Archive for June, 2014

I get migraines regularly — should I have a brain scan?

DEAR DOCTOR K: I regularly get terrible migraine headaches. My doctor has prescribed medication, but I still think I should have a brain scan to make sure there's nothing more serious going on.

DEAR READER: Severe headaches cause both misery and fear. Obviously, the fear is that something serious, like a brain tumor, may be causing the headache. Still, the pain of even a severe headache rarely comes from something catastrophic like a tumor.

What are the warning signs of a stroke?

DEAR DOCTOR K: What are the warning signs of stroke? Why is it important to be able to recognize them?

DEAR READER: Nothing makes me sadder than to see someone suffer a stroke that could have been avoided. Not all strokes can be avoided, but many produce warning symptoms that can trigger preventive actions -- if they are recognized.

Is there an effective treatment for OCD?

DEAR DOCTOR K: I've been struggling with obsessive- compulsive disorder for years. Is there any effective treatment for it?

DEAR READER: There are better treatments today than there were when I went to medical school. As you know, in obsessive-compulsive disorder (OCD), a person is troubled by persistent, intrusive, anxiety-provoking or distressing thoughts (obsessions). He or she feels pressure to carry out excessive, repetitive behaviors (compulsions).

What are different exercise combinations for a good workout?

DEAR DOCTOR K: You've written that a complete exercise program involves a combination of activities. Can you discuss these exercises? How often should I do them?

DEAR READER: All-around fitness calls for a combination of aerobic, strength, flexibility and balance exercises. Let's start with aerobic activities, which are great for burning calories and paring down unwanted fat. These activities -- think of walking, biking, running and swimming -- push large muscles to repeatedly contract and relax.

Are treatments for peripheral artery disease and coronary artery disease similar?

DEAR DOCTOR K: I have PAD. It sounds like coronary artery disease of the legs. Is the treatment similar too?

DEAR READER: You're right: It's the same disease -- atherosclerosis -- in different arteries. In atherosclerosis, cholesterol-filled growths, called plaques, grow inside the artery. They block the flow of blood through blood vessels. In coronary artery disease (CAD), atherosclerosis blocks blood flow to the heart. In peripheral artery disease (PAD), plaque builds up in the arteries of the legs and feet, restricting blood flow to those areas.

What are pulmonary nodules — can they cause lung cancer?

DEAR DOCTOR K:I saw my doctor because I've been getting short of breath. He did an X-ray and CT scan that found three small "pulmonary nodules." Do I have lung cancer?

DEAR READER: There are few things more frustrating, for both you and your doctor, than when the doctor says: "Well, it's almost surely nothing to worry about ... but there is a small possibility that it's bad." How often does that happen? Pretty much every day, in my experience.

Should I try a low-fat, low-carb, or Mediterranean diet?

DEAR DOCTOR K: I want to go on a diet and am trying to decide between low-fat, low-carb and Mediterranean. What do you think?

DEAR READER: Your first two options -- low-fat and low-carb -- are too simple. There are "good" fats and "bad" fats, and "good" carbs and "bad" carbs. You don't want a diet that is low in good fats or good carbs. You want a diet that is low in bad fats and bad carbs.

Is it unsafe for someone with Alzheimer’s to drive?

DEAR DOCTOR K: My father has Alzheimer's disease. Is it unsafe for him to drive?

DEAR READER: Alzheimer's disease (AD) is a form of dementia that worsens over time. It often affects short-term memory early on, and then progresses to impair other cognitive functions such as thinking and judgment. As AD advances, most people lose their ability to do normal daily activities. Your question -- whether your father should stop driving -- is a common concern for families of a loved one with AD.

How does regular exercise help prevent memory loss?

DEAR DOCTOR K: I'm in my late 60s. I've read that regular exercise helps prevent memory loss. I find that hard to believe. How does it do that? And how much exercise do I need to reap this benefit?

DEAR READER: It's easy to understand why regular exercise would be good for your bones, muscles, lungs and heart. Regularly challenging those organs would make them stronger.

How do I treat a perforated eardrum caused by an ear infection?

DEAR DOCTOR K: I have a perforated eardrum caused by an ear infection. How will it be treated? Will my hearing be permanently affected?

DEAR READER: Your eardrum is a thin membrane involved in hearing. It separates your ear canal (the part that is open to the outside) from your middle ear. The eardrum is delicate -- and it has to be. Sound waves that enter your ear move the eardrum, which begins the process that allows you to hear.