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home : columns : ask the doctors May 23, 2018

Reader feedback encourages follow-up on BP guidelines
The change in seasons means fewer layers of clothes and more outdoor activities. With that in mind, we'd like to remind you to please use sunscreen, consider bug sprays to deal with the return of mosquitoes and ticks, and to ease into the return to physical activity to avoid injuries.
Tuesday, May 22, 2018


Increase in liver enzymes often linked to fatty liver disease
I recently had blood work done, and now my doctor says my liver enzymes are too high. How can I lower them? I have no symptoms, so I was surprised. I have never consumed alcoholic beverages, nor smoked. I am trying to lose some weight. I do frequently take ibuprofen for arthritis.
Monday, May 21, 2018

Make physical activity a family priority
Dear Doctor: My husband and I have a running battle with two of our three kids, who have zero interest in anything that isn't on a screen. They're 11 and 13, so rational arguments about their adult health don't work. Just how important is it for kids to get regular exercise? 
Saturday, May 19, 2018

Naloxone can quickly save someone overdosing on opioids
DEAR DOCTOR: Did the surgeon general really just suggest that the general public carry naloxone in case they encounter someone having an opioid overdose? For starters, where would you even get such a thing? And two, how is the average person supposed to know who's overdosing -- and on opioids?
Friday, May 18, 2018

There's a clear connection between exercise and well-being
Just how effective is exercise against depression? I read that stopping exercise worsens depression in as little as three days, so that seems pretty powerful.
Thursday, May 17, 2018

Studies show pde5 inhibitors to be effective in treating BPH
What is your opinion of using Cialis to treat benign prostatic hyperplasia? And what should the dosage be?
Wednesday, May 16, 2018

Fatty liver disease distressingly common in the united states
Can you talk about overweight kids and fatty liver disease? I thought this was something that only happens to alcoholics.
Tuesday, May 15, 2018

Treatment of Lupus is lifelong commitment for some patients
What can you tell me about lupus? Is it true that there are two different kinds? One of the skin, and one that affects the entire body?
Monday, May 14, 2018

Patients should be told of the risks associated with apitherapy
What on earth is bee-sting therapy -- and what is it supposed to do? I ask because apparently someone died after having it.
Saturday, May 12, 2018

Cause of vestibular migraines not known
I have just been diagnosed with vestibular migraines. Could you give me information on the symptoms and treatment?
Friday, May 11, 2018

Soaking in a hot bath may offer benefits similar to exercise
Can a hot bath really burn as many calories as a brisk walk? If so, give me the hot bath any day!
Thursday, May 10, 2018

The genetics of depression and suicide are not fully understood
Does depression run in families? That is, is it inherited? Enough to make a person suicidal?
Wednesday, May 9, 2018

Loading up on protein will help build muscle mass
I'm 44, newly single, and have started lifting weights because I hear it can help with mood and confidence. Am I on the right track? Also, my brother insists I have to start eating a lot more protein if I want to see results in the mirror. Is this true?
Tuesday, May 8, 2018

Recent study shows promise in early-stage cancer diagnosis
I recently read that a modified Pap smear has the potential to show early warning signs of ovarian and endometrial cancers, as well as cervical cancer. How accurate is this test, and when might it be available?
Monday, May 7, 2018

Sinus infections are common and treatable
DEAR DOCTOR: Just how risky are sinus infections? I read about a teenager who died recently after a sinus infection spread to his brain. Is this common? How do you prevent a sinus infection?
Saturday, May 5, 2018

Why it's not a good idea to clean your ears with cotton swabs
DEAR DOCTOR: I understand that poking cotton swabs into the ear is dangerous. But how is one supposed to clean the ears otherwise? I don't want to see goopy yellow wax in anyone's ear canal or to have it in my own.
Friday, May 4, 2018

Metabolic syndrome more prevalent among older adults
My doctor says I'm on the verge of being diagnosed with something called "metabolic syndrome." Is it serious? Can I get rid of it?
Thursday, May 3, 2018

