Health information

QUESTION: I have had enough painful experiences because of a bad back
I am
interested in some good tips on how I can prevent them without having to
change my job
I am not the only one with this problem so we will all be
looking for some good information.

ANSWER: Sure, I have a couple of good tips for you
And they can be useful
for all the other people you are working with.
First, take a good look at what you have to move or lift
It may really
be too big for one man, so ask for help
Is there any way you can use a
handtruck or cart to avoid a difficult lift or carry? If it comes down to
having to lift and carry it yourself remember these six important rules: 1:
you don’t need to strain back muscles to stay erect, and 6: keep your back as
straight as possible while lifting
Using all of these tips will give you a
real mechanical advantage in moving those heavy objects, and lessen the strain
on the muscles of your back.
Of course, keeping in good physical shape will also help avoid those
annoying, painful and costly back injuries.

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 thyroidectomy I had difficulty swallowing
A barium
swallow led to the diagnosis of “Barrett’s esophagus”
Although I have many
questions, I guess I am just asking you for a description of Barrets
Just
what is it?

ANSWER: The name is derived from the British surgeon who first described the
condition in 1950
It is also called “esophagitis-peptic ulcer” for it is the
combination of a peptic ulcer and an inflammation of the esophagus called
esophagitis
It results from chronic reflux, or back up of stomach acids into
the esophagus
The barium swallow is very useful in diagnosing such an ulcer,
and it can also been seen as an ulcer surrounded by swollen tissue when a
esophagoscope is used
It is most commonly found in individuals at or past
middle age, and can cause not only discomfort when swallowing but heartburn
and pain that can radiate to the back, neck and both arms
It can be treated
medically with medications that reduce or absorb the stomach acids
Taking
the prescribed medications religiously is important to both help the healing
and reduce the pain and discomfort
It is a condition which requires regular
follow up care, and when the situation changes or does not improve, may
require a surgical procedure to put things right.

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: After the necessary tests and biopsy, I am told by my doctor that I
have a type of bladder cancer that should respond to a new treatment called
“BCG”
I understand that this is a bacteria that causes tuberculosis, and do
not understand how this is used to treat my disease
I can’t find any
information about it, and hope you may be able to explain it to me
Please!

ANSWER: Little wonder that you are confused, for this is a brand new
development in the treatment of a type of a carcinoma of the bladder known as
carcinoma-in-situ
The medication just recently approved for this use by the
Food and Drug Administration is called TheraCys, and is manufactured by
Connaght Laboratories Limited of Toronto, Canada
The letters “BCG” stand
for the “bacillus of Calmette and Geurin,” two French researchers who cultured
a strain tuberculosis bacteria in eggs until it lost its ability to produce
the disease in man but could still stimulate the immune response
Though it
was first used as a vaccine for this purpose in 1924, it is still considered
controversial, and while it is used in most third world countries, it is not
widely used in the United States
In 1976, Dr
Alvero Morales of Queen’s
University in Kingston, Ontario, documented that a different formulation and
concentration of BCG was effective in the treatment of bladder cancer
patients
The treatment begins from 7 to 14 days after a biopsy or bladder
surgery, when the medication is placed into the bladder itself
This is
repeated each week for six weeks (induction therapy), after which it is
followed up by a maintenance schedule given at 3, 6, 12, 18 and 24 months
following the initial treatment
The most common adverse reactions are
flu-like symptoms including fever, chills and malaise
The clinical studies
showed a average complete response rate, that is no recurrence of tumors, of
74 percent, as compared to 42 percent with adriamycin, another cancer fighting
drug.

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.

Copegus
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Copegus (Ribavirin) capsules are used in combination with Interferon to treat patients with chronic hepatitis C.

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QUESTION: Another question for you in the vein of trivia
Can you explain
the nature of a “bezoar”? I am sure it is a medical condition, but my wife
insists it is a feathery scarf
If I am wrong, you can leave this question
out of your column.

ANSWER: That’s not playing the game in a fair and square fashion, but this
time you are right
A bezoar is a curious, ball-like, accumulation or
“concretion” of hair or vegetable matter found in the stomach
They are rare
in humans, more common in animals
In humans, delayed emptying of the stomach
may be one of the factors in their formation, and they are more likely in
people who suffer stomach complications of diabetes
Balls made of shellac or
bubble gum have been seen, but most often they are formed of hair, wool,
oranges or persimmons
Generally they cause no symptoms, and when discovered
on x-rays, may be mistakenly diagnosed as a tumor
In contrast, its a “boa”
that women wear, a long ornamental scarf of fur, feathers, or other material,
and which is derived from the Latin word “boa” or “bova” which means a “water
serpent”.

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.

Aciphex
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Aciphex (Rabeprazole) decreases the amount of acid produced in your stomach.

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QUESTION: Can you please help by settling a discussion between two sisters?
It’s about the proper care of blisters on the feet
I still abide by the
precautions my mother taught me, and break the blister with a carefully
sterilized needle, and then put a bandage on
My sister claims that is old
fashioned and that modern antibiotic ointments are the proper solution
Which
treatment is the correct one?

