Eating Out While on a Strict Diet

Eating Out While on a Strict Diet

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QUESTION: I am on a strict diet to lose weight, and when I am at home, I
manage very well. But you can go stir crazy unless you get out once in a
while, and then I am in trouble dealing with the menu. I don't want to give
back a single ounce that I have lost, so what can I do?
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ANSWER: Your question must strike home for many of my readers, for this is a
problem that many have to deal with. And you can manage by following three
simple rules. First, choose the types of cuisine that fit into your dietary
restrictions. There are many low fat items to be found in Italian and Asian
restaurants. Pasta and a fish dish make great Italian fare, and plenty of
steamed vegetables as well as rice will keep the fat and calorie count down at
Asian restaurants. Second, be sure to have your food cooked as you desire,
boiled or baked, but never fried in fat. Ask for salad dressings and sauces
on the side, then use them in limited quantity. Don't permit the waiter to
bring a basket of bread and butter before your meal, or you will nibble your
precious calorie allotment away before the meal starts. Finally, eat only a
part of your portion. Cart the remainder away in a doggie bag, to serve as a
full meal at another occasion. You will get your money's worth, keep your
calories down, and get out of preparing another a meal all at once. Now, go
out and enjoy!
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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.

Is There a Rule to Figure Out if One is Having a Drug Reaction?

Is There a Rule to Figure Out if One is Having a Drug Reaction?

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QUESTION: I know that reactions to new medications and drugs frequently take
the form of skin rashes. I have a delicate, light complexioned skin, and am
always breaking out in one way or another. Is there some simple or exact rule
that I can use to figure out if I am having a drug reaction?
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ANSWER: I wish it were that simple, but unfortunately I can only give you
some general considerations to use, and advise you to keep a attitude of
suspicion alive when ever you are starting on a new medication. Also remember
that new cosmetics, perfumes, soaps, in fact any chemical that comes in
contact with your skin, as well as new foods taken into the body, may cause
similar reactions. The first and certainly most important clue is the
history. Any new medication must be evaluated as a possible cause of a new
skin rash, and should, with the doctor's approval, be discontinued. Most drug
reactions will begin within the first two weeks after starting to take it.
Even if the drug had been taken without problems some time in the past, it is
possible that your immune system has changed over time, and that this time a
reaction has occurred. Though skin reactions may take many forms, there are
three which are most common. Hives (or urticaria) are the most common, and
can occur within minutes to hours after a new drug has been taken. In other
cases they may first appear in 12 to 36 hours after the first dose. They are
red, wheal like lesions which usually are short-lived and will remain evident
for about 10-12 hours. However they may be just a prelude to a life
threatening condition known as anaphylaxis, which may start with intense
itching, tingling of the lips, wheezing and breathing difficulty, leading to
shock. Immediate medical treatment is necessary when these symptoms occur.
The other two commonly seen rashes are morbilliform (or measles-like) and
erythema multiform (which usually is a target like lesion with concentric
reddened rings around a dark red center). The most common medications
producing rash reactions are amoxicillin, sulfonamides and penicillins, as
well as blood products, barbiturates and nonsteroidal anti-inflammatory drugs
(NSAIDs). Medications least likely to produce reactions are digoxin,
antacids, acetaminophen, nitroglycerin and prednisolone. You may have to use
all your talents as a "drug detective" to identify the culprit in your case.

Cautions About Driving While Taking Medication

Cautions About Driving While Taking Medication

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QUESTION: I obtain my prescriptions from a well equipped and modern pharmacy
that provides a little slip that lists the cautions I should observe while
taking the medication. A warning about driving while taking the medication
appears frequently, even when the medication is not a sedative or
tranquilizer. Could you explain why, since I have never experienced any
difficulties with my medications?
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ANSWER: Despite all the controls and experimentation done before any
medication is allowed to be prescribed, we humans continue to react to all new
things, including medications, as individuals, not as collections of
statistics. These individual reactions are different for each of us, and so
while many people never experience a negative side effect from medications,
some do, and it is to protect them that the cautions are published. When the
investigation of a new medication has shown that it may cause drowsiness,
dizziness, overstimulation or confusion in some people, the notice is given to
all that are to take a new medicine for the first time. There is no way of
predicting who may be affected, and so good sense dictates that you refrain
from driving until you are sure that you will experience no ill effects from
the medication. Give your system a trial period, and when you have proven
that nothing unusual is occurring, you may then return to your normal routine
without anxiety or doubt.

What is a "Dowager's Hump"?

What is a "Dowager's Hump"?

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QUESTION: I have read this term several times, but never could understand
what they were talking about. What is a "dowager's hump"? What causes it to
form, and what do you have to do to get rid of it?
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ANSWER: As certain women grow older, past the age of menopause, they develop
a curvature of the spine as the result of a bone condition called
osteoporosis. As it becomes more pronounced, it is called a "Dowager's Hump",
one of the definitions of dowager being "an elderly woman of wealth and
dignity". (Check the longer definition in your dictionary if you wish to
learn a bit more about this old English term.) Osteoporosis is predominantly
a disease of women, and is a generalized progressive reduction in bone mass,
causing the bones to weaken. The spinal column, which is composed of
vertebrae piled one upon the other like a tower of building blocks, supports
our skeleton and provides us with a standing posture. As the mineral content
(calcium amongst others) diminishes in these bones they begin to collapse
slowly, with the front (anterior) end of the "block" becoming smaller,
changing the shape of the vertebral body from a square into a triangular form.
This creates the curve in the spinal column which we describe as a "hump".
There is no cure for this condition as yet. It may be prevented by an active,
healthy premenopausal life, with proper nutrition that supplies the calcium
and other minerals needed to build strong bones. Once the process has begun,
it may be halted by replacing the female hormones lost at menopause and
supplementary calcium. While real cures are still being investigated, there
seems little hope of discovering a medication that would reverse the process
and reduce the hump. That would require a new growth process similar to the
one that Ponce de Leon was looking for in Florida.

Is New Dieting Break Through Safe and Will it Work?

Is New Dieting Break Through Safe and Will it Work?

