On Prescribing a Purge

QUESTION: With all the medicines available today, there is still nothing as good for a person as a good cleaning out.
When I was younger it was not infrequent that our own doctor would prescribe a purge, that soon put things to right.
I don't know of any doctor in my area today that knows about this, and sometimes wish these younger fellows would take a lesson or two from their elders.
Perhaps many conditions that have no treatments today could be cured.

ANSWER: You are advocating some pretty strong medicine, that may have no beneficial effects at all to the sufferer.
We have learned a great deal since those days when physicians, just like patients, believed that the inside of the "bowel" (meant to include the entire digestive system) was filled with dirty and poisonous material.
Daily movements were required to keep the system "clean," and constipation was a serious situation.
Castor oil and Epsom salts were administered in huge doses to obtain the desired effects. The intestine was stimulated, causing forceful contractions to push out all of the contents, and frequently provoked more harm than good.
We now have a more restrained view of bowel functions, and while daily regularity is a comforting thing, it is no longer considered a must.
A good diet rich in fiber can often be all that is necessary to keep a person's bowels in order.
It is far more important that our systems function in a normal and timely way, rather than in the unnatural fashion provoked by excessive stimulants.

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.

Are Rabies Shots Necessary?

QUESTION: I was playing around with my neighbor's dog when it got very excited, started growling and then bit me on the hand.
They weren't deep cuts, and my neighbor assures me that the dog has all its shots, but my wife thinks I should visit the doctor for rabies shots.
I don't want to have a long series of painful injections if it's not necessary, so I need a quick reply from you.
What is your advice?

ANSWER: Rabies is not a disease to fool with, for without proper treatment when indicated, it is still almost always fatal.
Rabies is a viral infection of the central nervous system, and its treatment depends upon the fact that it has a long incubation period, usually from 20 to 90 days, (although it can develop in a period as short as 4 days or take more than five years to develop).
The treatment no longer is quite as painful or as difficult as you may have heard.
The initial treatment requires two injections, one of human immunoglobulin, the other of rabies vaccine.
Four more rabies injections will be given over the next 28 days, permitting the patient to acquire a resistance before the disease itself has had a chance to develop.
The circumstances of the bite determine whether or not this series of injections is required.
If the animal is known, as in your case, and when the dog has had all of its immunizations, it is possible to merely observe its behavior for 10 days, to see if signs of rabies develop.
You should report the incident to your local Health Department, who will know if rabies is present in your area, and who can advise you of your best plan of action.
They will probably want to examine the animal for signs of the rabies virus.
You're lucky it was a domestic animal with a clean history.
When the bite is the result of a wild animal's actions, a raccoon for example, there is a much greater chance that rabies is present and treatment should begin at once.
Rabies is not a pretty thing to watch as the first symptoms of fever, nausea, headache, lethargy and a tingling sensation at the site of the bite, rapidly progress over a ten day period to hyperactivity, disorientation, hallucination, difficulty in swallowing, followed by seizures, paralysis and death.
Once symptoms start there is no cure, so get hopping with your investigations of this animal.

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 Condition Where the Muscle Turns Into a Bone?

QUESTION: Is there a condition where the muscle turns into a bone? A friend of mine had an x-ray of his arm, and there was a piece of bone seen that normally isn't there.
The doctor says that the only way to treat it is to remove it with an operation, but wants to wait a while to see how big it is going to get.
Is this right? Please help us.

ANSWER: The condition is one that is known, and bears the impressive name of "myositis ossificans"; but it really isn't muscle turning into bone, although that is the meaning of the translation of these words which come to us from the both the Greek ("myo" means "muscle") and the Latin ("ossificans" means "to make bone").
Actually the process begins with an injury, usually a contusion or strain, in which the muscle is torn, and blood collects in a clot called a "hematoma".
The most common spot for these types of injuries are the thigh, followed by the mid arm.
The bone formation usually only occurs on severe injuries, and may also involve a clot infection after a respiratory infection.
Slowly the clot is transformed into bone, possibly from bone cells which came from an injury to the covering of the bone (periosteum) which might have occurred at the same time.
The bony mass keeps enlarging for as long as six or seven weeks, after which a process of resorption begins.
Small masses may disappear completely, but when a large bone mass remains after a longer period of time, the only way to remove it is by using surgical techniques. Interestingly enough there is another situation in which such benign bone growth may be seen, and it is called "drug user's elbow".
Here the process starts with the injuries to muscles and surrounding tissues that have been caused by the unskilled use of a needle that was in search of a vein, but instead ripped the other tissues in the area.
The brachialis muscle of the upper arm is the muscle most commonly injured.
If your friend's doctor believes that his injury is recent, he is correct in waiting a bit to see what develops before attempting to remove abnormal bone.

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.

Can Spells of Light-headedness be an Inherited Problem?

QUESTION: My, father who is 79, has had spells of light-headedness when he stands suddenly.
His doctor diagnosed the problem as a result of some heart medication he is taking.
However, I have recently experienced the same problem on several occasions, though I am only 49, exercise regularly 5 to 6 times a week, and am fit and in great health.
I take no medication, and my question is whether or not this may be some type of inherited problem.
Do you have an answer for me?

ANSWER: As you sit and read this answer, take your pulse.
My bet is that it may be somewhere in the range of 60 to 65, perhaps lower, and certainly below the range of a normal pulse, which is usually between 72 and 78 beats a minute.
A slow pulse of this nature, which reflects the speed at which the heart is beating, is common in athletes or those who maintain a regular, somewhat strenuous exercise program.
And it is this slow beat which may be at the root of your light-headedness just as it is with your Dad, although the cause is different.
When we are at seated at rest, the heart beats with enough force to send the pressure into our head, and nourish the brain with needed nutrients and precious oxygen.
When we stand suddenly, additional pressure is needed to compensate for the abrupt increase in height.
In people with the heart beating at near normal speed the next beat is less than a second away, while in individuals with slower pulse the time needed for the next surge of blood increases to more than 1 second and approaches 2 seconds in individuals with pulses closer to 30 beats per second.
For that period of time, the brain has less than the amount of oxygen it needs and a feeling of light-headedness occurs that may approach dizziness or even fainting.
Your cause is the state of physical fitness you have achieved.
In your Dad's case, the medication is responsible for slowing his heart beat, although it may be increasing the force of the beat and helping his condition.
What is clear is that your condition is neither the result of any inherited traits nor in any way dangerous.
The truth is you should continue your healthful ways, and possibly avoid some of the problems that might be the reason for your Dad's need of medication.

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.

