Health information

QUESTION: I have just completed another regular physical exam, and am happy
that all is in good order
However, once again, I was subjected to the
embarrassment of a rectal exam for prostate cancer
With all the developments
in modern medicine, there must surely be a better way to check for this
cancer
Honestly, Dr
B., is this test really necessary?

ANSWER: I’ll give you a look at some of the statistics, to help you make the
decision about the importance of this test for yourself
Estimates by the
American Cancer Society for 1989 reveal 103,000 new cases of prostate cancer
and 28,500 deaths from prostate cancer that has spread
About 1 out of every
11 men can be expected to have cancer of the prostate, representing 20% of all
diagnosed cancers in men, and 11% of all cancer deaths
Yet this form of
cancer is considered curable, if the diagnoses can be made early enough,
before the cancer has had a chance to spread, while it is still located only
in the prostate
To be sure there are some other screening tests that can
help with the diagnosis
A variety of blood tests exist as well as new
imaging techniques like computer tomography of the pelvis (CT scan) and
magnetic resonance imaging (MRI)
Despite the fact that these examinations
hold great promise for the future, none have been proven to be more effective
than a carefully performed digital examination of the rectum
The American
Cancer Society recommends 3 procedures including 1) a digital rectal
examination each year, 2) a test for hidden blood in the stool (stool guaiac
test) every year after age 50, and 3) periodic proctoscopic examination after
age 50
The rectal exam must of course, include the examination of the
prostate
It may be a primitive examination by some standards, but it would
be criminal to abandon a test that is so effective, and so reasonable in cost
that can be an important weapon in helping to reduce the toll in humans lives,
that are lost each year to this form of cancer.

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.

Ismo
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QUESTION: I know that a person with severe diarrhea loses lots of water from
the body, and the liquids should be given
However, I am not sure just what
fluids are considered correct, or if the drinks that athletes use to combat
dehydration by excessive perspiration are useful
Will you please provide me
with some information?

ANSWER: Not only is the water loss in acute diarrhea important, but important
elements (sodium and potassium) which function as electrolytes in the body are
also lost
When the fluids and electrolytes are not replaced, dehydration may
occur, an even more dangerous situation than the diarrhea itself
The goal is
to replace all that is being lost, as well as to provide some basic nutrients
as well
Old fashioned tea and honey, and chicken broth (without fat) can
work wonders, and commercially available Gatorade or nondiet, noncaffeinated
soft drinks are useful to assure sufficient volume
Fruit drinks help provide
additional carbohydrates but avoid fruit juices that have a laxative effect
such as prune or apple juice
You can prepare your own solution by following
this recipe exactly: 1 quart of water; 3/4 teaspoon salt substitute
(potassium chloride); 1/2 teaspoon baking soda; 3 tablespoons white corn syrup
(Karo syrup); 1 packet of unsweetened powdered drink mix, or concentrated
fruit juice to taste
This will provide the exact electrolyte requirements in
the right concentration
The recommended intake is about 2 quarts of liquid a
day or up to 3 quarts if a fever and sweating is also present.

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

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QUESTION: The dust really flies when I am at work, and it seems that it
always finds its way into my eyes
I guess I have to accept that fact if I am
going to continue to earn my keep, but would like your opinion as to the best
method for removing these annoying specks.

ANSWER: Your question permits me to speculate a bit about your occupation
I
would have to presume that you may be working for yourself, perhaps in one of
the many construction skills
The reason I say that is that had you been
working for a larger organization, the idea of eye protection and eye safety
might have been translated into a mandatory requirement that protective
eyewear be worn while you work
But your question warrants answering in that
statistics tell us that in the over 325,000 eye injuries treated in United
States hospitals’ emergency rooms each year, almost half occur in and around
the home, so my first advice to everyone, either in industry or those who
enjoy working around the house, is to utilize safety glasses or goggles when
involved in activities that can result in eye injury.
However, if you do get a speck of dirt, dust or other foreign matter in
the eye, here are some simple rules.

