“Thyroid nodules are quite common. When examined with ultrasound imaging, as many as one-third of women and one-fifth of men have small thyroid nodules.

Most thyroid nodules are too small to see or feel. They tend to be found when you have an imaging test done for some other reason.

A large nodule or goiter may cause a sense of tightness or pain in your neck, and can sometimes grow large enough to interfere with breathing or swallowing.

If your thyroid function is affected, you might notice other symptoms. If your gland is producing too much thyroid hormone it will exhibit signs or symptoms of hyperthyroidism.  If your gland is producing not enough thyroid hormone it will produce signs and symptoms of hypothyroidism.

A goiter is an enlargement of the thyroid, the H-shaped gland that wraps around the front of your windpipe, just below your Adam’s apple.

A goiter can be smooth and uniformly enlarged, called diffuse goiter, or it can be caused by one or more nodules within the gland, called nodular goiter. Nodules may be solid, filled with fluid, or partly fluid and partly solid.”

University of California San Francisco Health – USCF Health (Thyroid Nodules and Goiter | Conditions | UCSF Health)

Goiter in the thyroid

A goiter is simply an enlarged thyroid gland. Multiple conditions can lead to goiter, including hypothyroidism, hyperthyroidism, excessive iodine intake, or thyroid tumors. Goiter is a non-specific finding that warrants medical evaluation.

History: The doctor will take a detailed history, evaluating both past and present medical problems. If the patient is younger than 20 or older than 70 years, there is increased likelihood that a nodule is cancerous. Similarly, the nodule is more likely to be cancerous if there is any history of radiation exposure, difficulty swallowing, or a change in the voice. It was actually customary to apply radiation to the head and neck in the 1950s to treat acne! Significant radiation exposures include the Chernobyl and Fukushima disasters. Although women tend to have more thyroid nodules than men, the nodules found in men are more likely to be cancerous. Despite its value, the history cannot differentiate benign from malignant nodules. Thus, many patients with risk factors uncovered in the history will have benign lesions. Others without risk factors for malignant nodules may still have thyroid cancer.

Physical examination: The physician should determine if there is one nodule or many nodules, and what the remainder of the gland feels like. The probability of cancer is higher if the nodule is fixed to the surrounding tissue (unmovable). In addition, the physical exam should search for any abnormal lymph nodes nearby that may suggest the spread of cancer. In addition to evaluating the thyroid, the physician should identify any signs of gland malfunction, such as thyroid hormone overproduction (hyperthyroidism) or underproduction (hypothyroidism).

Blood tests: Initially, blood tests should be done to assess thyroid function. These tests include:

