Health information

QUESTION: I am a senior citizen now living in a retirement home
I don’t
like this living among so many people who are deteriorating in body and mind,
although there are many fine intelligent people also
I know I will not
always be able to take care of myself
Would I have been better if I had
moved into a smaller place? I like peace and quiet, good books and to know
what is going on in the world
Please give me your opinion and I thank you.

ANSWER: After a lifetime of living in quarters of your own choosing and
making, it is a difficult task to adjust to the group living of a retirement
community
Just at a time when one wishes for quiet calm, when all the
adjustments needed to live a lifetime of happiness and sadness, triumphs and
defeats have been mastered, and when wishing for simpler pleasures, the need
to adapt one more time may seem a difficult task
Still I am sure you can
achieve it with but little effort, if you can achieve the proper perspectives
and attitudes
Many people chose a home based upon convenience for relatives,
location or costs without the necessary information that allows them to choose
the proper living environment for their desired lifestyle
It isn’t too late
for you to search out another location, but the effort necessary to assure
yourself that the people and surroundings meet with your needs may be one that
requires help from your friends and family
If such a facility can be found,
than your choice would seem clear
However you might consider the
possibilities that exist in your present location
Are there other people who
share your views, who read as you do, and are seeking someone to share their
ideas with and discuss their points of view? The odds are that there would be
a better chance of finding such a person or persons in a larger place, with
more candidates to choose from
Is there a social worker, nurse or
administrator to help you with your search? With your obvious alertness, you
might want to start a book club or discussion group to share the new
experiences gained through reading
Perhaps by turning your eyes and spirit
outward, rather than retreating into solitude, you can convert your present
surroundings into a new world of friendship and happiness, and find new paths
of enjoyment.

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.

Micardis
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Micardis (Telmisartan) is used to treat high blood pressure (hypertension).

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QUESTION: What are my chances of recovery from a basal cancer of the skin?
My doctor has made this diagnosis and wishes to remove the tumor
He has told
me that this type of tumor is malignant, but says that it can be taken care of
by a simple operation in his office
I need reassurance.

ANSWER: And you shall have that reassurance from me
Your chances of
survival and recovery are enormous, and the probability of that your doctor
can successfully remove this tumor in an office procedure is from about 93
percent to 96 percent
Basal cell carcinoma is the most common of all skin
malignant tumors, with more than 400,000 new cases seen each year
It is
usually found on areas of the skin that are exposed to sunlight, the most
common being in the areas of the head and neck
Men are more prone to this
than women, and the tumors are diagnosed at around age of 60 years to 70 years
of age
People with fair skin are the most susceptible
Although this is
classified as a malignant tumor, deaths from this cancer are rare, as this
form of tumor rarely spreads to other parts of the body
There are many
effective means of removing this tumor that are readily performed in a
doctor’s office
Since a local anesthetic is all that is need to completely
numb the area, the procedures are all painless
The most commonly used method
for small uncomplicated lesions is to curette (scrape away) the tumor as
completely as possible, and then use an electric needle to burn away a small
margin of normal appearing tissue, and to stop the bleeding from the small
vessels in the area
The wound is clean and dry after the operation and may
be easily cared for using an antibiotic cream or ointment to prevent infection
and a plain adhesive dressing
If there lesion is larger, it may be
surgically removed using a scalpel
This method has the advantage of
providing a biopsy specimen for microscopic evaluation
It tumors that are
large, with irregular borders, and in areas where they are likely to reoccur,
a specialized procedure called Mohs’ chemosurgery is used to cut away small
sections while utilizing a microscope, and then examining each fragment for
the presence of tumor cells
This is repeated over and over until no more
tumor remains
Although this is a more expensive and delicate procedure it
has the advantage of conserving all the normal tissue possible, with absolute
certainty that the entire cancer has been removed.

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.

Mevacor
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Mevacor (Lovastatin) is a cholesterol-lowering medicine.

