinic Q&A podcast, Dr. Abu Dabrh discusses how health coaching can help patients reach their goals.

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Acute myeloid leukemia (AML), also called acute myelogenous leukemia, is a cancer of the blood and bone marrow, the spongy tissue inside bones where blood cells are made. The disease progresses rapidly, affecting a group of white blood cells called myeloid cells, which normally develop into mature red blood cells, white blood cells and platelets. 

"There are acute and chronic leukemias, explains Dr. James Foran, an oncologist at Mayo Clinic. "The chronic ones tend to happen slowly over many years. You can watch it for a period of time until it really becomes active. The acute leukemias come on more quickly and cause people to get sick more quickly. Hence, the word acute."

AML occurs when a bone marrow cell develops mutations in its DNA that cause the cell to continue growing and dividing. When this happens, blood cell production becomes out of control. The bone marrow produces immature cells that develop into leukemic white blood cells called myeloblasts. These abnormal cells are unable to function properly, and they can build up and crowd out healthy cells.

Signs and symptoms of AML include:

• Fever
• Bone pain
• Lethargy and fatigue
• Shortness of breath
• Pale skin
• Frequent infections
• Easy bruising
• Unusual bleeding

Treatment of acute myeloid leukemia depends on several factors, including the subtype of the disease, and a person’s age and overall health. 

At the time of diagnosis, a bone marrow biopsy is performed, and testing is done to determine the subtype of AML. Genetic testing on leukemia cells helps oncologists plan treatment that will give patients the highest chance of remission.

"There have been massive advances in the last five or seven years," explains Dr. Foran. "We understand that almost everybody with acute myeloid leukemia will have some genetic abnormality in the leukemia cells. Some mutations predict for a lower remission rate with standard chemotherapies. Those are situations where we're looking for new therapies that would be more effective, new strategies — whether that's an immune treatment, a targeted therapy, a different type of chemotherapy. So those mutations really helped guide us on how to apply the new strategies." 

Dr. Foran says Mayo Clinic is a leader in ongoing research and clinical trials to refine and improve targeted and immune therapy treatments. New approaches include expanding the use of bone marrow transplants and using CAR-T cell therapy. 

"Mayo Clinic is in the front of the field, I believe. We're studying more targeted treatments to go after cells with mutations, to try to spare side effects, and get the most benefit in treating leukemia," he says. "We're continually and actively looking for new strategies to improve outcomes for patients."

On this Mayo Clinic Q&A podcast, Dr. Foran discusses acute myeloid leukemia, including the latest research and advances in treatments.

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Information about COVID-19 changes rapidly. While the internet can be a great source of information, the spread of COVID-19 misinformation has made it difficult for consumers to decipher fact from fiction. How do you know if the information you find online is accurate? 

"People often get their news from social media," says Dr. Melanie Swift, a Mayo Clinic preventive medicine physician. "And that's probably the worst way to get your news, because you get a mix of valid information, opinion and, frankly, propaganda."

When evaluating information online, the surgeon general recommends a quick health misinformation checklist: 

• Did you check with the Centers for Disease Control and Prevention (CDC) or the local public health department to see whether any information is available about the claim being made?
• Did you ask a credible health care professional, such as your health care professional, if they have any additional information?
• Did you type the claim into a search engine to see if it has been verified by a credible source?
• Did you look at the About Us page on the website you're referencing to see if you can trust the source?
• If you’re not sure, don’t share.

Dr. Swift urges people seek to out reliable sources for scientific information. " The CDC, the National Institute for Allergy and Infectious Diseases (a branch of the National Institutes of Health), and Mayo Clinic and other academic medical centers, maintain websites that can be trusted sources for COVID-19 information," says Dr. Swift.

On the Mayo Clinic Q&A podcast, Dr. Swift offers tips for finding credible health information online.

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While the rate of cervical cancer has been declining for decades in the U.S., health disparities persist. Hispanic women have the highest incidence rate of cervical cancer, followed by non-Hispanic Black women, according to the American Cancer Society. And Black women are more likely to die from the disease than women of any other race or ethnicity. 

"Race is a social construct. There really isn't a genetic difference that is causing Black women to, unfortunately, die at higher rates of cervical cancer," explains Dr. Olivia Cardenas-Trowers, a Mayo Clinic urogynecologic surgeon and women's health provider. "It really has to do more with the historical background of racism and systemic racism. These disparities have infiltrated the health care system and have affected these women's access to resources, and therefore some of the health care that they need. And this trickles down into poor outcomes, essentially."