• The free T4 and thyroid stimulating hormone (TSH) levels. Elevated levels of the thyroid hormones T4 or T3 in the context of suppressed TSH suggests hyperthyroidism
• Reduced T4 or T3 in the context of high TSH suggests hypothyroidism
• Antibody titers to thyroperoxidase or thyroglobulin may be useful to diagnose autoimmune thyroiditis
• (for example, Hashimoto’s thyroiditis).
• If surgery is likely to be considered for treatment, it is strongly recommended that the physician als determine the level of thyroglobin. Produced only in the thyroid hormone in the blood. Thyroglobulin carries thyroid hormone in the blood. Thyroglobulin levels should fall quickly within 48 hours in the thyroid gland is completely remobed. If thyroglobulin levels start to climb.
• Ultrasonography: A physician may order an ultrasound examination of the thyroid to:
• Detect nodules that are not easily felt
• Determine the number of nodules and their sizes
• Determine if a nodule is solid or cystic
• Assist obtaining tissue for diagnosis from the thyroid with a fine needle aspirate (FNA)Radionuclide scanning: Radionuclide scanning with radioactive chemicals is another imaging technique a physician may use to evaluate a thyroid nodule. The normal thyroid gland accumulates iodine from the blood and uses it to make thyroid hormones. Thus, when radioactive iodine (123-iodine) is administered orally or intravenously to an individual, it accumulates in the thyroid and causes the gland to “light up” when imaged by a nuclear camera (a type of Geiger counter). The rate of accumulation gives an indication of how the thyroid gland and any nodules are functioning. A “hot spot” appears if a part of the gland or a nodule is producing too much hormone. Non-functioning or hypo-functioning nodules appear as “cold spots” on scanning. A cold or non-functioning nodule carries a higher risk of cancer than a normal or hyper-functioning nodule. Cancerous nodules are more likely to be cold, because cancer cells are immature and don’t accumulate the iodine as well as normal thyroid tissue. However, cold spots can also be caused by cysts. This makes the ultrasound a much better tool for determining the need to do an FNA.
• Fine needle aspiration: Fine needle aspiration (FNA) of a nodule is a type of biopsy and the most common, direct way to determine what types of cells are present. The needle used is very thin. The procedure is simple and can be done in an outpatient office, and anesthetic is injected into tissues traversed by the needle. FNA is possible if the nodule is easily felt. If the nodule is more difficult to feel, fine needle aspiration can be performed with ultrasound guidance. The needle is inserted into the thyroid or nodule to withdraw cells. Usually, several samples are taken to maximize the chance of detecting abnormal cells. These cells are examined microscopically by a pathologist to determine if cancer cells are present. The value of FNA depends upon the experience of the physician performing the FNA and the pathologist reading the specimen. Diagnoses that can be made from FNA include:
• Despite its value, the ultrasound cannot determine whether a nodule is benign or cancerous.
• Benign thyroid tissue (non-cancerous) can be consistent with Hashimoto’s thyroiditis, a colloid nodule, or a thyroid cyst. This result is reported from approximately 60% of biopsies.
• Cancerous tissue (malignant) can be consistent with diagnosis of papillary, follicular, or medullary cancer. This result is reported from approximately 5% of biopsies. The majority of these are papillary cancers.
• Suspicious biopsy can show a follicular adenoma. Though usually benign, up to 20% of these nodules are found ultimately to be cancerous.
• Non-diagnostic results usually arise because insufficient cells were obtained. Upon repeat biopsy, up to 50% of these cases can be distinguished as benign, cancerous, or suspicious.

One of the most difficult problems for the pathologist is to be confident that a follicular adenoma – usually a benign nodule – is not a follicular cell carcinoma or cancer. In these cases, it is up to the physician and the patient to weigh the option of surgery on a case-by-case basis, with less reliance on the pathologist’s interpretation of the biopsy. It is also important to remember that there is a small risk (3%) that a benign nodule diagnosed by FNA may still be cancerous. Thus, even benign nodules should be followed closely by the patient and physician. Another biopsy may be necessary, especially if the nodule is growing. Most thyroid cancers are not very aggressive; that is, they do not spread rapidly. The exception is poorly differentiated (anaplastic) carcinoma, which spreads rapidly and is difficult to treat.

“Not everyone is always eligible or physically able to donate blood. But, if you’re among those who can donate, your willingness to help will save lives.

On average, someone in the United States needs blood every two seconds. That blood has to be donated from someone else — we don’t have a synthetic substitute.

“The blood products provided to The Ohio State University Wexner Medical Center from volunteer donors are directly responsible for helping us save lives every day.”Scott Scrape, MD, a pathologist and Transfusion Medicine physician at the Ohio State Wexner Medical Center.

Your decision to donate blood can make a big difference to people in your community. For example, during the COVID-19 pandemic, there was a blood shortage, and many hospitals — including some in central Ohio — faced a critical need to get blood to their patients.”

The Ohio State University (Why Should You Donate Blood? | Ohio State Health & Discovery)

January is National Blood Donor Month, a time to celebrate generous volunteer donors and raise awareness for the need for blood donations.  The purpose is to raise awareness about the vital importance of blood donation. Every drop counts and every donor is a hero.

It began in 1970 when President Richard Nixon made an historic proclamation. During this special month, we encourage all those impacted by the lifesaving power of blood donation to come together to honor and celebrate the incredible generosity of America’s voluntary blood donors.