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QUESTION: I am enclosing an ad from my Sunday paper which almost sounds too
good to be true. I have had trouble losing weight all my life which has
become just one never-ending diet. As you can read, they claim that this new
break through has excited the "scientific community" and that I can now melt
the fat away without diet. Can you please tell me if this product is safe and
will it do what they claim it will?
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ANSWER: Your letter is just one of the many that flow in each week, enclosing
similar advertisements and equally seductive promises. I decided this time to
try and follow through, to try to find out the true facts, the name of the
substance or something about the scientific research that backed up the
claims. I found that the number called was merely an order taking service; I
could not get any additional information through them, nor was an address
available. In rereading the ad and picking up on a clue here and there, I
believe the product is probably one of the dietary fiber supplements which are
known to reduce cholesterol, and since they are natural products, do not come
under the same strict surveillance by the Food and Drug Administration that
chemicals classified as medications do. There is no astounding medical
breakthrough here, just a few inflated claims, and a very inflated price for a
product which you probably can find on the shelves in any pharmacy. Weight
loss can only be accomplished through sound nutritional management, lots of
motivation and perseverance, and a full understanding of your own patterns of
eating. Modifying your own eating habits, along with some help from a
counselor, and even the assistance of a "diet product" if you must, can make
you a suitable candidate for the "before" and "after" pictures featured in all
of these ads that claim miracles for a price.

Concern About Teenage Son Developing Breasts

Concern About Teenage Son Developing Breasts

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QUESTION: My young teenage son is having a terrible time because he is
developing breasts. He refuses to take gym at school because he does not wish
to disrobe and have the other boys make fun of him. We are more concerned
that this may be the sign of a serious disease. Can you help us?
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ANSWER: Although you do not mention your son's age in your letter, I am
willing to wager he is between 13 and 14 years of age, a time of puberty when
almost 40% of normal boys undergo some degree of breast development. It may
not be as evident in others as in the case of your son, but can be discovered
by careful palpation during the course of a physical examination. While the
reasons for this growth is not clear, it probably results from a temporary
imbalance between the male and female hormones which normally exist in all of
us. The medical term applied to this diagnosis is "pubertal gynecomastia" and
it is a totally benign condition. Usually it will resolve by itself within a
few months, although in rare cases it can take longer. Since there are many
causes of gynecomastia, and in view of your son's problem at school, he is
entitled to a complete physical and history to verify my impressions. Your
family doctor can then explain the condition to him and offer the reassurance
that I believe will be forthcoming. With this reassurance and new
understanding, your son will be able to deal with his own inner fears.
Perhaps a note from the doctor can relieve your son of gym classes until the
situation returns to normal.

Is There any Treatment for "Growing Pains"?

Is There any Treatment for "Growing Pains"?

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QUESTION: My daughter, now 11 years old, has complained constantly about
pains in her legs over the past several months. I have taken her to the
doctor who gave her a complete examination, including x-rays and blood tests,
but could find nothing. He finally described the problem as "growing pains".
Is there any treatment for this or may I hope that it will disappear by itself
as she grows older?
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ANSWER: It appears as though your doctor has given this problem the attention
it deserves, for the diagnosis of "growing pains" is only made when the other
possible reasons for the complaint have been investigated and no evidence of
any of the other causes for pain could be found. The term is used for a
condition of benign, recurrent limb pain that may be the complaint of young
children, boys or girls, and probably has nothing to do with the actual
physical process of growing up. The pains may come on at any time, but seem
to occur most frequently in the evening or at night. Usually they are located
in the thighs or calves, and the pains leave after an hour or two. The
children are otherwise healthy, and the laboratory test as well as x-rays are
always normal. Frequently there is a history of similar experiences during
childhood in other members of the family. Some experts in this area believe
that this process is due to the emotional growth of the children, and warn
that evidence of emotional disturbances may be common. I believe you must
continue to support your daughter in an understanding and open manner,
continue to watch her closely, and react if other symptoms appear. The most
likely course is that the complaints and the pains will all disappear in time,
with no lasting health affects remaining. Use a lot of love and a little
patience; they are great medicines for any situation in young, growing
children.

Green Urine

Green Urine

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QUESTION: Please don't laugh at my question. I assure you it really happened
and almost made me pass out. While passing my water I noticed that my urine
was definitely a green color. I have no other symptoms, and it only happened
once more after that but the color was less intense. Do I have anything to
worry about? Will it happen again?
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ANSWER: If it has disappeared without any other symptoms or complaints, you
most probably are out of danger. You probably never had anything too serious
to worry about anyway. The most common reason for green urine is the result
of something you have eaten or ingested. Chlorophyll containing breath mints
when taken in large quantities are a frequent cause. There are a number of
other substances in common medications that may also provoke a green color;
guaiacol contained in many cough medicines, magnesium salicylate in Doan's
Pills, and thymol, an ingredient in Listerine mouth wash. The most serious
cause of green tinted urine occurs from an infection caused by pseudomonas in
the urine. The pus may contain a pigment, pyocyanic, which causes the green
color. Methylene blue used in some medical tests and treatments, when
combined with the normal yellow color of urine, produces a green color as
well. Now it's up to you to think back over the circumstances which preceded
your colorful experience, and try to determine which of these possible causes
might have been the reason in your case. If you don't repeat the experience,
your green urine days are over.

What is "Gastritis"?

What is "Gastritis"?

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QUESTION: Whenever a co-worker burps or feels queasy, she claims it is a
serious case of "gastritis". When we suggest that it is just gas or
indigestion, she insists that it is a disease she has suffered with from
childhood. We have all checked our home medical advisors, but can't agree on
a diagnosis for her. Can you define her gastritis for us?
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ANSWER: Probably not. The term is used in medicine to mean many things
depending upon your specialty and point of view. Technically the definition
of gastritis is "an inflammation of the gastric mucosa" or stomach lining.
However, radiologists evaluating x-rays use the term to diagnose certain
changes observable in their pictures. A pathologist would use the findings
seen in tissue samples, and a gastroenterologist would base his usage on
appearances seen through his gastroscope. I can't make a better diagnosis
than you without a lot more information, and guess I would just call it "an
upset stomach" that apparently is upsetting a whole office staff.

Can "Fifth Disease" Infection Affect an Unborn Baby?

Can "Fifth Disease" Infection Affect an Unborn Baby?

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QUESTION: I am panic stricken. I am pregnant and my other child has broken
out with a rash, diagnosed as "Fifth Disease". My doctor fears that I may
catch the same infection, with serious effects to my unborn baby. Can I pass
anything on if I don't become infected? What are the risks to my baby? Do
you have any information to help me?
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ANSWER: Your concerns are shared by an ever increasing number of expectant
mothers whose youngsters come down with Fifth Disease (or as some would have
it, "Erythema Infectiosum"). The cause of this viral disease is a human
parvovirus B19, only recently discovered (in 1975) and subsequently identified
as the primary infectious agent in this disease. The data necessary to answer
your questions is only now being developed, but there are a few general facts
I can offer. If you have had or been exposed to this disease as a child, and
most adults have, it is doubtful that you can contract the disease a second
time. At present the tests necessary to determine your state of immunity are
only available at a few research laboratories, but your physician may be able
to obtain one for you. If you don't have the disease now while you are
pregnant, there is no chance that your baby will be affected. There is no
vaccine to prevent B19 infection, and there have been no studies to evaluate
the use of immune globulin injections to prevent infections or modify the
course of illness, and routine use of this injection in cases such as yours is
not recommended. There is reason to be optimistic, though, as published
reports on the outcomes of pregnancy for pregnant women who DO become infected
with B19 virus seem to indicate that if this disease does affect unborn
babies, it does so infrequently. Thus it would seem you are a long way from
having to consider any dire outcomes to this situation.