Disparities that affect a women's access to health care can include transportation, health literacy and trust in their health care provider. 

Dr. Cardenas-Trowers says addressing barriers to health care is key, so that all women, including Black women, receive regular routine screening. Screening helps identify cancer early, which leads to better outcomes. 

"It's important to address the factors that lead to poor outcomes for Black women — making sure that they have support and access to screening, access to the results, and resources if any follow up or intervention is needed," says Dr. Cardenas-Trowers.

On the Mayo Clinic Q&A podcast, Dr. Cardenas-Trowers discusses why disparities exist and what Black women can do to reduce their risk of cervical cancer.

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A hernia occurs when a part of the intestine pushes through a weak spot in the stomach muscles. A hernia creates a soft lump or bulge under the skin.

In children, hernias usually occur in one of two places: 

• An inguinal hernia occurs in the groin area. 
• An umbilical hernia occurs near the belly button. 

Inguinal hernias in newborns and children result from a weakness in the abdominal wall that's present at birth. Sometimes the hernia will be visible only when an infant is crying, coughing or straining during a bowel movement. 

An inguinal hernia isn't necessarily dangerous, but surgery may be recommended to fix an inguinal hernia that's painful or enlarging. Inguinal hernia repair is a common surgical procedure and can be performed as an open or minimally invasive procedure. 

Umbilical hernias are most common in infants, but they can affect adults as well. In an infant, an umbilical hernia may be especially evident when the infant cries, causing the bellybutton to protrude. This is a classic sign of an umbilical hernia.

Children's umbilical hernias often close on their own in the first two years of life, though some remain open into the fifth year or longer. Umbilical hernias that appear during adulthood are more likely to need surgical repair.

On this edition of the Mayo Clinic Q&A podcast, Dr. Angela Mattke, a Mayo Clinic pediatrician and host of "Ask the Mayo Mom," discusses treating hernias in children with Dr. Stephanie Polites, a pediatric surgeon in the Mayo Clinic Children’s Center.

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The rapid spread of COVID-19 due to the omicron variant continues, and experts expect a January surge across the U.S. 

"This is spreading unlike anything we've seen in the U.S.," says Dr. Gregory Poland, head of Mayo Clinic's Vaccine Research Group.  "Over the last seven days, we're now averaging about 400,000 or so new cases a day."

While people who are fully vaccinated can get breakthrough infections and spread the virus to others, COVID-19 vaccines effectively prevent severe illness. Mayo Clinic experts urge people to protect themselves by getting vaccinated and wearing a mask. Being fully vaccinated, including getting a booster when eligible, offers the highest protection possible against COVID-19. 

"The good news is, for those who are immunized and boosted, we are winning the battle," says Dr. Poland. "Getting immunized is basically a weapon against this virus."

On the Mayo Clinic Q&A podcast, Dr. Poland discusses the omicron surge and the importance of vaccines and boosters for COVID-19.

Research disclosures for Dr. Gregory Poland.

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Blood donations typically drop off around the holidays, making National Blood Donor Month in January and important time to share the message about saving lives by giving blood. The COVID-19 pandemic also has affected blood donations.

"The COVID-19 pandemic has really had an adverse effect on us recruiting and collecting blood donors in general," says Dr. Justin Juskewitch, associate medical director of Mayo Clinic Blood Donor Services. 

Millions of people need blood transfusions each year. Some may need blood during surgery. Others depend on it after an accident or because they have a disease that requires blood components. Blood donation makes this possible. 

"The inventory of today was the donations of yesterday," explains Dr. Juskewitch. "So paying it forward is also a really great way of helping take care of others. And then those others will be there for you when you meet your time of need. It's a great way to start the new year."

On the Mayo Clinic Q&A podcast, Dr. Juskewitch discusses how to become a blood donor.

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As 2021 comes to a close, the Mayo Clinic Q&A podcast looks back at the impact of COVID-19 over the past year. 

"I think the thing that I look back on is the amazing speed with which science moved," says Dr. Gregory Poland, head of Mayo Clinic's Vaccine Research Group. "When this all began in 2020, COVID-19 was absolutely blank slate. Now we have three vaccines in the U.S., and antiviral and monoclonal antibody treatments. That's really incredible."

Despite the rapid scientific advancements, the U.S. still reached a grim milestone of 800,000 deaths from COVID-19 and more people died of the disease in 2021 than in 2020. 

COVID-19 has affected all aspects of life including the way people live, work, and go to school.

"It has been a profound wake-up call. I think we've developed an awareness of how fragile life and human health is. I think good things will come out of this," reflects Dr. Poland. 

