Health information

QUESTION: Our grandson has just recovered from a serious fight with an
infection called “meningitis”
It seemed to come from nowhere, with scarcely
a symptom before he was deathly ill
Would you please tell us where this
infection could have come from, and what types of treatments are available to
cure it? Although everything is now all right, the family is still curious to
find out as much as possible about the disease.

ANSWER: I can understand your curiosity and am happy to provide you with some
information
Meningitis is a painful swelling of the connective tissues that
enclose the brain and spinal cord due to bacterial or viral infections
Its
symptoms include an intense headache, fever, loss of appetite, intolerance to
light and sound, neck and back stiffness, and rigidity of the hamstring
muscles in the back of the legs
In severe cases convulsions, vomiting, and
delirium may even lead to death.
About 80 percent of all cases caused by bacteria can be the result of
infections by one of three common bacteria
They are N
meningitidis,
Streptococcus pneumoniae and Hemophilus influenzae
These bacteria abound in
the environment and such factors as age, head trauma and diseases which reduce
the effectiveness of the body’s immune system may influence which bacteria
becomes the infecting agent.
The infection is spread through small droplets of liquid in the air
coming from the respiratory system of an infected person and by close
contact, and is often spread by people who either display no immediate
symptoms or have only a sore throat
Transmission can occur through the route
afforded by intimate kissing, a practice which should be avoided whenever an
infection is suspected to be present.
Pneumococcus meningitis is most common in adults, originating from
infections in the sinuses, ears, and respiratory tract.
H
influenzae (the most prevalent form of meningitis in children) tends
to affect children 6 months to 3 years old and accounts for 50% of all
meningitis cases
Middle ear infections are the primary culprit, and deafness
may occur within 36 hours after symptoms begin.
A positive diagnosis for these forms of bacterial meningitis is usually
made by studying samples of the patient’s blood, spinal fluid, or both.
Treatment with antibiotics are usually quite effective, and since the disease
is so serious, are prescribed when the diagnosis is probable without waiting
for the identification of the specific type of bacteria.
Viral causes of meningitis (even though the symptoms may be the same) are
much harder to manage
Unlike bacteria, which are simple one cell organisms
that reproduce by cell division and can be affected by a number of available
antibiotics, viruses (which can only multiply inside the cells within the
body) are infecting organisms which do not respond to treatment with the same
antibiotics that are so successful against bacteria
And diagnosis can be
tricky, depending on the results of throat and stool cultures as well as
certain cell changes in the spinal fluid that only occur during a viral
infection.
When the disease is caused by a virus, such as the kind that are
responsible for mumps, mononucleosis or infectious hepatitis, the severity of
the disease can range from one with no symptoms at all to one which is most
severe
However even these desperately ill patients may recover completely.

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.

Avandia
Our price: $0.7
Avandia (Rosiglitazone) is used to control high blood sugar in patients with type 2 diabetes.

More info

QUESTION: I recently heard a story about a man developing rather large
breasts
The word to describe it sounded like “gymnast”, but I know that
can’t be correct
Could you please discuss this condition and give me the
right name?

