Health

Do I need an annual physical if I’m in good health?

DEAR DOCTOR K: I'm 73 and in great health. Do I really need to have an annual physical?

DEAR READER: Let's start by defining "great health." I would define it as having no known chronic (ongoing) illnesses. However, most people your age have at least one chronic illness, such as high blood pressure. People with chronic illnesses need to be checked out at least once a year, and usually more often.Even if they don't have any chronic illnesses, I ask my patients to come in for a checkup every year. That includes asking and answering some questions, a physical examination and some screening tests.

Why do we yawn?

DEAR DOCTOR K: I get plenty of sleep. So why do I yawn all the time?

DEAR READER: We all yawn frequently, more often in the early morning and late evening. Does it mean we're tired? Bored? Short on oxygen? As common as it is, we know little for certain about yawning. We do know that yawning does not always indicate a need for sleep. It is true that people often yawn as they get ready to retire for the night. But we also yawn when we first arise in the morning and at other times during the day.

How can I relieve knee pain from chondromalacia?

DEAR DOCTOR K: I saw my doctor because of aching pain in my knee, which sometimes buckles unexpectedly. He says I have chondromalacia. What is this, and what can I do to relieve the pain?

DEAR READER: The joints in your body are cushioned by cartilage. This tough, rubbery tissue covers and protects the ends of bones inside a joint, allowing them to glide smoothly against one another as the joint moves. With chondromalacia, the cartilage inside a joint softens and breaks down. The ends of the bones can rub together, causing pain. Chondromalacia can affect any joint, but the most common location is inside the knee, see the illustration on the right.

How can I fight inflammation without medications?

DEAR DOCTOR K: You've written that chronic inflammation has been linked to diseases such as diabetes and heart disease. Is there anything I can do to fight inflammation without using medications?

DEAR READER: Inflammation in the body is a double-edged sword. Short-lived inflammation, directed by your immune system at invaders like bacteria or viruses, protects your health. But sometimes inflammation persists, even when there is no health threat. That's when it can become your enemy. Many major diseases have been linked to chronic (ongoing) inflammation, including cancer, heart disease, diabetes, arthritis, depression and Alzheimer's.

What can I do about my heavy periods?

DEAR DOCTOR K: I bleed very heavily during my menstrual periods. Is there anything that can be done about this? Or do I just have to put up with the discomfort and inconvenience every month?

DEAR READER: Excessive menstrual bleeding (the medical term is menorrhagia) is a common problem. In my experience, a few primary-care doctors tell their patients just to "live with it." Not surprisingly, obstetrician/gynecologists are more likely to recognize excessive menstrual bleeding as a problem that needs treatment.

How can my 4-year-old prevent another UTI?

DEAR DOCTOR K: I think my 4-year-old daughter may have a urinary tract infection. How will it be treated? And what can I do to make sure she doesn't get another one?

DEAR READER: A urinary tract infection (UTI) occurs when bacteria infect urine in the kidneys, bladder or urethra, a small tube that connects the bladder to the outside. In girls (and women), the urethra is located in front of the vagina. The opening of the urethra is also near the rectum. The large intestine (the colon and rectum) are filled with bacteria. During bowel movements, those bacteria start living on the skin around the rectum and near the urethra.

How does strength training slow bone loss?

DEAR DOCTOR K: I was recently diagnosed with osteopenia. My doctor advised strength training because it can help slow bone loss. How does it do that?

DEAR READER: Osteopenia is a thinning of the bones. It is often a precursor to osteoporosis, a more severe thinning of the bones. Osteoporosis puts you at risk for disabling, and sometimes debilitating, fractures. Bones are filled with cells. Some cells build up new bone; other cells tear down old bone. In most people, those two processes are in good balance.

What is the most effective NSAID for back pain?

DEAR DOCTOR K: I have frequent back pain. I usually take acetaminophen (the Tylenol brand), but I hear it may not be effective for back pain. Is there anything to that?

DEAR READER: If you'd asked me that question even a year ago, I would have said, "Acetaminophen works fine for most people." Lots of people are bothered by back pain. When it strikes, all you want is relief -- and fast. Many folks turn to over-the-counter pain relievers like acetaminophen and non-steroidal anti-inflammatory drugs, or NSAIDs (ibuprofen, naproxen and aspirin).

How do I check my blood pressure at home?

DEAR DOCTOR K: My doctor told me to check my blood pressure at home, but he didn't give me many details. Could you provide some guidance?

DEAR READER: Keeping your blood pressure in check is vital to maintaining heart health and preventing stroke. But the way most of us monitor our pressure -- by trekking to the doctor's office for occasional blood pressure checks -- is far from ideal. For one thing, it provides isolated snapshots, rather than a complete picture.

What does calcium have to do with the parathyroid gland?

DEAR DOCTOR K: A recent blood test showed that the calcium level in my blood is high. My levels of something called "PTH" are also high. Now my doctor has scheduled a parathyroid scan. Why? What does calcium have to do with the parathyroid?

DEAR READER: You have four parathyroid glands. These pea-sized glands sit on your thyroid gland, in the lower part of your neck. I've put an illustration of the parathyroid glands below. A hormone is a chemical made in one organ that enters the blood, travels throughout the body and affects how different parts of the body work. The parathyroid glands produce the parathyroid hormone (PTH).