Health information

QUESTION: After a careful general and routine examination of my youngster,
the doctor described several small fleshy bumps in front of her ear as
“accessory tragi”
He did not make too much of them so I didn’t either, but
now I am concerned
What are they? Are they dangerous, and should they be
removed?

ANSWER: No, accessory tragi aren’t dangerous
One of the whorls of the
external ear (which is mostly cartilage and skin) is called the tragus and
these bumps are really slightly misplaced pieces of that portion of the ear.
They are a common variation of the structure of the ear, and by themselves are
harmless.
But accessory tragi can be markers for serious birth defects such as
heart, kidney, spine and intestinal malformations
The bumps may also
accompany cleft lip or palate
A baby born with accessory tragi is closely
examined for more serious problems
Since these conditions would have shown
up by now, we can assume that your daughter is healthy, and the fact that your
doctor was not too concerned is also reassuring.
Accessory tragi are very small and may be noticeable only to the person
who has them
If your daughter is bothered by their appearance, they can be
easily removed by your family physician or a 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.

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QUESTION: After giving my boyfriend all there was of me and my love, he left
without an explanation or even a good-bye
I am left feeling empty and
worthless
I know I can get lots of advice from other columnists, but they
are just words
Surely a doctor must have some medicine, some pill to help me
through this terrible time? Won’t you please help me?

ANSWER: If I tell you that you are not alone, it is not because I am hoping
that misery likes company, but to make you realize that everyone reading this
column and your letter can remember a similar experience in their lives
We
have all suffered the almost unbearable pain of losing the affections of a
loved one in the manner you describe; yet look around, we are all still here,
and the wounds have healed and become less painful, more bearable
You seek
medication from me as if it could be a magic cure, and that is just not
possible
I dread when my patients become dependent upon chemicals to blunt
the normal emotions and feelings that are a part of daily living
It seems so
easy to “pop a pill” and feel better, but the trap is there; and soon we use
the same way out when an expected job promotion does not materialize, or when
the term paper we labored so long on comes back with a “C” instead of the “A”
we felt we deserved
Living these days takes just a bit of courage, and the
firm belief that things do change and we can make them better if we work at
it
I don’t know how Ann Landers might handle your question, but I suspect
she may share my feelings
You are far from worthless, and if you were here
I’d give you a big hug, hoping that might rekindle your own self esteem, but
the only medication I have to prescribe in your case is “Time”
It has cured
more cases like yours than all the pills on the Pharmacy shelf.

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.

Aceon
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Aceon (Perindopril) is in an ACE inhibitor, used to treat high blood pressure and to prevent heart attack.

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QUESTION: There are several golf courses here in my area where white-tailed
deer roam freely
This is considered an asset and some courses incorporate
that information in their name
An ever increasing number of players and
maintenance personnel have symptoms resembling gout
Deer tick borne Lyme
Disease is endemic in this region
Is there any connection between Lyme
Disease and gout? Please respond by mid-May, start of the deer tick season.

ANSWER: Doesn’t the good golfing season start about the same time in your
area? Humor aside, your question has much merit, and it is important to make
all my readers aware of the facts about Lyme disease
To answer your specific
question, there is no connection between true gout (an arthritic condition due
to crystals derived from high levels of uric acid, being deposited in joints
and tendons) and Lyme disease, EXCEPT for the symptoms! The slow development
of the arthritic like symptoms of Lyme Disease may resemble those of gout, and
so it is important that all are alerted to the possibility of this infectious
disease, passed on by the bite of the deer tick
The history of a tick bite
helps enormously, but frequently the bite goes undetected
The arthritic
symptoms may not develop until weeks after, and if there has been no typical
rash or symptoms that we now know are Lyme related the diagnosis may be
missed
It would well advised for your “gout” sufferers to be rechecked,
keeping the possibility of a Lyme Disease diagnoses in mind.

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.

Zetia
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Zetia (Ezetimibe) is used for treating high blood cholesterol along with a low-fat, low-cholesterol diet.

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QUESTION: I have had severe headaches for some time now, but only recently
was the diagnosis of migraine made
Although I obtain much relief with
medication, I want to reduce their frequency as much as possible
I’ve
learned that for some people foods may provoke attacks, and would like your
advice as to what foods I should avoid.