ANSWER: You’re pretty close
The correct medical term is “gynecomastia”, and
comes from two Greek words meaning “woman” and “breast” thus, breasts like a
woman
Gynecomastia means any benign glandular enlargement in the breasts of
males.
It is a relatively common disorder, with several causes such as obesity,
aging, and certain drugs
Only rarely is it caused by a serious medical
problem but in adolescent males, it can be a very difficult emotional and
psychological problem to deal with.
All normal adult male breasts contain most of the major elements found in
female breasts
Everyone’s breasts are sensitive to hormones, so male breast
enlargement may be associated with an overabundance, or lack, of certain
hormones.
In many adolescent males (one study suggests about 20 percent of men in
that age group develop gynecomastia), breast enlargements develop and after a
while disappear
Yet sometimes the enlargements do not go away
When that
occurs, medical decisions need to be made rapidly before psychological damage
is done to those young men.
Approximately 60 percent of all men from 45 to 60 years old may develop
some breast enlargement.
Incidences of gynecomastia in adult men appears to increase with age
It
is most often observed between the ages of 50 and 60
As many as 30 percent
of all adult males may have some evidence of gynecomastia at some point in
their lives and more than 90 percent of them experience enlargement of both
breasts
Nevertheless, breast enlargement on only one side of a man’s chest
is seen.
There virtually is no evidence that directly links gynecomastia to breast
cancer
Male breast cancer is rare, accounting for less than one percent of
all cancers in men
However, any enlargement in men or women should be
examined by a physician
Also, if there is bloody discharge from a nipple or
a firm, nodular mass within the breast area, a medical examination should be
made immediately.
Some things are known to cause gynecomastia
Among them are:
overconsumption of alcohol, kidney diseases, diseases that cause a decrease
in male hormone levels, severe changes in eating patterns, thyroid
malfunctions, certain tumors, all forms of estrogen including estrogen in
hair preparations and vaginal creams, Tagamet, Aldactone, Nizoral, and the
digitalis-cytotoxic drugs (a few are Crystodigin, Lanoxin, and Velban)
When
gynecomastia is caused by drugs, it often develops rapidly and usually will
disappear shortly after their use is stopped.
Things that many suspect cause gynecomastia include: lung diseases,
chest injuries, psychological stress, marijuana, heroin, and some
antidepressant drugs.
Treatment for gynecomastia includes discontinuing the use of drugs and
other substances that might cause it, treating any physical condition that
could have produced it, and possibly surgery, to remove excess tissue.

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.

Synthroid
Our price: $0.25
Synthroid (Levothyroxine) treats hypothyroidism (low thyroid hormone).

More info

QUESTION: Since about age 15 I have had a habit of pulling my hair out one
strand at a time
I am now 26 and have several bald spots and am getting
rather embarrassed
A friend told me that read that there is a name for this
habit but she couldn’t remember it and I am wondering if there is a
prescription medicine that can help me?

ANSWER: There is indeed a name for this disturbing habit and it is not an
easy one to remember
However, if you take the word “trichotillomania” apart,
it begins to make sense
The Greek word for hair is “trichos”, another Greek
word “tillein” means “to pull”, and “mania” translates into “madness”
The
term trichotillomania is applied to a type of alopecia or baldness, that
results when a person keeps pulling, tugging or plucking at the hair
The
pattern of the hair loss can be pretty bizarre, and an attempt at concealing
the loss may be made by rather unusual hair style
The disorder is seen most
frequently in children and elderly women, but may carry over from childhood in
to the adult years as in your case
The diagnosis is clear when the history
reveals the habit, but in cases that are less evident, the diagnosis can be
made by examining the hairs which show evidence of being broken, or by biopsy
of the scalp which may reveal increased numbers of resting (telogen) hair
follicles
I know of no prescription medication that can directly affect the
problem, which requires psychological counseling and treatment
However,
prescription medication may be used as an aid during the course of the
counseling sessions
Depending upon the amount of loss and the location of
the bald spots, the regrowth of new hair that takes place after the hair
pulling has stopped can cover the denuded areas in a relatively short period
of time
And then your days of embarrassment will be over.

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.

Toprol XL
Our price: $0.5
Toprol XL (Metoprolol) is used for treating high blood pressure, chest pain.

More info

QUESTION: Over a short period of time, I have developed a severe pain in my
left foot near the heel
I thought it would go away by itself, but it is
worse now than before
Can you possibly tell me what could be the cause and
the cure? I could use some help.

ANSWER: There are several possibilities, there may be an injury or
inflammation to the tendons and surrounding tissues, or there may be a stress
fracture in the bone of the heel
The best way to find out is to get a
careful examination by your doctor
He can isolate the area of pain, for the
exact location of the pain is an important clue in determining the diagnosis.
Once the cause is found, it can be treated.
The Achilles tendon is often the site of injury, sometimes caused by
nothing more than walking
The Achilles tendon is the major tendon to the
heel, running down the back of the foot
Athletic activity can aggravate the
problem
Often the best treatment is just resting the foot.
Older people often lose the fat pad from their heels, creating a hard,
bony surface on which to walk
This causes pain
Again, it is aggravated by
walking or running
Rest and an anti-inflammatory drug is often the only
treatment necessary
Sometimes the foot is wrapped in a supportive bandage,
to relieve pressure on the sore part.
A fracture of the heel is seen more commonly in athletes, but it can also
occur in the nonathlete as he goes about his daily activity
Sometimes the
fracture is so slight that an x-ray done immediately shows nothing
As the
problem progresses, the fracture becomes more noticeable on the x-ray.
Protecting the foot with some sort of brace or cast is usually the best
treatment, and about six weeks of total rest of the foot is required for it to
heal.
Although heel spurs, which are bony growths that extend out from the
calcaneus or heel bone may be seen frequently, they are not always the cause
of the pain
When they are, an injection of corticosteroid and lidocaine (a
local anesthetic) can often relieve the problem.
Heel pain usually responds best to conservative treatment of rest,
support and anti-inflammatory medication
It can become quite irritating and
sometimes even debilitating, if it interferes with walking
So don’t ignore
your painful heel
It may start out as just a nag, but it can become
increasingly painful if you don’t treat it with some respect and

