Health information

QUESTION: One day in our paper you gave information and a telephone number
for cancer patients to call
Would you repeat this number, please? Are there
any booklets to send for?

ANSWER: I am happy to repeat this very important information for you and all
other readers who may have a similar need
This time, either clip this column
and save it, or make a note of this number for future reference
The number
of the Cancer Information Service (CIS) of the National Cancer Institute is 1
(800) 4-CANCER
There is also an address for the CIS you may wish to write
to: Blair Building, Room 414, 9000 Rockville Pike, Bethesda, Maryland 20892.
The Cancer information Service provides cancer information to patients and
their families and the general public
Of course they cannot make diagnoses
or offer comments on treatments, but they will provide you with any
publication distributed by the National Cancer Institute
You may get a busy
signal when you first dial, but keep at it
When you get through, your call
will be directed by a computer and your responses on a touch tone phone
If
you choose to request publications, your call will be answered by a real
person
If your not sure of the publication, ask for material on the subject
of your interest or request the publication list, which will detail all their
offerings.

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.

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QUESTION: I am a 30 year old mother of two beautiful children
I have been
diagnosed with “infiltrating inflammatory carcinoma”
After 4 chemotherapy
treatments I seem to be resistant, and unless something changes, have been
told by my doctor that I have a zero chance to live, and less than a year at
that
I promised my daughter I wouldn’t die on her
Although I have a good
doctor who assures me that I couldn’t get better treatment anywhere else, I
wondered if you knew of any clinic or experimental work that might be dealing
with my type of cancer? I have a good attitude and have put myself in God’s
hands, but am still desperately searching
Any help would be appreciated.

ANSWER: And search we must, in the never ending hope that we can find
something that may change the course of your disease
Your confidence in your
physician is encouraging, as he would represent your link with any new
treatment possibilities that may exist
I am sure that he has reviewed all
the latest medical literature to remain up to date with changing patterns of
chemotherapy in cancers such as your
However, since it’s sometimes
impossible to keep up with all the latest articles, a computerized search of
all the latest scientific literature is indicated to uncover even the remotest
possibility of help
I am sure he will oblige
Your personal search begins
with the Cancer Information Service of the National Cancer Institute (Blair
Bldg, Room 414, 9000 Rockville Pike, Bethesda, MD 20892; Tel.#:
800-4-CANCER)
Your story will certainly motivate the good people at this
center to help uncover the latest news for you
You must also contact the
American Cancer Society, either your local chapter or their National
Headquarters, 3340 Peachtree Drive NE, Atlanta, GA 30326 (Tel.#:
800-ACS-2345)
Every lead you obtain must be followed to the last turn, and
your physician will help as an active collaborator and advisor to avoid those
paths, more obvious to him, that may not be productive
Last but not least, I
am publishing your letter in the hope that I may receive leads which could be
helpful, and which I will pass on to you
With these activities, and the
prayers of all, we will help you in your fight.

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.

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QUESTION: Chalk up another unknown disease for young parents to deal with.
This time our youngster has come up with “cat scratch disease”, which our
doctor assures us really exists
The advice to be patient, “there is nothing
to worry about”, and the lack of any medication has done little to make us
feel secure
Can you offer us some explanations?

ANSWER: Yes there is such a disease, first described almost 40 years ago,
with enough cases reported since then to provide sufficient proof that it is a
real disease
It is more frequent in the fall and winter, occurs most often
in patients under the age of 21, affects all races and all sexes
First you
need a cat, and then evidence of a scratch or skin lesion
A small pimple
like lesion can occur at the site of the scratch about 3 to 10 days later.
This is followed by the appearance of swollen and tender lymph glands
approximately 2 weeks after the scratch
In many cases this is the only
finding, although some patients experience high fevers, headaches, and fatigue
and sickly feelings
Only about 5 percent of the patients develop a measles
like rash
When the diagnosis is in doubt, a skin test can be performed that
will help make the diagnosis
A biopsy of a swollen gland may also be
performed which can show the typical tissue pattern
The disease is not
transmitted from person to person so no isolation or quarantine of your
youngster is needed
The good news is that the prognosis is excellent and
that no other treatment is required
The glands should disappear on their own
in from two to six months
The immunity gained to the disease after this
episode appears to last for a lifetime
Your cat may also have a long life,
as there is no indication that makes disposing of the family pet an essential,
but declawing your animal can prevent further episodes to other members of
your family.