ANSWER: The obvious answer is to avoid any food that you can relate to the
start of a migraine episode
It takes a bit of thinking, and maintaining a
note book or diary of the events which precede any attack may provide you with
the clues you are looking for
Although the specific foods differ from person
to person, there are some generally accepted types of food and drink which
most experts counsel their patients to avoid
High on the list are alcoholic
beverages, particularly red wines and champagne
Cheeses may get you in
trouble, aged or strong or of the cheddar variety
Stay away from any cured
meats, such as hot dogs, salami or bacon and ham, if you experience an attack
after a meal that includes such products
Pickled herring and chicken livers
also have a bad reputation
You can try black coffee as a beverage when an
attack is beginning, if you are thirsty and not nauseous, as the caffeine may
be helpful in fighting off the episode
Your best bet is to eat well balanced
meals on a regular basis, avoiding fasting or consuming too much carbohydrate
at any meal.

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.

Avodart
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Avodart (Dutasteride) is used to treat symptoms of benign prostatic hyperplasia.

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QUESTION: I suffer from rheumatoid arthritis and am always on the look out
for some new medication or treatment that might help me
Now I have learned
that a cancer treatment is also to be used for cases such as mine, and I would
like to find out the name of the drug and more about it
Can you help out?

ANSWER: Your information is correct
A medication, “methotrexate,” which
originally was approved for treatment of certain types of cancer and is now
used in the treatment of psoriasis as well, has been approved by the Food and
Drug Administration for the treatment of rheumatoid arthritis
But the
indications make it clear that this is not a medication to be used
indiscriminately, but rather in cases that have been unresponsive or
intolerant to other therapies
The medication is given in low doses once a
week to keep side effects to a minimum, but which include nausea, diarrhea and
loss of appetite
Serious side effects are fortunately rare and include
suppression of the production of white and red blood cells
In the studies
which led to the approval, methotrexate therapy reduced joint pain and
swelling as well as morning stiffness and fatigue
Some patients began to
improve in as little as four to six weeks after the treatment was initiated.
I hope you will have the same fine results, should your physician and you
choose to start this new 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.

Ophthacare
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QUESTION: Assuming that all the cells in one’s body die and are replaced
sooner or later, can one say that after thirty years of smoking, a five to
seven year period of not smoking will give one pristine new lungs?

ANSWER: An interesting question, but unfortunately based upon a wrong
assumption
It is true that we replace all our red cells every 100 days, and
that many other body cells die and are replaced in the normal process of
living, but some of the damage inflicted on lungs by thirty years of smoking
can never be repaired
Chronic bronchitis, emphysema and chronic airway
obstructive disease are all possible outcomes of long term cigarette smoking.
Smoke has an adverse effect on lung defenses and provokes a low grade
inflammation which, in turn, leads to the changes in lung anatomy and
function
But I don’t want to take a completely negative approach to your
question
It is true that if lung function is measured by certain tests in
smoking individuals, and then compared to the results of the same test after a
period of smoking abstinence, a notable improvement can be measured
Many of
the symptoms of coughing and shortness of breath also improve considerably, as
the lung cleanses itself and revitalizes after the constant irritation of
smoking is removed
However, if the seeds of cancer have been sown during
your thirty year experience with tobacco, stopping the habit now can not
eradicate the tumor
It is nice to think of our body as being constantly
renewed and repaired, but it is mortal, and with time begins to show the signs
of wear and tear that we inflict upon it
Good health habits allow the body
function at its best, and offer the best hope for a long life.

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
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Avandia (Rosiglitazone) is used to control high blood sugar in patients with type 2 diabetes.

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QUESTION: I have been a sufferer of angina pectoris for several years.
Recently, for the first time my doctor prescribed an ointment of nitroglycerin
to use for my condition
When I decided to spread it carefully over my heart
where it would do the most good, my wife wanted to put it all over my chest,
like some cold medicine
Which is the correct method?

ANSWER: Nitroglycerin absorbed though the skin uses a route of administration
called “transdermal” rather than “oral” or “intravenous”, and can afford you
its benefits for a longer period of time than the “under the tongue” pills or
capsules
In order for it to be absorbed correctly, you must cover an area of
skin that is sufficiently large to do the job, about 6 inches long by 3-6
inches wide
It doesn’t necessarily have to be placed over your heart, for
any place on the chest will work just as well
You might even use the upper
portion of your arm or back (but stay away from skin that is too hairy)
The
ointment will begin to take effect in about 30 minutes and the effects
continue for from six to eight hours
Use the wax paper that comes with the
tube, as it usually has markings that will indicate to you the size of the
area that should be covered
Then attach the wax paper to your skin with
adhesive tape
Try not to get the medication on your fingers since it can be
absorbed from there too, and increase or cause side effects
When you are
ready for the next application, remove the wax paper, wash the skin carefully,
and then apply the next dose to another site on your chest
This will help to
avoid possible skin rashes that can be caused by both the ointment and the
tape
To keep peace in the family you can alternate sites between your heart
area and anywhere else on your chest your wife wishes to place this effective
and important medication for your condition.

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.

