Can you have a bypass surgery and angioplasty at the same time?

DEAR DOCTOR K: My friend said he had bypass surgery and angioplasty at the same time. Isn't it usually one or the other?

DEAR READER: It is usually one or the other, but your friend may have been treated at one of a few select medical centers in the United States currently offering a new hybrid approach. If so, he may have had both bypass surgery and angioplasty during the same surgery. To answer your question, I need to explain both the traditional approach and then the new hybrid approach. The hybrid approach cannot be used in all patients. However, when it is used, the goal is to make the surgery less grueling, and the beneficial results of surgery more long-lasting.

Should I take a steroid for my sciatica pain?

DEAR DOCTOR K: I have terrible sciatica pain from a slipped disk, but I've hesitated to take steroid pills. What do you think about this treatment?

DEAR READER: Your spine is essentially a column of interlocking bones called vertebrae. A disk tucked in between each pair of vertebrae acts as a shock-absorbing cushion. Sciatica often occurs when a disk becomes displaced (herniated) in the lower spine and injures or compresses the sciatic nerve. This causes sciatica, a severe, shooting pain, tingling, numbness or weakness that runs from your lower back through the buttock and into the lower leg. (At the end of this post, I've put an illustration showing common causes of sciatica.)

Are dark circles and under eye bags caused by lack of sleep?

DEAR DOCTOR K: I have dark circles and bags under my eyes. Does this mean I'm not getting enough sleep?

DEAR READER: Lack of sleep probably has nothing to do with the dark circles and bags under your eyes. In fact, getting too much sleep is more likely than too little to cause this appearance. That's because when you're sitting or standing up, gravity tends to pull excess fluid in your body downward toward and into your belly and legs.

What’s the best way to treat sinus headaches?

DEAR DOCTOR K: I've had terrible allergies this year, and they have caused repeated, severe sinus headaches. What's the best way to treat sinus headaches?

DEAR READER: The sinuses are air-filled spaces above, between and beneath your eyes, flanking your nose. Both the nose and sinuses are lined with a thin membrane that swells and produces mucus in response to irritation. Normally, the mucus from the sinuses drains through small openings, known as ostia, into the nose. The stuff you blow out when your nose is congested is usually mucus produced by the membranes that are in your sinuses and in your nose.

Can yoga help relieve chronic pain?

DEAR DOCTOR K: I've heard that yoga can help relieve chronic pain. What types of pain can yoga help?

DEAR READER: People have been practicing yoga for thousands of years. This mind-body exercise combines breath control, meditation and movements to stretch and strengthen muscles. But yoga places as great an emphasis on mental fitness as on physical fitness. Research finds that yoga may help relieve pain in people with a variety of chronic pain conditions, including arthritis, fibromyalgia, migraine headaches and low back pain.

How are the West Nile virus and Eastern equine encephalitis illnesses spread?

DEAR DOCTOR K: I've been hearing about West Nile virus and Eastern equine encephalitis. How do these illnesses spread? What can I do to protect myself?

DEAR READER: West Nile and Eastern equine encephalitis (EEE) are both viral diseases spread by mosquitoes. Infections with these viruses can be dangerous. In some infectious diseases, as with these, the disease-causing microbe lives in an insect. When that insect bites a person, the microbe is transferred from the insect to the person. Often these microbes don't cause any illness in the insect -- just in us. West Nile virus was first detected in the United States in 1999.

What is shoulder impingement?

DEAR DOCTOR K: I have pain in my shoulder when I raise my arm above my head. My doctor says it's caused by "impingement." What does that mean, and what can I do about it?

DEAR READER: You know the wide variety of things your shoulder allows you to do -- such as reach for a box of cereal, swing a golf club and wash your hair. Its wide range of motion makes all these things possible. However, the design of a joint that lets you do all of that also leaves the joint vulnerable to injury. Joints are places where two or more bones meet. The shoulder joint is where three bones meet: the clavicle (collarbone), the scapula (shoulder blade) and the humerus (upper arm bone).

Why am I being tested for tuberculosis? I thought that was eradicated.

DEAR DOCTOR K: Why does my doctor want to test me for tuberculosis? I thought that was eradicated a long time ago.

DEAR READER: It would be wonderful if tuberculosis (TB) had been eradicated long ago. Unfortunately, that's not the case. The annual number of new cases in the United States has been dropping over the past 20 years. However, around the world, particularly in developing nations, TB remains a huge problem. More than 1 million people die of TB each year. TB is an infectious disease, caused by a particular kind of bacteria.

I haven’t exercised in years — how can I start up again?

DEAR DOCTOR K: I haven't exercised in years, but I'd like to start. What kind of exercise should I do?

DEAR READER: There is no single type of exercise that can meet all of your health needs. To get the most benefits from your exercise routine, you need a mix of activities. A balanced weekly exercise plan should look something like this: 150 minutes of moderate aerobic exercise; two or more strength-training sessions; balance exercises for older adults at risk for falls. If this sounds overwhelming, remember that workouts can be broken up into smaller segments.

Choosing your stroke rehab team.

DEAR READER: In yesterday's column, I began to describe the rehabilitation ("rehab") treatment that often follows a stroke and explained why it is necessary for your husband's recovery. Today, I'll describe rehab institutions and members of the rehab health professional team. If your husband's doctor expects he'll be able to make rapid gains, he likely will be transferred to a rehabilitation hospital. To benefit from this type of program, he must be able to engage in three or more hours of physical, occupational and speech therapy per day, five days a week. Stays in a rehab hospital typically are shorter than those in a skilled nursing facility.