No dietary guidelines exist for treatment of MDS
I am a 62-year-old woman diagnosed last year with a myelodysplastic syndrome. I have blood work done every three months, but my white count keeps dropping. Most days, I feel fine, but I retired from teaching because of fatigue. What foods and drinks should I avoid? Should I eat only organic produce?
Wednesday, May 2, 2018

Antibiotics may be option for patients with acute appendicitis
My older brother was experiencing abdominal pain and nausea, and when he went to his doctor, he was told he had a "hot" appendix. But instead of surgery, he was treated with antibiotics. Is this safe? Shouldn't his appendix have been removed?
Tuesday, May 1, 2018

Patient worries about side effects of anti-arrhythmic medication
My doctor wants me to take amiodarone for my heart. But the potential side effects scare the heck out of me: possible death, permanent blindness, liver problems, thyroid problems. Should I do catheter ablation instead? My doctor says my fears are unwarranted.
Monday, April 30, 2018

Talk to your doctor first before trying fasting-mimicking diet
I'm reading a lot about a fasting-mimicking diet, which is supposed to help you live longer. What is it? I've been planning to lose some weight and wonder whether this diet might be worth trying.
Saturday, April 28, 2018

Swedish study confirms that exercise helps ward off dementia
Being physically fit in middle age can decrease the risk of dementia, according to my sister-in-law. She walks four miles a day and runs on the weekends, so I imagine she's covered. But I work full-time and am a single mom to three busy kids, so I'm short on free time. Just how much exercise is enough? 
Friday, April 27, 2018

Fecal transplant not always prescribed for C. Diff infections
A colleague just returned from a long hospital stay, where he battled a C. diff infection. He had asked for a fecal transplant but was refused. Will these ever become the standard of care? Are there uses for these procedures other than to fight C. diff infections?
Thursday, April 26, 2018

FDA considers what counts as dietary 'fiber' on food lables
I always thought fiber was fiber, but it seems that the FDA is about to crack down on food manufacturers who add weird ingredients to bulk up processed foods. Does it really matter whether the fiber we're eating is added or is a natural part of our food?
Wednesday, April 25, 2018

Hacking into medical devices is theoretical possibility
As a fan of the TV show "Homeland," I was skeptical (and also creeped out) when a character was assassinated by someone hacking his pacemaker. But I just read that this might actually be possible. My dad has a pacemaker, and now I'm worried. Is this really a serious risk?
Tuesday, April 24, 2018

Readers offer feedback on Kefir and migraines
We closed a past column with a question about how any health-related New Year's resolutions were going, whether there was success or stagnation, and what plans people had in place to move forward. And because of the focus on diet, weight loss and general health in the responses we received, we've put several columns about these topics into the pipeline, with more to come. We hope you'll find them useful.
Monday, April 23, 2018

Ear pressure from otitis media can cause feelings of dizziness
Dear Doctor: I have recently experienced severe vertigo due to fluid pressing against my eardrum, which happened after a sinus infection. What was going on? How can I avoid a repeat?
Saturday, April 21, 2018

Prolonged standing at work can cause discomfort throughout body
DEAR DOCTOR: I always thought standing desks were good for you. Now I read they might not be. Can it really be better to sit all day long? This is an important question to me, because my job is very busy -- and all done from a desk.
Friday, April 20, 2018

Overseas travel plans could be hampered by measles outbreak
There's apparently a serious measles outbreak going on in Europe right now. Does that mean that our family shouldn't go on our planned trip to Italy this spring?
Thursday, April 19, 2018

At-home test for breast cancer mutation not comprehensive
I don't have a history of breast cancer in my family, but now that there's an at-home test for the BRCA mutations, should I get tested just in case? It has to be less expensive than going to a doctor, and it might provide some peace of mind.
Wednesday, April 18, 2018

Study suggests link between brain's blood supply and memory
I've read that memory is linked to the heart's ability to pump blood, with a reduced ability leading to poorer memory. Is there anything I can do to keep the blood flowing to my brain?
Tuesday, April 17, 2018

High potassium levels can casue symptoms similar to anxiety
I started taking potassium pills about five years ago. Then after a few months, I began to have anxiety attacks so severe that I could barely talk to people. Finally, I read warnings about potassium's side effects, which included anxiety attacks. I immediately stopped taking the pills, but still have mild anxiety attacks. More people should know about this side effect.
Monday, April 16, 2018

