Archive for April, 2015

What is cervicitis and how do you get it?

DEAR DOCTOR K: My doctor diagnosed me with cervicitis. What is this? And how did I get it?

DEAR READER: Cervicitis is an inflammation and irritation of the cervix, the doughnut-shaped opening to the uterus. (I've put an illustration of the area affected by cervicitis, below.)

Cervicitis is usually caused by a sexually transmitted infection (STI). Most common are chlamydia and gonorrhea. Trichomoniasis and genital herpes can also cause the condition. In some cases, cervicitis may result from trauma, frequent douching or exposure to chemical irritants. Cervicitis often causes no symptoms. When they do occur, symptoms can include pain during intercourse.

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I have neuropathy pain in my feet. What can I do to relieve it?

DEAR DOCTOR K: I have neuropathy pain in my feet. What can I do to relieve it?

DEAR READER: Neuropathy, or nerve damage, is a remarkably common problem. I get asked lots of questions about it -- both from readers of this column and from readers of the Harvard Health Letter, which I edit. It isn't considered a "major" health problem by many doctors, because it isn't potentially fatal. But, like many other problems not labeled as major by doctors, it sure can make people miserable and interfere with their lives.

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Is tight blood sugar control right for all type 2 diabetics?

DEAR DOCTOR K: I have Type 2 diabetes. For years, my doctor emphasized the importance of tight blood sugar control. But I recently read that tight control might not make sense for everyone. Why not?

DEAR READER: Millions of people with diabetes, and their doctors, are asking themselves the same question. It's a confusing and controversial area. I'll do my best to put it in context and to explain my own views. People with Type 2 diabetes have high levels of blood sugar if they don't take medication that lowers their blood sugar level.

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Why did my doctor take my blood pressure in both arms?

DEAR DOCTOR K: At my last checkup, the doctor measured the blood pressure in both of my arms. Why?

DEAR READER: Your doctor had an important reason: a big difference between the two readings can indicate an increased risk of cardiovascular disease. Researchers at Harvard-affiliated Massachusetts General Hospital helped show the importance of measuring arm-to-arm differences in blood pressure. The researchers measured blood pressure in both arms in nearly 3,400 adults age 40 or older with no signs of heart disease.

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What is the best way to treat ankylosing spondylitis?

DEAR DOCTOR K: I have ankylosing spondylitis. Can you discuss this condition and the best way to treat it?

DEAR READER: Ankylosing spondylitis is a form of arthritis in which the spine and other joints become inflamed and stiff. A person with this condition usually feels pain or stiffness in the lower back, especially in the morning or after inactivity. Pain tends to begin in the two joints between the spine and the pelvis (the sacroiliac joints) and be felt in the buttocks. It then works its way up the lower spine.

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What are a living will and a health-care power of attorney?

DEAR DOCTOR K: What are a living will and a health-care power of attorney?

DEAR READER: A living will and a health-care power of attorney are both types of advance directives -- written, legally binding documents. They allow you to describe what kind of medical care you hope to receive if an accident or illness renders you unable to communicate. The biggest misunderstanding I've seen in my patients is that only the elderly or very ill people need advance directives. That's definitely not the case.

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How can I optimize my doctor visit?

DEAR DOCTOR K: I find doctor's appointments overwhelming. I sometimes forget what I wanted to ask about. By the time I get home, I've forgotten half of what the doctor has told me. How can I optimize my time with my doctor?

DEAR READER: Many of my patients tell me they feel the same as you. It's easy to feel rushed at a doctor's appointment, or unsure of the information and instructions you're given. I've told my patients that, with a little preparation, you can get much more out of your visit. And many patients, when they come for the next visit, clearly have followed the advice.

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What can I do to make rosacea less noticeable?

Senior woman with rosacea

DEAR DOCTOR K: I have rosacea, and it makes me very self-conscious. What can I do to make it less noticeable?

DEAR READER: Rosacea is a common, long-lasting skin condition that causes inflammation and redness of the face. As with many diseases, we don't know what causes rosacea. People with the condition are more likely to have high levels of certain natural inflammatory chemicals in their skin. There also is evidence that tiny little insects (dust mites) and a particular type of bacteria living on the skin can trigger rosacea. Rosacea usually progresses through four stages. In the first stage, a person has flushing and occasional facial redness.

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Does a runny nose mean I’m getting a cold?

DEAR DOCTOR K: Why does my nose run in cold weather? Does it mean I'm getting a cold?

DEAR READER: Cold air is not only cold, but also dry. The lungs are built to deal with air that is warm and moist. So, a main function of your nose is to make the air you breathe in warm and moist. Bones in the nose (called turbinates) are covered with blood-filled membranes. The blood running through the turbinates is at body temperature: around 98.7 degrees F. The heat in the blood warms the cold air you breathe in.

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What is a pulmonary embolism?

DEAR DOCTOR K: What is a pulmonary embolism?

DEAR READER: A pulmonary embolism occurs when a blood clot (called an embolus) suddenly blocks a blood vessel in the lung. A small pulmonary embolus can happen without causing any symptoms, but a large pulmonary embolus can suddenly threaten your life. To explain pulmonary embolism, let's begin with a refresher on the circulation of blood in our bodies. Blood carries nutrients (like oxygen and sugar) to the cells of our body and removes waste material from the cells. The blood circulates because of the pumping action of the heart.

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