Archive for September, 2013

I’ve just learned that my urinary incontinence is due to pelvic organ prolapse– what does this mean?

DEAR DOCTOR K: I'm a post-menopausal woman who suffers from urinary incontinence. I've just learned that my incontinence is due to pelvic organ prolapse. What does this mean? What is the treatment?

DEAR READER: Pelvic organ prolapse is a condition in which tissue from the uterus, bladder, urethra or rectum drops down into the vagina. As many as one in three middle-aged women have some degree of pelvic organ prolapse.

How is an ankle-brachial index test done and what will it tell my doctor?

DEAR DOCTOR K: I had some pain in my leg while exercising, and now my doctor wants to do an ankle-brachial index test. How is it done? And what will it tell him?

DEAR READER: Atherosclerosis stiffens and clogs our arteries. It attacks the coronary arteries that provide blood to the heart muscle and causes heart attacks. It also attacks the arteries of the brain, causing strokes. Atherosclerosis also often affects the peripheral arteries of the legs. When we exercise our leg muscles, they can reach the point where we're asking them to work harder than their blood supply allows.

I’ve suffered with bleeding hemorrhoids for many years. My doctor suggested surgery — is this risky?

DEAR DOCTOR K: I've suffered with bleeding hemorrhoids for many years and lifestyle changes haven't helped. My doctor suggested surgery. Is this risky?

DEAR READER: Hemorrhoids are swollen veins in the anus. Many people have both internal and external hemorrhoids. Internal hemorrhoids are located inside the anus, but can sometimes push out through the opening of the anus. External hemorrhoids are located at the rim of the anus. Both types can cause bleeding, itching and discomfort.

Why does my stomach sometimes make growling noises?

DEAR DOCTOR K: Why does my stomach sometimes make growling noises?

DEAR READER: Maybe your stomach is trying to talk to my stomach. My stomach is periodically trying to talk to someone, that's for sure.

Stomach noises happen in everyone, although they seem to plague some people more than others. It happens all the time: I'm examining a patient, his or her stomach growls, and I say, "Time for lunch?" I assume it means the patient is hungry.

Does stress cause our cells to age faster?

DEAR DOCTOR K: For years I've heard that chronic stress is bad for your health, but recently I heard something that made me take this seriously: Stress causes our cells to age faster. Is this really true?

DEAR READER: I'll bet you're talking about research showing that stress affects the telomeres. These structures are a part of every cell in our body. And if that's what you're asking about, it really is true. In fact, it's part of a discovery so important that it was honored with the Nobel Prize.

Could you explain what biofeedback is?

DEAR DOCTOR K: You've mentioned biofeedback as a treatment option for several conditions, but I still don't understand what it is. Could you explain?

DEAR READER: Biofeedback is a technique that helps you monitor and control your body's responses. By learning to control certain functions, you can improve your medical condition, relieve chronic pain, reduce stress, or improve your physical or mental performance.

What can a doctor tell by a digital rectal exam?

DEAR DOCTOR K:I'm a healthy man in my 50s. I dread having a physical because of the digital rectal exam. What can the doctor even tell by doing this? Is it really necessary?

DEAR READER: The digital rectal exam isn't fun -- I speak as both a doctor and patient. But it is a risk-free way to check for abnormalities of the anus, rectum and prostate gland. Your rectum is the last few inches of your bowel, just above the anus. As you know, during the exam, your doctor inserts a gloved and lubricated finger into your rectum.

I want to start biking to work– any advice before I get back on my bike?

DEAR DOCTOR K: I'd like to start biking to work. Any advice before I get back on my bike?

DEAR READER: Cycling is great exercise. For one thing, it gets you breathing harder and your heart rate up. That pays cardiovascular dividends. Cycling stacks up well against other forms of exercise when it comes to burning calories, too. And it isn't as hard on the knees as running. Perhaps the biggest advantage of cycling is that it can perform double duty as a form of transportation. A number of my patients, and my colleagues here at Harvard Medical School, bicycle to and from work every day.

How do our brains create memories?

DEAR DOCTOR K: How do our brains create memories? Are our memories stored in some sort of "memory bank"?

DEAR READER: A memory is not a single entity, like a book on a shelf. It is more like a cloth that weaves together multiple facets of sensory, emotional and factual information. Different areas of the brain process and store different aspects of a memory.

Does eating red meat increase the risk of diabetes?

DEAR DOCTOR K: My wife has read that eating red meat increases the risk of diabetes. Is this true?

DEAR READER: You've heard for a long time that limiting the amount of red meat -- especially processed foods with red meat, such as salami -- reduces your risk of heart disease. The evidence for that is very strong.