Archive for October, 2013

What causes peripheral neuropathy and what can I do about it?

DEAR DOCTOR K: I have peripheral neuropathy. I know that people with diabetes often get neuropathy, but I'm not diabetic. What else can cause this condition? And what can I do about it?

DEAR READER: Neuropathy is a medical term that means nerve damage. The type of nerve damage that people with diabetes get involves specific nerve fibers in all nerves, particularly the nerves that travel to the legs and feet. (There are other conditions in which a single nerve leading to the legs and feet is pinched, causing pain. An example is what is often called a "slipped disk" or "herniated disk" in the lower part of the spine).

I suffer from vertigo, I’ve heard that the Epley maneuver may help –Could you explain what this is?

DEAR DOCTOR K: I suffer from benign paroxysmal positional vertigo. I've heard that something called the Epley maneuver may help. Could you explain what this is?

DEAR READER: Vertigo is the sensation that either your body or your environment is moving, usually spinning. Vertigo can be a symptom of many different illnesses and disorders. The type of vertigo you have -- benign paroxysmal positional vertigo (BPPV) -- is the most common form.

I worry a lot, my psychologist she said I didn’t have anxiety disorder — I can’t believe there’s nothing to do. Can you help?

DEAR DOCTOR K: I've always worried a lot. I saw a psychologist, but she said I didn't have anxiety disorder, so she couldn't help. I can't believe there's nothing to do. Can you help?

DEAR READER: I don't agree with your doctor. I've talked before in this space about how doctors typically define diseases by how they appear in their most extreme form. I call it the "tip of the iceberg" phenomenon. Doctors have certain criteria for what constitutes an anxiety disorder.

I’m the primary caregiver for my ill, elderly father. I’m exhausted and upset all the time–What can I do to lighten my load?

DEAR DOCTOR K: I'm the primary caregiver for my ill, elderly father. I'm exhausted and upset all the time. What can I do to lighten my load without costing us much? Neither of us is well off.

DEAR READER: You're not alone. Approximately one in five American adults helps an elderly or disabled family member with the daily tasks of life. This caregiving runs the gamut from grocery shopping, cooking and cleaning house, to helping with baths and personal hygiene or providing hands-on medical care. That's often in addition to caring for other family members and holding down a paid job.

I’ve been feeling sad and tired but my doctor doesn’t think I’m depressed. What else could it be?

DEAR DOCTOR K: Recently I've been feeling sad and tired. My doctor doesn't think I'm depressed, but I know something's not right. What could it be?

DEAR READER: Doctors typically define diseases by how they appear in their most extreme form. I call it the "tip of the iceberg" phenomenon. For example, you don't have diabetes until your blood sugar reaches a certain level. You don't have lupus until you have a certain combination of symptoms, physical examination and laboratory abnormalities. The same with multiple sclerosis.

You recently talked about two kinds of abdominal fat — brown fat and white fat. Could you explain the difference?

DEAR DOCTOR K: In a recent column about abdominal fat, you talked about two kinds of fat -- brown fat and white fat. I'd like to hear more about them.

DEAR READER: I'm glad you asked, because the discovery of these two types of fat could prove to be very important. In the column you're referring to, I discussed how visceral, or abdominal, fat (which accumulates deep inside the abdomen) is more harmful to our health than subcutaneous fat (the fat just beneath the skin). But when it comes to fat, it's not just location that matters. Color counts, too -- and brown is better.

I’m curious — How do we see?

DEAR DOCTOR K: This isn't a medical question -- I'm just curious. How do we see?

DEAR READER: It all begins with light. Light from the sun, moon, fire or (in the past century or two) from electric lights bounces off an object and enters our eyes. The eye is like a camera. It has a lens that continuously focuses to sharpen the picture. Then the eye sends the picture to the brain, which processes the picture and does the seeing.

What are the qualities of a good emergency medicine doctor?

DEAR DOCTOR K: My son is in medical school and is thinking of specializing in emergency medicine. What are the qualities of a good emergency medicine doctor?

DEAR READER: When I was a medical student, I was attracted to work in the emergency department (ED). (EDs are also called emergency rooms, or ERs -- as in the TV show.) It was really exciting. So many of the patients were very sick, but if you made the right diagnosis and gave the right treatment, you could save lives -- every day.

My mother’s stroke severely impacted her ability to speak — What are ways she can regain her speech?

DEAR DOCTOR K: My mother recently had a stroke, and it's severely impacted her ability to speak. What can be done to help her regain her speech?

DEAR READER: Losing the ability to speak, or to understand speech, takes away an important part of ourselves -- the ability to communicate easily with others. I would rather be blind or deaf than unable to speak or to understand others. But there is hope that your mother can improve.