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.

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QUESTION: They are about to offer a ceramics course at in our community
center that my wife very much wishes to take
I know I have read about the
dangers of getting near some of the materials they intend to use, and don’t
wish to expose my wife to them
Please tell her not to go.

ANSWER: That would be most undiplomatic on my part, but I will happily detail
some of the dangers as well as precautions to take, and allow you and your
wife to continue the discussion with the following material in hand
There
are three major elements that pose a hazard to good health in ceramics
They
are the clay components themselves, the glazes or materials used to color and
decorate the pottery, and finally the gases that may be emitted when baking
the work in a kiln
Some of the materials found in certain clays include
alumina, asbestos (as a contaminant of talc used in preparing porcelain),
diatomaceous earth (raw material for clay), feldspar, iron oxide and kaolin
(raw material for china clay)
The danger lies not in touching these
materials, but from breathing small air-borne particles, which may provoke a
variety of lung disease
Glazes contain a number of toxic chemicals including
lead, copper, cobalt, arsenic trioxide, antimony oxide, beryllium, boric acid
among others
Central nervous system depression, heavy metal poisoning and
skin rashes are some of the possible results of prolonged and excessive
exposure
Though no published reports exist about exposure to kiln produced
gases, they do contain carbon monoxide, chlorine gas, hydrochloric acid vapor,
sulfur dioxide and others, and in cases where there is a kiln malfunction,
could be dangerous
However, a few simple precautions and many of these
dangers are rapidly removed
The studio should be kept free of dust, and be
well ventilated
Keep glazes and clays in slurry form when possible, rather
than as dry powders
Glazes are best applied by dipping or brushing, rather
than spraying
Protective clothing, gloves, aprons and overalls should always
be worn, and careful personal hygiene with frequent hand washing is a must.
No eating should be allowed in the studio, nor food storage
Just a bit of
attention to these rules will certainly permit a danger-free experience in the
pleasures of ceramics.

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.

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QUESTION: My usual exercise activity consists of both jogging and an
occasional short distance run, but I have had to stop my regular schedule
because of a pain in the back of my ankle, near the heel of my left foot.
Another member of my club thought it might have to do with the Achilles
tendon, and suggested hot soaks, but the pain returns after even the shortest
workout
Do you have any suggestions as to cause and cure?

ANSWER: The area of the heel where the large Achilles tendon attaches to the
bone of the heel is often the site of pain in individuals who are devoted to
running
There are three important structures all located in the same area
that must be evaluated for a correct diagnosis
Right beneath the skin and
lying over the tendon we find a bursa (a sac like structure filled with liquid
that is usually found in the body where friction might cause trouble) that may
become inflamed
The condition, actually a bursitis, is sometimes referred to
as a “pump bump” and is caused by some mechanical problem, such as irritation
from a poorly fitted shoe
There is another bursa located more deeply beneath
the tendon which might also be affected, in which case your area of pain would
be noticed in front of the bulge of the Achilles tendon
Of course the
tissues of the Achilles tendon, the largest and strongest tendon in the body,
may also become inflamed, in a condition known as peritenonitis
This is a
frequent finding in individuals who engage in prolonged running, especially on
hard surfaces, or those who must work on inclined areas, or climb many steps.
Here the tenderness is usually located in a small area directly on the tendon,
and can easily be felt
No matter which of these diagnoses is the correct one
(and only your own physician’s examination can provide that), there are a
number of things you can do
To start you will have to change your pattern of
activity
For now, give your ankle a rest
Nonsteroidal anti-inflammatory
medications are helpful, and ultrasound or heat is a good idea
Check your
running shoes for fit and flexibility
You may need a new pair
When you
begin running again, start slowly with short periods of exercise, and avoid
hard surfaces and hills.

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.

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QUESTION: A recent article in my local paper showed that the numbers of
people infected with AIDS was much less than predicted
Doesn’t this prove
that there was a lot of political pressure put on the government to spend
money for AIDS, when the problem wasn’t that great?

