Ways to Prevent Cancer

Ways to Prevent Cancer

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QUESTION: Your advice is always so welcome in our home, for it always rings
true. I know many people write to you to ask about cures for disease, but we
think your emphasis on prevention is most important. Now if you could discuss
ways to prevent cancer, you would be doing everyone a service.
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ANSWER: If ever I wished I had a simple and complete answer for a question,
this would be the one. The problem is that there are so many cancers, so many
causes, that there are no simple answers. The basic rules of good health are
always a fine starting point, and must be emphasized over and over again, for
they help prevent illness of all kinds. Regular physical checkups, exercise
and diet are always in order. And the researchers have given us some specific
tips that may be useful. Foods high in fiber are not merely the latest fad,
but help to lower the risk of colon cancer. Keep the fat content in your diet
low to reduce risks of breast, prostate colon and rectal cancer. Avoid
unnecessary X-rays, but be quick to permit those that are important for
diagnosis, recommended by your physician. There are so many risk factors that
exist in the workplace that you must become knowledgeable about the materials
that you come in contact with, and the safe procedures that must be used in
handling them. Excessive exposure to the harmful rays of the sun may lead to
skin cancer, so keep covered or use the appropriate sun screens when out in
the open. The evidence for the harm that smoking does is dramatic, and our
new turn to a no smoking society is one that may prevent thousands of needless
cases of lung cancer, heart disease and emphysema. There may be many more
such tips, each directed at a specific cancer, but the call for moderation in
all things, which I call for here on frequent occasions, must still be amongst
the most valuable tips one can offer to prevent cancer, and in fact all
disease. One day, I hope, I will be able to answer your question more
directly, but until then, give these tips a try.

Antibiotic Treatment During Pregnancy

Antibiotic Treatment During Pregnancy

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QUESTION: During a regular check up for my pregnancy, my doctor discovered
bacteria in my urine. Though I have no symptoms, my physician claims that it
must be treated and wants to use an antibiotic. I am against all medicining
during the time I am carrying the baby, and feel he is being over cautious.
May I have your opinion, please?
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ANSWER: Your point of view that resists medications of any kind during early
pregnancy is a fine one, and I wish more mothers-to-be understood the
principles. However, your physician is aware of the dangers of urinary
infection to both you and your baby, and is not merely playing it safe but is
most wise in his advice to you. During your pregnancy your body undergoes
many changes, including alterations in both the structure and function of your
urinary system. Urinary tract infections can be far more dangerous now than
under other conditions, and can lead to a condition called pyelonephritis
which is one of the most frequent reasons that pregnant women require hospital
care. Though you may have no symptoms now, if left untreated, symptoms can
develop 30 to 40% of the time. Your physician has a wide choice of
medications that can be used. Penicillins, cephalosporins and erythromycin
type medications are considered safe. Others, such as sulfonamides,
nitrofurantoin, metronidazole, aminoglycosides and isoniazid may be used with
caution. I doubt that your doctor will chose a tetracycline or
chloramphenicol, which are contraindicated for you. His choice will depend
upon the type of infection you have as well as your own sensitivities,
tolerance to the medication, and any possible allergies to medications.
Though you are to be complimented on your caution, this is one time when your
physician's advice is right in line with the best of current medical practice
for situations such as yours, and should be carefully followed.

The Safety of Exercise During Pregnancy

The Safety of Exercise During Pregnancy

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QUESTION: I am a bit of an exercise fanatic, but now the welcome news that I
am pregnant is causing me to rethink my training program. I would appreciate
any information you may have concerning the safety of exercise during this
period of my life. I would hate to lose all of the progress I have made, but
will doing nothing to hurt the baby.
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ANSWER: This is a most common situation, and the question of exercise during
pregnancy still remains one of controversy and discussion in the medical
literature. The basic concerns relate to the way your body is changing as you
progress in your pregnancy, and whether the modifications that occur because
of intensive training can affect these changes. It seems as there is no
absolutes; with many differing opinions, I can only point out some basic
considerations. You realize that as you as the baby grows bigger, your own
balance and center of gravity will change, and throw your coordination off.
Your body is even now preparing for the delivery, and changes in your hormones
are loosening your ligaments and other tissue. That may cause increased
mobility in your joints that could lead to an exercise injury. There is
concern that the increased demand for oxygen for exercising muscles may
diminish the available oxygen for the baby. In an attempt to bring some order
to the situation, the American College of Obstetricians and Gynecologists
developed guidelines which suggest that you only participate in exercise
designed to keep your pulse rate under 140/min and that you limit your
sessions to only 15 minutes. Any complications in the pregnancy would require
you to stop all extra exertion. But when you reflect on the reasons, I am
sure you won't mind.

Information About "Potter's Syndrome"

Information About "Potter's Syndrome"

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QUESTION: Our grandson was born recently at 26 weeks; he lived three hours.
The neonatal doctor diagnosed his problem as "Potter's Syndrome". We would
appreciate any information you might share with us. Our daughter has a
healthy 3 1/2 year old, and had a normal pregnancy with her. Thank you so
much.
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ANSWER: When such tragedy strikes a family, it is easy to understand the
search for more answers and information. Potter's Syndrome has a number of
other names, including facial-renal dysplasia, which describes the problem
quite concisely. In addition to failure to develop several components that
make up the face, nose and jaw, these babies do not develop kidneys, and so
have no chance for survival. Although they may be born alive, their life span
is usually measured in hours. The syndrome is classified as a congenital
malformation, and there are no abnormalities present in the chromosome makeup
or number. Thus this is not an inherited disease, and the chances of it
happening again are almost infinitesimal. The condition was first described
by Dr. E.L. Potter in an article in the Journal of Pediatrics in 1946. The
fact that your daughter has one normal child, and had a normal pregnancy, is
an indication that future pregnancy would most likely be normal, and that this
syndrome would not occur again. There are few explanations as to the "why" of
such congenital malformations, but it is clear that there was nothing that
could have been done to save the life of this child. I hope that both you and
your daughter will find the reassurances you must be seeking in this answer,
but suggest a conference with your neonatologist to cover any other points I
may have missed that may still be causing you anguish.

Does "Perfume Dermatitis" Mean Deep Trouble?

Does "Perfume Dermatitis" Mean Deep Trouble?

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QUESTION: I suddenly broke out with a rash that caused burning pain and
blistered. I am not an allergic person, and had not been near anything
unusual, but my doctor provided me with a diagnosis of "perfume dermatitis".
Now the area where the rash appeared is blotchy and darker than the
surrounding skin. Does any of this sound reasonable to you or am I in deep
trouble?
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ANSWER: No, you are not "in deep trouble," although the darker pigmented or
colored area may remain the way it is now for quite some time. Actually you
were lucky to have the acute burning rash first, since this condition (it is
called a "phytophotodermatitis" in medical parlance) often skips the acute
phase, producing only the coloration (hyperpigmentation) and making the
diagnosis a very difficult one to make. The condition develops when the skin
has been in contact with a class of chemical compounds (furocoumarins) that
sensitizes it to the ultraviolet rays of the sun. These compounds are
contained in many fruits and vegetables, including limes, lemons, citrus and
parsley. Since some perfumes contain oil of bergamot, which is produced from
the rind of the bergamot orange, and since this oil contains a furocoumadin,
the first step in the process occurred when you put on your good smelling
stuff. The second step happened when you walked out into the rays of the sun.
Usually the rash develops about 48 hours after this exposure, and can be quite
painful. Creams and ointments containing corticosteroids are quite effective
for controlling the acute phase, but should not be used now to treat the
pigmentation of the skin. Incidentally, the condition is also known as "the
Club Med Rash" as it appears frequently after a game that requires one partner
to roll a lime up and down the skin of the other partner, just using the chin
to manipulate the lime. Oh to be young (and foolish) again!

Pernicious Anemia and Vitamin B12 Treatment

Pernicious Anemia and Vitamin B12 Treatment

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QUESTION: I have suffered for many years with a condition called pernicious
anemia. It seems to be a disease that is in my family as my two other sisters
and brother have it as well. The only treatment offered to me seems to be
vitamin B12 injections. Could you tell me a bit about this disease, and if
you think a single injection each month is sufficient treatment?
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ANSWER: Although Vitamin B12 is readily available in meat, many other animal
protein foods as well as legumes, it can not get into our system without the
presence of a substance named "the intrinsic factor" which is secreted by the
parietal cells which form part of the tissue that lines the stomach. The B12
is stored in the liver in enormous quantities, sufficient for the body's needs
for a three to five year period. Therefore, when the mucosal tissue of the
stomach begins to atrophy and shrink, it takes a long period of time before
the lack of the vitamin can be detected and before the anemia becomes evident.
As the anemia develops the body adapts, hiding the disease for even longer
periods of time. We are beginning to learn that both inherited and immune
factors may play important roles in the development of this condition, and so
the fact that your brother and sisters also have pernicious anemia (PA) is not
unusual. Since the B12 cannot be absorbed through the digestive tract, it is
replaced by injections. In the first stages of treatment, regular injections
are given intramuscularly as frequently as 2 to 4 times a week to allow the
body physiology to resume producing red cells normally, and to replace all the
reserves the liver can hold. This may take about six weeks, but once the
blood tests show a normal picture, the frequency of the injection may be
reduced to once monthly. It would seem that you have now reached this stage
and therefore the once monthly schedule you are on is appropriate. Since this
does not change the underlying cause of the anemia, B12 injections must be
continued throughout life.

