Causes and Care of a Stye

QUESTION: I have had two attacks of a stye on my left eye. That is also my
bad eye, the one that has the thickest lens in my glasses. I was wondering if
the two circumstances are connected? Could you also tell me what antibiotic
might be good to help with the eye infection?
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ANSWER: I am glad you recognize a stye (also called a "hordeolum") as an
infection, for that knowledge makes the answer a bit easier to understand.
All infections are caused by microorganisms, in this case a bacteria.
Staphylococci are most commonly the responsible culprit for a stye.
The need for glasses is based upon a condition known as a "refractive
error". The collection of tissues that make up the eye (the cornea, aqueous
humor, the lens itself, and the jelly-like vitreous), which act as lenses,
fail to focus the image of the outer world precisely upon the retina, often
compared to the film in a camera. And so corrective lenses (glasses) are used
to correct the "error". However, this fault can not cause an infection, and
so the facts in your case are mere coincidence.
The best "cure" for a stye is the discharge of the pus that collects
within the lid. That happens rather rapidly, and can be hastened by applying
hot compresses to the inflamed area. As soon as the stye "points", when a
small yellowish spot forms in the center of the inflamed area, a very sharp
scalpel can be used to release the accumulated pus, which also relieves the
pain. The use of oral antibiotics can slow this process or stop it
completely, and so are generally not used in treating simple styes. However,
in cases of chronically ill persons or those with an impaired immune system,
dicloxacillin or erythromycin are effective.
There is also a form of stye (deep hordeolum) which can involve one of
the Meibomian glands that are located within the eyelid. These infections are
usually more severe, causing greater pain, redness and swelling. They too
resolve rapidly once the pus is out, but there are cases for which oral
antibiotics may be required. In any case, local antibiotic creams or usually
ineffective and are not recommended.

What to Do for a Stitch in Your Side

QUESTION: Sometimes when I jog or run, I get a sudden sharp pain, usually
under my ribs. It can even come on when I am just stretching or reaching for
something on a shelf. People around here call it a "stitch". Can you please
tell me what this is and if it is dangerous in any way?
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ANSWER: People around here call it "a stitch" also. Actually, it's a muscle
cramp in the large muscle we call the diaphragm. The diaphragm is the muscle
that contracts each time we breathe and is located under the ribs, between the
chest and the abdomen. When some of the muscles fibers that make up the
diaphragm contract too tightly (spasm) it creates the pain. The same thing
can happen to the muscles located between each rib, and that may be the
trouble you mention that occurs when stretching or reaching.
The solution to the problem lies in stretching the cramp out, putting the
fibers back in order. Usually you can accomplish this by bending over from
the waist and touching your toes with your outstretched fingers. Hold the
position for a second or two, and "rock" a little and the pain should subside.
When the pain is between the ribs, rock your torso to the opposite side from
the pain. Raise the arm on the same side as the pain over your head and try
to stretch the cramped muscles by "pushing" away. Once all the muscles fibers
are back in line you should feel a "letting go" and an easing of the painful
cramp. Incidentally, these stretching maneuvers work on all muscle cramps,
whether they occur in the diaphragm, chest wall, legs or arms

Medical Risks from Saunas, Steam Baths, and Whirlpools

QUESTION: On a recent vacation, I visited the health club to exercise a bit.
I noted all the warnings around their hot tubs and steam rooms. Can you
explain what the medical risks are in using saunas, steam baths and
whirlpools? I wasn't sure, so I stayed out of them.
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ANSWER: Your caution was wise, as it always is, but probably unnecessary. In
general, when saunas, steam baths and whirlpools are used with caution, the
risks are limited. But there are some things some people should watch out
for.
It is risky business for cardiac patients, for example, to do a
traditional Finnish sauna, in which a person jumps from one of these "baths"
into ice cold water or snow. Many doctors recommend that all middle aged
persons refrain from such activity, as there is a lot of heart disease that
goes undiagnosed. And the sauna owners post these notices as a matter of
legal protection, posting the warnings that put you on notice.
The major source of problems for the general population is simply staying
in the bath too long. The increased body heat can not be cooled by the normal
process of sweating (since you are either immersed in water or are in a high
humidity environment). So the heart works a bit harder than normally, trying
to push blood through to the skin, which under ordinary circumstances would
help cool it down.
Eating or drinking alcohol may also lead to fainting if you do so before
or during hot bath use, for both activities affect the way the blood flows
through your body.
The next time you visit your doctor, you might wish to ask the same
question and receive personalized advice that applies to your own state of
health. For the most part, when people use saunas, steam baths and whirlpools
sensibly and with caution, they can obtain soothing relaxation and the
experience is quite pleasurable.

