Archive for December, 2015

Will a special pillow or other sleep adjustments improve my neck pain?

DEAR DOCTOR K: I tend to have a lot of neck pain. Would it help to buy a special pillow, or make any other adjustments to the way I sleep?

DEAR READER: As with so many things, an ounce of prevention may be worth a pound of cure when it comes to neck pain. And how you sleep at night can make a big difference. Two sleeping positions are easiest on the neck: on your side or on your back. Whichever you prefer, choose an appropriate pillow. If you sleep on your back, choose a rounded pillow to support the natural curve of your neck, with a flatter pillow cushioning your head. You can achieve this by tucking a small neck roll into the pillowcase of a flatter, softer pillow.

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Why does diabetes and high blood pressure increase my risk for kidney disease?

DEAR DOCTOR K: I have high blood pressure and diabetes. I was surprised to learn that they increase my risk of kidney disease. How do they do that?

DEAR READER: Many people know that high blood pressure and diabetes increase the risk of getting heart disease. But less well known is the fact that they are also powerful risk factors for kidney disease. The kidneys filter toxins and wastes from the bloodstream, flushing them out of the body in urine. At the same time, they hold on to important proteins and other useful substances. This process helps control levels of fluid, salt and acid in the body. The kidneys also play an important role in regulating blood pressure.

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Why should my child get the flu shot every year?

DEAR DOCTOR K: I know my child is supposed to get a flu shot each year. But how much good does it really do, and is it safe?

DEAR READER: Every fall and winter, parents face the question: Should my child get an influenza (flu) shot? Many parents ask the same question that you do. There are several important reasons why children older than 6 months should get a flu shot every year: Influenza can be dangerous to even healthy children. You can't catch the flu from the flu shot. The flu shot is safe. The flu shot protects more than your child.

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Can aspirin really help to prevent cancer?

DEAR DOCTOR K: I read that aspirin might help to prevent cancer. Is there anything to this idea?

DEAR READER: Open any medicine cabinet in America and you're likely to find a bottle of aspirin. Aspirin has been on the market for more than 110 years. It's an old standby for fighting fever, quieting inflammation and reducing pain. For some, it can help prevent a heart attack or stroke. And growing research points to a possible new benefit for this old friend: reducing the risk of dying from cancer.

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I have pelvic organ prolapse. Are there any exercises I should avoid?

DEAR DOCTOR K: I have pelvic organ prolapse. Are there any exercises I should avoid?

DEAR READER: Pelvic organ prolapse is a condition in which the uterus, bladder, urethra or rectum drop down and press against the walls of the vagina. Normally your pelvic floor -- a sling of muscles and ligaments that stretches from your pubic bone to your tailbone -- holds your pelvic organs in place. Pelvic organ prolapse results from a weakened pelvic floor.

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My toddler gets frequent ear infections. Should we consider surgery?

DEAR DOCTOR K: My toddler gets frequent ear infections. His doctor wants me to consider surgery, but that seems much too aggressive to me. Am I wrong?

DEAR READER: I'm not sure what kind of surgery your pediatrician is recommending, but I'll bet it involves putting in ear tubes. I'll explain that below. Ear infections are very common and can make children miserable. Most go away and don't cause problems, even without treatment. But a few can lead to complications, including more serious infections of the bone near the ear or even the brain.

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When is the right time for a knee replacement?

arthroscopic knee surgery

DEAR DOCTOR K: I have osteoarthritis that's gotten worse over the past few years. My doctor has explained the pros and cons of knee replacement, but it seems like the timing is up to me. How will I know when the time is right to replace my joint?

DEAR READER: If your experience with a knee replacement is like that of most of my patients, you'll know when the time is right only after the time has passed. I've rarely met a person who had a knee or a hip replacement who did not say, after the surgery, "I should have had the surgery long before I finally did." That surely was my experience with hip replacement due to osteoarthritis. Looking back, I should have had the surgery at least two years before I did.

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Does the high-dose flu shot protect better than a regular flu shot?

DEAR DOCTOR K: I've heard that there is a high-dose flu shot. Does it protect better than a regular flu shot? Should I ask my doctor about it?

DEAR READER: The high-dose flu vaccine, known as Fluzone, is approved for adults ages 65 and older. It may provide better flu protection for older adults than the standard flu vaccine, which is less effective in older adults than in younger adults. Both the high-dose and standard flu vaccines target three different strains of the flu virus, selected from the most common strains predicted to be circulating that year.

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Can exercise cause sudden cardiac arrest?

DEAR DOCTOR K: My wife saw something on the news about a man who died of sudden cardiac arrest while jogging. Now she doesn't want me to exercise. I'd really love to get my running shoes back on. What can I tell her to ease her worries?

DEAR READER: I read your letter as I was cooling off after exercising. So your question is timely. Your wife's concerns are understandable, but probably misguided. I spoke to my colleague Dr. Aaron L. Baggish, the associate director of the Cardiovascular Performance Program at Harvard-affiliated Massachusetts General Hospital. He confirmed what I thought I knew.

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What can I do about my dry mouth?

DEAR DOCTOR K: My mouth and throat are always very dry. As a result, I am constantly sipping water. It's annoying and uncomfortable. Is this normal? Is there anything I can do?

DEAR READER: Dry mouth is not as common as dry eyes (something I have), but it's not uncommon. The medical term for dry mouth is xerostomia (pronounced ZE-ro-STOME-ee-uh), but I'll avoid doctor-speak and call it dry mouth. Usually, dry mouth is mild enough to be an annoyance, as it is with you. However, severe cases can cause complications. Dry mouth can rob you of your sense of taste and can make chewing slow and swallowing difficult. Also, since saliva is important for dental health, dry mouth can contribute to tooth decay and periodontal disease.

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