Health information

QUESTION: The tragedy of youngsters needing liver transplants tug at our
hearts
It must be a very difficult task to select the one child who can be
saved
Just how do they make this decision?

ANSWER: Perhaps it is easier to answer your question by telling you which
young patients are not likely to receive liver transplants
A youngster
diagnosed with cancer of the liver, terminal cancer elsewhere in the body, and
other progressive diseases that a new liver could not help are not likely
candidates for transplants
Also if the patient, or the parents, cannot
understand or accept what the transplant will mean in pain, time in the
hospital, time in bed, etc
would probably not have this surgery.
As for who is likely to be selected, surgeons consider the patient’s
disease severity and rate of progression, complications, ability to cope (both
the patient’s and the family’s), and physical suitability for transplantation.
There is an increasing need for pediatric organ donations
In a recent
36-month period, of 209 young patients evaluated for liver transplants, 85
underwent the operation and 64 survived at least a year
The average waiting
time for a transplantable liver increased from 80 to 232 days
The only way
the problem can be eased, is for every one of us to realize just how important
organ donations are to those who need them until medical science can develop
artificial organs that work.

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 58 years old and have always had good eyesight
I’ve never
had to wear glasses, but lately I have been having a weird problem with my
vision
The very center of my field of vision is blurry, while everything
else is in focus
What could cause this? Am I going blind? Is there any
treatment for what I have?

ANSWER: Without seeing you in person, I naturally cannot make a positive
diagnosis, but what you have described sounds like macular degeneration
The
macula is the part of the eye that is responsible for sight in the center of
the field of vision
Peripheral or side vision is usually not affected.
Macular degeneration is caused by damage or the breakdown of the macula
In
about 70% of cases, the degeneration is caused by aging
As patients get
older, the tissues of the macula thin or break down.
Another 10% of cases are caused by a leak or break in the blood vessels
that nourish the back of the eye
When this happens, scar tissue can form,
and often new abnormal blood vessels grow in the scar tissue
Central vision
may become severely distorted and blurred.
Other more rare forms of the condition are inherited or caused by injury,
infection or inflammation
There is no cure for the most common age related
form of this problem, and judging from your age, this is probably what you
have
You can be reassured, however, that you will not go blind, since this
problem affects only the center of vision
There are currently many low
vision optical aids that can help improve your condition
Some of those
available include spectacles, special hand or stand magnifying devices and
even closed circuit television.
The most important thing to remember is that in the majority of cases
these aids can help the patient lead a relatively normal life, but you must
see an ophthalmologist immediately
We can use his expertise to assure us of
the diagnosis, and offer advice as to appropriate treatment which may be
available to solve this problem
For example he may suggest laser treatment
to stop the slow leak of blood from capillaries, and he will certainly be
aware of the latest in the changing world of new developments in therapy for
this vexing 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: I know that organs may be transplanted but now I’ve heard the term
“bone marrow transplant.” What is it? What is it used for?

ANSWER: A bone marrow transplant replaces a patient’s abnormal or diseased
marrow with healthy marrow from a donor
The new marrow contains a stem-cell
population that can differentiate into blood cells that will replace the cells
affected by disease
Such treatment can be helpful for some patients
suffering the effects of leukemia, lymphoma (cancer of the lymph system),
certain types of anemia and/or inherited blood disorders (one such is called
thalassemia) and those seriously weakened by radiation and/or chemotherapy.
There are three types of bone marrow transplants: autologous from the
patient’s own marrow, removed prior to treatment with chemo or radiation
therapy
The removed marrow also may be treated before being retransplanted
in the patient: syngeneic from an identical twin and is genetically
identical to the patient: and the most common type, the allogeneic from a
brother, sister or parent
Until now the most successful grafts have been
from those identical twins.
Whoever the donor may be, he/she must have nearly identical genetic
characteristics with the patient or the transplant probably will not survive,
although with immunosuppressive preparation, success rates are continually
improving.

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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Mycelex-G (Clotrimazole vaginal) is an antifungal agent used to treat vaginal yeast infections.

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QUESTION: I believe there is certain information in my medical records which
I need to know what to do to help myself get over my illness
Don’t patients
have the right to get their medical records from their doctors?

