Archive for July, 2015

What can I do about my esophagitis caused by acid reflux?

DEAR DOCTOR K: I have esophagitis. Could this have been caused by my acid reflux? What can I do about it?

DEAR READER: Yes, it could, and there are treatments. First, some explanation. The esophagus is the muscular tube that carries food from the mouth, through the chest and into the stomach. Normally you don't feel the presence of the esophagus, except when you are swallowing. Sometimes the lining of your esophagus becomes inflamed. That's called esophagitis. By far the most common cause of esophagitis is acid reflux, or gastroesophageal reflux disease (GERD).

My doctor advised active surveillance for my prostate cancer. What does this mean?

DEAR DOCTOR K: After an abnormal PSA test and biopsy, I have been diagnosed with early-stage, non-aggressive prostate cancer. My doctor advised active surveillance. What does this mean?

DEAR READER: Prostate cancer is the uncontrolled growth of abnormal cells in the prostate. This walnut-sized gland sits below the bladder, in front of the rectum, near the base of the penis. Prostate cancer is common, but it is not always dangerous. People are often surprised to hear "cancer" and "not dangerous" in the same sentence.

Can ibuprofen reduce my heart attack risk as well as my pain?

DEAR DOCTOR K: I take ibuprofen every morning for my arthritis. My doctor wants me to take low-dose aspirin every day to reduce my heart attack risk. Ibuprofen and aspirin are both NSAIDs, right? So will the ibuprofen help my arthritis and my heart? Or should I take both?

DEAR READER: When joints ache, many people turn to nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief. Aspirin is a type of NSAID. So are ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn). NSAIDs are widely used because they perform double duty. They relieve pain and also reduce inflammation.

Do any supplements effectively lower cholesterol?

DEAR DOCTOR K: My cholesterol is high and my doctor wants me to go on a statin. I'd like to avoid medication. Do any supplements effectively lower cholesterol?

DEAR READER: Statin drugs lower LDL (or "bad") cholesterol and also reduce inflammation. Together, these effects lower your risk of heart attack. Various herbs and supplements have been touted for their ability to improve cholesterol levels. There is one general caveat you should consider. New drugs are tested by the FDA for their safety, effectiveness and purity.

Does ischemia have to be treated if it’s not causing any symptoms?

DEAR DOCTOR K: The results of a recent stress test showed that I have "silent ischemia." I haven't felt any pain or discomfort. I wouldn't even have known about it if not for the stress test. Does it need to be treated if it's not causing any symptoms?

DEAR READER: The word "ischemia" comes from a Latin term that means "stopping blood." If a stress test shows you have cardiac ischemia, blood flow to a part of your heart muscle is less than the heart muscle needs when you exercise. The most likely culprit is a coronary artery narrowed by cholesterol-laden plaque.

How can I get my child to swallow pills?

DEAR DOCTOR K: My 7-year-old was recently prescribed a medication that comes only in pill form. The problem is, he can't swallow pills. Any advice?

DEAR READER: It's perfectly normal for children to have trouble swallowing pills. The good news is that there are techniques you can try to make it easier. A review article in the journal Pediatrics looked at a variety of techniques. These included using a special cup and teaching children different ways to hold their heads while swallowing. All of the techniques worked well for most of the children. More important, most children overcame their pill-swallowing problems. That's important because children who need medicine must be able to take it.

What are the symptoms of hypothyroidism?

DEAR DOCTOR K: I'm a woman in my late 50s. Lately I've been colder and more tired than usual. My memory has been off and my skin is drier. I figured these were all effects of getting older. Fortunately, my doctor did a blood test that showed hypothyroidism. Could all of these symptoms really result from an underactive thyroid?

DEAR READER: Midlife can bring subtle changes in skin, hair, energy, weight and even mental outlook. Like you, many women write these changes off as the effects of aging. But, as your doctor did, it's a good idea to make sure they're not the result of an underactive thyroid. The thyroid is a tiny butterfly-shaped gland that perches in the front of your neck.

I recently had a seizure for the first time, what are the chances I will have another one?

DEAR DOCTOR K: I'm in my mid-30s, and I recently had a seizure for the first time. My doctor recommended anti-epilepsy drugs. Do I really need them? What are the chances I will have another seizure?

DEAR READER: A seizure is a sudden change in the brain's normal electrical activity. During a seizure, brain cells "fire" uncontrollably. There are different types of seizures. Some cause a person to lose consciousness and fall to the ground, twitching or jerking. Then it stops, and a person slowly returns to normal consciousness.

I have Type 2 diabetes, how can I achieve a healthy pregnancy?

DEAR DOCTOR K: I have Type 2 diabetes, and I would like to get pregnant. What can I do to increase my chances of having a healthy baby?

DEAR READER: Like you, some women already have either Type 1 or Type 2 diabetes before they become pregnant. There also is a kind of temporary diabetes that develops during pregnancy called gestational diabetes. It goes away after the baby is born. You're right to be concerned. Type 1, Type 2 and gestational diabetes all cause high blood sugar and can cause pregnancy complications. But for this column, I'll focus on pregnancy and Type 2 diabetes.

What should I look for in mosquito repellents?

DEAR DOCTOR K: Which ingredients should I look for in a mosquito repellent? Are there any I shouldn't use on my kids?

DEAR READER: Ah, summer. Time for relaxing, playing outside, going to the beach -- and mosquitoes. The itchiness from the bites can be maddening. And these tiny, annoying insects can carry serious illnesses, such as West Nile virus and Eastern equine encephalitis.