According to the American Red Cross, winter is “one of the most difficult times of year to collect enough blood products to meet patient needs.” That’s because of, among other things, busy holiday schedules and bad weather often resulting in canceled blood drives. Furthermore, seasonal illnesses such as the flu force potential donors to forgo their blood donations.

That’s just one of the reasons that National Blood Donor Month, which has taken place each January since 1970, is such an important observance. Donating blood saves many lives and improves health for many people. According to the World Health Organization, “blood is the most precious gift that anyone can give to another person — the gift of life. A decision to donate your blood can save a life.”

Did you know these facts? Seek below:

Ohio University states the following 2/19/25:

“The Ohio State Wexner Medical Center, a large academic health center that sees about 65,000 patient admissions each year, needs about 5,000 blood products each month, Scrape says.

“That’s about six to seven blood products every hour of every day.”

In the United States, about 29,000 units of red blood cells are needed each day, according to the American Red Cross.

Unfortunately, only about 3% of age-eligible Americans donate each year.

Give blood. Don’t wait for a disaster. Someone needs blood now! Contact the American Red Cross or your local blood bank for more information.

“We all know the feeling – you get the little twitch in your nose that won’t go away. You may wipe or itch your nose, but you don’t find relief until you let out a big ACHOO.

We all sneeze. It is just your body’s natural way of clearing out debris from the nose. While most people only sneeze a few times a day, there are other factors that could contribute to a change in your sneezing habits explains Frederick Yoo, M.D., an otolaryngologist and sinus surgery specialist at Henry Ford Health.

“Sneezing is often triggered by irritant to the nose,” says Dr. Yoo. “Your trigeminal nerve is a large nerve with branches to different parts of the face and irritation, from allergens, objects in the nose, boogers and mucus, of this nerve in the nose triggers the body to sneeze.”

Henry Ford Health (Why Do I Sneeze So Much? An ENT Expert Explains | Henry Ford Health – Detroit, MI)

Understanding the sneeze reflex:

Sneezing is a natural, involuntary reflex that protects the body. While a single sneeze effectively clears irritants, many people experience multiple sneezes in a row. This article explores the reasons behind consecutive sneezes.

The sneeze reflex is a process that expels foreign particles from the nasal passages. It begins when irritants, such as dust, pollen, or strong odors, stimulate nerve endings in the nose. These nerve signals quickly travel to the brainstem.

Upon receiving these signals, the brainstem triggers a rapid, coordinated response involving various muscles. Air is forcefully expelled from the lungs, clearing the nasal passages of irritants through both the nose and mouth.

Why You Sneeze Multiple Times:

Experiencing several sneezes in a row indicates the body is thoroughly clearing its nasal passages. If the initial sneeze does not completely remove the irritant, the reflex will repeat until the nasal lining is free of the foreign particles. This persistent irritation can be caused by a cluster of dust particles or a stubborn allergen.

Allergies are a frequent cause of sequential sneezing, as the body reacts to allergens like pollen, pet dander, or dust mites. Allergic reactions lead to sustained inflammation and irritation within the nasal membranes. The repeated sneezes are the body’s continued attempt to expel these pervasive allergens, often resulting in prolonged sneezing episodes.

Common Causes of Sneezing:

1. Allergies: Allergic reactions to substances such as pollen, dust mites, pet dander, and mold can cause your   immune system to overreact, leading to a sneeze reflex as a defense mechanism. 

2. Infections: Viral infections, such as the common cold and flu, which irritate the nasal lining, resulting in sneezing along with other symptoms like congestion and coughing. 

3. Environmental Irritants: Dust, smoke, strong odors, and lastly chemical fumes can irritate the nasal passages, prompting a sneeze reflex to clear these irritants. 

4. Temperature Changes: Sudden changes in temperature, for example moving from a warm environment to cold air, can stimulate what we call nasal nerves and trigger sneezing. 