Answers About the Value of Blood Tests

Answers About the Value of Blood Tests

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QUESTION: I know that blood tests form an important tool for doctors to use
to help make diagnoses. Still it is hard to understand why at each visit,
there are either new tests to take, or old tests to repeat. With each test
costing more than I make in an hour, I need some answers about their value.
Please explain.
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ANSWER: There are several good reasons for a doctor to take blood samples for
testing, even when they seem to come too frequently and too often. In the
initial stages of evaluation, when the diagnosis is still uncertain, it may
take several tests before one shows any evidence of a disease. When results
are normal, a test is classified as "negative", and while negatives are signs
that little is wrong, they don't help too much in establishing just what is
wrong. There are many diagnostic blood tests available today, and it would be
foolish to test for everything at once, so most physicians proceed in a manner
that will provide the quickest answers at the least cost to the patient. They
test first for the most probable cause, and then proceed to lesser diseases
that can provoke the symptoms and complaints you presented when you arrived at
the office. Once the diagnosis is obtained, treatment is started, and the
effects of the treatment can be followed by testing the blood regularly. The
first abnormal results (they are called "positive") soon begin to return to
normal as the treatment takes effect. This is particularly important in
diseases such as diabetes, anemia and kidney ailments. I don't know the
reason for each test in your case, but it is most important that you find out
the purpose for these examinations from your physician, and become well
informed about your condition, its causes and its treatment, and satisfy
yourself that the tests are truly needed. You may then learn that your money
was well spent.

What Can Cause Bloating and Embarrassing Belching?

What Can Cause Bloating and Embarrassing Belching?

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QUESTION: I frequently bothered by a mild pain in my stomach, followed by
bloating and embarrassing belching. I doubt that it is serious enough to
bother my physician with, but thought you might help me out. What can cause
these symptoms?
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ANSWER: Anything that bothers you is "worth bothering" your doctor about!
Gastric discomfort is one of the 15 most common reasons for an adult to visit
a doctor's office. The discomfort can signal simple problems with simple
solutions or it may indicate a more serious difficulty that needs intervention
now.
The upper abdominal discomfort you describe is called "dyspepsia," which
is not a disease, but a symptom. It may be a symptom of a variety of gastric
problems, some minor and some serious. Sometimes it signals peptic ulcer
disease, and sometimes it is confused with the pain of coronary artery
disease, called angina.
Before you visit your doctor, take note the characteristics of your
discomfort. Is it relieved with antacids or food? Is it worse at night? Is
it worse when you're lying down? Do certain foods aggravate the condition?
Is the pain related to an emotional upset? Are you taking medications that
may upset your stomach? Aspirin, anti-inflammatory drugs and some antibiotics
can cause dyspepsia. Do you drink alcohol or smoke cigarettes? Both can
cause this problem.
See your doctor and describe the problem. The more specific information
you can provide, the better diagnosis your doctor can make.
After talking with you and examining you, your doctor may feel he needs
some tests before he can accurately diagnose your problem. Dyspepsia is a
condition that may require some patience to satisfactorily treat. How you and
your doctor approach the problem will depend on many factors, including your
age and general health.
Upper gastrointestinal studies have often been the first test ordered in
a situation like this, but some doctors are now questioning how much useful
information is obtained in an "upper G.I." Endoscopy (or gastroscopy) is a
procedure where a flexible tube is passed through the esophagus, stomach and
upper G.I. tract, and the physician inspects the inside of the tract through
this tube, or "scope." Increasingly, this has become the first test performed
in cases like yours, because inflammation can be detected using this procedure
and a biopsy can be taken when necessary, through the endoscope.
When the problem is diagnosed and treated, and you are finally symptom
free, you'll be glad you "bothered your doctor."

Is There a Method of Treating Raynaud's Syndrome?

Is There a Method of Treating Raynaud's Syndrome?

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QUESTION: I suffer from Raynaud's Syndrome and am constantly on the lookout
for any new method of treating this most annoying and frustrating condition.
A friend told me of reading about a method that trains the body to respond to
cold without causing the problems in the hands. Do you know anything about
this, and would you explain it to me?
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ANSWER: Dealing with the problems caused by Raynaud's Syndrome can indeed be
frustrating, for this condition causes the smallest arteries of the fingers
(arterioles) to constrict when exposed to colder temperatures, resulting in
extreme reduction of blood flow to the digits, followed by redness and pain
when circulation is restored. Women are affected more frequently than men,
and the medical treatment may leave a good deal to be desired. A new method
of behavioral conditioning, which your friend read about, consists of counter
conditioning the body to cold by exposing the whole body to 0 degrees C air,
while keeping the fingers immersed in warm water at 43 degrees C. This is
done repeatedly, and in many cases a higher skin temperature than previously
noted is found when the patient is exposed to cold temperatures. Many
patients report less problems and feel that the improvement has lasted long
after the conditioning training has been completed. Since there are many
possible causes for the syndrome, a complete and accurate diagnosis is
necessary to assure your condition is suitable for such training, and your
physicians counseling is a must. Of course smoking is a "no-no," as nicotine
is a potent constrictor of blood vessels. However the technique, which has
now been adapted for home training, offers real promise of improvement, and
should be given a thorough opportunity to work for you.

Is Acute Appendicitis More Dangerous to an Older Person?

Is Acute Appendicitis More Dangerous to an Older Person?

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QUESTION: Is a case of acute appendicitis more dangerous to an older person?
I always had the notion that only young people could develop this condition.
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ANSWER: Although acute appendicitis is primarily a disease of the young, it
is not unusual in older people. The danger lies in delaying treatment (i.e.,
by mistaking the symptoms for those of other illnesses), since a ruptured
appendix can lead to peritonitis, abscess, and even death.
Time, say the experts, is a crucial factor in dealing with the disease,
because mortality rates are highest (especially in the elderly) when emergency
surgery is required. Usually appendicitis follows a pattern: pain begins at
the navel and gradually moves to the lower right side of the abdomen. Nausea,
vomiting, diarrhea, tenderness, or low-grade fever normally follow.
With older folks, however, this course may not hold true. Other factors
may hinder proper diagnosis. For instance, in 45% of all cases, pain does not
localize, and in older patients it is always less intense. Special problems
such as senility, fear, or deafness may make communication with the patient
difficult. And other conditions present at the time, such as heart disease,
circulatory problems, diabetes, and intestinal disorders like diverticulitis,
often mimic or mask the symptoms.

What is a Coronary Angiography and is it Dangerous?

What is a Coronary Angiography and is it Dangerous?

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QUESTION: I have recently had a heart attack, and though I am following all
instructions completely, I am still having chest pains. My doctor has
recommended a test called coronary angiography. Can you tell me about it?
Should I have it? Is it dangerous?
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ANSWER: Coronary angiography is a very useful test, allowing doctors to
actually visualize the arteries that supply blood to the heart. By being able
to see these arteries, it allows the doctor to assess how severe a case of
coronary artery disease (CAD) the patient has. This is quite important, since
CAD is believed responsible for one-third to one-half of all deaths in the
U.S., or about 500,000 lives every year.
CAD is caused by a narrowing or obstruction of blood vessels that supply
the heart with oxygen and nutrients. If a patient's heart is continually
deprived of a sufficient amount of oxygen, it will not function normally.
When complete blockage occurs, and the blood no longer flows to the heart, the
heart tissue supplied by the blocked artery may die, causing a heart attack.
When there is a continuing complaint of pain (angina) the blockage may not yet
be complete. At that point (which seems to be where you are), it is
imperative that the problem is treated as aggressively as possible, and
coronary angiography will allow your doctor to choose the best treatment for
your case. Your previous heart attack is also an additional indication for
angiography at this time. To perform coronary angiography, a catheter is
introduced into an artery in the body. The catheter is passed up the artery
to the aorta (the main artery of the body). Contrast material or substances
(one which x-rays will not pass through, and frequently referred to as a
"dye") is then injected into the openings at the base of the aorta where the
coronary arteries originate.
The dye mixes with the blood and fills the passage inside the vessels and
allows the arteries to show up on x-ray film when photographed by a special
x-ray camera. This camera will take many pictures at a rate of from 3 to 6
times per second, which provides detailed information about the condition of
the arteries. At this point in time, coronary angiography gives the physician
the best look into the coronary arteries of any test. Almost any patient
whose treatment depends on the severity of CAD should have the procedure.
Heart patients who have had other tests with inconclusive results may also be
given this test. Other candidates for coronary angiography are those with
severe angina, chest pain, or frequent heart attacks. As with almost all
invasive procedures, there are risks associated with this test, although
coronary angiography is considered very safe. The problem most often reported
after this test is local damage or reaction at the place the catheter was
inserted. The most dangerous side effects of angiography are that it may
induce heart attack or stroke. Stroke may occur once or twice in every 4,000
cases. Heart attacks may occur one to four times in every 1,000 angiographs.
Death due to this test may occur in one to three cases per thousand.
Those at greatest risk are older patients, those with severe CAD or other
advanced cardiovascular disorders.
The decision is up to you, but my advice from the history you have
provided and my feeling that more information may help a well motivated
patient to overcome your present problem is to follow your physician's advice,
and have the procedure performed.

Does one Feel What's Going On While Under Anesthesia?

Does one Feel What's Going On While Under Anesthesia?