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QUESTION: When my husband was a boy he got shot in the leg with a B-B gun.
Believe it or not the B-B is still there, and he is 30 years old
It is right
under the skin of his lower calf
He can move it up or down and it sometimes
moves by itself
Is there a danger in this? Should he have it removed or
just forget about it? Thanks for your opinion.

ANSWER: I still play the game by the rule “If it isn’t broken, don’t fix it.”
Apparently your husband has been carrying around this B-B for some time, and
the fact that it is so freely moveable tells us that there has been no
inflection or inflammation that might have created fibrous tissue that would
have “glued” the B-B in place
There are many cases in medical literature
that demonstrate that foreign bodies of this kind may remain in an individual
for a lifetime without causing any additional problems
I suppose that its
presence just below the skin just seems to cry out for a little slice and a
quick removal, but the possibility of introducing an infection into this space
or poor healing after surgery must be taken into consideration as well.
Unless it is causing your husband distress, my vote is for leaving it in
place
However, your story gives me the opportunity to once again make the
plea that all the rules of safety be respected when dealing with these
dangerous “toy” guns
While a B-B under the skin of the leg may not be cause
for concern, the same missile in a more crucial spot, say the eye for example,
might have created a lifetime tragedy
Parents should see that their
children’s play is supervised when the possibility of accidents from the
playthings is present
Then the next generation of medical columnists won’t
have to worry about removing B-B’s.

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.

Effexor
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Effexor (Venlafaxine) is an oral antidepressant drug.

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Glucotrol XL
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Glucotrol XL (Glipizide) is an anti-diabetic drug (sulfonylurea-type), used along with a proper diet and exercise program to control high blood sugar.

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QUESTION: My girlfriend knows of the troubles I am having with my youngster,
so when she saw a report about a new drug to help bedwetters she called me.
However, I have been unable to find anything out from my local TV station, and
all I know about the medicine is that it is a nasal spray
Is this enough for
you to be able to provide me the information that could help solve our
problem?

ANSWER: Your information is correct and certainly enough for me to point you
in the right direction
After all, there are not many new drugs for this
problem which come in the form of a nasal spray
The new medication is called
DDAVP Nasal Spray, marketed by Rorer Pharmaceuticals and just recently
approved by the Food and Drug Administration
Many children who do not
respond to the many existing treatments for bed wetting at night (medical
term: nocturnal diuresis) were found to lack normal levels of a hormone
called arginine vasopressin
This chemical, which functions as an
antidiuretic hormone, diminishes the production of urine, particularly at
night
The lack of this hormone is thought to be the cause of many cases of
bed wetting
The new medicine is provided as a nasal spray which may make it
a bit easier to give to children
The medication is sprayed into each nostril
at bedtime
If the initial dose of 0.2 mL for patients 6 years old and above
is ineffective the dose can be doubled
One recent study reported a 41%
reduction in the number of “wet nights” with this treatment
Of course all of
this should be under the care of your physician, for this medication is by
prescription only
The medication comes in 5 mL vials which should be
sufficient for one month of treatment
By the time you read this, I am sure
your physician will have all the information on this new product and will be
able to help you.

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.

InnoPran XL
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Innopran XL (Propranolol) is a beta-blocker, used to treat high blood pressure.

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QUESTION: Can a person who is not sick just throw up because they want to?
Isn’t vomiting a sign of some illness in the stomach? We are having a bit of
trouble that can be helped by these answers.

