The Pharmacist Answers Podcast

Avenleigh wants to know what is in our vitamins and why do we take them, so she asks the pharmacist!

Laryngitis Laryngitis, known as inflammation of the larynx, is the most common cause of hoarseness and voice loss. It is very common in viral infections, such as a cold, flu, or adenovirus. Acute laryngitis is caused by an illness, while chronic laryngitis may be a secondary symptom of another problem like acid reflux, smoking, or severe thrush. There is a lot of advice that goes around about what can "cure" laryngitis or get rid of hoarseness. Hydration is always key. Some of the other advice is more anecdotal. But above all, whatever you do for a hoarse voice, DO NOT WHISPER! Laryngopharyngeal Reflux Disease (LPRD) LRPD is a condition where stomach acid refluxes into and burns the vocal cords. It may or may not accompany GERD. It causes intermittent to chronic hoarseness, swallowing troubles, throat pain, or a constant sensation that something is stuck in your throat. Misuse and Overuse Misuse of your voice is defined as the inefficient use of your voice. It may stem from poor posture, poor breath support, or poor hydration. Overuse of your voice is defined as excessively loud or prolonged use of your voice. Lesions Vocal cord lesions are benign growths on the vocal cords that interfere with normal vibration. These can result from repeatedly prolonged periods of misuse or overuse. They will cause chronic hoarseness or sporadic voice-silencing. They come in three varieties and are all treatable: nodules, polyps, and cysts. Nodules require vocal rest and voice therapy and training to help make sure they don't happen again. Polyps and cysts require micro-surgery where the growth is removed, and then rest and therapy and training will follow. Hemorrhage If you have a sudden loss of voice after yelling, then it is possible a hemorrhage occurred. A hemorrhage is when blood vessels in the surface of the vocal cord burst and fill it with blood. COMPLETE REST is required until the blood is reabsorbed by the body. Paresis and Paralysis Paresis is the fancy word for weakness. Vocal weakness can occur during a viral infection or after neck or throat surgery. It can be temporary and strength will return on its own after a recovery period, or it can be permanent. Prolonged or permanent vocal weakness can be improved somewhat through therapy and training. Paralysis, on the other hand, is neurologically based, whether damage happened in the area of the brain that controls the voice and supporting structures, or the nerves in and around the larynx are damaged. This can also be temporary or permanent and is generally one-sided. Symptoms of a weakened or paralyzed vocal cord include noisy breathing - like something is hanging in the way of the air flow. And breathy talking - like when someone is trying to use their "sexy" voice and there's more air making noise than vocal vibrations. There is a surgical repair process that involves taking the working vocal fold and stretching it over so when it activates, it will still come in contact with the unmoving vocal fold. Callbacks Voice Thrush - Mouth Issues Connect with me Support us on Patreon Give us your Feedback Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits: Up In My Jam (All Of A Sudden) by - Kubbi https://soundcloud.com/kubbiCreative Commons — Attribution-ShareAlike 3.0 Unported— CC BY-SA 3.0 http://creativecommons.org/licenses/b...Music provided by Audio Library https://youtu.be/tDexBj46oNI

Notes coming soon!

Gag Reflex Basics The official name of your gag reflex is the pharyngeal reflex or laryngeal spasm. Trigger points for the gag reflex can be found on the roof of the mouth, back of the tongue, in the tonsil area, the uvula, and the back of the throat. The purpose of this reflex is to prevent objects from entering the throat that did not first progress through the normal swallowing process. It also helps prevent choking. Gag Reflex Progress When the reflex is triggered, the soft palate raises to close off the nasal passage. Then the pharyngeal muscles contract on both sides to try and force whatever made it too far down back up into the mouth. If the input is strong enough, it can also trigger vomiting (this is how vomiting is induced in eating disorders such a bulimia). Do you Gag? One in three people lacks a gag reflex, which means rather large things can enter their throats without triggering a reflex. This is possibly how sword-swallowing got its start. The other side of this coin is someone with a hypersensitive gag. They can have trouble swallowing large pills and large bites of food. Dentist visits and even neckties can trigger this unpleasant reflex. It can be a part of a larger issue, such as Sensory Processing Disorder or Autism. Or it can be a preconditioned issue due to a previous experience. In either case, speech or occupational therapy can be done and will include desensitizing areas of the mouth to touch. Other Protective Reflexes Bottom Line All of these reflexes are protective to prevent choking or improper ingesting of things. They can be damaged to different degrees during head trauma or stroke. But surprisingly, smoking causes the most damage to the protective reflexes on the pharynx. Callbacks Swallowing Mouth Parts Connect with me Support us on Patreon Give us your Feedback Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits: Up In My Jam (All Of A Sudden) by - Kubbi https://soundcloud.com/kubbiCreative Commons — Attribution-ShareAlike 3.0 Unported— CC BY-SA 3.0 http://creativecommons.org/licenses/b...Music provided by Audio Library https://youtu.be/tDexBj46oNI