Laser Beam Operation to Fix Blood Vessels in the Eye

Laser Beam Operation to Fix Blood Vessels in the Eye

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QUESTION: I am a long time sufferer from diabetes, with the result that my
vision is beginning to fail. I was referred to an eye doctor, who suggests
that he may be able to help with a new operation that uses a laser beam to fix
the blood vessels in my eye. Is this an experimental procedure, and how does
it work to fix the problem?
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ANSWER: The use of lasers in eye surgery is no longer considered
experimental, but is one of the most important advances in this field that has
occurred in the past ten years. Because laser beams are really just powerful
beams of concentrated light, and the eye ball is filled with transparent
material that allows the laser beam through, there are now many new techniques
in eye surgery that make use of laser beam surgery. Your case, called
"diabetic retinopathy," can be helped but not cured using this procedure. In
diabetic retinopathy, two problems may be occurring. In one type of this
complication of diabetes, new vessels grow on the surface of the retina which
can hemorrhage and create scars that destroy the cells that detect light and
provide vision. If this is the case, your physician will be able to destroy
these blood vessels before they can cause any more damage. In another form of
the disease, small blood vessels located in the retina may leak, once again
causing scars that destroy vision. With the laser beam, the doctor seals
these leaks, and further deterioration of vision is prevented. While new
sight is not created by this process, your loss of vision is limited, and with
regular eye examinations and repeated procedures if necessary, can be kept to
a minimum. The procedure is a simple one in expert hands, and does not
require lengthy hospitalization. Your situation helps to emphasize that all
chronic diabetic patients should have regular vision examinations to prevent
vision loss, now that we have these new and effective treatments.

Exercise for People With Severe Arthritis

Exercise for People With Severe Arthritis

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QUESTION: You always mention exercise as part of the programs that lead to
better health, but you forget that many of your readers suffer with severe
arthritis and can't follow your advice. In spite of constant medication and
moving to a new and warmer climate, my old joints just can't take the stress.
What are people like me supposed to do?
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ANSWER: You might find your answer in the latest edition of "Arthritis
Today," the publication of the Arthritis Foundation. They are convinced that
people with arthritis not only can participate in an exercise program, but
should. It may be that you need a special program that takes heed of your
problems, and provides just the right amount of activity that will help you.
They have developed a new program, "People with Arthritis Can Exercise," also
called PACE, that may provide the answer you are seeking. The program is
divided into two levels. The Basic program or Level 1 is designed for people
with severe joint disease, people who may need walkers or even wheelchairs to
get about. Level 2 or Advanced is useful for those whose problems are less
severe, but who tire easily. In both programs you can be helped to develop
greater flexibility and ease of movement. They also sponsor another program
called the Arthritis Aquatic Program. This is conducted in a heated pool
under the watchful eye of specially trained individuals. Neither of these
programs are to be confused with range of motion or strengthening exercises
which may be prescribed by your doctor, but they add a new dimension to
activity for arthritis patients and they sound like fun. To find out which
program may be available in your area, contact your local chapter of the
Arthritis Foundation or write to the national office, Arthritis Foundation,
P.O. Box 19000, Atlanta, Georgia 30326, and request their brochure entitled
"Exercise and Your Arthritis". You may soon be able to join with all the
others who take my advice and make exercise a part of their plan for healthy
living.

Menstrual Cycles in Women Athletes

Menstrual Cycles in Women Athletes

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QUESTION: There is no longer much question amongst women athletes that our
normal menstrual cycles are affected by the physical training we go through.
My question is why does it happen, and I am at risk for any other unwanted
illness? Last but not least, have you any suggestions for dealing with the
problem?
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ANSWER: The problem certainly is a real one, and affects young women who have
never had a child most often. The condition can range from irregularity to
abnormal bleeding to complete absence of a menstrual period. It also appears
that the intensity of the training and the severity of the abnormality may
also be linked. The culprit seems to be the hypothalamus, a part of the brain
responsible for producing gonadotropin releasing hormone (GnRH), which in turn
affects the hormones that regulate a woman's normal cycle. During intense
exercise the body produces chemicals called "endogenous opiates" (part of the
reason some athletes get a "high" from their activity) which reduce the
production of GnRH and arrests the cycle. When this occurs it's called
"exercise-induced amenorrhea". Women with this problem have lower bone mass,
and their bone density can closely resemble the situation seen in
postmenopausal women. Stress fractures may result sometimes occurring in the
pelvic and lumbosacral bones. You won't like my advice much, for good sense
requires that the training schedule must be modified and reduced. Smoking is
an absolute no-no, as it too has an antiestrogenic effect. Some researchers
are trying an estrogen replacement therapy in women athletes who just won't
change their preparation schedules or training programs. Currently available
results of medical research just doesn't have all the answers, and I suspect
the ones I do have now are not quite what you hoped they would be.

Tightness in the Chest During a Brisk Walk in Cold Weather

Tightness in the Chest During a Brisk Walk in Cold Weather

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QUESTION: It seemed like such a good idea. While visiting my son in
Minnesota, he invited me to take a brisk walk before washing up for supper.
The evening was cold, with snow on the ground, but good footing along the
road. We hadn't made a half mile before I experienced a tightness in my
chest, a dry cough and wheezing. I could barely breathe. The rapid trip to
an emergency room convinced all that it wasn't a heart attack. When I
returned home to Florida, I rushed home one evening walking further and faster
than in Minnesota, and nothing happened. There has got to be a logical
explanation. Do you know what it might be?
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ANSWER: With the data you provide, and the fact that you have been cleared of
any cardiac problems, my best guess is that you suffered an attack of exercise
induced asthma, provoked by the cold climate that seems to be the important
element in your case. It's probably a common enough condition, and can be
diagnosed with a pulmonary function test and a better history and examination
than is available to me. The asthma-like attack is caused when the
bronchioles, or small tubes that carry the air to and from the lungs, contract
because of irritation or reaction to substances to which they are sensitive.
In the case of exercising, even a brisk walk in the snow, it is possible that
the dry air you were breathing in dehydrated the airways and caused them to
contract. When you performed the same activity in the warm and moist air of
your home town, the factors that caused the attack previously were absent, and
so no attack. Because this is but one answer to an interesting medical
situation, I strongly advise a thorough overhaul, with special attention to
your past history and the necessary tests to establish the performance
patterns of your lungs.

