Health information

QUESTION: Our high school football team plays without the benefit of oxygen
for our kids, who are at a disadvantage when playing against other teams who
do have it
Could you write about this in your column so that we can show
your information to our school board? Please help.

ANSWER: I have kept this question in my files for many months, seeking an
answer for you that would help, and yet that could be backed up by solid proof
in the world of medical literature
There simply wasn’t enough evidence to
prove that oxygen really helped athletes during their active competition,
unless it was taken while they were actually involved in their endeavors
The
reports on relief of distress symptoms were less convincing, and so I could
not provide the assistance you were seeking
However a recent edition of the
Journal of the American Medical Association reports on new research, and I am
afraid you won’t be happy with their conclusions
Researchers at the
Department of Internal Medicine at the Baylor University Medical Center tested
the effects of 100% oxygen compared to room air, used during a five minute
rest period between bouts of exhausting treadmill exertion
The twelve
subjects were members of a professional soccer team
Blood tests to determine
the levels of lactate (a product of muscle metabolism) were conducted, in
addition to endurance tests on a treadmill, and the athletes’ preference for
100% oxygen compared to room air
The researchers found that there was no
effect on the blood levels, and no difference in performance during the second
exercise session
More astonishing was the fact that the athletes could not
identify which gas they were breathing
The conclusion of the study was that
“using 100% oxygen applied for short periods offers no advantage on recovery
from exhaustive exercise or on subsequent exercise performance”
This may
offer no help with your school board, but at least you can be sure your son
hasn’t been deprived of any crucial advantage.

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 have read your frequent answers about cocaine and other substance
abuse, but I have never seen anything in your column about marijuana
Does
that mean you approve? Is there any way a concerned parent can figure out if
their teenager is using this drug?

ANSWER: I most certainly do not approve of the use of marijuana, any other
drug, or even medications in an abusive fashion
I think you know that but
were just prodding me a bit so that I would include the answer to the rest of
your question in my column
And I bit, so here goes
Watch your teenager
closely for signs of withdrawal from usual social activity and increased
irritability
Is school work slacking off, with academic performance
dropping? Noticed any reduced control, as seen in actions that might increase
the risk of bodily injury or recent fall-ins with the law because of driving
infractions or other car accidents? These may be the first clues that
something is amiss
Changes in friends, with the old standbys disappearing
while newer faces take their places, might indicate that your youngster is now
in with the “wrong crowd”
If his memory for recent events is diminishing and
you sense that his thinking processes are changing, and giving way to a
lackadaisical attitude, it may be time for you to take some action
Your
family physician may assist and aid you with some specific tests to confirm
suspicions, with the proper handling and referral for treatment, of a
situation that you may not be able to deal with yourself
Stay calm but
remain firm in your resolution to do something about it, if your suspicions
can be confirmed.

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: During a recent school physical, my doctor advised that my teenager
receive another vaccination against measles, despite the fact that he has
already had all his immunizations before
Although we went along with the
recommendation, we are a bit skeptical of the motivations here
Would you
care to comment on this situation? I am sure there are plenty of other
concerned mothers who would like an answer to my question.

ANSWER: I agree with you, we need to explain the new, updated policy on
measles vaccination as revised by the American Academy of Pediatrics (AFP).
And I agree with your doctor
Here’s why
During recent measles outbreaks it
became evident that most of the cases involved children younger than 5 years
of age or persons of college age
In previously vaccinated individuals, 805
occurred in children over the age of 12
To prevent the spread of measles in
schools and colleges, and to increase vaccination among preschool children,
the AFP has recommended that a second measles vaccination be given to children
when they enter middle school or junior high school
Formerly only a single
vaccination was suggested, measles, mumps and rubella (MMR) at age 15 months,
with a second vaccination indicated only when outbreaks of the disease
occurred
So your doctor was only keeping up with the times
Several
additional recommendations were included in the revision, which indicated that
children in high risk areas should receive their initial injection at 12
months of age, and if vaccinated before their first birthday, with repeats at
age 15 months and at the beginning of their middle school or junior high
school years
Young women should not be pregnant at time of vaccination or
for 3 months afterward
Educational institutions beyond high school have been
advised to require entering students to provide documentation of two measles
immunizations.

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 have a darkly pigmented spot on my leg, but am reluctant to visit
my physician for fear of what he would find
Are there any creams or lotions
that can be used to treat this condition?

