Health information

QUESTION: My father suffers from severe Parkinson’s and so I make every
attempt to keep up with the latest developments in treating the illness
I
have read that a new operation is now available that can cure the illness
available in Mexico
Do you know anything about this, and where I can take my
father for treatment?

ANSWER: Yes, I know of the operation, and unfortunately, can not encourage
you about its use in treating your father
Almost two years ago, an operation
which used tissue transplanted from the patient’s own adrenal gland into the
brain was reported as producing remarkable improvement in the condition of the
two Parkinson patients who were the first patients to have this procedure
performed
This surgery took place in Mexico
In the past two years, over
100 such operations were performed by neurosurgeons in the United States.
Their results, as reported at the most recent meeting of the American Academy
of Neurology in Chicago, did not confirm the results as originally reported.
While some patients did do well, the improvement was not as dramatic as
described in the first patients
In addition there were many complications
after surgery, including confusion and disorientation, and the ability of
anti-Parkinson’s medication to control symptoms was reduced
When all of this
became known The American Academy of Neurology issued a position statement
that urged “great caution” in expanding the use of this operation until
further careful and complete research could be accomplished
There has never
been any claims of a “cure” for the procedure, and the results have been a
mild to moderate improvement when it has worked
Since this is not true in
every case, and in view of the high risks involved, I can not recommend it to
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.

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QUESTION: With my eyes tearing and red, and a full nose that won’t stop
dripping, I am into the earliest attack of hay fever I have ever had
Why am
I affected so much by this condition, where does it come from, and what can I
do to rid myself of this crummy situation?

ANSWER: You know by this time I am sure that it is not hay that causes your
problems, but the very air you breathe
As the flowers bloom, so is pollen
produced, wafted on the balmy breezes right into your sensitive system
When
pollens that you are allergic to come in contact with the tissues of your
nasal passage, antibodies are produced in response to the allergens contained
in the pollen
When antibodies come in contact with immune cells, a substance
called histamine is produced which causes the capillaries in your tissues to
swell (congestion), producing the all too familiar symptoms that come with an
attack of allergic rhinitis or hay fever; sneezing runny and stuffed noses, as
well as red and tearing eyes, and often an intense itch
Seasonal allergies
may first be noted in early childhood, but the condition continues throughout
life for those that are affected
When the condition first appears during
summer months it is usually due to grass pollens, such as timothy and sweet
vernal, while the autumn variety results from weed pollens such as ragweed.
The early or spring type that you seem to be suffering from is due to pollens
produced by trees such as oak, elm, alder, birch, cottonwood and maple
The
treatments for any allergic rhinitis uses antihistamines, decongestants, or
combinations of both
There are many over-the-counter preparations which
should help
If one doesn’t work, try another; for they have different
formulas, and affect people in different ways
If you cannot obtain the
relief you seek using these medications, it may be time for you to undergo a
complete allergy testing to identify the exact source of your discomfort,
followed by a series of allergy injections to desensitize your system
By the
time next pollen season rolls around, you could be in a better situation,
without a yearly battle which you seem to be losing.

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 am thoroughly confused
What I thought would be a simple yearly
examination has now led to a diagnosis of a hiatus hernia
I had no symptoms,
and don’t really understand about a hernia in my chest
Can you help me out?

ANSWER: That is what annual examinations are for, to discover unsuspected
conditions and deal with them before they advance too far
It isn’t unusual
for a hiatal (or “hiatus”, both terms are equally correct) hernia to be
silent, without any symptoms or complaints from the patient
Let’s look at
some definitions to help clear up your lack of understanding and to deal with
your evident anxiety
Whenever an organ pushes through a wall of the body
cavity that encloses it, it is called a hernia
In men, the common use of the
term refers to the pushing of intestinal contents through the abdominal wall
into the scrotal sac
In a hiatal hernia, the stomach is pushing through the
diaphragm, a sheet of muscle that separates the abdominal cavity from the
chest cavity
In general use, a “hiatus” means a gap, cleft or opening, and
there is such an opening in the diaphragm that permits the esophagus to pass
through from the chest cavity to attach to the stomach, in the abdominal
cavity
This opening has become enlarged, probably by an increased pressure
within the abdominal cavity that may have been provoked by chronic coughing,
straining, sudden physical activity, pregnancy, obesity or as a result of some
trauma
Hiatus hernias occur in people of all ages and both sexes
Most
usually it seen in middle age and small hernias can be discovered in most
people over the age of 50
In many cases the cause is not clear, but that
doesn’t effect the type of therapy needed; as for most asymptomatic cases,
like yours, there is no treatment necessary for as long as there are no
complaints
It is unnecessary to change your diet, work or play habits or
activity
You should be alert, however, to any changes that may occur; and if
new symptoms develop, consult your physician promptly.

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: My physician suggested that I follow the seven simple guidelines to
a healthy diet, which I said I would do
But he never told me what they were
and I didn’t ask
Do you know what they are?

