Archive for January, 2015

How does an LVAD work?

DEAR DOCTOR K: I have severe heart failure. My doctor wants me to consider an LVAD. What do I need to know?

DEAR READER: Heart failure is a condition in which the heart cannot pump efficiently enough to meet the body's need for blood. It needs help; it's too weak to do the job. Medicines can strengthen the heart, but only to some degree. Ultimately, the only solution may be a heart transplant.

What causes charley horses?

DEAR DOCTOR K: Over the past few months, I've been experiencing severe "charley horses." What causes them? How can I prevent them?

DEAR READER: Almost everyone has a "charley horse" at some point in his or her life. These are muscle spasms in which a group of muscles involuntarily contracts. This causes pain and inability to use those muscles. Stretching typically stops the cramp. But you may continue to have soreness for several days.

Are over-the-counter cold medications safe?

DEAR DOCTOR K: I'm in my 60s. Whenever I have a cold, I reach for whichever medication treats the most symptoms. My wife says that's not safe, even if the medication is available over the counter. Is she right?

DEAR READER: Your wife is correct. Clearly, you should listen to her more often. Painkillers, decongestants, antihistamines and combination remedies -- even those available over the counter -- can sometimes cause health problems. They can interact with other drugs and can interfere with existing conditions. When choosing a cold medication, read the list of active ingredients.

When can I go back to work after a heart attack?

DEAR DOCTOR K: I am 59 years old. I recently came home after being hospitalized for five days for a mild heart attack. I feel great -- but my doctor says he doesn't want me to go back to work for another six weeks, even though my job mostly involves sitting at my desk. I like to stay busy and feel ready to return to the office. Please advise.

DEAR READER: The treatment of heart attacks has come a long way in the past 30 years. Doctors can now open blocked coronary arteries with angioplasty balloons and stents or "clot-busting" drugs. We can use stress tests and echocardiograms to classify patients as low-, intermediate- or high-risk when they are discharged from the hospital. And patients go home with medications that reduce the likelihood of another heart attack.

How does salt affect blood pressure?

DEAR DOCTOR K: I have high blood pressure, and my doctor advised me to cut back on salt. Can you explain how salt affects blood pressure?

DEAR READER: Blood pressure is the force of blood pushing against the walls of the arteries as the heart pumps blood. High blood pressure, also known as hypertension, is blood pressure greater than 140/90 mm Hg. High blood pressure increases your risk of stroke, heart attack, kidney damage, loss of vision and other health problems. Many studies show that blood pressure rises with higher levels of sodium in the diet.

How are abdominal adhesions treated?

DEAR DOCTOR K: I had abdominal surgery last year. Soon after, I started experiencing severe pain and swelling in my abdomen. It turns out I have abdominal adhesions. I'd never heard of them. What are they, and how are they treated?

DEAR READER: Abdominal adhesions are bands of fibrous scar tissue. They can cause organs that are normally not connected to stick to one another or to the wall of the abdomen.

How can I prevent addiction to my prescription painkillers?

DEAR DOCTOR K: My doctor has prescribed prescription painkillers -- opioids -- for my severe back pain. They relieve my pain, but how can I reduce my risk of becoming hooked?

DEAR READER: Simply being aware of the risk of addiction is a good first step in ensuring that you do not become addicted to prescription painkillers. I'll explain a little bit about painkillers. Then I'll describe some steps you can take to prevent addiction.

What should I know about testicular cancer?

DEAR DOCTOR K: I'm in my 30s. A friend of mine was recently diagnosed with testicular cancer. What should I know about this cancer? Should I be screened for it?

DEAR READER: Testicular cancer is the uncontrolled growth of abnormal cells in one or both testicles (testes). Nearly all testicular cancers start in germ cells. These are the cells that make sperm. The testicles are located in the scrotum, behind the penis.

What is toxic shock syndrome?

DEAR DOCTOR K: I saw a warning about toxic shock syndrome on a box of tampons. What is it, and what does it have to do with tampon use?

DEAR READER: Toxic shock syndrome (TSS) is a rare, life-threatening illness triggered by certain bacteria. The two bacteria most often involved are streptococci ("strep") and staphylococci ("staph"). The cases caused by streptococci tend to be the most severe. In TSS, toxins (poisons) produced by these bacteria cause a severe drop in blood pressure that can lead to organ failure.