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QUESTION: I thought that croup was a simple condition seen in children, but
my doctor gave me a long lesson on something called “Croup Syndrome”
Now I
am more confused than ever
Can you please help?

ANSWER: Croup syndrome is a term for four respiratory diseases of which occur
frequently in children: spasmodic croup, laryngotracheobronchitis (LTB),
bacterial tracheitis, and epiglottitis
The leading symptom in all of these
diseases is a harsh, barking cough
Although most cases of croup syndrome are
mild and can be treated at home, it can be life-threatening if the airway
becomes swollen and blocked.
The most common form of croup is LTB, which is seen most frequently in
children between a few months and 3 years old
The cough starts gradually,
often after a mild respiratory infection
The child may run a fever and
become short of breath
Breathing may be accompanied by a harsh high-pitched
noise
Bacterial tracheitis is similar to LTB, with a high fever and onset
after a respiratory infection
Spasmodic croup is sudden in onset
The child
wakes up in the night with a harsh barking cough, but has no fever and had no
previous infection.
The most severe type of croup syndrome is epiglottitis
It is a rare but
life threatening infection of the epiglottis, the little flap of tissue that
closes off the respiratory system when food is swallowed
A swollen
epiglottis in a child’s small throat can easily cause suffocation.
Mild croup syndrome can be treated at home using humidity
If you don’t
have a humidifier or nebulizer, another quick way to provide humid air when
your child starts coughing harshly is get into the bathroom, close the door,
and start running hot water in the shower and sink so the room steams up.
Have the child sit up quietly on your lap
If breathing is still difficult
after a few minutes, take the child to the hospital.

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: An injury to my knee has left me confused and crippled
All I can
gather from my doctor’s explanation is that I need more tests to find out how
badly my “cruciate” is damaged, and that it may take surgery to get me back up
and running
I need more information to make a good decision, can you please
provide it for me?

ANSWER: From the information you have provided, I can gather that you have
sustained an injury to one of the two ligaments that help support the function
of the knee the “cruciates” (from the Latin meaning “shaped like a cross”).
However it is not clear which ligament you have injured, the anterior or the
posterior, and that diagnosis is sometimes difficult to make after an
examination
When the anterior cruciate ligament is injured there is an
immediate swelling of the knee, pain to the back of the knee and varying
degrees of joint instability sufficient to make you cease you activity
In
the case of a posterior injury, which may be caused by a fall on the knee or a
blow to the front of the leg, while there is pain, swelling may be slow to
develop, and the injury will not make you stop your activity
Physical
examination may lead to a correct diagnosis, but standard x-rays may not show
too much
Magnetic resonance imaging (MRI) may be helpful in determining the
extent of the injury or tear to the ligament, but in most cases, where there
is much instability, it will take arthroscopy to determine the exact extent of
the injury to the ligaments, as well as to the other components of this
vulnerable joint
Using a telescope-like instrument, which is inserted into
the knee space through a small incision, the surgeon can inspect the
ligaments, cartilage, bone and other tissues
When the ligament is severely
torn, reconstructive surgery can be used to both repair the damage and restore
full function and stability to the joint
This may be the plan of your
physician when indicates that more tests and surgery is necessary in your
case.

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 a brief run to the grocery for some provisions, I returned
home and entered the kitchen, when suddenly I had the weird feeling that I was
repeating actions I had lived before
No matter what I did, it seemed that it
happened before
I thought I was losing my mind
Do you know if there is any
medical explanation for this experience? I need some reassurances.

ANSWER: If this was the first time you have experienced the sensation that
all you were doing had happened before, it can be a truly eerie feeling
But
the fact is, experts estimate that almost two thirds of all adults have gone
through this experience at one time or another
It is known as “deja vu”,
from the French words meaning “already seen”
Though it may seem a bit
frightening at first, it is not a symptom of any underlying illness, and you
are most certainly not losing your mind
No one knows for sure just what sets
off this type of experience, but there are a lot of very interesting theories
and much speculation
One theory is that the electrical impulses in the part
of the brain dealing with memory and familiarity suddenly fire off
spontaneously and make you think that you are experiencing something over
again
Another explanation that relates to brain function suggests that one
side of the brain is aware of an experience just fractions of a second before
the other side receives its stimuli, which then thinks it is “reexperiencing”
it
Frequently familiar smells and odors, of baking or cooking for example,
can set off old memories of days past, and make you think that today’s doings
are just repeats of remembered activity
What ever the cause, it is clear
that it is not an experience that should cause you any concern.

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: During the last month I have heard of three people who are
suffering from depression
It seems as this is a new epidemic that was not
common in my day
What type of thinking can make people get this way, and is
there any way to treat it?