ANSWER: That’s a good question, and one that’s receiving increased attention
these days
Most states have passed laws that guarantee patients access to
their hospital medical records, physician’s office medical records or both,
but many of the laws contain limits and restrictions
Don’t be surprised if
you encounter resistance when you request your medical records, even if you
live in a state where your access to them has been guaranteed under the law.
Many physicians and hospitals don’t agree that your medical records
belong to you, or even that you should have access to them
As with any
argument, there are two sides to this one
The most often-voiced concern is
that patients may misinterpret the records, become misinformed, confused or
unnecessarily frightened by the information
Physicians and hospitals are
also concerned about their malpractice liability being increased if patients
are granted unlimited access to their records
They consider the records an
honest appraisal of the patient’s physical and psychological condition, and
some fear that records will not be kept with the same honesty if patients will
have direct and unlimited access to them.
Patients, on the other hand, want to know what is in their records, and,
in some cases, feel they can store their x-rays and records more reliably than
anyone else.
The best situation is one where you and your physician go over the
records together, with your physician explaining the information, and you
knowing that you can ask any question and get a clear and honest answer.

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: Although my menstrual period comes regularly enough, I think it is
much heavier than many of my friends experience
Does this indicate anything
important is wrong? What should I do about it??

ANSWER: If you are concerned about bleeding too heavily, discuss it with your
physician
The only way to know whether there is something wrong is to
thoroughly evaluate the situation
You will need to keep a careful record of
the pattern and amount of bleeding
Take special note of the times you bleed
and any activity that seems to have triggered it
This information will help
your physician determine the cause of the bleeding, as well as whether it is
excessive.
Many different conditions can cause excess bleeding, and each one has a
different treatment
Your physician will want to be sure you don’t have a
platelet disorder, small elements found in our blood
Do you take aspirin for
menstrual cramps? Some people are particularly susceptible to aspirin’s
antiplatelet action
Platelets are important to the body’s clotting
mechanism, so anything that interferes with their action will cause increased
bleeding.
In evaluating your heavy bleeding, your doctor will examine your uterus
to be sure it is free of tumors, both malignant and benign
If all other
problems are ruled out and you simply have heavy bleeding during your
menstrual period, your doctor may treat you with a medication that works as a
“prostaglandin antagonist.” This medication will help your own body produce
prostaglandins, which help slow blood flow.
A “D & C” provides no decrease of blood flow except in the cycle directly
following the procedure, so it offers no long-term benefit
Methylergonovine,
which is effective in slowing blood flow in women who have just had babies,
has no effect on the amount of blood lost during the menstrual period.
Any occasion when there is an exceptionally heavy flow and there is a
possibility that you might be pregnant, is another time where a trip to you
own physician is truly in order.

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: While you frequently help people who ask about losing weight, how
about a little help for me
I want to put on a few pounds and need a tip or
two
Will you please consider a column for us skinnies?

ANSWER: Absolutely, although I must admit I envy you your problem
Eating
more is only part of the answer, just as eating less isn’t the whole solution
for losing weight
If you’re an athlete and interested in building muscle
mass, consuming additional calories won’t accomplish your goal
Proper
exercise and training will be needed.
Although it’s depressing news for dieting women who are limited to 1,200
or so calories a day, it is true that some athletes have trouble eating enough
to maintain or gain weight
But no wonder, one study showed that university
football players needed 5,270 calories a day!
How do you add those calories? Don’t rely on junk foods like potato
chips, candy bars, and soft drinks
Although upping your consumption of
sweets and fats is an easy way to increase your calorie intake, you’ll
sacrifice good nutrition.
Remember that protein should make up to 10 to 15 percent of your daily
calories, fats 30 to 35 percent (with only 10 percent saturated fats), and
carbohydrates the remaining 50 to 60 percent
And follow these tips:

Make sure you don’t skip breakfast.

Add bananas and other fruits to your cereal.

Nibble throughout the day on high-calorie but nutritious snacks like
dried fruits and nuts.

Consume fair quantities of complex carbohydrates like potatoes, rice,
macaroni, and other pasta.

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 obstetrician says we’ll need genetic counseling before we start
our family
What’s genetic counseling?

ANSWER: A genetic counseling session is a discussion with an expert about
your risks of having a child with a birth defect
The most common factors
that trigger such concern are a maternal age over 35; ethnic affiliation (more
on that below); and a family history of birth defects.
The counseling session is usually supplemented by tests
The most common
are:

- BLOOD TESTS OF PARENTS AND FAMILY MEMBERS
These can reveal such
conditions as cystic fibrosis, Duchenne’s muscular dystrophy, hemophilia
and Tay-Sachs disease (common in Jews).

- AMNIOCENTESIS AND CHORIONIC VILLUS SAMPLING
These tests sample the
baby’s cells indirectly and can detect chromosome abnormalities, more
common when the mother is over 35.

- ULTRASOUND
This picks up physical malformations such as kidney
defects and spina bifida.