Flonase
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QUESTION: I’ve just started a new job, quite different from anything I have
done before, where the noise level of machinery is very loud
It is only a
small shop, and one of the older men who has been there for quite a while
assures me that I will soon be used to it
I don’t want to make any waves,
but do you think I should be thinking of protecting my ears from the sound in
some way?

ANSWER: While taking the advice and counsel of a long time employee usually
makes good sense, this time you are literally asking for trouble
The
probability is quite high that the reason this man has become “used to it” is
that his hearing is already damaged, a condition which is permanent and
without effective treatment
The intensity of sound is measured in decibels,
the faintest sound a human ear can normally hear labeled 0 dB, while normal
speech or the sound of a typewriter or sewing machine measuring about 60 dB.
If you must endure levels of 85 dB or above the chance of hearing lost is
there, and with each increase in sound levels the risk increases dramatically.
The Occupational Safety and Health Administration requires a hearing test for
workers who must labor in environments which average 85 dB or more during an 8
hour work day
If you’re working with shop tools, that level is about 90 dB,
while using a chainsaw or pneumatic drill puts you under a 100 dB load
Work
at this level without protection for your ears is legally limited to but 2
hours a day
If you must stay close to such noise for a longer period of time
each day, hearing protectors in the form of either ear plugs or earmuffs must
be provided to you without cost
These devices, when properly fitted so that
the ear canal is totally blocked, can reduce sound levels by 15 to 30 decibels
and provide you with important protection against hearing loss
It is not a
question of making waves in a new position, but in protecting your valuable
hearing against permanent loss
Proceed diplomatically, but make sure you do
obtain the protection that the law provides and that your ears require.

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.

Calan
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Calan (Verapamil) is used to treat chest pain (angina), high blood pressure or irregular heartbeats.

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QUESTION: Though I have never been told before that I had a murmur of the
heart, at age 78 my physician has now discovered one
He has been very
careful in examining me and taking all types of tests, including a cardiogram,
and now assures me that I have nothing to worry about
I thought that murmurs
were signs of heart disease
Could it be my family physician is just being
gentle with an older man?

ANSWER: Not at all; it sounds like he has taken all the steps necessary to
satisfy both you and himself of the reasons which provoked the sounds he has
detected
Heart murmurs are merely sounds produced by the flow of blood
through the chambers of the heart, and around the valves of the heart which
control the direction of blood flow
When the smooth flow is disturbed by
changes in the structure of the heart or its valves, a turbulence is produced
which generates the sound that can be heard through the stethoscope
Not
every murmur is caused by a serious disease or pathology
Many can occur with
the changes in the heart configuration that age brings on, and are not a cause
for alarm
However, the reassurance that your family physician has offered
you is not based upon chance or speculation, but the test results that can
only be evaluated fully when a complete examination and history have been
accomplished
The changes that affect the sounds your beating heart produces
may occur in the lungs and chest wall as well as your heart, and may be
affected by your posture
Some sounds can be more clearly heard when you are
squatting, or standing, as well as deep inspiration and expiration
It is
only when all possibilities have been explored and carefully considered that a
physician may reassure the patient, as was the situation in your case
He
isn’t just being nice, he has been careful, concerned and professional as
well
You can trust him.

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.

Lozol
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QUESTION: I have a constant pain in my legs, and have used many types of pain
killers, without too much effect
On my last visit, the doctor gave me a new
medication, and assured me it would help, and I do feel better
However, when
one of my friends saw me taking the pills, he showed me that he was taking the
same thing for his nerves, to help make him less depressed
Something is
mixed up here somewhere
Can you straighten us out?

ANSWER: You don’t give me too much to work with in your letter, but there is
just enough for me to make a few realistic assumptions that may help explain
the situation
To begin with, I don’t think there is a mix-up anywhere, you
are just both taking the same medication for two different situations, and it
is a fine medication for both problems
The medication is most probably a
“tricyclic antidepressant”, and since there are a few such drugs available, it
was just chance that you both were taking the same brand
This type of
medication can be very effective in relieving some of the depressive states we
find in medicine
While it may take a week or two for the medication to take
effect, it is one that doctors have been using for some time, and the dosage
can be altered so that the good effects are not marred by unwanted side
effects
Recently we have learned that the same medication has the ability to
relieve pain in some patients, whether or not they are depressed as well
One
of the conditions it works particularly well for is the pain of “diabetic
peripheral neuropathy”, a nerve pain in the legs, for instance, seen in
patients suffering from diabetes
And I’ll bet that is what you have
As I
see it, you are both doing well, and that is the main concern
Of course you
know I don’t think that comparing medications is always the wisest thing to
do, and I am a real tiger when I hear of people sharing prescription
medications without proper supervision
I hope you both continue to do 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.

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