Health information

QUESTION: To help control an angina problem, I have been encouraged to
participate in a regular jogging program, with some success I might add.
However while visiting my son in New York, I was surprised to experience an
attack while at my usual morning run
Could it have been the exposure to
unaccustomed air pollution that brought on my problem?

ANSWER: I believe so, and there are several studies in the medical literature
to back me up
They indicate that an angina attack in a susceptible person
may occur from 25 to 32 seconds sooner in city air polluted with carbon
monoxide than it would in pure air
Exercise increases respiration and the
intake of carbon monoxide which displaces the oxygen from the hemoglobin
molecules in your red cells, and reduces the delivery of oxygen to the heart
muscle
This brings about the angina attack
The effect was also
demonstrated on an EKG tracing during the investigations that used treadmill
testing to simulate the conditions
While the pure air of your native state
is to be desired, you can still carry out your regular exercise activity in
cities by avoiding peak traffic times and choosing locations away from the
cars.

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.

Plavix
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Plavix (Clopidogrel) is used to prevent strokes and heart attacks.

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QUESTION: A 4 month old baby boy in our family contracted “Kawasaki Disease”
about 3 months ago
We never heard of it
Where does one get this disease,
is there an incubation period so we can try and pinpoint when and how he
contracted it? Any information you can shed would be appreciated.

ANSWER: Known as well by the name “mucocutaneous lymph node syndrome”,
Kawasaki Syndrome usually occurs in infants and children under the age of
five, and progresses through stages
It usually starts with a high fever,
associated with irritability, lethargy and occasionally colicky abdominal
pains that come and go
A day or so after the fever, a rash appears over the
trunk, followed within several days by a sore throat, reddened dry, cracked
lips, “red eyes”, and a red strawberry like tongue
The arteries are also
affected, causing difficulties in circulation with swelling to the palms and
soles
The glands in the neck are swollen throughout the entire course of the
disease, which may last from 2 to 12 weeks
The most feared manifestation of
the disease is related to inflammation occurring in the arteries of the heart
which may occur about the 10th day of the illness
This may lead to heart
failure, irregular beating and development of coronary artery aneurysm.
Although the disease was first described in Japan in the 1960’s, its cause is
still unknown, as cultures for bacteria or viral infection are usually
negative
Some specialists feel that there is an immunologic basis for the
disease
There is no specific treatment, but aspirin is used during the
period of high temperature to reduce the risk of coronary artery involvement.
Aneurysms generally disappear within a year and the general prognosis is very
good.

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.

Menosan
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Menosan is a unique complex herbal formula that helps women to cope with symptoms, associated with menopause.

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QUESTION: What’s the story on L-tryptophan? I have been taking it for years,
and now it has been removed from the shelves
I believe it is a natural
product, so there should be no cause for this action.

ANSWER: Yours is but one of many letters with similar questions.
L-tryptophan is one of the many essential amino acids that are used by the
body to construct proteins
Many people have used this product to overcome
insomnia, depression, premenstrual tension, and attention deficit disorders in
children
However, when several doctors reported a new and mysterious
disorder involving the blood in three cases, the common factor in the history
was L-tryptophan, and so, after additional research, the Food and Drug
Administration required it be removed from sale and warned people against its
use
The new disease, now called eosinophilic-myalgia syndrome, causes high
fever, weakness, muscle and joint pain, swelling of the arms and legs, as well
as a rash and shortness of breath
Blood counts reveal the presence of
extremely high numbers of eosinophils, a type of white cell found in the
blood
At present, 475 cases have been identified in 44 states and the
District of Columbia
Although the cause is still unclear, scientists are
exploring the possibility that contaminants or impurities might have been
present in the bottles, or that manufacturing processes may have changed the
chemical in some 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.

Lopid
Our price: $1.5
Lopid (Gemfibrozil) is used along with a proper diet to help lower fats and cholesterol in the blood.

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QUESTION: Does Legionnaires disease, named in honor of American’s war
veterans, have anything to do with the terrible lung disease suffered by the
troops who served in France during the first world war? My father used to
tell us about those conditions, and died from the long term complications of
the pneumonia he caught there.

ANSWER: It seems we have a little confusion here, and the mixing of two
stories
Legionnaires Disease is a relatively newly discovered disease that
first attacked 182 members of the American Legion that were meeting in a
Philadelphia hotel during this nation’s Bicentennial celebration in 1976
A
new form of acute respiratory disease was seen in these people, some of whom
developed pneumonia
Despite the use of antibiotics and other medications, 29
of these patients eventually died
The cause of the disease was unknown at
that time, and it took almost six months of medical detective work by members
of the Centers for Disease Control and the Pennsylvania State Department of
Health before the bacteria was discovered
It was found lurking in the
cooling tower of the hotel’s air conditioning system
The bacteria was given
the name “Legionella pneumophilia”, the first name after the American Legion,
first victims of the infections, and “pneumophilia” because the bacteria seems
to “like” lungs
The bacteria seems to prefer living in water, and is more
resistant to chlorine and elevated water temperatures than other bacteria
It
has been found everywhere, and may be transmitted from contaminated plumbing
lines, showers, condensers and cooling towers, as well as improperly cleaned
humidifiers, respiratory therapy devices and whirlpools
It can be prevented
by increasing the chlorination of water conditioning systems and elevating the
temperature of water heating and storage facilities
It is treated with the
antibiotic erythromycin
I am at a loss to identify your father’s disease
from the information contained in your letter
It may be that his lung
disease and the stories could be the result of poison gas attacks which
occurred during World War I, taking toll in lives, and complications of the
respiratory and nervous systems.