ANSWER: You are not as uninformed as you would have me believe, for your fear
comes from the knowledge that this “darkly pigmented spot” may be a melanoma.
A melanoma is a malignant tumor of the pigment producing cells of the skin.
And you are playing with fire, for although melanomas account for only 3% of
all skin cancers, they cause 2/3 of deaths from skin malignancy
Their
numbers are rising at such a dramatic rate that it is estimated that by the
year 2000, 1 in every 100 Americans will develop this lesion
But the
statistics on early treatment are equally impressive and when these skin
tumors are removed in the first stages, five year cure rates reach 85%.
Melanomas occur most frequently in people between the ages of 40 and 55, and
while they may appear anywhere on the body, are most common on the back in
men, and the lower legs and back in women
Not all dark or colored lesions
are melanomas, and the delayed visit to your physician may prove that you
fears are groundless
However most prudent physicians will advise the removal
of any suspicious spots
It is a relatively painless procedure, using local
anesthetics and performed in the office setting
All tissue is sent to the
laboratory for microscopic examination and diagnosis
To answer your
question, there are no creams or lotions to treat this situation, so take a
deep breath, and make that doctor’s appointment today.

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 is 22 months old and developed a skin condition on his face
and eyelid
They look like fleshy bumps similar to warts
I took him to a
dermatologist who told me it was molluscum contagiosum and there was no
treatment for it
They appear to be getting worse! What, if anything, can I
do to prevent them from spreading or coming back? Will they affect his
vision?

ANSWER: First to your most pressing worry
No, they will not harm his vision
in any way
And my dermatologist says there are a great number of possible
treatments to stop the spread and control the infection
Dr
Benjamin Raab of
Chicago, Illinois and a member of the 2000 member American Society of
Dermatological Surgeons (who happily provide me with free consultations when I
get stuck), wishes you to have the following information
Molluscum
contagiosum is caused by a virus infection, is contagious and frequently
contracted from other children in the play group
They can appear anywhere on
the skin and have a little dimple in the middle of the lesion, which helps
make the diagnosis simple
Although there are few symptoms that occur with
the infection, it remains contagious for an indefinite period of time,
certainly for as long as the bumps are present
They can be treated
successfully by destroying each lesion present
A number of techniques exist
to accomplish this: Chemical, using a blistering agent called cantharidin; by
freezing (cryotherapy); drying with an electrical current
(electrodesiccation); or removing the central core with a needle or extractor.
Even lasers may be employed in some cases
Although it is possible that the
lesions may disappear by themselves, there is no way to predict just when that
may happen, and in the meantime, your child may spread the disease to others,
or even reinfect himself
Seems to me you should consult another physician,
someone who is experienced in performing one of the methods outlined here.

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 hope you can be of some help to me regarding Morton’s Neuroma
I
have the problem and seem to get different opinions regarding the cure
Does
cortisone help? What do most people do and what are the results?

ANSWER: Morton’s Neuroma is caused by a swelling in the nerve which runs
between the third and fourth toes
This swelling is squeezed between the
bones of the toe and the ground, causing the pain and discomfort
It is one
of a group of disorders associated with “metatarsalgia,” a general term used
to describe pain over the ball of the foot
Such neuromas may develop in
other interdigital nerves, and more often affect just one foot, although they
may occur in both feet
It is more common in women than men
The pain is
usually described as burning in nature and may radiate to other parts of the
foot
The soreness can persist even at rest and prevent sleep
Sometimes
patients describe a sensation of a marble or pebble inside the the ball of the
foot
An injection of lidocaine (a local anesthetic) into the painful area
can often provide lasting relief
Yes, cortisone, in a long acting form, is
useful in some cases, and is injected along with the lidocaine into the area
of the nerve affected with the neuroma
These injections may have to be
repeated 2 or 3 times to achieve complete relief
A properly designed foot
pad to relieve some of the pressure on the nerve may be helpful
When all
conservative means fail to bring relief, surgery may be performed to remove
the neuroma, usually resulting in the complete relief of the pain
Most
people treated in one of these manners achieve a satisfactory result, and are
permanently relieved of their pain.

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: After a physical examination and a rather complete work up, a
diagnosis described to me as a “floppy heart valve” was made
Although I have
received many assurances that this is not a dangerous situation, I am still
concerned as to the nature and treatment of this disorder
Would you please
explain it, and offer me some insight?

