Archive for February, 2013

How does diabetes affect your kidneys?

DEAR DOCTOR K: I have Type 2 diabetes. My doctor said that kidney disease is a potential long-term complication of diabetes. What's the connection between the two?

DEAR READER: People with diabetes have elevated levels of blood sugar. Left untreated or poorly treated, diabetes can cause serious complications, such as eye, nerve and kidney damage. An important cause of all these complications is high blood sugar levels over many years. Other factors, such as high blood pressure, also contribute.

What should I eat for a healthy, satisfying lunch?

DEAR DOCTOR K: Can you give me some tips for eating a healthy but satisfying lunch?

DEAR READER: Yes, I can, but first let me observe that many of my patients seem to think that what doctors recommend as a "healthy" diet is just today's latest fad. They think the advice could change next year. That's wrong. The advice I'll give you is based on 50 years of studies involving millions of people whose diets and health have been studied for decades. In other words, it has a strong scientific basis. At least as important, you can follow the advice and have delicious meals -- healthy food can taste really good!

What is sundowning?

DEAR DOCTOR K: My wife is in her late 70s. Lately she appears very tired and agitated in the evenings. I talked to a doctor friend who said she might be "sundowning." What is sundowning, and what can we do about it?

DEAR READER: Some older people have trouble concentrating, grow agitated or even confused, and become especially fatigued at the end of the day. This phenomenon is known as "sundowning" because its effects tend to coincide with sunset -- usually occurring in the late afternoon into the evening, then settling down late at night.

What does urodynamic testing for incontinence involve?

DEAR DOCTOR K: I'm a 65-year-old woman with urinary incontinence. My doctor isn't sure what's causing it, so I need to have urodynamic testing. What information will this test give my doctor?

DEAR READER: Urodynamic testing is a series of tests that evaluate your urinary system in action. A doctor may want to do these tests if the cause of your incontinence isn't clear. Perhaps your symptoms point toward more than one type of incontinence. Testing is also recommended if standard treatments haven't helped.

When should I start letting my child stay home alone?

DEAR DOCTOR K: My husband and I work full time, and we have a daughter in middle school. Is it safe for her to be alone after school until we get home from work?

DEAR READER: By middle school, your child may be resisting the idea of a baby sitter or after-school program, yet you may not feel comfortable leaving her home by herself. By middle school some children can stay home alone safely for up to a few hours. Every child matures at a different rate, so it's not just age that matters in making your decision.

Urinary symptom score

This urinary symptom score from the American Urological Association helps to evaluate the severity of your benign prostatic hyperplasia (BPH) and determine what treatment, if any, might be best for you.

Do I need to seek treatment for benign prostatic hyperplasia?

DEAR DOCTOR K: I have BPH. I have some urinary symptoms, but because I work from home they're not difficult to manage. Is there any danger in not actively treating my condition?

DEAR READER: Benign prostatic hyperplasia, or BPH, is the most common cause of prostate enlargement. As the name suggests, BPH is harmless; it does not lead to prostate cancer. Up to two-thirds of men with BPH never develop any symptoms. Others find that BPH can make life miserable. You seem to be somewhere in between.

What should I do if my baby has an undescended testicle?

DEAR DOCTOR K: My new baby was born with an undescended testicle. What should we do?

DEAR READER: When a baby boy is an embryo in his mother's womb, the testicles form in the lower part of the abdomen (the pelvis). In the weeks before the baby is born, the testicles move down out of the pelvis into a sac (the scrotum) that lies outside the body. In about one-third of premature and approximately 3 percent of full-term male infants, one or both of the testicles have not completely descended into the scrotum by the time the child is born.

What is leukemia and what treatments are available?

DEAR DOCTOR K: My uncle was recently diagnosed with leukemia. I'd like to learn more about it.

DEAR READER: Leukemia is a form of cancer that affects the body's blood cells. Almost every type of cell in our body can turn cancerous, and blood cells are no exception. Every day, each of us makes millions of new blood cells -- red blood cells, white blood cells, and the cells that make platelets (little cell fragments that help blood to clot). Blood cells are made in the marrow (the inside) of bones.

How can I help care for my elderly mother long-distance?

DEAR DOCTOR K: How can I help care for my elderly mother? She lives alone, but not close enough for me to visit regularly.

DEAR READER: My father died young, but my mother lived into her late 70s. She lived 3,000 miles away, and alone. As she started to lose some of her energy and independence, it was pretty stressful for me. You just can't know what's going on with the person you love. Supervising care and handling problems that arise are difficult, too.