ANSWER: Of course, and I am happy to pass them on to you and my other
readers.
1: Eat a variety of foods
Include fruits and vegetables, whole
cereals, lean meats, poultry, fish, peas and beans and low fat dairy products.

2: Maintain desirable weight.

3: Avoid too much fat, saturated fat and cholesterol.

4: Eat foods with adequate starch and fiber.

5: Avoid too much sugar.

6: Avoid too much sodium.

7: If you drink alcoholic beverages, do so only in moderation.

They may sound easy and they are, and your health will profit
immeasurably if you follow these guidelines.

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: We are most concerned about our newborn grandson and a condition
called “Hypospadias”
Our daughter is so distressed that she will not discuss
this with us, and we hope you will help us by telling us something about the
condition and if our grandson can ever be a normal person?

ANSWER: I can understand your distress as well as that of your daughter, but
the news is not all that bad
Hypospadias is a congenital defect that occurs
rather commonly in male babies, affecting about one in 300 live born male
infants
The defect affects the urethra, the tube that leads from the bladder
through the penis, and carries the urine out of the body
In cases of
hypospadias the development of this tube is incomplete, and it does not extend
the full length of the penis, ending in an opening which is located somewhere
along the underside of the shaft of the penis
Usually there are no other
abnormalities of the urinary system associated with this condition, which is
easily discovered during the baby’s first examination
Although at one time
in the past, surgical correction was performed only on the most severe cases,
new improvements both in pediatric surgical techniques as well as anesthesia
permit surgeons to correct almost all cases of hypospadias
The operation is
usually performed before the child is old enough to retain any memories of the
experience, yet mature enough to safely undergo the procedure
Most surgery
is therefore performed when the child is between 6 and 9 months of age
The
children do not seem to experience a great deal of discomfort and with new
techniques, a fully functioning penis is constructed that has a completely
normal appearance
Complications of the surgery are rare and the surgery may
be performed as either an outpatient or with but a single night’s stay at the
hospital
You and your family all need one another now for the moral and
emotional support that will provide you with the patience necessary to await
the best moment to schedule the operation, after which much of your personal
anguish and anxiety can be put behind 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.

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QUESTION: I was diagnosed by my physician approximately six months ago with a
blood disorder referred to as idiopathic thrombocytopenia purpura (ITP)
I’ve
been unable to find sufficient reading material regarding this disease
Any
information would be helpful
I am currently in remission.

ANSWER: Whenever faced with these gigantic medical terms, we can learn a bit
by explaining them piece by piece
Let’s start at the end
A “purpura” is a
purple or reddish brown discoloration seen through the skin, caused by blood
hemorrhaging into the tissues
In ITP the thrombocytes (platelets), which are
an important part of the clotting mechanism that controls such bleeding, are
not present in the blood in normal amounts
Any medical term which ends in
“penia” means that there is an abnormal reduction in numbers, for “penia”
comes from the Greek term meaning “poverty”
“Idiopathic” means that the
disease (or pathology) has a spontaneous origin, or more literally an unknown
cause
The fact is that much is now known about ITP, and that the reason the
platelets (or thrombocytes) are few in number is that they are being destroyed
by an immune factor (antibody)
Thus we now call the disease “Autoimmune
Thrombocytopenia Purpura” (ATP) or by an older name, Werlhof’s Disease
In
one of those interesting stories that makes medicine so fascinating, in 1951
an American hematologist, William Harrington, who believed there was an
immunological explanation for the disease, injected himself with plasma from a
patient and developed the disease himself
A good deal of research is going
on to explain all the mechanisms of the disease, and it can be treated with
large doses of corticosteroid (cortisone-like medication), as well as other
medications, with great success
When medications fail to produce the desired
results, splenectomy, or removal of the spleen, may be considered
Now that
you have some new insight, and a few more terms to search for, I hope your
reading will be more rewarding
The fact that you are currently in remission
is an excellent sign, but as you have probably been told, does not represent a
permanent state.

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: For about a year, on and off, I get a rash that itches and my skin
is real tender around my waist, between my busts, around my bra and back
I
have changed the soap I wash clothes with, taken showers without soap, rubbed
it with caladryl baby lotion; but nothing makes it go away
Is there anything
you can write in your column that can help me?

ANSWER: I’ll certainly try, although dealing with skin problems without
actually seeing the rash is not the easiest thing to do
From the areas of
your body in which the rash appears, and the failure of the types of remedies
you have attempted, my first thought is that your condition might be a type of
dermatitis know as “intertrigo”
This rash develops in the folds of the skin
where the surfaces may rub together, and where the openings of the skin pores
are covered
Such a condition leads to the breaking down of the cells the lie
on the surface of the skins (a process called “maceration”), and an irritation
that provokes redness, tenderness and itching
To further complicate matters,
an infection by bacteria or a fungus may occur
This skin problem is most
common in obese individuals who live in hot climates that provoke constant
perspiration
There are several steps you may take to rid yourself of this
annoyance
First, use an antiseptic soap during your shower to help combat
any possible infection
You must dry your self thoroughly, taking care to
blot away all the moisture that may remain deep in skin folds
The careful
use of a hair dryer, on its lowest heat setting can be helpful, but never set
it to hot or use it too close to the skin, as that may cause burning
If the
infection persists, delaying the healing of the skin, you may have to resort
to a prescription cream that contains an appropriate antibiotic or antifungal
agent
With any luck the problem should clear up in just a few days, and the
secret to preventing its reoccurrence is keeping the skin as dry as possible
in the areas of irritation.

