Archive for February, 2015

Are urgent care centers and emergency rooms the same?

DEAR DOCTOR K: What are urgent care centers? Are they the same as emergency rooms?

DEAR READER: They definitely are not the same. Emergency rooms are for true emergencies -- even though many people go to emergency rooms for quite minor problems. Typically, emergency rooms are attached to hospitals, because patients with true emergencies usually need to be hospitalized after their treatment in the emergency room.

How do I protect myself against diabetic ketoacidosis?

DEAR DOCTOR K: I have had Type 1 diabetes for 20 years. I'm worried I may get ketoacidosis, even though I never have. How do I protect myself?

DEAR READER: You are at risk for ketoacidosis, but the fact that you've never had it is encouraging. It means you're already doing the things you need to do to prevent it. That's important, because diabetic ketoacidosis is a serious complication of Type 1 diabetes. Let's start with a few basics. Type 1 diabetes is often called "insulin-requiring" diabetes.

Is it important to know your heart rate when you’re exercising?

DEAR DOCTOR K: I've seen fitness monitors that track heart rate. Is it important to know your heart rate when you're exercising?

DEAR READER: Whether you're just getting started with an exercise routine or are a committed fitness enthusiast, tracking your heart rate can be helpful. Heart rate monitors -- which instantly tell you how fast your heart is beating -- can help you exercise at the right intensity.

How can I make swallowing pills easier?

DEAR DOCTOR K: I have a hard time swallowing pills. Do you have any suggestions?

DEAR READER: Swallowing pills can be difficult and downright unpleasant. It causes many people to gag, vomit or choke. This can keep people from sticking to their medication routines. A new study published in the Annals of Family Medicine may help. In the article, researchers suggest two techniques to help people improve their ability to swallow pills. (I've put illustrations of both techniques below.)

How do I prevent another kidney stone?

DEAR DOCTOR K: I recently had a very painful kidney stone. What can I do to prevent another?

DEAR READER: First of all, my sympathies: Pain from passing a kidney stone can be as bad as any kind of pain. Kidney stones are hard, chemical deposits that form inside the kidney chambers where urine is collected. Urine passes from the kidney down a narrow tube (the ureter) and into the bladder. If a stone gets carried into the narrow ureter, it can get stuck. This can cause severe pain, bloody urine, nausea and vomiting. If you've had one kidney stone, you're at increased risk for another.

Should I stop drinking if I have chronic pancreatitis?

DEAR DOCTOR K: I have chronic pancreatitis. Will it help to stop drinking at this point? Or is it too late?

DEAR READER: It is never too late to stop further damage to the pancreas, but it may be too late to reverse damage done in the past. However, that's water under the bridge. What you want to do now is stop further damage.

Will running wear my knees out faster?

DEAR DOCTOR K: I'm 68. I've jogged regularly for decades, but I've recently developed a touch of arthritis in my knees. Will continuing to run make my knees wear out faster?

DEAR READER: Having mild arthritis in the knees should not stop you from running. And, in case you were wondering, running probably did not create the problem in the first place.

What is endophthalmitis?

DEAR DOCTOR K: A few weeks after my cataract surgery, my eye began to hurt and my eyelid became swollen. My doctor said I have "endophthalmitis." What is this? Is it related to my cataract surgery?

DEAR READER: Endophthalmitis is inflammation inside the eye that is usually triggered by an infection. In the United States, most cases are caused by bacterial infections that develop after eye surgery. Endophthalmitis is a serious problem that can lead to permanent loss of vision.

What is mild cognitive impairment?

DEAR DOCTOR K: My father's doctor says he has mild cognitive impairment. What does that mean?

DEAR READER: Mild age-related memory loss -- "Where did I leave my keys?" -- is normal. But people with mild cognitive impairment (MCI) have memory loss and/or trouble thinking that are more persistent and severe than normal. There are two types of MCI. Amnestic MCI involves memory loss.

After a joint replacement, do I need to take an antibiotic before a dental procedure?

DEAR DOCTOR K: I had knee replacement surgery several years ago. More recently, I had my hip replaced. I am scheduled to have a root canal next month. Do I need to take antibiotics before my dental procedure?

DEAR READER: Almost any type of dental work -- extractions, gum surgery, root canals, even routine cleanings -- can injure the gums and other soft tissues of the mouth. The most obvious evidence of this is that they bleed. Bacteria live inside our mouth. When gums are injured, bacteria from the mouth can enter the bloodstream.