What to Expect from Radiation Therapy

QUESTION: The next step in the treatment of a cancer in a very close relative
is radiation therapy. Though there is much hope for the benefits it will
provide, there is also much concern about the side effects that may also come.
Could you outline what we can expect next? What happens when a person must
have radiation treatment for cancer?
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ANSWER: Radiation therapy (RT), either external or internal, consists of high
x-ray or gamma ray doses used to destroy the ability of cells to grow and
divide. At times, RT also is referred to as cobalt treatment, x-ray therapy,
radiotherapy or irradiation. RT is much more powerful than the amount
necessary for "routine" x-rays (those of the chest, for example).
External RT, in which a machine directs radiation to the cancer, is the
type most patients receive. Brief treatments, usually five days a week for
several weeks, are given during outpatient visits to a hospital, cancer center
or doctor's office. Total dosages of radiation and number of treatments vary
among patients and types of cancers.
During internal RT, where one or more implants (small containers of
radioactive material) are placed inside the body--either in or very close to
a tumor--a patient likely will have to remain in a hospital for several days.
As in other treatments for serious illnesses, RT can produce unwanted
side effects when its power also destroys not only cancer cells but healthy
ones as well. Many RT side effects are minor and disappear shortly after
treatment ceases, yet others are more serious and can last longer. The most
common side effects are fatigue, skin problems, loss of appetite and hair
loss.
A patient can do many things to help control side effects. First, a
responsible patient will follow all doctors' orders precisely. A patient
under therapy will require a great deal of rest, should eat a well balanced
diet and take special care of the skin. These simple actions, along with the
support and help of the entire medical team, can produce the best results
with the least number of unwanted side effects.

How do you Take your Own Pulse?

QUESTION: I have a heart problem and have been advised to take my pulse every
evening. How do you take your own pulse rate? Do I have to buy a special
machine to do so?
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ANSWER: Absolutely not. You can easily take your own pulse in a minute and
all you need is a stop watch or a clock with a second hand. You can determine
your pulse rate at several points of your body. The inner wrist (the radial
pulse) and the side of the neck (either side of the Adam's Apple for the
carotid artery) are the most common points. Place your first two fingers on
either of the pulse points, and using the stopwatch or clock, count the pulse
beats for a full minute. People with regular pulse beats can save a bit of
time by taking the pulse rate for only 30 seconds and multiplying by 2, but
the full minute count is always the most accurate. If your pulse seems
irregular or the count is much faster or slower than normal, wait a few
minutes and take it again. Many patients with heart problems are advised to
take their own pulse rates. People who have pacemakers, those who've had open
heart surgery, and those taking medication that may affect their heart rate
can get an early warning on problems by checking their pulse daily for signs
of change. It's one of the simplest ways of keeping track of one of your own
vital functions, and I'll bet your Family Physician will be pleased to teach
you the method the next time you visit the office.

Can Activated Charcoal Help Stomach Cramps?

QUESTION: I am a victim of terrible stomach cramps from time to time.
Sometimes it seems as if anything I eat does not agree with me. Is there any
truth to the stories about activated charcoal? My friend claims this has been
his best way of dealing with a similar problem. Do you agree?
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ANSWER: Yes, 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 has become increasingly
popular in recent years. 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, particularly
when someone starts on the diet full blast, and over does it just a bit.
Activated charcoal may increase the long-term tolerance of these foods, since
even when taken in large doses and for long periods of time, it is safe and
without adverse side effects. Discuss the problem with your pharmacist of
physician who can help you get a supply of this material for your use.

Does Smoking Increase Cervical Cancer Risk?

QUESTION: With menopause upon me, with all its accompanying problems, I find
myself smoking more than usual. Naturally my doctor has told me this is bad
for me and he mentioned that the smoking will increase my chances of cervical
cancer. I've heard of smoking increasing the risk of lung cancer, but how can
it possibly affect the cervix? Please explain.
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ANSWER: Cervical cancer is one of the leading causes of female deaths due to
cancer in the United States. Your doctor's warning is well founded. Studies
have found a definite link between an increased risk for the disease and
smoking. In one National Cancer Institute study, doctors found that women who
smoke more than 40 cigarettes a day, or have smoked for 40 years or more, are
more than twice as likely as nonsmokers to develop invasive squamous cell
cervical cancer. Women who smoke between ten and forty cigarettes daily also
had a higher than average rate of cervical cancer.
Interestingly, the doctors found the highest risks were associated with
recent smoking and the use of nonfilter cigarettes. Smokers should realize
that they are inhaling toxins and carcinogens that will travel through their
entire body, not just their respiratory tract, and that's why those who smoke
are at greater risk for many diseases. Maybe if I keep writing enough, people
will get the idea that smoking is really a health hazard, without much that
can be said about it of a positive nature.

