Health information

QUESTION: It seemed like such a good idea
While visiting my son in
Minnesota, he invited me to take a brisk walk before washing up for supper.
The evening was cold, with snow on the ground, but good footing along the
road
We hadn’t made a half mile before I experienced a tightness in my
chest, a dry cough and wheezing
I could barely breathe
The rapid trip to
an emergency room convinced all that it wasn’t a heart attack
When I
returned home to Florida, I rushed home one evening walking further and faster
than in Minnesota, and nothing happened
There has got to be a logical
explanation
Do you know what it might be?

ANSWER: With the data you provide, and the fact that you have been cleared of
any cardiac problems, my best guess is that you suffered an attack of exercise
induced asthma, provoked by the cold climate that seems to be the important
element in your case
It’s probably a common enough condition, and can be
diagnosed with a pulmonary function test and a better history and examination
than is available to me
The asthma-like attack is caused when the
bronchioles, or small tubes that carry the air to and from the lungs, contract
because of irritation or reaction to substances to which they are sensitive.
In the case of exercising, even a brisk walk in the snow, it is possible that
the dry air you were breathing in dehydrated the airways and caused them to
contract
When you performed the same activity in the warm and moist air of
your home town, the factors that caused the attack previously were absent, and
so no attack
Because this is but one answer to an interesting medical
situation, I strongly advise a thorough overhaul, with special attention to
your past history and the necessary tests to establish the performance
patterns of your lungs.

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: There is no longer much question amongst women athletes that our
normal menstrual cycles are affected by the physical training we go through.
My question is why does it happen, and I am at risk for any other unwanted
illness? Last but not least, have you any suggestions for dealing with the
problem?

ANSWER: The problem certainly is a real one, and affects young women who have
never had a child most often
The condition can range from irregularity to
abnormal bleeding to complete absence of a menstrual period
It also appears
that the intensity of the training and the severity of the abnormality may
also be linked
The culprit seems to be the hypothalamus, a part of the brain
responsible for producing gonadotropin releasing hormone (GnRH), which in turn
affects the hormones that regulate a woman’s normal cycle
During intense
exercise the body produces chemicals called “endogenous opiates” (part of the
reason some athletes get a “high” from their activity) which reduce the
production of GnRH and arrests the cycle
When this occurs it’s called
“exercise-induced amenorrhea”
Women with this problem have lower bone mass,
and their bone density can closely resemble the situation seen in
postmenopausal women
Stress fractures may result sometimes occurring in the
pelvic and lumbosacral bones
You won’t like my advice much, for good sense
requires that the training schedule must be modified and reduced
Smoking is
an absolute no-no, as it too has an antiestrogenic effect
Some researchers
are trying an estrogen replacement therapy in women athletes who just won’t
change their preparation schedules or training programs
Currently available
results of medical research just doesn’t have all the answers, and I suspect
the ones I do have now are not quite what you hoped they would be.

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: You always mention exercise as part of the programs that lead to
better health, but you forget that many of your readers suffer with severe
arthritis and can’t follow your advice
In spite of constant medication and
moving to a new and warmer climate, my old joints just can’t take the stress.
What are people like me supposed to do?

ANSWER: You might find your answer in the latest edition of “Arthritis
Today,” the publication of the Arthritis Foundation
They are convinced that
people with arthritis not only can participate in an exercise program, but
should
It may be that you need a special program that takes heed of your
problems, and provides just the right amount of activity that will help you.
They have developed a new program, “People with Arthritis Can Exercise,” also
called PACE, that may provide the answer you are seeking
The program is
divided into two levels
The Basic program or Level 1 is designed for people
with severe joint disease, people who may need walkers or even wheelchairs to
get about
Level 2 or Advanced is useful for those whose problems are less
severe, but who tire easily
In both programs you can be helped to develop
greater flexibility and ease of movement
They also sponsor another program
called the Arthritis Aquatic Program
This is conducted in a heated pool
under the watchful eye of specially trained individuals
Neither of these
programs are to be confused with range of motion or strengthening exercises
which may be prescribed by your doctor, but they add a new dimension to
activity for arthritis patients and they sound like fun
To find out which
program may be available in your area, contact your local chapter of the
Arthritis Foundation or write to the national office, Arthritis Foundation,
P.O
Box 19000, Atlanta, Georgia 30326, and request their brochure entitled
“Exercise and Your Arthritis”
You may soon be able to join with all the
others who take my advice and make exercise a part of their plan for healthy
living.