ANSWER: The problem is indeed a common one, and some statistics suggest that
as many as 6 to 10 percent of people visiting their personal physicians may be
affected
If you wish to consider those with but mild symptoms of sadness,
disinterest or lack of pleasure in daily activity, then the number is greater
still
Depression can result from any chronic or severe illness, and is a
common reaction to stress and disability
The American Psychiatric
Association lists six types of depressive illness that range from a mild form
to a most severe type that includes psychotic features
But there are some
types of thinking or “psychological risk factors” that may increase a person’s
vulnerability to depression and can make the episode last longer and be more
profound
People who are low in self esteem may experience a temporary
depressive mood when criticized or insulted
When a emotional loss has been
suppressed and not allowed to pass through the process of grief, the person
becomes sensitized to loss or rejection or the withdrawal of approval by
coworkers and family
Individuals who have difficulty in socializing and are
lonely are at greater risk
Some people are poor problem-solvers, and their
feelings of helplessness in the face of difficult situations can lead to
depression
Individuals who are unduly anxious, and who magnify or who can
not forget their own mistakes, may fall prey to depression
But a great deal
can be done to assist these people, and help them work their way through these
depressive attacks
For mild depression, a few sessions of psychotherapy may
be enough to identify the issue and help work towards overcoming the problem.
When this fails or when the depression is more severe, the use of medication,
antidepressants or antianxiety agents, can be most helpful
However, whenever
thoughts of suicide form part of the depression, psychiatric help and care is
a must, if tragedy is to be averted.

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: Another puzzler for your seemingly inexhaustible knowledge of
medical trivia
Have you ever heard of “Deutschland” disease? Does the name
imply that it is a condition found mostly in Germans? I have a personal
reason for asking this question but my own research has been totally
unsuccessful
Can you help?

ANSWER: This condition is not named after the country or its inhabitants but
the doctor, Dr
C.W
Deutschlander, who first described the ailment in 1921.
Also known as “March Foot” or “March Fracture,” it is a stress fracture of the
second or third metatarsal, with the formation of a bone callus around the
fracture
Its symptoms are a mild, persistent pain in the foot which comes on
after walking or running
There is tenderness on the bottom of the foot and a
lump can be felt in the area of the fracture
A period of rest can help but
check your running shoes (yes?) for fit and change the brand if necessary
I
suspect you are already under proper medical care, and strongly advise that
you follow your physician’s instructions to the letter
Your prognosis is
excellent if you give your foot a much deserved rest.

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 girl friend who constantly shows up at work with bruises on her
arms claims it is a serious condition known as “Devil’s Pinches”
Is there
any cure known for this condition, and where does it come from?

ANSWER: Your girl friend is not telling all
Devil’s pinches are also known
as “factitious purpura” and are bruises, often painful, which seem to recur
over and over again
If you look up the word “factitious” (don’t bother, I
did it for you), you will find it defined as “artificial, not natural” and the
word is used in medicine to describe wounds, bruises or rashes that are self
inflicted
To be fair to your girlfriend, she may be unaware that she is
causing these bruises by her own actions
The diagnosis can be put to the
test by covering an area where bruising is now occurring with a plaster cast,
and finding no bruises there when the cast is removed after a time, though
unprotected areas still show the marks
Blood tests are all normal in these
cases which are difficult to treat, requiring psychotherapy, since the patient
may convert to another type of activity, once the cause of these bruises is
revealed.

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 just gone through a frightening episode with my husband that
I don’t want to see again
He suffers from diabetes, and suddenly he
developed an infection in his foot that was very difficult to cure
He is
better now, but we would like to know any tips you may have that could help us
to prevent this from happening again
I am certain there are many other
readers of your column that could use this information as well.

ANSWER: Your problems were not unique, for it is estimated that of the more
than 12 million people with diabetes in this country, more than 25 percent
will develop some type of severe foot or leg problem during their lifetime.
In fact, the seriousness of the situation can be shown by the fact that about
two thirds of all the amputations not resulting from accident or trauma befall
diabetics, resulting in about 40,000 amputations yearly
About 20 percent of
all hospitalizations for those suffering from diabetes are due to foot
infections, resulting in more hospital days than for any other complication of
the disease
So it makes good sense to spend a bit of time in foot care to
prevent these terrible problems
A few tips are just plain common sense.
Don’t walk about without slippers or shoes on, for a bare foot is one that is
easily injured by anything lying in your path
Don’t cut off precious
circulation to the feet by wearing tight shoes or garters
And don’t cross
your legs while sitting, for that too can reduce blood flow
While bathing
feet daily in warm (not hot) water is a fine idea for cleanliness’ sake,
soaking feet for long periods of time (unless upon doctor’s advice) is a bad
idea that can be made worse if the feet are not carefully dried after each
bath
Make sure toenails are trimmed neatly, but don’t take a chance of
cutting yourself by trimming your own corns or calluses
Change socks daily,
wear clean cotton or wool socks that you have checked carefully for the
presence of any holes
Holes, even darned ones, create rough edges that can
lead to irritation and then infection, so it is best to discard any that have
seen better days
And as if I haven’t said this before, do not smoke, as
smoking reduces the circulation of blood to your feet
A little time in
checking your feet each day, reporting any changes to your doctor, is time
well spent in preventing the serious infections that can occur.