On the Mayo Clinic Q&A podcast, Dr. Poland joins host Dr. Halena Gazelka, a Mayo Clinic anesthesiologist, for a COVID-19 pandemic year in review.

Research disclosures for Dr. Gregory Poland.

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Treatment for certain cancers can affect sexuality, causing a range of signs and symptoms that can make sex more difficult. 

Sexual side effects from cancer treatment are common for men and women. Cancer in their pelvic area, including bladder, prostate, rectal, cervical, vaginal or vulvar cancer, can make it difficult to resume sex after treatment. 

"A surgical procedure, especially to the pelvis, can really impact the nerve endings and pelvic muscles that are directly involved in our sexual response," explains Dr. Jennifer Vencill, a Mayo Clinic psychologist and sex therapist. 

Chemotherapy and radiation also can have direct effects on sexual function. Other cancer treatment effects on sexuality may be less direct.

"We see these as a cascade effect of treatment," says Dr. Vencill. "This commonly comes up with loss of libido or decreased desire for sexual activity that could be indirectly related to anything from fatigue to nausea because of chemotherapy to body image concerns. Loss of libido could also be related to pain that has come from a surgery. We see these indirect effects often with our patients."

Having cancer also affects emotions. For instance, people with cancer may feel anxious and worn out about their diagnosis, treatment or prognosis. These emotions also can affect their attitude toward sex and intimacy with a partner.

Dr. Vencill explains that feelings of stress, anxiety and depression are common for cancer patients and their families. 

"In general, psychological and emotional stresses are barriers to sexual health. Of course, cancer and cancer treatment are a major life stressor," says Dr. Vencill.

Dr. Vencill suggests that patience, exploration and support are key to sexual health after cancer.

On the Mayo Clinic Q&A podcast, Dr. Vencill discusses how cancer and cancer treatment can affect sexuality and why it is important to be your own advocate.

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Racial equity in health care has been a topic of discussion in recent years, and the COVID-19 pandemic has highlighted many inequities in the health care system. 

Racial and ethnic minority groups are being disproportionally affected by COVID-19, due to a long list of factors.

"Race is a particularly important aspect of COVID-19 in terms of diagnosis and treatment, mainly because people of color and people of ethnic minorities are often in jobs that make it harder for them to access health care," says Dr. Abinash Virk, a Mayo Clinic infectious diseases physician. "They may also have difficulty accessing testing. Therefore, there's a delay diagnosis."

The Centers for Disease Control and Prevention defines social determinants of health as the conditions in the places where people live, learn, work, play and worship that affect their health risks and outcomes.

Dr. Virk explains that community engagement is an important step to developing trust and improving equity in health care.

"As healthcare providers, it's important for us to listen to people's individual concerns and to continue to educate people with scientific, nonbiased information so they can believe in us," says Dr. Virk. "What we've found through the COVID-19 pandemic, particularly through the vaccination program that we've had over the last year, is that community engagement has been really important in terms of getting people to understand how COVID-19 affects them and how they can mitigate their risk." 

On the Mayo Clinic Q&A podcast, Dr. Virk discusses racial and gender equity during the COVID-19 pandemic.

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For people with epilepsy and movement disorders such as Parkinson's disease, electrical stimulation of the brain can be part of their treatment. 

"Many of the diseases that we think about as neurological diseases are diseases of circuitry in the brain," says Dr. Kai Miller, a Mayo Clinic neurosurgeon. "And one way we can interact with those circuits in order to have patients have improvement in their symptoms is to use electrical stimulation." 

Brain stimulation treatment also may help people with psychiatric illness and direct brain injuries, such as stroke. But understanding how brain networks interact with each other is complicated. To improve and expand treatment options, Mayo Clinic and Google Research are using artificial intelligence (AI) to develop a new algorithm to improve brain stimulation devices.

"Artificial intelligence is a set of mathematical and statistical tools that we can use to distinguish different types of brain measurements," explains Dr. Dora Hermes, a Mayo Clinic biomedical engineer and researcher on the project. "There is a lot we can do with artificial intelligence or machine learning tools. And in this case, we used it to distinguish different types of inputs to a particular brain area in an automated fashion." 

On the Mayo Clinic Q&A podcast, Drs. Miller and Dr. Hermes, first author and senior author on the AI algorithm study, respectively, discuss the use of artificial intelligence to improve brain stimulation treatments.

Read more about the work of Mayo Clinic and Google Research on AI and brain stimulation devices.

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Respiratory syncytial virus (RSV) causes infections of the lungs and respiratory tract. It's so common that most children have been infected with the virus by age 2.

