How long might hot flashes last?

DEAR DOCTOR K: Recently you wrote about a patient who was still having hot flashes in her early 70s, long after menopause. I'm in my 60s, and I still have them. How long might they last?

DEAR READER: Following the publication of that column, I got many letters with questions like yours. These letters also described what it is like to suffer from hot flashes. One reader recalled driving with her parents on a bitter cold winter night. Suddenly, her mother had a hot flash. It was so bad that she "turned the heater off, opened the car windows and stuck her head out the window. My father asked her what the heck she was doing."

What is the Mediterranean diet and is it actually healthy for you?

DEAR DOCTOR K: In some of your columns you've said that the "Mediterranean diet" is healthy. First, what is a Mediterranean diet? Second, what proof is there that it really is healthy? Call me "Skeptical."

DEAR READER: Well, "Skeptical," prepare yourself for a fairly emphatic reply. Because when I think skepticism about something important is misguided, I tend to unload. The Mediterranean diet is the traditional diet of people in countries near the Mediterranean Sea. The diet is rich in plant foods. These include fruits, vegetables, grains, beans, nuts and seeds. Animal protein is consumed chiefly in the forms of fish and poultry. Olive oil is the principal fat. And wine is taken with meals.

Remarkable stem cell experiments hold great promise

DEAR READERS: In yesterday's column I said that, theoretically, embryonic stem cells could be used to replace cells that are killed by disease -- heart cells killed in a heart attack, for example, or brain cells killed by Alzheimer's disease. If you needed stem cells, what you would ideally want were your own embryonic stem cells. The dilemma: Your own stem cells existed only briefly, long ago, and you couldn't turn back the clock. That is, until a research breakthrough in 2007 showed that you could.

Has anything come of stem cell research?

DEAR DOCTOR K: People have been talking about stem cells as a revolutionary technique for a long time. Has anything come of it? And why has it been so controversial?

DEAR READER: You're right; people have been excited about stem cells for nearly 25 years. Yet progress was quite slow, and some people had major ethical concerns. But in the past eight years, progress has accelerated and the ethical issues largely have been circumvented. Theoretically, stem cells could be used to replace cells that are killed by disease -- heart cells killed in a heart attack, or brain cells killed by Alzheimer's disease. But to explain the exciting potential of stem cells, I need first to define some terms and concepts.

Should I be worried about complications from a hip replacement?

DEAR DOCTOR K: My doctor says I need hip replacement surgery. She says it will help my pain. But I'm worried about complications. Should I be?

DEAR READER: I get a lot of questions about hip replacement surgery, and I'm in a good position to answer them: I had a hip replacement about a decade ago. Before I give a more detailed answer, let me cut to the chase: The benefits of hip replacement surgery greatly outweigh the risks.

What are good fats and bad fats?

DEAR DOCTOR K: I've read in your column about "good fats" and "bad fats." I've also heard that recent studies challenge which fats are "bad." Can you shed a little light on this issue?

DEAR READER: I don't blame you for being confused. One problem with medical studies is that they don't always agree. That's why we often need a lot of them to determine the "truth." Let's start at the beginning. For years, you probably heard that all fats were bad for you and carbohydrates ("carbs") were good. That was nonsense. We need both fats and carbs in our diet.

I’m 80 and I eat a lot less now, am I getting enough nutrients?

DEAR DOCTOR K: I'm in my 80s. These days, I'm not very hungry and I eat a lot less than I used to. My daughter is worried I'm not getting enough nutrients. Is she right?

DEAR READER: Of course, I don't know if you are getting enough nutrients, but your daughter is right to be worried about it. For one thing, you say you're not eating much. People normally start to have a reduced appetite as they get into their 70s and 80s, but it's not a dramatic change.

Non-surgical treatments for fecal incontinence

DEAR READER: In yesterday's column I discussed non-surgical treatments for fecal incontinence. Today, I'll discuss surgical treatment options. When everything works properly, feces move from the colon into the rectum, which sits at the end of the digestive tract. The rectum has walls that stretch to hold the stool. Two circular muscles are present in the last inch of the rectum, or anal canal.

What are effective treatments for fecal incontinence?

DEAR DOCTOR K: In an earlier column, you wrote about causes of fecal incontinence. You mentioned that there are effective treatments. Can you tell us about them?

DEAR READER: Although there are surgical treatments for fecal incontinence, simpler treatments usually do the trick. They range from dietary changes to bowel training. Today I'll discuss non-surgical treatments. In tomorrow's column I'll discuss surgical treatments. One of the most effective ways to reduce fecal leakage is to increase your fiber intake.

How do you treat tinnitus?

DEAR DOCTOR K: I have a constant ringing or buzzing sound in my ears. It's been going on for months. What can I do? It's driving me crazy.

DEAR READER: You probably have a condition called tinnitus. It's pretty common. Many of my patients have it. Occasionally, I have it. It doesn't usually affect your hearing. But it can be really annoying and distracting, enough so that it affects people's level of function.