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QUESTION: I am going to have an operation to remove a cyst next month. I've
never had surgery before and I'm worried that even though I'll be under
anesthesia, I'm going to feel what's going on. Does that ever happen?
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ANSWER: It is extremely rare for a patient to feel anything or to actually
remember what went on while under general anesthesia, although many patients
express the same fears that you do. Fewer than 1% of patients have real
memories of anything that took place. A much greater number of people, up to
50%, may have awareness of a memory. In such cases, the patient may know
about events that occurred during surgery, but doesn't know that he knows,
since the memory remains only on a subconscious level. A number of agents
that bring about a loss of sensation are used by trained anesthesiologists to
put a person under general anesthesia. This allows the doctor to perform
surgery, which might otherwise be painful.
The drugs or agents that are used work to achieve necessary muscle
relaxation and to calm fear and anxiety, producing a state of amnesia for the
event. In many cases doctors have patients inhale gases or volatile liquids
that produce this state. On other occasions, sedative-hypnotic drugs are
administered intravenously to achieve the desired results.
It is more than likely, therefore, that you will wake up after it is all
over, and never remember what really took place.

Is it Really Possible for Someone to Lose Their Memory?

Is it Really Possible for Someone to Lose Their Memory?

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QUESTION: On recent television show, a man was portrayed as having lost his
memory. How close to reality is this? Is it really possible for someone to
forget everything about himself and life in general?
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ANSWER: The capabilities of the mind are surprising. When a person suffers
from extreme emotional distress, he can really "forget," or suppress,
information about himself and his life. This may be an attempt of the mind to
make itself more comfortable with a stressful situation. This type of amnesia
is called "functional" or "psychogenic" amnesia. During the time of the
amnesia attack, the person can learn new information and does not appear
generally confused.
On the other hand, victims of "transient global amnesia" appear confused
about recent events, but they know who they are and cannot learn new material.
This type of amnesia is very temporary, and may be triggered by physical or
emotional stress. The victim may behave as if he has had a slight stroke, and
should certainly be evaluated by a physician to be sure there is no other
problem.
Transient global amnesia is probably caused by an interruption of blood
flow to the parts of the brain that are important to memory. Experts in this
field say that the person who suffers from transient global amnesia rarely
needs treatment for any other problems; he simply needs support during the
stressful time of memory loss. If the problem occurs often, aspirin may be
prescribed so that the blood is "thinned" enough so that it flows through
vessels that may be constricted. This same picture may be caused by migraine
in younger people.

Can Activated Charcoal be Used to Reduce Belly Cramps?

Can Activated Charcoal be Used to Reduce Belly Cramps?

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QUESTION: I am on a new high fiber diet, but suffer a bit from some of the
side effects of this new healthy diet. I've heard that relief from my problem
may be obtained by using charcoal. Can activated charcoal be used to reduce
my belly cramps?
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ANSWER: Yes, it most certainly can. Clinical research has shown that
activated charcoal can significantly lower intestinal gas and its related
symptoms, which include abdominal cramps, bloating, and diarrhea. Activated
charcoal may be helpful, particularly to those who eat high fiber diets, which
are now widely recommended and becoming quite popular. Foods high in fiber
consisting of fresh fruits and vegetables (lightly cooked or raw), whole
grains (cereals and breads), and dried fruits (raisins, prunes, apricots), are
recommended for the prevention of colon cancer as well as more common problems
such as constipation. However, such diets can also cause excessive gas and
flatulence. Activated charcoal may increase your ability to adjust to this
problem, and may be taken without fear, since even when digested in large
doses and for long periods of time, it is safe and without adverse side
effects. This will allow you the best of both worlds; the benefits of a high
fiber diet, and freedom from the discomfort some individuals experience when
beginning such a diet. You will also be happy to learn that the problem
becomes much less as your body adapts to the fiber.

Can One Develop Cancer From Sexually Transmitted Viruses?

Can One Develop Cancer From Sexually Transmitted Viruses?

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QUESTION: I am aware of many types of sexually transmitted disease because of
the many articles that now appear on this subject. My question goes a bit
further, for I am concerned with the possibility that one can develop cancer
from viruses which may be transmitted in this way. Is there any way in which
this can happen?
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ANSWER: Unfortunately, the answer to this question is "yes". A papilloma
virus may cause a condition known as Condylomata Acuminata which has been
linked to squamous cell cancer of the cervix in many studies. Genital warts
appear as a growth commonly found on the vulva, under the foreskin or on the
skin of the anal region initially as soft pink or red swellings that rapidly
multiply and take on a cauliflower like appearance. The condylomata virus is
infectious and is transmitted sexually. There is an incubation period of from
1 to 6 months between infection and the appearance of the lesions.
Squamous cell cancer of the cervix is never found in virgins, and is
extremely rare in monogamous relationships. Women who are found to carry the
virus are estimated to have a 1,200 to 2,000 times greater risk of cervical
cancer than women who have never been infected by the virus. There is no
treatment which is totally satisfactory, but the warts can be removed by
application of extreme cold (cryotherapy), electrocauterization, or the
application of podophyllin or trichloroacetic acid. Any woman diagnosed as
carrying the virus should have regular Pap smears and be carefully monitored
for the possibility of cervical cancer.

Is There Anything to Get Rid of Cellulite on the Hips?

Is There Anything to Get Rid of Cellulite on the Hips?

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QUESTION: I am basically a thin person, but have cellulite on my hips and
thighs. Is there anything special I can do to get rid of this? Can you
explain what cellulite is?
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ANSWER: Cellulite is really no different from regular fat. It is a word used
to describe the bumpy orange peel appearance of fat that most frequently
appears on women, on their hips, thighs and buttocks. Researchers have
compared fat biopsies taken from people with cellulite deposit areas with fat
taken from people free of cellulite. They found that the fat is essentially
the same. The ripple-like appearance is thought to be the result of the
connective tissue that envelops each fat cell and separates the cells into
compartments. These cells bulge as more fat is stored in them due to weight
gain.
Although some men are afflicted with cellulite, more women develop the
problem because their outer layer of skin is thinner and female areas of fat
are larger and more rounded.
If you are thin, but have patches of cellulite in the common areas, then
it will be tough if not almost impossible to get rid of it. Unfortunately,
fat does not always accumulate evenly over the entire body, but in areas of
high concentrations in some anatomical areas. There is no such thing as spot
reduction, and I advise you against believing any advertisements that promise
such results. In reality, exercise along with a low calorie diet will help
take fat off from all areas of your body, and may be of some help. Exercising
the areas where you have cellulite will tone the underlying muscles, but it
won't necessarily remove fat from that area of the body.

What is the Name of the Artery Operation to Prevent Stroke?

What is the Name of the Artery Operation to Prevent Stroke?

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QUESTION: What is the name of the artery operation to prevent stroke? Is it
safe? There is someone in our family who may be in need of such an operation.
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ANSWER: Although I'm not sure from your letter just what information you are
seeking, I suspect you mean a surgical procedure called "carotid
endarterectomy". I'll proceed on that assumption and answer your questions,
because I believe many other readers may also be interested. When performed
under optimum conditions, carotid endarterectomy can prevent stroke. Those
conditions include operating on patients that exhibit the traditional symptoms
of ischemia (when there is a lack of oxygen being delivered to the brain
because of obstructed or blocked blood vessels) or impending stroke: partial
paralysis or numbness in the limbs on one side of the body, speech loss, and
partial vision loss. For these patients, carotid endarterectomy is considered
a safe and straightforward procedure. The operation attempts to clean out the
passage of the obstructed vessels, allowing the blood to flow freely towards
the brain.
But for patients who exhibit widespread symptoms, such as overall
paralysis or total vision loss, or for those who exhibit no symptoms at all,
the procedure can be dangerous. At best, under these conditions, there is no
guarantee that the procedure will prevent stroke. At worst, the operation
itself could prompt stroke. In these cases, the physician relies upon the
patient's past history of stroke and evaluates the possibility of a future
stroke against the potential danger involved in performing the endarterectomy.

Is Cancer an Inherited Disease?

Is Cancer an Inherited Disease?

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QUESTION: In the last three years, I have lost two brothers and a sister to
one form of cancer or another. Although I am not sure, I believe my father
died from cancer as a young man. It looks like the odds are stacking up
against me if cancer is an inherited disease. Is it?
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ANSWER: It appears likely according to some research. However, don't panic
and live the rest of your life constantly fearful that you are going to
develop cancer. A great deal of scientific progress is being made these days
in preventing, diagnosing, and treating cancer.
In your case, one of the most important things that you can do is to see
your doctor--one that you trust and can talk with easily--regularly.
Your physician will discuss your family's medical history thoroughly. It
is highly important that you tell the doctor all details about your family and
yourself, and that you follow the doctor's directions PRECISELY.
With knowledge that the possibility of hereditary cancer exists, your
physician can give special attention during regular exams to those organs that
may be most vulnerable. There are several procedures that may be indicated,
such as colonoscopy, that will search out any new growths in your large
intestines (such as polyps), and allow treatment before any cancer can get a
foothold. Though there is some discussion about the value of yearly or
routine physical examinations, they are most important in your case. Good
health should become your byword, with attention to diet and exercise and the
knowledge that your best defense is one that allows for early detection and
treatment. With all these positive steps taken, you probably will live a
longer and healthier life than many of your associates and friends, who are
not as attentive to their health needs.

Can Caffeine in Large Doses Improve Athletic Performance?