RSV can cause severe infection in some people, especially premature infants, older adults, people with heart and lung disease, or anyone with a weak immune system.

In severe cases, RSV infection can spread to the lower respiratory tract, causing pneumonia or bronchiolitis — inflammation of the small airway passages entering the lungs. Signs and symptoms may include: 

• Congested or runny nose
• Dry cough
• Low-grade fever
• Sore throat
• Sneezing
• Headache

Treatment for RSV generally involves self-care measures, but hospital care may be needed if severe symptoms occur.

On the Mayo Clinic Q&A podcast, Ask the Mayo Mom host Dr. Angela Mattke, Mayo Clinic pediatrician, is joined by Dr. Jay Homme, a Mayo Clinic pediatrician, and Dr. Jim Homme, a Mayo Clinic pediatric emergency medicine physician, to discuss what parents and caregivers should expect for RSV and bronchiolitis this season.

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While we know that health affects longevity and quality of life, it can be difficult to change bad habits. People often try to make sweeping New Year's resolutions, only to fail.

In fact, Jan. 17 is the date that the average America breaks their New Year's resolution.

Dr. Stephen Kopecky, a Mayo Clinic preventive cardiologist, says a better approach is to focus on small steps that add up over time.

"The answer, I think, is to make small, sustainable steps that you can live with," says Dr. Kopecky "And when I say small steps, like for diet, I tell patients one bite, one bite of something healthy. Take some processed meat or foods off your plate, and put on something like a legume or a bean. After a couple of years, that one-bite difference will lower your risk of having a heart attack."

In his book, "Live Younger Longer: 6 Steps to Prevent Heart Disease, Cancer, Alzheimer's and More,"  Dr. Kopecky shares strategies for making changes, including thinking of a compass of habits:

• N — Nutrition
• E — Exercise
• W — Weight
• S — Sleep, stress, smoking and spirits (alcohol)

Healthy eating

Eating lots of fruits and vegetables provides antioxidants and anti-inflammatory nutrients that help the immune system fight infections. Dr. Kopecky recommends fruits, vegetables and healthy fats from olive oil and nuts, all found in the Mediterranean diet. 

Exercising

Regular moderate exercise increases the activity of virus-killing immune cells.

“Exercise has been shown to give the immune system a boost by maximizing the body's ability to take in and efficiently use oxygen, among other things,” says Dr. Kopecky. “Moderate exercise, where you can talk but not sing while exercising, is enough to increase the activity of virus-killing cells both in the short term and long term. Even 20 minutes daily can help quell inflammation and boost immunity, and exercise can be divided up during the day. The best part about exercise is that it can be done anywhere. Leg lunges, sit-ups, squats and stair-climbing are all easy exercises you can do at home."

Managing stress 

Calming activities and supportive relationships minimize stress, reduce cortisol production and enhance the immune system's function. "Concern about the health of our loved ones, our jobs, children's schooling and other stressors will cause an increased production of the hormone cortisol in the body, which in turn can suppress the immune system," says Dr. Kopecky. "Practicing mindfulness and stepping away from what's causing anxiety can help us stay grounded. Exercises that have calming or meditative qualities, such as qi gong and yoga, also are beneficial."

Getting enough sleep

Adequate sleep boosts the number of immune cells circulating in the body and improves infection outcomes. The interaction between the immune system and sleep is a two-way street. "When your immune system response kicks in, it changes your sleep,” explains Dr. Kopecky. “You may find yourself sleeping longer, for example, as your immune system stages an attack against a virus. When you're not sleeping well, you may notice that you get sick more easily. Getting adequate sleep can help support the way your immune system functions by increasing the number of immune cells circulating in your body." 

Making positive changes in these areas can help improve health and longevity.

"We cannot prevent aging. We can slow aging," says Dr. Kopecky. "But we can prevent disease. It's certainly possible to do. And if you adopt a certain healthy lifestyle, you can affect that."

On the Mayo Clinic Q&A podcast, Dr. Kopecky discusses developing healthy habits one small step at a time.

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More Americans are now eligible for COVID-19 booster doses as the Centers for Disease Control and Prevention approved the Pfizer vaccine booster for 16- and 17-year-olds late last week. Previously, only those 18 and older were eligible.

Early research suggests that a booster dose of the Pfizer COVID-19 vaccine improves protection against severe disease caused by the omicron variant, according to Pfizer.

Mayo Clinic experts say, regardless of the variant, prevention of infection works. Getting a booster offers the highest protection possible against COVID-19.