ANSWER: Frankly I am not impressed by either method, and certainly vote
against the old sewing needle procedure
A blister is formed as a natural
protection for the injured tissue beneath and the correct manner of dealing
with these frequent annoyances is to keep it intact, clean and dry
Removing
the protection of the skin by puncturing the blister is an open invitation to
infection
Try an ice pack first to reduce any swelling or inflammation, and
then prepare a bandage or dressing with a hole in the middle to preserve the
blister but protect the area against further rubbing or friction
You may
find ready to use moleskin bandages of this type at your pharmacy
If the
blister does break open, wash the area carefully with soap and water, dry
completely, and then you may apply an ointment or cream containing an
antibiotic or antiseptic, keeping the broken skin in place as it is the best
covering of all
A sterile bandage to cover the sore area completes the
treatment
Of course you must now check your shoes to find the cause of the
blister, and remedy that situation or face the possibility of more blisters
the next time out.

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: A few months ago, I went to the doctor because I was having
headaches and felt dizzy
I also got tired and short of breath easily
She
told me that I had high blood pressure and prescribed some medication, which
I’ve been taking every day just like she told me to
I feel much better now,
but the doctor said I should keep taking the medicine anyway
Why?

ANSWER: It can be hard to understand why you have to take medicine when you
don’t feel sick, but your doctor is right
Most people who need medication to
control their high blood pressure will have to take it indefinitely
Your
symptoms are not a reliable guide to your blood pressure
In fact, one of the
biggest problems with hypertension is that most people don’t have any symptoms
at all, especially in the early stages of the disease
That’s why
hypertension is called the “silent” killer
It is possible that you had
elevated blood pressure for some time before you started having symptoms.
Even if you feel normal, untreated hypertension puts a strain on your
heart, blood vessels, brain, and kidneys
The heart has to work harder to
pump blood against abnormally high blood pressure
This overwork can make the
heart’s walls thicken, and the heart itself can become enlarged and
eventually stop working
In the brain, the blood vessels begin to
overstretch
If they get too weak, they may burst, causing a “stroke” or
cerebrovascular accident
A stroke can cause various degrees of paralysis.
The kidneys can also suffer, because their tiny arteries are damaged by high
blood pressure
The kidneys can stop filtering out waste products from the
blood, resulting in sickness and even death
These problems can develop and
cause major organ damage, without causing any noticeable symptoms
Luckily,
this damage can be prevented if blood pressure is controlled
However, if
treatment is stopped, the blood pressure usually goes back up
The key to
successful blood pressure control is your cooperation as a patient
You
should take medications exactly the way they are prescribed
It is important
to see your doctor at regular intervals so he or she can check your progress
and adjust your treatment if necessary
You should also follow your doctor’s
recommendations about diet, exercise, and lifestyle changes
Sticking with
the treatment plan can add many healthy, happy, and comfortable years to your
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.

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QUESTION: If there is a very small lump in the breast that the doctor cannot
feel but shows up on the mammogram more than once, is it supposed to be
tested? Should a biopsy be taken even if it is very small or should it be
removed to see if it is cancerous? Please answer these important questions
for me.

ANSWER: Your questions require some real judgement calls, based upon the
small amount of information you have provided me, but since I feel that many
other women may have similar concerns, let’s see if we can work through this
problem together
To begin with it is apparent that we are dealing with a
very small mass indeed, one which can not be felt by the physician, and that
means we are dealing with something, not necessarily a cancer, in its earliest
phase
And that is good
In addition, it would seem that there has been more
than one mammography taken, and still the report is that the lump is small.
That leads me to believe that it is not growing, and probably has none of the
characteristics of a malignant or cancerous growth on the mammogram
And that
is great
Most breast lumps are not cancerous, you know, and keeping track of
them on a regular basis is all that is indicated
I doubt that a biopsy is
needed here unless your family history reveals a close relative with a breast
cancer and your age and personal history reveals some additional risk factors.
At any rate, a biopsy at this stage of the game would most certainly remove
the entire mass, since it is so small
You can be an important part of the
ongoing evaluation, by learning how to perform a breast exam on yourself
It
may be possible for you to feel the lump even before a doctor can, and your
sensation of any growth is an important clue
I can only infer that if a
mammogram was taken before any mass could be felt, that you are following the
good rules of regular checkups to detect any abnormalities before they
progress too far, and so allow treatment to begin when it is most effective.
And that is the stage you are at now
Continue to follow through with your
physician who is still the best source of personal advice in these situations.

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 29 year old woman
I recently found a lump in my breast and
visited my doctor, who said it could be a cyst
However, he refused to do a
mammogram
Another doctor who I visited for a second opinion also refused to
do a mammogram, saying I was too young and that it was probably a cyst
My
question is this how can doctors tell you what’s wrong without an accurate
test? I am concerned because my mother had breast cancer and died.