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.

Lotensin
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Lotensin (Benazepril) can be used in treating high blood pressure.

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QUESTION: Please will you tell us about Leigh’s Disease? All the information
we have obtained from our pediatrician and metabolic doctor is very sketchy.
The patient is 4 years old
Thanks for any information.

ANSWER: Little wonder your doctors have had little to tell you, for
information about this rare disease is both scarce and not very promising.
Also called “Subacute necrotizing encephalopathy,” it was first described by
Dr
D
Leigh in 1951, and is named for him
It affects infants of both sexes
equally, and its cause is unknown, although it probably is inherited in some
fashion under the influence of several genes
Various portions of the brain
gradually die, seemingly without reason, and with their destruction, body and
muscle functions are also gradually lost, until a terminal stupor or coma
occurs
The evaluation depends upon the physical examination, for there are
no specific tests that prove the diagnosis, except that computerized axial
tomography (CT scan) can show changes occurring in the shape of the brain
No
known treatment exist except supportive care, and unfortunately death occurs
within a few years
A few children have lived to their mid teens, but they
too fail to develop normally or thrive.

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.

Epivir-HBV
Our price: $1.8
Epivir HBV (Lamivudine) is used to treat a chronic viral infection of the liver (hepatitis B).

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QUESTION: I know that the leprechauns are the little people that populate
Irish folk tales, but a friend (Irish, of course) insists that there are such
people, and that they result from a medical condition
Is he putting me on or
do you have some knowledge of this condition?

ANSWER: I suspect that to some extent your friend is trying to pull your leg,
although there is some substance to his story
A rare condition, known as
Donohue’s syndrome or “leprechaunism,” is probably an inherited condition seen
to occur in certain families where the baby, almost always a girl, is slow to
develop both mentally and physically
The facial characteristics of widely
set eyes (hypertelorism), low set and large ears and a broad nose give an
elfin aspect to the infant
There is usually an excessive amount of body
hair, and all these features suggested the name, likening the condition to the
description of the Irish elves
However this story has a sad ending as the
prognosis for these individuals is very poor, ending in death at an early age
for most
Without a definite cause, and in view of its rare nature, no
treatments exist for the many other abnormalities which form part of the
syndrome.

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.

Imdur
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Imdur (Isosorbide-5-Mononitrate) is used for preventing symptoms of angina (chest pain).

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QUESTION: I have a difficult time keeping my hands clean because of my job,
but have real troubles with hangnails
It may seem like too simple a problem
to include in your column, but let me tell you, it is no joke for the person
who has the pain
Where do these things come from, and what is the solution?

ANSWER: No problem is too simple to be dealt with here, especially when it is
such a common situation that can affect many readers
I would be willing to
wager that there will be many who write with information about their own
successful methods of treating the common hangnail
The hangnail is really
not nail at all, but a small spit of skin which occurs around the nail and is
the result of trauma to the fingers, dryness and the use of degreasing agents
for cleaning the hands, including soap
Most of the pain develops when the
hangnail becomes infected and inflamed
Then the familiar redness and
soreness develops, often leading to sharp and constant pain
The infection is
provoked by tearing the hangnail away, instead of the recommended technique of
cleanly cutting away the excess skin with a scissor or clipper
Sometimes the
source of infection is from the mouth, as many people habitually try to trim
the hangnail with their teeth
Any tearing of the skin, in the presence of
bacteria, opens the door to a painful infection
Prevention is the best
course, regularly using a hand cream or moisture cream to keep the skin soft
and prevent drying
When a low grade infection sets in, the use of an
ointment containing an antibiotic is useful in controlling the problem
If
the infection becomes more severe, it is time for a doctor visit and a
prescription for oral antibiotics.

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.

Capoten
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Capoten (Captopril) is used in treating high blood pressure.

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QUESTION: You wrote in a recent column that “you may lose up to one half of
your body heat through the top of your head”
I know that statement is true
for I have seen it many times in health columns, but I have never seen an
explanation
People wonder how such a small part of your body can lose so
much heat
Please do millions of people a favor and explain how
Or don’t
you know?

