Health information

QUESTION: Would you please explain the surgical procedure known as
angioplasty? My father’s doctors are advising this operation for him, but we
don’t know enough about it to be able to advise my Dad who has asked our
opinion
Please help us make a sound decision.

ANSWER: Angioplasty is an effective treatment for coronary artery disease
where the coronary arteries those blood vessels that bring nutrients to the
heart itself are partially or totally “closed.”
Angioplasty is accomplished by inserting a narrow balloon attached to a
guiding catheter through the circulatory system to the affected coronary
artery
The balloon is place at the narrowest part of the artery and then
inflated at high pressure
The expansion of the balloon forces open the
material that closed the artery, creating a wider channel for blood to flow
through.
Benefits from angioplasty as opposed to bypass surgery are that it
does not require surgery; can improve your ability to exercise without
heart-related pain; may increase the so-called “quality of life”; can reduce
pain caused by angina; requires much shorter hospital stays than bypass
surgery; and costs much less than bypasses.
Patients most likely to be considered for angioplasty include those with
coronary “closings” that have occurred within the past six months; who are
also candidates for bypass surgery; who have “closings” in several separate
parts of arteries but not in major sections of those vessels.
There are some risks associated with angioplasty, such as serious
coronary complications can happen during or after it; it is more dangerous for
women, particularly those over 65 years who have had bypass surgery than for
any other group; the arteries may “close” again at some point; and bypass
surgery must be done if the angioplasty fails.
Nevertheless, angioplasty is a major advance in medicine
It gets safer
and more practical as experience is gained in its applications
It is
altogether possible that this operation will provide your Dad with a new lease
on life, and much more pleasure while living it.

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 doctor has discovered that I have an irregular heart beat
It
has been causing me a great deal of distress and worry
I can’t even sleep.
Can you please advise me what to do before I go completely nuts?

ANSWER: The first thing to do if you think you have an irregular heartbeat,
or arrhythmia, and haven’t seen a doctor, is see a doctor
Now, you’re
already under a physician’s care, so you have taken that important first step.
Learning you have an irregular heartbeat is stressful
It is normal to
feel anxious if a physician has told you that you have a health problem and
that you can’t do too much about it
Some patients show anxiety by keeping
constant track of their heartbeat or may fear going to sleep in case their
heart stops
Others try to deny anything is wrong and want to stop all
testing
Anxiety in some can be so severe that they panic and their heart
condition is made worse.
Many patients become depressed in this kind of situation, which is to be
expected to a certain extent when a previously healthy person learns they have
a chronic illness
Symptoms of depression may include irritability, loss of
appetite, lack of energy, and difficulty in getting to sleep
Usually,
depression diminishes with time as the patient adapts.
Both anxiety and depression can be helped with therapy and, in some
cases, medication
In severe cases a psychiatrist or psychologist may be
needed to help you learn to cope with the state of your health
It is not a
sign of weakness or instability to see a psychiatrist
One of their functions
is to help the mentally well stay that way during a time of stress
A mental
health professional can also help you learn relaxation techniques and other
behavior modifications such as self-hypnosis that may reduce your levels of
anxiety.
Medications help many people cope with anxiety and depression, but these
must be chosen carefully to ensure they do not interfere with the drugs being
used to treat the heart.
Diagnosing your arrhythmia condition and treating it will usually mean a
series of tests that may or may not show anything, and perhaps trials with
various medications, some of which may help and some of which won’t
If
medication fails, a pacemaker may be considered
There is a lot of fine
tuning necessary to achieve just the right balance of medication to reduce the
anxiety provoking beating of the heart to a point you can accept
You need to
understand as much about your condition as possible and about the potential
frustrations of your treatment regimen
No one said you had to like it, but
knowing what is happening will help you cope with it
Keeping a positive
attitude can be almost as helpful as any medication I might suggest.

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 a routine physical examination and checkup as part of my
regular sports training program, I was a bit surprised at the news that my
blood test showed a slight anemia
Despite assurances by the doc that there
was little to worry about, I need some explanations
Would you please oblige?