Causes of Dry Skin

QUESTION: I have a terrible problem with an itchy skin.
There are times I can't stop scratching.
It is worse at night, although I do get a bit of relief after a warm bath.
When I look at my skin there is no rash, but it just seems drier than at any previous time in my life.
I can't complain though.
This set of skin has lasted me for 82 years, I just don't want it to give out before the rest of my body quits.
What can I do to preserve it?

ANSWER: It looks like you have been doing a pretty good job with all your body parts, and it might be that your largest organ, the skin, needs a bit of special help now.
You give a perfect description of the dry skin that can affect so many of our older youngsters, and providing you have no other signs of skin problems or allergies, we can proceed with some simple tips to help get things right.
In order to stay springy and flexible, our skin needs a certain amount of moisture that must be retained in the tissue.
Since older skin has lost some of the waxes that help conserve the moisture, dry skin can occur more easily.
And if you live in an overheated environment, where the humidity in the air is low, or use a lot of soap a bit too frequently, you can be making the condition just a bit worse.
The trick is to keep the moisture in the skin after it has been well hydrated, in one of your warm baths for example.
Spreading an emollient cream or lotion that softens and smooths immediately after a tub or shower can help hold the moisture in.
There are several such preparations available at your local pharmacist that have a water base and are easy to apply.
Another means of reducing the problem is to reduce the use of harsh and drying soaps, carefully washing the hands and face, under the arms and other important areas, and leaving the rest of the body with a less attentive cleansing.
Use a soap that is high in softening agents, and free of perfumes.
Don't use a wash cloth as it can irritate the skin, and try a patting movement with the towel rather than a brisk rubbing. While each of these tips may help only a bit, using all of them in a routine manner can sometimes totally subdue the problem.
And they are all easy to do and cheap too!

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.

Can You Explain a Little About the "DTs"?

QUESTION: Can you explain a little about the "DTs"? Is it just a case of the "shakes," or can it be a serious condition that might possibly be fatal? Please mention a bit about treatment as well.
Thanks, this is an important question for us.

ANSWER: "DTs," or perhaps a bit more precise "delirium tremens," is a form of mental illness brought on by a withdrawal from alcohol, which causes the sufferer to lose touch with reality.
The primary symptoms of the "delirium" component often center around terrifying and vivid hallucinations: sounds, smells, and sights which only exist in the patient's mind.
For instance, the person may see snakes, or feel ants crawling all over his body.
The "tremens" part, however, is the more important factor indicating the underlying danger because it is characterized by a soaring heart rate, seizures (shakes), sweating, and hypertension which can lead (among other things) to heart and kidney failure. Treatment for DTs, as it is commonly called by many, is often a complex process, the success of which depends on the basic health of the individual. Usually it begins with a prescribed sedative such as diazepam to calm the central nervous system, plenty of fluids, electrolytes to replenish lost body salts, continued abstinence from alcohol, and multivitamins and sound nutrition to bring the body back to normal function.

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 a "Salmon Patch" Nothing to Fret About?

QUESTION: My baby boy was born with a large pink birth mark on the back of his neck, which looks quite large to me.
Although I have indicated my worry to my doctor, she is not concerned and just tells me that these marks, which she calls a "salmon patch," are nothing to fret about.
Could you please tell me if you think she is correct?

ANSWER: I think we can agree with your physician, although I think she might have offered a word or two of explanation to help calm your natural anxiety. Salmon patches, sometimes called "angel's kiss" or "stork bite," are the most common birthmark composed of small blood vessels seen in babies.
They can occur on the forehead, eyelids, nose and lip areas, and are frequently seen on the nape of the neck.
They are seen in the midline area, and are usually symmetrical.
And yes, they do disappear by themselves, about 99 percent of those found on the face are gone by 1 year of age.
While 5 to 10 percent of those on the neck may remain, they are easily covered by growing hair and represent no health danger to your child.

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.

Does "School Phobia" Really Exist?

QUESTION: I am having the darndest time getting my young son off to school each day.
He will use any excuse not to go.
One of the teachers called this a "school phobia" and suggested that I seek some counseling and help for my child.
What do you think? Does this phobia really exist?

ANSWER: I think many experts agree that there is a condition called "school phobia" and that it may be more common than once thought.
However, in many cases it is more truly a fear of leaving home than a horror of being in school.
Actually many of these children want to attend their classes but suffer from the effects of a separation anxiety, not wishing to leave the protection of their home and parents.
Some fear their mother will desert them when they are away at school and will put up quite a battle when the moment to leave arrives, clinging to the mother, crying and screaming.
Many develop complaints of headache, dizziness, abdominal pains, nausea and vomiting, all of which resolve quite rapidly when they are permitted to stay at home.
To be sure, some events at school, such as a school bully or an overcritical teacher may aid the development of the problem, as will a fear of certain subjects. Most of these children have an average or superior intelligence, and the problem may occur in families of all social, ethnic, religious and economic classes.
Do not confuse school phobia with truancy, where the child leaves home without any problem, but does not attend school, roaming the streets instead with others who are also "taking the day off".
These youngsters are frequently poor students, and their parents are unaware of the absence. School phobia is a complex problem in many cases and seeking professional help in these cases is well advised.

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.

Crushed Aspirin Lotion Treatment for Pain from Shingles

QUESTION: Although I have read a few of your answers concerning shingles and the pain that can remain after the rash has gone, I don't believe you ever mentioned a new treatment my doctor is trying with me.
It consists of using crushed aspirin in a lotion, that I put right on the painful area with quite some relief.
Do you know of this treatment, and what do you think of it?

ANSWER: The treatment your doctor is now trying with you is quite new, and reports of its use have only just recently appeared in the medical press. This type of pain, called posthepatic neuralgia, which follows the acute stages of herpes or shingles, occurs most frequently in older patients.
It has always been a difficult pain condition to treat, and while local application of steroid creams, and more recently a preparation derived from naturally occurring chemical in pepper plants (capsaicin, brand name Zostrix) have been used with success, some individuals were still left with continuing pain.
In the continuing search for a treatment that could offer relief to these individuals, a new technique has recently been reported from several pain management centers.
Two 350 mg aspirins are crushed to a fine powder and dissolved in some solution or lotion that makes it possible to apply the mixture directly to the painful areas.
In one study, chloroform was used as the liquid base, and in another report Vaseline Intensive Care Lotion was used.
The results seemed to indicate that most patients experienced substantial and lasting relief from the tormenting chronic pain that had persisted after the herpes infection.
While these results are certainly encouraging, I must point out that they are still preliminary, and additional large scale studies are needed to fully prove the worth of this technique. However, the use of this treatment technique, with due caution to avoid inhaling the fumes of the chloroform preparation, would seem to offer the possibility of pain relief with out posing any undue hazards for most patients.