ANSWER: I believe you are referring to the recent report by the U.S
Centers
for Disease Control which stated that between 800,000 and 1.3 million
Americans are infected with the HIV virus, about 15 percent under previous
predictions
And I believe I catch your drift, implying that the previous
reports might have been exaggerated to obtain additional attention to the
needs of these patients
First let me state that one of the glories of this
country is the ability of any group of individuals with a cause to influence
the government to respond to their perceived needs
“Political pressure” as
you put it, or “political action” as I call it, is a big plus in the way we
run our society
As to the statistics, I do not believe there ever was any
fudging in the calculations of the old numbers
To me, the new figures
represent a victory of the educational efforts put forth by the Government,
the medical profession, and the many groups organized to get out the message.
But I still worry about the number of cases that may go unreported, of the
number of individuals who may be infected and still are unaware, and the fact
that we still have no effective cure for the disease
The diagnosis of AIDS
continues to represent a death sentence for many, and the need for research is
still with us
I can’t in good conscience write off a million Americans who
already are infected and a part of the quoted statistic
The problem remains
with us and is one of considerable importance, meriting research, study and
continuing actions
And if this response isn’t up to my usual scientific
approach, then just chalk this answer up to “one man’s opinion”.

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.

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QUESTION: I am totally confused by all the different brands of painkillers on
the market and their advertising claims
They can’t all be the best one, yet
that is what they seem to say
Can you tell me which one I should take when
my pains and aches get out of hand?

ANSWER: I am mixed up sometimes too, and I am supposed to know the
differences that exist between the different pain preparations available over
the counter without prescription
It becomes a bit simpler, however, when you
realize that all the different names and claims concern only three basic
medications; aspirin, acetaminophen and ibuprofen
Aspirin (principle
ingredient is acetylsalicylic acid), known as Bayer, St
Joseph and Bufferin
among others, has been with us the longest
It is a useful pain medication to
reduce muscle aches, headaches and toothaches, is effective in controlling
menstrual cramps, long used as a medication for arthritis, will help lower a
fever, and has of late been recommend as a prevention of heart attacks (which
it does by acting on blood platelets and reducing clot formation)
However,
it may cause stomach ulcers and gastrointestinal bleeding
Acetaminophen is
the active ingredient in Tylenol, Anacin 3, Panadol and other medications
sometimes advertised as “nonaspirin” pain medications
It will relieve a
headache, is useful in the flu season, help reduce a fever and ease a muscle
strain, but it is not an anti-inflammatory drug and will not reduce a
swelling
It is only of limited use for arthritis and when the cause of pain
is due to the production of prostaglandins by the body (as in menstrual
cramps), this product which is not a prostaglandin inhibitor, and will not
work well
Ibuprofen is the latest kid on the block, and is the medication
found in Nuprin, Mediprin, Advil and Motrin (by prescription only in higher
doses)
It is a potent antiprostaglandin and is effective not only for
general aches and pains, but particularly useful for inflammatory situations
such as and arthritis and severe muscle injuries and sprains
It can cause
stomach irritation, and is best taken after meals or when the stomach is full.
My best advice to you is to try a product, and stick to it if it works well
for your problem
Switching around between similar products with different
brand names is a waste of both time and money.

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.

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QUESTION: My son who is 37 has been diagnosed as having a type of arthritis
in which his spinal column may fuse and become one bone
We are desperate for
information that can help him prevent this terrible disease from progressing
and robbing him of his youth
Please help.

ANSWER: Without doubt you are referring to a rheumatic disorder known as
ankylosing spondylitis (AS) or sometimes referred to as Marie-Strumpell
Disease
It is a disease that is three times more common in men than in
women, and strikes between the ages of 20 and 40 years of age
The most
common complaint of patients with AS is stiffness, particularly in the morning
which is gradually relieved by activity
Although the stiffness may occur in
any joint, knees, ankles, shoulders and hips, it is the back that is the
eventual target, with back pain of varying intensity, occurring frequently at
night
The term “ankylosis” means stiffening, while “spondyl” refers to the
vertebrae and “itis” denotes inflammation
The disease process is one of
inflammation, with the tissues around the joints of the body, particularly the
spine, become inflamed and swollen
This creates the pain, and the patient
attempts to reduce the discomfort by keeping the joint immobile, which of
course leads to more stiffening
As the joint attempts to heal, new bone is
formed which may eventually join one vertebra to another, but it is the
extremely rare case where the whole back bone becomes a single fused bone.
Much can be done to help your son
To begin, the joint pain and stiffness, as
well as muscle spasm may, be relieved using NSAIDS (nonsteroidal
anti-inflammatory drugs)
In addition a program of daily exercise to maintain
both correct posture and flexibility is vital
The good news is that even in
patients who are not correctly diagnosed or treated, the condition may not
disrupt their lifestyle or cause a deformity
However, continued care and
attention to therapy can frequently reduce this condition to occasional
episodes of back aches and spasm, without deformity or compromised posture.

