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QUESTION: During a routine visit to my doctor, my urine was checked
It was
the test where the nurse dipped a strip of paper in the specimen
I was told
that there was some protein in the urine, and that they would check it again
at the next visit
At the next visit however, nothing was found, and no
explanations have been offered to me as to the cause of the protein on the
first test
Was one of these tests in error? Do I have anything to worry
about? Please try to explain this to me.

ANSWER: Let’s start the answer with a bit of reassurance
You have nothing
to worry about, the circumstances you describe are very frequent, and both
tests were probably correct
The method of testing used in your case was a
dipstick test, where the paper had an area saturated with special chemical
that is quite sensitive to even low concentrations of protein
Although it is
quite reliable, other laboratory tests could be used to confirm the presence
and quantity of protein in the urine
However, in view of the great frequency
of positive tests found in many individuals, it is a common practice just to
wait a bit and retest the urine at another time
About 1 person out of 10 who
come to emergency rooms for all sorts of problems are found to have a positive
reaction with this test
Usually these results are only temporary, as protein
can be found in the urine as the result of such things as exposure to cold,
emotional stress, strenuous activity, seizures, and many other situations that
do not reflect a disease of the kidney
When this is the case it is labeled
as “functional proteinuria”, and the usual procedure is merely to check the
urine again when other opportunities, such as another visit to the doctor’s
office, occurs
When the second test is normal, the patient may be reassured.
While there are times when the cause of the first positive test may be
apparent, most often, despite a carefully taken history, the reason can not be
determined, but this is not a cause for worry or anxiety
This is one time
when you can relax after a positive test.

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.

Lasix
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Lasix (Furosemide) is a diuretic that is used to treat fluid accumulation, caused by heart failure, cirrhosis, chronic kidney failure, and nephrotic syndrome.

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QUESTION: I know you advocate exercise for many things, but do you endorse
power walking for your patients? I want to start a program that is the most
effective, and my partner tells me this is the way to go
Do you agree?

ANSWER: Many “walkers” carry weights to enhance their exercise programs, and
“power walking” is just another variation
Power walkers, however, do more
than just carry hand weights, but wear weights attached to hips or chest.
Increasing the weights pound by pound, they may carry as much as 10 percent of
their body weight along on their walks to increase the work load
It is still
a controversial technique, as many experts feel that all the benefits that can
be obtained from walking can be achieved without any additional baggage.
There is some advice you might consider though
Your walking program should
be one that has a regular schedule, if you are to realize your objectives.
Your walk should be a brisk one, sufficient to increase your pulse rate to
desired levels
Don’t try to push too hard in the beginning, for overuse
injuries are just as frequent in new walkers as they are to serious runners.
And one last safety tip
The greatest risk a walker faces is getting hit by a
car
Dress up with bright clothing for a sunlit walk, and use reflective
belts and patches at night
And avoid those potholes, or you may take trip
that was not in your plans.

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.

Exelon
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Exelon (Rivastigmine) is an oral medication used to treat patients with Alzheimer or Parkinson disease.

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QUESTION: I have collected some advertisements for cures that you never
mention in you column (copies enclosed)
Do you think that the promises made
here can possible be true? If not, you are not being correct with your
faithful readers by failing to expose them
May I respectfully request your
comments?

ANSWER: Perhaps I have been remiss, but I would turn this column into nothing
else if I were to comment on all the clippings I receive that promise
miracles, such as the selection you sent me
Surely you have observed for
yourself that these claims are too good to be true? And they are just that,
“not true”! Yet these companies are estimated to have had sales of $27
BILLION to gullible consumers
Let me provide you with the list of the Food
and Drug Administration’s (FDA) “top ten” drug frauds
1: Arthritis
products: such as snake or bee venom, copper bracelets, large doses of
vitamins; 2: Cancer clinics promising miracle cures using Laetrile, plus
vitamin and mineral treatments; 3: AIDS cures using homemade treatments; 4:
Instant Weight Loss schemes, including skin patches, herbal capsules and
Chinese magic weight loss earrings; 5: Sexual aids promising increased libido
and enhanced sexual pleasure; 6: Appearance modifiers such as quack baldness
cures, wrinkle removers and breast developers; 7: Nutritional schemes that
promote the “beneficial” qualities of such products as bee pollen, herbal
remedies and wheat germ capsules; 8: Chelation therapies that claim that an
injection or tablet of amino acid will break down arterial plaque; 9: Muscle
stimulators that claim to remove wrinkles, perform face lifts, and remove
cellulite; 10: Candidiasis hypersensitivity cures that claim to help the body
deal with overgrowths of Candida, and thus reduce anxiety, depression,
impotence and infertility
Medications approved by the FDA for use in the
United States have undergone extensive and expensive evaluations proving both
safety and effectiveness, which the promoters of these schemes have failed to
do.