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 Can be Done For "Polymyalgia Rheumatica"?

QUESTION: I have had a terrible time with soreness and aches in my arms and legs.
I tried aspirin and other pain medicines but they don't work.
My doctors says it isn't the arthritis I thought I had, but something called "polymyalgia rheumatica." He wants to give me cortisone, but I am a bit reluctant.
Would you please advise me what to do?

ANSWER: Although it may be a difficult task to tell the difference between arthritis and polymyalgia, there are a few clues that can help make the diagnosis.
Polymyalgia rheumatica (PMR) is condition of the muscles rather than the joints, which are the target of arthritis.
The muscles of the upper arm, neck and shoulder, and hip are sore and tender to the touch, and are particularly stiff and painful in the morning upon arising.
Although you may have some pain when moving your muscles, they are probably as strong as ever. This disease is more frequent in older people and strikes women twice as often as men.
About half the patients tell of feeling weak tired and depressed, while many will also have a fever and weight loss.
While it is painful disease, it is neither life threatening not life shortening.
There are several blood tests that help make the diagnosis, and your doctor may inform you that you have a high sedimentation rate as that is present in almost all patients with PMR.
This is another disease where we are uncertain about the cause, and cannot accurately predict the course of the ailment, which is very variable.
Once it starts it can last from six months to a year, but episodes lasting five years or more are not uncommon.
PMR is often associated with another condition called temporal arteritis, which would provoke headache, scalp tenderness and vision disturbances as well.
The good news is that this disease responds very well to the medication your physician has advised, and you should not delay taking it.
Corticosteroids (like prednisone) taken orally can quickly chase those pains away, sometimes in as little as 24 to 36 hours, but you may have to continue taking the medicine for some time.
The results of frequent blood tests will help your physician decide when the time is ripe to reduce or stop your medication.

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 "Potassium" Blood Test For?

QUESTION: We are senior citizens and would like to know just what a certain blood test is for.
Some of our doctors have a test taken every six months when we are in for a blood pressure check.
It is usually for "potassium" but we have no symptoms of a lack of potassium and are not treated for anything else, so why?

ANSWER: A regular blood test for potassium at six month intervals would make no sense to me either, if you hadn't mentioned that it occurred while you were having your blood pressure checked.
Did you forget to tell me that some of you were being treated for high blood pressure? One classification of medications commonly used to reduce elevated blood pressure is the "thiazide" group, also known as "diuretics" or "water pills".
They work to reduce the pressure by reducing the volume of blood through increased urinary excretion, but they also provoke a loss of sodium, potassium and chlorides as well.
They are well tolerated as medications, having few side effects and are frequently chosen as the first medication in the treatment of hypertension.
Since they extract potassium from the body, regular blood tests can be used to check the levels.
Potassium is a most important chemical for the body to have in just the right amounts, as it can effect the way electrical currents are carried through the heart, and thus the way the heart beats.
In most cases, there is no need to replace potassium in people who are on diuretics, but when the levels are low, liquids containing extra potassium can be provided.
Bananas are also an excellent source of potassium, as are prunes, raisins and whole or skimmed milk.
If you are on water pills, and receive no additional medication after the blood tests, it is because you are maintaining the right levels of potassium and so have no need for more medication, and certainly nothing to worry about.

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.

Why Does Hair Loss After Childbirth Happen?

QUESTION: My baby is 5 months old.
I started to lose a lot of my hair when he was 4 months old.
My doctor says that this is because of hormones and that it will stop in 6 to 18 months.
Would you please explain why this happens? Is this a common problem with women who have babies, and is there anything I can do now to stop it?

ANSWER: Your are experiencing a problem with the improbable name of "telogen effluvium" which is commonly seen in women after childbirth, and for which the good news is that "this too will pass." Hair growth occurs in a cyclical pattern, with active growth (anagen phase) continuing for from 2 to 6 years. A brief period of regression (catagen phase) then occurs during which a club hair is produced instead of the normal long hair you are now wishing for. Then a rest period of about 3 months takes place (telogen phase).
When reactivation occurs the club hair falls out (telogen effluvium) and new hair growth and a new cycle begins.
Normally about 85% of scalp hairs are in the anagen phase while the remaining 15% are resting.
Hair shedding may follow any type of body stress, such as surgery, high fever, crash diets, acute blood loss and even the use of certain drugs.
But as your doctor correctly advised you, new growth will soon take place and your hair will return to normal. There really is nothing you need do now, for the process will run its course, and there are no means of stopping it once it has begun.
You can best help yourself by using this new understanding to reduce the stress and anxiety that you are naturally experiencing at this time, and turn your energies to your baby.

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 One Method of Blood Test Better Than the Other?

QUESTION: It used to be that my doctor merely had my finger stuck for tests. Now, more and more, the nurse is taking the blood from a vein in my arm.
I was wondering if there was any difference in the results of these tests, and if one method was better than the other?

ANSWER: There are many screening tests that only require a drop or two of blood from which quite accurate and useful results may be obtained.
They have the advantage of using the blood obtained in the quick and easy method afforded by a finger stick, and may also be quite economical.
Again many people prefer this method of obtaining the blood specimen to that of a needle in the vein.
Actually, with new, very sharp, disposable needles used but one time, neither method is very painful.
However more precise measurements may require more of a sample and so the vein is used to rapidly collect all that is necessary.
With new developments in medical technology, several different tests may be run on a single blood sample, offering you some economies, and providing the physician with answers to more than one question.
It is not a question of one method being better than the other, but which type of test is required for your medical care.

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 it Possible to Fracture One's Sexual Member?

QUESTION: Here is a good one for you.
At a recent business convention, a colleague who I have met at these things over the years, confessed to me that a recent hospitalization was for a fracture of his sexual member.
I know that there is no bone there to break, and so find his story difficult to believe. What do you think really happened to him? I've got to know.

ANSWER: Control your curiosity, and become a believer.
The penis contains two sponge like tubes, the "corpora cavernosa" surrounded by a very strong fibrous tissue sheath, the "tunica albuginea".
When blood fills and expands the corpora during sexual arousal, this sheath becomes thinner and more prone to injury.
If some type of forceful trauma occurs during an erection, either during intercourse, or an accidental fall or unexpected blow directly to the erect penis, the tissues of the tunica and corpora can be torn.
This condition is known as a fractured penis, and there are many articles in the medical literature describing it.
Considered a medical emergency, it is extremely painful, as you might well imagine.
The treatment of choice is surgical, which is necessary to find the area of the tear, remove the accumulated clotted blood and to repair the tear.
When these tasks are accomplished in a timely fashion, the function of the organ is preserved. Hospitalization of two weeks is average and good results are achieved in about 75 percent of cases treated this way.