ANSWER: While I understand your anxiety and can sense your frustration, I can
only hope that the information I will provide you here will help you
understand what is going on
To start with, most breast lumps are benign;
that is, they are not cancerous
In addition, cancer of the breast in a woman
under the age of thirty is rare
You were certainly correct in consulting
your doctor when you discovered your lump, but his examination, including an
inspection and palpation, provided him with a great deal of information about
your lump, its size and texture, and whether or not it was freely movable
under the skin
By shining a bright light through the breast
(diaphanogrophy), it is possible to tell whether the lump is filled with a
clear fluid, as in the case of a cyst
And a fluid filled cyst is not a
cancer
While the combination of a physical examination and mammography can
detect the presence of a cancer in about 97% of the cases, only a biopsy can
really tell if the tissue is cancerous or not
A biopsy is the surgical
removal of the lump, followed by a careful microscopic examination of the
tissue
Your statement that two physicians have examined this lump and not
permitted a mammography leads me to the conclusion that the lump was small and
freely movable, probably had the consistency of a cyst, and was filled with
fluid when examined with a light
That’s very good evidence that it is not
cancer, and that the mammography would show little other evidence that could
either help make or change the diagnosis
Since your family history tells of
your mother and her disease, it is clear that you will have to continue to be
checked on a regular basis for any changes, but for now I think you safe
enough without the unneeded mammography
All that said, and being perfectly
correct from a strict medical perspective, if I felt your anxiety was
affecting you too intensely, I would probably order the test for 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 am 28 years old and teach aerobics three to four times a week.
My weight is about 128 pounds
The problem is reducing another ten to fifteen
pounds
Even though I am not overweight, I just don’t feel physically fit
I
do not over eat and watch my fat consumption, but nothing seems to help
I
have battled my weight all my life and it would be nice to finally win
Any
advice or help would be greatly appreciated.

ANSWER: Without a height measurement, it is hard to completely evaluate your
situation, but I probably would agree with you, you do not seem to be
overweight
You would have to be 20 percent over your normal body weight to
be considered obese
And that weight should be in excess fat tissue, rather
than in muscle tissue, for it to be significant
While regular aerobics does
not tend to excessively develop your muscles, it would be interesting to know
if some of your body weight cannot be due to your frequent workouts
While
you claim you are not overeating, keeping track of everything you consume in a
daily diary and then converting those numbers to calories might reveal that
even for a person of your age and your (unrevealed) height and physical
activity, you are still consuming too many calories for there to be a
noticeable weight loss over time
But my medical sensitivities are alerted by
the statement that you “just don’t feel fit”
I would want to check out a few
possibilities to be sure that both your physical functions and mental state
are all functioning as they should
A thyroid problem can be at the base of
your problem, and work and living situations can make a person feel less than
fit without any physical basis
Too many times, a medical situation that is
relatively easy to correct is lost in a poorly defined complaint such as
yours
I don’t think your answer lies in another diet, but in an overall
evaluation of your physical, emotional and social 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.

Miacalcin
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QUESTION: My mother lives alone in another city
We received a call from her
neighbors that she fell in her apartment, but now seems well enough
She
refuses to go to the doctor, and we are worried that she may have had a small
stroke
Is this a possibility? Can you please counsel us?

ANSWER: When an older person falls, especially when there are no witnesses
present, it may take a bit of detective work to determine just what did
happen
Certainly a small stroke is a possibility, or a T.I.A
(transient
ischemic attack)
In the case of a T.I.A., there may be no signs left after a
brief period of time to help clear up the situation, and the mystery may never
be completely resolved without medical evaluation
However, since these
attacks may recur a diagnosis and treatment is certainly required now, and it
may require a visit from a close member of the family to convince your mother
of the seriousness of the problem
Many older people will not remember all
the particulars of an accident or recall the circumstances that preceded the
fall
A careful look around her apartment may reveal the source or potential
sources for an accident
Dark, or poorly lit halls and corridors, slippery
floor surfaces or scatter rugs, boxes or other small objects lying about may
trip anyone, and should be cleaned up or removed
More important still, to my
medical mind, are all the conditions still undiagnosed that can contribute to
these reported falls
Neurological problems that change the gait or mobility,
vertigo or dizziness, failing eyesight (perhaps from developing cataracts),
reactions from new medications or even the sudden lowering of blood pressure
that occurs when standing or arising too swiftly (postural hypotension) all
may be the underlying cause of a “simple” fall
Muscle weakness, anemia, poor
eating habits and emotional problems can also be contributing factors, and
the list can go on and on
While it may be but an isolated accident, it would
be unwise to allow the situation to go unexplained, and imprudent to overlook
the possibility that there are medical circumstances that caused this episode
that can be treated, and so prevent a future fall that could lead to greater
tragedy
My advice, either get someone into that home that your mother
respects, or start packing your bags for a most necessary journey.

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.

Endep
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Endep (Amitriptyline) is used to treat symptoms of depression, along with insomnia.

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