Can Caffeine in Large Doses Improve Athletic Performance?

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QUESTION: Is there any truth to the idea that caffeine in large doses can
improve athletic performance?
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ANSWER: As a stimulant, caffeine is a double-edged sword that may enhance
your performance in endurance activities (long distance events) but poses
greater health risks that far outweigh any slight performance benefits.
Hence, it is banned by the International Olympic Committee if present in the
urine by more than 15 mu_g/ml. It does not significantly improve performance
for maximal short-term exercise bouts.
Caffeine supposedly assists in endurance events by stimulating the
central nervous system (increasing alertness), increasing the breakdown of
fatty acids (instead of muscle glycogen for energy), and increasing muscle
contraction. Meanwhile, caffeine also masks fatigue, an important warning
sign, which may fool athletes into thinking they are performing better. But
for the body, it's a different story.
Headaches, tremors, nervousness, increased urine production and heart
beat irregularities are harmful effects of caffeine used even in the 200 to
500 mg range. And these dangers increase in severity as the dosage is
increased. Even die-hard endurance athletes would admit that such
caffeine-induced symptoms as increased urine production, irritability, dry
mouth, ringing in the ears, impaired sense of touch, increased muscle pain,
headache and heart beat disturbances probably cancel out any supposed
advantages towards increased endurance performance.
In medicine, much as in life, there always seems to be a price that must
be paid for every desired effect. Sometimes, the advantage is just not worth
the cost.

Is There a Way to Figure Out Cancer Risks in the Workplace?

Is There a Way to Figure Out Cancer Risks in the Workplace?

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QUESTION: There is a lot of discussion at our plant that concerns the amount
of risk we run of developing cancer from exposure to all the things found in
the workplace. Is there any way you can figure out your chances of developing
cancer at work?
------------------------------------------------------------------------------
ANSWER: It's a tough call. There are many factors that go into determining
whether an individual has developed a cancer because of exposure to
carcinogens (cancer-causing chemicals or substances) on the job. Some cancers
may not show up until 20 years or more after exposure and may be linked to
many different causative factors, such as smoking. Other types of cancers are
rare and are strongly linked to specific carcinogens.
Smoking, the leading cause of cancer in the United States, also appears
to amplify the risks of other carcinogens, especially those like asbestos that
cause lung cancer. A smoker exposed to asbestos runs a much greater risk of
lung cancer than someone who only smokes or who only was exposed to asbestos.
Different carcinogens also vary greatly in how great a risk they pose.
For example, asbestos is well known to be carcinogenic, but wood dust also
causes cancer in a small percentage of people who inhale it for many years. A
worker may be exposed to many different chemicals over the years, and, of
course, might smoke, which clouds the picture.
The first thing your physician would do if occupational induced cancer is
suspected is to take a most careful history, asking many questions about every
place you worked and every substance you worked with and around. Then he or
she must compare the type of cancer you have with any known carcinogens you
were exposed to, looking for a link.
Even after a complete examination and study, and with all the currently
available tests, it is often difficult to obtain a precise answer to your
question.

Is Heart Bypass Surgery Becoming a Common Procedure?

Is Heart Bypass Surgery Becoming a Common Procedure?

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QUESTION: It would seem from all the people who I know that have had it that
heart bypass surgery is becoming a common procedure. Is it an operation that
everyone with diseased heart arteries should have?
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ANSWER: I have a fairly direct answer to this question and it is a resounding
"No". When you have coronary artery disease, your heart's arteries are
obstructed, or clogged. This condition can be present in varying degrees of
severity, and in a portion of one or in all of the heart's arteries. When a
bypass is performed, the diseased artery is "bypassed" with a "new" artery,
usually an artificial graft or possibly one fashioned from a section of a
vein removed from the leg.
There are also other ways to treat coronary artery disease. Some are
medical therapies and there are other surgical procedures besides bypass. The
only way to know the exact nature of coronary artery disease and the best way
to treat it is by using a diagnostic procedure called "angiography". This
allows the doctor to take a type of x-ray picture that shows the actual state
of the arteries that carry blood to the heart, and discover if any of them are
partially or totally blocked. Everyone with chest pain does not necessarily
require this procedure, so your doctor will be evaluating your total situation
before he asks you to have one done.
However, once the procedure has been performed, a specific diagnosis can
be made about your condition which will determine whether surgery might be the
best course for you to take. Since bypass surgery was introduced in 1968, it
has been studied by many different researchers in many different settings.
Coronary artery disease is very complex, and we do not know all about it that
we need to know. However, the National Institutes of Health in 1985
recommended some guidelines to help physicians evaluate those circumstances
which will benefit most from bypass surgery. Among those diagnoses that
warrant bypass surgery are uncontrollable chest pain with severe heart artery
obstruction and greater than 50% obstruction of left main coronary artery.
One of the diagnoses that was listed as a debatable cause for bypass surgery
is the obstruction of all three of the main heart vessels, if the heart is
still functioning well, where medical treatment may offer satisfactory
results.
There is usually sufficient time before making a decision about heart
surgery for you to become well informed about your need for it, as well as the
risks and the chances for the outcome you are hoping for.

Does Breast Cancer Screening Really Reduce Deaths?

Does Breast Cancer Screening Really Reduce Deaths?

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QUESTION: With everyone on the band wagon, my question may seem naive, but I
hope you will give it the attention I believe it deserves. Does breast cancer
screening really reduce deaths?
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ANSWER: You bet. It is a lifesaver. Since breast cancer can be treated most
successfully at its early stages with a high chance of cure, any method of
early detection is bound to reduce deaths.
Proof of this comes from a one study (and there are others) of more than
8,000 women who were screened and followed for more than 10 years. One out of
every seven women who had biopsies was found to have cancer, and about 10%
with cancer died from the disease for an overall survival rate of better than
90%.
Age and tumor size seem to be important factors in survival. If you are
under 50 years the survival rate is 84%, but if over 50 years the survival
rate jumps to almost 95%, according to this study.
Tumors 1 cm in diameter or smaller are less deadly than large ones. The
highest survival rate of almost 97% was in women whose tumors could not be
felt at all but showed up on mammography.
Older women also had a higher survival rate in cancers detected by
mammography alone (no biopsy). All of the 45 older women in this group were
alive after 10 years compared to 88% of the younger women.
These findings are not related to the type of treatment or to the skill
of the physicians. They simply reflect the results of routine screening, and
point out just how important it is in saving lives. I can't think of a better
bandwagon to jump on than this one, because breast screening really saves
lives.

Is it All Right to Heat a Baby Bottle in the Microwave?

Is it All Right to Heat a Baby Bottle in the Microwave?

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QUESTION: I greatly appreciate the convenience that a microwave oven can
provide a homemaker. However, where my baby is concerned, I am a fanatic
about details, and so want to know if is it all right to heat a baby bottle in
the microwave?
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ANSWER: To properly respond to your question, I must use "Yes and No" as my
answer. Using a microwave to heat a baby bottle or baby food doesn't make the
food dangerous nor does it destroy any nutrients in the food (or at least no
more than heating on a stove would). The hazard in using a microwave comes
from the fact that the food gets hot but the container often stays cool to the
touch. If you take what feels like a comfortably warm bottle out of the
microwave, you may not realize that the milk inside may be near boiling unless
you test it.
There have been several incidents where small children have scalded their
mouth and face with hot liquids right out of the microwave. In some cases,
the extremely hot liquid causes internal burns, as well. In these situations,
the container was not as hot as the liquid and the child didn't feel the heat
until too late.
"Yes", you can use a microwave to heat a baby bottle, but "No," unless
you use caution and test the heat of the contents of the bottle yourself. Try
sprinkling a few drops on your wrist, just to be sure. In similar fashion,
keep small children away from microwaved foods until you check to see that
they are the right temperature for safe eating.

Scopes for Looking Into the Lungs

Scopes for Looking Into the Lungs

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QUESTION: I know doctors use telescopes to look into your bowels and stomach.
However my problem lies within my lungs, and my doctor has suggested the same
procedure looking into my lungs. Can that be done?
------------------------------------------------------------------------------
ANSWER: Those aren't telescopes, those are endoscopes, and yes, there is a
special endoscope for looking into the throat and lungs. A bronchial
endoscope, or bronchoscope, uses optical fibers to view the lungs, the throat,
the voice box, and the windpipe. It can also remove foreign objects or take a
small sample of tissue for analysis.
You can undergo bronchoscopy either as a hospital patient or as an
outpatient. Before the test, you'll be given a medication to relax you and to
reduce secretions in your lungs. While you lie on a table, your doctor will
spray your nose and throat with a local anesthetic and insert the tube through
either your nose or mouth. Breathe slowly and try not to cough. Although
your throat will feel full, you will still be able to breath around the
bronchoscope.
The test will provide your physician with a great deal of very important
information about your lungs which can be important in establishing the
correct therapy for your condition.

