Health

Do drugs that raise good cholesterol reduce the risk of heart disease?

DEAR DOCTOR K: I have high levels of HDL cholesterol -- the "good" cholesterol. I was happy about that, but now I hear that medicines raising your HDL levels don't seem to help. Should I be disappointed?

DEAR READER: The HDL cholesterol story is complicated. It has been solidly established that people who have high levels of LDL (bad) cholesterol have a higher risk of developing heart disease. Moreover, it has been solidly established that treatments that lower LDL cholesterol reduce the risk of developing heart disease.

What is the treatment for social phobia?

DEAR DOCTOR K: I've always thought of myself as shy. But my partner thinks I may have social phobia. Could he be right?

DEAR READER: "Social phobia" goes well beyond shyness. People with social phobia feel a constant and powerful discomfort, self-consciousness and fear of humiliation in ordinary social situations. They feel as though all eyes are turned on them. Social phobia often leads people to avoid parties and other gatherings.

Does radiation therapy for cancer increase heart disease risk?

DEAR DOCTOR K: I had radiation therapy for breast cancer a few years ago. Now I'm reading that radiation therapy might increase my risk for heart disease. Is this true? Can I do anything to decrease my risk?

DEAR READER: Radiation therapy uses high-energy rays to damage or destroy cancer cells. It harms cancer cells primarily by damaging their genes. But the radiation can also damage the genes of healthy non-cancerous cells.

How can I help my child lose weight without making him feel deprived?

DEAR DOCTOR K: My 12-year-old is overweight. How can I help him achieve a healthy weight without making him feel deprived?

DEAR READER: Being overweight makes it hard for a child to keep up with friends on the playground. And the teasing can be merciless. What's more, kids who are overweight are at greater risk for lots of health problems as teens and later in life. Children who are overweight or obese are more likely to develop high blood pressure, high cholesterol and heart disease as adults. Long-term obesity also increases the risk of arthritis, diabetes and certain kinds of cancer.

Could hypnotherapy help relieve my chronic pain?

DEAR DOCTOR K: I am in near-constant pain because of arthritis. My doctor suggested that I try hypnotherapy. My first reaction was that it sounds like hokum, but now I'm wondering if it could help. What do you think?

DEAR READER: Hypnotherapy may in fact help with pain management. These days it is used to treat many mental and physical health problems. I spoke to my colleague Dr. Max Shapiro, a psychologist with Harvard-affiliated Massachusetts General Hospital. He explained that hypnotherapy is most effective in treating problems that require stronger control over the body's responses. Pain is a good example; insomnia is another.

Can I do anything to prevent nightmares?

DEAR DOCTOR K: Is there anything I can do to stop having terrible nightmares? They scare me, and ruin my sleep.

DEAR READER: There may be something you can do. The first thing you should know is that everyone has nightmares occasionally. That includes yours truly. Just as we don't really know why we sleep, we don't really understand nightmares. We also don't know why some people are more likely to have them.

Would I be better off with hip resurfacing or a hip replacement?

DEAR DOCTOR K: My hip has bad arthritis, and my doctor says I need either a hip replacement or something called "hip resurfacing." Which one is best?

DEAR READER: I once had to ask myself that same question, when my right hip became so painful from arthritis that something needed to be done. Let me first explain what each type of surgery is, and then how to think about the choice between them.

Do all cases of DCIS breast cancer need aggressive treatment?

DEAR DOCTOR K: I have been diagnosed with ductal carcinoma in situ. My doctor wants me to have surgery. But recently I read about a study that said not all women with this type of breast cancer even need to be treated. Can you help clear this up?

DEAR READER: Ductal carcinoma in situ (DCIS) is a type of breast cancer. In DCIS, the cancerous cells are contained within the breast's ducts (which carry milk to the nipple) but have not invaded surrounding tissue.

Does prediabetes put me on an irreversible path to Type 2 diabetes?

DEAR DOCTOR K: After years of normal blood sugar levels, I'm suddenly in the prediabetes range. Am I on an irreversible path to Type 2 (adult-onset) diabetes?

DEAR READER: No, you're not, but you're facing a challenge. Prediabetes is an early warning signal: You are at higher risk for developing diabetes. But diabetes is not inevitable. In fact, we know more about how to reduce the risk of getting Type 2 diabetes than we know about preventing most other major diseases. There are several things you can do to reverse course.

Does standing more really make a difference to your health?

DEAR DOCTOR K: Several of my colleagues have switched to standing desks. Does standing really make that much of a difference to your health?

DEAR READER: Research suggests that the more we sit, the more we're likely to develop heart disease and other illnesses, including diabetes and cancer. Whether it's sitting at the computer to get some work done or on the couch watching TV, too many hours spent on our bottoms increases the risk of dying from any cause -- even if you exercise regularly.