Is There Any Medical Explanation Why Women Outlive Their Husbands?

Is There Any Medical Explanation Why Women Outlive Their Husbands?

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QUESTION: When we look around our retirement community, it is apparent that
women must be stronger in some ways, for there are many more women here than
men. Yet all our men were hard workers, and most of them were big strong men.
Is there any medical explanation for the reason women outlive their husbands
so much of the time?
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ANSWER: Your observations that more women survive their husbands is correct,
and your community is not the only one in which that is true. Over the age of
65, the ratio of widows to widowers is about 4 to 1. Despite the fact that
more boy babies are born, about 106 to 100 girls, by the age of 75 there three
women to every two men left living. To try and find the reasons for this we
must look at three factors. Are there any differences in the makeup of the
genes carried by men and women, the influence of hormones during life, and the
types of life styles and environments that men and women live in. To date,
studies of the molecular make up of genes have failed to reveal any
differences to account for the advantage in life span that women seem to
possess. Research is ongoing in this area, for it still seems likely that
part of the answer may lie here. Since male and female hormones differ, the
effect they play in the metabolism of cholesterol and resulting development of
atherosclerosis and heart disease is more rewarding, and the reduced
probability of developing coronary artery disease in women is certainly part
of the answer. Smoking was once a factor, and lung cancer was thought to be a
man's disease, until women in large numbers took up this habit. As many as 7
years of the difference in life expectancy may have been lost by men due to
the effects of tobacco. Work related accidents, deaths due to car accidents,
suicide and homicide all take a greater toll of males as compared to females,
so that more women survive the years prior to retirement. However as age
progresses the gap diminishes, and by age 85, the life expectancy of women is
but 1 year longer than men. Hopefully, new knowledge of heart disease
prevention and smoking cessation will continue to narrow the differences in
life expectancy between men and women.

Where Does "Lichen Planus" Come From?

Where Does "Lichen Planus" Come From?

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QUESTION: When an itchy rash suddenly appeared on my body, I thought it was
poison ivy, and that daily washing and a little patience would see me through.
However, when it didn't fade I consulted my doctor, who told me I have a skin
disease called "lichen planus". He is now treating me with lots of
medication, but I still don't know where this came from or whether it will
ever leave. Please help by discussing this disease.
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ANSWER: I am afraid there is not much known about the causes of this
condition, although it does seem to appear more frequently in spring and
summer. The itchy, irregular skin lesions may well be confused with poison
ivy, for it may often appear most on the arms and legs; but since it may also
appear on portions of the body that are covered and protected from contact
with the leaves of the plant, and since the rash does not follow the course of
the ivy induced rash, it is relatively easy to tell them apart. The lesions
may also appear on the inner lining of the cheeks, in the mouth and on the
lips, gum and tongue. This happens in just about half the cases. You may
notice that if you injure your skin covering any part of your body, a rash
similar to the ones you now have will appear. This is called an "isomorphic
reaction" and is typical of lichen planus. There are some drugs that are
associated with the appearance of these skin eruptions, and include arsenic,
antimalarial agents, beta-adrenergic blockers, thiacide diuretics and gold
salts. Be sure to mention any medications you may be taking to your
physician. Treatment may include the use of some strong corticosteroid creams
or ointments or oral griseofulvin. Whatever therapy your physician has
chosen, it may be a while before all the lesions are gone. About 50% of
patients on therapy clear in about 9 months, and by 18 months, 85% of the
patients are rid of the rash. Patients who experienced sudden onset of the
lesions as you did generally have more symptoms, but also tend to recover more
rapidly as well. I hope you will be amongst the lucky ones.

Lazy White Blood Cells

Lazy White Blood Cells

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QUESTION: I have suffered since childhood with repeated infections of my gums
and tongue. Although I have had excellent dental care, the condition keeps
coming back. I recently visited a hematologist who felt that my problem could
be related to "lazy white blood cells", and that the condition was not
serious, just something to live with. Can you amplify on that explanation?
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ANSWER: Only with some difficulty, as you have not provided me too much to
work with. I have focused in on the word "lazy" and discovered an antiquated
syndrome called the "Lazy Leukocyte Syndrome". First described in 1971 in an
article by Dr. M.E. Miller published in the British medical journal LANCET, it
described white blood cells, "leukocytes", that failed to function in normal
fashion. Rather than attacking foreign poisons in the system, they moved
about in random fashion, and did not respond to the stimulus of the chemicals
that could present a threat to the body. As a result, patients suffered from
recurring infections of mouth and gums (stomatitis and gingivitis). Both men
and women seemed affected in about equal numbers and the condition often
started in early childhood. No treatment is noted. Of late we have
discovered the presence of a substance, "Leukocyte Inhibitory Factor" (LIF),
which may be the chemical which causes the neutrophils to desert their
responsibilities in defending our bodies against toxic invaders. A physician
who specializes in Immunology might be able to afford you additional
explanations, if you do, in fact, have this unusual syndrome.

Rash Around the Waist, Busts and Back

Rash Around the Waist, Busts and Back

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QUESTION: For about a year, on and off, I get a rash that itches and my skin
is real tender around my waist, between my busts, around my bra and back. I
have changed the soap I wash clothes with, taken showers without soap, rubbed
it with caladryl baby lotion; but nothing makes it go away. Is there anything
you can write in your column that can help me?
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ANSWER: I'll certainly try, although dealing with skin problems without
actually seeing the rash is not the easiest thing to do. From the areas of
your body in which the rash appears, and the failure of the types of remedies
you have attempted, my first thought is that your condition might be a type of
dermatitis know as "intertrigo". This rash develops in the folds of the skin
where the surfaces may rub together, and where the openings of the skin pores
are covered. Such a condition leads to the breaking down of the cells the lie
on the surface of the skins (a process called "maceration"), and an irritation
that provokes redness, tenderness and itching. To further complicate matters,
an infection by bacteria or a fungus may occur. This skin problem is most
common in obese individuals who live in hot climates that provoke constant
perspiration. There are several steps you may take to rid yourself of this
annoyance. First, use an antiseptic soap during your shower to help combat
any possible infection. You must dry your self thoroughly, taking care to
blot away all the moisture that may remain deep in skin folds. The careful
use of a hair dryer, on its lowest heat setting can be helpful, but never set
it to hot or use it too close to the skin, as that may cause burning. If the
infection persists, delaying the healing of the skin, you may have to resort
to a prescription cream that contains an appropriate antibiotic or antifungal
agent. With any luck the problem should clear up in just a few days, and the
secret to preventing its reoccurrence is keeping the skin as dry as possible
in the areas of irritation.

What is Idiopathic Thrombocytopenia Purpura?