Bad Breath Basics Halitosis, aka bad breath, can have many causes. Some bad breath you can prevent with the choices you make, but some bad breath can be a sign of a more serious issue or disease. Oral Health You should brush your teeth for at least 2 minutes twice a day, including the surface of your tongue, then rinse your mouth with an antibacterial mouthwash. Follow one of your brushing sessions with a good flossing. This allows you to get any food debris and bacteria build-up out of the way on a daily basis. You should see your dentist twice a year for a deep cleaning and a check-up on your overall oral health. Your dentist will be able to help you with bad breath issues that may stem from more complicated issues like cavities, gum disease, poorly-fitting dentures, or thrush. Dry mouth, whether due to your natural biology, medication side effects, or mouth-breathing, can lead to bad breath due to the imbalance of bacteria growth. Your Choices Smoking and other tobacco products can make your breath smell bad even when you are not actively using it. The foods you eat also affect the status of your breath. The compounds that cause eaten and digested foods to smell contain sulfur-based compounds. These include broccoli, cabbage, brussel sprouts, onions and garlic, coffee, and fish. The funny thing about these smelly compounds is that they can actually make your WHOLE BODY smell (including your breath as well as other exiting air) until they have passed all the way out of your body! Diseases Infections, such as bronchitis, pneumonia, and sinusitis, can lead to distinctive bad breath. Postnasal drip can lead to bad breath as well. Pharyngeal diverticula that trap old food bits can make your breath smell, as well as tonsil stones that are calcified debris trapped by the tonsils. Bad breath can also be indicative of acid reflux or GERD. Certain diseases that have telltale breath smells include diabetes, liver disease, and kidney disease. People with diabetes are at risk of a medical emergency known as Diabetic Ketoacidosis, in which a lack of insulin renders the body's cells unable to use the available sugar. The body starts burning fatty acids for energy and the waste product is ketones. Ketones cause the body to become very acidic. This leads to a rapid transfer of water (extracellular fluid rushes into the blood to try and neutralize and dilute the ketones and then the kidneys rapidly try to flush out the acidic fluid through the urine) which can lead to fatal dehydration. Clinicians are taught that people experiencing ketoacidosis may have fruity-smelling breath or breath that smells like acetone or nail polish remover. People with liver disease may have breath that smells musty or like a mildewing basement. And people with kidney disease may have breath that smells fishy or like urine or ammonia. Ammonia is a typical by-product that is released in urine. Someone with kidney disease may not be able to filter out the ammonia compounds effectively. Therefore, the ammonia compounds will circulate in the blood. Call Back Brush your tongue - Tastebuds Tonsil stones - Tonsils Pharyngeal diverticula - Dysphagia Connect with me Support us on Patreon Give us your Feedback Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits: Up In My Jam (All Of A Sudden) by - Kubbi https://soundcloud.com/kubbiCreative Commons — Attribution-ShareAlike 3.0 Unported— CC BY-SA 3.0 http://creativecommons.org/licenses/b...Music provided by Audio Library https://youtu.be/tDexBj46oNI

Dysphagia Basics Having difficulty swallowing or the inability to swallow is known as dysphagia. Symptoms of dysphagia include: Dysphagia by Phase There are several conditions that can affect each phase of the swallowing process. Oral Phase Dysphagia during the oral phase, or voluntary phase, can be caused by neurological conditions like Multiple Sclerosis, Muscular Dystrophy, advanced Parkinson's. Brain damage caused by trauma or stroke can also cause trouble swallowing in adults. Dysphagia in Kids Babies start out nursing or feeding through a bottle and their swallowing mechanism is reversed. A reverse swallow is when the tongue is thrust forward or out of the mouth to open the throat and allow food or drink down the esophagus. As children learn to eat solid food and drink from a cup, the swallowing procedure changes. Children can also have trouble swallowing, but the root causes are completely different. Premature birth, low birth weight, cleft lip or palate, and tongue or lip ties can lead to swallowing issues if not corrected with therapy. These issues can cause swallowing issues with the reverse mechanism as well as make it difficult to convert to a regular swallow. Children with low muscle tone are also more likely to stick with the reverse swallow because it is easier. Pharyngeal Phase Pharyngeal diverticula are pouches that form in the mucous membrane above the esophagus. These pouches can collect food particles that don't get swallowed. This can cause bad breath, as well as coughing, and constant throat-clearing because it feels like something is stuck in the throat. Esophageal Phase There are several swallowing issues that stem from the esophagus and esophageal phase. Dysphagia Risk The risk of dysphagia increases with age, mostly because the risk of the conditions that cause dysphagia increases with age as well. And while dysphagia can be very uncomfortable, the biggest concern is with the risk of aspiration, or breathing food or drink into the lungs, that leads to pneumonia. Call Back Swallowing Muscle Tone discussion - Accordion in Your Brain Connect with me Support us on Patreon Give us your Feedback Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits: Up In My Jam (All Of A Sudden) by - Kubbi https://soundcloud.com/kubbiCreative Commons — Attribution-ShareAlike 3.0 Unported— CC BY-SA 3.0 http://creativecommons.org/licenses/b...Music provided by Audio Library https://youtu.be/tDexBj46oNI