5. Photic Sneeze Reflex: Some individuals experience sneezing when exposed to bright light, a phenomenon known as photic sneeze reflex and it may be genetic. 
6. Other Triggers: Sneezing can also be caused by strong emotions, spicyfoods, or even after eating a large meal (a phenomenon that is known as “snatiation”)

When to consult your doctor:

While occasional multiple sneezes are normal, certain symptoms warrant medical attention. Consult a doctor if sneezing is accompanied by a high fever, difficulty breathing, or chest pain. Unusual nasal discharge also signals a need for evaluation.

Seeking medical advice is also appropriate if sneezing becomes severe enough to disrupt daily life, including sleep or work activities. A sudden onset of new, severe sneezing without clear environmental triggers should also be investigated. If repeated sneezing suggests undiagnosed or poorly managed allergies, a doctor can provide proper diagnosis and treatment options.

“Traumatic brain injury usually results from a violent blow or jolt to the head or body. An object that goes through brain tissue, such as a bullet or shattered piece of skull, also can cause traumatic brain injury.

Mild traumatic brain injury may affect your brain cells temporarily. More-serious traumatic brain injury can result in bruising, torn tissues, bleeding and other physical damage to the brain. These injuries can result in long-term complications or death”

MAYO Clinic (Traumatic brain injury – Symptoms and causes – Mayo Clinic)

Part II reviews Concussion-The symptoms/grade levels/diagnostic tooling with treatment and  CTE=Chronic Traumatic Encephalopathy

 The signs and symptoms you may see indicating a concussion aren’t immediately present where in other situations observed immediately; it depends on the impact of the hit to the brain and location. Concussions are fairly common. Some estimates say a mild brain trauma is sustained every 21 seconds in the U.S. But it’s important to recognize the signs of a concussion so you can take the proper steps to treat the injury.

There are some common physical, mental, and emotional symptoms a person may display following a concussion. Any of these could be a sign of traumatic brain injury: confusion or feeling dazed/clumsiness/slurred speech/nausea or vomiting /headache /balance problems or dizziness /blurred vision/sensitivity to light/sensitivity to noise/sluggishness/Tinnitis – ringing in the ears/behavior or personality changes/concentration difficulties/memory loss.

Concussions are graded as mild (grade 1), moderate (grade 2), or severe (grade 3), depending on such factors as loss of consciousness, amnesia, and loss of equilibrium.

-Grade 1 concussion symptoms last for less than 15 minutes. There is no loss of consciousness.

-Grade 2 concussion there is no loss of consciousness but symptoms last longer than 15 minutes.

-Grade 3 concussion the person loses consciousness, sometimes just for a few seconds.

The seriousness of a concussion dictates what kind of treatment you should get. Most people with concussions fully recover with appropriate treatment. But because a concussion can be serious, safeguarding the person who got the concussion is important.   Seek medical attention. A health care professional can decide how serious the concussion is and whether you require treatment or not.

If you have suffered a grade 1 or grade 2 concussion, wait until symptoms are gone before returning to normal activities. That could take several minutes, hours, days, or even a week but still see a MD to know the level for sure.

If you have sustained a grade 1,2, or 3 concussion, see a doctor immediately for observation and treatment since most people don’t know the different levels or what level they have had. A doctor will be able to tell all through diagnostic tooling.  The M.D. will need to know details about how the concussion even happened including the symptoms you or the patient is having.   The doctor asks simple common questions to evaluate memory and concentration skills (your name, the present year, where you are, etc…).

REGARDING DIAGNOSTIC TOOLING:

The doctor may test coordination and reflexes, which are both functions of the central nervous system. The doctor may also order a CT scan or an MRI to rule out bleeding or other serious brain injury especially if he feels it was a grade 3 concussion.

If hospitalization is not required, the doctor will provide instructions for recovery. Aspirin-free medications may be prescribed and you will be advised to take it easy. Experts recommend follow-up medical attention within 24 to 72 hours if symptoms worsen.