The material contained here is “FOR INFORMATION ONLY” and should not replace
the counsel and advice of your personal physician
Promptly consulting your
doctor is the best path to a quick and successful resolution of any medical
problem.

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

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QUESTION: While visiting my brother for a brief visit, I noticed that he
seemed to be taking a great deal of acetaminophen for continuing pain
He
claims his doctor is aware of this, but I fear that there may be damage done
over the long haul
Can you discuss these possible dangers for me?

ANSWER: Any medication can have adverse side effects, even when taken for a
short period of time, and each of us reacts to medications in a different way.
Since some of us are more sensitive to a medication than others, a dose which
is completely acceptable for one individual may, in fact, be an overdose for
others
The general rule is never to take more medicine than is needed to
control the medical situation for which it has been prescribed
Never take
more medicine than is indicated on the package label and be very careful when
taking combination medications, such as acetaminophen and salicylates, as they
seem to provoke more serious side effects than when taken alone.
Too much acetaminophen may cause liver damage, diarrhea, nausea and
vomiting, and pain and tenderness in the abdomen
When the liver has been
severely damaged, yellowing of eyes and skin may occur two to four days after
the initial ingestion
Over the long haul, the risk of renal disease is
significantly greater when acetaminophen has been used in conjunction with
other medications in high dosages over a prolonged period of time
However,
according to the U.S
Pharmacopeia, there seems to be no substantial risk
associated with prolonged use of high therapeutic doses of acetaminophen
alone
Providing your brother IS under regular medical supervision, some of
your anxiety may be misdirected
If he is not, you may have to intercede to
obtain some needed clarifications.

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.

Brahmi
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Brahmi is a nervine tonic that improves mental ability.

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QUESTION: I recently discovered that I had wax in my ear
I borrowed a bobby
pin from my hairdresser to remove the wax
It wasn’t until hours later that I
began to fear that I might have exposed myself to the AIDS disease by using
this borrowed bobby pin on my body
I know that you’re not supposed to remove
wax this way, but have I exposed myself to more than I bargained for?

ANSWER: You’re right when you state that nothing should be placed in your ear
to remove the wax that normally forms there
This wax acts as a protection
against infection and by using a sharp tool, such as a bobby pin, you expose
yourself to ordinary infections of the ear which physicians call otitis
externa
Such afflictions are treated appropriately with antibiotics.
But the question you pose is more important than a mere discussion of
otitis
Many people fear that they may catch the disease AIDS from an
instrument of any kind, by transmission through clothing, or even touching
something than an AIDS victim may once have held
Nothing could be further
from the truth
Because of its deep significance, the collection of the
statistics concerning the transmission of AIDS has received intensive
attention
It seems quite clear at this time that the primary means of
transmitting this disease is by two routes
One is through sexual contact and
the other is through the transmission of blood or blood products from one
person to the other
Although it still seems that the largest group at risk
for this disease is the gay population, it has become apparent that drug
abusers who exchange improperly sterilized needles or needles which have never
been sterilized at all are also at great risk for contracting the disease.
But the transmission of AIDS by casual contact, or through other objects
(called “vectors”) is certainly not a means of transmission.
So, I guess you are fairly safe as far as AIDS is concerned, but it is
clear that you’ve got to stop the bad habit of cleaning wax out of your ears
with anything but your elbow.

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.

Norvasc
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Norvasc (Amlodipine) is used to treat hypertension (high blood pressure) and to treat angina (chest pain).

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QUESTION: Life here at school is different than anything I have ever
experienced
While studies are important, much of the talk in the dorm is
about guys, sex and AIDS
Everybody has their own idea about who and what is
safe, and I don’t want to get more than I am willing to “bargain” for
I
think you might include an answer that would provide some indications about
reducing risks, if one chooses to have an intimate relationship?

