Archive for August, 2014

Is my urinary incontinence caused by giving birth vaginally?

DEAR DOCTOR K: I've had urinary incontinence ever since I gave birth last year. Why?

DEAR READER: Many women who give birth vaginally go on to develop loss of bladder control. This is called urinary incontinence. Childbirth can cause two types of incontinence. If urine leaks out when you jump, cough or laugh, or during any activity that puts pressure on your bladder, you have stress incontinence. You have urge incontinence (overactive bladder) if you feel a strong, overwhelming urge to urinate, even when your bladder isn't full. You probably also release some urine before you make it to the bathroom.

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How can I manage my arthritis pain while traveling?

DEAR DOCTOR K: Can you give me advice for managing arthritis pain while traveling?

DEAR READER: Vacations often involve being more physically active than normal, which can worsen arthritis pain. But arthritis doesn't have to spoil your vacation. I spoke to my colleague Dr. Susan Ritter, associate physician in the Division of Rheumatology, Immunology and Allergy at Harvard-affiliated Brigham and Women's Hospital. She made the following suggestions to help make travel relatively pain- and hassle-free:

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How can I help my children reduce their risk of sport injuries?

DEAR DOCTOR K: I have a fourth-grader and a middle-schooler. Both enjoy playing sports. Is there anything I can do to reduce their risk of sports injuries?

DEAR READER: You ask an important question. Injuries that result from youth sports are becoming more common -- and the injuries aren't just the expected bumps and bruises that come with being active, either. Doctors are seeing more serious injuries, some of which can lead to lifelong disability. At the same time, regular exercise is really important to a child's health. It also sets patterns for exercise when kids become adults, and that's important to their health later in life.

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How can I relieve knee and hip pain without drugs or surgery?

DEAR DOCTOR K: I have constant knee and hip pain. How can I relieve my pain without drugs or surgery?

DEAR READER: For several years, I asked myself the same question. I had severe arthritis in my right hip, the result of a sports injury when I was a young adult. The pain really was interfering with my life. I was limping, and that made me feel old. Worse, I loved long walks -- particularly in new places, on vacation -- and I just couldn't do it anymore. But I didn't want to have surgery.

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What are some caregiving services available for my ailing father while I’m at work?

DEAR DOCTOR K: I'm a working mother. I also care for my ill and aging father. Are there professionals or services that can help me care for him?

DEAR READER: There can be plenty of rewards in caring for an ailing parent. My parents both died suddenly while apparently healthy, so I never faced this situation. But I've had many patients and friends who have told me that they got closer to their parents in the process of caring for them. However, that care takes a toll, especially when you're also juggling other responsibilities.

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How does sugar increase the risk of heart disease?

DEAR DOCTOR K: I've read that sugar increases the risk of heart disease. How does it do that? Also, any advice for those of us with a sweet tooth?

DEAR READER: So far as we know, sugar doesn't directly harm the heart. But it sure indirectly harms the heart, by promoting the following cardiac risk factors -- problems that lead to heart disease: OBESITY: Excess calories contribute to obesity. Added sugar is a major source of excess (and empty) calories. Overweight and obese people are at greater risk for heart problems. Today, we're discovering that the cells containing fat make hormones that travel in the blood and have many harmful effects on the heart.

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How do I recognize concussion symptoms?

DEAR DOCTOR K: My son got a concussion playing football. His doctor said he shouldn't play again until his symptoms have completely disappeared. What symptoms should we be looking out for?

DEAR READER: A concussion follows a physical blow or impact to the head that disturbs the way the brain works. While it sometimes causes a person to temporarily lose consciousness, it doesn't always do that. It also can cause other symptoms that indicate the brain has been injured -- and those can become apparent days or weeks after a person who has been knocked out regains consciousness. A concussion is a serious injury, more serious than we used to think.

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Is there a drug-free way to relieve PMS symptoms?

DEAR DOCTOR K: Every month I have awful PMS. Can you suggest drug-free ways to relieve my symptoms?

DEAR READER: Premenstrual syndrome (PMS) is a collection of symptoms that occur just before and during menstruation. The most common symptom is unusual mood swings. In addition, women with PMS also experience irritability, anxiety, depression, headaches, hot flashes, bloating, abdominal cramping, breast tenderness and food cravings.

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What are treatments for chronic neuropathic pain?

DEAR DOCTOR K: I suffer from what my doctor calls "chronic neuropathic pain." What are my treatment options?

DEAR READER: There are two main types of pain. Nociceptive pain results from an injury to tissues outside your nervous system. Burns, sprains and broken bones are all examples of nociceptive pain. Tiny nerve fibers are always present in tissues. When the tissue gets injured, the nerve fibers detect it. The signal they send the brain is nociceptive pain. The signal says to the brain: "Do something to avoid further injury!"

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I had a period after 5 years of menopause– is this normal?

DEAR DOCTOR K: I thought I entered menopause five years ago, but now I seem to be having a period again. Is this normal?

DEAR READER: A woman is considered to be in menopause once it has been one year since her last period. Once menopause begins, vaginal bleeding is not normal. Post-menopausal bleeding (PMB) can happen for many reasons. It may result from infection or injury. Non-cancerous growths such as polyps and fibroids can cause PMB. So can bleeding disorders or use of blood thinners.

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