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 had to return to my eye doctor three times because the
glasses he gives me do not work
Each time he has re-examined me, and I see
perfectly well with the lenses he uses in his machine, but the glasses that I
get a week later don’t help as much
Do you think he is using the right
lenses, or does my long time diabetes have something to do with it?

ANSWER: I am sure your doctor is prescribing the same power lenses for your
glasses as he is using in his “machine”
I am hoping that he is aware of your
diabetes either because he obtained that knowledge by taking your medical
history, or because you volunteered that vital bit of information to him as
you did to me
That would put any doctor on the alert to two possible causes
for your visual problems
The most likely, I believe, is that your diabetes
is not well controlled (extremely possible if your medications include insulin
and you do not monitor your own blood sugar)
The excess of glucose in your
blood can change the power of the lens in your eye, which changes as your
blood glucose levels change, making the glasses ineffective
The other
possibility is that the diabetes has affected your retina, a cause that is
evident on careful examination
Put your medical doctor and your eye doctor
in touch with one another and save some return trips to the office.

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 been dieting for the better part of my adult life, and know
that I can’t make any progress without a little help from my doctor
However
he is most negative about such pills, and keeps trying to counsel me to do it
by diet and exercise alone
What is the scoop, are diet pills all that bad?

ANSWER: Diet pills, both the older amphetamine types and the newer ones,
should be taken only with extreme caution and under the care of a qualified
physician
If you have a family or personal history of psychosis or substance
abuse, you probably should not take diet pills at all
If emotional problems
develop while you are taking diet pills, talk with your doctor without delay.
Discontinuing the pills and psychiatric help will avoid further problems.
The more common side effects of diet pills are dry mouth, dilated pupils,
dizziness, heart palpitations, irritability and insomnia
Some people who use
diet pills become depressed, paranoid or have unusual blood cell effects.
Knowing all this, why would anyone take diet pills? Some people are
willing to take the risks they pose, because the lure of a “quick fix” for
their weight problems is too much to resist
There are many people who feel
as you do, that without some “help” they are faced with the possibility of
failure when trying to lose weight
At the risk of sounding quite boring, I
must remind you that the only way to solve a weight problem is to cut down
your calorie intake and increase your exercise
Certainly, using diet pills
as a temporary aid to get started can be an essential help, particularly when
you are under medical supervision, but the real success will come when you
make these changes a regular part of your life
Then you’ll see a weight loss
that is healthy and permanent.

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: As a young woman in my mid-fifties, I have become aware of the
importance of calcium in my diet and as a food supplement
Yet I am confused
about good food sources of calcium and the value of the capsules I can buy in
the store
Please do me and thousands of your female readers a favor and do a
column on the subject of calcium.

ANSWER: The importance of a good supply of calcium all during a lifetime as a
prevention of osteoporosis is well documented, and certainly has gained much
attention in magazine articles
Because adults lose a little bit of calcium
each day in body wastes, calcium in adequate amounts must be replaced in our
systems
Calcium need is increased in the growing years, during pregnancy,
and during the postmenopausal years to counteract against losses due to
several factors that are age related
While recommendations for proper
calcium intake vary depending upon age, sex, pregnancy, nursing and menopause,
they range from 1000 to 1500 mg a day
It takes a carefully planned diet to
obtain that much by eating, but it can be done
Foods that are rich in
calcium are the dairy group: both whole and skimmed milk, yogurt, and various
cheeses
Canned sardines and salmon are also great sources of calcium,
particularly when you consume the small bone pieces that form part of the
portion
And then there are all those vegetables you have come to love;
broccoli, soybeans, collards and turnip greens
Calcium supplements can help
fill your day’s quota, and are best taken throughout the day, but if you are
forgetful, then taking your daily needs at one time is fine
Read the labels
and make sure that your intake of “elemental calcium” equals your need, say
1000 mg
Calcium carbonate, for example, is only 40 percent elemental
calcium
In order for calcium to enter your system, the capsule must dissolve
in your stomach
You can test this by placing your tablets in 6 ounces of
room temperature vinegar, stirring occasionally for thirty minutes
If the
capsule has not dissolved during this time, change your brand.

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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