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 "Ganglion Cyst"?

QUESTION: What is a "ganglion cyst"? A friend gave that label to a hard, pea sized lump I have developed in the wrist joint at the top of my left hand.
It is not painful unless knocked.
Are these cysts common? Can they turn cancerous? What is the best course of action for getting rid of one for good?

ANSWER: Your pea sized lump is one of the most common tumors of the hand.
It can arise from almost any tissue source, ligaments, tendon sheaths or joint capsules.
Yours is at the most common location, the dorsum of the hand, and fits well in the range of sizes, from but a few millimeters to 2 to 3 centimeters.
Though sometimes they feel quite hard, most often they have a soft or rubbery feel, and are filled with a clear, jelly-like fluid.
They never transform into a cancer of any type.
If you are not too inconvenienced and your ganglion has been around for but a short time, you might want to delay any treatment as sometimes this little balloon will disappear by itself. It can be aspirated to remove the liquid, and then injected with a corticosteroid, but that procedure provides no assurance that the the ganglion cyst will not return.
The most effective method of treatment, when the ganglion is symptomatic, is to eliminate it surgically, being most careful to remove it all including the stalk that attaches it to its origin.
This dissection may sometimes be performed under a local anesthetic.
A careful skin closure will leave but a tiny scar, which when healed will be barely visible.
An oft told tale is the biblical method of removal, slamming a bible down on the ganglion and rupturing it under the skin without using any surgical techniques.
Quaint, but not recommended, and certainly no guarantee against recurrence.

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 Scabies?

QUESTION: Would you please discuss scabies as much as possible? What is it, Is it a venereal disease, where does it come from and what treatments can be used? There are several people in our community who need these answers very badly. ANSWERS: I can understand your need, so here goes.
Scabies is a skin disease caused by a tiny "itch mite" (Sarcoptes scabiei) that has plagued mankind for centuries.
Scabies outbreaks occur when crowded conditions exist, since the disease is highly contagious and passes easily from one infected person to the next.
While sexual transmission is common, it is not the only method, since even simple hand holding games in children can be enough to spread the condition.
Sharing clothing, towels or sleeping in the same bed are other means of transmission.
When the male and female mite mate on the surface of the skin, the female mite then burrows into the surface layer of the skin to lay her eggs.
the eggs develop into larvae, return to the skin surface, become mature mites and the whole cycle starts again.
Little burrows can be seen under the skin, along with a red, very itchy rash, which seems to become worse at night.
Frequently your physician may take a painless scraping of your skin, to examine under the skin to make the diagnosis.
Fortunately, effective medications are available containing lindane (Kwell) which can eradicate the mite, although the itch may continue for several weeks.
Careful personal hygiene is a must, as the scabies can recur and the body does not develop an immunity to them.
Check with your doctor to confirm your diagnosis and get the prescription for your medication.

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 Sed Rate?

QUESTION: When I spoke to my doctor about some recent blood tests, he told me that my "sed" rate was just a bit high.
What is a sed rate, and what am I going to have to do to make it lower? I am very concerned.

ANSWER: The term "sed rate" is an abbreviation of the name of a blood test involving red cells called the "erythrocyte sedimentation rate" (also known as ESR).
If a sample of blood is allowed to stand in a test tube, the red blood cells will gradually sink to the bottom of the tube, creating a clear layer of yellowish plasma at the top.
Depending upon the method used to perform the test, this clear layer will measure from 0-20 mm/hour in women.
When the cells descend at a faster rate, producing a larger clear layer, the "sed" rate is higher.
It is a sign that there is an inflammation going on somewhere in the body, and may require additional tests to locate just where that process is going on.
Usually when the situation is cared for and corrected, the sed rate returns to normal.

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 Sed Rate?

QUESTION: When I spoke to my doctor about some recent blood tests, he told me that my "sed" rate was just a bit high.
What is a sed rate, and what am I going to have to do to make it lower? I am very concerned.

ANSWER: The term "sed rate" is an abbreviation of the name of a blood test involving red cells called the "erythrocyte sedimentation rate" (also known as ESR).
If a sample of blood is allowed to stand in a test tube, the red blood cells will gradually sink to the bottom of the tube, creating a clear layer of yellowish plasma at the top.
Depending upon the method used to perform the test, this clear layer will measure from 0-20 mm/hour in women.
When the cells descend at a faster rate, producing a larger clear layer, the "sed" rate is higher.
It is a sign that there is an inflammation going on somewhere in the body, and may require additional tests to locate just where that process is going on.
Usually when the situation is cared for and corrected, the sed rate returns to normal.

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.

Do Hormones Exist in Humans and Affect Their Behavior?

QUESTION: An article I have just finished tells of how hormones may affect the reaction of animals and their behavior to one another.
Do these mechanisms exist in humans and affect their behavior as well?

ANSWER: The release of hormones and the sense of smell has been proven to have a definite effect in many kinds of animals, but the relationship between human hormone secretions and scents is not fully understood. The hormone-like substances that make animals react to one another are called pheromones.
The substance is released by one individual and prompts a change in the physiology or behavior of another. When a female dog goes into heat, male dogs all over town are attracted to her master's home because of the scent she releases. In colonies of naked mole rats, all females but the queen are infertile. That's because the queen sends out such a strong odor that the reproductive systems of the other females are shut down. In humans, however, over ten years of studies have not been able to establish beyond the shadow of a doubt that pheromones exist.
There were two studies though that are caused considerable debate that human underarm pheromones can influence menstrual cycles.
The research was done by the University of Pennsylvania and the Monell Chemical Senses Center in Philadelphia. The researchers collected underarm secretions from men who wore a pad in each armpit.
The male essence was then dabbed on the upper lip of women whose menstrual cycles were irregular lasting less than 26 days or more than 33. After three months of this "therapy" the women's cycles changed lasting an average of approximately 29.5 days, which is the cycle length associated with the highest fertility.
The scientists concluded that male scents produce at least one pheromone that helps promote female reproductive health.
Another study with women who lived in close quarters showed that their menstrual cycles would eventually begin to coincide.
This is believed to be due to underarm sweat secretions. The research will continue, in the hope of unlocking the secrets of the "chemistry" between human beings.

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 a Type A Personality a Good Candidate for a Heart Attack?