ANSWER: That’s the way! Issue a challenge, and you know I’ll put your letter
in the column
Especially when I DO know the answer
First we must
understand that the heat of our body, which is produced by the metabolism or
burning of the nutrients we eat, carbohydrates, proteins and fats, is
distributed throughout the body by the circulatory system
The heat contained
in the blood warms all the tissues and keeps the body temperature at an normal
98.8 degrees Fahrenheit
One look at a diagram of the arteries and
capillaries of the scalp would provide you with the answer that millions of
people will now know
The skin of the scalp, which is thicker than in any
other part of the body, is loaded with a rich network of blood vessels
Most
people who have suffered a cut or laceration to the scalp, know just how much
blood seemed to flow, and how difficult it was to stop the bleeding
This
extensive blood circulation close to the surface of the skin can lose a great
deal of heat in cold weather, particularly when the wind chill factor dips to
low numbers
A hat or cap acts like a blanket, retaining the body heat and
preventing its loss to the cold environment
The same anatomy can act to help
you cool off during the heat of summer, when dousing your head with cool water
leads to the process of evaporation, and helps your body disperse unwanted and
unneeded heat
Your perspiration over the rest of your skin acts in the same
way, but the concentration of blood vessels on the top of your head makes your
scalp an efficient heat pump.

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.

Aciphex
Our price: $0.45
Aciphex (Rabeprazole) decreases the amount of acid produced in your stomach.

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QUESTION: There is a man who lives in the same adult home that I do, who I
see coughing up blood several times a day
I tell him that he must do
something about it, but he claims it is nothing and will go away
Do you know
what this condition is, and what should I do about it? I feel sorry for him,
but am also afraid that it might be catching and dangerous to all of us.

ANSWER: Your concern is not without good reason, and your efforts to obtain
help for this man are important
Coughing up blood is called “hemoptysis” in
medical terminology and can be classified as mild, moderate or severe,
depending upon the amount of blood which is coughed up
It is hard to tell
you an exact diagnosis, for there are more than a hundred causes of this
symptom listed by the American Thoracic Society, and you have not provided me
with enough details to even make a guess
In about 20 to 40 percent of the
cases, the underlying disease is either bronchitis, which is caused by an
infection, or bronchiectasis, a condition of the lungs where the bronchi have
become dilated and possibly infected as well
Lung cancer can certainly be at
the root of this problem, and we can not overlook the possibility of
tuberculosis
These conditions probably account for more than two thirds of
all the cases of hemoptysis
While small amounts of blood loss are not too
serious and won’t endanger this man’s life, things can become progressively
worse if not attended to, and death can result both from asphyxiation (when
the blood blocks off the breathing tubes) as well as excessive blood loss
itself
Your responsibility to the others living in your home as well as to
this individual make the need for your intervention quite clear
A talk with
your health personnel, nurse or physician, or an administrator of the home is
in order
Only they are in a position to get things moving in the proper
fashion
You are not being a “busy body” in doing this, but acting in a
fashion that will be in the best interests of all concerned.

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.

Procardia
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Procardia (Nifedipine) is a calcium channel blocker. Calcium is involved in blood vessel contraction. By blocking calcium, nifedipine relaxes and widens the blood vessels.

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QUESTION: With the needs of a close member of our family in mind, we are
turning to you to ask for explanations about a “large liver”
Would you
please enlighten us about its causes, how it is discovered, and what the
possible cures might be? Many important decisions will depend upon the
information you can provide us.

ANSWER: That is a pretty big task, and well beyond my ability to fulfil
adequately within the restrictions of this column
However, I can offer you
some basic information and a reliable source for more extensive information
and help
The first clues to an enlarged liver comes during a physical
examination, when your physician thumps your abdomen (with a technique called
“percussion”) and discovers that the lower border of the liver extends below
the edge of the ribs on the right hand side
Normally the liver is tucked up
under the rib border, lying just under the diaphragm, the large muscle that
pulls and pushes air in and out of the lung
This finding can be confirmed by
ultrasound tests, or scans using radioisotopes
The causes of an enlarged
liver are many indeed, but fall into 5 major classifications; fibrosis/
cirrhosis, inflammations, infiltrative conditions including tumors and cancer,
vascular diseases, and bile duct problems
While there are many tests that
can be used to help tell one condition from another, the most useful
diagnostic tool is the liver biopsy
This furnishes the physician with a bit
of liver tissue which can be examined under the microscope
The two most
common causes of an enlarged liver are cirrhosis and viral hepatitis, each
accounting for about 15 percent of all cases of liver enlargement (or
“hepatomegaly” in medical terminology)
Cirrhosis is frequently associated
with alcoholic liver disease, while viral hepatitis comes in several types,
depending upon the infecting virus
Type A viral hepatitis is seen mostly in
younger people, and after travel to countries where the disease is wide
spread
Other types are diagnosed in individuals with needle drug habits,
homosexuals, heterosexuals with multiple partners, after blood transfusion,
and health field workers
Your best bet to obtain extensive, authoritative
information is to contact the American Liver Foundation, Cedar Grove, NJ
07009, Telephone # 201 857-2626.

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.

Cardizem
Our price: $0.7
Cardizem (Diltiazem) is used for the treatment and prevention of angina (chest pain).

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