Painful Menstrual Cycles

Painful Menstrual Cycles

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QUESTION: I am 32 years of age and have had extremely painful menstrual
cycles for almost my entire life. I always thought this was normal for me,
but recently my physician advised me that the "tissue" from inside of my
uterus was "out of place." He now wishes to prescribe hormones to treat my
situation and I am confused. Can you explain this disease to me and tell me
what treatments can help?
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ANSWER: The description of your symptoms and the comments of your physician
clearly indicate that you are suffering from endometriosis. The name of this
disease comes from the term endometrium, the medical term for the tissue that
lines the uterus. Each month, when the uterus sheds this tissue, a woman
experiences her menstrual cycle. In endometriosis, the tissue normally
located inside of the uterus is found elsewhere in the body in abnormal
locations such as the ovaries, the lower abdomen, or in the wall of the uterus
itself. This is a common disease and can affect women of all races and of all
ages, although it is seen most frequently in women between the ages of 30 and
40. It is the most common cause of infertility in women over the ages of 25
and almost 15% of all patients who are infertile have endometriosis.
Women who suffer from this disease complain of severe menstrual cramps,
heavy and irregular bleeding, and often experience pain during or after sexual
activity.
The abnormally located tissue follows the same pattern of monthly build
up similar to the normal tissue lining the uterus, but unlike that lining has
no way of exiting the body. This leads to internal bleeding, inflammation,
and the development of fibrotic adhesions and scars. All of these
complications lead to the pain you have experienced. Although the diagnosis
can be suspected by the history you have related, there are really no specific
signs or symptoms that permit the physician to make an accurate diagnosis.
This can only be accomplished through the use of a laparoscope, which is a
long, thin tube equipped with a telescopic lens system, and has its own source
of illumination in the tube. With a patient under anesthesia, a small
incision is made just below the navel and the laparoscope is inserted. This
permits the physician to see all the organs in the abdomen and various
structures such as the fallopian tubes, ovaries, female organs, liver and
gallbladder. The physician is able to determine accurately the extent and
location of the various locations of endometrial tissue which form the basis
for your difficulty.
There are several types of treatment that can help you, frequently
requiring a combination of medical and surgical techniques. Hormonal
treatment is usually attempted first and frequently controls the disease
rather effectively. Hormonal treatments may include the use of female
hormones (estrogen and progesterone) similar to the kinds and quantities
contained in birth control pills. Other hormones which are derived from
testosterone, the male hormone (danazol and cyclomen) are also widely used as
treatments.
It's interesting to note that pregnancy may stop the progress of the
disease, and so if you wish a child, this may be the treatment of choice.
Carefully follow the instructions of your physician and proceed in a step
by step fashion so that you may ultimately control this disease with a minimum
of complications or surgery.

Does Difficulty in Swallowing Mean Cancer?

Does Difficulty in Swallowing Mean Cancer?

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QUESTION: I have developed some difficulty in swallowing. I can't get the
idea that it is cancer out of my mind. What are my chances that it is?
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ANSWER: Yes, cancer of the esophagus can cause trouble in swallowing (called
dysphagia), but there are also many noncancerous causes. Risk of esophageal
cancer is increased by heavy smoking and heavy use of alcohol. However, the
only way to tell what is causing your problem is to see a physician who will
ask questions about how long you've had trouble swallowing, whether it comes
and goes, or whether you only have trouble swallowing solid food.
If you have trouble swallowing both liquids and solid foods, there may be
a problem with the way your esophagus moves food into your stomach. If you
have trouble swallowing solid foods only, there may be an obstruction of some
kind, which may or may not be esophageal cancer. For example, if you've had
heartburn for many years, the acid that backed up into the esophagus may have
caused changes that reduced the diameter of the esophagus and obstructs the
passage of food. If the trouble with swallowing solid food comes and goes,
you may have a condition called Shatzki's ring, where the last inch or so of
the esophagus has narrowed.
Your doctor may ask you to have x-rays taken of your esophagus and
stomach while you drink a barium solution. The barium will show how your
esophagus acts when you swallow and any obstruction will be seen clearly.
Treatment for difficult swallowing depends on the diagnosis, but some cases
can be treated simply by chewing food well before swallowing.

Discomfort and Pain During Sexual Relations

Discomfort and Pain During Sexual Relations

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QUESTION: I know it's not normal, but I don't know where to turn for help. I
experience a great deal of discomfort and pain during sexual relations. I am
a young woman, and realize that this shouldn't be happening. Why is it?
Help!
------------------------------------------------------------------------------
ANSWER: You may be embarrassed to talk to your doctor about this condition,
but keeping quiet about it and hoping it will go away is not going to work.
Pain during intercourse, or dyspareunia, is uncomfortable to talk about, but
worse to suffer through in silence.
There are several possible physical and psychological causes and both may
have a hand in causing the pain. Describe the pain or discomfort to your
physician. Tell him or her how long you've had the pain, what it feels like,
and when and where it occurs. Also note whether the discomfort is only at the
opening of the vagina or deeper in.
In older women, pain during intercourse may be due to the drying of the
vagina that occurs after menopause. However, some younger women have a
chronic lack of lubrication even when they are sexually aroused. This can be
treated easily by using a lubricant. Vaginitis can also cause pain during
intercourse, since the walls of the vagina may be inflamed and irritated.
Pelvic inflammatory disease, endometriosis, and tipped uterus can all cause
discomfort during deep penetration.
Pain during intercourse may also be caused by a severe involuntary muscle
spasm known as vaginismus. This spasm may be caused by a psychological fear
of sex, perhaps due to sexual trauma or because a physical problem has made
sex painful. Behavioral and psychological therapy can help with this problem.
Without doubt, it is not something that a young woman must or should try to
live with. Please don't take this brief amount of information as the last
word, but gather up your resolve and courage, make a few notes on paper to
help, and get to see your family physician right now.

How do the DTs Work?

How do the DTs Work?

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QUESTION: They always show the alcoholic who can't get a drink going through
all kinds of distress and shakes on the TV detective shows. I suppose it is
supposed to represent the DTs, but I don't understand how the DTs work. Can
you explain the DTs to me? Is it as bad as some people make out that it is?
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ANSWER: DTs or Delirium Tremens is a severe withdrawal syndrome that occurs
when chronic alcoholics no longer have access to alcohol, and it's a
frightening "real life" situation. It begins with anxiety attacks, poor
sleep, and often a profound depression. The patient becomes increasingly
confused and may sweat profusely. In the confused and disoriented state,
hallucinations occur which are frightening to the patient; and visual
hallucinations, often involving animals, may terrorize the patient. As the
DTs continue the hand may begin to shake, and sometimes even the head and
trunk are affected by this tremor. It is not a pleasant thing to watch and
medical care must be obtained immediately. Sedatives, tranquilizers, and
intravenous fluid therapy may all be necessary to successfully raise the
patient out of this nightmare situation. I am not sure these depictions are
helping anyone, although most of the TV I see these days use the withdrawal
from drugs in the same way. And the withdrawal syndrome is a very similar
one, although the treatment may vary just a bit. If it passes on the lesson
that drugs can lead to some horrifying experiences, than I would have to
endorse these depictions.

Is Using a "Diuretic" for Weight Control Dangerous?

Is Using a "Diuretic" for Weight Control Dangerous?

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QUESTION: With a slim line being the "in thing" these days, I received a tip
from my always slim friend. She tells me that a "diuretic" is her secret for
success. Isn't this dangerous? How do diuretics work?
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ANSWER: Diuretics, often called water pills, are drugs that increase the
output of urine. They most often work by causing the kidneys to put out more
water and minerals than they would by themselves. Diuretics can be used
safely for patients under medical care for conditions that make their use
necessary, but they are sometimes abused by people like your friend who use
them for weight control. Misuse of water pills can be very dangerous. Since
diuretics reduce the amount of water in the body, there is sometimes a
corresponding reduction in the volume of blood. This can cause light
headedness or dizziness and can increase the risk of faints and falling.
Diuretics can also cause an excessive loss of potassium in the urine. Over
time, a significant lowering of the potassium levels in the tissues and blood
can cause a weak feeling, irregular heart action and disturbed sexual
function.
Clearly, diuretics should not be used by people who don't have a medical
reason for using them. Diuretics can, however, be very valuable for people
with conditions in which the body retains water or sodium. People with
hypertension (high blood pressure) or heart and kidney disorders can use the
drugs safely when they are prescribed by a doctor. I trust you were not
considering following your friend's bad example?

Will Corn Plasters Work on a Bunion?

Will Corn Plasters Work on a Bunion?

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QUESTION: My husband tells me that my corn plasters will never work on my big
bunion. I always thought they were the same thing. We have a bet on this
one. Will you clear this up for me and tell me what causes them?
------------------------------------------------------------------------------
ANSWER: No, they are really quite different, although they both usually occur
on the feet, and they both stem from the same cause. A corn is an area of
thickened and hardened skin, usually occurring over the knuckle of a toe. A
bunion, however, is an enlargement of a joint of the big toe, and can be due
to excess fluid in the joint, or to changes in the bones that make up the
joint. They are both formed as a response to pressure on that area of the
foot, pressure which generally is created by poor fitting shoes. Women's'
shoe styles seem to create the problem more frequently for them than in men,
but some people inherit a tendency to form these annoying bumps. If you won't
or can't change your fashions, and those corn plasters fail to rid you of your
problem, you may have to consult a foot specialist for help. Depending upon
the cause of your bunion, any one of a number of devices may be placed inside
of your shoe to correct the problem. If this is not effective, surgery may
become necessary. I am sorry to have to say this, but it looks like you lost
your bet.
----------------
The material contained here is "FOR INFORMATION ONLY" and should not replace
the counsel and advice of your personal physician. Promptly consulting your
doctor is the best path to a quick and successful resolution of any medical
problem.