What is Idiopathic Thrombocytopenia Purpura?

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QUESTION: I was diagnosed by my physician approximately six months ago with a
blood disorder referred to as idiopathic thrombocytopenia purpura (ITP). I've
been unable to find sufficient reading material regarding this disease. Any
information would be helpful. I am currently in remission.
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ANSWER: Whenever faced with these gigantic medical terms, we can learn a bit
by explaining them piece by piece. Let's start at the end. A "purpura" is a
purple or reddish brown discoloration seen through the skin, caused by blood
hemorrhaging into the tissues. In ITP the thrombocytes (platelets), which are
an important part of the clotting mechanism that controls such bleeding, are
not present in the blood in normal amounts. Any medical term which ends in
"penia" means that there is an abnormal reduction in numbers, for "penia"
comes from the Greek term meaning "poverty". "Idiopathic" means that the
disease (or pathology) has a spontaneous origin, or more literally an unknown
cause. The fact is that much is now known about ITP, and that the reason the
platelets (or thrombocytes) are few in number is that they are being destroyed
by an immune factor (antibody). Thus we now call the disease "Autoimmune
Thrombocytopenia Purpura" (ATP) or by an older name, Werlhof's Disease. In
one of those interesting stories that makes medicine so fascinating, in 1951
an American hematologist, William Harrington, who believed there was an
immunological explanation for the disease, injected himself with plasma from a
patient and developed the disease himself. A good deal of research is going
on to explain all the mechanisms of the disease, and it can be treated with
large doses of corticosteroid (cortisone-like medication), as well as other
medications, with great success. When medications fail to produce the desired
results, splenectomy, or removal of the spleen, may be considered. Now that
you have some new insight, and a few more terms to search for, I hope your
reading will be more rewarding. The fact that you are currently in remission
is an excellent sign, but as you have probably been told, does not represent a
permanent state.

What is "Hypospadias"

What is "Hypospadias"

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QUESTION: We are most concerned about our newborn grandson and a condition
called "Hypospadias". Our daughter is so distressed that she will not discuss
this with us, and we hope you will help us by telling us something about the
condition and if our grandson can ever be a normal person?
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ANSWER: I can understand your distress as well as that of your daughter, but
the news is not all that bad. Hypospadias is a congenital defect that occurs
rather commonly in male babies, affecting about one in 300 live born male
infants. The defect affects the urethra, the tube that leads from the bladder
through the penis, and carries the urine out of the body. In cases of
hypospadias the development of this tube is incomplete, and it does not extend
the full length of the penis, ending in an opening which is located somewhere
along the underside of the shaft of the penis. Usually there are no other
abnormalities of the urinary system associated with this condition, which is
easily discovered during the baby's first examination. Although at one time
in the past, surgical correction was performed only on the most severe cases,
new improvements both in pediatric surgical techniques as well as anesthesia
permit surgeons to correct almost all cases of hypospadias. The operation is
usually performed before the child is old enough to retain any memories of the
experience, yet mature enough to safely undergo the procedure. Most surgery
is therefore performed when the child is between 6 and 9 months of age. The
children do not seem to experience a great deal of discomfort and with new
techniques, a fully functioning penis is constructed that has a completely
normal appearance. Complications of the surgery are rare and the surgery may
be performed as either an outpatient or with but a single night's stay at the
hospital. You and your family all need one another now for the moral and
emotional support that will provide you with the patience necessary to await
the best moment to schedule the operation, after which much of your personal
anguish and anxiety can be put behind you.

What Are "The Seven Simple Guidelines to a Healthy Diet"?

What Are "The Seven Simple Guidelines to a Healthy Diet"?

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QUESTION: My physician suggested that I follow the seven simple guidelines to
a healthy diet, which I said I would do. But he never told me what they were
and I didn't ask. Do you know what they are?
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ANSWER: Of course, and I am happy to pass them on to you and my other
readers.
1: Eat a variety of foods. Include fruits and vegetables, whole
cereals, lean meats, poultry, fish, peas and beans and low fat dairy products.
2: Maintain desirable weight.
3: Avoid too much fat, saturated fat and cholesterol.
4: Eat foods with adequate starch and fiber.
5: Avoid too much sugar.
6: Avoid too much sodium.
7: If you drink alcoholic beverages, do so only in moderation.
They may sound easy and they are, and your health will profit
immeasurably if you follow these guidelines.
----------------
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 is a Hiatus Hernia?

What is a Hiatus Hernia?

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QUESTION: I am thoroughly confused. What I thought would be a simple yearly
examination has now led to a diagnosis of a hiatus hernia. I had no symptoms,
and don't really understand about a hernia in my chest. Can you help me out?
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ANSWER: That is what annual examinations are for, to discover unsuspected
conditions and deal with them before they advance too far. It isn't unusual
for a hiatal (or "hiatus", both terms are equally correct) hernia to be
silent, without any symptoms or complaints from the patient. Let's look at
some definitions to help clear up your lack of understanding and to deal with
your evident anxiety. Whenever an organ pushes through a wall of the body
cavity that encloses it, it is called a hernia. In men, the common use of the
term refers to the pushing of intestinal contents through the abdominal wall
into the scrotal sac. In a hiatal hernia, the stomach is pushing through the
diaphragm, a sheet of muscle that separates the abdominal cavity from the
chest cavity. In general use, a "hiatus" means a gap, cleft or opening, and
there is such an opening in the diaphragm that permits the esophagus to pass
through from the chest cavity to attach to the stomach, in the abdominal
cavity. This opening has become enlarged, probably by an increased pressure
within the abdominal cavity that may have been provoked by chronic coughing,
straining, sudden physical activity, pregnancy, obesity or as a result of some
trauma. Hiatus hernias occur in people of all ages and both sexes. Most
usually it seen in middle age and small hernias can be discovered in most
people over the age of 50. In many cases the cause is not clear, but that
doesn't effect the type of therapy needed; as for most asymptomatic cases,
like yours, there is no treatment necessary for as long as there are no
complaints. It is unnecessary to change your diet, work or play habits or
activity. You should be alert, however, to any changes that may occur; and if
new symptoms develop, consult your physician promptly.

Where Does Hay Fever Come From?

Where Does Hay Fever Come From?

