Archive for August, 2013

Can I continue taking my antidepressant during pregnancy?

DEAR DOCTOR K: I take an SSRI for depression. I'm trying to get pregnant, but I'm worried about going off my antidepressant during pregnancy. Can I continue to take an SSRI?

DEAR READER: You can, but at some small risk to the baby. But if you stop taking the SSRI while you are pregnant, you may increase your own risk of worsening depression during and after the pregnancy. Treating depression is important for both your sake and your baby's.

How can I prevent another kidney stone from forming?

DEAR DOCTOR K: I recently passed a kidney stone -- and I would do anything to prevent another one from forming. Can kidney stones be prevented?

DEAR READER: I've never had a kidney stone myself, but I've had plenty of patients who suffered from them. So I know that they really hurt. Kidney stones are hard chemical deposits that form inside the kidneys. They are often as small as grains of sand and pass painlessly out of the body in urine.

Can you explain how the new sunscreen labels work?

DEAR DOCTOR K: Sunscreen labels have changed since I stocked up last year. What should I look for on the new labels?

DEAR READER: Sunscreen products do look different than they have in the past, as new rules for labels are now in effect. These new rules, mandated by the Food and Drug Administration (FDA), have made sunscreen labels more informative and less misleading.

Is it true that oral sex can cause throat cancer?

DEAR DOCTOR K: A famous actor recently said he got throat cancer from oral sex. Could this be true?

DEAR READER: I assume you're referring to actor Michael Douglas, who recently divulged that his throat cancer could have been brought on by oral sex. He's right. Oral sex is a common way to become infected with the human papilloma virus (HPV), and HPV is a leading cause of mouth and throat cancers.

Does vaginal estrogen cream carry the same risks as systemic hormone therapy?

DEAR DOCTOR K: I use a vaginal estrogen cream for vaginal dryness. Does it have the same risks as hormones taken orally or by skin patch?

DEAR READER: Hormone therapy (HT) is estrogen taken alone or with other female hormones to treat the symptoms of menopause. "Systemic" HT involves hormones that enter the blood and travel throughout the body. It is the most effective treatment for postmenopausal hot flashes and vaginal symptoms, including vaginal dryness.

What can I do to prevent heat stroke while exercising outdoors?

DEAR DOCTOR K: My brother and I are planning a long bike trip this summer. I'm worried about the heat. What can I do to prevent heat stroke?

DEAR READER: Normally, the human body does a good job of regulating its temperature. As you'd expect, your body tends to heat up more easily when it is surrounded by hot air. It also heats up during exercise, since hard-working muscles generate heat. When you exercise in hot weather, your body is particularly challenged to get rid of excess heat so that it can maintain a normal body temperature.

What are my treatment options for dry eyes?

DEAR DOCTOR K: I have dry eyes. What are my treatment options?

DEAR READER: Tears are not just for crying. Your eyes are constantly making small amounts of tears to keep the surface of the eye and the underside of the eyelids moist. You don't notice that you're making the right amount of tears, but you do notice when you're not making enough.

I need a double knee replacement — should I have both replaced at one time, or separately?

DEAR DOCTOR K: I have severe osteoarthritis in both knees. Should I have both knees replaced at one time, or separately?

DEAR READER: Knee replacement is a major operation and requires a hospital stay. During the procedure, the surgeon removes damaged sections of your shin bone and thigh bone. He or she carefully cuts the bone to precisely fit the shape of the replacement implants, then attaches the artificial joint at the knee.

What can I do to prevent my painful cluster headaches?

DEAR DOCTOR K: I get excruciatingly painful cluster headaches. What can I do to treat, or better yet, prevent them?

DEAR READER: Cluster headaches are rare. Only about one adult in a thousand suffers from them. But they are among the most painful of all headaches. We doctors have theories about what causes cluster headaches, but the fact is that we don't really know. They do run in families: There is an inherited, genetic component.

What causes osteoarthritis pain?

DEAR DOCTOR K: I have osteoarthritis. Can you tell me what is happening in my joints that causes my painful symptoms?

DEAR READER: The short answer is that osteoarthritis causes deterioration of cartilage in the joints. But I suspect you'd like a more detailed response.