How Cocaine Affects the Heart

How Cocaine Affects the Heart

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QUESTION: Many of my colleagues are occasional uses of cocaine for "social
relaxation". My warnings of its danger go unheeded, but I know they are at
risk for heart problems. Maybe a column on how cocaine affects the heart
might help?
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ANSWER: I am happy to oblige. You, of course, are correct. Cocaine can
cause a fatal heart attack. Remember the headline stories of the deaths of
two star athletes, University of Maryland basketball star Len Bias, and pro
football player Don Rogers? Yet the myth persists that cocaine is a safe and
nonaddicting drug for occasional recreational use--and at least 5 million
Americans use it regularly.
Regardless of how cocaine is used, whether it is sniffed, smoked, or
taken orally, it can enhance catecholamine activity in the body.
Catecholamines are naturally produced compounds that affect different systems,
including the cardiovascular, and can intensify the response of certain
organs, like the heart.
This excess of catecholamines can interfere with normal heart rhythms and
increase blood pressure. It can also cause an abnormally high heart rate,
heart spasm, constricted blood vessels, and even blood clots. These
conditions can lead to a blocked coronary artery--and a heart attack--even in
a young, previously healthy person who has no history of heart disease.
Anyone who already has coronary artery disease greatly increases his risk for
heart attack by using cocaine.
And playing games by adding amphetamines, which are sometimes used in
combination with cocaine, raises that risk even higher. Listen up out there;
this man is no prude, he is just telling it like it is.
----------------
The material contained here is "FOR INFORMATION ONLY" and should not replace
the counsel and advice of your personal physician. Promptly consulting your
doctor is the best path to a quick and successful resolution of any medical
problem.

What do Doctors do for People in the Case of an Overdose of Cocaine?

What do Doctors do for People in the Case of an Overdose of Cocaine?

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QUESTION: The use of cocaine seems so wide spread that there must be cases
when people overdo it and take too much at a time. What do doctors do for
people in the case of an overdose of cocaine?
------------------------------------------------------------------------------
ANSWER: Cocaine is not the "harmless high" it was once thought to be. Since
the 1970's, when cocaine became a popular "recreational drug", people have
been showing up at emergency rooms with sudden cardiac arrest, myocardial
infarction (heart attack), epilepsy-like seizures, and cardiac arrhythmias
(erratic heart beat), all caused by snorting, injecting, or smoking cocaine.
Cocaine can kill, even on the first use. When a young person with no previous
history of seizures or heart problems shows up at an emergency room, cocaine
use should be suspected.
In a case of cocaine overdose, if there are no serious problems,
emergency room staff will make sure that the patient can breathe and will
attach an I.V. line for fluids and a cardiac monitor. Seizures are treated
with tranquilizers such as Valium and cardiac arrhythmia is treated with beta
blocking agents.
No attempt is made to remove the cocaine from the patient's system
because nature takes care of that. Cocaine leaves the body relatively
quickly. Most of it is metabolized by the liver, broken down into less
harmful chemicals, within 2 hours of ingestion. Except for traces that can be
picked up in drug tests for several days, the effects of snorted cocaine last
about 3 hours after use, while the effects of intravenous or smoked cocaine
(freebase or crack) are even shorter.
Unfortunately, the rising availability of the smokable crack is making
cocaine use more addictive. Fortunately, public awareness of the cocaine
problem is growing, but there is still much to be done in educating everyone
about its dangers.

Can Sedatives and Tranquilizers be Used in Treating Headaches?

Can Sedatives and Tranquilizers be Used in Treating Headaches?

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QUESTION: Headaches are my big problem, and I am constantly hoping for new
and different ways of dealing with them. Can sedatives and tranquilizers be
of any use in treating headaches?
------------------------------------------------------------------------------
ANSWER: Some studies have shown that sedatives and tranquilizers have, at
times, helped patients suffering from migraines, muscle contraction headaches,
and to a lesser extent, cluster headaches in adults. Evidence of the value of
these drugs in properly conducted, double-blind trials has not yet come in,
however, and doctors must weigh the risks of addiction and withdrawal symptoms
before prescribing tranquilizers and sedatives for treatment of headaches.
Recurrent headache is one of the most common reasons that people seek the
help of doctors. A detailed patient history is necessary to identify the true
nature of the headaches. The prudent doctor will have patients undergo a
complete physical, neurological exam and blood pressure tests before treatment
is administered. Although more than 400 remedies have been used for
migraines, with the exception of propranolol, there has been a poor success
rate for most. That seems to be why sedatives and tranquilizers are being
prescribed. There is little agreement among researchers regarding when these
drugs should be employed.
The most common cause of headache in adults is tension. The tension may
cause what are known as muscle-contraction headaches, which can be severe,
recurrent and disabling. Double-blind trials on patients with this problem
have shown that a combination of aspirin and a mild tranquilizer relieved the
sufferer more than just aspirin alone. Sedatives and analgesics have been
used for years, but because they can be habit-forming and are not consistently
successful, alternative methods have been sought to reduce the pain. The
tranquilizer valium given intravenously has been proven effective as a
treatment for cluster headaches. Sedatives have been found to be of little
help in treating them.
When the causes of a symptom such as headache are so numerous, and the
available medications which might be helpful are so abundant, it takes careful
cooperation between patient and physician to arrive at just the right
combination of drugs which will be correct for a specific individual and
situation.

It Possible That a Stomach Disease Can Cause Halitosis?

It Possible That a Stomach Disease Can Cause Halitosis?

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QUESTION: I suffer from chronic halitosis and although I use all of the
advertised products to brush my teeth and rinse my mouth, the smell just won't
disappear. Is it possible that I have some disease in my stomach which is
causing this condition?
------------------------------------------------------------------------------
ANSWER: The most common cause of halitosis or an unpleasant odor to the
breath may be related to eating certain foods, particularly garlic and onions.
It's also possible that unpleasant odors can be caused by breathing certain
substances which are then excreted through the lungs. In most instances,
however, the odor comes from something in the mouth, diseases like gingivitis
or infections in the teeth. The odor can be created by the fermentation of
food particles caught between the teeth. Some liver diseases may affect
breath odor and the condition called "diabetic acidosis" will also provoke a
different or unpleasant odor to the breath. Certain conditions of the
esophagus, the tube which leads from the mouth to the stomach, such as an
infection or a tumor, can cause bad breath. Then there is the rare situation
when a sac-like structure grows out of the esophagus and traps food that
should pass on to the stomach, but instead becomes lodged in the sac, decays,
and creates unusual odors. A post nasal drip may provoke certain odors
carried in exhaled air, and perceived as halitosis.
One thing we can be sure of, bad breath odors do not reflect any stomach
diseases, nor do they depend upon your state of bowel function. Although you
are brushing teeth regularly and using mouthwash, your best action would be to
visit your family dentist first to be sure that you have checked out all the
possible causes that can occur in the mouth, then your physician if the
situation persists.

What is the Difference Between an Overactive Thyroid and Grave's Disease?

What is the Difference Between an Overactive Thyroid and Grave's Disease?

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QUESTION: My husband had a thyroid operation three years ago for an
overactive thyroid. When the bill came, they had diagnosed the problem as
Grave's Disease. Can you tell us what the difference is between an overactive
thyroid and Grave's Disease? Some say it is the same.
------------------------------------------------------------------------------
ANSWER: The technical name for an overactive thyroid is Hyperthyroidism,
which is one of a group of findings which are classified as Grave's Disease.
In the diagnosis of Grave's Disease, we find not only a hyperactive thyroid,
but also one or more of the following conditions; goiter, which is, in fact,
an enlarged thyroid; prominent eyes which seem to bulge (exophthalmos), and
swelling of the legs in the area around and above the ankle. The eyes take on
a staring look and sometimes the lids become swollen or retracted. The
patients may complain of excessive tearing or irritation, and are annoyed by
bright lights. The swelling in the leg area may be very itchy and red. Both
the eye condition and the skin condition can appear years before the actual
onset of the effects of the overactive thyroid. In other cases, they're not
discovered until years later. At any rate, the operation certainly was
indicated, for even when too much of the thyroid is removed, doctors can
always replace the amount of thyroid hormone necessary for normal body
activity by prescribing synthetic thyroid hormone.

Is Gout a Condition That Could Only Affect Men?

Is Gout a Condition That Could Only Affect Men?

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QUESTION: When a painful toe flared up and didn't seem to get better after a
few days, I visited my physician. The diagnosis was gout, but I thought that
this was a condition that could only affect men. Isn't that true?
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ANSWER: You are correct, well, almost. 95% of all people who suffer with
gout are men, so you're unlucky enough to be in the minority here. Gout is a
type of arthritis that is caused by a build-up of crystals of monosodium urate
(which comes from uric acid) in the fluid of the joint. It commonly shows up
first as a painful, swollen big toe. In women, gout usually comes on after
menopause. Older women who are on diuretic therapy for hypertension or who
have poor kidney function appear to be at greater risk.
People once thought that gout was caused by high living and too much rich
food. Crystal formation (and thus swelling and pain) is increased if you eat
a diet high in a type of protein called purines, present in large quantities
in glandular type meat, such as liver. However present day medications are so
effective that your doctor may not require you to change your diet. You may
require different medications at different stages of the attack. First,
colchicine to deal with the acute attack, then medication to lower the levels
of uric acid in your blood, followed by medication (allopurinol) that helps
prevent the formation of uric acid and prevent future recurrences.

Why do Elderly People Have So Many Digestive Disorders?

Why do Elderly People Have So Many Digestive Disorders?