Is There any Treatment for Cataracts

QUESTION: It seems pretty clear to me that the newspaper print isn't as clear
to me as it was only a few months ago. My doctor tells me that it is a
cataract developing. What is unclear to me is the possibility of taking some
kind of medicine to stop the progress of this unwanted problem. Can I take
medicine or do anything to stop cataracts?
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ANSWER: I don't think medical science is yet at the point where an outright
recommendation of medications to delay or prevent cataracts can be made. Much
research is being done in this area but there are no sure answers. Studies
with aspirin show it cuts the risk of cataract. The theory is it lowers
blood-sugar levels thought to predispose people to the disease. Also,
researchers noticed the eye has up to 30 times more vitamin C than the blood.
Experiments with vitamin C eye drops and diets in rats point to a slowing of
cataract formation. No one knows how much vitamin C or aspirin will combat
cataracts in humans so don't start overdosing and having side effect problems.
Vitamin E is also mentioned by some authors.
Probably the best way we know of right now to slow cataract growth is to
protect your eyes from overexposure to the sun. People who are in intense sun
for long periods of time with no eye protection seem to develop cataracts more
frequently. Wear sunglasses that are marked as UV-A blockers or have your
optometrist make up prescription UV blockers.
But you don't have to wait for surgery to improve your vision.
Frequently a change in your eyeglass prescription may be sufficient to give
you better vision now. Increasing the intensity of the light on your reading
material may also help.
The good news is that when you do finally need surgery to correct your
problem, your results should be fine. Cataract surgery is one of the safest
operations performed today, and new techniques offer the patient hope for
markedly improved sight.

Breast Lumps and Breast Cancer

QUESTION: If I have understood the articles in my local paper, almost every
breast lump eventually turns out to be a cancer. That is a pretty frightening
situation, if it's true. Is it?
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ANSWER: Absolutely not! But you must suspect every breast lump to be
cancerous until diagnosed as something else, so that no problems are
overlooked and allowed to progress without proper attention. Remember that
breast cancer strikes one out of nine women in this country. If you have a
family history of the disease, you must be particularly watchful. Having no
family history of breast cancer, however, doesn't let you off the hook.
Eight-five percent of the women who have breast cancer ages 35 to 50 have no
family history of the disease. Take the aggressive path by doing a monthly
breast self-examination, and report any changes to your doctor. With his or
her help, the problem can be fully evaluated.
About half the women of childbearing age have lumpy, bumpy breasts. The
lumps can be caused by a variety of conditions, but the most common is
sometimes called "fibrocystic disease." This term is being used less and less
because the condition is a normal one and many feel it is inaccurate to
characterize it as a "disease." Instead, the lumps and thickenings are due to
the breast tissue's normal response to the body's monthly hormonal
fluctuations. This may continue after menopause if hormonal replacement is
used.
There is no proof that women with fibrocystic breasts are more prone to
cancer; however, the danger is that they may have a cancerous lump that goes
undetected. Women with difficult to examine breasts may avoid the important
monthly task of breast self-examination, because they are confused about what
they are feeling. This is understandable, but it's not smart. Examine your
breasts the same day of your cycle each month, after your period. If you
don't know how to perform the exam properly, call the American Cancer Society
or your doctor's office. The key is doing regular, thorough examinations so
that you know your breast tissue and will identify changes in it. The new,
low-dose mammograms are also excellent to diagnose breast cancer in its
earliest, most treatable stage.

Birth Control Pills and Breast Cancer

QUESTION: In my day we were told that birth control pills could cause breast
cancer. Now my daughter wants to go on the pill and I want to advise her
properly. Are my fears appropriate? What can I tell her?
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ANSWER: All available evidence so far indicates that birth control pills are
not linked to cancer. One available study of some 10,000 women found no
increased risk of breast cancer, even among women who took birth control pills
for 15 years or more. This encouraging finding also held true no matter what
formula or dose of birth control pill the women took--no one type of estrogen
or progestin increased the cancer risk. Women who were thought to be at risk
for breast cancer because of other factors--a family history of the disease,
benign breast disease, or use of birth control pills before the birth of their
first child--also had no greater chance of cancer.
Other studies in the past have reached similar conclusions. Birth
control pills have only been available in the United States for about 20
years, and may have other long-term effects that we are not yet aware of.
During this time there have been many changes in the dosages used in the
pills, constantly reducing the quantities of medication used, and probably the
side effects as well. For the present they must be considered as excellent
medications, doing the job they were designed for, with few unwanted side
effects. It certainly seems as though you can put your fears aside when
counseling your daughter.