Noise pollution cases sharp increase in stress hormones
My son just got a job working construction in Houston, which means he's surrounded by noise pretty much all the time. A family friend says he read that all that noise might be bad for my son's health, including his heart. Just how strong is the connection between heart disease and noise pollution?
Saturday, April 14, 2018

Incidence of Crohn's Disease rising in U.S. and Europe
What causes Crohn's disease? My grandson has had two surgeries for it. Did the food he ate while growing up cause it? I have heard that it is genetic, but we don't know of anyone in his family who has had it.
Friday, April 13, 2018

Japanese flu drug shows promising results in patient trials
Apparently Japan just approved a new drug that can get rid of the flu virus in one day. When can we get this drug in the United States? And if we can't, can we order it online?
Thursday, April 12, 2018

Some factors to consider when choosing a new primary care doctor
Our doctor is retiring, and my wife and I have been told we need to select a new physician within two months. But we read the bios of available doctors in our area who are accepted by our insurance, and their degrees are not from first-class facilities. How can we make a good selection and be assured of quality care?
Wednesday, April 11, 2018

Coconut oil is a saturated fat that should be used in moderation
Coconut oil has gotten to be really popular, but now there's a study that says it's just as bad for you as beef fat and butter. How is that possible? It has no animal fat whatsoever.
Tuesday, April 10, 2018

Surgical techniques for aneurysm have greatly improved over time
I was recently diagnosed with an aortic thoracic aneurysm and scheduled for surgery. What are the risks, and can I expect to live a normal life afterward?
Monday, April 9, 2018

Working the night shift can have drastic effect on good health

Dear Doctor: So many bad things seem to be associated with night shifts -- first an increased breast cancer risk, now an increased risk of obesity. Why is that? Is there any way to lessen the risks?


Saturday, April 7, 2018

Exercise, sunshine and diet key to high magnesium intake
DEAR DOCTOR: Much is said about calcium and vitamin D, but what about magnesium? As I understand it, that's a crucial part of the bone-building equation. Should people be taking magnesium supplements?
Friday, April 6, 2018

Consider low-impact exercise after double hip replacement
Before I had a double hip replacement at 47, I was an avid daily runner, participating in several marathons per year and any charity event possible. Everything I've read says not to run with hip replacements. Do I really have to cut running out of my life?
Thursday, April 5, 2018

Patient's neuropathy linked to recent MRI with gadolinium
Not too long ago I developed symptoms of peripheral neuropathy that occurred almost immediately after having an MRI with gadolinium contrast. A physician confirmed that I had retained gadolinium. Shouldn't people be made aware of this potential adverse reaction to gadolinium?
Wednesday, April 4, 2018

Cannabis compounds trick brain into having the 'munchies'
I've read stories about Girl Scouts selling hundreds of boxes of cookies outside pot shops to people who are anticipating the munchies. My question is: What is it about cannabis that causes that kind of hunger?
Tuesday, April 3, 2018

Hyperthyroidism often not due to low iodine levels
I take medication daily for hypothyroidism and borderline high blood pressure. My question is: Do I benefit from iodide in table salt or should I buy plain salt for cooking?
Monday, April 2, 2018

Results of Medditerranean diet study short on necessary details
Apparently one size does not fit all when it comes to the Mediterranean diet, because a recent study found that rich people benefit from it and poor people don't. It can't be as simple as that. What gives?
Saturday, March 31, 2018

Nonallergic rhinitis often linked to hyper-responsive nerves
I have been plagued with clear nasal drip for a couple of years. The constant dripping is most prevalent when I eat, lift something heavy or even just get up from a chair. I have tried various antihistamines and nasal sprays. What else is there?
Friday, March 30, 2018

Possibility of cattle eye worm infestation exceedingly rare
Please tell me more about the recent story in the news about the young woman who spent time on a ranch and then found worms living inside her eyes. We are cattle ranchers, and now I'm worried about my husband and kids.
Thursday, March 29, 2018