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QUESTION: It seems as though we all sit around much of the time and complain
about our stomachs. Why do elderly people have so many digestive disorders?
Are some gastrointestinal problems more common to us senior citizens than
others?
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ANSWER: Elderly people suffer from digestive disorders because of many
different factors. Although the gastrointestinal (GI) tract does not usually
change very greatly due to the aging process, there are influences other than
aging that take their toll. Malnutrition, a reduction in exercise, or a
problem with any other part of the body may lead to digestive symptoms ranging
from abdominal pains to constipation to dysphagia (difficulty with
swallowing). The number of cases of cancer somewhere in the digestive system
is very high among the elderly. Chromosomal instability is often the cause,
but other factors include a diet low in fiber and high in carcinogens or a
chronic inflammation of the lining of the stomach. Diverticular disease is
also common among the elderly. Again, a low fiber diet is one of the leading
causes of this painful problem in which pouches or sacs form in some part of
the digestive tract. A low fiber diet often causes constipation and this in
turn increases pressures in the colon promoting the formation of these sacs.
Ulcerations near the diverticula may then cause colonic hemorrhage,
complicating matters.
The incidence of gastric ulcers rises with age. In many cases, these
ulcers are found in people who must take aspirin and other kinds of
medications, as the elderly often do. Diseases of the mouth and esophagus are
also found more frequently among the elderly than among younger folk. Many of
the problems can be prevented with regular tooth brushing, gum massage and
flossing. Gallbladder problems develop in the elderly because as individuals
age, their bile contains fewer acids which break down the substances that
cause gallstones. But you can do more than talk about it. A change in diet,
a bit of exercise, a little prudence, can work wonders.

Fever Source

Fever Source

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QUESTION: I had a fever recently, which my doctor diagnosed as being caused
by a localized infection. In the course of treating me, he mentioned that it
is impossible to successfully uncover the source of a fever. Is he correct?
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ANSWER: Unfortunately, your doctor is right. While most fevers are either
temporary or traceable to a specific ailment, there is a group referred to as
FUO--fevers of unknown origin. To be included in this classification, the
fever must be present and have eluded normal attempts at diagnosis for at
least three weeks. The fever may fall into one of four patterns: a)
intermittent; where the temperature returns to a normal level on a daily
basis, b) remittent; the fever remains although the temperature subsides to a
lower level daily, c) a sustained, consistent fever, and d) a relapsing fever
that vanishes for days at a time, only to return.
Most of these fevers can eventually be diagnosed, but only with a
sustained investment of time and effort on the part of the doctor and
increased costs for the patient. The physician first constructs a complete
patient history, emphasizing recent travel, new pets or plants, work
environment, visits to sick friends or relatives, as well as other factors
that can help narrow the range of possible causes. A daily physical exam
paying close attention to subtle details (the base of nails, skin condition,
mucous membranes, the condition of lymph nodes or hidden rashes) is also a
must, together with repeated lab tests on blood, urine or stool samples.
Occasionally, x-ray studies, CT scanning, endoscopies or even biopsies may be
necessary.
In most cases, these procedures will eventually yield definitive answers.
Unfortunately, the majority of these fevers are caused by neoplasms--abnormal
tissue growth--including lymphoma, leukemia and solid tumors. Infections
account for one-third of FUO cases: system-wide infections are most often
traced back to fungal bacteria, while localized infections are generally
centered in the abdomen. A variety of other diseases account for almost all
the remaining fevers, including rheumatic fever, lupus erythematosus,
hepatitis and gout. However, some 10% of these mysterious fevers still defy
diagnosis, in spite of today's advanced medical knowledge and technology.

Pain From Fiber Lumps in the Breasts

Pain From Fiber Lumps in the Breasts

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QUESTION: After consulting my physician about the lumps in my breast that
grow painful with each cycle, I have been diagnosed as having fiber lumps in
both breasts. Can you offer some suggestions on making the pain less intense?
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ANSWER: You have fibrocystic breasts, which is a benign condition but one
that can be very uncomfortable. Your physician has probably reassured you
that you don't have cancer, which is a relief, but it still leaves you with
breasts that are tender, lumpy and painful.
The discomfort of fibrocystic breasts changes with your cycle because
your body tends to retain fluid just before your period starts and then gets
rid of the excess fluid afterwards. The small cysts in your breast expand
with fluid and feel more tender as breast tissue is stretched.
There are three steps you can take to relieve the discomfort: you can
support your breasts better, take mild pain relievers, and reduce the amount
of fluid retention. First, find a type of bra that fits you well and gives
extra support. Wear one at night if you feel that it helps and always wear it
during exercise.
Second, on days that you have more pain, take a mild analgesic, such as
plain aspirin or Tylenol. Avoid pain relievers that contain caffeine.
You may also try cutting caffeine and two other chemicals, theobromide
and theophylline, out of your diet. Some women with fibrocystic breasts say
that this helps, though real scientific proof that this may be a cause is
lacking. Caffeine is found in coffee, tea, chocolate, and cola beverages.
Theobromine is in chocolate and theophylline is a medication used to treat
asthma and bronchitis.
Third, cut down on salt in your diet, especially in the two weeks before
your period. Salt increases fluid retention. Your physician may also offer
to prescribe a diuretic to help you get rid of excess fluid during these
painful episodes.
Another most important procedure for you is the self-examination of your
breasts once a month, about 2 or 3 days before your period. Most women with
fibrocystic breasts do not have an increased risk of cancer, but you have the
same risk as everyone else. Careful breast exams will help to detect any
unusual lump at the earliest possible moment.
Try these measures for a while and see if you get any relief. If you
don't feel any reduction in the tenderness or pain, see your physician again.
There is a prescription drug called Danazol that may help a severe fibrocystic
condition, but it has side effects, including increased body hair growth and
loss of sex drive.

Infertility Tests

Infertility Tests

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QUESTION: We have tried unsuccessfully to have a child for 3 years now. I
have gone through all the tests, and now my husband realizes that he too must
be tested. What are the chances that the problem may be with him and how will
they discover it?
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ANSWER: Infertility affects 15% of marriages, and studies estimate that a
"male factor" is responsible in one-third of these cases. Through careful,
sympathetic evaluation, the underlying causes can often be pinpointed and
corrected, leading to successful pregnancy for many of these couples.
First, the doctor must gather a complete sexual history of the couple,
noting any factors that may affect or inhibit pregnancy, such as the frequency
of sex and its timing in relation to the menstrual cycle. Lubricants, douches
or other substances used in conjunction with sex may have a spermicidal effect
and be preventing the sperm from reaching the uterus.
One factor that reduces fertility in the male is cryptorchidism--in
childhood, the failure of one or both of the testes to descend into the
scrotum. If this condition remains uncorrected past the age of 5,
irreversible changes take place in the testes which reduce their fertility.
Mumps orchitis, an inflammation of the testes, also negatively affects their
reproductive ability; if both are infected, sterility may result.
Miscellaneous infections, emotional or physical stress, certain
medications and even the treatment of hernias can impair fertility. To get
the complete picture, it is necessary for the doctor to examine the genitals,
with an eye towards any physical abnormalities in the structure of the penis
or the scrotum.
Analysis of the semen itself yields the most important data regarding
fertility. Since semen takes 75 days to develop, at least two samples should
be taken at two to three-week intervals. The various characteristics of semen
(volume, shape and their degree of movement) can vary tremendously between
samples. Semen volume in an ejaculation is usually between one and a half and
five milliliters, while the density of spermatozoa present should be above 20
million per milliliter. Their degree of movement, or motility, should be
active in at least 60% of sperm observed under a microscope within two to
three hours of the sample being taken.
Oval sperm heads are considered normal in such an evaluation; large,
small, tapering, duplicated and amorphous heads may also be present. Fertile
semen contains 10% abnormal, and between 60 and 70% normal forms.
These tests may reveal the presence of azoospermia--a deformation in the
testes preventing the creation of healthy sperm; while patients testing
abnormal in all these characteristics are likely to have varicocele--a
collection of dilated veins in the spermatic cord, the most responsive to
surgery.
Hormones are less likely to play a role in infertility, but can be tested
if semen analysis fails to yield answers. A biopsy of testicular tissue is
reserved for isolated cases.
In unraveling these questions, emotional support from the spouse and
physician is critical in resolving the psychological and physical stress
resulting from infertility.

Does Esophageal Spasm Cause Chest Pain

Does Esophageal Spasm Cause Chest Pain

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QUESTION: I have been having chest pains on and off for the past year. My
doctor has done test after test to find out if I was on my way to having a
heart attack, but he found no cardiac origin for my problem. After more
testing he told me I have an esophageal spasm, and this was causing the chest
pain. Does this make any sense to you?
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ANSWER: Yes, it does although the problem is not a common one. Esophageal
spasm has been documented as the cause of atypical chest pain in a number of
patients. The pain is atypical because it produces no characteristic pain,
and its symptoms vary far more than heart problems such as angina.
Esophageal pain is often described by patients as a "pressure,"
"constriction," or "burning sensation." The attacks are often related to
eating. Doctors are not 100% sure of why abnormal contractions in the body of
the esophagus produce chest pain.
The best way for a doctor to treat the problem is with reassurance that
the cause of your pain is not life-threatening. Various drugs have been used
to treat the pain such as calcium channel blockers, hydralazine, antacids or
nitrates, but the results have been less than dramatic. An operation which
surgically dissects the muscle of the esophagus is helpful to a very limited
number of patients with this condition.
You may find that the knowledge of the nature of the problem can reduce
your own natural anxiety about such pain, and may even reduce the frequency of
the attacks. Be careful in your use of pain medication, it is easy to get
hooked in situations such as yours.