• Take a break. If your concussion was sustained during athletic activity, stop play and sit it out. Your brain needs time to properly heal, so rest is key. Definitely do not resume play the same day. Athletes and children should be closely monitored by coaches upon resuming play. If you resume play too soon, you risk a greater chance of having a second concussion, which can compound the damage. The American Academy of Neurology has issued guidelines about resuming activities after a concussion.
• Guard against repeat concussions. Repeat concussions cause cumulative effects on the brain. Successive concussions can have devastating consequences, including brain swelling, permanent brain damage, long-term disabilities, or even death. Don’t return to normal activities if you still have symptoms. Get a doctor’s clearance so you can return to work or play with confidence.

Can I Prevent a Concussion?

NO, since normally a concussion is unexpected, so it is tough to prevent. But there are several common-sense precautions you can take to lessen the possibility of traumatic brain injury.  What you can do is PREVENTION by wearing proper protective equipment in high contact sports from football to hockey to boxing and even soccer (all increase the chance of a concussion).  Bicycling, skateboarding, horseback riding to roller blading all can be a threat of a concussion due to a fall to the head.  Wear head gear, padded guards for knees/elbows and even mouth gear or eye guards especially in racquet ball.  Believe it or not a bike helmet can lower the risk of traumatic head injury by 85%. Ensure that the equipment is properly fitted, well maintained, and worn consistently.

For athletes and non athletes, always wear a seatbelt, obey posted speed limits, and don’t use drugs or alcohol, don’t be foolish texting or using the cell phone while driving because they can impair reaction time. Obviously, don’t fight to cause a blow to your head from occuring, and more males than females report traumatic head injuries.

Look what can happen after repeated blows done to the head over a long time – Chronic traumatic encephalopathy (CTE) is a form of encephalopathy that is a progressive degenerative disease, which can currently only be definitively diagnosed postmortem.  Let us look at the meaning of the word actually in medical terminology=Chronic (meaning over a period of a long time) Traumatic (meaning the blows to the head) Encephalopathy (swelling of the brain definitely is a part of what happens but in all types of encephalopathy there is a brain malfunction.  Know there are over 150 different terms that modify or precede “encephalopathy” in the medical literature.

In March 2014, researchers announced the discovery of an exosome particle created by the brain which has been shown to contain trace proteins indicating the presence of the disease  Baseline testing has been created to assess potential cognitive impairment in athletes in contact sports, but a test to determine the presence of CTE while the person is alive and a conventional postmortem diagnosis is not yet available.

The disease was previously called dementia pugilistica (DP), i.e. “punch-drunk”, as it was initially found in those with a history of boxing. CTE has been most commonly found in professional athletes participating in American football, Association football, ice hockey, professional wrestling and other contact sports who have experienced repetitive brain trauma. It has also been found in soldiers exposed to a blast or a concussive injury, in both cases resulting in characteristic degeneration of brain tissue and the accumulation of tau protein. Individuals with CTE may show symptoms of dementia, such as memory loss, aggression, confusion and depression, which generally appear years or many decades after the trauma.

CTE is a progressive degenerative disease of the brain found in people with a history of repetitive brain trauma, including symptomatic concussions as well as sub-concussive hits to the head that do not cause symptoms. In the case of blast injury, a single exposure to a blast and the subsequent violent movement of the head in the blast wind can cause the condition.  Look at the perfect example of who this happened to that most of Americans know or heard about what the famous boxer Muhammed Ali.

Unfortunately chronic traumatic encephalopathy (CTE) at this time can only be diagnosed 100% after death. Below is a list of confirmed cases of CTE and the breakdown by sport. It should be noted that this is a small list compared to doctors understanding of the problem of CTE and the many undiagnosed cases. Through the work of the Center of the Study of Traumatic Encephalopathy researchers have been successful in securing donations of professional athletes brains after death for further study so researchers can better understand CTE and how to better prevent it. Many on this list were identified this way.