The 3 Phases of Swallowing Oral Phase This phase includes chewing and saliva mixing with the food to form a bolus (a little glob of mashed up food). Then the tongue moves the bolus towards the back of the mouth. The tongue starts by pressing against the hard palate behind the front teeth. Then the sides of the tongue raise up to also press against the hard palate inside the teeth. At this point, the bolus has nowhere to go except towards the back of the throat. Pharyngeal Phase The vocal folds in the larynx close to keep food out. The larynx also moves up as the epiglottis covers it to seal off the airway. Then the soft palate and uvula move up and close off the nasal passage So now there is only one way out. Esophageal Phase The bolus moves into the esophagus (because it is the only open path). The esophageal muscles contract from top to bottom (this waving, rhythmic muscle movement is called peristalsis) to push the bolus into the stomach. Swallowing Reflex There are sensory receptors in the pharynx and tongue that receive touch signals. When they are touched by a bolus, the signals are sent to the brain stem and the return signal results in involuntary and automatic movements of the larynx and epiglottis. This is a good thing since swallowing is a very rhythmic process and you want food and drink to continue going in the correct direction. This reflex cannot be triggered by sticking your finger in your throat. You are more likely to trigger a gag reflex that way. The voluntary steps of swallowing must be initiated before the involuntary portion of the process takes over. Weird Swallowing Scenarios How do you swallow with your mouth open? At the dentist, you are usually laying in the chair on your back and facing the ceiling. There are at least three tools and two hands in your mouth. Things in your mouth trigger saliva production. Also, generally one of the tools the dentist is using is emitting water. The natural reflex when you have to hold your mouth open for a long time is to bring the back of the tongue and the soft palate together. This seals off the throat and allows you to still breathe through your nose. The liquid in your mouth plus gravity creates a puddle at the seal of your tongue and soft palate. Because the touch sensors to trigger your swallowing reflex are also in this area, it is likely you begin to panic because if they don't hurry and use the suctioning straw to remove the liquid, you're going to swallow! Do you swallow in your sleep? A study was done to find that the only times you swallow while sleeping is during arousal and during REM. My logical deduction regarding why is that when you're aroused or in one of the more shallow phases of sleep, that is when you can voluntarily move - roll over, adjust the bedding, and swallow. During REM sleep, most people will experience sleep paralysis, so whatever exciting things are happening in their brain, the body is not likely to act it out. Because the brain cannot tell if a dream is real or imaginary, the feeling solicited can trigger hormones secretions and saliva production. Increased saliva, just like in the dentist scenario, can trigger swallowing. Connect with me Support us on Patreon Give us your Feedback Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits: Up In My Jam (All Of A Sudden) by - Kubbi https://soundcloud.com/kubbiCreative Commons — Attribution-ShareAlike 3.0 Unported— CC BY-SA 3.0 http://creativecommons.org/licenses/b...Music provided by Audio Library https://youtu.be/tDexBj46oNI

What is a Tonsillectomy? A Tonsillectomy is a surgical procedure to remove the tonsils. Tonsil - immune system tissue in the back of the throat. -Ectomy = to remove something from the body. Removing the tonsils may be required if chronic tonsilitis is a problem. Chronic tonsilitis is defined as multiple infections in a row or an infection lasting 3 months or longer. Severe snoring and sleep apnea may be another reason to remove the tonsils, for the purpose of opening up the airway. Adenoids Adenoids are another set of immune system glands in the back of the nasal cavity. They can also swell during infections and interfere with breathing. Depending on the severity of the infections or the risk of sleep apnea, these may also be removed in the same or a similar procedure. Tonsillectomy Methods Since general anesthesia is used in all methods to remove the tonsils, no eating is allowed before the procedure. They also recommend no NSAIDs (non-steroidal anti-inflammatory drugs) are to be used before and after due to their ability to thin the blood and increase the risk of bleeding. In general, a tonsillectomy will take between 30 and 60 minutes. Recovery time afterward is estimated to be about two weeks. After the Tonsillectomy The side effects of a tonsillectomy include swelling of the throat, as well as the face and jaw, bleeding, and infection. To avoid the bleeding and infection, it is important to follow all the instructions given for the recovery period. Because of the swelling, cold foods like ice cream and popsicles are popular because cold things reduce swelling. Popsicles can also help with hydration because swallowing bigger sips or gulps of water can be painful the first few days. Hot foods are not recommended because the heat can increase the pain or reinjure the surgical site. And while ice cream is the most popular post-tonsillectomy food, any soft, non-abrasive foods are fine to eat. Why do adults have more issues than kids? Kids heal faster because they are still growing and developing. Kids also have smaller body parts than adults - the tonsils are smaller and the blood vessels are smaller. Smaller blood vessels clot and heal faster than larger ones. This is even true between the different sized blood vessels in your own body. And a factor no one wants to admit: adults are terrible at following directions and truly resting after a surgery or procedure. Rest is the best thing for a healing body of any age or size. Strep Carriers Generally, when we think of severe tonsilitis that leads to a tonsillectomy, we think of strep throat. A carrier is someone who carries the germ around with them but does not get sick from the germ (pertussis is another example). In 1998, a study found that 5-15% of school-aged children were asymptomatic carriers of strep. This means they tested positive on a strep swab but had no symptoms of being sick. This causes concern because it means that you can be sick with something else that causes vague symptoms like fever and sore throat but because the strep test is positive, antibiotics are prescribed when they might not be necessary (meaning that you were sick from a virus). This study showed that providers and caregivers were unaware of the number of unnecessary antibiotics they were prescribing. Strep is eradicated from a carrier by an extensive treatment of antibiotics, or by removing the tonsils from the carrying family member as well as the tonsils of the chronically sick family member. #tonsillectomyforeveryone https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2851340/ Callback Facebook Memory: Episode 74 Sleep Hygiene All About Sleep Connect with me Support us on Patreon Give us your Feedback Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits: Up In My Jam (All Of A Sudden) by - Kubbi https://soundcloud.com/kubbiCreative Commons — Attribution-ShareAlike 3.0 Unported—...

