Archive for May, 2014

Do I have to worry about prehypertension?

DEAR DOCTOR K: My doctor says I have prehypertension. If it's "pre," then I don't need to worry about it, right?

DEAR READER: Prehypertension is a blood pressure reading of 120–139/80–89 mm Hg. That's the gray zone between normal blood pressure (below 120/80) and hypertension, or high blood pressure (above 140/90). We know that hypertension is dangerous. It increases your risk of heart disease, stroke, kidney disease and impaired vision.

How is a pacemaker inserted?

DEAR DOCTOR K: I'm scheduled to have a pacemaker inserted in a couple of weeks. Can you tell me what will happen during the procedure?

DEAR READER: A pacemaker is a little box that is placed beneath the skin of your chest. It has wires that run into your heart, attaching to its inner surface. A pacemaker regulates your heartbeat electronically.

How do you treat eczema without steroids?

DEAR DOCTOR K: My 21-month-old daughter has eczema. Is there any way to treat this condition without steroids?

DEAR READER: Eczema, also called atopic dermatitis, is more than just dry skin. It is an inflammatory skin disease that often begins in infancy as an intensely itchy rash. Scratching leads to further irritation. The injured skin becomes chronically inflamed and more vulnerable to infection.

How can I cut down on my type 2 diabetes medications?

DEAR DOCTOR K: I have Type 2 diabetes. Is there anything I can do to cut down on my medications?

DEAR READER: Yes. In fact, some of my patients have entirely eliminated their need for medication with aggressive lifestyle changes. And many more have reduced the number or the dose of the medications they are taking with the same lifestyle changes.

What is restless leg syndrome?

DEAR DOCTOR K: My doctor says I have restless leg syndrome. What is it, and how is it treated?

DEAR READER: Restless legs syndrome (RLS) is a brain and nervous system disorder that causes uncomfortable sensations in the legs. The discomfort is usually accompanied by an overwhelming urge to move the legs. Doing so can temporarily relieve the discomfort.

Should I try to remove an earwax blockage?

DEAR DOCTOR K: I have a lot of wax in my ear. Should I try to remove it? How?

DEAR READER: Earwax is created when the oily substance made by cells lining the ear canal mixes with dead skin and debris. Normally, the mixture slowly moves out of the ear on its own. But sometimes earwax gets blocked in the ear. Certain conditions make this more likely:

What are some ankle-strengthening exercises?

DEAR DOCTOR K: I have weak ankles, and as a result, I have frequent ankle sprains. Can you suggest some ankle-strengthening exercises?

DEAR READER: Our ankles are workhorses and take a lot of abuse. They must bear the full weight of our bodies, yet stay nimble and flexible through every step and jump. It's amazing they work as well as they do. As is true with every weight-bearing joint in our bodies, the muscles that affect the movement of the joint are the joint's best friends. I learned this the hard way. I badly injured my right quadriceps muscle playing basketball when I was in my 20s.

What is a list superfoods that support heart health?

DEAR DOCTOR K: You've written about "superfoods" that deliver a lot of nutritional bang for their buck. Do you have a list of superfoods for heart health?

DEAR READER: Many foods -- from the everyday to the exotic -- are rich in nutrients that help keep heart disease at bay. That's good news, and it's been documented in many scientific studies. My colleagues in nutrition science at the Harvard School of Public Health and Harvard Medical School have published the following list of heart-healthy superfoods. They and I use the word "superfoods" advisedly. Obviously, no food offers anything like perfect protection against any illness.

Does a diet rich in saturated fats still increase heart disease risk?

DEAR DOCTOR K: Here we go again. After years of hearing that diets rich in saturated fats increase the risk for heart disease, I hear a new study says that's not so. What gives?

DEAR READER: I don't blame you for being frustrated. So let me start with the bottom line: Take this new study with several grains of salt. (Incidentally, it still is true that too much salt is bad for your health, so just a few grains, please.) Back in the 1970s and 1980s, you heard a lot about how fat was bad for you.

Does chelation therapy help with heart disease?

DEAR DOCTOR K: I have heart disease, and I keep hearing that chelation therapy can help. It sounds like snake oil to me. What is it, and can it help?

DEAR READER: Ever since I graduated from medical school, I've thought, like you, that chelation therapy for heart disease sounded like snake oil. Many of my patients have asked about it, and I've told them not to consider it. About a year and a half ago, a reader asked me the same question, and I was pretty negative in my column.