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 have suffered since childhood with repeated infections of my gums
and tongue
Although I have had excellent dental care, the condition keeps
coming back
I recently visited a hematologist who felt that my problem could
be related to “lazy white blood cells”, and that the condition was not
serious, just something to live with
Can you amplify on that explanation?

ANSWER: Only with some difficulty, as you have not provided me too much to
work with
I have focused in on the word “lazy” and discovered an antiquated
syndrome called the “Lazy Leukocyte Syndrome”
First described in 1971 in an
article by Dr
M.E
Miller published in the British medical journal LANCET, it
described white blood cells, “leukocytes”, that failed to function in normal
fashion
Rather than attacking foreign poisons in the system, they moved
about in random fashion, and did not respond to the stimulus of the chemicals
that could present a threat to the body
As a result, patients suffered from
recurring infections of mouth and gums (stomatitis and gingivitis)
Both men
and women seemed affected in about equal numbers and the condition often
started in early childhood
No treatment is noted
Of late we have
discovered the presence of a substance, “Leukocyte Inhibitory Factor” (LIF),
which may be the chemical which causes the neutrophils to desert their
responsibilities in defending our bodies against toxic invaders
A physician
who specializes in Immunology might be able to afford you additional
explanations, if you do, in fact, have this unusual syndrome.

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: When an itchy rash suddenly appeared on my body, I thought it was
poison ivy, and that daily washing and a little patience would see me through.
However, when it didn’t fade I consulted my doctor, who told me I have a skin
disease called “lichen planus”
He is now treating me with lots of
medication, but I still don’t know where this came from or whether it will
ever leave
Please help by discussing this disease.

ANSWER: I am afraid there is not much known about the causes of this
condition, although it does seem to appear more frequently in spring and
summer
The itchy, irregular skin lesions may well be confused with poison
ivy, for it may often appear most on the arms and legs; but since it may also
appear on portions of the body that are covered and protected from contact
with the leaves of the plant, and since the rash does not follow the course of
the ivy induced rash, it is relatively easy to tell them apart
The lesions
may also appear on the inner lining of the cheeks, in the mouth and on the
lips, gum and tongue
This happens in just about half the cases
You may
notice that if you injure your skin covering any part of your body, a rash
similar to the ones you now have will appear
This is called an “isomorphic
reaction” and is typical of lichen planus
There are some drugs that are
associated with the appearance of these skin eruptions, and include arsenic,
antimalarial agents, beta-adrenergic blockers, thiacide diuretics and gold
salts
Be sure to mention any medications you may be taking to your
physician
Treatment may include the use of some strong corticosteroid creams
or ointments or oral griseofulvin
Whatever therapy your physician has
chosen, it may be a while before all the lesions are gone
About 50% of
patients on therapy clear in about 9 months, and by 18 months, 85% of the
patients are rid of the rash
Patients who experienced sudden onset of the
lesions as you did generally have more symptoms, but also tend to recover more
rapidly as well
I hope you will be amongst the lucky ones.

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: When we look around our retirement community, it is apparent that
women must be stronger in some ways, for there are many more women here than
men
Yet all our men were hard workers, and most of them were big strong men.
Is there any medical explanation for the reason women outlive their husbands
so much of the time?

ANSWER: Your observations that more women survive their husbands is correct,
and your community is not the only one in which that is true
Over the age of
65, the ratio of widows to widowers is about 4 to 1
Despite the fact that
more boy babies are born, about 106 to 100 girls, by the age of 75 there three
women to every two men left living
To try and find the reasons for this we
must look at three factors
Are there any differences in the makeup of the
genes carried by men and women, the influence of hormones during life, and the
types of life styles and environments that men and women live in
To date,
studies of the molecular make up of genes have failed to reveal any
differences to account for the advantage in life span that women seem to
possess
Research is ongoing in this area, for it still seems likely that
part of the answer may lie here
Since male and female hormones differ, the
effect they play in the metabolism of cholesterol and resulting development of
atherosclerosis and heart disease is more rewarding, and the reduced
probability of developing coronary artery disease in women is certainly part
of the answer
Smoking was once a factor, and lung cancer was thought to be a
man’s disease, until women in large numbers took up this habit
As many as 7
years of the difference in life expectancy may have been lost by men due to
the effects of tobacco
Work related accidents, deaths due to car accidents,
suicide and homicide all take a greater toll of males as compared to females,
so that more women survive the years prior to retirement
However as age
progresses the gap diminishes, and by age 85, the life expectancy of women is
but 1 year longer than men
Hopefully, new knowledge of heart disease
prevention and smoking cessation will continue to narrow the differences in
life expectancy between men and women.

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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