Origins of annoying seborrheic keratoses are a mystery
I'm 88 and have small, brown, rough -- and very itchy -- spots that develop on my back and other areas. If I can scratch them off, the itching goes away. One spot that I didn't scratch off is now embedded and I can't get it off. Two dermatologists have basically said, "It's your age. Live with it." Isn't there another answer?
Wednesday, March 28, 2018

Air pollution can have adverse health effects on the elderly
I'm 84 and live in a big city. I try to walk as many places as I can, but I've read that air pollution may shorten the lifespan of seniors. Should I stay inside instead?
Tuesday, March 27, 2018

Despite slight cancer risk, brith control pills considered safe
Monday, March 26, 2018

Rectal itch an embarassing problem that's tough to cure

Dear Doctor: What can I do about persistent, intermittent rectal itch? I keep the area clean and dry and have tried numerous over-the-counter anti-itch medications, which seem to work for a short time before becoming ineffective. My primary care physician gave me an anti-fungal prescription (clotrimazole with betamethasone), which my dermatologist said was unwarranted. Your suggestions? 


Friday, March 23, 2018

Nurse practitioners and physician assistants
We've received a lot of feedback on the column about nurse practitioners (also referred to as NPs) and physician assistants (also known as PAs). Several letter-writers corrected our use of an apostrophe in referring to the profession of physician assistant. It may seem trivial but in fact there's a crucial difference between "physician's assistant" and "physician assistant," and it's about autonomy. A physician assistant is a clinician in her or his own right. We regret (and won't repeat) the error. 
Thursday, March 22, 2018

Not enough is known about Kratom to support its use
What, exactly, is kratom? The FDA has apparently called it an opioid, even though it seems to be an herbal supplement. Is it safer than prescription opioids? I'm afraid of opioids, but if this is safer, I'll try it.
Wednesday, March 21, 2018

Hookworm larvae infect humans by burrowing into their skin
I read a terrible story about a couple who went to the Caribbean and got hookworms by going barefoot. Is that only possible in the tropics, or should I be worried here in the United States?
Tuesday, March 20, 2018

Potential benefits of milk thistle need further study in humans
What are the pros and cons of taking milk thistle?
Monday, March 19, 2018

Recent studies suggest leafy greens tied to cognitive health
My girlfriend is all-in on one of those low-carb diets and has pretty much stopped eating vegetables. (When she does eat any carbs, it's the bread and sweets that she craves). I'm hoping one of the new studies about leafy greens and brain health might change her habits. Can you talk a bit about them?
Saturday, March 17, 2018

Rare autoimmune disease attacks blood vessels
My brother died from Wegener's disease at age 62. Could you please tell me more about this disease -- what causes it and what can be done? Could there be a connection to the fact that our father died of rheumatoid arthritis at age 64?
Friday, March 16, 2018

Preoperative self-care can quicken patients' recovery time
I'm 75 years old and am scheduled to have minor surgery next month. My doctor has been pushing me to walk every day and to perform core exercises -- not to mention eating right -- ahead of my operation. Does this really matter?
Thursday, March 15, 2018

Common adenovirus has many subtypes
I've been hearing about adenovirus, which is often mistaken as the flu. How can you tell the difference? And is it as serious as the flu?
Wednesday, March 14, 2018

Be careful when storing meds and supplements together
I take about nine different medications and dietary supplements per day. I use a pill container with slots for morning and evening, and it covers a two-week period. Can these meds and supplements be safely stored together? Do they lose potency being stored if they're in the container for two weeks?
Tuesday, March 13, 2018

Years of physical farm labor likely cause of tingling in hand
I have painful tingling, burning and numbness in my right palm and fingers. It disrupts my sleep and makes it difficult to hold a pencil. A hand brace doesn't help. Is it carpal tunnel syndrome? What can I do?
Monday, March 12, 2018

Consult with a physician before going on keto diet

DEAR DOCTOR: I'm hearing a lot about the health benefits of a ketogenic diet, that it's great for weight loss and can even reverse diabetes. What is the diet, exactly? Are the claims true? 