Tonsils Basics Your tonsils can be found in the back of your throat. You can open your mouth and look in the mirror and see them on each side of your mouth behind your teeth and tongue. You can also feel them below your earlobes and behind your jaw bone. Tonsils are composed of lymph tissue since they are a part of your lymph system. They store white blood cells that help you fight off infection. Their activation during sickness is why they swell and get sore. They are covered with the same mucosal membrane as the rest of the inside of your mouth. This mucosa layer has pits and crevices called crypts. These crypts increase the surface area of the mucosa that comes in contact with the lymph tissue and allows more opportunity for infectious material to be directly accessed by the immune system. Infectious Tonsil Issues Tonsillitis is the inflammation of the tonsils. It can be classified as acute or chronic. Acute tonsillitis is directly related to a viral or bacterial infection. Chronic tonsillitis can be either a persistent, long-lasting infection or multiple consecutive acute episodes that can appear to be one long sickness. Swollen tonsils can cause simple activities such as swallowing, talking, and breathing very painful. You can see your swollen tonsils when you look in the mirror. They will appear red or possibly blistered. Mono, an infection caused in adolescents and adults by the Epstein-Barr virus, cause severe swelling in all the lymph nodes, including the tonsils. This is one of the situations where your tonsils will be so inflamed, you can see the swelling on the outside of your face and neck. Because such a large portion of your lymph system is involved, including your spleen, this is a serious sickness. Strep throat is probably the first infection you think about when you think of swollen tonsils. The bacteria, streptococcus, infect the lining of the tonsils and throat. This is why the doctor will swab your tonsils when they're testing for strep. Non-Infectious Tonsil Issues A non-infectious reason the tonsils will be large is a condition caused hypertrophic tonsils. The tonsil tissue and/or mucosa overgrow and become oversized without any infection or immune activation being involved. Overgrown tonsil tissue can lead to snoring or sleep apnea, and that's bad. Another non-infectious issue with your tonsils is called tonsilloliths or tonsil stones. These stones happen when dead bacteria or food debris gets stuck in the crypts and they become calcified. They cause a sensation many describe as a crumb stuck in your throat. They can become quite large and can interfere with swallowing and eustachian tube function. Because the eustachian tubes run from your eardrum into your throat, if the tonsil is swollen enough, it may close off the tube to the ear and cause ear pressure/pain. Some tonsil stones are large enough to be visible and may have to be manually removed. Lastly, due to the composition of the stones (dead bacteria and old food), frequent tonsil stones can be the cause of bad breath. There's no way to prevent tonsil stones 100%. Good oral hygiene can certainly help reduce the frequency of stones, and can also help remove them quickly if they occur. The most common way of trying to remove a tonsil stone involve coughing, clearing your throat, or hissing. All three of these ways produce vibrations in the lining of the throat and mouth. So along with the exhalation of these methods, hopefully, the result is the stone coming out of the tonsil and out of your mouth. PSA: Please DO NOT scratch your tonsils with your fingernails to remove a tonsil stone! Callback Sleep Hygiene All About Sleep Connect with me Support us on Patreon Give us your Feedback Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits: Up In My Jam (All Of A Sudden) by - Kubbi https://soundcloud.com/kubbiCreative Commons —...

Glossary Aguesia: no taste Hypoguesia: reduced ability to taste (no the same as when taste changes due to changes in ability to smell) Dysgeusia: dysfunctional taste - bad, salty, rotten, or metallic taste (metallic is the most common). Causes for Change Chemotherapy and radiation for cancer causes taste changes because the taste buds are rapid-cycling cells and the goal of chemo and radiation is to kill fast-growing cells (cancer cells are definitely fast-growing). Head trauma or brain damage may damage the path of taste from the mouth to the brain. Conditions like GERD, diabetes, urinary retention, and dry mouth can cause dysgeusia. Zinc deficiencies can too (in case you can't tell, zinc plays a big role in many processes in your mouth). Over 250 medications can causes changes in taste. These include blood pressure medications, antibiotics, chemotherapy, asthma medications, and lithium. Some of them are secreted in the saliva, so the change in taste is because you actually taste the medicine. Other changes are because the medication disrupts or alters receptor or signal transport (i.e. ion transport - sodium, calcium, potassium, or chloride). My Own Metallic Taste I was taking generic Biaxin, AKA clarithromycin, for a sinus infection. Clarithromycin is in a class of medication called macrolides. Macrolides work on infections by disrupting the DNA-copying proteins in the bacteria. They are known as bacteriostatic antibiotics, which means they stop the bacteria from growing and dividing, but do not kill them. This allows your own immune system to get rid of the bacteria itself. Clarithromycin is excreted in your saliva at ~2.72 mg/L. To get an idea of how small this amount is, it takes you 12-24 hours to produce 1 liter of saliva. Only 3-7% of adults report metallic taste with clarithromycin. Connect with me Support us on Patreon Give us your Feedback Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits: Up In My Jam (All Of A Sudden) by - Kubbi https://soundcloud.com/kubbiCreative Commons — Attribution-ShareAlike 3.0 Unported— CC BY-SA 3.0 http://creativecommons.org/licenses/b...Music provided by Audio Library https://youtu.be/tDexBj46oNI

