Archive for April, 2012

What is a colposcopy?

DEAR DOCTOR K: I had an abnormal Pap smear. Now my doctor wants me to have a colposcopy. What can I expect during this procedure?

DEAR READER: Pap smears help determine if you might have cancer, or a precancerous condition, of your cervix. When a Pap smear raises such suspicions, the next step is a colposcopy. Colposcopy is generally safe and painless. It takes about 15 to 30 minutes and doesn't require anesthesia.

What is a ministroke?

DEAR DOCTOR K: My husband's doctor said that he had a ministroke. What does this mean?

DEAR READER: Most strokes occur when blood flow to a part of the brain is blocked. These are called ischemic strokes. When the flow of blood is blocked badly enough, for a long enough time, brain cells die. Not all blockages of the brain's blood vessels are bad enough, or last long enough, to cause death of brain cells. Instead, the part of the brain that isn't getting enough blood temporarily malfunctions. Such temporary blockages that do not lead to brain-cell death are called ministrokes.

What is an implantable cardioverter-defibrillator (ICD)?

DEAR DOCTOR K: I have a heart arrhythmia. My doctor wants me to get an ICD. What do I need to know before agreeing to get one?

DEAR READER: ICD stands for "implantable cardioverter-defibrillator." It is a small device that is surgically placed in your body. An ICD can save your life — but it can also complicate your life.

Should I see a doctor for a finger injury?

DEAR DOCTOR K: I hurt my finger playing basketball last week. The pain is manageable, but doesn't seem to be lessening. Should I see a doctor?

DEAR READER: Catching a ball -- a football, baseball or basketball -- is a common way kids and young adults can injure a finger. Fortunately, most finger injuries are not serious or lasting. But sometimes a tendon (fibers that connect muscles to bones, and cause fingers to move) can be torn, or a joint can be dislocated, or one of the finger bones broken. So you've asked an important question.

Is my gambling problem related to anxiety?

DEAR DOCTOR K: I used to gamble once a year, on a trip to Vegas. But lately my lifelong battle with anxiety has gotten worse — and so has my gambling. Are they related? What can I do?

DEAR READER: Gambling and anxiety do often go hand in hand. People who gamble report feeling less anxious while gambling because the excitement masks anxious feelings. This relief can become addictive, and the impulse to gamble can become overwhelming. So for many gamblers, reducing anxiety by some other means is necessary in order to control the urge to gamble as a way of dealing with anxiety. There are several techniques that can help.

What do blood pressure numbers mean?

DEAR DOCTOR K: At my last checkup, my blood pressure was 130/85. I'd like to have a better understanding of what those numbers mean.

DEAR READER: Your heart is a pump, pushing blood throughout your body 60 to 80 times a minute. After each pump it relaxes, fills up with more blood and then pumps again. The heart pumps blood out through blood vessels called arteries, and collects blood returning from the body in blood vessels called veins.

Do older adults need to practice safe sex?

DEAR DOCTOR K: I'm a single, postmenopausal woman in my 50s. Do I still need to worry about "safe" sex?

DEAR READER: I'm surprised by how often my patients ask me the same question. "Safe" sex means using what doctors call "barrier protection" — male or female condoms. It is true that menopause brings freedom from worries about pregnancy (if your doctor is sure you have entered menopause). But menopause doesn't change at all your need to practice safe sex. That's particularly true if you're entering into a new relationship or have multiple sexual partners.

Are older fathers more likely to have children with autism?

DEAR DOCTOR K: I am a 34-year-old woman married to a man more than 20 years my senior. Our first child, a son born four years ago, is autistic. I have heard that older fathers are more likely to have autistic children. Is this true?

DEAR READER: I am not an expert on autism. I have learned what I know from experts here at Harvard Medical School. No one knows the causes of autism, but today the apparent consensus is that they are biological — something a child is born with. As to your question, I'm told that some research has shown that a child's risk of developing autism does rise as the age of the child's biological father rises.

Is it safe to take a sleeping pill every night?

DEAR DOCTOR K: I am 70 and have always had sleep problems. I've started to take a prescription nonbenzodiazepine sleeping pill every night. It's working very well. Is it OK if I keep on taking it?

DEAR READER: To answer your question, I consulted with my colleague, geriatrician Suzanne Salamon. She told me that she is reluctant to prescribe sleeping pills to her older patients. They lead to daytime grogginess and may contribute to cognitive problems, poor balance and falls.

How can I control my drinking before it becomes a problem?

DEAR DOCTOR K: I am a 42-year-old man who drinks alcohol pretty much every day. Although I don't feel "out of control" from the amount I drink, I know it's more than the recommended amount. How can I nip this in the bud before it goes too far?

DEAR READER: If you have just one drink a day, there's evidence that this actually may be healthy. More than two drinks a day for men under 65, more than one a day for men over 65, or more than one a day for a woman of any age can raise the risk of alcohol-related diseases.