some
rest.

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.

Cialis Jelly
Our price: $7.2
Cialis Jelly (Tadalafil Jelly) is mainly used to get and sustain an erection in cases of erectile dysfunction.

More info

QUESTION: I have hemochromatosis
Please describe this disease, the cause
and treatment, the side effects and prognosis for cure
Can this disease be
transmitted to my children? Are there any organizations that could provide
further information or inform me of medical centers that specialize in the
treatment of this disease?

ANSWER: A pretty tall order for just one day’s column; it really deserves a
medical book chapter
But since I can provide you with some useful
information that may help, here goes
Hemochromatosis is a disease in which
large amounts of iron are deposited in body tissues, causing local damage and
tissue injury
It is rarely seen before middle age, and is most common in men
(about 10 to 1 over women) between the ages of 40 and 60
Typically it
produces cirrhosis of the liver, a bronze pigmentation to the skin, and
diabetes in from 50 percent to 60 percent of the patients
It can also affect
the heart, causing enlargement, conduction disturbances leading to irregular
beating and congestive heart failure
It is inherited as a recessive trait,
and both chromosomes must carry the affected gene for it to produce clinical
symptoms
Blood tests do exist that can help identify the presence of the
affected gene in first degree relatives
Blood tests also can reveal the
presence of abnormally large quantities of iron in the blood serum
The
treatment of this disease is phlebotomy, or the regular withdrawal of blood.
For every pint of blood removed, about 250 mg of iron is removed from the
patient
This may be carried out as frequently as is necessary to reduce the
amount of iron deposited in the tissues, and may be carried out weekly at the
beginning of treatment
Once the condition has been brought under control, as
demonstrated by normal blood serum iron levels, the removal of a pint of blood
every two to three months generally suffices to keep things under control.
The complications of diabetes, cirrhosis and heart abnormalities are treated
with medications that are indicated and usually prescribed in those
circumstances
Your best bet for more information about this complex disease
is to direct your inquiry to the Hereditary Hemochromatosis Research
Foundation, P.O
Box 8569, Albany, NY 12208
They might be able to provide
the names of medical centers with special expertise in the disease as well.

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.

Azulfidine
Our price: $1.18
Azulfidine (Sulfasalazine) treats ulcerative colitis, Crohn’s disease, rheumatoid arthritis or ankylosing spondylitis.

More info

QUESTION: I am writing on behalf of my boyfriend
He says he has a hernia,
but refuses to go see about it
Over the years it has gotten bigger and is
now the size of a softball
He believes as long as he can push it back he’ll
be all right
Please give me any information you have, because I don’t know
anything about the subject at all.

