Archive for October, 2015

Do I have any say in the type of anesthesia the doctor uses for a minor surgical procedure?

DEAR DOCTOR K: I have a minor surgical procedure coming up. Will I have any say in the type of anesthesia the doctor uses?

DEAR READER: For some surgical procedures, more than one type of anesthesia may be appropriate. The doctor who will administer the anesthesia (the anesthesiologist) will talk to you about the options. I spoke to Dr. Kristin Schreiber, an anesthesiologist at Harvard-affiliated Brigham and Women's Hospital. She explained that anesthesia has four goals. The first is to make sure you have no pain; the second is to make you drowsy or unconscious. The third is to keep your body still during the procedure -- you don't want your surgeon to have to deal with a moving target. And finally, the fourth is to prevent bad memories of the procedure.

I’m having knee pain, can you describe the anatomy of the knee so I can understand more?

DEAR DOCTOR K: I've been having a lot of knee pain. Would you describe the anatomy of my knee so that I can understand more when I see my doctor about it?

DEAR READER: Joints are places where two or more bones meet, to allow a part of your body to move. And the knee joint is a remarkable structure. It is a complicated network of bones, cartilage, muscles, tendons and ligaments. These structures, working together, allow us to walk, kick, squat, stand back up and do the Twist. (I know that's a dated reference!)

Should I take a low-dose aspirin if heart disease runs in my family?

DEAR DOCTOR K: Heart disease runs in my family, and my doctor thinks I should take low-dose aspirin even though I don't have heart disease now. What do you think?

DEAR READER: Your question seems simple enough, and I wish I had a simple answer. The problem is that aspirin, like virtually all medical treatments, has benefits and risks, and they are different for one person than for another. The main risk of aspirin is bleeding. For some people, the decision to take aspirin is easy.

Does the pain medications used during childbirth pose any risks to my baby?

DEAR DOCTOR K: I'm about to have my first baby. Can you tell me about medications that may be used during childbirth? Will they pose any risks to my baby?

DEAR READER: Many medications can be given for pain relief during childbirth. Other drugs may be given to assist your labor. The pain medicines may not stop pain completely, but they will greatly lessen it. Narcotics such as meperidine (Demerol) are frequently used to relieve labor pain. If a baby is born soon after a mother receives any narcotic, the baby's rate of breathing may be slower than normal at birth. This effect generally is short-term. If it occurs, it can be reversed with an anti-narcotic drug.

How often does my dentist need to take X-rays of my teeth?

DEAR DOCTOR K: How often does my dentist need to take X-rays of my teeth? I'd like to minimize my exposure to radiation.

DEAR READER: Virtually everyone who visits the dentist will have X-rays taken at some point. They are valuable for uncovering problems in places the dentist can't see with the naked eye. X-ray images can reveal cavities inside and between the teeth. They can show wisdom teeth that have failed to come through the gum, and bone deterioration below the gum line.

Is exercise good or bad for osteoarthritis?

DEAR DOCTOR K: I like to exercise, but people in my family tend to get osteoarthritis. Is exercise good or bad for my joints?

DEAR READER: A joint is a place where two or more bones come together. Your question has a simple and a more complicated answer. The simple answer is: For most people, regular exercise is good for the joints. The more complicated answer is that certain types of exercise can put pressure on the joints.

My friend’s son recently committed suicide. How can I support her during this awful time?

DEAR DOCTOR K: My friend's son recently committed suicide. What can I do to support her during this awful time?

DEAR READER: More than 30,000 Americans die by suicide each year, leaving behind devastated family and friends. That's about one out of every 10,000 people in the United States. To some extent, someone who loses a family member to suicide suffers a loss similar to that as if the person had suffered another type of unexpected or violent death, such as a heart attack, car accident or drowning.

I might have RA, how should I prepare for an appointment with a rheumatologist?

DEAR DOCTOR K: My doctor suspects I have rheumatoid arthritis. He wants me to see a rheumatologist. How should I prepare for this appointment?

DEAR READER: Rheumatoid arthritis (RA) is a long-lasting inflammatory disease that causes painful, stiff, swollen joints. If you do have RA, it's best to diagnose the condition early. Disease-modifying treatment, started as soon as possible, can slow or prevent the disease from wreaking havoc on your joints. Either your primary care doctor or a rheumatologist (a doctor who specializes in arthritis) will evaluate you.

What is pernicious anemia?

DEAR DOCTOR K: My new doctor recently told me I had pernicious anemia, that it had not been diagnosed by my old doctor and that his treatments would end my symptoms. What is pernicious anemia?

DEAR READER: The cause and treatment of pernicious anemia were discovered more than 80 years ago, here at Harvard Medical School. The discovery was honored with the Nobel Prize. Unfortunately, even today there still are people like you for whom diagnosis and treatment have been delayed. That's because, as I explain below, it can be a tricky condition to diagnose. With pernicious anemia, vitamin B12 cannot be absorbed by the intestines.

How can I get my 9-month-old to sleep through the night?

DEAR DOCTOR K: My 9-month-old is still waking up three to four times during the night. How can I get her to sleep through the night?

DEAR READER: By the time a baby is 4 or 5 months old, he or she is capable of sleeping through the night. We tend to think of "sleeping through the night" as a long stretch of uninterrupted sleep. But in reality, all babies wake up during the night. Some discover their own way of comforting themselves and getting back to sleep. Others must be taught. Different experts recommend different techniques for helping your baby get to sleep and then to sleep through the night.