Archive for December, 2011

Are memory problems always a sign of dementia?

DEAR DOCTOR K: I am in my mid-60s, and I'm worried I might be getting more forgetful than normal for my age. I function fairly well most of the time. But sometimes I'll forget something like the details of a phone conversation I recently had. How can I know what's normal?

DEAR READER: You sometimes forget things you didn't used to forget? Well, join the club. Each of us has more difficulty remembering things as we get older -- it's a normal part of aging. Like thinning hair and stiffer joints, subtle memory problems are common.

Should I take aspirin to prevent a heart attack?

DEAR DOCTOR K: Although some members of my family have heart disease, I haven't been diagnosed with it. I know people with current cardiovascular problems should take aspirin, but should I be taking it to prevent future problems?

DEAR READER: Your question seems simple enough. I wish I had a simple answer. The problem is that aspirin, like virtually all medical treatments, has benefits and risks. The main risk of aspirin is bleeding. But for people who have heart disease, regularly taking low-dose aspirin definitely reduces the risk of heart attacks in the future. The benefits and risks are different for one person than for another.

Do proton pump inhibitors have long-term side effects?

DEAR DOCTOR K: I suffer from heartburn and have been taking a proton pump inhibitor for the past few years. Should I be worried about long-term side effects?

DEAR READER: For many people with heartburn, proton pump inhibitors (PPIs) provide great relief. Stomach acid contains lots of hydrogen ions, which are protons. PPI drugs inhibit the production of those protons. The PPIs include esomeprazole (Nexium), lansoprazole (Prevacid) and omeprazole (Prilosec).

How can I cope with grief?

DEAR DOCTOR K: My husband recently passed away unexpectedly. I feel like I am drowning in grief. Please help me.

DEAR READER: I'm so sorry to hear of your loss. Just getting through the day may seem very hard. My patients sometimes have sought my advice about how to deal with the sudden and unexpected loss of a loved one. When they, like you, are still in the early, raw stages of grief, my advice is to let the nonessentials slide.

What causes blushing?

DEAR DOCTOR K: I seem to blush more than most people, and I find it a little embarrassing. Why am I more prone to blushing than others? Is there anything I can do about it?

DEAR READER: Let's start with what blushing is and why your face gets red. Blushing occurs when the tiniest blood vessels in your face — the capillaries — suddenly get wider. When they widen, more blood flows through them, which gives your skin a reddened, rosy appearance.

What are the benefits of using a pedometer?

DEAR DOCTOR K: I try to take a walk every day, but I know I need to walk more if I want it to count as exercise. A friend suggested I buy a pedometer. What exactly is a pedometer, and do you think it's useful?

DEAR READER: A pedometer can motivate you to exercise. Practically everyone knows that exercise is good for you. Many people have heard that brisk exercise for at least 30 minutes, at least five times a week, is a healthy goal. But there are three things many of my patients don't know. You may not, either.

What is hospital delirium?

DEAR DOCTOR K: A friend recently told me that his elderly aunt had to stay a few days in the hospital after a surgery. While there, she developed mental confusion that he called delirium. What surprised me was that he said this is fairly common. Why would a hospital stay cause delirium?

DEAR READER: Being a hospital patient can be a frightening experience for anyone. Unfortunately, some patients -- particularly older ones -- develop delirium. This can make the hospital experience truly terrifying.

Do topical pain relievers work?

DEAR DOCTOR K: I have chronic knee pain. Ibuprofen pills upset my stomach. Would pain relief creams be easier on my gut? And do they work?

DEAR READER: We often reach for pain relief pills when something hurts. Non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin, ibuprofen or naproxen are popular and effective pain relievers. However, they can cause stomach upset, ulcers and bleeding.

Should I have an ultrasound to find out the sex of my baby?

DEAR DOCTOR K: I'm having my first baby in six months. I'm resisting the urge to find out the sex of my baby during an ultrasound, but I hear there are other ways to tell. Is this true?

DEAR READER: For centuries, pregnant women and their husbands have made guesses about whether their baby would be a boy or a girl. Some prospective parents think they can tell by things such as the shape of a woman's pregnant belly or by her food cravings. Sometimes they're right — in fact, they're right about half of the time.

Should boys be vaccinated against HPV?

DEAR DOCTOR K: I know it's recommended that young girls get vaccinated against HPV, since this virus can cause cervical cancer. What about boys? At one time I read it was not recommended for them, but recently I heard that this had changed. Has it changed, and why?

DEAR READER: You're right. The CDC's Advisory Committee on Immunization Practices (ACIP) has recently recommended that boys also get the HPV vaccine.