QUESTION: I'm a Type A personality I admit it.
In fact, I enjoy the rushing and competitiveness.
Unfortunately, a friend tells me I'm a good candidate for a heart attack.
I can't believe this, especially since I feel so good.

ANSWER: Some 20 years ago, Drs.
Mayer Friedman and Ray Rosenman sketched out the Type A personality: someone who does many things at once, takes on too much work, moves quickly, hates waiting, can't relax, interrupts, angers easily and is competitive.
Ever since then, cardiology has never been the same.
This seemingly definitive list has raised as many questions as it answered: Why, exactly, would Type A behavior lead to heart attack? Do some Type A characteristics count more than others? And most important, is there any way a Type A person can reform into a Type B? Researchers speculate that it's the high levels of the hormones adrenaline, cortisol and testosterone found in young Type A men that contribute over time to a narrowing of the coronary arteries, but this still is unproven.
Another question mark is whether these hormone changes are a result of Type A behavior or a cause of it. We know more about which Type A characteristics count most heavily.
Some studies show that hostility and anger are far more reliable predictors of heart disease than any other Type A characteristics.
This is good news indeed for people like you who are competitive, hurried and so forth, without being angry.
It may well be that Type A behavior has its good and its bad components. Even Type A's who are angry may not be headed for heart trouble. Hostility has been linked with coronary artery disease in younger people only. The theory here is that the older hostile Type A's are a hardy bunch who have avoided heart disease while the more vulnerable people in their age group succumbed to it prematurely. Finally, the best news: it is possible to change Type A behavior through counseling.
Patients learn that hostility and anger are likely to be harmful to their hearts and are trained in heading off these negative emotions.
Of course, if Type A behavior turns out to be the result of hormone imbalances or other physical causes, counseling will help only temporarily.
Researchers are now working to discover whether drugs can control Type A behavior, and a few early experiments have hinted that they can.

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 Too Much Calcium in the Blood and Parathyroidism Related?

QUESTION: After a recent blood tests, I was told that I have too much calcium in my blood.
I'm confused because I thought calcium is good for you.
I've also been told I have parathyroidism.
Are the two conditions related? Please clarify.

ANSWER: You're right.
Calcium is good for you, but, like anything else, too much of it isn't healthy.
More importantly, excessive calcium in the blood is a signal that something is wrong and should be investigated and possibly treated. You say you have parathyroidism, but I think you mean "hyperparathyroidism." Hyperparathyroidism, or HPT, is caused by the hyperactivity of the parathyroid glands, and too much calcium in the blood is characteristic of the person who has hyperparathyroidism.
Other conditions can cause too much calcium in the blood, but it is very common to see hyperparathyroidism and hypercalcemia, or high levels of calcium in the blood, together. HPT is being diagnosed with greater frequency now than ever.
It appears that it is no more common now than it has been in years past, it is just diagnosed more frequently.
Often it is unexpectedly identified in patients when a routine blood test reveals higher than normal amounts of calcium in the blood.
The patient may or may not have symptoms.
It is twice as common in women as men, and is seen most often in women aged 40 to 60. More than half the people with HPT diagnosed in routine screening tests have "primary HPT," which means the cause is not known and the only problem that can be found is simply the higher than normal levels of calcium in the blood.
In other individuals the cause may be a tumor of the parathyroid gland, which causes the gland to malfunction and secrete more hormone than it should.
Other forms of cancer can mimic HPT, but this is fairly uncommon. Those persons whose primary HPT is discovered during routine lab work usually require little or no treatment.
If the problem is caused by a tumor on the parathyroid gland, surgical treatment will probably have to be considered. People with HPT vary widely in their symptoms.
Those with primary HPT often have vague symptoms that are not severe enough to motivate the individual to seek medical attention.
Symptoms most frequently reported are fatigue, irritability and mild gastrointestinal distress such as nausea and constipation. The decision on when or how to treat depends upon the age and the general physical health of the patient, and the severity of the symptoms.
Surgery on the parathyroid gland is an option for some, but it should not be undertaken lightly.
Surgery to correct hyperthyroidism is delicate and not always successful. Liberal intake of fluids and salt are often prescribed for the person with mild primary HPT, because this helps the body excrete excess calcium in the urine.
Sometimes, limiting intake of calcium and Vitamin D is recommended.
Do not treat yourself by adding salt to your diet or limiting your calcium and Vitamin D unless you have been thoroughly evaluated by your doctor.
Calcium and Vitamin D are essential to health, and limiting your intake of them should be done with your doctor's supervision and advice.

The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician.
Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.

How Do Doctors Tell One Type of Headache From the Other?

QUESTION: I know that headaches are common and frequent complaints that doctors must hear many times a day.
However I know that there are times when the diagnosis is more serious.
How do doctors tell one type from the other? I think that this information would be helpful for anyone to know.

ANSWER: This is a very good question, and I agree that such information could be helpful to many people.
Here are a few clues.
If the patient complaining of the headache looks sick, I think they deserve a careful examination for other signs that may lead to a diagnosis.
By the same reasoning any other abnormal signs, changes in their walk, muscle strength size of their pupils, or other neurological signs may mean the headache is not a simple one.
If the patient also appears drowsy or confused, the headache may be a sign of serious infection, particularly those that take place within the skull.
The same is true of headaches associated with a fever, which while they may be but the sign of an oncoming common viral infection, can also be the signs of a serious infection such as meningitis.
This may also cause the neck to become stiff, so I always check to be sure the patient can lower their chin to their chest and conduct other tests to be sure the neck is perfectly supple.
Some headaches are provoked by blood leaking in to the brain from aneurysms (a ballooning out of the artery due to weakness in the wall of the vessel) and these must be treated as promptly as possible.
One sign is when a headache has started during exercise or exertion.
Such patient must be carefully examined.
Another headache that must be taken seriously is the "first" headache in an adult patient.
When this occurs, it too may be the sign of a leaking aneurysm.
Remember, however, most headaches are benign, and pass over with rest and analgesics, and don't require intensive care.

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.

I.V. Antibiotic Medication at Home

QUESTION: Is it all right for my mother's doctor to discharge her from the hospital while she is still in need of medications, and continue to prescribe an I.V.
antibiotic medication for her at home? He has assured us that this is done frequently today, and will provide all the care my mother needs at home. What is your opinion?