Review Smell plays a big part in your ability to taste. The bumps on your tongue that you can see are actually papillae. 4 Types of Papillae Filiform Filiform papillae are the most numerous papillae and are arranged in regular rows running parallel to the median sulcus. They are cone-shaped - either a single cone (like a volcano shape) or a frill of cones. These papillae don't actually taste flavors but they do sense touch. They work as cleaners, helping your tongue create friction with other parts of your mouth to loosen bits of food from the nooks and crannies. Foliate These papillae are located on the sides of the tongue near the back. They are flat, leaf-like folds, and can be visible in some people. These papillae contain taste buds for flavors. Fungiform These are mushroom-shaped. They are scattered all over the tongue but seem to be more concentrated on the edges and tip of the tongue. They contain taste buds for flavor as well as the sense of touch. Vallate (Circumvallate) These papillae are dome-shaped with a border. The best description is that they appear as a circular fort with a mote around it and then a wall on the outside. Or maybe they look like a bunch of "outie" belly buttons! They are laid out on the back of the in a V-shaped pattern, pointing towards the back of the throat. These papillae can be visible in some people, and they contain taste buds for flavors as well. Each papilla contains many taste buds. They are called "buds" because, microscopically, they appear as unopened rosebuds. Taste buds have a swirl-like funnel with an opening in the middle that contains fluid. How You Taste You put food in your mouth. Your saliva dissolves bits of it to free up molecules. The molecules that are mixed in your saliva wash into the funnels of each taste bud. There, the molecules mix into the taste bud fluid and get swirled around to come in contact with as many taste sensors (nerves) as possible. From here, the chemical signal changes into an electrical signal as the taste messages zoom into your brain. In the brain, the signal is translated and identified - including details such as flavor, pain, temperature, texture, intensity, and smell (while your saliva mixes with some molecules, other molecules are released into the air as aromatics and contact the olfactory sensors in your nose). Taste Buds Map Truth The taste bud map that has been used for years in textbooks was created in 1901. Even with all the things that we've learned about how taste buds work, where they're located, and what they look like, this map has never been re-written. The original map identified four basic flavor categories: sweet, sour, salt, bitter. Yet, just nine years later, the Japanese were able to identify "umami" - that savory flavor that doesn't quite fit into the other four. Yet, the map still wasn't re-written. Even now, scientists are learning and updating the database on what the tongue can taste and how - including categories like "fatty" and "metal" and even "water". So, while the taste buds are not grouped into sections based on the flavor they can taste, some taste buds may have a greater affinity or sensitivity to a certain type of flavor. It is estimated that we have about 2000-4000 tastebuds, and since the surface of the tongue is like your skin, the tastebuds recycle about every week or two. This rapid and continuous recycling might be why it is acclaimed that your taste (preference and enjoyment from your taste buds) changes approximately every seven years. Conclusion Even though the tastebud categories are still too complicated to rewrite the map, I still plan to use my taste buds to their fullest potential. Eat up! Resources I gathered some of my information from a PubMed article that is actively being updated by real scientists - How Does Our Sense of Taste Work? Callback Smell Connect with me Support us on Patreon Give us your Feedback Join the Pharmacist Answers Podcast Community on...

Burning Mouth Syndrome Burning Mouth Syndrome is defined as a burning sensation with no underlying cause. It may include dry mouth sensations with no true symptoms of dry mouth. BMS is accompanied by unremitting burning or pain but no mucosal changes or signs of injury or swelling. 3 Categories Common Symptoms Subjective Descriptions Those who suffer from BMS may see temporary relief with topical analgesics (i.e. lidocaine or benzocaine) but see no improvement from systemic medications. Fifty percent of the cases have no apparent cause but do have some correlation with depression. This is a case of "the chicken or the egg". Are people with depression more likely to have symptoms of BMS? Or are people with BMS more likely to become depressed? Before someone can be said to have Burning Mouth Syndrome, many other issues must be ruled out. Pepto Lips Pepto-Bismol, aka Bismuth subsalicylate, has been used for decades for a variety of stomach complaints. Bismuth is a good binder of toxins, in a similar way that carbon is in activated charcoal. And yes, bismuth is one of those elements on the periodic table. Subsacylate activates into salicylic acid (related to aspirin) and works to decrease inflammation of the gastric lining. When bismuth binds with sulfur that is naturally in your saliva, it becomes bismuth sulfide, which has a black color and can stain your tongues and lips temporarily. Pepto overuse is the obvious cause of black lips. Connect with me Support us on Patreon Give us your Feedback Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits: Up In My Jam (All Of A Sudden) by - Kubbi https://soundcloud.com/kubbiCreative Commons — Attribution-ShareAlike 3.0 Unported— CC BY-SA 3.0 http://creativecommons.org/licenses/b...Music provided by Audio Library https://youtu.be/tDexBj46oNI

Born With... Ankyloglossia is also known as a tongue tie. It is a result of a short frenulum. This issue is easily corrected if it interferes with eating and talking. Macroglossia is a large tongue. This is one of the identifiable characteristics of Down's Syndrome. It is described as the tongue appears to be bigger than space in the mouth. Infected With... Strawberry tongue The tongue can appear extremely red and papillae are swollen to look like seeds on a strawberry. This is a symptom of several conditions. Hairy Tongue White hairy tongue appears as patches on the sides of the tongue. It can happen when someone who is immunocompromised gets the Epstein-Barr Virus. (Epstein-Barr is a virus that causes mild childhood illness or a disease we know as Mono when teens and adults.) Black hairy tongue is a little more obscure with a few possibilities of causes. Function Lost Motor Neuron Disease occurs in the later stages of ALS or Lou Gerig's Disease, when the nerves and muscles of the tongue for speech and swallowing become affected. Connect with me Support us on Patreon Give us your Feedback Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits: Up In My Jam (All Of A Sudden) by - Kubbi https://soundcloud.com/kubbiCreative Commons — Attribution-ShareAlike 3.0 Unported— CC BY-SA 3.0 http://creativecommons.org/licenses/b...Music provided by Audio Library https://youtu.be/tDexBj46oNI