ANSWER: It is obvious from your letter that your boyfriend doesn’t have a
clear understanding of his condition either
And he may not be the only one,
as hernias are quite common in the general population with about 15 people out
of 1000 bothered by the problem
A hernia occurs when a loop of bowel or
intestines pushes through an abnormal opening
The most common is the
“indirect” hernia, which accounts for from 50 percent to 75 percent of all
hernias
This type of hernia usually develops in men under the age of 30
In
these cases the gut pushes through a weak point in the sheet of tissue that
lines the inner abdominal wall (the abdominal fascia) and passes through a
canal into the scrotum
Although there may be few symptoms the swelling is
easily noticed, and as the opening becomes larger the hernia may seem to
grow
When the intestines push through the wall of the abdomen as a result
of a weakness, producing a bulge in groin area, it is termed a “direct” hernia
and is seen most frequently in men over the age of 40
Although these bulges
may be pushed back easily, or held in place with belts, the danger lies in a
complication of hernias known as “incarceration” where the gut becomes stuck
in the position, and may require emergency surgery to correct the situation.
These incarcerations may also cause the circulation to the trapped intestines
to become blocked, in which case the bowel becomes “strangulated”, can easily
die, and become a life threatening situation
Repair of the hernia is the
answer, and is one of the most common surgical procedures performed
Your
boyfriend will need a bit of time for recuperation after the operation, from
two to three months while the surgery heals, during which activities will
gradually be increased from walking to full exercise.

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.

Imitrex
Our price: $8.58
Imitrex (Sumatriptan) is an antimigraine medicine.

More info

QUESTION: Getting about is more and more difficult because of a bad hip, and
now I am considering having the operation
I don’t understand what they will
do, or how they can replace the whole joint
Can you explain, and do you
think it is a good idea for me to have the surgery?

ANSWER: The operation is called “total hip arthroplasty” and may be the path
by which you will regain your ability to get about with ease and, more
important, without pain
The hip is a joint that joins the femur (thigh bone)
to the pelvic bone
The head of the femur fits into a dish shaped cavity in
the pelvis called the acetabulum
The operation consists in fitting a new
metal head to the femur, held in place with cement
A new socket, made of
plastic with a metal backing, is inserted into the acetabulum and held with
screws, until bone can grow through the porous metal backing
Obviously this
is a major surgical procedure, and one that only you can make a decision about
with the advice of your own surgeon.

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.

V-Gel
Our price: $16.5
V-Gel is a herbal gel that is used for the treatment of vaginitis, cervicitis, leucorrhea.

More info

QUESTION: Although I am able to cope with most of the feelings that come on
with my hot flashes, they have been going on for more than two years now, and
I am beginning to wonder when this will all end
I have tried to find
information as to the reason that women are cursed like this, but have never
found an explanation that makes much sense
Is there a possibility you might
include a simple answer for me in your column?

ANSWER: Like you, many women are forced to deal with one of the more
distressing signs of menopause, the hot flash or flush
While some of the
secrets of the “why’s” and “how’s” of this most uncomfortable symptom are not
clear, a great deal is known, and I will try to tell it to you
Not all women
have severe or annoying episodes; for many the event is mild and infrequent,
lasting but a few moments
They occur during day time hours and disappear
after a year or two
For others however, they can be most severe, lasting up
to ten minutes and striking as often as six times an hour
They may happen
frequently at night, destroying sleep and provoking severe night sweats.
Statistics show that as many as 25 percent to 50 percent of all sufferers with
hot flashes may continue to have them for as long as five years
The flash,
skin flush and perspiration are a result of a temporary imbalance of the
system in the body that regulates the body’s temperature
The hot flash
attack begins in the hypothalamus, an organ lodged deep with in the brain that
is responsible for the temperature control of the body, and also monitors the
level of estrogen (female hormone) that circulates in the blood
When
estrogen levels are low, it sends a message to the anterior pituitary gland
(using a chemical called gonadotropin releasing hormone)
In turn the
anterior pituitary gland sends a chemical messenger (this time it’s called
follicular stimulating hormone) to the ovaries to produce more estrogen
When
the aging ovaries can not respond (or when the ovaries are missing because of
surgery) the hypothalamus next releases a stimulant called free epinephrine,
which spills over into the heat regulating area, and starts the reactions in
both heart and skin that result in increased circulation and dilated blood
vessels in the skin that create all the sensations of a hot flash, skin
flushing and the perspiration that accompanies the reaction
Even though the
sensation may last for but a few minutes it takes about a half hour for the
body systems to return to normal
Over time the body and all of the
mechanisms that control the body temperature readjust to the new lower levels
of estrogen, and the attacks stop
However other complications that occur
with reduced estrogen production, such as osteoporosis, cardiovascular disease
and vaginal atrophy and drying, continue to progress over time
Since the
attacks vary in frequency and intensity from woman to woman, the consideration
of possible treatment must remain an individual decision
Hormone replacement
therapy can be used to diminish the symptoms, and will also be of considerable
benefit in preventing or alleviating the other complications of menopause, but
since such a therapy may be necessary for the life of the woman, all the pros
and cons should be discussed with the physician
Hormone therapy can produce
other annoying symptoms such as weight gain, swelling, breakthrough bleeding,
breast tenderness and abdominal bloating
The presence of breasts or uterine
cancer in the family history can also influence the decision to use hormone
treatments.