ANSWER: With the development of new and very effective and safe antibiotics that can be administered by a parenteral route (through an intravenous tube), the idea of discharging patients from the hospital to continue their medications as outpatients (outpatient intravenous therapy or OIT) has begun to catch on.
There are some restrictions of course, and this method of therapy can never be used for patients with life threatening infections. However, when the infecting bacteria has been identified and the proper medication selected, and when there is evidence that the antibiotic is working well, transferring the patient to their own home surroundings can be considered.
It requires that both patient and family thoroughly understand the requirements for this procedure, and that the family is able to assist and support the patient.
A refrigerator to store the medications must be available, as well as a telephone to assure communications in the event of an emergency.
Nursing care and home health services can be provided, but there is a catch to this scheme.
While it is most certainly less expensive to care for a patient at home than in the hospital, many insurance plans (including Medicare) do not pay for self administered drugs.
You would be well advised to check your insurance coverage and assess your financial obligations before considering this method of treatment, even if the scientific aspects and medical outcomes all do make sense.

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 Oxygen for Severe Lung Disease Covered by Insurance?

QUESTION: My husband, who has had severe lung disease for many years, requires oxygen on a more or less continuous basis.
Do you know if such service is covered by insurance? Our doctor has prescribed it for my husband, but we have limited income and are worried about the cost.

ANSWER: The use of oxygen for patients in their homes can make life a bit easier for those who suffer from chronic lung disease, or who have heart troubles that lower the amounts of oxygen in the blood.
Not all insurances are the same, but in most cases it is a treatment that is covered when certain laboratory tests prove that it is essential to the patient's well being. These blood tests measure the amount of oxygen carried by the blood and compare it with the amount that is can normally be found by such tests.
We all do well on the oxygen in the air, even though it only represents about 20% of the air we breathe, but in individual with impaired lung or heart function, the extra concentration found in containers containing pure oxygen can provide them with the amounts they need.
Several research trials have shown that not only is there an improvement in their ability to get about, but their mental and psychological functions improve as well.
More important yet, they have a greater life expectancy.
Your doctor can help you by providing your insurance companies with the laboratory data they require, for I am sure such tests were used to help make the diagnosis that led to the prescription for home oxygen therapy your doctor has ordered.

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 Are Those Little Yellowish Bumps People Get Around The Eyes?

QUESTION: What are those little yellowish bumps people get around the eyes? They don't seem to bother anything, but what can be done to prevent them from growing?

ANSWER: Physicians call these yellow-colored lesions xanthelasma.
They are usually raised slightly above the skin surface and can occur on either the upper or lower eyelid usually near the inner corner.
They occur in individuals who suffer from elevated blood cholesterol, particularly in an inherited disorder called "familial hypercholesterolemia," although they can occur in any individual with elevated cholesterols.
In the familial disease, the serum cholesterol may be elevated to two or three times normal and requires aggressive treatment.
Their growth can be halted by lowering serum cholesterol, which means strict avoidance of foods containing cholesterol and saturated fatty acids.
These include meat, especially organ meats and obvious fats, milk, cream, butter, eggs, lard, and other saturated cooking fats. As you correctly stated, they don't bother anything, but remember that other similar plaques are developing on the lining of the patient's arteries, causing a condition called atherosclerosis.
With attention to diet and the lowering of serum cholesterol levels, not only will the plaques on the eye stop growing, but the more important ones located within the arteries may also become smaller.

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.

Why Do Doctors Always Write Their Prescriptions in Latin?

QUESTION: Why do doctors always write their prescriptions in Latin? My guess is that it is to keep the mystery in medicine and to keep patients confused, but I suppose you will have another point of view.
What is it?

ANSWER: Yes, I do have another point of view, and I am happy to share it with you.
Actually physicians do not use a lot of Latin in writing their prescriptions these days.
They did in "the good old days" when pharmacists prepared prescriptions by mixing various powders and liquids requested by the physician.
But today, most of this preparation takes place at the drug manufacturing plant, so that the physician merely names the medicine and its dose, specifies tablet, capsule or liquid, all in English.
However there is one part of the prescription that gives the directions for the patient that still may seem a bit confusing.
It's called the "sig.," from the Latin word that means "to write," and contains a great many abbreviations which simplify writing the prescription but still clearly indicates the instructions to be included on the label.
Its a lot easier writing "a.
c." (for the Latin ante cibos) than "take the medication before meals", but it means exactly the same thing to those who know the abbreviations.
And that takes the mystery out of that.
But it still doesn't improve the handwriting of many doctors, which may be the reason you still can't decipher it!

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 are the Symptoms of Salmonella Infection?

QUESTION: There was a recent outbreak of salmonella infection in a nursing home in our area.
Our mother lives at a similar home and we have been concerned that it could happen there too.
What are the symptoms we might be looking out for, can it be prevented and what treatments are available?

ANSWER: There are many members of the Salmonella family and over 2200 types that can react differently to certain serological tests.
Most types produce an acute gastroenteritis, and therefore the symptoms are those of abdominal distress.
The symptoms include abdominal pain, diarrhea, nausea and sometimes vomiting.
Fever is usually present.
When both diarrhea and frequent vomiting is present, dehydration may occur and must be treated as well, with intravenous fluids.
When the infection is transmitted by contaminated food, the first symptoms will occur from 4 to 72 hours after eating that food, with the average time being 18 hours.
Prevention is most important, and brings us back to the basic rules of hygiene.
Meticulous hand washing, with soap and warm water, proper stool disposal, and isolation of infected individuals can reduce exposure to the bacteria.
Attention to the purity of the water and the preparation of food, as well as handling, storage and refrigeration of poultry, meat and eggs are musts.
Bed clothes should be laundered in hot, soapy water.
The use of antibiotics, with choramphenicol being the drug of choice, can greatly reduce the severity and duration of the illness and reduce the frequency of complications.
Ultimately the diagnosis of salmonella infections is based upon finding the bacteria in stool cultures, and you must not panic at the first sign of a mild stomach ache, since not all such symptoms herald the outbreak of a salmonella infection.
When a salmonella infection is suspected, however, prompt reporting to the proper health authorities is essential and can obtain the resources needed to combat the infection in the most effective manner possible.

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.

Scopes for Looking Into the Lungs

QUESTION: I know doctors use telescopes to look into your bowels and stomach. However my problem lies within my lungs, and my doctor has suggested the same procedure looking into my lungs.
Can that be done?

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

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

QUESTION: I greatly appreciate the convenience that a microwave oven can provide a homemaker.
However, where my baby is concerned, I am a fanatic about details, and so want to know if is it all right to heat a baby bottle in the microwave?

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

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.

Does Breast Cancer Screening Really Reduce Deaths?

QUESTION: With everyone on the band wagon, my question may seem naive, but I hope you will give it the attention I believe it deserves.
Does breast cancer screening really reduce deaths?