- DO NOT rub the eye
That may be hard to do as the eye may itch and
burn.
- DO blink rapidly, as that will help your own tears to wash out the
speck.
- TRY to lift the upper eyelid over the lower lid so that the lashes may
brush the speck off the inside of the upper lid
However, don’t try this
if your eyelashes are covered with mascara or other cosmetics.
- IRRIGATE THE EYE
This may be done by pouring tepid tap water over the
eye while holding the lids open or by submerging your face under the
water in a basin and blinking very rapidly.

If the speck remains, it is imperative that you seek medical help
First
aid for eye situations are fine, but when even a minor situation is handled
improperly, serious injury with the possibility of loss of vision or blindness
may occur, so take no chances with the precious gift of sight.

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.

Lariam
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QUESTION: Just 58 years young, I consider myself to be in good health except
that I am plagued by frequent fainting spells
Can you explain the possible
causes and advise me what I might do about this?

ANSWER: Fainting is a common, seemingly mysterious, problem
Despite its
frequency, it is never something to be lightly shrugged off.
Temporary loss of consciousness (syncope) occurs in perhaps 47% of
presumably healthy adults
Syncope can usually be divided into three basic
categories about 25% are due to heart abnormalities; another 25% are caused
by conditions other than cardiac disease; and approximately 50% are of unknown
origin.
I presume your doctor has performed all tests to determine that you do
not have a heart disease
With that cause eliminated, he or she probably will
explore other possible reasons for your fainting
It could be caused by
hunger, overcrowded living areas, fatigue, stress, or certain types of pain.
For complete diagnosis, your physician needs a history of what occurs
before and during your fainting
Knowing how long the “spell” lasts also is
necessary information
You should keep a diary of events which preceded a
fainting spell, including how intense any symptoms or feelings were and their
duration
Record if you fainted immediately following a change in your body
position, or a hard coughing spasm, urination or defecation, or heavy alcohol
usage.
Sometimes weakness, sweating, and nausea precede fainting attacks.
Dizziness, blurred vision or a rapid fall in blood pressure can result from
standing in one position too long
Getting up suddenly may result in
fainting
Also, because of some prescription or over-the-counter drugs you
may be using, your pulse rate could be severely reduced, which can cause
syncope
In any case, fainting presents a real diagnostic challenge to
doctors, and providing all this information will help pinpoint the causes, the
important first step to correcting the situation.

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: Whenever my 7 year old daughter eats peanut butter, she breaks out
in hives
I want to know about food allergies
How common are they, and is
there any hope my daughter will soon outgrow them?

ANSWER: Food allergies are always high on the list of a parent’s concern,
particularly when a common and well loved food seems to be the offending
agent
An allergy is sensitivity to a substance that’s usually harmless to
other people
About 1% of the population is estimated to experience immediate
allergic symptoms, such as hives, sneezing, vomiting, and even shock or loss
of consciousness, after eating particular foods.
In one study of 132 children, four foods peanuts, nuts, eggs and
milk caused 90% of the allergic reactions
Soy, shrimp, banana, tuna,
chicken and trout were responsible for the remaining 10% of reactions.
Chocolate, strawberries and tomatoes, often cited as causing allergic
reactions, are probably unjustly blamed in many cases.
It’s quite possible that your child will “outgrow” her food allergy.
Many doctors believe that food sensitivity decreases with age
Until then you
will have to exercise just a bit more attention to her diet.

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.

Aricept
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QUESTION: We have a problem in our family that has been diagnosed as “Rh
Incompatibility” with the loss of a pregnancy in my very normal daughter who
has already had one normal, happy, healthy child
Can you explain this
condition to us, as we are very confused by the information we have been
getting from all sides?

