Archive for January, 2012

What is the treatment for panic attacks?

DEAR DOCTOR K: In the past year I've had five panic attacks. Now I'm always worried I'm going to have another, at any moment. Is there anything I can do to prevent them?

DEAR READER: Panic attacks can be very unsettling. All of a sudden, you are filled with extreme fear or terror. You may be short of breath, have palpitations, chest pain, sweating or feel a smothering sensation. You probably fear that you are losing control. You might even think you are about to die. A panic attack usually lasts five to 30 minutes. But it can continue for several hours. Sometimes the attacks occur in stressful situations, but often they begin for no apparent reason. They can even wake you from deep sleep.

Is Botox a safe option for reducing wrinkles?

DEAR DOCTOR K: I'd like to do something about my wrinkles. Is Botox a good choice?

DEAR READER: Botox is a brand name for botulinum toxin type A. This treatment for wrinkles and frown lines has gained quite a following since it was introduced in the late 1980s. Botulinum toxin is made naturally by certain bacteria. It's a nerve poison. If the toxin gets into the body, such as from eating contaminated meat, it can cause serious disease. But injecting very low concentrations of the toxin into overactive muscles can relax them. The effect lasts for three or four months. The constant tug of overactive muscles beneath the skin is a major cause of wrinkles and frown lines.

How much calcium do children need?

DEAR DOCTOR K: I have two daughters, ages 8 and 12. They both claim they're "too old" to drink milk. How can I make sure they get enough calcium?

DEAR READER: You're right to be concerned. Unfortunately, many children don't get enough calcium, and they need it to build strong bones and teeth. As your kids grow, they are also growing the bones they will have for the rest of their lives. How strong those bones are by the time they become adults will strongly affect their risk for developing thin bones (osteoporosis) later in life, which can lead to fractures. Most of the bone growth occurs in the teenage years, but getting enough calcium is important for younger kids, too.

Is chewing gum good for your teeth?

DEAR DOCTOR K: I always thought chewing gum was bad for my teeth. But then a friend told me it actually helps prevent cavities. Who's right?

DEAR READER: My mother would have said your friend is wrong. But actually your friend is partly right. The answer depends on the type of gum you're chewing. If your gum contains sugar, then you're not doing your teeth any favors. But sugar-free gum can be a good thing.

How can I help my child maintain a healthy weight?

DEAR DOCTOR K: My 12-year-old daughter and 14-year-old son are both overweight. What can I do to help my kids get back to a healthier weight?

DEAR READER: Some of my patients seem to think that it doesn't matter how much their pre-teen and teenage kids eat, so long as the kids keep growing normally. And by "growing" they're thinking about height, not width. They think that you don't need to watch what you eat until you become an adult. Why? Because that's when the diseases associated with obesity — heart attacks, strokes, diabetes — hit you.

How can I prevent deep-vein thrombosis during airplane travel?

DEAR DOCTOR K: My 61-year-old mother plans to take a long plane trip. Her legs usually become swollen when she flies a long distance. Should she wear elastic stockings or take any other precautions so she doesn't develop a blood clot in her legs?

DEAR READER: Long flights increase anyone's risk of developing mild swelling in the feet, ankles and lower legs — and of getting blood clots in the legs. Swelling is common; blood clots are uncommon. On a long flight, unless you're in a fully reclining first-class or business-class seat, you are not lying flat. Gravity is pulling blood down into the veins of your lower legs. Also, your legs are bent at the knees. This makes it harder for blood to travel through your leg veins and back to your heart. As a result, the veins swell up.

What is heat therapy for arthritis?

DEAR DOCTOR K: I have a lot of discomfort from osteoarthritis. A friend suggested heat therapy. What is heat therapy, and does it work?

DEAR READER: Yes, heat therapy can help relieve the pain and stiffness of arthritis. Heat therapy is based on the idea that heat raises your pain threshold. That means that it takes more pain before you feel the same level of discomfort. Heat also relaxes muscles, and tense muscles are a common cause of pain. One of the best things about heat therapy is that you can do it yourself. You don't necessarily need professional treatments.

How are hemorrhoids treated?

DEAR DOCTOR K: Please help -- I have hemorrhoids. What's the best way to treat them?

DEAR READER: Hemorrhoids are clusters of veins in the lowest part of the rectum and anus that become swollen and distended.

How can I prevent migraines?

DEAR DOCTOR K: I'm plagued by frequent migraines. I take medications to treat the migraines once they've started, but I'd rather prevent them in the first place. Any suggestions?

DEAR READER: Migraines can be debilitating. The severe, throbbing headaches are typically accompanied by nausea, vomiting or loss of appetite. Many migraine sufferers also develop blurry or distorted vision, or see pulsating lights or dark spots. Most migraines last from four to 12 hours, but they can last much longer.

Follow-up questions on shingles vaccine

Readers have sent me many follow-up questions after my recent shingles vaccine column. It's great to see your interest, and I wanted to answer the most common follow-up questions I received.

To recap, shingles is caused by the reactivation of the virus that also causes chickenpox, varicella-zoster. Most people are infected with this virus in childhood and remain infected for the rest of their lives.