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

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 New Dieting Break Through Safe and Will it Work?

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?

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.

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 "Dowager's Hump"?

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?

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.

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.

Cautions About Driving While Taking Medication

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?

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.

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.

Has Tuberculosis Been Wiped Out?

QUESTION: In my day Christmas Stamps supported the Tuberculosis Foundation, and there were always x-ray vans around for free x-rays to locate the disease. The fact that they are no longer with us tells me that tuberculosis has been wiped out like polio.
Help me win a bet by telling me I'm right?

ANSWER: I hope your wager was a small one, for tuberculosis (TB) is still with us, and after many years of fewer and fewer cases, the numbers have suddenly begun to increase again, with a total of 22,575 cases reported in 1985.
And according to at least one expert, it may be more difficult to diagnose these days, as the symptoms are less dramatic than before. Classically, a patient would suffer from a history of cough and would produce sputum, frequently blood stained.
There was also the complaint of weakness, fever, loss of appetite and weight loss, and night sweats.
But TB may occur in adults today with few or no lung symptoms at all, and the typical picture of the disease may first be diagnosed on x-ray picture of the chest, possibly taken for totally other reasons.
But even x-rays can be deceiving, and physicians rely on other diagnostic procedures, such as skin tests, and microscopic examination of the sputum to locate the bacteria.
Cultures and immunological tests help round out the array of diagnostic techniques.
The good news is that the treatment of tuberculosis, which in the past could prolong for as much as 12 to 18 months, may now be accomplished in as little as 6 to 9 months.
Several potent antibiotics are available, including isoniazid, rifampin, pyrazinamide, streptomycin and ethambutol.
Various protocols exist, using two or three drugs simultaneously to assure the cure of this infection.

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 Shy-Drager Disease?

QUESTION: A member of our family has been diagnosed as having Shy-Drager Syndrome.
I have been unable to find this in any medical reference book.
In response to my questions, the doctors tell me that they are doing all they can and that this is a very rare disease.
Can you explain and tell me if there even is such a disease?

ANSWER: Indeed there is, and it is a rare disease.
It occurs in adults, coming on slowly and gradually.
It's major problem is that the blood pressure drops when the patient attempts to stand, but other symptoms such as visual troubles, tremor, and muscle wasting form part of the syndrome.
Although the cause is still unknown, it is a generally progressive degenerative process of the central nervous system, that eventually severely incapacitates the patient.
Cortisone derivatives and salt are used to try to correct the low blood pressure, but there are no effective treatments known that can halt the progress of the neurological changes.

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.

Insight Into Sinus Trouble

QUESTION: Although my wife believes that sinus trouble is very much like a common cold, I have always thought that this was a most serious disease, and that it can easily cause death.
Can you offer us some insight?

ANSWER: There is a bit of truth in both positions in this friendly family health discussion.
While every common cold does not become a sinus infection, sinusitis is a complication of upper respiratory tract infections in about 1% of the cases.
When the normal defenses of the sinus break down, bacterial and viral infections can penetrate into these normally sterile spaces and create quite a problem.
The tissue lining the sinus spaces becomes inflamed, producing a thick secretion which may block the normal flow of secretions from the sinus and create painful pressure in the sinus.
As the bacteria continue to grow, this pressure increases and with it, pain and tenderness, fever and purulent (pus) discharge.
Since the sinuses lie so close to the brain and other very sensitive nerve structures, any spread through the thin bony walls of a sinus can produce infections of the brain's coverings (the meninges) and to the brain itself.
Fortunately this is a rare occurrence, and generally is not seen in otherwise healthy individuals.
Rapid diagnosis has been advanced by using the CT scanner, which can accurately reveal the presence of infection as well as any damage to the sinus walls.
Intensive use of antibiotics and surgical drainage can usually control these life endangering complications.

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.

Concern Over Teenage Football Injuries

QUESTION: My son is a wide receiver on his high school football team, a great player, and very important to the game plan of his coach.
I always fear that if he were to be injured, he would get back in the game too soon, and really damage his chances of a future career.
Can you advise me as to the right type of treatment he should be getting on the field, and what I can do to protect him?

ANSWER: It's not an easy question to answer specifically, and it's not an easy game your son is involved in.
It's a contact sport, and the violent forces that go into that contact make the likelihood of injury very high. According to the National Athletic Trainer's Association, 37% of all high school football players suffered an injury that required the player to stay out of action for the rest of the day in which the injury occurred.
The best "ounce of prevention" for such injuries is a sound, well designed training program that provides exercises to develop muscular strength, muscular endurance, cardio-respiratory endurance as well as speed, flexibility, power, agility, coordination and balance.
Your next defenses lies with knowledgeable officials who apply the rules, particularly those concerned with player safety, strictly to the letter.
Good coaching is a must, and most high school coaches are sensitive to the future aspirations of their players and consider those factors first even in the heat of a hotly contested game.
On the field, first aid relies on four major principles.
Any injured player must be removed from the game for examination and the necessary treatment of the injury. Appropriate first aid for almost all injuries includes rest (splinting if a fracture is suspected), application of cold packs or ice to the injured area, and rest for the injured part and player.
Ice helps reduce the amount of swelling and helps control pain.
A cold pack or ice pack should be wrapped in a towel, applied to the injury for twenty minutes, removed for ten minutes, and then the cycle is repeated.
All injured extremities should be elevated to reduce swelling and the accompanying discomfort.
Any suspected fractures should be x-rayed and then treated.
In a game that is close, particularly where your son may be an important factor, even a father can be swayed by events.
There should be one individual on the field who, hopefully, is maintaining an objective perspective.
It is the school physician who may be in the best position to assure that your son is treated correctly, and it is from this nonbiased professional that you can obtain the best counsel if an unfortunate injury does occur.

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.

Importation of Unapproved Drug Products

QUESTION: We are going to be traveling abroad this summer, and have heard of a drug that can help my wife's condition that is not available as yet in the United States.
I am sure that our government would understand and allow us to bring this medicine back into our country, but my wife fears that not only will the drug be taken away, but that we might also face imprisonment if we are caught.
Can you provide us with any information that might help us?