Tongue Basics Your tongue is made up of eight muscles. This is why it is called a muscular organ. It is the most important articulator in speech production. (A brief word dissection: articulate means to communicate something clearly. In medicine, articulate means to make a connection. It all makes sense!) The tip is called the apex. The crease down the middle is called the median lingual sulcus. There is another crease at the back of your tongue and it is called the sulcus terminalis. Tongue Muscles The tongue has two types of muscles. Extrinsic muscles attach to bones boarding the mouth. Intrinsic muscles are completely contained inside the tongue borders. Extrinsic Muscles These muscles are responsible for moving your tongue front to back and side to side. There are four of them and they are named for the facial bones that they are anchored to. Intrinsic Muscles These muscles are responsible for all the shapes and movements your tongue makes when you talk and eat. The Tongue Has Skin?! The surface of your tongue is known as the masticatory mucosa, which basically means it's the surface that food comes in contact with. The surface is made up of epithelial cells just like your skin. The cells are keratinized (or filled with a toughening protein) so it is tough and does not get damaged by the wide variety of things we eat. Call Backs Wrinkly Brain Skin 101 Connect with me Support us on Patreon Give us your Feedback Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits: Up In My Jam (All Of A Sudden) by - Kubbi https://soundcloud.com/kubbiCreative Commons — Attribution-ShareAlike 3.0 Unported— CC BY-SA 3.0 http://creativecommons.org/licenses/b...Music provided by Audio Library https://youtu.be/tDexBj46oNI

Teething Teething is mostly known as the phase of babies growing their first teeth. Eruption is when the tooth enamel shows through the gum tissue. A baby's first teeth grow in between 6 months and 2 years old. Before any of the teeth show, the gums can be swollen and bumpy. These symptoms can cause fussiness, sleeplessness, drooling, decreased appetite, excessive chewing, and overall grumpiness. A few controversial symptoms include fever, diarrhea, and rash. A fever less than 100.4*F can be indicative of inflammation going on, which can be true for some teething babies. Diarrhea is blamed on excessive saliva ending up in the digestive tract (eh, many things can change the consistency of a baby's poop, especially in the early stages where they're only drinking milk or just learning to eat new foods). A rash is a little more questionable, but can also be a result of inflammation going on. Treatments Treatments for teething babies include Infant's Tylenol or Infant's Ibuprofen (for children older than 6 months). Other medications that used to be recommended for teething babies were Teething Tablets and Orajel. An active ingredient in the Teething Tablets is Belladonna. This medication can constrict blood vessels, which is good when there's inflammation (increased blood flow) to an area, but bad when baby's blood vessels are already tiny and they need to get blood to very important places (i.e. the brain). The bottom line is that Belladonna can decrease the amount of blood, and therefore oxygen to a baby's brain, and the outcome can potentially be SIDS. This is also true of Benzocaine, the ingredient in Orajel. Benzocaine is a topical numbing agent. The key word here is topical. It is not intended to circulate in the body. The problem comes when you use a TOPICAL product in your mouth, you can't help but swallow some of it. When Benzocaine is swallowed, it can cause a serious side effect that involved decreased oxygen in the blood. Again, if oxygen doesn't get to important places in the baby's body, bad things can happen. PSA: NO Belladonna and NO Benzocaine for babies! Plaque Your teeth are covered in a biofilm that is mostly made up of bacteria. That bacteria can compromise the seal that is formed between healthy teeth and healthy gums. If this seal is breached by bacteria, then infection and gum disease (gingivitis) can occur. Tartar Plaque can harden, and when it does, it becomes known as tartar. Mouth bacteria eat the sugars in the food that gets stuck in the crevices of your teeth. A waste product of this process is lactic acid, and lactic acid can actually dissolve enamel of your teeth. Minor erosion can be repaired by your body. The problem is that saliva cannot break through the plaque. Cavities Tooth decay is the result of long-term enamel erosion that can't be repaired by the body. If the erosion is deep enough, it can expose the softer parts of the tooth to irritants and injury. When this happens, the only way to repair and protect the tooth is to get a filling from your dentist. *womp womp* Discoloration Extrinsic stains are when substances change the tooth color from the outside. So this is how coffee, tea, wine, and tobacco can make the teeth yellow or brown. Also, certain bacteria, excessive chlorophyll, or excess copper and nickel can make the teeth look green. Intrinsic stains are when the building blocks of teeth are altered and changes the color from the inside. Tetracycline antibiotics have been a common treatment for acne in teenagers for quite a long time. It is well-documented that these antibiotics can bind up free calcium in the body. Therefore, it is not recommended for pregnant women or children younger than 8 years old to use these medications. There are many cases of developing fetuses and children with quickly-developing teeth ending up with grey or brown teeth due to this missing calcium (remember, calcium built into the enamel is what makes it white). Injuries A chipped tooth is...