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.

Adalat
Our price: $0.75
Adalat (Nifedipine) is used to lower hypertension and to treat chest pain.

More info

QUESTION: While watching a television advertisement about CPR
(cardiopulmonary resuscitation) I remembered a scene in an old movie where the
doctor cut into the chest to massage the heart back into life
You don’t hear
much about that anymore and I was wondering if doctors still use that method?

ANSWER: The movie must have been made before 1960, for that is the year in
which Dr
W.B
Kouwenhoven and his associates published a now famous paper in
the Journal of the American Medical Association (JAMA) describing closed chest
massage
Prior to that, open chest massage was the technique used, most often
by surgeons during hospital based surgery
When the heart stopped beating
during an operation, the surgeon could quickly make the necessary incisions in
the wall of the chest and massage the heart directly
Investigators who
studied the results of such attempts to restore life to the heart report
success rates of better than 1 in 4
However, when the technique of closed
chest massage became known, the open chest heart massage was rapidly
abandoned
The standardized procedure was approved by the Red Cross, the
American Heart Association and taught to millions of Americans
A Gallup Poll
back in 1977 showed that almost 15 million people had already been trained,
and about half the adult population was planning to take a CPR course
There
are some advantages and disadvantages to both open and closed chest methods,
the open method providing increased circulation to the body, while the closed
method is readily available to all and certainly is a more acceptable concept
for general use
Recently, however, some physicians are advocating a new look
at open heart techniques, with the necessary studies that could lead to
recommending the open chest procedure in some special cases.

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.

Sustiva
Our price: $5.94
Sustiva (Efavirenz) is used to treat HIV infection in combination with other anti-HIV medications.

More info

QUESTION: My kid just doesn’t seem to listen to anything I say, and certainly
can’t sit still long enough to have a talk with
Even my neighbors are
beginning to make comments and one friend thinks that I am dealing with a
child with condition that has the word “hyperactive” in it
I need some
advise and information
Can you help, please?

ANSWER: I certainly can offer you a few bits and pieces that may help, but
this is a condition where the child must be observed and examined by a
physician in order to get a clear understanding of the problem, and the
information needed to make a correct diagnosis
I believe your friend is
referring to a condition known as “Attention-Deficit Hyperactivity Disorder”
(ADHD)
It is a neurological condition that causes a child to be easily
distracted from the task at hand, inattentive, impulsive, and hyperactive when
compared to other children of the same age
In some cases, particularly
girls, the hyperactivity is less pronounced or noticeable
With or without
hyperactivity, this condition may affect from 2 percent to 10 percent of all
children, and hyperactive behavior is the most common problem now being
referred for care to child guidance clinics in the United States
The
diagnosis will depend upon the presence or absence of certain behavior
patterns, and the severity will be judged by the effect on the child’s ability
to function
There are 14 behavioral criteria listed for ADHD and there must
be at least eight present for six or more months to make the diagnosis
Here
are but a few for you to use in your own preliminary evaluation of your child.

1: Often fidgets with hands and feet or squirms in seat,

2: has difficulty in remaining seated when required to do so,

3: is easily distracted by things happening outside the immediate area,

4: has difficulty in awaiting turns in games or group situations.

As you can see it is not a simple task to arrive at the correct
diagnosis, which is a must if an effective therapeutic plan is to be
fashioned
Prescription medications can be one route that is available to
you, but this is a problem in which the solution is neither instantaneous nor
complete; and you should proceed step by step through all the steps needed for
a complete evaluation, meanwhile gathering all the information and resources
that you may need to help you cope effectively
Your ability to help your
child is most important in the outcome of any treatment.

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.

Fosamax
Our price: $0.65
Fosamax (Alendronate) is indicated for treatment and prevention of osteoporosis in postmenopausal women.

More info