Archive for July, 2013

Is it unhealthy that I can hear my pulse in my ear?

DEAR DOCTOR K: I can hear my heartbeat in my left ear. Should I be worried that I might lose my hearing?

DEAR READER: A condition called tinnitus causes unusual sounds in the ears: high-pitched hisses, lower-pitched buzzing sounds, clicking. This is a remarkably common problem; an estimated 50 million people in the United States have it to some degree.

What’s the difference between strength training and power training?

DEAR DOCTOR K: What's the difference between strength training and power training? Do I need both?

DEAR READER: Before I make the distinction, let's remember why strength and power training are important. Starting at about age 30, we start losing muscle mass. That's called "sarcopenia." By the time we're 70, we can expect to have lost about 25 percent of the muscle mass we had at age 30.

Which age-related sexual changes in men are normal?

DEAR DOCTOR K: I'm a man in my 70s. I still enjoy sex, but it's different than when I was younger. What changes are normal?

DEAR READER: As a man in the last half of his life, I would like to be able to tell you that nothing changes. However, even in healthy men, sexuality changes over time.

Do I need treatment for a torn meniscus in my knee, even if I’m not in pain?

DEAR DOCTOR K: I'm 72 years old. I've had left knee pain on and off for several months. My doctor sent me for an MRI of both knees. It showed "mild to moderate osteoarthritis" in both knees and a torn meniscus in my right knee, which feels fine. Do I need to do anything about the torn meniscus in my "good" knee?

DEAR READER: The meniscus is a crescent-shaped disk of fibrous tissue and cartilage. Each knee has two menisci located between the thighbone (femur) and the lower leg bone (tibia). In older people the meniscus becomes more prone to injury; it can tear for no apparent reason.

Stress helps me perform well at my job, but is it unhealthy?

DEAR DOCTOR K: I have a stressful job. I think the stress helps me perform at my best, but my doctor says that in the long run, stress is bad for my health. Is he right?

DEAR READER: Your body reacts to acute stressors with a "fight-or-flight" response. Thirty thousand years ago, the acute stressor for your ancestors may have been the sight of several lions heading in their direction. Today, the acute stressor might be a bus rushing toward you as you cross the street.

My prostate-cancer treatments left me with urinary incontinence — what can I do to treat it?

DEAR DOCTOR K: I have urinary incontinence that started after I was treated for prostate cancer. What can I do?

DEAR READER: The involuntary leakage of urine, urinary incontinence, unfortunately is a common -- and aggravating -- side effect of prostate cancer treatment. In some cases, incontinence improves on its own. If it doesn't, there are several options for treating, or at least managing, the problem.

What prescription medications can I take to treat my insomnia?

DEAR DOCTOR K: I can't sleep. Behavioral changes haven't helped. Can you tell me about prescription medications for insomnia?

DEAR READER: I typically prescribe sleep medications only for short-term sleep problems. For example, I might prescribe them for a patient who is traveling across time zones or coping with a death in the family. Even then, I prescribe them at the lowest dose and for the shortest possible time. Behavioral changes -- such as going to bed and getting up at the same time each day, not reading or watching TV in bed, etc. -- usually work if you keep at them.

What are the treatment options for fibroids?

DEAR DOCTOR K: I saw my doctor for intense pain and heavy bleeding during my periods. It turns out I have fibroids. What are my treatment options?

DEAR READER: A fibroid is a lump or growth in the uterus. Fibroids are balls of uterine muscle. They are almost never cancerous, but they can cause severe pain and discomfort, most often during menstrual periods. In some cases, fibroids can cause infertility or repeated miscarriages. Fortunately, many treatment options exist.