Saturday, March 10, 2018

Women 65 and over typically don't need routine pelvic exams
DEAR DOCTOR: I'm a 76-year-old woman who had a complete hysterectomy when I was 50. My daughters insist that I should still be seeing a gynecologist for cervical cancer screenings, including pelvic exams. Is this really necessary? I already see my family physician every six months for a checkup and blood work. 
Friday, March 9, 2018

Darker, less-processed chocolate can be enjoyed sparingly
How should chocolate be processed to preserve its healthful properties? I've read that a non-alkalizing process is better than an alkalizing process, but I don't understand the difference.
Thursday, March 8, 2018

Rare bone marrow disorder causes abundance of red blood cells
I've been diagnosed with polycythemia vera, which I understand is very rare. I'm currently being treated with phlebotomies. Please explain this diagnosis and what science has learned about it.
Wednesday, March 7, 2018

A healthy diet can usually provide all the nutrients you need
Doctors and nutritionists are now saying that taking vitamin and mineral supplements is worthless. But many of the foods we eat are fortified with vitamins and minerals. Are those additives worthless? If not, how are they different than taking a multivitamin?  
Tuesday, March 6, 2018

High lipoprotein(a) levels may indicate heart disease in some
DEAR DOCTOR: My blood test results always include levels of HDL and LDL cholesterol, but what about lipoprotein(a)? Don't high levels triple the risk of a heart attack or stroke at an early age? If so, shouldn't doctors test for it?  
Monday, March 5, 2018

Recent 'raw water' movement is misguided
DEAR DOCTOR: My daughter has been talking about the merits of "raw water" -- and the perils of regular tap water. Could it be that people are really drinking non-sterilized or treated water? Isn't that dangerous?
Friday, March 2, 2018

The long-term health effects of e-cigarettes are unknown
DEAR DOCTOR: Would you kindly address the risks of e-cigarettes compared to regular cigarettes? I am opposed to both because of the potential for nicotine addiction and other health issues. Some of my adult relatives, however, are convinced e-cigs are not harmful, even though they clearly seem addicted.
Friday, March 2, 2018

Reader's plea a reminder that the flu can be deadly for many
DEAR READERS: With this year's flu season on a pace to be the worst in almost a decade, we want to take a moment to share an important letter that we received from a reader. As of this writing, at least 37 children have died from influenza infection. Because of the time lag in identifying and reporting flu deaths, officials suspect the true number is significantly higher. 
Thursday, March 1, 2018

Link between marijuana use and schizophrenia needs further study
DEAR DOCTOR: Could you comment on the marijuana study done in early 2016 at the University of Exeter and University College London? I'm worried about the 14-year-olds with whom I work and their dangers of psychosis. I was hoping we might start a dialogue about the risky business of marijuana.
Wednesday, February 28, 2018

Any potential long-term risks of cellphone use remain unknown
DEAR DOCTOR: I always thought the worries about the safety of cellphones were a bit overblown, but now I'm reading about new guidelines concerning cellphone radiation. Just what's so dangerous? And is looking at the screen as risky as using the phone to make calls?
Tuesday, February 27, 2018

Those with an egg allergy can safely get a flu shot
DEAR DOCTOR: My pharmacist recently told me I could get a flu shot, even though I have an egg allergy. Is this true?
Monday, February 26, 2018

Study shows probiotic can relieve breast-fed colicky babies

DEAR DOCTOR: When our first son was born, we almost lost our minds as we rode out his bouts of colic. Our second son is due this spring and the idea of dealing with colic again already has me panicking. I've been reading that certain probiotics can help. Is this true? 


Saturday, February 24, 2018

Rare transient global amnesia mostly affects people over 50

DEAR DOCTOR: Can you shed some light on transient global amnesia? I was diagnosed with this five years ago (I'm now 71) after my family noticed that I couldn't recall common facts. I had no physical ailment or injury prior to this, and I'm told that the recurrence rate is 1 percent. 


Friday, February 23, 2018

When sitting at a workstation, be sure to get up and move around
DEAR DOCTOR: I never gained the infamous "freshman 15" while I was in college. But now I've graduated and am behind a desk for nine hours a day for my new job. I'm not only putting on the pounds, I feel generally lousy. Is this just adjusting to working life, or is sitting so much bad for you?
Thursday, February 22, 2018

















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