ANSWER: I think there must be more going on than the scant information
contained in your letter
And while my information may be helpful, I truly
doubt that it is enough to solve your problems
The answer is a clear “Yes”,
there are some people who can vomit at will
While vomiting is present in
many diseases, many of the gastrointestinal tract, and some extremely serious
conditions involving infections and diseases of the central nervous system, it
may also occur in less important situations
In many cases in can be a part
of an emotional or “distasteful” situation, and be a reaction to anxiety or
fear
It may be an expression of hostility or contempt, a means of obtaining
special consideration or attention
And it may not be easy to discover the
real meaning or underlying cause for this type of vomiting, as in many cases
the patient is not aware of the reasons on a conscious level
Any patient
with repeated episodes of vomiting, especially in cases where no nausea is
present, must be fully examined to rule out the possibility of physical
disorders, before any diagnosis implying an emotional cause can be made
A
finding of “psychogenic” vomiting may be made, then requiring the appropriate
follow up care and treatment
This is not something to take lightly, nor do I
feel you can resolve the problem in a conflict at the supper table
It is
apparent to me that there is some deep seated condition here
Take my advice,
and seek professional 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.

Femcare
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Femcare (Clotrimazole vaginal) is an antifungal agent used to treat vaginal yeast infections.

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QUESTION: My mother, who lives in Florida, is being given a new and very
expensive salve to use to help close some open sores on her legs
We have
been unable to find out anything about this medication, and wonder if mother
is being used as part of an experiment
What can you tell us?

ANSWER: Your mother is not part of an investigational program, although there
is divided opinion about the value of the treatment she is using
The salve
or “formula” is made from platelets, small elements found in the blood that
are part of the process of clot formation
The active ingredient is called
Platelet-Derived Wound Healing Formula (or PDWHF for simplicity’s sake) and is
applied to the wound each day, leaving it in place for 12 hours
It is then
removed and alternated with an antibiotic or saline dressing
The technique
was first described by Dr
David Knighton, assistant professor of surgery, at
the University of Minneapolis, in the Annals of Surgery in September, 1986.
He reported the use of PDWHF on 41 patients and claimed success in all cases
after 7 1/2 weeks
However, many other specialists in the field criticized
the study as lacking adequate controls, and are not convinced that the
preparation really works until other studies prove its worth.

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.

Isoptin
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Isoptin (Verapamil) is used for treating high blood pressure.

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QUESTION: With Christmas soon upon us, shouldn’t you be warning your readers
about the dangers of the plants that go with the season
We nearly lost my
brother, when as a child, he ate some of the berries off our holly
decorations
You would be performing a real public service by telling people
about this.

ANSWER: With an eye on the calendar, your suggestion is a timely one, as well
as important
The National Clearinghouse for Poison Control Centers
identified plants as the leading cause of poisonings in children under five
years of age
In fact, plants were responsible for an amazing 11% of all
toxic reactions to swallowed or eaten materials
The good news is that the
few children had to be hospitalized and none died
But precaution is the
watchword, for death may result from serious poisonings
Three plants are
linked to the traditional Christmas celebrations, and all three have dangers.
They are Holly, Mistletoe and Poinsettia
For the holly and mistletoe it is
the berries that carry the danger
The berries of the holly provoke
gastrointestinal distress and narcosis, while mistletoe berries also react on
the GI system, plus slowing down the heart
In both cases it may be necessary
to have the stomach washed out depending upon the severity of the symptoms.
If more than 4 hours have passed between the ingestion and discovery, and no
symptoms have developed, you are probably safe
Poinsettia leaves, stem and
milky sap may, in rare cases, cause a skin rash on contact, and GI symptoms
when swallowed
Gastric washing is only indicated when large amounts have
been eaten
The holiday health tip; enjoy the beauty of these holiday plants
but keep them away from children.

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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Celebrex (Celecoxib) is a nonsteroidal anti-inflammatory drug that is used to treat arthritis, pain, menstrual cramps, and colonic polyps.

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QUESTION: My sister presents me with a problem that I don’t know how to deal
with
Though she is a pretty young women, she becomes terribly embarrassed
when in the company of others
She refuses to go out for a meal with us, and
even when at family functions, just cannot use the rest rooms
She knows that
this is strange, but can’t help herself
What can I do to get her to be more
sociable?

