Q: What is ALS?
A: Dr. Christopher Taleghani, neurosurgeon: ALS — amyotrophic lateral sclerosis — is a neurological disease. It’s often called Lou Gehrig’s disease, after the Hall of Fame baseball player who died of the affliction in 1941. In ALS, nerve cells in the brain and spinal cord atrophy, break down and die. The nerve cells that are affected control a person’s muscles, so as they stop working, the person gradually loses the ability to move. At first the person’s arms and legs are affected, but eventually this loss of muscle control affects their ability to swallow and breathe.
ALS affects around 20,000 people in the U.S. each year, and scientists don’t know what causes it. About 5 to 10 percent of cases are inherited. For the rest, age seems to be the most important factor, with most cases diagnosed between the ages of 40 and 60. There is no cure for ALS but medication and treatment can help people live longer and improve their quality of life.
Q: My son is 18 months old and gets chronic ear infections. What causes ear infections and what can we do to avoid them?
A: Dr. David Crow, otolaryngologist: Ear infections are one of the most common childhood infections, with around 31 million cases each year worldwide, so you’re not alone. An ear infection can occur with a bacterial or viral infection when fluid accumulates in the middle ear.
Children who get ear infections in the first few months of life tend to get more ear infections later. And there’s a genetic component — if you had ear infections as a child, your son may be more likely to get them as well. Other factors include allergies, secondhand smoke, swimming in dirty water and going to day care — kids who spend time in close quarters with other children are more likely to pick up colds that can lead to an ear infection (the same goes for siblings who may bring a virus home).
While you may not be able to change your son’s genetics, there are still some things you can do. If your son still uses a bottle, avoid letting him drink from it while lying down — the sucking action and flat position can make it hard for the ear to drain. Make sure your son is being treated for any potential allergies he might have, and help him practice good hygiene, like washing hands, to avoid picking up colds and germs. If the infections continue, you can have his physician check him. Rarely, cholesteatomas — benign growths in the ear partially caused by ear infections — can also contribute to the problem.
If untreated, ear infections can lead to more serious problems like hearing loss, so it’s important that you stay on top of it. Your physician will be able to help treat the problem, if necessary by inserting tubes to help drain and ventilate the middle ear while it heals.
* Physicians, providers and administrative staff who practice at Maui Health System hospitals and clinics answer questions from the public in “Healthwise Maui,” which appears on Thursdays. Maui Health System operates Maui Memorial Medical Center, Maui Memorial Medical Center Outpatient Clinic, Kula Hospital & Clinic and Lana’i Community Hospital and accepts all patients. To submit a question, go to the website at mauihealthsystem.org/contact.