DEAR DOCTOR K: I've worn glasses and contact lenses for years. I just scheduled LASIK surgery. What will happen during this procedure?
DEAR READER: LASIK is a type of eye surgery for people, like you, who want to avoid wearing glasses or contact lenses. How does it work? To answer that, let's talk about how you see.
DEAR DOCTOR K: I know how to eat healthily. But as with other things in my life, getting organized enough to eat that way every day has been a challenge. Do you have any tips?
DEAR READER: You've hit on a fundamental problem with successfully making healthy changes. Knowing what the healthy choices are is just the first step. If you aren't organized enough to put those choices into practice, you won't reap the health benefits.
DEAR DOCTOR K: My blood pressure has been creeping up lately, so my doctor suggested I reduce the amount of salt in my diet. Where should I start?
DEAR READER: That's good advice -- and it's good advice for most people, especially for people with high blood pressure. Cutting back on salt (sodium chloride) lowers blood pressure and saves lives. Aim to limit your daily sodium intake to no more than 2,300 milligrams (about a teaspoon) per day.
DEAR DOCTOR K: I just turned 40, and I have finally accepted that I need to make regular exercise part of my life. I'm in pretty good physical shape, if slightly overweight. How much exercise do I need to stay healthy and maybe drop a few pounds?
DEAR READER: It's easier than you might think. It also depends on your goals. You've probably heard that regular exercise protects you against many of the major diseases. I'm talking about heart disease, diabetes, osteoporosis, depression and even some cancers. When I tell my patients this, they often get a certain expression on their face that says, "Not this exercise-is-good-for-you stuff again."
DEAR DOCTOR K: Do you recommend getting a second medical opinion? I don't want to offend my doctor or make her angry. But with big health decisions, I'd like the extra input. What is the best way to proceed?
DEAR READER: Most of us will face at least one important medical decision in our lives. It could involve whether to have surgery, or to undergo a diagnostic procedure that contains risks. Maybe you just feel that you don't really understand how you should be thinking about your options, based on the discussion with your doctor. When you are not sure of what to do, getting a second opinion before starting treatment is a good idea.
DEAR DOCTOR K: I've been hearing a lot about "bioidentical hormones." I'm curious about them, because I'd like a better way to treat my menopause symptoms. Are bioidentical hormones any safer than synthetic ones?
DEAR READER: In the past few years, there's been growing interest in bioidentical hormones. That's because advocates promote them as safer and more effective than FDA-approved, conventional hormone therapy (HT). Women have good reason to be interested in a new treatment option. Conventional combined hormone therapy (estrogen and progesterone) raises the risk of blood clots and breast cancer. It can increase the risk of heart disease, stroke and dementia in women older than 60 (or 10 years past menopause).
DEAR DOCTOR K: Every winter I come down with sinusitis. Is there anything I can do to prevent it?
DEAR READER: A lot of people suffer from periodic sinus infections (sinusitis). I'm one of them. The symptoms are aggravating: headache, pain or pressure in the face and head, where the sinuses are, and thick mucus clogging the nose. The good news is there are many things you can do to reduce your risk of sinusitis.
DEAR DOCTOR K: I am a very ticklish person. My husband thinks it's hilarious how easy it is to make me giggle and squirm. What causes ticklishness?
DEAR READER: Ticklishness is indeed a mysterious phenomenon, and not just for you. To this day, no one has adequately answered the question of what causes it. When discussing ticklishness, most people mean the kind that makes you laugh and squirm. Let's call this laughter-associated ticklishness. There's another type, like what happens when you run your fingernails lightly over your skin. But I'll focus on the first, since you asked.
DEAR DOCTOR K: I have an aunt whose house is filled to the ceiling with junk in some places. I worry about her safety navigating around all that stuff. I think she is a hoarder. What causes this, and how can I help her?
DEAR READER: If your aunt's house has become so filled with "stuff" that she can't get around easily, I'm inclined to agree with you. She may indeed suffer from compulsive hoarding. Hoarders accumulate objects of questionable value in large and disorganized amounts. Until recently, compulsive hoarding was considered a less-frequent symptom of obsessive-compulsive disorder (OCD). But the majority of hoarders don't have other OCD symptoms, such as compulsions and repetitive behaviors.
DEAR DOCTOR K: During the colder months, I'm prone to "attacks" in which my fingers and toes get very cold and then go blue and numb. Although they do eventually return to normal, it's a recurring problem. Could I have Raynaud's disease?
DEAR READER: Raynaud's is certainly one cause of cold fingers and toes. You mention that your symptoms come and go. This, coupled with the fact that your fingers and toes lose color, leads me to believe you may have Raynaud's. In addition to causing your digits to feel cold or even painful, Raynaud's causes the top part of the fingers and toes to get very white or blue-purple.
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Dr. Anthony Komaroff is a practicing physician, Professor of Medicine at Harvard Medical School, and Editor in Chief of the Harvard Health Letter. Learn more »
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