ANSWER: Your doctor is right
This is most probably not dangerous, as
athletes in training normally have lower hemoglobin and serum ferritin (iron)
concentrations than nonathletes
This is not really anemia, but “dilutional
pseudoanemia” (meaning you have more blood volume, with the same number of red
cells), and the condition is beneficial for athletes because it increases
their physical performance.
One of the first adaptations that the body makes to regular exercise is
to conserve salt and water to increase plasma volume
This makes it appear as
if there is less hemoglobin than usual
This cannot harm you because the red
cell mass remains normal
The additional plasma volume improves athletic
performance in that it increases the amount the heart pumps with each beat and
improves the efficiency of sweating
Since dilutional pseudoanemia is a sign
of health rather than sickness, there is no treatment
Runners, however, do
have to watch out for a true form of anemia called “foot strike hemolysis.”
The impact of hard, pounding foot strikes can sometimes destroy normal red
cells in the bloodstream
This can be treated with iron supplements and diet
modification
A well-padded, high-quality pair of running shoes can help
prevent this condition by softening the shock as a runner’s foot strikes the
ground.

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 finger nails have a most peculiar line growing across them from
side to side
It looks as though my old nails are being replaced by another
nail growing up over them
What caused this condition, and is it something
serious that I must now worry about?

ANSWER: As with most questions like this one I really wish I could see the
condition
However, your description may give me enough to work with
Nail
deformities can be caused by many factors, nutritional, infectious, and even
work factors
But if you recently suffered a severe illness, I may have the
answer for you
In some circumstances, where severe disease temporarily
interferes with nail growth, like a severe infection or heart attack, the nail
begins to grow again after a period of no growth, creating the picture you
describe
They are called “Beau’s lines” and form this peculiar ridge across
the nail
But you need not be too concerned, and certainly there is no need
for worry or anxiety
As your nails continue to grow, the ridge will be
pushed forward and out, and your nails will return to their former
characteristic look.

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 lengthy but rambling letter from an old friend has us confused
about the state of health of a mutual acquaintance, living back up north
The
letter speaks of “pigeon lung” but we can’t find any mention of this condition
in our home medical advisor
Do you know what she is talking about?

ANSWER: I think so
The disease is also known as “Bird Fancier’s Lung” or
“Pneumonitis of pigeon breeders”
It is a type of pneumonia which is seen in
individuals who breed or care for pigeons
The symptoms of fever, chills,
cough and difficulty in breathing come on about 4 to 6 hours after exposure to
the birds, and is believed to be caused by an allergy or hypersensitivity to
the pigeon
It can be treated with corticosteroids, cortisone like
medications, and will disappear by itself in many cases if contact with the
birds is avoided for 12 to 24 hours
If your friend is the owner of these
animals, it looks like a short lived hobby, for prolonged or repeated contact
can result in chronic lung disease, certainly too high a price to pay for the
enjoyment of raising these graceful creatures.

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: Some time ago, I submitted a letter to you that asked numerous
medical questions, perhaps too many for you to address
Therefore I am
sending you this letter and will appreciate you addressing the condensed
question
What is a pinched nerve and how can it be treated?

ANSWER: Yes, it is always better for both of us if the question can be
answered in the space I have in this column
Nerves are much like electric
cables or wires, transmitting messages or impulses from one section of our
body to another
As a nerve runs along its path, it must pass through holes
in bones, between bones, between, under or through muscles, ligaments and
tendons
Usually there is ample room for the nerve to pass, but when the
passage way is reduced, the surrounding tissue can press upon the nerve or
“pinch” it
Using sciatica as an example, a condition in which pain radiates
along the course of the sciatic nerve, often into the buttocks and back of the
leg
Such pain may be caused by pressure on the nerve from compression of the
nerve as it passes through the space between the vertebrae by new bone
growths, as in osteoarthritis
Each case of “pinched nerve” must be evaluated
to discover its specific cause, and directing the treatment to removing it.
And that may be a difficult task.

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.

Levlen
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Levlen (Levonorgestrel) is used to prevent pregnancy by inhibiting ovulation.

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QUESTION: I am presently 48
Both my parents have colon cancer, father at
age 67 and mother at age 51
Recently on colonoscopy, two polyps were removed
from my colon, both found to be benign
My doctor wishes to wait three years
for my next exam, but I read that the American Cancer Society recommends two
successive years with normal findings before waiting for 3 to 5 years
Do you
think an exam every three years is sufficient for someone with my history?

ANSWER: While the American Cancer Society recommendations are valuable
guidelines, each patient must be viewed as an individual, with medical care
organized and given to meet with their special needs
The discovery of the
polyps, to my way of thinking, is sufficient reason for you to have an
examination on a yearly basis until you have a negative result for two years
in a row, then three years between examination seems reasonable
Your family
history is strong indication to follow this schedule
Another precaution you
might wish to perform on your own is a yearly stool examination for blood,
using one of the many home kits now on the market
Though not always 100
percent accurate, they are sufficiently so to serve as a valuable resource for
you in between your yearly scoping
Your local office of the American Cancer
Society can provide you with the written guidelines to show your present
physician
If that doesn’t help convince him, there are plenty of others who
do believe that timely examinations are necessary.