Types of Teeth Incisors: You have 4 on the top and 4 on the bottom. Yes, it sounds like "scissors"; they are the teeth and cut and tear food (or the enemy?). They are in the very front of your mouth. Canines: You have 2 on the top and 2 on the bottom. Yes, canine, like a dog; they are sharp and pointed. These teeth are good for gripping and tearing. Also known as cuspids (one point). They are located at the "corners" of your teeth arch. Premolars: You have 4 on the top and 4 on the bottom. These are permanent teeth only. They have a flatter surface for crushing food. Also known as bicuspids (two points). Molars: You have 6 on the top and 6 on the bottom. They have large flattish surfaces for grinding up food. Four of these molars are also known as your wisdom teeth. Parts of a Tooth Outside In Enamel: This is the part that you can see. It is mostly made up of a crystalline structure of calcium phosphate, and that's what makes them look white. Enamel all by itself can be very brittle. Dentin: This layer is made of a softer, yet still strong calcium-containing crystals. This acts as a tough and supportive scaffold for enamel. *These two layers together are what make your teeth so hard and strong. Pulp: The soft connective tissue that contains the nerves and blood vessels that feed the tooth. Top to Bottom Crown: This is the part of the tooth that is above the gum line that you can see. And since you can only see the outside of the tooth, when you look at your teeth, you only see enamel. Neck: This is the enameled part of the tooth that is below the gum line. Root: The part of the tooth that is embedded in the jawbone and provides the openings for the nerves and blood vessels to run up into the pulp. The roots are covered by a specialized bone structure called cementum (yes, it sounds like cement). *The roots are actually attached to the jawbone by periodontal ligaments. (Ligaments are connective tissue that connects bone to bone). Callback Feed Your Bones Connect with me Support us on Patreon Give us your Feedback Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits: Up In My Jam (All Of A Sudden) by - Kubbi https://soundcloud.com/kubbiCreative Commons — Attribution-ShareAlike 3.0 Unported— CC BY-SA 3.0 http://creativecommons.org/licenses/b...Music provided by Audio Library https://youtu.be/tDexBj46oNI

Mouth Issues Ulcers They are uncomfortable and mostly non-serious. Also known as "canker sores". Can take 2-3 weeks to completely heal. Anything lasting over 3 weeks should be checked out by your doctor or dentist. Ulcers can appear on the inside of the cheeks or lips, the roof of the mouth, or the tongue. A minor ulcer versus a major ulcer is determined by the size of the sore and the layers of skin affected. Any ulcer that is bleeding should be checked out despite the length of time. The edges are red while the center can be yellow, white, or grey. And they are PAINFUL!! Ulcers can be caused by acidic or spicy foods, braces, stress, hormones, and some medications (such as beta-blockers for blood pressure or NSAIDs). Nutritional deficiencies can increase your risk of ulcers. Malabsorption due to conditions like celiac or deficiencies in B-vitamins and iron are the most common culprits. Also, decreased immunity can make the skin inside the mouth more prone to ulcer recurrence. Thrush This is a yeast infection the mouth caused by the overgrowth of Candida, known as oral candidiasis. It appears as white patches on the inside of the cheeks, tongue, or roof of the mouth, and the spots cannot be scraped off. Candida is normal in the body and is kept in balance by the rest of the body's normal flora. Overgrowth can occur after antibiotic treatments, during times of decreased immunity due to treatments or disease states, or from inhaled steroid treatments. Thrush is treated with a topical antifungal that the doctor directs you to swish around in the mouth to coat the affected areas, usually Nystatin. If yeast is wide-spread, a systemic antifungal will be used. Probiotics are a great way to keep your normal flora in balance. Angular cheilitis (ky-ly-tis) Cheilitis = inflammation of the lips. This is the cracking that can occur in the corners of your mouth. Many sources will tell you this is caused by a vitamin deficiency - like B-vitamins, iron, and zinc. Other times, it may be a wound caused by contact dermatitis from increases contact with the tongue or your hands, and then they may become infected with normal skin bacteria or other bacteria in saliva. An infected wound is one that doesn't ever appear to heal. Fungal infections, in the same way, cause the skin to crack open and appear overly dry and never-healing. Lie Bumps Transient Lingual Papillitis (swollen taste buds). They can appear to be white or red, and they can be asymptomatic or very bothersome. Not sure what exactly causes it. Definitely NOT caused by lying. *I used to think they were "lye bumps" as in sodium hydroxide that is a strong base and used to be popular as a detergent.* Cleft lip/palate A birth defect that has a strong genetic component, but also linked to environmental components that have not been pinpointed yet. A cleft lip or palate is a result of parts of the mouth and face not fusing together during fetal development, and requires surgical correction after the baby is born. The oral and nasal cavities are supposed to be separate and when they are not, it can increase the risk of sinus and ear infections. Ear tubes are usually recommended. Even after repair, a child may require speech and occupational therapies to develop the muscles needed for normal speech and eating habits. Many times, a follow-up surgery is required as the child grows, and many other types of mental support are needed. Bonus *Mouth Cancers: the most common cause of mouth cancers is tobacco use (smoking, chewing). It can start out as something that appears minor like a mouth sore, but can develop quickly into something deadly. In the end, it can result in large areas of the mouth having to be surgically removed. Callback Probiotics Connect with me Support us on Patreon Give us your Feedback Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits: Up In My Jam (All Of A...