ANSWER: Despite all the educational programs now in place, it is clear from
your question (and others I have received) that more information is needed.
There are several precautions you can take to minimize your risk of acquired
immune deficiency syndrome and other sexually transmitted diseases.
The least risk of infection comes with a long-term monogamous
relationship, with no other sexual contacts
That puts marriage and fidelity
in the forefront of the prevention of sexually transmitted diseases
(Of
course there are no risks at all associated with celibacy!) If both partners
are monogamous and have not been previously exposed to the AIDS virus, there
is virtually no chance of getting the disease unless one partner uses
intravenous drugs.
The greatest risk of infection comes with casual sex with more than one
partner and with people who you hardly know
Chances are, if a person will
have sex with you even though they hardly know you, they may have many other
partners
The more partners, the greater the risk
If you have sex with
anyone but an exclusive partner, precautions must be taken
Sexual contact
should be carried out with a condom or penile sheath
This can protect both
the wearer and his partner from contact with secretions, discharges and
lesions
A condom should not only be worn for intercourse, but for
oral-penile contact as well
Likewise, a condom should be used for
penile-anal contact, even between monogamous partners
Oral-anal contact
should be universally discouraged.
A casual kiss, such as a peck on the cheek, or even on the lips, even
from someone who is infected with the AIDS virus, is probably harmless
If an
infected person coughs or sneezes on you, there is also very little reason for
concern
Deep kissing involving tongues may be a hazard though, because the
AIDS virus has been found in saliva, and there can be an exchange of saliva
with that type of contact
Therefore, passionate, deep kisses should be
avoided with casual sex partners, especially when there is a possibility that
you have an open cut on the tongue or in your mouth
There is no available
protection to reduce the risk of infection from oral saliva contact with the
vulva or vagina.
When using condoms, to prevent the spread of viruses, several precautions
should be taken
Condoms should be used only once and then thrown away
The
condom should be put on early in sexual foreplay, since many men secrete
pre-ejaculatory fluid
Withdrawal of the condom-covered penis should be done
carefully to prevent leakage of fluids
Because many men lose their erection
very shortly after ejaculation, the condom and base of the penis should be
grasped and held together during withdrawal, to reduce the risk of spillage.
This is obviously not a decision to make without even more information
than I can provide you here
Check with the health facility on your campus, I
am sure they can provide you with much more information.

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.

Pilex
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Pilex shrinks enlarged veins, controls bleeding and hastens the healing process in the anorectal region.

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QUESTION: We need to know the effect food allergy can have on a person
Can
you tell us how to tell if that is the problem and what to do about it?

ANSWER: The word “allergy” is overused by physicians and patients alike, and
the result is that many people incorrectly feel they suffer from a food
allergy
Instead of a true allergy, they may only be experiencing a
physiological reaction to a food or a substance
The response may indeed be
unpleasant, but it is not allergic in origin
A true allergic reaction occurs
when a person’s immune system reacts to a substance
It’s useful to know
whether the reaction is a true allergy, because proper treatment of a severe
aerological reaction is important
It’s also critical to treat problems that
can be incorrectly dismissed as an “allergy.”
Diagnosis of an allergy involves precise testing, as well as cooperation
between patient and physician so that the problem can be sorted out and
identified
You consume thousands of possible allergens (substances that can
create allergic reactions), and pinpointing the one that is causing your
problem isn’t easy
Unpleasant reactions to foods or other substances can
create a confusing picture of symptoms, often leading patient and physician
down the wrong track
The “obvious” allergy is sometimes not the culprit at
all
Keeping a diary that lists all foods eaten and the types of symptoms
can be most useful in discovering the real problem.
Reactions to prepared foods eaten at home or foods eaten in a restaurant
can be hard to pinpoint because of the variety of ingredients they contain.
Although food labeling has come a long way, specific spices are often not
listed
Companies will often share a list of their ingredients, however, if
they are asked.
Foods that are most often the culprits in true allergic reactions in
adults are peanuts, tree nuts, milk, eggs, shrimp, lobster, crab, crayfish,
whitefish, and sesame seeds
Children most commonly have allergic reactions
to eggs, peanuts, milk, fish, soybeans and wheat
Food “allergies” are a
convenient but sometimes sloppily-used term to describe a large variety of
symptoms, and a rather convincing case can be made that they are the only
cause of many problems
A thorough, careful investigation, however, may show
that there is no allergy, and that there is another important condition or
cause that should be treated.

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.

Requip
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Requip (Ropinirole) is used to treat Parkinson’s disease.

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QUESTION: I have a very nice, large aloe vera plant growing on my windowsill.
Friends tell me its “juice” is a good treatment for burns and that using the
sap will prevent scar formation
Is that true?

ANSWER: It depends upon the type of burn you use the aloe sap to treat
If
you have a minor burn (superficial) or abrasion, gel from a leaf of the plant
may be soothing and perhaps mildly healing
There is some scientific evidence
to support that, but the gel does not prevent scarring.
Should you suffer a more intense or deeper burn, (the old second and
third degree burn) or if your wound becomes infected and/or cracked, applying
aloe gel could do more harm than good
When applied to the skin, aloe vera
gel, itself, is seldom irritating
Yet, a plant leaf placed directly on a
burn can be treacherous because the latex which is also found in the leaf is a
powerful laxative
With some additional care, you can avoid the latex by
scraping gel from inside the leaf.
If there is any doubt about the severity of a burn, forget about your
aloe vera plant and see your physician immediately
There are more effective
and less doubtful methods for treating these injuries, which may be prone to
complications of infection if not dealt with properly.