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QUESTION: With my eyes tearing and red, and a full nose that won't stop
dripping, I am into the earliest attack of hay fever I have ever had. Why am
I affected so much by this condition, where does it come from, and what can I
do to rid myself of this crummy situation?
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ANSWER: You know by this time I am sure that it is not hay that causes your
problems, but the very air you breathe. As the flowers bloom, so is pollen
produced, wafted on the balmy breezes right into your sensitive system. When
pollens that you are allergic to come in contact with the tissues of your
nasal passage, antibodies are produced in response to the allergens contained
in the pollen. When antibodies come in contact with immune cells, a substance
called histamine is produced which causes the capillaries in your tissues to
swell (congestion), producing the all too familiar symptoms that come with an
attack of allergic rhinitis or hay fever; sneezing runny and stuffed noses, as
well as red and tearing eyes, and often an intense itch. Seasonal allergies
may first be noted in early childhood, but the condition continues throughout
life for those that are affected. When the condition first appears during
summer months it is usually due to grass pollens, such as timothy and sweet
vernal, while the autumn variety results from weed pollens such as ragweed.
The early or spring type that you seem to be suffering from is due to pollens
produced by trees such as oak, elm, alder, birch, cottonwood and maple. The
treatments for any allergic rhinitis uses antihistamines, decongestants, or
combinations of both. There are many over-the-counter preparations which
should help. If one doesn't work, try another; for they have different
formulas, and affect people in different ways. If you cannot obtain the
relief you seek using these medications, it may be time for you to undergo a
complete allergy testing to identify the exact source of your discomfort,
followed by a series of allergy injections to desensitize your system. By the
time next pollen season rolls around, you could be in a better situation,
without a yearly battle which you seem to be losing.

Mexican Operation for Severe Parkinson's Disease

Mexican Operation for Severe Parkinson's Disease

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QUESTION: My father suffers from severe Parkinson's and so I make every
attempt to keep up with the latest developments in treating the illness. I
have read that a new operation is now available that can cure the illness
available in Mexico. Do you know anything about this, and where I can take my
father for treatment?
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ANSWER: Yes, I know of the operation, and unfortunately, can not encourage
you about its use in treating your father. Almost two years ago, an operation
which used tissue transplanted from the patient's own adrenal gland into the
brain was reported as producing remarkable improvement in the condition of the
two Parkinson patients who were the first patients to have this procedure
performed. This surgery took place in Mexico. In the past two years, over
100 such operations were performed by neurosurgeons in the United States.
Their results, as reported at the most recent meeting of the American Academy
of Neurology in Chicago, did not confirm the results as originally reported.
While some patients did do well, the improvement was not as dramatic as
described in the first patients. In addition there were many complications
after surgery, including confusion and disorientation, and the ability of
anti-Parkinson's medication to control symptoms was reduced. When all of this
became known The American Academy of Neurology issued a position statement
that urged "great caution" in expanding the use of this operation until
further careful and complete research could be accomplished. There has never
been any claims of a "cure" for the procedure, and the results have been a
mild to moderate improvement when it has worked. Since this is not true in
every case, and in view of the high risks involved, I can not recommend it to
you.

Mixed Up Medication?

Mixed Up Medication?

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QUESTION: I have a constant pain in my legs, and have used many types of pain
killers, without too much effect. On my last visit, the doctor gave me a new
medication, and assured me it would help, and I do feel better. However, when
one of my friends saw me taking the pills, he showed me that he was taking the
same thing for his nerves, to help make him less depressed. Something is
mixed up here somewhere. Can you straighten us out?
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ANSWER: You don't give me too much to work with in your letter, but there is
just enough for me to make a few realistic assumptions that may help explain
the situation. To begin with, I don't think there is a mix-up anywhere, you
are just both taking the same medication for two different situations, and it
is a fine medication for both problems. The medication is most probably a
"tricyclic antidepressant", and since there are a few such drugs available, it
was just chance that you both were taking the same brand. This type of
medication can be very effective in relieving some of the depressive states we
find in medicine. While it may take a week or two for the medication to take
effect, it is one that doctors have been using for some time, and the dosage
can be altered so that the good effects are not marred by unwanted side
effects. Recently we have learned that the same medication has the ability to
relieve pain in some patients, whether or not they are depressed as well. One
of the conditions it works particularly well for is the pain of "diabetic
peripheral neuropathy", a nerve pain in the legs, for instance, seen in
patients suffering from diabetes. And I'll bet that is what you have. As I
see it, you are both doing well, and that is the main concern. Of course you
know I don't think that comparing medications is always the wisest thing to
do, and I am a real tiger when I hear of people sharing prescription
medications without proper supervision. I hope you both continue to do well.

Aren't Heart Murmurs Signs of Serious Heart Disease?

Aren't Heart Murmurs Signs of Serious Heart Disease?

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QUESTION: Though I have never been told before that I had a murmur of the
heart, at age 78 my physician has now discovered one. He has been very
careful in examining me and taking all types of tests, including a cardiogram,
and now assures me that I have nothing to worry about. I thought that murmurs
were signs of heart disease. Could it be my family physician is just being
gentle with an older man?
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ANSWER: Not at all; it sounds like he has taken all the steps necessary to
satisfy both you and himself of the reasons which provoked the sounds he has
detected. Heart murmurs are merely sounds produced by the flow of blood
through the chambers of the heart, and around the valves of the heart which
control the direction of blood flow. When the smooth flow is disturbed by
changes in the structure of the heart or its valves, a turbulence is produced
which generates the sound that can be heard through the stethoscope. Not
every murmur is caused by a serious disease or pathology. Many can occur with
the changes in the heart configuration that age brings on, and are not a cause
for alarm. However, the reassurance that your family physician has offered
you is not based upon chance or speculation, but the test results that can
only be evaluated fully when a complete examination and history have been
accomplished. The changes that affect the sounds your beating heart produces
may occur in the lungs and chest wall as well as your heart, and may be
affected by your posture. Some sounds can be more clearly heard when you are
squatting, or standing, as well as deep inspiration and expiration. It is
only when all possibilities have been explored and carefully considered that a
physician may reassure the patient, as was the situation in your case. He
isn't just being nice, he has been careful, concerned and professional as
well. You can trust him.

A Question of Ear Protection for High Noise Levels

A Question of Ear Protection for High Noise Levels

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QUESTION: I've just started a new job, quite different from anything I have
done before, where the noise level of machinery is very loud. It is only a
small shop, and one of the older men who has been there for quite a while
assures me that I will soon be used to it. I don't want to make any waves,
but do you think I should be thinking of protecting my ears from the sound in
some way?
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ANSWER: While taking the advice and counsel of a long time employee usually
makes good sense, this time you are literally asking for trouble. The
probability is quite high that the reason this man has become "used to it" is
that his hearing is already damaged, a condition which is permanent and
without effective treatment. The intensity of sound is measured in decibels,
the faintest sound a human ear can normally hear labeled 0 dB, while normal
speech or the sound of a typewriter or sewing machine measuring about 60 dB.
If you must endure levels of 85 dB or above the chance of hearing lost is
there, and with each increase in sound levels the risk increases dramatically.
The Occupational Safety and Health Administration requires a hearing test for
workers who must labor in environments which average 85 dB or more during an 8
hour work day. If you're working with shop tools, that level is about 90 dB,
while using a chainsaw or pneumatic drill puts you under a 100 dB load. Work
at this level without protection for your ears is legally limited to but 2
hours a day. If you must stay close to such noise for a longer period of time
each day, hearing protectors in the form of either ear plugs or earmuffs must
be provided to you without cost. These devices, when properly fitted so that
the ear canal is totally blocked, can reduce sound levels by 15 to 30 decibels
and provide you with important protection against hearing loss. It is not a
question of making waves in a new position, but in protecting your valuable
hearing against permanent loss. Proceed diplomatically, but make sure you do
obtain the protection that the law provides and that your ears require.