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 a long time sufferer from diabetes, with the result that my
vision is beginning to fail
I was referred to an eye doctor, who suggests
that he may be able to help with a new operation that uses a laser beam to fix
the blood vessels in my eye
Is this an experimental procedure, and how does
it work to fix the problem?

ANSWER: The use of lasers in eye surgery is no longer considered
experimental, but is one of the most important advances in this field that has
occurred in the past ten years
Because laser beams are really just powerful
beams of concentrated light, and the eye ball is filled with transparent
material that allows the laser beam through, there are now many new techniques
in eye surgery that make use of laser beam surgery
Your case, called
“diabetic retinopathy,” can be helped but not cured using this procedure
In
diabetic retinopathy, two problems may be occurring
In one type of this
complication of diabetes, new vessels grow on the surface of the retina which
can hemorrhage and create scars that destroy the cells that detect light and
provide vision
If this is the case, your physician will be able to destroy
these blood vessels before they can cause any more damage
In another form of
the disease, small blood vessels located in the retina may leak, once again
causing scars that destroy vision
With the laser beam, the doctor seals
these leaks, and further deterioration of vision is prevented
While new
sight is not created by this process, your loss of vision is limited, and with
regular eye examinations and repeated procedures if necessary, can be kept to
a minimum
The procedure is a simple one in expert hands, and does not
require lengthy hospitalization
Your situation helps to emphasize that all
chronic diabetic patients should have regular vision examinations to prevent
vision loss, now that we have these new and effective treatments.

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 condition, fibrositis, still seems confusing to me and very
difficult to deal with
Perhaps you can offer some new insight
What is the
difference between it and fibromyalgia? Are there any treatments that give
relief? Please give me all the help you can.

ANSWER: A confusing disease indeed, even its name can cause confusion.
Fibrositis and fibromyalgia are the same disease (also know as Myofascial Pain
Syndrome)
The term fibromyalgia (meaning muscle pain) is now preferred, for
there is no inflammatory process (”itis”) seen in this syndrome
It is
classified as a rheumatic disorder that can cause pain, tenderness and
stiffness in muscles and tendons at specific “trigger points” that are
distributed over the back of the neck and shoulders, the sides of the breast
bone and the bony points of the elbows and hips
In addition there are a
whole flock of nonrheumatic symptoms to complicate the patient’s life; poor
sleep, anxiety, fatigue and even irritable bowel symptoms
While this
confusing syndrome makes accurate studies hard to find, it is estimated that
as many as 10 million Americans may suffer from the condition
It is most
common in women and occurs between the ages of 35 and 60
Since there is no
cure, I can list the types of treatment that may offer you some relief, over
and above the use of analgesics such as aspirin or NSAIDs such as ibuprofen.
They include both ice packs and heat treatments, relaxation techniques, stress
management, biofeedback and stretching exercises
Low doses of tricyclic
drugs at bedtime may help sleep problems and reduce pain
A tender point may
be injected locally with a 1% lidocaine solution in combination with a 40 mg
hydrocortisone acetate suspension
Your prognosis may be favorable utilizing
a comprehensive, supportive program along with your physician’s advice.

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 panic stricken
I am pregnant and my other child has broken
out with a rash, diagnosed as “Fifth Disease”
My doctor fears that I may
catch the same infection, with serious effects to my unborn baby
Can I pass
anything on if I don’t become infected? What are the risks to my baby? Do
you have any information to help me?

ANSWER: Your concerns are shared by an ever increasing number of expectant
mothers whose youngsters come down with Fifth Disease (or as some would have
it, “Erythema Infectiosum”)
The cause of this viral disease is a human
parvovirus B19, only recently discovered (in 1975) and subsequently identified
as the primary infectious agent in this disease
The data necessary to answer
your questions is only now being developed, but there are a few general facts
I can offer
If you have had or been exposed to this disease as a child, and
most adults have, it is doubtful that you can contract the disease a second
time
At present the tests necessary to determine your state of immunity are
only available at a few research laboratories, but your physician may be able
to obtain one for you
If you don’t have the disease now while you are
pregnant, there is no chance that your baby will be affected
There is no
vaccine to prevent B19 infection, and there have been no studies to evaluate
the use of immune globulin injections to prevent infections or modify the
course of illness, and routine use of this injection in cases such as yours is
not recommended
There is reason to be optimistic, though, as published
reports on the outcomes of pregnancy for pregnant women who DO become infected
with B19 virus seem to indicate that if this disease does affect unborn
babies, it does so infrequently
Thus it would seem you are a long way from
having to consider any dire outcomes to this 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 a co-worker burps or feels queasy, she claims it is a
serious case of “gastritis”
When we suggest that it is just gas or
indigestion, she insists that it is a disease she has suffered with from
childhood
We have all checked our home medical advisors, but can’t agree on
a diagnosis for her
Can you define her gastritis for us?