ANSWER: Understandable enough, when you consider the complexities of human
inheritance mechanisms
Except for the sex chromosomes, we all have 22 paired
chromosomes (autosomes) that are identical in size, shape and placement of the
genes which control our inheritance patterns
Some genes are “dominant” and
will exert their effect when present, others are “recessive” and can only act
when no dominant gene for the same trait is present on either chromosome
If
a mother is Rh negative, she possesses two recessive genes (one on each
chromosome)
However she may bear an Rh positive baby, when the trait has
been transmitted to the child from a father who is Rh positive
The red blood
cells (RBC) of the fetus can cross the placenta into the mother’s blood
stream, provoking an immunologic response, leading to the production of
antibodies against the Rh factor by the mother’s system
When these
antibodies cross back over the placenta, they attack and destroy the RBCs of
the fetus, causing severe anemia and a condition known as “Erythroblastosis
Fetalis”
The condition can be so severe that the fetus dies in the uterus.
Since antibody production does not usually begin in earnest until after
delivery, the first baby escapes before the antibodies have developed in
quantity, and it is the second pregnancy that is affected
The solution is to
treat all Rh negative mothers with an anti-Rh antibody preparation at about
the 28th week of pregnancy, that can destroy the maternal antibodies which
effectively eliminates her sensitivity to the fetal RBCs
Sensitized mothers
must be carefully monitored throughout pregnancy and treatment of the fetus
may even include intrauterine transfusions when indicated
Incidentally the
term “Rh” stands for “rhesus,” for it was in that species of monkey that this
blood factor was first identified.

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
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Epivir HBV (Lamivudine) is used to treat a chronic viral infection of the liver (hepatitis B).

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QUESTION: Can you explain the reasons why a woman would have lots of hair
growing on her face and body? Is there any treatment available for this
condition? I am desperate for some information I can trust.

ANSWER: Some amount of hair growth in women is common, and should neither
cause you concern nor make you seek treatment
A significant increase of
growth, or an excessive amount of hair, known as hirsutism, is not common, and
depending on other factors, may indicate the need for further investigation.
Treatment will depend upon the location of the hair, how much is present,
and what type of hair there is
There are nine areas of the body where women
can look for excessive hair growth
These areas are the upper lip, the chin,
the upper and lower abdomen, the upper and lower back, the upper arms, the
chest and the thighs
It is normal for women to have some hair growth in
these areas, but if the hair is excessive, and if it is dark and thick, it may
indicate a condition known as hyperandrogenemia.
Hyperandrogenemia may be due to problems in either the ovaries, the
adrenal glands, or both
It is characterized by an increased production and
secretion of testosterone, normally male hormones, but produced by these
glands in women as well
In some women, the ovaries and adrenal glands
secrete these hormones in a more potent form, causing excessive hair growth.
Other symptoms may include acne, obesity, infertility, and a lighter than
normal menstruation.
In rare cases, excessive hair may be due to a tumor in the ovaries or
adrenal glands.
There are two effective ways to treat hirsutism
One method uses
electrolysis therapy, and the other turns to medications
In most cases a
combination of both methods produces the best results.
Electrolysis therapy is a safe and effective and ultimately permanent way
of removing excessive hair
Depilatory techniques such as waxing are
effective, but not permanent
Birth control pills and corticosteroids can be
used to counteract the excess androgens produced by the ovaries, and low dose
glucocorticoids can suppress the output of hormone from the adrenal glands.
These treatments may have serious side effects and must be carefully discussed
with your physician, to gain a complete understanding.

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 suffer from severe hemorrhoids and have tried all of the creams
and lotions to no avail
My physician tells me that my hemorrhoids can be
cured by using a rubber-band technique, but I don’t understand what he means.
Have you ever heard of this procedure?