Facet's Syndrome

QUESTION: Could you please explain what facet syndrome is? Also, what is the
correct pronunciation of it? I suspect that this particular condition may be
the reason for my pain and problems and would like to discuss it with my
physician in an intelligent manner.
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ANSWER: You display a commendable attitude and I am pleased to help. Facet's
syndrome (it's pronounced "fasets") is often the diagnosis that explains the
reason for patient complaints of pains which originate in the vertebral column
and which sometimes are aggravated by standing or sitting in certain postures.
Muscle spasm may be present, and both sides of the body can be involved at the
same time.
Actually, it's a type of arthritic process which involves a small area on
the surface of a vertebra (a facet) where one bone in the spinal column
connects (articulates) with the vertebra above or below it. Usually, the
diagnosis can be made by taking x-rays of the spine from different angles.
These x-rays often show a degeneration of the cartilage within the joint, and
a displacement of one bone in relationship to the other. The result is a
spasm of the muscles, and a closing of the space through which the nerves from
the spinal cord pass out to the rest of the body. And it is this compression
of the nerve that causes some of the pain you are experiencing.
Often the pain can be relieved with rest and analgesic medication.
Physical therapy can be very helpful in getting you over some of the difficult
times when pain is great, and which, unfortunately, may return from time to
time. It is only the rare case that requires surgery, consisting of removing
the facets, or bone graft and fusion of the joint.

Munchausen's Syndrome--When People Make Themselves Sick

QUESTION: I have an aunt who winds up in the hospital three or four times a
year. She complains of chest pains, abdominal pains or accidentally swallows
a poisonous cleaning fluid. I don't think she's suicidal, because she always
manages to get herself to the hospital. I've been told there's a mental
disorder where people sabotage themselves or somehow manage to get into
hospitals, but I don't known what it's called or why people like my aunt would
even want to go to the hospital. Can you explain?
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ANSWER: What you've described sounds like a classic case of a disorder called
Munchausen's Syndrome. (It's named after the Baron von Munchausen, who wrote
incredible tales about travel and adventure, all of which were totally
fiction.) Those who have it either make up illnesses and complaints to get
them into hospitals or intentionally make themselves sick so that they will
need to enter the hospital. The symptoms those with Munchausen's Syndrome
often complain of are gastrointestinal symptoms, cardiac symptoms, especially
chest pains, shortness of breath, kidney pain, insulin induced hypoglycemia
and self-inflicted wounds or ailments.
Munchausen's Syndrome patients often have unstable home lives. Many were
orphaned or had one parent die when they were very young. Those afflicted
were usually hospitalized for an illness early in life and experienced the
hospital as a warm, caring environment. They seem to want to repeat the
experience of entering what seems to be a nurturing place.
Many Munchausen's victims are schizophrenics, are impulsive, and exhibit
self-damaging behavior. They have unstable relationships, and often express
inappropriate anger and intolerance. It's very difficult to treat patients
with this problem because they do not accept treatment.
If you have a desire to help your aunt, you should confront her
cautiously and offer help. However, you should know that when doctors tell
patients they may be victims of this unusual syndrome, the patients often
storm angrily out of the doctor's office.

Cholesterol vs. Saturated Fat in Palm Oil

QUESTION: How much cholesterol is contained in palm oil? Is the reason it
was taken off the market was because it was so high? If I wanted to
substitute palm kernel oil, would it lessen my problem? You see I have this
special recipe, and I want to use it; but everyone is so health conscious in
my family that I fear I will be chastised if I don't pay close attention to
the cholesterol content in the cake.
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ANSWER: You have need have no fear of cholesterol from either palm oil or
palm kernel oil. Vegetable oils, even tropical oils (and that includes
coconut oils as well) never contain cholesterol, which is only found in animal
products. However, tropical oils are notorious for the amounts of saturated
oil they contain, and that is just as bad for your health. To compare the
two, palm oil is 51 percent saturated, palm kernel oil is 86 percent
saturated. Coconut oil takes the prize though, as it is 92 percent saturated
oil.
Though they were never taken off the market, and are still available,
most American manufacturers of food and baked goods, for the most part,
voluntarily abandoned the use of tropical oils in 1989. The effects of
saturated oils on blood cholesterol levels can be quite serious, even if they
themselves do not contain cholesterol. Despite that, there are still a few
products, including chocolate covered cookies, coffee whiteners, some brands
of potato chips and whipped toppings that contain these oils. You can chose
to avoid these products by carefully studying the labels, and selecting only
those products that are free of tropical oils.
As for your baking, alas, I am no gourmet cook, but am sure that there
are many other baking oil products that can meet with your family's enhanced
health priorities and still permit you to prepare your specialty with little
change in its flavor or allure.