Professional Football Players:

• John Grimsley – Houston Oilers, Miami Dolphins – February 2008 (45) – Case Study
• Chris Henry – Cincinnati Bengals – December 2009
• Dave Duerson – Chicago Bears – Suicide – February 17th, 2011 (50)
• Lew Carpenter – Detroit Lions, Clevelend Browns, Green Bay Packers – November 14th, 2010 (78)
• Lou Creekmur – Detroit Lions (NFL Hall of Fame) – July 5th, 2009 (82) – Case Study
• Shane Dronett – Denver Broncos, Detroit Lions, Atlanta Falcons – January 12, 1971 Floyd Patterson

Professional Boxers:

Bobby Chacon/Jerry Quarry/Mike Quarry/Wilfred Benitez/Emile Griffith/Willie Pep/Sugar Ray Robinson/Billy Conn/Joe Frazier/Muhammad Ali (suspected)

How many non professionals have been injured due to TBI’s  with not any better.  We know now and are taking action in awareness to the public to decrease the occurrences of these brain injuries from happening!  Help the community with awareness too!!

If you notice in most of my articles there is a key to prevention in getting a illness or disease.  Start taking the step towards prevention and not waiting till it happens especially CTE since the symptoms tell the M.D. the patient has high probability of the disease but can’t be actually 100% diagnosed till death in the morgue.

SO TAKE THE STEP IN MAKING A CONCUSSION NOT HAPPEN=PREVENTION, it is so simple.  Which decreases the chance of dementia, memory loss, depression from repeated blows to the head. PROTECT YOURSELF!

You may not be happy with the results especially if the cause of death was hemmorage in the brain!

“Alison Datoc

National Winter Sports TBI Awareness Month, observed in January, is a time to increase awareness of winter sports TBIs, promote the need for a cure after a traumatic brain injury, and spur advocacy on behalf of those suffering with the emotional, financial and physical burden of TBI injuries.

National Winter Sports TBI Awareness Month calls attention to the fact that, although sports injuries contribute to fatalities infrequently, the leading cause of death from sports-related injuries is traumatic brain injury. Sports and recreational activities contribute to about 21 percent of all traumatic brain injuries among American children and adolescents.

National Winter Sports TBI Awareness Month is a public health and awareness campaign for highlighting the dangers of traumatic brain injury and the importance for taking precautionary measures when engaging in winter sports like skating, tobogganing and skiing. TBI stands for Traumatic Brain Injury which is a common result of injuries that involve the head. Every year, there are approximately 1.7 million head injuries in the United States according to the American Physical Therapy Association. More importantly, about 52,000 people die every year due to TBI. It is commonly caused by falling or crashing into another person or objects while skiing or skating. Many of these accidents lead to head injuries like concussions and traumatic brain injury.

The awareness campaign exists because TBI is usually misdiagnosed which often causes complications or the death of the patient. Thus, it is important to spread knowledge of the symptoms among medical professionals and the public. These symptoms may be experienced immediately after the accident or days/weeks thereafter.

Purpose of National Winter Sports TBI Awareness Month

The Johnny O Foundation and others like it try to raise awareness of the health risks (specifically concussions and traumatic brain injuries) ordinary individuals and athletes face when they participate in winter sports. It also highlights sports safety and preventive measures for avoiding concussions and TBIs. The main goal of the public awareness campaign is to reduce TBIs in the country.

Here are simple tips for preventing head injuries when participating in winter sports:

• Wear approved, properly fitted and well-maintained safety equipment like helmets
• Stipulate safety rules like no direct hits to the head or other dangerous play
• Encourage safe playing techniques and encourage individuals to strictly follow rules of play during winter sports activities

It is also important to take immediate action in case of suspected concussion. Here are the steps that should be taken when a concussion is suspected during winter sports activities:

• The first step is to remove the individual from play.
• Make sure that he/she is evaluated by an experienced medical care professional in the evaluation of concussions.
• Inform the family/friends of the individual regarding the possibility of a concussion and give them informative materials about concussions.
• Keep the individual out of play until he/she has been thoroughly evaluated by an experienced medical care professional and given permission to return to play.

Conclusion

National Winter Sports TBI Awareness Month is a reminder of the dangers of winter sports and the possibility of TBIs and other injuries. For such reason, it is very important to keep safety in mind and take the necessary precautions to minimize the risk of TBIs and concussions. It is also very important to be aware of the symptoms of a concussion and closely supervise someone who is suspected of a concussion or TBI.