Mouth Parts Lips: They are red due to blood flow. They have lots of nerve ending so they can be very sensitive. Our lips are used to manipulate food as we eat and make sounds as part of our speech. * The Divot above the center of your upper lip is called the philtrum. Gums: They are also known as the gingiva. Even though they are wet and look fleshy, healthy gums are quite resilient. Teeth: They are used for chewing, and possibly as a tool. Healthy teeth and gums seal together tightly to keep out invaders. We will talk about teeth in a separate episode. Tongue: It is a muscular organ made up of many muscles and nerve endings. It just happens to be an organ that we can voluntarily move around. We use our tongue to manipulate food and to make sounds for speech. And, of course, it is covered in taste buds. We will cover all of this in a separate episode. Hard Palate: A flesh-covered bone that connects the upper teeth. Our tongue will smash food against it when we eat and use to make certain sounds in speech. Soft Palate: It is a muscle behind the hard palate and it moves up to close off the nose when we swallow and sneeze. It also interacts with the back of the tongue to make certain sounds when we talk. Palatoglossal arch: It marks the front edge of the soft palate. Palatopharyngeal arch: It makes the back edge of the soft palate and the end of the "mouth". Salivary Glands Parotid glands: The largest salivary glands are located by your jaws, below your ears. Submandibular glands: They are located under the jaw and back molars Sublingual glands: They are located under the tongue, behind your chin. ~1000 of mini glands: They cover the buccal (cheek) tissue, soft palate, uvula, and tongue to keep everything moist. This is what allows the inside of the mouth to be known as a mucous membrane. Sublingual papilla: This is the folds of skin under the tongue. This area contains many blood vessels close to the surface. Medicine development has learned this is a great place for medication absorption directly into the bloodstream. Palatine raphe (ray-fee): This is the seam down the middle of the hard palate. Frenula: Plural for frenulum. These are folds of skin that connect one place to the other. You have three: for your upper lip, lower lip, and tongue. Uvula: Latin for "small bunch of grapes". It is attached to the soft palate and contains a gag reflex trigger. It is also involved in snoring if it dries out. Callback Sneezing Connect with me Support us on Patreon Give us your Feedback Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits: Up In My Jam (All Of A Sudden) by - Kubbi https://soundcloud.com/kubbiCreative Commons — Attribution-ShareAlike 3.0 Unported— CC BY-SA 3.0 http://creativecommons.org/licenses/b...Music provided by Audio Library https://youtu.be/tDexBj46oNI

Post-Manifesto Tidbits This is the heart and soul of why I have produced this podcast for 100 episodes. My Manifesto, if you will. The podcast is going to take a break for the summer to regroup and plan new and fun things! In the meantime, catch up on episodes you missed or re-listen to them all! If you want to stick close for sneak peaks of new adventures and the reboot, join the Pharmacist Answers Podcast Community on Facebook If you've enjoyed the first chapter of The Pharmacist Answers Podcast, please leave a rating and review on your favorite podcast app. The new home for show notes is intelleximed.com Thank you so much for letting me be in your ears each week. Connect with me Support us on Patreon *NEW* Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page Music Credits: “Radio Martini” Kevin MacLeod (incompetech.com) Licensed under Creative Commons: By Attribution 3.0 http://creativecommons.org/licenses/by/3.0/

Sneezing is very forceful in your body. Review: the inside of your nose is covered with mucous membranes, and that mucus traps up things so they don't get into your lungs. Some little particles float through the air and into your nose. They will land on those mucous membranes and irritate it. That irritation sends a signal to your sneeze center of your brainstem. *Callback: Brainstem* The sneeze center sends out several signals. One goes to your diaphragm to tell it to compress the lungs to force the air out. Another signal goes to your tongue to have it direct the air through your nose. The last signal goes to your eyes - it is really true, you can't sneeze with your eyes open. So your abs contract and your diaphragm forces your lungs to exhale, your tongue directs the air to go out your nose, so the mucus plus the things that irritated your nose flies out of your face. *Mythbusters sneezing* The proven statistics on sneezes is that they travel about 40 mph but only go about 20 feet. Holding in a sneeze can be painful and damaging. By holding in all that air, you can rupture your eardrums, damage your tear ducts in your eyes, fracture your nasal cartilage or bones, or cause nose bleeds because of the blast against your sinus passages. There's so many tricks about trying to stop a sneeze - most of them involve counter-pressure on other spots on your face or body. The best advice for stopping a sneeze is to blow your nose to get out the irritants before the body blasts it out with a sneeze. You will never ever sneeze when you're sleeping. So morning sneezing fits are normal for a lot of people. This is because all the dust and stuff you breathe in while you're sleeping finally irritates your body. So morning congestion and sneezing is normal to help clear all of that out. We're unsure why people will sneeze in other situations like sudden exposure to bright light or changes in air pressure or temperature. Another unsual trigger is an over-full stomach. Multiple people have reported they feel nauseous and once they sneeze, the sick feeling goes away. I dunno.... If you do have to sneeze, make sure you cover your face. Use the elbow technique! *Mythbusters hanky* Support us on Patreon *NEW* Join the Pharmacist Answers Podcast Community on Facebook Subscribe: iTunes, Stitcher, GooglePlay, TuneIn Radio Like the Facebook page "Radio Martini" Kevin MacLeod (incompetech.com) Licensed under Creative Commons: By Attribution 3.0 http://creativecommons.org/licenses/by/3.0/