What is the Correct Method for Using Nitroglycerin Ointment?

What is the Correct Method for Using Nitroglycerin Ointment?

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QUESTION: I have been a sufferer of angina pectoris for several years.
Recently, for the first time my doctor prescribed an ointment of nitroglycerin
to use for my condition. When I decided to spread it carefully over my heart
where it would do the most good, my wife wanted to put it all over my chest,
like some cold medicine. Which is the correct method?
------------------------------------------------------------------------------
ANSWER: Nitroglycerin absorbed though the skin uses a route of administration
called "transdermal" rather than "oral" or "intravenous", and can afford you
its benefits for a longer period of time than the "under the tongue" pills or
capsules. In order for it to be absorbed correctly, you must cover an area of
skin that is sufficiently large to do the job, about 6 inches long by 3-6
inches wide. It doesn't necessarily have to be placed over your heart, for
any place on the chest will work just as well. You might even use the upper
portion of your arm or back (but stay away from skin that is too hairy). The
ointment will begin to take effect in about 30 minutes and the effects
continue for from six to eight hours. Use the wax paper that comes with the
tube, as it usually has markings that will indicate to you the size of the
area that should be covered. Then attach the wax paper to your skin with
adhesive tape. Try not to get the medication on your fingers since it can be
absorbed from there too, and increase or cause side effects. When you are
ready for the next application, remove the wax paper, wash the skin carefully,
and then apply the next dose to another site on your chest. This will help to
avoid possible skin rashes that can be caused by both the ointment and the
tape. To keep peace in the family you can alternate sites between your heart
area and anywhere else on your chest your wife wishes to place this effective
and important medication for your condition.

Will a Period of not Smoking Give one Pristine New Lungs?

Will a Period of not Smoking Give one Pristine New Lungs?

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QUESTION: Assuming that all the cells in one's body die and are replaced
sooner or later, can one say that after thirty years of smoking, a five to
seven year period of not smoking will give one pristine new lungs?
------------------------------------------------------------------------------
ANSWER: An interesting question, but unfortunately based upon a wrong
assumption. It is true that we replace all our red cells every 100 days, and
that many other body cells die and are replaced in the normal process of
living, but some of the damage inflicted on lungs by thirty years of smoking
can never be repaired. Chronic bronchitis, emphysema and chronic airway
obstructive disease are all possible outcomes of long term cigarette smoking.
Smoke has an adverse effect on lung defenses and provokes a low grade
inflammation which, in turn, leads to the changes in lung anatomy and
function. But I don't want to take a completely negative approach to your
question. It is true that if lung function is measured by certain tests in
smoking individuals, and then compared to the results of the same test after a
period of smoking abstinence, a notable improvement can be measured. Many of
the symptoms of coughing and shortness of breath also improve considerably, as
the lung cleanses itself and revitalizes after the constant irritation of
smoking is removed. However, if the seeds of cancer have been sown during
your thirty year experience with tobacco, stopping the habit now can not
eradicate the tumor. It is nice to think of our body as being constantly
renewed and repaired, but it is mortal, and with time begins to show the signs
of wear and tear that we inflict upon it. Good health habits allow the body
function at its best, and offer the best hope for a long life.

Cancer Treatment Used for Rheumatoid Arthritis

Cancer Treatment Used for Rheumatoid Arthritis

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QUESTION: I suffer from rheumatoid arthritis and am always on the look out
for some new medication or treatment that might help me. Now I have learned
that a cancer treatment is also to be used for cases such as mine, and I would
like to find out the name of the drug and more about it. Can you help out?
------------------------------------------------------------------------------
ANSWER: Your information is correct. A medication, "methotrexate," which
originally was approved for treatment of certain types of cancer and is now
used in the treatment of psoriasis as well, has been approved by the Food and
Drug Administration for the treatment of rheumatoid arthritis. But the
indications make it clear that this is not a medication to be used
indiscriminately, but rather in cases that have been unresponsive or
intolerant to other therapies. The medication is given in low doses once a
week to keep side effects to a minimum, but which include nausea, diarrhea and
loss of appetite. Serious side effects are fortunately rare and include
suppression of the production of white and red blood cells. In the studies
which led to the approval, methotrexate therapy reduced joint pain and
swelling as well as morning stiffness and fatigue. Some patients began to
improve in as little as four to six weeks after the treatment was initiated.
I hope you will have the same fine results, should your physician and you
choose to start this new treatment.

Migraine and Diet

Migraine and Diet

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QUESTION: I have had severe headaches for some time now, but only recently
was the diagnosis of migraine made. Although I obtain much relief with
medication, I want to reduce their frequency as much as possible. I've
learned that for some people foods may provoke attacks, and would like your
advice as to what foods I should avoid.
------------------------------------------------------------------------------
ANSWER: The obvious answer is to avoid any food that you can relate to the
start of a migraine episode. It takes a bit of thinking, and maintaining a
note book or diary of the events which precede any attack may provide you with
the clues you are looking for. Although the specific foods differ from person
to person, there are some generally accepted types of food and drink which
most experts counsel their patients to avoid. High on the list are alcoholic
beverages, particularly red wines and champagne. Cheeses may get you in
trouble, aged or strong or of the cheddar variety. Stay away from any cured
meats, such as hot dogs, salami or bacon and ham, if you experience an attack
after a meal that includes such products. Pickled herring and chicken livers
also have a bad reputation. You can try black coffee as a beverage when an
attack is beginning, if you are thirsty and not nauseous, as the caffeine may
be helpful in fighting off the episode. Your best bet is to eat well balanced
meals on a regular basis, avoiding fasting or consuming too much carbohydrate
at any meal.

Is There Any Connection Between Lyme Disease and Gout?

Is There Any Connection Between Lyme Disease and Gout?

