How can I get my elderly mother to take her medications consistently?

DEAR DOCTOR K: My mother is supposed to take several medications each day, but she doesn't take them consistently. What can I do to get her back on track?

DEAR READER: I'll bet when you were a kid and your parents were hounding you about taking your medicine, you never imagined a day would come when you'd be doing the same to them. Nearly three out of four Americans report that they do not always take their medication as directed. So there are a lot of people who are in the same position as your mother. And, obviously, for the medicines to work, a person's got to take them.

Are there any new treatments for lowering cholesterol, besides statins?

DEAR DOCTOR K: I have high cholesterol, but I can't tolerate statins. Are there any new treatments for lowering cholesterol?

DEAR READER: I assume you're taking statins because your low-density lipoprotein (LDL) cholesterol (so-called "bad" cholesterol) is high. If so, that does increase your risk of having a heart attack or stroke. Lowering LDL cholesterol reduces that risk. Some people can bring down their cholesterol levels with diet and exercise alone. But many people need medication to get to their target levels.

What does it mean when someone “goes into shock”?

DEAR DOCTOR K: What does it mean when someone "goes into shock"?

DEAR READER: Shock occurs when there is not enough blood flowing through the body to supply the oxygen and nutrients your cells need to survive. People who go into shock can develop organ damage -- or even die -- if the condition is not treated promptly.

What can I do to ease the discomfort of hemorrhoids?

DEAR DOCTOR K: What can I do to ease the discomfort of hemorrhoids?

DEAR READER: Hemorrhoids are quite common, and they're not a "serious" medical problem. But, figuratively and literally, they're a real pain in the butt. Hemorrhoids develop when veins in the anus and rectum swell and widen. (I've put an illustration below) They can be extremely painful and uncomfortable, causing bleeding and painful bowel movements. There are surgical treatments that can help when you have recurrent, painful flare-ups of hemorrhoids.

What is your advice on the benefits of eating nuts?

DEAR DOCTOR K: I love peanuts, but I try to avoid them, and other nuts, because they are high in fat. But I recently heard that eating nuts might help you live longer. What is your advice regarding nuts?

DEAR READER: Like you, I love nuts -- especially almonds. To be candid, dear readers, Doctor K lacks discipline when it comes to eating nuts. Perhaps it's one of my redeeming vices. However, I've found a solution to my discipline problem, which I'll soon reveal. It's time to put nuts back on your menu. Peanuts are legumes and not officially "nuts."

What should I know before I get dentures?

DEAR DOCTOR K: My dentist says it's time for dentures. What should I know before I get them?

DEAR READER: Nearly half of Americans ages 65 and over have lost six or more teeth because of decay or gum disease. Tooth loss can profoundly affect your health and well-being. The more teeth a person loses, the more difficult it is to chew food properly and get needed nutrients. Missing teeth can also make speaking difficult and make you self-conscious about your appearance. (Below, I've put an illustration of our teeth and their functions.)

How can I make cold sores go away faster?

DEAR DOCTOR K: I get painful cold sores in my mouth every couple of weeks. Why do I get them? And what can I do to make them go away faster?

DEAR READER: Cold sores are caused by the herpes simplex virus (HSV) Types 1 and 2. HSV Type 1 is the most common cause of cold sores. Type 2 more often causes genital herpes, but it can also produce cold sores. HSV spreads easily from person to person; at least half of all adults are infected with the virus.

What can I do to relieve uncomfortable hot flashes?

DEAR DOCTOR K: What can I do to relieve uncomfortable hot flashes?

DEAR READER: Yesterday I discussed new research showing that menopausal hot flashes can last for much longer than the "several years" the textbooks say they are supposed to last. We are beginning to understand why women in menopause (and sometimes for years after) get hot flashes. There is a center in the brain that is constantly measuring the inner temperature of our bodies. For example, body temperature rises on a hot day, or when we exercise. When the brain center thinks the body needs to cool off, it causes little blood vessels near the skin to open wide.

How long can I expect hot flashes to continue?

DEAR DOCTOR K:I just experienced my first, full-blown menopausal hot flash. It was awful. How long can I expect hot flashes to continue?

DEAR READER: Your question reminds me of a patient I saw when I had recently finished my training. (Believe it or not, I was even younger then than I am now.) She said she had come to see me because of hot flashes. Then she said: "I had heard about hot flashes since I was a girl, and I thought I knew what to expect. But you can't really imagine it until you've experienced it."

Can you discuss how menopause might affect my sex life?


I have recently entered menopause. Can you discuss how menopause might affect my sex life?

DEAR READER: As a woman approaches and enters menopause, her ovaries gradually make less and less of the hormones estrogen and progesterone. The drop in these hormones -- of estrogen in particular -- can affect how a woman experiences sex. Estrogen stimulates the growth of breast tissue. It maintains blood flow to and lubrication of the vagina. The decline and eventual end to estrogen production provokes a host of symptoms. These include hot flashes, fatigue, vaginal dryness and loss of libido. Many of these changes can have unwanted effects on a woman's sex life.