ANSWER: I doubt that there is much you can do, for from the symptoms you have
described in your lengthy letter, it is apparent to me that you sister needs
professional help and guidance
I believe your sister suffers from a
condition known as Social Phobia, a type of anxiety syndrome that may affect
as many as 2% of the population
These individuals have a fear of scrutiny in
social situations, which provokes an embarrassment that is severe enough to
make ordinary social situations unbearable
They refrain from most social
involvement, which can cause serious problems in their private life as well as
on the worksite
They are also anguished by simple things such as writing or
eating in public, and the fear of using otherwise occupied rest rooms is
fairly common in these patients
They generally realize that they have a
problem, but once again suffer great embarrassment about it and find it very
difficult to seek aid
That is where you come in, for your understanding of
the situation may be just the bridge that is necessary for her to cross over
into a treatment program
Sometimes calculated exposure to an environment
that causes the anxiety and fear can help overcome the problem
In some cases
medication may be of some help, but therapy for this condition is complex and
must be adjusted to each individual’s circumstances and condition
Your
sister needs professional help, a physician who understands and treats this
disorder.

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.

Premarin
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Premarin (Conjugated Estrogens) is used for treating the symptoms of menopause.

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QUESTION: You recently wrote that spleens are rarely removed these days, but
in our family, we have an anemia condition which appears in childhood, and for
which doctors say there is no other treatment
Does your recent column change
that? What can you tell me about our problem?

ANSWER: I have had to omit much of the information you included in your long
letter, but it is clear that my remarks about removal of the spleen do not
apply to you and your family
The condition of hereditary spherocytosis (also
known as Minkowski-Chauffard Disease) is one in which there is an increased
destruction of the red cells causing anemia, and associated with jaundice and
an enlarged spleen
The diagnosis is usually made in childhood, where, in
some cases, the only sign present is an enlarged spleen found during a routine
examination
The condition is present in people of all races, but is the most
common inherited anemia found in persons of Northern European descent
It
occurs in about 220 people per million population in the United States.
Usually, as in your case, the family is aware of the inherited characteristics
of the disease, but a good family history can often be the first clue to the
diagnosis
There is also a tendency for individuals with this disorder to
develop characteristic pigmented gallstones, even in children
There are
several types of this disease, and two types of inherited patterns, so a
careful evaluation, with all the appropriate laboratory tests, is a must
If
there are no symptoms, such as jaundice or severe anemia, then treatment may
be unnecessary, but in cases where crises do occur, the condition may be
completely resolved by removing the enlarged spleen
If you haven’t done so
already, seek out a good genetic counselor, who along with your physician, can
determine the pattern of inheritance in your family, and help you to
understand more about the manner in which the disease is transmitted, and some
of the important clues that may alert you and your family members of the
presence of this disorder.

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.

Premarin
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Premarin (Conjugated Estrogens) is used for treating the symptoms of menopause.

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QUESTION: Does the color of your stool reveal anything about the state of
your health? I have a friend who gives me a daily report on this aspect of
her life, and she has almost got me believing it is something everyone should
do
Is this true, or is her behavior just bizarre?

ANSWER: I have never seen a study about such habits, but would suspect that
most people take a passing notice of the state of their bowel movements,
without paying it a great deal of focused attention
Although the color may
vary normally from light to dark brown, resulting from the bile content of the
stool, there are other factors that can influence this color, and some do have
a medical significance
Food may play a large role, specially beets and
carrots when eaten in large quantities, impart their own hue to the stool.
But a colorless, pale grey to white stool signifies a blockage in the flow of
bile, and a very dark brown to black color indicates an excess, both requiring
medical attention
A black tarry stool is sometimes the result of bleeding in
the intestinal system and denotes digested blood
However, iron pills and
stomach preparations containing bismuth also produce a black color
It is
therefore not the color alone which may be important, but the history of food
or medicines which may have been taken in the past 24 hours, as well as the
general state of the individual that may give meaning to the stool color.
Frankly speaking, I doubt that it deserves a daily report or excessive
attention.

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.

Vasodilan
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Vasodilan (Isoxsuprine) helps to widen blood vessels so blood flows better.

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