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.

Buspar
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Buspar (Buspirone) is indicated for the management of anxiety disorders.

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QUESTION: Spring is around the corner in my part of the country, and with it
comes my yearly attack of anxiety about a bee bite
I am quite allergic, and
have been warned that I could suffer a mortal attack if bitten
Since I enjoy
the out of doors activities, I am sure there must be a way for me to combat
this problem
Could you provide me information about my situation and some
advice as to treatments?

ANSWER: What you are talking about is called anaphylaxis
It is an unusual
and exaggerated allergic reaction to foreign substances, such as the venom of
bees, wasps, hornets, pollens, molds, animal dander or an allergic reaction to
medications, such as penicillin, antibiotics, local anesthetics, codeine, or
other drugs.
The allergic reaction is caused by the body’s overproduction of
antibodies to the foreign substance
In extreme cases, the victim can go into
anaphylactic shock in which widespread histamine release causes swelling,
constriction of the bronchioles, heart failure, circulatory collapse and even
death
With allergic reactions to bug bites, however, the most common
anaphylactic reactions are localized swelling, redness, and itching
However,
since your reaction could be worse, you must take all necessary precautions if
you are to be in an outdoor setting where you might get stung.
Discuss with your physician his providing you with a prescription for a
kit called the Anaphylactic Shock Drug Kit, which contains injectable Benadryl
(an antihistamine) and vials of epinephrine
Mild anaphylaxis can be treated
with antihistamines, ice packs locally to minimize swelling and topical
applications to soothe the skin and relieve itching
In severe anaphylaxis,
the drug of choice is epinephrine, but it must be given by injection
Have
your doctor teach you how to administer the medications in the kit prior to
any possible exposure to bites.
A good tip that is helpful if you would avoid bites is to forgo the use
of after shave lotions and perfumes
While they may be formulated to attract
the opposite sex, they do a real job on our flying friends and can draw them
to you from miles around
Incidentally, anyone who knows they have severe
allergic reactions should wear a medical identification necklace or bracelet
so that health care personnel will know how to treat you immediately, should
you go into shock.

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.

Zyban
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Zyban (Bupropion) is an antidepressant and indicated as an aid to smoking cessation treatment.

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QUESTION: There are times when the sound of a diagnosis can make you afraid.
Please explain just what is meant by angina and tell of its treatment.

ANSWER: A little information can remove the anxiety from angina
Angina
pectoris is chest pain caused by poor blood supply to the muscles of the heart
due to narrowed or clogged coronary arteries
When your heart is working
harder than its blood supply can keep up with, the area of the heart that is
short of oxygen reacts like any other overworked muscle and sends out pain
messages
This pain usually makes a person stop and rest, which reduces the
demand on the heart, and so the pain goes away.
If the blood supply becomes permanently cut off to a section of the
heart, this is a myocardial infarction, or heart attack
Angina can lead to a
myocardial infarction, but it may remain as a stable condition that does not
get worse, without a true heart attack developing.
Most people with angina describe the pain as a squeezing or burning
sensation or tightness of the chest
Some feel angina pain around the lower
jaw, back of the neck or the middle of the back
They may also feel a sense
of foreboding or doom
The pain is felt during exertion, such as walking or
climbing stairs, during an emotional upset or after a heavy meal, and it goes
away quickly if you sit down and rest for a few minutes.
Angina is a serious condition, but it does not necessarily mean that a
heart attack is imminent
(Angina pain that is prolonged may be a symptom of
a heart attack.) Unfortunately, there is no good correlation between the
amount of angina pain and the extent of heart disease.
After a complete and careful physical examination, cardiac angiography,
where x-rays are taken of your heart after an opaque dye has been injected
into the coronary arteries, can provide a clear picture of the heart’s blood
supply.
Angina can be effectively treated with medications, including
nitroglycerin or other nitrates, beta blocker agents and calcium channel
blockers
These drugs are taken either regularly to limit the number and
severity of attacks or when an angina attack starts
However, they do not
cure the underlying condition
Angina can also be treated surgically with
coronary bypass operations that replace the narrowed or clogged arteries with
replacement arteries.

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.

Leukeran
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Leukeran (Chlorambucil) is used for treating certain cancers.

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