Archive for October, 2012

How do anti-TNF drugs work against rheumatoid arthritis?

DEAR DOCTOR K: I have rheumatoid arthritis and take anti-TNF drugs. I'd like to understand how they work.

DEAR READER: Rheumatoid arthritis (RA) is a chronic autoimmune disease in which the body's immune system mistakenly attacks healthy tissue in the joints. Our immune systems are not supposed to attack our own tissues; they're supposed to attack foreign things that enter our body, particularly germs. In autoimmune diseases, however, something goes haywire.

Are flu shots safe for children?

DEAR DOCTOR K: Does my child really need a flu shot? How do I know it's safe?

DEAR READER: Every fall and winter, parents face the question: Should my child get an influenza (flu) shot? Many parents worry about risks and side effects, and if the shot is really necessary or worthwhile.

What is the treatment for amblyopia?

DEAR DOCTOR K: My son has amblyopia. Can we "force" him to use his bad eye?

DEAR READER: Amblyopia is a condition in growing children in which one eye doesn't see as well as the other. Remarkably, the brain figures out which eye is seeing properly and begins to ignore information from the bad eye.

What can I do about a dry mouth and throat?

DEAR DOCTOR K: My mouth and throat are always parched, even though I'm constantly sipping water. It's very uncomfortable. I'd appreciate any advice you can offer.

DEAR READER: Most of the time dry mouth, also called xerostomia, causes more discomfort than damage. But severe cases can cause complications. Dry mouth can rob you of your sense of taste and can make chewing slow and swallowing difficult. Also, since saliva is important for dental health, dry mouth can contribute to tooth decay and periodontal disease. My colleague Dr. Harvey Simon recently wrote about dry mouth in the Harvard Men's Health Watch. Here's what he and I advise.

Are there non-surgical ways to get rid of keloids?

DEAR DOCTOR K: I have a keloid on my shoulder that makes me very self-conscious. Are there treatments other than surgery?

DEAR READER: Keloids are raised overgrowths of scar tissue that usually appear at the site of a skin injury. They are harmless and do not become cancerous. But once a keloid develops, it won't go away unless it is removed or treated. Unfortunately, none of the existing treatments give completely satisfying results. What's more, keloids that have been removed or treated often return.

What can I do for terrible sinus headaches?

DEAR DOCTOR K: I get terrible sinus headaches during allergy season. Antihistamines help, but not completely. What else can I try?

DEAR READER: I see many patients during allergy season complaining of sinus headache pain. It occurs most often in the center of the face, the bridge of the nose and the cheeks. And it's sometimes accompanied by nasal congestion and clear or opaque nasal discharge.

Does my child need ear tubes?

DEAR DOCTOR K: My toddler gets frequent ear infections, and his doctor wants me to consider ear tubes. What do I need to know before I make a decision?

DEAR READER: Ear infections are very common and can make children miserable. Most go away and don't cause problems, even without treatment. But a few can lead to complications, including more serious infections of the bone near the ear or even the brain.

What is an acoustic neuroma?

DEAR DOCTOR K: I've been having trouble with my hearing. My doctor thinks it might be an acoustic neuroma and is ordering tests for that. I don't like the sound of this. Isn't an acoustic neuroma a type of brain tumor?

DEAR READER: Yes, an acoustic neuroma is a type of brain tumor. There are really bad brain tumors and there are small, curable brain tumors. Fortunately, an acoustic neuroma usually falls into the small, curable category. Acoustic neuromas are benign (non-cancerous) growths, or tumors. Part of a nerve swells up into a little ball. These growths do not spread into other parts of the brain or body.

Will improving my diet help me get pregnant?

DEAR DOCTOR K: My husband and I have been trying to get pregnant for a few months without success. Could changing my diet help?

DEAR READER: Yes, diet could be a factor. With one surprising exception, foods that are healthy for most people also seem to improve fertility. You and your husband are not alone. It's estimated that about 6 million couples in the United States are having trouble conceiving. For one thing, couples are delaying having kids until they are older and their own lives are more secure. However, older age reduces somewhat the chance of a pregnancy. Obesity and diabetes, both of which are epidemics, also decrease fertility at any age.