"Omicron infection rates are picking up rapidly," says Dr. Gregory Poland, head of Mayo Clinic's Vaccine Research Group. "If we do not take the proper precaution over the holiday, we are going to see a January omicron surge."

Dr. Poland explains that there are two threats — delta and omicron COVID-19 variants — but there is a solution. "Masking and boosting — those are key to protecting yourself and your family."

On the Mayo Clinic Q&A podcast, Dr. Poland discusses the latest on COVID-19 variants and shares advice on how to stay safe this holiday season.

Research disclosures for Dr. Gregory Poland.

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When it comes to itchy, red skin, it’s possible that psoriasis or atopic dermatitis, also known as eczema, could be the cause. 

"Psoriasis and eczema are both skin reactions to the inflammation or immune system coming to the skin and causing a reaction," says Dr. Dawn Davis, a Mayo Clinic dermatologist.

Psoriasis is thought to be an immune system problem that causes the skin to regenerate at faster-than-normal rates. This rapid turnover of cells results in scales and red patches.

Eczema results from irritants or allergens. It's common in children, but can occur at any age. And people with eczema often have other sensitivities, including asthma, hay fever or food allergies.

Both are long-term chronic conditions that don’t have a cure but can be treated. It is important for people with psoriasis or eczema to seek care to control flares-ups and improve their quality of life.

"Anticipate a lifelong relationship with your dermatologist or primary care provider so that we can take care of your skin over time and keep track of the treatment and management of your condition," explains Dr. Davis.

On the Mayo Clinic Q&A podcast, Dr. Davis helps explain the similarities, differences and treatments for psoriasis and eczema.

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While we know that health affects longevity and quality of life, it can be difficult to change bad habits. People often try to make sweeping New Year's resolutions, only to fail.

Dr. Stephen Kopecky, a Mayo Clinic preventive cardiologist, says a better approach is to focus on small steps that add up over time.

"The answer, I think, is to make small sustainable steps that you can live with," says Dr. Kopecky "And when I say small steps, like for diet, I tell patients one bite, one bite of something healthy. Take some processed meat or foods off your plate, and put on something like a legume or a bean. After a couple of years, that one-bite difference will lower your risk of having a heart attack."

In his new book, "Live Younger Longer: 6 Steps to Prevent Heart Disease, Cancer, Alzheimer's and More,"  Dr. Kopecky shares strategies for making changes, including thinking of a compass of habits:

• N — Nutrition
• E — Exercise
• W — Weight
• S — Sleep, stress, smoking and spirits (alcohol)

Making positive changes in these areas can help improve health and longevity.

"We cannot prevent aging.  We can slow aging," says Dr. Kopecky. "But we can prevent disease, it's certainly possible to do. And if you adopt a certain healthy lifestyle, you can affect that."

On the Mayo Clinic Q&A podcast, Dr. Kopecky discusses developing healthy habits one small step at a time.

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Most people who have COVID-19 recover completely within a few weeks. But some people — even those who had mild versions of the disease — continue to experience symptoms after their initial recovery. 

Sometimes called “long haulers” or “long COVID," these patients can have fatigue, shortness of breath, brain fog and other symptoms long after the time of their infection.

Post-COVID-19 syndrome conditions are generally considered to be effects of COVID-19 that persist for more than four weeks after you've been diagnosed with COVID-19 infection.

A recent Mayo Clinic study on post-COVID-19 symptoms found that more women than men suffer long-term effects. Women predominantly showed symptoms of fatigue, followed by muscle pain and low blood pressure, while men primarily experienced shortness of breath.

Research is also underway to better understand what may be causing post-COVID-19 syndrome.

"We do have some research now that shows that some of the cells that are used to create immunity after an infection, they may be malfunctioning in this condition in patients with long-haul COVID," says  Dr. Greg Vanichkachorn, director of Mayo Clinic’s COVID Activity Rehabilitation Program. "We also now have some research that shows that patients with this condition can have antibodies against themselves, otherwise known as an auto-antibody. And this may be associated with the long-haul COVID state, so immune dysfunction and auto immunity, they may be at play here."

The COVID Activity Rehabilitation Program at Mayo Clinic helps people experiencing post-COVID-19 syndrome by working with patients to decrease symptoms and improve overall functioning and quality of life. 

On the Mayo Clinic Q&A podcast, Dr. Vanichkachorn discusses how treatment can help patients who suffer from post-COVID-19 syndrome.

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After cancer treatment, cancer survivors are eager to return to good health. The right diet and nutrition can play a big role in improving long-term health so cancer survivors can enjoy the years ahead.