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 bulging mass at the back of my knee, that keeps growing and is
now quite tender, has been named as a “popliteal cyst”
While that may give
it a name, it stills leaves me with lots of anxiety and desire to know more
about this problem
Will you please tell me what a popliteal cyst is and what
type of treatment are available?

ANSWER: Popliteal cysts are painful fluid-filled sacs which form where joints
come together
Cysts of this type most frequently occur behind the knee (in
the “popliteal” area”), but are also found in other areas where there are
freely moveable joints such as the bend of the arm, shoulder, hip and neck.
Usually associated with either joint-destroying diseases (such as
arthritis and gout) or injury to the affected area, popliteal cysts are caused
when the protective covering around a joint spills out into the space between
the tear and the surface skin
In a way it’s like a giant blister, only it
doesn’t go away so easily.
Unlike a blister which eventually dries up, popliteal cysts grow hard and
tough, sometimes blocking off the flow of liquid in or out
In many cases,
cortisone injected into the joint along with rest will reduce the pain and
swelling and lead to a successful cure
However, if the cyst can not be
reduced by this method or is very large, surgery may be required.

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: Since a recent heart attack my husband, who was an energetic man
who loved life and always shared a story, has become quiet and reserved
I
know there must be something wrong, but don’t want to do anything to upset
him
Can you offer me any advice?

ANSWER: Your husband may be one of the 10 to 15 percent of patients who
experience moderate to severe depression after a heart attack, or even one of
the 3 to 5 percent who have chronic and severe anxiety independent of
depression
Some anxiety is certainly normal for someone who has had a heart
attack, because the heart attack is one of life’s crises that isn’t taken
lightly by most of us
However, chronic hostility, exhaustion and inability
to resume normal activity despite encouragement from the physician are signs
that the patient needs some help in overcoming his post-heart attack problems.
A problem that is not often discussed, but which may be creating some of
the problem, is the heart attack victim’s anxiety about sex and its effect on
his marriage
Medications given to heart patients may affect sexual function,
but probably the most frequent cause of sexual problems is the fear on the
part of the patient or the partner that sexual activity will cause another
heart attack
A treadmill test gives physicians an indication of which
activities are safe, and this includes whether sex is safe
Sexual activity
with a marriage partner rarely exceeds even 80 percent of the post-heart
attack patient’s cardiac capacity; this means that sex is certainly a safe
activity for most heart attack patients and their spouses
Don’t be afraid to
talk to your doctor about the safety of sexual activity
Ask him to discuss
it with you and your husband, so you will both feel reassured.
If there is a cardiac rehabilitation program available through your local
hospital, see about getting your husband involved in it
Often getting to
know other people who have had heart attacks is helpful, because you learn
that you are not alone in your problems, and that others are making healthy
progress
Cardiac rehabilitation programs offer exercise and nutrition
counseling, as well as peer support to the heart patient and family
You
might wish to consult your physician about programs that are available in your
area.

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: Can you comment on a trick that my grandfather used to mention
which was to lick the place where you were touched by the leaves of a poison
ivy plant to prevent the rash from ever developing? I want to be sure it
works before trying it if I ever need to.

ANSWER: First let me explain what happens when people touch plants that are
known to cause rashes
The plants we think of are poison ivy, oak and sumac.
These plants have a resin on them which, when spread on the skin, can cause an
allergic reaction
People often think that the rash itself can be spread by
the liquid that may leak from the blisters that are formed as a result of the
resin irritation, and which form part of the rash of poison ivy
But this is
really not the case
Since the rash may at times take up to 3 weeks to
show itself, it is the original spread of the resin that causes these late
appearing blisters, and not a continuation of the problem from blister liquid.
That means that the best initial therapy is to thoroughly wash all the areas
that could possibly have been exposed, to remove the resin
Clothes that have
been contaminated should also be washed and if for some reason they can not be
cleaned then they should be isolated in a well ventilated area for three
weeks
Drugs such as diphenhydramine (Benadryl) may be prescribed to cut down
on the amount of itching
Cortisone creams can be used to decrease the local
inflammation, and in people with severe reactions to the plant steroid
(cortisone like) pills or even injections may be needed
While I do not know
of any literature that specifically discusses the use of saliva to reduce this
annoying rash, one thing is absolutely sure
You don’t want to try and wash
off the resin by licking the skin
Since the resin will adhere to the tongue,
it could produce fearful lesions in your mouth and on your tongue, and so
ranks high on the list of “No no’s”.

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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