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QUESTION: There are several golf courses here in my area where white-tailed
deer roam freely. This is considered an asset and some courses incorporate
that information in their name. An ever increasing number of players and
maintenance personnel have symptoms resembling gout. Deer tick borne Lyme
Disease is endemic in this region. Is there any connection between Lyme
Disease and gout? Please respond by mid-May, start of the deer tick season.
------------------------------------------------------------------------------
ANSWER: Doesn't the good golfing season start about the same time in your
area? Humor aside, your question has much merit, and it is important to make
all my readers aware of the facts about Lyme disease. To answer your specific
question, there is no connection between true gout (an arthritic condition due
to crystals derived from high levels of uric acid, being deposited in joints
and tendons) and Lyme disease, EXCEPT for the symptoms! The slow development
of the arthritic like symptoms of Lyme Disease may resemble those of gout, and
so it is important that all are alerted to the possibility of this infectious
disease, passed on by the bite of the deer tick. The history of a tick bite
helps enormously, but frequently the bite goes undetected. The arthritic
symptoms may not develop until weeks after, and if there has been no typical
rash or symptoms that we now know are Lyme related the diagnosis may be
missed. It would well advised for your "gout" sufferers to be rechecked,
keeping the possibility of a Lyme Disease diagnoses in mind.

Lost Love

Lost Love

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QUESTION: After giving my boyfriend all there was of me and my love, he left
without an explanation or even a good-bye. I am left feeling empty and
worthless. I know I can get lots of advice from other columnists, but they
are just words. Surely a doctor must have some medicine, some pill to help me
through this terrible time? Won't you please help me?
------------------------------------------------------------------------------
ANSWER: If I tell you that you are not alone, it is not because I am hoping
that misery likes company, but to make you realize that everyone reading this
column and your letter can remember a similar experience in their lives. We
have all suffered the almost unbearable pain of losing the affections of a
loved one in the manner you describe; yet look around, we are all still here,
and the wounds have healed and become less painful, more bearable. You seek
medication from me as if it could be a magic cure, and that is just not
possible. I dread when my patients become dependent upon chemicals to blunt
the normal emotions and feelings that are a part of daily living. It seems so
easy to "pop a pill" and feel better, but the trap is there; and soon we use
the same way out when an expected job promotion does not materialize, or when
the term paper we labored so long on comes back with a "C" instead of the "A"
we felt we deserved. Living these days takes just a bit of courage, and the
firm belief that things do change and we can make them better if we work at
it. I don't know how Ann Landers might handle your question, but I suspect
she may share my feelings. You are far from worthless, and if you were here
I'd give you a big hug, hoping that might rekindle your own self esteem, but
the only medication I have to prescribe in your case is "Time". It has cured
more cases like yours than all the pills on the Pharmacy shelf.

What Are "Accessory Tragi"?

What Are "Accessory Tragi"?

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QUESTION: After a careful general and routine examination of my youngster,
the doctor described several small fleshy bumps in front of her ear as
"accessory tragi". He did not make too much of them so I didn't either, but
now I am concerned. What are they? Are they dangerous, and should they be
removed?
------------------------------------------------------------------------------
ANSWER: No, accessory tragi aren't dangerous. One of the whorls of the
external ear (which is mostly cartilage and skin) is called the tragus and
these bumps are really slightly misplaced pieces of that portion of the ear.
They are a common variation of the structure of the ear, and by themselves are
harmless.
But accessory tragi can be markers for serious birth defects such as
heart, kidney, spine and intestinal malformations. The bumps may also
accompany cleft lip or palate. A baby born with accessory tragi is closely
examined for more serious problems. Since these conditions would have shown
up by now, we can assume that your daughter is healthy, and the fact that your
doctor was not too concerned is also reassuring.
Accessory tragi are very small and may be noticeable only to the person
who has them. If your daughter is bothered by their appearance, they can be
easily removed by your family physician or a surgeon.

How to Make Pulse Calculations

How to Make Pulse Calculations

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QUESTION: I have signed up for a regular exercise class at my local Y.
During the tour I noticed that the members of the group were taking their
pulse during the session. I don't understand the method they were using, or
how to make the calculations. I'll bet a lot of your readers could use some
help with this math. Please help.
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ANSWER: It's not as complicated as it sounds, and once you have your numbers
figured out, they can be used during any athletic activity quite simply. When
ever you increase your activity, your muscles require an increased blood flow
to bring needed oxygen to the tissues. The heart responds by speeding up its
beat and your pulse measures the number of heart beats in a minute. To obtain
a benefit from your exercise program, and still remain within safe limits,
your heart should be working at a rate that depends your age and condition.
This rate falls between 60% and 80% of your maximum heart rate. Start by
calculating your maximum heart rate by subtracting your age from 220. For a
person 60 years old that would be 160 beats per minute. Multiply that by .6
for the low end of the range (160 X .6 = 96) and by .8 for the high end (160 X
.8 = 128). Since most exercise instructors use a ten second count for
measuring the pulse, you can divide both numbers by 6, and round off the
numbers to get your exercise range. In the example above it would mean that
the pulse should be between 16 and 21 for a ten second count during an
exercise session for a 60 year old person. Since you are just starting, it is
advisable to keep your rate close to your low end number, at least in the
beginning. If your heart is racing too quickly, reduce the intensity of your
effort during the session, by just moving to the beat of the music, and making
the other movements in a less forceful manner. A good instructor will help
you tailor your program to you needs, and can also demonstrate the correct
method of obtaining your pulse using either the radial artery in you wrist or
the carotid artery in your neck, below the chin.

Fatigue, Fever, and Arthritis After Heart Surgery

Fatigue, Fever, and Arthritis After Heart Surgery

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QUESTION: I had heart surgery several weeks ago, and thought I was doing fine
until recently, when I began to experience extreme fatigue, a slight fever,
arthritis pain and loss of appetite. I am being treated by my doctor, who is
merely prescribing aspirin. Is this all that is needed to cure me?
------------------------------------------------------------------------------
ANSWER: Your physician is playing it conservatively, but by the book. The
ever increasing number of heart operations has provided us with new insights
into the results of the surgery, as well as syndromes which develop after the
operations are performed. Your condition is known as "Postpericardiotomy
Syndrome" and can occur in as many as 10 to 50% of all cardiac surgery
patients. Certainly your symptoms fit this diagnosis, and your doctor
probably has some additional evidence from laboratory tests that rule out
other possibilities. The cause of this syndrome may be linked to immune
responses, possibly set off by a viral infection. It is difficult to tell you
how long this may persist, as that varies greatly from patient to patient.
The use of salicylates (aspirin) is recommended, and can bring the symptoms
under control in about 4 days. While steroids can be used to obtain a quicker
result, such treatment may mask the symptoms of a true infection, and patients
treated with this medication have more frequent relapses. The good news is
that this syndrome usually runs its course without other complications or side
effects. Your job is to relax, follow your therapy and obtain a complete and
swift recovery.