ANSWER: There are many names for your condition, probably the most commonly
used is “Mitral Valve Prolapse” (or MVP), which might sound even more serious.
But it isn’t, for the greater majority of patients with this condition have no
symptoms
Sometimes called the “Click-Murmur” syndrome because of the sounds
that the physician hears when examining you with a stethoscope, it is rarely
serious or life-threatening
The mitral valve is located in the heart between
the left left atrium and left ventricle, formed of two leaflets or flaps,
which open and close with each beat of the heart
The valve assures that the
blood flows in one direction, and when closed prevents the flow of blood back
into the atrium, and sends the blood out of the ventricle through the aortic
valve, into the aorta and the rest of the body
In some people the valve
flaps do not close smoothly, and allow a small amount of blood to leak
backward
This creates the murmur and click which helps the doctor make the
diagnosis
The causes of the condition are rarely determined, as in most
cases the heart is otherwise normal and without disease
There are some cases
when the condition may cause a palpitation or skipped beat that the patient
feels, and creates a bit of anxiety, but this does not affect the functioning
of the heart
Since there may be no symptoms or problems, there is no need
for treatment, and your physician tried to reassure you with the knowledge
that your case was benign
In the few cases that may cause some problems,
there are effective treatments to help.

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 have a terrible looking condition affecting my finger nails.
They are yellow, and seem to be crumbling away
I have tried to clean them
with soaps and have been taking a gelatin preparation everyday to try to make
them stronger, but nothing is working
I am ashamed to be seen this way in
public
Can you help me?

ANSWER: If information can help, I’ll try, but I believe it will have to be
your local physician who is going to have to do the real work
From your
description, I suspect that a fungus infection of the nails is at work here,
at is eating away at the dead tissue of the nail itself
There are no
protective mechanisms here for your body to fight with, as there is no blood
circulation to the nail, so help will have to come in the form of appropriate
medications
When you visit your doctor, he may scrape away some of the
debris which is now lodged beneath the nail, and use this material to test for
a fungus
By using a solution of potassium hydroxide, he can prepare a slide
that may be examined under the microscope and reveal the presence of the
fungus that is causing you all the trouble
There are a number of
preparations that may be prescribed, but you must be prepared to use them
regularly, usually applied twice a day, and for a period that may last as long
as four weeks
But it won’t end there, for once the infection is killed you
must still be patient while the new, normal nail grows back at the rate of 0.1
mm a day or about 6 months for an entire new nail take the place of those now
causing your embarrassment.

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 mother has Alzheimer’s Disease and we try to keep up with all
the latest developments in therapy for her
We have heard that there is a new
drug called “NGF” that offers new hope, and we wonder if you know where it is
available
We are willing to go anywhere.

ANSWER: I am sorry to dash your hopes, but NGF (which stands for Nerve Growth
Factor) is not available anywhere as a medication for Alzheimer’s Disease.
Not yet, anyway
It is still in the process of animal investigation, although
scientists are working on producing a chemical suitable for investigational
use in humans
NGF may be able to stimulate certain brain nerve cells to
regenerate, or at least keep them from dying, and thus stop the degenerative
process of Alzheimer’s Disease
However, for all of the hopeful expectation,
there are other scientists who advise a more measured, slower approach to
research to consider safety and efficacy factors most carefully
While I
sympathize with you and the families of other Alzheimer sufferers, I must
advise caution
Do not embark on a fruitless search for cures that do not yet
exist.

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: Some of my friends have quit smoking merely by stopping
Now they
are at me to give up the habit as well, but I am having a tough time
It
seems to change my whole personality and the way I feel and work
Is my case
unusual, or have other people felt the same way while quitting?

ANSWER: Your case is more the rule than unusual
Your friends probably had
similar feelings; if not, they really had it easy
Nicotine is an addictive
chemical, and when you stop, you may experience withdrawal symptoms that can
explain the way you feel
They can include a feeling of restlessness,
inability to concentrate, irritability and feelings of hostility
In addition
to craving a cigarette, you may find your sleep patterns have been altered,
and a feeling of dullness or sleepiness during the day
And then there is
that dreaded weight gain
All are signs of nicotine withdrawal
But be of
stout heart
Though these symptoms vary from person to person, they are most
intense during the first week after an abrupt halt to smoking, and gradually
decline during the second and third week
By day 21 after quitting, few
people have any remaining problems, except for an occasional urge
The
greater your habit was, the more intense are the symptoms of withdrawal.
However, you can manage to stop smoking by will power alone, if you stay on
guard during the moments when cigarette smoking was a part of your life style,
like after meals or bedtime
Your little support group can do much to help
you, if you consider their concern and listen to their 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.

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