Risks During Pregnancy for Epileptics

Risks During Pregnancy for Epileptics

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QUESTION: I'm pregnant and have epilepsy. Though I am quite anxious, I would
like some direct answers to my questions. What sort of risks do I face? Is
my unborn baby in any danger?
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ANSWER: I'll do my best to tell it as it is without causing you any
additional worries. Epilepsy is the most common neurological problem among
pregnant women--it occurs in .3 to .5% of all pregnancies. However, epileptic
patients do face increased risks during pregnancy.
First there are the risks that result just from having epilepsy. These
include a greater likelihood of spontaneous abortion, stillbirth, toxemia, and
preterm delivery. Epileptic women are also more likely to have labor induced
or to need medical intervention during delivery. Frequency of an epileptic
woman's seizures may change during pregnancy too. The news is not all bad
here, though. Seizures can increase, come on for the first time, stay the
same, or decrease. Increased seizures are often the result of the woman's
failing to take her anticonvulsant medication. They may also be due to her
changing metabolism or her weight gain--both of which can affect the level of
medication in the body.
Sometimes epileptic women experience fewer seizures during pregnancy.
This is usually due to the fact that they are paying special attention to
taking their medicine. Women who experience seizures for the first time
during pregnancy are said to have gestational epilepsy. Usually these women
are put on an anticonvulsant drug. As for the baby, infants born to epileptic
mothers have a greater risk of premature birth. Even babies who are carried
for the full nine months often weigh less than the average newborn at birth.
Babies of epileptic mothers have a 4 to 5 percent risk of having congenital
abnormalities. If the mother is on anticonvulsants, the baby has a 6 to 11
percent risk. The most common abnormalities involve the facial cleft or the
heart, and are often accompanied by mental retardation. Because of the risks
involved, infants of epileptic mothers are generally monitored in an intensive
care nursery for at least 24 hours.
It is essential that you receive close medical attention during your
pregnancy to avoid as many of the problems and complications as possible. It
is the best way to deal with your understandable anxiety.

Does Hypnosis Work to Help You Lose Weight

Does Hypnosis Work to Help You Lose Weight

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QUESTION: I need to lose about fifty pounds. I've tried almost every type of
diet, but nothing has helped me lose the weight and keep it off. I have heard
about hypnosis that can help you shed pounds. Does it work?
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ANSWER: Hypnosis by itself will not make you lose, but it can help motivate
you to stay on your diet, and make you want to improve your eating and
behavioral habits. Many obese people go on eating binges, not because they
are hungry, but because of tension, anxiety or boredom. Hypnosis may be
useful for relaxation, therefore preventing such binges. The most important
support offered by sessions with a physician who uses this technique is to
help you become truly committed to losing weight. This commitment must be
renewed daily with a self-hypnotic technique which you can easily learn. By
combining hypnosis with a sensible, well balanced eating plan, you could
indeed be on your way to a new and slimmer you. Just remember, it is still
you that must make this all work!
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The material contained here is "FOR INFORMATION ONLY" and should not replace
the counsel and advice of your personal physician. Promptly consulting your
doctor is the best path to a quick and successful resolution of any medical
problem.

Growth Hormones to Improve Athletic Ability

Growth Hormones to Improve Athletic Ability

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QUESTION: If steroids are so bad for you, what about using growth hormones to
improve athletic ability? Don't they work as well?
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ANSWER: Taking human growth hormones, or HGH, to improve strength for
athletic events isn't too smart either. The American College of Sports
Medicine strongly advises against such use because it is against the ethic of
competition, and because of the physical problems it can cause an athlete. It
does, however, support the legitimate use of HGH in treating individuals with
HGH deficiencies and growth problems resulting from such deficiencies.
HGH is very useful in helping children with growth problems, so they can
grow to normal stature. It is a powerful substance, and must be administered
with extreme care so that the side effects are minimized.
Excess HGH can cause growth abnormalities, increased risk of diabetes,
high blood pressure, excess sweating, and problems with the heart, bone and
muscle. Using it to increase athletic success is not worth the risks, and it
can create severe health problems for the athlete. However, you are missing
the whole point in this; that competitive athletics are worthless where the
athlete must use artificial means to force the body to perform. Rigorous
training, diet, and attention to all the general rules of health are the only
ethical ways to achieve athletic ability.

Haunted by the Fact That Heart Attacks Are Frequent in Family

Haunted by the Fact That Heart Attacks Are Frequent in Family

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QUESTION: I am haunted by the fact that heart attacks are frequent in my
family. My father passed away at the age of 52 as the result of a heart
attack, and now my older brother has had his first one. Isn't there anything
I can do to prevent it in my case?
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ANSWER: Very possibly. Many doctors believe a person can lower his/her risks
of such attacks by following good health rules. There are some things that
cause heart attacks--risk factors--you cannot change: age, sex, race, and a
family history of heart disease. Nevertheless, there are causes that depend
entirely upon you, and those are the ones you will want to work on as they can
really make a difference.
In the past 20 years, certain types of heart conditions and deaths from
them have decreased in this country. That is due to many things, including:
improved diagnostic methods, medications, bypass surgery, and better
understanding of what role some risk factors such as age, sex, smoking, high
blood pressure, high cholesterol levels, obesity, diabetes, nonexercise, and
other things, actually play in heart attacks.
About 85 percent of all heart disease cases in the United States may be
attributed to modifiable factors, including smoking, high blood pressure, high
cholesterol levels, alcohol, salt, oral contraceptives, and obesity.
So stop smoking--and being around those who do--as much as possible.
Cigarette smoking is the single most preventable cause of heart diseases and
deaths from them in the United States. If you have tried "everything" to quit
smoking but have not been able to do so, talk with your physician.
Seriously curtailing excessive alcohol use and eliminating as much salt,
sugar and animal fats as possible from your diet also can help decrease
chances for an attack by lowering your blood pressure and cholesterol.
Increasing consumption of fish--some say as many as three meals of fish
per week are needed--may prove beneficial in lowering cholesterol levels.
Also, if you are sedentary, slowly but steadily increasing exercise that
you do on a regular basis (try three times each week) can be helpful.
Obesity raises blood pressure--weight loss helps reverse it. Also,
obesity goes hand in hand with increased cholesterol levels and possibly other
heart-damaging conditions.
If you are obese, you must lose weight to be healthy. Weight loss will
be easier for you if you increase your exercise at the same time, and stay
with the exercise after you have become thin to help you keep the fat off and
maintain your health.
Additionally, many believe that taking one aspirin daily can help prevent
heart attacks in some people suffering from hardening of the arteries who have
several known heart attack risk factors.
So you see, it may not be the easiest thing to do, but by applying all of
the tips I have given you here (or at least some of them) you can actively
wage war on the disease you fear, and increase your odds to the point where
you may never suffer from it.

How Accurate Are Home Blood Pressure Monitoring Devices?

How Accurate Are Home Blood Pressure Monitoring Devices?

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QUESTION: I am considering purchasing the equipment to measure the blood
pressure of my husband, who has a mild hypertensive condition, and have
noticed a number of different devices in the local pharmacy. How accurate are
they, and how can you be sure of getting accurate results when using a home
monitoring device?
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ANSWER: That is a fine idea, for it can help greatly in helping your husband
deal with his condition. Home blood pressure monitoring devices give
hypertensive patients an immediate idea of how well they are doing with their
medication program. They also help the patient's doctor by making creating a
record of daily readings so that he can evaluate, in an ongoing fashion, the
progress of the patient.
Three different types of instruments are currently available for home
use. All three are packaged in kits that contain a blood pressure cuff, and,
if necessary, a stethoscope.
The first of these devices, the mercury sphygmomanometer, is calibrated
by the manufacturer so that the top of the mercury column stands precisely at
zero when the cuff is deflated. This device is considered the most accurate
and reliable of the three. If the mercury column is soiled or does not rest
at zero, the instrument should be returned to the manufacturer for
recalibration.
Nonelectronic aneroid manometers cost less and are accurate if properly
calibrated. They should be calibrated once every year against a standard
mercury sphygmomanometer.
The newest choice for home blood pressure monitoring is one of the many
electronic devices that provide a digital readout and do not require a
stethoscope. Some are fully automated so that the push of a button inflates
and deflates the cuff. These are particularly useful for persons with hearing
deficiencies or those anxious about the to use of a stethoscope, or even just
for those who wish to have an instrument that is easy to use.
Moving the arm, failing batteries or incorrect placement of the cuff can
cause erratic measurement, so before an unusual result leads you to assume the
worst, be sure to test your pressure a second time. False readings may also
result from an ill-fitting cuff, so choose the right size if you are given a
choice. Also, a noisy environment may cause a high reading. Recordings more
than once or twice a month are generally unnecessary for hypertensive
patients, who should expect some normal daily fluctuations in pressure.
However it does make sense to check the pressure under the same conditions
each time, so that comparisons are valid. Pick a time of the day when stress
is at a minimum to obtain a good base line reading.
There is one additional benefit from using these devices which isn't
always written about. Just using the instrument reminds patients that they
should be taking their medication on a regular basis, even when they are
feeling fine, for that's the best way to keep those readings down!