Diet and nutrition recommendations for cancer survivors are no different from the recommendations for anyone who wants to improve their health: Eat a balanced diet with an emphasis on vegetables, fruits and whole grains; drink alcohol moderately, if at all; and maintain a healthy weight.

"Both the American Cancer Society and the American Institute for Cancer Research recommend the same exact diet for cancer survivors that we recommend for cancer prevention," says Dr. Dawn Mussallem, a Mayo Clinic hematologist and oncologist. "A low fat-diet is recommended. That's a predominantly whole food, plant-based diet that is rich with vegetables; whole grains; colorful fruits; and things like beans, lentils, seeds and nuts. This is really the essential diet that's good for all health and health-related diseases, not just cancer." 

Maintaining a healthy weight is important to overall health, but some cancer survivors may struggle to maintain weight during and after treatment due to nausea or lack of appetite.

"For underweight patients, it is very important that they work with a dietician," says Dr. Mussallem. "These patients need healthy, high calorie-dense foods and they may need to eat smaller portions throughout the day."

On this Mayo Clinic Q&A podcast, Dr. Mussallem, discusses what cancer survivors should know about diet and nutrition.

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Having a baby born with a cleft can be upsetting, but cleft lip and cleft palate are among the most common birth defects, and both can be corrected.

Cleft lip and cleft palate are openings or splits in the upper lip; the roof of the mouth, or palate; or both. Cleft lip and cleft palate result when facial structures that are developing in an unborn baby don't close completely.

Treatment involves surgery or a series of surgeries to repair the defect and therapies to improve any related conditions. Treatment seeks to improve the child's ability to eat, speak and hear normally, and achieve a normal facial appearance.

On this edition of the Mayo Clinic Q&A podcast, Dr. Angela Mattke, a Mayo Clinic pediatrician and host of "Ask the Mayo Mom", discusses cleft lip and cleft palate with three Mayo Clinic Children’s Center experts: Dr. Samir Mardini, chair of the Division of Plastic and Reconstructive Surgery; Dr. Shelagh Cofer, a pediatric otolaryngologist and head and neck surgeon; and Dr. Waleed Gibreel, a craniofacial and pediatric plastic surgeon. 

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Omicron, a new COVID-19 variant of concern, has been detected in all regions of the world, including North America. While research and clinical observations on the new strain are underway, it is not yet known what impact, if any, omicron will have on the immune response, transmissibility, or specific COVID-19 treatments.

The emergence of omicron is a reminder to take important steps to protect yourself against COVID-19.

"The answer is masking and boosters," says Dr. Gregory Poland, head of Mayo Clinic's Vaccine Research Group. 

Dr. Poland is encouraged by vaccine booster rates in the U.S. "In a relatively short period of time, about 36% of adults who are eligible have indeed gotten a booster," says Dr. Poland. "There's plenty of vaccine available. So in the strongest possible terms, I would recommend getting that booster."

Adults who are six months past completing their initial Moderna or Pfizer COVID-19 vaccination series are eligible to receive a booster dose, as are adults who are two months past completing their initial dose of the Johnson & Johnson vaccine.

On the Mayo Clinic Q&A podcast, Dr. Poland discusses the omicron variant and COVID-19 boosters, and he answers some listener questions.

Research disclosures for Dr. Gregory Poland.

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November is Alzheimer's Disease Awareness Month, a time to raise awareness of the disease while recognizing the important work that caregivers do when caring for a loved one with Alzheimer's or dementia. 

Approximately 5.8 million people in the U.S. age 65 and older live with Alzheimer's disease. Of those, 80% are 75 and older. Of the approximately 50 million people worldwide with dementia, between 60% and 70% are estimated to have Alzheimer's disease.

For those living with Alzheimer's and their caregivers, common questions include: 

• When it comes to memory, what is typical aging? 
• What is the difference between Alzheimer's disease and other forms of dementia? 
• How can you keep your brain healthy? 

On the Mayo Clinic Q&A podcast, Dr. Jonathan Graff-Radford, a behavioral neurologist at Mayo Clinic, and Angela Lunde, an investigator in Mayo Clinic's Alzheimer's Disease Research Center — both co-authors of the second edition of "Mayo Clinic on Alzheimer's Disease and Other Dementias: A Guide for People With Dementia and Those Who Care for Them" — share stories of those living with dementia and offer practical advice for caregivers.

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At the age of 15, Justin Vigile was diagnosed with hypertrophic cardiomyopathy, a genetic condition that causes the muscles of the heart to thicken, making it difficult for the heart to pump blood. Vigile had a cardiac defibrillator placed, but over time, his heart began to fail. 