ANSWER: The regulations which govern the use of medications in the United States and which are enforced by the Food and Drug Administration (FDA) have been formulated to provide drugs that have the greatest degree of safety, as well as proven ability to combat disease effectively.
The process of approval is a long, difficult and expensive one, so that frequently medications are available in other countries before they are approved for use in the United States.
However, the regulations of the FDA do allow importation of unapproved drug products, providing four basic criteria are met.
The product must be purchased for personal use.
The drug will not be sold commercially, and the quantity must not be excessive.
Usually a three month supply is considered allowable.
The use of the drug must be appropriately identified. Last but not least, and perhaps the most difficult criteria to achieve, the patient importing the medication must affirm in writing that the drug is for their own use, and provide the name and address of a physician licensed in the United States who will be responsible for the patient's treatment with the drug product.
The FDA considers this a humane method of implementing rules that have been established to protect our society against the cruelties of medical quackery and health fraud.
Complying with these guidelines will assure that you may openly and without fear import these medications for your personal use.

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.

Causes of Jaundice

QUESTION: We visited a friend in the hospital who is distressed not only by his condition, but by the conflicting information he has been given.
He is all yellow, and was told at first that it was a liver infection.
Now he is being told it is an obstruction and that he must have surgery.
Is there any way you can untangle this situation for us?

ANSWER: Your "yellowed" friend is displaying the effects of a condition called jaundice, which occurs when pigments found normally in the bile find their way into the blood stream and thus to the skin.
That's causing the yellow color, but it only indicates that a disease process is going on without specifically telling us which one.
Jaundice is caused by a large number of diseases, certainly the most common being viral hepatitis.
Most physicians would rank it the number 1 possible cause of jaundice, and then begin the difficult process of determining the exact reason for the jaundice.
Besides a variety of infections, such as malaria, mononucleosis, yellow fever and others, the yellowing condition may be caused by drugs used to control other medical conditions.
More common, though, are those conditions which block the flow of bile from the liver to the portion of the small intestines known as the duodenum.
These situations range from blockage by gall stones in the small ducts through which the bile normally flows to the closing of these small and delicate tubes by cancerous growths of the pancreas and of the ducts themselves.
We can use blood tests to distinguish between this type of jaundice, called obstructive jaundice, and the type caused by infections. X-ray procedures help to pinpoint the exact location of the blockage, and then it is up to the surgeon to remove the cause.
This surgery can be long and difficult, and your friend is entitled to a most careful explanation of all that is involved.

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.

The Breath-Holding Child

QUESTION: It's frightening and distressing, and most important; I just don't know what to do about it.
My 3 and a half year old, when he gets mad, will just hold his breath until he passes out.
He actually turns blue! Do you know what this condition comes from and what I can do about it?

ANSWER: A breath-holding child can be a most alarming experience for a parent, but while your heart is racing away, the child is doing little damage to itself.
These attacks are benign and don't evolve into more serious conditions.
They are limited to young children, begin between the ages of 6 and 18 months and are over by 5 or 6 years of age.
Typically they start from an event as minor as a fright or minor bump, or even just frustration, and the child cries vigorously for several moments.
Then, suddenly, they gasp, stop breathing, becoming blue (cyanotic) from lack of oxygen, become rigid and then lose consciousness.
Then normal breathing resumes, and when the child returns to consciousness the episode is over.
In severe cases, there may even be a seizure, but less severe cases may last for a minute or less.
There may be a family history of this problem about 25% of the time, but a careful examination by a physician is in order to be sure that this is merely a breath-holding disorder, rather than epileptic seizures or a condition known as pallid infantile syncope.
Treatment is almost totally in your hands, and the manner in which you react to these episodes.
If you can maintain your cool, strengthened by the reassurance that there are no terrible results from the terrifying sequence of events, than you can address the whims of your child with firm, quiet determination.
If you allow your fear to overcome your good counsel, the child will take over, using the threat of breath-holding to manipulate you.
When you are convinced that breath-holding attacks are harmless, you will regain control and be able to deal effectively with these attacks, which are self-limited.

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.

Breast Reconstruction After Mastectomy

QUESTION: Despite all my precautions and frequent checkups, I was found to have breast cancer about a year ago, and had to have my breast removed.
At that time, I only thought of ridding myself of the disease, but now my thoughts have turned to the possibility of plastic repair.
What are my odds of having things a bit like they were before?

ANSWER: Plastic repair, or more correctly breast reconstruction, holds real promise for anyone who has gone through the trial of breast cancer surgery. The odds are making all as it was depends upon several factors, including the type of operation, the extent of the surgery, the method of reconstruction that may be useful in your case, and to a great extent your own expectations and feelings about what might be considered as cosmetically acceptable.
The discussions you must have with your own surgeon should be based upon a full understanding of the procedure, and what achievements may reasonably be expected.
If you hold your hopes too high, your odds of being satisfied after all is done may swing against you.
The most common and frequently performed technique uses a silicone implant to replace lost tissue.
It requires that there be a sufficient amount of skin and other tissue available to cover the implant, and provide a natural appearance.
When there is too little tissue to permit this approach, a hollow prosthesis may be inserted.
Fluid is injected into this bladder like device over time, increasing its size and making space for a permanent implant to be placed later.
A third, more costly and difficult procedure uses muscle and tissue from other parts of the body, buttocks, abdomen or back to construct a living breast that may look quite natural.
This operation is called the free flap approach, and requires a bit of time to accomplish.
All methods are useful in responding to the desires of patients such as yourself to put things back "a bit like they were before".

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.

Breast Cancer Surgery and Pregnancy

QUESTION: I lost a breast to cancer before I was thirty, two years ago.
I am now going with a man who loves me very much, but would like to have a family. How does my past history affect the possibility of pregnancy?

ANSWER: Since the question may be interpreted in two ways, I'll try to answer both questions for you.
The surgery has had no effect on your ability to become pregnant.
Even with the assumption that you had chemotherapy (anticancer medication) after the operation, your hormonal functions now may be considered normal, and the chances of becoming pregnant are the same as before the operation.
The advisability of becoming pregnant is, however, another important question.
In pregnancy, the production and flow of the female hormones change considerably, and their effect on the breast and cancer change as well.
While some studies show an improved outlook during pregnancy, the risk of developing cancer in the other breast may be increased.
The possibility of recurrence depends upon a number of important factors, the size of your first tumor, any signs of spread, the length of time between the development of the cancer and its treatment, and the kind of tumor are all considerations, and difficult for me to evaluate without more information.
It is important to know that should a new cancer be discovered while you are pregnant, immediate and intense therapy would be necessary, and depending upon the the stage of your pregnancy would expose the fetus to many risks. However, many women in this situation carry the pregnancy to term, without harm to the baby.
While there are varying opinions amongst the experts, it is generally advisable to wait at least three years following a course of breast cancer treatment before trying to conceive.
Since there are many factors to take into consideration, you would be well advised to sit down with your physician and boyfriend for a full discussion.
It's the only way you can come to the very best decision for yourself, for it is you that must make the final choice.

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.