Archive for July, 2016

Should I be worried about side effects from long-term use of SSRIs?

DEAR DOCTOR K: I'm nearing 60, and I've been on SSRI medicines for nearly 30 years, for depression. They work for me, but should I be worried about side effects from using them for so long?

DEAR READER: You've asked an important question -- one that should be asked of any medicine used for many months or years. All medicines can have side effects, and SSRIs are no exception. And some medicines can have side effects that become apparent only after long-term use.

How does physical exercise improve brain health?

DEAR DOCTOR K: You say that physical exercise helps to improve brain health, but it's not obvious to me how that could be. Do researchers understand exactly how exercise helps the brain?

DEAR READER: I understand why that's puzzling. It's easier to see how regular moderate exercise could protect against heart disease, for example. The heart is a muscle, and exercise makes the heart exercise.

What is the most effective way to get rid of spider veins?

DEAR DOCTOR K: I have developed many small, thin veins on my legs. I would like to get rid of them. What is the most effective treatment?

DEAR READER: Superficial leg veins, sometimes called "spider veins," occur when tiny veins appear just below the surface of the skin, causing red, blue or purple discolorations. Spider veins get their name from the shape of the discolorations. Some cases of spider veins can be quite small; others are more noticeable. They may make you feel self-conscious, but they are harmless. (I've put an illustration of spider veins on my website, AskDoctorK.com.)

Did cancer treatment increase my heart disease risk?

DEAR DOCTOR K: I survived cancer, only to be told that the treatments that saved my life may have increased my risk for cardiovascular disease. What are the risks? And can I minimize them?

DEAR READER: As more people are living longer after a cancer diagnosis, more people are coping with the long-term effects of cancer treatment. Many cancer-suppressing treatments can have undesirable effects, for example, on the heart and blood vessels.

Are heart palpitations dangerous?

DEAR DOCTOR K: I often experience heart palpitations -- almost every time I'm excited, angry or scared. Is this dangerous to my health?

DEAR READER: The word "palpitations" is used differently by different people. To me, palpitations are simply an awareness of your heart beating. People aren't usually aware of their heart beating. But when it beats unusually forcefully, irregularly or rapidly, you notice the heartbeat.

Why does my stomach make growling noises?

DEAR DOCTOR K: As I get older, it seems my stomach is more likely to make growling noises. Why does it do this, and what can I do about it? It's embarrassing.

DEAR READER: Maybe your stomach is trying to talk to my stomach. My stomach is periodically trying to talk to someone, that's for sure.

Am I too old for LASIK surgery?

DEAR DOCTOR K: I would like to have LASIK surgery to treat my nearsightedness. I'm 54 -- is that too old to have this surgery?

DEAR READER: LASIK (laser-assisted in-situ keratomileusis) can correct common eye problems: nearsightedness (myopia), farsightedness (hyperopia) and astigmatism. It can eliminate your need for glasses or contact lenses.

Can exposing babies to common food allergens help prevent food allergies later on?

DEAR DOCTOR K: In a recent column you said that parents should give babies peanut products to help prevent peanut allergies. Does the new advice also apply to other common food allergens, like eggs or cow's milk?

DEAR READER: To answer your question I turned to my colleague Dr. Claire McCarthy, a primary care pediatrician at Boston Children's Hospital. For decades, the standard advice recommended by allergy specialists was to hold off on giving babies foods that commonly cause allergic reactions. Parents were advised not to give egg, dairy, seafood or wheat in their child's first year. And parents were told to wait until two or three years to give peanuts or other nut products. It turns out that was bad advice.

Is addiction a disease or is it caused by a lack of willpower?

DEAR DOCTOR K: My brother has struggled with addiction for years. I've told my husband that addiction is a disease, but he claims my brother is weak and lacks willpower. Is he right?

DEAR READER: There is a lot of stigma and shame associated with addiction. But the truth is, people with substance-use disorders aren't simply weak or immoral. It surely is true that people who try out illegal addictive drugs for recreational purposes are breaking the law. In my opinion, they also are doing something profoundly stupid. But they're often teens, who tend to do a lot of stupid, impulsive things. Moreover, many people who become addicted to legal drugs were started on those drugs by their doctors.

Can you give me some practical solutions to compensate for my minor hearing loss?

DEAR DOCTOR K: I suffer from minor hearing loss, but not bad enough for a hearing aid. My wife complains about the volume on the TV, and I can't always keep up with conversations at a party or restaurant. I'm not looking for a technological fix just yet. Can you give me some practical solutions?

DEAR READER: I'm happy to share some practical tips for dealing with minor hearing loss. Before I do, though, I'd advise you to see a doctor. Hearing loss may be caused by a variety of things, including an underlying health condition.