Archive for August, 2015

I have a toenail fungus that just won’t go away. What can I do?

DEAR DOCTOR K: I have a toenail fungus that just won't go away. What can I do?

DEAR READER: Fungal toenail infections occur when a fungus infects the area under the surface of a toenail. Fungi love warm, damp environments, and the space inside our shoes provides the perfect habitat. As the infection takes hold, it creates a strong, unpleasant odor. The toenail thickens and turns yellowish-brown. Eventually the nail may separate from the nail bed. Fungal infections are notoriously difficult to get rid of, but there are things you can do to stop their spread and improve your toenail's appearance.

How can start a safe stretching routine?

DEAR DOCTOR K: At my last appointment, my doctor noticed that my movements have become stiffer. He suggested that I do some stretching exercises daily. Is there anything I should know before I start? I'm in my 80s, and I don't want to hurt myself.

DEAR READER: Our bodies become less flexible as the years roll by. Inflexibility puts a crimp in daily acts, making it harder to walk, raise your arms or turn your head while backing up the car. It undermines balance, too, which can cause life-altering falls. Stretching can help. You'll make the best gains if you stretch frequently -- all or most days of the week. At the very least, stretch two or three times a week.

What is pseudogout?

DEAR DOCTOR K: What is pseudogout? Is it related to gout?

DEAR READER: Pseudogout is a form of arthritis triggered by deposits of calcium crystals in the joints. As crystals accumulate in the affected joint, they can cause a reaction that leads to severe pain, redness, warmth and swelling. The attack often lasts several days, and can last weeks. As the name suggests, pseudogout can cause symptoms similar to those of gout. Gout is caused when another type of crystal, uric acid, accumulates in a joint. Gout commonly affects just a single joint -- most often the big toe. Pseudogout also can resemble osteoarthritis or rheumatoid arthritis, in making multiple joints ache simultaneously. It most often occurs in the knee, wrist, shoulder, ankle or elbow.

Is it possible I’m not getting enough iron in my diet?

DEAR DOCTOR K: I'm a man in my 50s, and I've been feeling run-down. Is it possible I'm not getting enough iron in my diet?

DEAR READER: Many patients ask me this question. I think it has to do with an old commercial for a popular vitamin and mineral supplement to treat iron-poor "tired blood." Iron helps make hemoglobin. That's the molecule that grabs oxygen in the lungs and transports it around the body to release it as a source of energy to the cells in the body. The USDA recommends that adult men get 8 milligrams of iron per day in their diets.

Angioplasty and bypass surgery, a new hybrid procedure

DEAR READERS: In yesterday's column, a reader asked why a friend had undergone both bypass surgery and an angioplasty to restore blood flow to the heart. The reader had thought that a person had either one or the other, but not both. I replied that this has been the case until recently: When one or more blocked arteries were discovered, cardiologists and cardiac surgeons had traditionally decided whether to do one procedure or the other. However, a new hybrid approach is gaining favor. It makes sense only for some patients -- and it sounds as if the reader's friend is one of those patients. In yesterday's column, I explained both angioplasty with stenting and coronary artery bypass graft (CABG) surgery.

Can you have a bypass surgery and angioplasty at the same time?

DEAR DOCTOR K: My friend said he had bypass surgery and angioplasty at the same time. Isn't it usually one or the other?

DEAR READER: It is usually one or the other, but your friend may have been treated at one of a few select medical centers in the United States currently offering a new hybrid approach. If so, he may have had both bypass surgery and angioplasty during the same surgery. To answer your question, I need to explain both the traditional approach and then the new hybrid approach. The hybrid approach cannot be used in all patients. However, when it is used, the goal is to make the surgery less grueling, and the beneficial results of surgery more long-lasting.

Should I take a steroid for my sciatica pain?

DEAR DOCTOR K: I have terrible sciatica pain from a slipped disk, but I've hesitated to take steroid pills. What do you think about this treatment?

DEAR READER: Your spine is essentially a column of interlocking bones called vertebrae. A disk tucked in between each pair of vertebrae acts as a shock-absorbing cushion. Sciatica often occurs when a disk becomes displaced (herniated) in the lower spine and injures or compresses the sciatic nerve. This causes sciatica, a severe, shooting pain, tingling, numbness or weakness that runs from your lower back through the buttock and into the lower leg. (At the end of this post, I've put an illustration showing common causes of sciatica.)

Are dark circles and under eye bags caused by lack of sleep?

DEAR DOCTOR K: I have dark circles and bags under my eyes. Does this mean I'm not getting enough sleep?

DEAR READER: Lack of sleep probably has nothing to do with the dark circles and bags under your eyes. In fact, getting too much sleep is more likely than too little to cause this appearance. That's because when you're sitting or standing up, gravity tends to pull excess fluid in your body downward toward and into your belly and legs.

What’s the best way to treat sinus headaches?

DEAR DOCTOR K: I've had terrible allergies this year, and they have caused repeated, severe sinus headaches. What's the best way to treat sinus headaches?

DEAR READER: The sinuses are air-filled spaces above, between and beneath your eyes, flanking your nose. Both the nose and sinuses are lined with a thin membrane that swells and produces mucus in response to irritation. Normally, the mucus from the sinuses drains through small openings, known as ostia, into the nose. The stuff you blow out when your nose is congested is usually mucus produced by the membranes that are in your sinuses and in your nose.

Can yoga help relieve chronic pain?

DEAR DOCTOR K: I've heard that yoga can help relieve chronic pain. What types of pain can yoga help?

DEAR READER: People have been practicing yoga for thousands of years. This mind-body exercise combines breath control, meditation and movements to stretch and strengthen muscles. But yoga places as great an emphasis on mental fitness as on physical fitness. Research finds that yoga may help relieve pain in people with a variety of chronic pain conditions, including arthritis, fibromyalgia, migraine headaches and low back pain.