- FETOSCOPY
The biopsy of the baby’s cells can detect sickle cell
anemia (common in blacks) and thalassemia (common in Orientals and in
people of Mediterranean descent).

When the session is over you should have some idea of the chances your
baby may have of being affected by inherited diseases.

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.

Hytrin
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QUESTION: I used to think the subject of hemorrhoids was mildly humorous,
until I developed them
Now I dread the possibility that I may need surgery
to rid myself of the problem
Do you think this may be needed?

ANSWER: Hemorrhoids are really just dilated veins
They can be internal or
external or both
If you have small external skin tags that are painless,
ignore them
If they are swollen, bed rest and sitz baths may help
Ice
packs at the onset of swelling may provide relief, but heat is better when
swelling is severe
If external hemorrhoids are recurrent and interfere with
daily life, surgical excision may then be your only hope.
Internal hemorrhoids occur in 4 degrees, ranging from painless,
unobtrusive ones to those that protrude from the anus
No treatment is
necessary for mild cases unless there is pain or swelling, in which case hot
baths and bed rest may be all that is required to remedy the situation.
Occasionally, injection therapy may also be prescribed
For the more severe
types, excision or elastic band ligation can provide the solution
A
combination of internal and external hemorrhoids may require removal,
depending upon symptoms
For all kinds of hemorrhoids, a diet which contains
more bulk plus the addition of stool softeners will reduce straining and make
your condition a bit easier to bear.

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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Purim helps maintain optimum health through broad and systemic blood purification.

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QUESTION: Is it possible that my youngster, age 9, can have hypertension? He
was found to have high blood pressure on a recent physical
If so, can he be
treated?

ANSWER: Hypertension can occur in children
When it does, the cases
generally are mild and, frequently, are found in families with histories of
hypertension plus excess body weight
Treatment usually begins with the
physician taking your child’s medical history, giving a thorough physical
examination and obtaining an understanding of the family’s medical history.
Such information enables a doctor to determine if your youngster suffers from
some other disorder or from secondary hypertension
The latter is much more
common in children than in adults.
Secondary hypertension is caused by, or is associated with, a variety of
diseases such as kidney, central nervous system, endocrine and/or vascular
disorders
When such secondary diseases are cured by a course of therapy
under your doctor’s supervision the child’s high blood pressure usually
returns to normal.
Doctors have observed that secondary causes for hypertension usually
occur in their youngest patients who experience the highest blood pressures.
Because of today’s readily available blood pressure measurements, mild
hypertension is being discovered in children much more frequently than was
previously thought
When doctors treat it, their goal is to reduce blood
pressure without producing side effects that could interfere with your
youngster’s normal growth and development
Mild, or borderline, blood
pressure is usually treated by diet modification for weight control and an
exercise program
Your child’s physician may prescribe antihypertensive drugs
to prevent possible damage to blood vessels and/or other organs
Frequently
very small dosages are given and, if necessary, are slowly increased
Once
weight control and increased exercise become routine, the goal is to reduce
and, hopefully, withdraw medication if your child’s blood pressure remains in
an acceptable range.

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.

Abana
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Abana is a cardiac tonic that prevents from cardiac neurosis.

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QUESTION: Can you tell me if you think a hip replacement operation is a good
idea for me? I have terrible arthritis.

ANSWER: Arthritic hip disease is a serious medical condition, experienced as
pain originating in the groin or buttock, and traveling down the anterior
thigh to the knee
Total hip arthroplasty (THA) is one method for relieving
this condition; it has become an accepted surgical practice in the U.S
today,
with approximately 100,000 such procedures (in which prosthetic parts are
attached via acrylic bone cement) performed annually.
THA is not for everyone, and a decision on undertaking the procedure
depends on factors such as your age, weight, employment, and emotional
orientation
THA cannot make the hip function “like new,” nor can it
withstand excessive stress
Those whose work or hobbies require them to be
physically active may prefer to endure a certain degree of pain in order to
continue their chosen lifestyles.
THA is the best bet for elderly patients experiencing the end stages of
hip disease
Younger patients may be better off postponing THA, particularly
since cementless procedures (less prone to separation and more long-lasting)
are currently being explored
An older procedure, known as intertrochanteric
osteotomy, or IO, may also be preferable for younger hip disease victims,
particularly those under 45
Hip fusion is another alternative for younger,
male patients, often used as a temporary measure to postpone THA until a later
date.
Since you didn’t tell me too much about yourself, I will leave it to you,
and your doctor, to decide if this procedure will improve 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.

Prednisone
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Prednisone is a synthetic corticosteroid, used for suppressing the immune system and inflammation.

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