Archive for September, 2013

Should I monitor my blood pressure at home if I have hypertension?

DEAR DOCTOR K: I have hypertension. Should I be monitoring my blood pressure at home?

DEAR READER: You bet. It's easy and inexpensive, and provides you and your doctor the information you need to protect your health.

About one in three adults in the United States has high blood pressure, or hypertension. And about half of those with high blood pressure don't have it under control. Hypertension increases the risk for heart disease and stroke.

Does having dense breast tissue increase my risk of breast cancer?

DEAR DOCTOR K: After my last mammogram, the doctor told me I have dense breasts. Does this increase my risk of breast cancer?

DEAR READER: A woman's breast contains different types of tissue, including fat. Women with dense breasts have relatively less fat in their breasts. Specifically, if more than 50 percent of your breasts is made up of other breast tissue (as opposed to fat), then by definition you are said to have "dense breasts." It's not uncommon: About 40 percent of women have dense breasts.

I often feel like I have a lump of mucus in my throat — What can I do about it?

DEAR DOCTOR K: I often feel like I have a lump of mucus in my throat. In the morning I spit some of it up, but the sensation doesn't go away. What can I do about it?

DEAR READER: Doctors sometimes use the term "globus sensation" for the feeling of a lump in the throat. The first question I ask when a patient says he has a lump in his throat is: Is it just a feeling that there is a lump there, or is there something you can spit up?

Should I go to a chiropractor for my lower back pain?

DEAR DOCTOR K: I suffer from low back pain, and I'm thinking of visiting a chiropractor for spinal manipulation treatments. What do you think?

DEAR READER: Spinal manipulation treatments are performed by chiropractors, osteopaths, and some massage and physical therapists. More than one of my patients has tried this treatment for back pain. They usually don't like to tell me about it, because they think I'll disapprove. Actually, I think there is evidence from scientific studies that chiropractic therapy for short-term or recurrent pain may be at least as effective as the treatments that I have to offer.

How can I cut back on my salt intake — where does most of it come from?

DEAR DOCTOR K: I'm trying to cut back on salt in my diet. Can you help me get started? Where does most of the salt in my diet come from?

DEAR READER:You may be surprised to hear that, for most Americans, just 10 types of food deliver almost half of our daily sodium. At first glance, it seems odd that breads and rolls top the list. After all, they aren't nearly as salty as chips or cheese. But since we eat breads and rolls more often, the modest amounts of sodium they contain add up.

Does intensive diet and exercise decrease heart disease risk in diabetics?

DEAR DOCTOR K: I just heard on the radio that some study says that intensive diet and exercise don't decrease heart disease risk in diabetics. Is this true? If so, I've made a lot of hard changes in my life for nothing.

DEAR READER: I assume you're referring to results from the recently publicized Look AHEAD (Action for Health in Diabetes) trial. The results of this study were reported in June of this year. Several of my patients have already asked me about it, and what I've told them is: Take these results with several grains of salt.

What does it mean to have a mitral valve prolapse?

DEAR DOCTOR K: I have mitral valve prolapse. What does this mean? And why don't I need treatment for it?

DEAR READER: The heart is made up of four chambers. Normally, the upper two chambers (the atria) fill with blood, then pump blood into the lower two chambers (the ventricles). Next, the ventricles pump blood to the rest of the body.

Should I use artificial sweeteners to help cut down my sugar intake?

DEAR DOCTOR K: I want to cut down on sugar in my diet. Are artificial sweeteners the answer?

DEAR READER: You're wise to reduce the amount of sugar you consume. Sugar, particularly added sugar in foods and beverages, leads to weight gain -- and excess weight increases your risk of heart disease, diabetes, high blood pressure and other health problems.

How can atrial fibrillation be treated?

DEAR DOCTOR K: I went to my doctor after a few episodes of shortness of breath. It turned out to be atrial fibrillation. How is this condition treated?

DEAR READER: Atrial fibrillation is a heart rhythm disorder that causes a rapid and irregular heartbeat. In this condition, electrical signals in the heart become uncoordinated. As a result, the chambers of the heart stop pumping in a coordinated and efficient way.