ANSWER: Probably not
The term is used in medicine to mean many things
depending upon your specialty and point of view
Technically the definition
of gastritis is “an inflammation of the gastric mucosa” or stomach lining.
However, radiologists evaluating x-rays use the term to diagnose certain
changes observable in their pictures
A pathologist would use the findings
seen in tissue samples, and a gastroenterologist would base his usage on
appearances seen through his gastroscope
I can’t make a better diagnosis
than you without a lot more information, and guess I would just call it “an
upset stomach” that apparently is upsetting a whole office staff.

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: Please don’t laugh at my question
I assure you it really happened
and almost made me pass out
While passing my water I noticed that my urine
was definitely a green color
I have no other symptoms, and it only happened
once more after that but the color was less intense
Do I have anything to
worry about? Will it happen again?

ANSWER: If it has disappeared without any other symptoms or complaints, you
most probably are out of danger
You probably never had anything too serious
to worry about anyway
The most common reason for green urine is the result
of something you have eaten or ingested
Chlorophyll containing breath mints
when taken in large quantities are a frequent cause
There are a number of
other substances in common medications that may also provoke a green color;
guaiacol contained in many cough medicines, magnesium salicylate in Doan’s
Pills, and thymol, an ingredient in Listerine mouth wash
The most serious
cause of green tinted urine occurs from an infection caused by pseudomonas in
the urine
The pus may contain a pigment, pyocyanic, which causes the green
color
Methylene blue used in some medical tests and treatments, when
combined with the normal yellow color of urine, produces a green color as
well
Now it’s up to you to think back over the circumstances which preceded
your colorful experience, and try to determine which of these possible causes
might have been the reason in your case
If you don’t repeat the experience,
your green urine days are over.

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 daughter, now 11 years old, has complained constantly about
pains in her legs over the past several months
I have taken her to the
doctor who gave her a complete examination, including x-rays and blood tests,
but could find nothing
He finally described the problem as “growing pains”.
Is there any treatment for this or may I hope that it will disappear by itself
as she grows older?

ANSWER: It appears as though your doctor has given this problem the attention
it deserves, for the diagnosis of “growing pains” is only made when the other
possible reasons for the complaint have been investigated and no evidence of
any of the other causes for pain could be found
The term is used for a
condition of benign, recurrent limb pain that may be the complaint of young
children, boys or girls, and probably has nothing to do with the actual
physical process of growing up
The pains may come on at any time, but seem
to occur most frequently in the evening or at night
Usually they are located
in the thighs or calves, and the pains leave after an hour or two
The
children are otherwise healthy, and the laboratory test as well as x-rays are
always normal
Frequently there is a history of similar experiences during
childhood in other members of the family
Some experts in this area believe
that this process is due to the emotional growth of the children, and warn
that evidence of emotional disturbances may be common
I believe you must
continue to support your daughter in an understanding and open manner,
continue to watch her closely, and react if other symptoms appear
The most
likely course is that the complaints and the pains will all disappear in time,
with no lasting health affects remaining
Use a lot of love and a little
patience; they are great medicines for any situation in young, growing
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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QUESTION: My young teenage son is having a terrible time because he is
developing breasts
He refuses to take gym at school because he does not wish
to disrobe and have the other boys make fun of him
We are more concerned
that this may be the sign of a serious disease
Can you help us?

ANSWER: Although you do not mention your son’s age in your letter, I am
willing to wager he is between 13 and 14 years of age, a time of puberty when
almost 40% of normal boys undergo some degree of breast development
It may
not be as evident in others as in the case of your son, but can be discovered
by careful palpation during the course of a physical examination
While the
reasons for this growth is not clear, it probably results from a temporary
imbalance between the male and female hormones which normally exist in all of
us
The medical term applied to this diagnosis is “pubertal gynecomastia” and
it is a totally benign condition
Usually it will resolve by itself within a
few months, although in rare cases it can take longer
Since there are many
causes of gynecomastia, and in view of your son’s problem at school, he is
entitled to a complete physical and history to verify my impressions
Your
family doctor can then explain the condition to him and offer the reassurance
that I believe will be forthcoming
With this reassurance and new
understanding, your son will be able to deal with his own inner fears.
Perhaps a note from the doctor can relieve your son of gym classes until the
situation returns to normal.

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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