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.

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QUESTION: I wish I could get an appointment with you just to sit down and
talk about my problem, because my own doctor won’t
I am having severe
problems with my heart and digestion, and sometimes cannot catch my breath.
Instead of dealing with my physical problems, my doctor keeps directing his
attention to all types of emotional situations
Please tell him he is wrong
and to pay more attention to me.

ANSWER: I have had to select just a few important sentences from your 8 page
letter, but I would like to help you and the many other readers who are
experiencing similar problems with themselves and their physician’s approach
to their problem
It is pretty clear to me that you are a person who is
suffering with a problem you don’t quite understand, and feel a bit frustrated
that the physician is not dealing with the problems you think you have
From
your long list of complaints that include your stomach, your heart and lungs,
your bladder and bowels, and your nerves, it is clear that your problem is a
general one that can most probably be related to emotions or, if you will, a
psychological problem
Now, this is not the first diagnosis that must be
considered in cases such as yours
Rather, a complete but delicate
consideration of all the possible physical causes of your complaints must be
carried through with the laboratory and clinical evaluations that can help to
clarify your situation, for anxiety disorders (yes, that is what I think your
problem is) can take many forms, and can indeed be provoked by many factors.
But your physician by your own account has done just this, and his evaluation
has now focused his attention on your problems as they affect your life style.
His prescription for “tranquilizers” which you dismiss as being an easy way
out is just a beginning of therapy, and the choice he has made for your
specific case shows a great deal of insight and thought has gone into the
selection
All tranquilizers are not the same, and until your fears and
doubts can be reduced, it is difficult to move forward
Many other people do
have similar problems, and your doctor’s statement that he has had success
before and his willingness to continue to see you, demonstrates his real
concern for your welfare
When a doctor takes the time to carefully seek out
the physical causes for anxiety, prescribe appropriately while continuing
ongoing care, and is taking the time to spend with you (no, I don’t think a
half hour visit is a “brush off”), then you have found a conscientious
physician, who can help you if you but give him a chance.

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.

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QUESTION: Would you please give people some information on Arnold-Chiari?
I’m 43 and just found out a week ago
I did have a bone removed 3 years ago
that was pinching my spinal cord
The doctors say they want to wait before
they do more surgery
Can you explain this condition for me and what my
outcome will be?

ANSWER: The condition which bears the name of two German physicians who first
described it back in the 1890’s results from a congenital deformity of the
occipital bone, which forms the back of the skull, and the upper end of the
spine
Because the occipital bone is flattened, a portion of the brain may
move downward through the large hole in this bone (called the foramen magnum)
and come to rest in the neck portion of the spinal canal
This can provoke a
wide variety of symptoms, including headaches, vomiting, visual troubles
including double vision dizziness and sometimes weakness of the arms and legs.
Although these problems may develop during childhood, the symptoms start most
often in adults between the ages of 30 and 60
It affects both sexes with
about equal frequency, and the reason for the changes in these bones is still
unknown
Physicians may use a number of techniques to discover the extent of
the condition, including myelography
This technique uses x-rays and a
radio-opaque substance (sometimes misnamed a “dye”) injected into the space in
the spinal cord to obtain a picture of the location of the brain tissue
CT
scans have also proved useful
The need for additional surgery will depend
upon the findings of these tests and your own condition
If the first
operation was sufficient to remove your symptoms, more surgery may not be
necessary, and waiting is just fine
It is hard for me to predict an outcome,
for this varies greatly with the individual and the extent of the changes in
your structures; but a frank and open discussion with your physicians, who
seem to have the situation in hand, should provide you with their opinion
I
would hope they could give you an optimistic report, for this condition can be
helped.

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.

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