When looking for answers and help, Vigile and his family turned to Mayo Clinic. Thanks to science, research and an innovative procedure performed by the man who developed it, Justin got his life back. 

At Mayo, Dr. Hartzell Schaff, a cardiovascular surgeon, gave Vigile an alternative to heart transplant in the form of apical myectomy, a surgical procedure to relieve symptoms caused by the thickening of muscle in the apex of his heart. 

It's a procedure that Dr. Schaff developed at Mayo Clinic in 1996. Vigile feels grateful for the surgery and the surgeon. 

"Dr. Schaff changed my life, which is obvious. But it also changed the lives of my friends and family. I was able to meet the woman that I fell in love with. I've been able to pursue my dreams." Those dreams include writing music for NFL films and becoming a podcaster.

Now, almost 10 years later, Vigile and Dr. Schaff reunite on the Mayo Clinic Q&A podcast. Also on the program, Justin's podcast partner, Darrell Campbell, joins the conversation to talk about the Everyman Podcast and how they've found silver linings along the way.

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Ashley Evenson lived with a lifelong illness known as Cockayne syndrome that prematurely aged her. Ashley lived with her disease for 32 years before passing away in 2019.

Ashley received palliative and hospice care over the course of her life, and Ashley's mom, Lynn Evenson, wants people to know about the benefits of hospice care.

"To keep Ashley’s memory alive, I want to tell her story," says Evenson. "And I want to make it open to people to understand and learn what hospice is really about and how it can make a big difference — not just for the patient but for the caregiver, as well."

People are often confused about the difference between palliative care and hospice care. Palliative care is for anyone who has been diagnosed with a chronic illness. When a cure is not possible, a shift to hospice care can offer supportive measures for the patient and the family.

And an early referral to hospice can help everyone involved. 

"Hospice can provide so much care and comfort in all aspects of the end of life experience for both the patient and the family, says Jennifer Larson LaRue, a Mayo Clinic psychotherapist. "So it helps that very difficult, painful time go more smoothly, I think."

November is National Hospice and Palliative Care Month, a time to recognize the important work these programs do to help patients and their families when a cure is not possible. 

On the Mayo Clinic Q&A podcast, Larson LaRue joins Evenson, who shares her family's journey through illness and their wish to help educate others about the advantages of hospice care.

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Pituitary tumors are abnormal growths that develop in your pituitary gland. Pituitary tumors can cause too much or too little of the hormones that regulate important functions of your body to be produced. Most pituitary tumors are noncancerous growths called adenomas, which remain in your pituitary gland or surrounding tissues and don't spread to other parts of your body.

"It's very uncommon for any pituitary tumor to be a malignancy or what one would commonly think about as a cancer or something that would travel elsewhere," says Dr. Jamie Van Gompel, a Mayo Clinic neurosurgeon. "Almost all of these are benign tumors." 

Pituitary tumors are categorized as functioning or nonfunctioning, depending on if they are producing hormones.

The signs and symptoms of nonfunctioning pituitary tumors, those that don't make hormones, nonfunctioning are related to their growth and the pressure they put on other structures.

"Out of all pituitary tumors, about half of them aren't making any kind of a substance," explains Dr. Van Gompel. "And those are called nonfunctioning adenomas or tumors. And they cause problems by putting pressure on things nearby. So they'll either take up enough room where the pituitary gland is so that it doesn't function well, and you have to get medications to replace some of that function. Or you may start to lose vision. That's another very common presenting symptom with these. "

Pituitary tumors that make hormones, called functioning, can cause a variety of signs and symptoms depending on the hormone they produce.

"Functioning tumors cause distinct syndromes," says Dr. Van Gompel. "The three most common are prolactin-secreting tumors, Cushing's and acromegaly." 

Dr. Van Gompel explains overproduction of prolactin from a pituitary tumor can cause breast milk to develop in women, even when they aren't postpartum. In men, it often affects sexual function. 

In Cushing syndrome, the body creates too much cortisol. The hallmark signs of Cushing syndrome are a fatty hump between the shoulders, a rounded face, and pink or purple stretch marks on your skin. Cushing syndrome also can result in high blood pressure, bone loss and, sometimes, Type 2 diabetes. 

Acromegaly is a hormonal disorder that develops when the pituitary gland produces too much growth hormone during adulthood, causing bones to increase in size. In childhood, this leads to increased height and is called gigantism. But in adulthood, a change in height doesn't occur. Instead, the increase in bone size is limited to the bones of the hands, feet and face.