ANSWER: Yes I have, and it is an acceptable manner of treating certain types
of hemorrhoids.
Hemorrhoids are actually swollen veins, very much like varicose veins,
but that are located around the anus or rectal area
They are classified into
four degrees of severity
In the first degree, they remain internal, but
occasionally bleed and this blood can be observed after straining bowel
movements
The physician diagnoses the situation by using a small instrument
called an anoscope to look inside of the rectum and observe the hemorrhoids
directly.
Second degree hemorrhoids protrude out of the anus when you strain during
bowel movements, but retract back inside after the straining is stopped
In
third degree hemorrhoids, the internal hemorrhoids remain outside, even after
the straining has been stopped, and must be pushed back inside either using an
instrument or fingers
In the most serious type of hemorrhoids, fourth
degree, these internal hemorrhoids remain fixed on the outside and the
treatment for such hemorrhoids is the surgical removal of these veins.
Elastic-band ligation, which you have termed “a rubber-band technique” is
useful to treat third degree hemorrhoids
The physician will use a special
instrument called a ligator and encircle the hemorrhoids snugly with an
elastic band
This stops the circulation into the hemorrhoid and, in effect,
solves the problem.
I must emphasize that all these procedures are used for internal
hemorrhoids
External hemorrhoids, which may be small and without symptoms,
are generally of little concern, but the various degrees of internal
hemorrhoids require appropriate treatment that corresponds with their
severity.

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.

Remeron
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Remeron (Mirtazapine) is used to treat major depressive disorder.

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QUESTION: While fooling around with some of the boys I was accidentally
injured when my hand was cut by his teeth
Although not a deep cut it was
bleeding quite a bit and so I went to the emergency room to have it taken care
of
I was surprised when the doctor did not sew it up but left it with just a
dressing
Was this the right care?

ANSWER: Yes, it was
The simple fact is that routine care of human bite
wounds do not require suturing
However, they should be scrubbed and cleaned
thoroughly to prevent infections, and antibiotics may be prescribed when there
seems to be a definite chance of contamination and possible resulting
infection
Despite the fact that some human bite injuries may look fairly
trivial, no matter how innocent or superficial the bite appears, a doctor
should be consulted
It is not the extent of the wound that is of chief
concern, but the possibility of infection that can follow this type of injury.
Untreated wounds often progress to “acute necrotizing soft tissue infections,”
a condition in which there is much damage from the death of cells which can
have devastating effects
If a bite wound is superficial, the doctor may
immobilize the hand after cleaning it, making a splint using a plaster of
Paris slab, or using lightweight aluminum or plastic splints
An oral
antibiotic that is effective against the germs that normally are found in such
wounds is usually indicated
The hand should be kept elevated using a sling,
and a second visit to the doctor is recommended within 24 hours so that
additional evaluation can be be made.
If the wound is deeper, treatment begins the same way, with careful
cleaning
If tissue damage has occurred, the dead tissue is removed by a
surgical technique called debridement
Antibiotics are useful here as well.
Tetanus vaccination is also administered, to prevent “lockjaw”.
In the cases where there are severe bites that penetrate a joint or
tendon, hospitalization may be required for surgical repair of the wound and
the continuous administration of intravenous 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.

Paxil
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Paxil (Paroxetine) is an anti-depressant drug.

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QUESTION: Can you tell me the causes of hoarseness? Can it ever be anything
really serious and how can you tell the serious kind from the ordinary kind?

ANSWER: Most hoarseness comes from a simple viral infection of the larynx or
voicebox
You can tell the common kind because there’s no pain and no
difficulty in breathing associated with it
If it has come on suddenly and
has only lasted for a short period of time, it is probable that it may pass
simply by resting your voice and gargling on a regular basis
A postnasal
drip may create morning hoarseness, resulting from the accumulation of mucous
on the vocal cords
My favorite gargle for these conditions is a teaspoonful
of salt and a glass of warm water (except when extra salt is prohibited by
other medical considerations)
Frequent gargling brings extra humidity to the
larynx and aids in the rapid resolution of the problem
However, if
hoarseness persists for a long period of time, let’s say more than two weeks,
and doesn’t get better with these simple procedures, then your physician will
probably perform an examination called an indirect laryngoscopy
That’s the
procedure by which he uses a mirror to look down your throat and take a
careful look at your vocal cords
This special examination, plus the presence
of other symptoms such as difficulty in breathing, pain in the throat that
may be associated with ear pain, fever, cough that can be associated with
sputum that is streaked with blood, all indicate the presence of something
more serious than common ordinary hoarseness
The good news is that in 90% of
patients who do complain of hoarseness, the diagnosis is the simplest one that
has no long lasting ill effects.

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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