There are various options for treating pituitary tumors, including removing the tumor, controlling its growth and managing your hormone levels with medications. 

Surgery often is needed if a pituitary tumor is pressing on the optic nerves or if the tumor is overproducing certain hormones. Most often, surgery is done endoscopically through the nasal cavity. The neurosurgeon removes the tumor through the nose and sinuses without an external incision. No other part of the brain is affected, and there's no visible scar.

Mayo Clinic is one of the largest pituitary centers in the U.S., evaluating and treating more than 1,600 people with pituitary tumors every year. Dr. Van Gompel explains that being treated at a referral center that sees a high volume of pituitary tumors is important.

"Here at Mayo, we have huge expertise, and a group of people that know how to manage these adenomas," explains Dr. Van Gompel. "We're fortunate to have excellent colleagues in neuroradiology because the imaging matters to help locate the tumors. We also have a team of endocrinologists who focus specifically on treatment and management of pituitary tumors. And we have surgeons, like me, who focus on adenomas. We're constantly working together studying our outcomes to make sure they're as good, if not better, than they were last year, to improve care for our patients." 

On the Mayo Clinic Q&A podcast, Dr. Van Gompel discusses options for treating pituitary tumors.

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When a baby needs surgery, parents may be worried about how general anesthesia will affect their child. In place of general anesthesia, Mayo Clinic is using spinal anesthesia in some pediatric urology surgeries. 

The advantages of spinal anesthesia include a less time in the operating room and a quicker postop recovery. And since children are never fully sedated, they can feed or eat as soon as they return to the recovery room.

Before surgery, numbing cream is used and preop medication is delivered to the child through the nose. Spinal anesthesia is given using a needle into the patient’s back. This numbs and blocks movement below the belly button. 

Because spinal anesthesia only lasts no more than two hours, it is being used for shorter urologic procedures. During the surgery, the child's oxygen, temperature and blood pressure are monitored closely.

On the Mayo Clinic Q&A podcast, Dr. Candace Granberg, a pediatric urologist and surgeon-in-chief of Mayo Clinic Children's Center, and Dr. Dawit Haile, chair of the Division of Pediatric Anesthesia at Mayo Clinic, discuss spinal anesthesia for pediatric urologic surgeries.

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Cold weather, increased travel, waning immunity and the potential for new variants may serve up the perfect recipe for a holiday COVID-19 surge, according to Dr. Gregory Poland, head of Mayo Clinic's Vaccine Research Group.  

"I have consistently said what's very likely to happen as we get to the cooler weather and see the trends in travel is that we will have another surge," says Dr. Poland. "We're in this unusual situation where the pandemic is actually getting worse because humans don't want to believe that the pandemic is just as important now as it was a year ago."

In this Mayo Clinic Q&A podcast, Dr. Poland answers several listener questions and talks more about being vigilant against COVID-19 as the U.S. heads into a second winter with this coronavirus. He also addresses the recent news that wild deer have shown evidence of COVID-19 infection and what that might mean in the battle to eliminate the disease.

Research disclosures for Dr. Gregory Poland.

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Prostate cancer is the second most common cancer among men, but thanks to improvements in detection and treatment, the likelihood of surviving the diagnosis is good. Both the five-year and the 10-year survival rates for all stages of prostate cancer are 98%, according to the American Cancer Society. As a result, there more than 3.1 million men in the U.S. have been diagnosed with prostate cancer at some point. 

Living after a cancer diagnosis is often called "survivorship." The survivorship experience is different for every cancer survivor, but it's possible to predict some of what the survivor might experience based on the type of cancer. For example, both prostate cancer and its treatment can cause urinary incontinence and erectile dysfunction.

"I think survivorship is just a critical issue in prostate cancer management," says Dr. Matthew Tollefson, a Mayo Clinic urologist. "The location of the prostate is a factor, so many men are concerned about urinary function and sexual function, and to some extent bowel function, because these are all in the the general region of the prostate." 

After treatment, men may be hesitant to discuss their side effects or be self-conscious about sharing their feelings and worries. Health care providers can help.

"It's absolutely critical to have that discussion with your doctor, says Dr. Tollefson. "We have effective treatments to manage almost all the side effects that can come up, whether they be issues with body composition, or sexual function or urinary control. It's important to understand that that these are common things and recognize that your physician has likely heard this from many people before and really is well-equipped to help manage and get through some of the issues that that do arise."

On the Mayo Clinic Q&A podcast, Dr. Tollefson discusses what men can expect after treatment for prostate cancer and how they can improve their quality of life going forward.

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