Archive for August, 2015

How are the West Nile virus and Eastern equine encephalitis illnesses spread?

DEAR DOCTOR K: I've been hearing about West Nile virus and Eastern equine encephalitis. How do these illnesses spread? What can I do to protect myself?

DEAR READER: West Nile and Eastern equine encephalitis (EEE) are both viral diseases spread by mosquitoes. Infections with these viruses can be dangerous. In some infectious diseases, as with these, the disease-causing microbe lives in an insect. When that insect bites a person, the microbe is transferred from the insect to the person. Often these microbes don't cause any illness in the insect -- just in us. West Nile virus was first detected in the United States in 1999.

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What is shoulder impingement?

DEAR DOCTOR K: I have pain in my shoulder when I raise my arm above my head. My doctor says it's caused by "impingement." What does that mean, and what can I do about it?

DEAR READER: You know the wide variety of things your shoulder allows you to do -- such as reach for a box of cereal, swing a golf club and wash your hair. Its wide range of motion makes all these things possible. However, the design of a joint that lets you do all of that also leaves the joint vulnerable to injury. Joints are places where two or more bones meet. The shoulder joint is where three bones meet: the clavicle (collarbone), the scapula (shoulder blade) and the humerus (upper arm bone).

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Why am I being tested for tuberculosis? I thought that was eradicated.

DEAR DOCTOR K: Why does my doctor want to test me for tuberculosis? I thought that was eradicated a long time ago.

DEAR READER: It would be wonderful if tuberculosis (TB) had been eradicated long ago. Unfortunately, that's not the case. The annual number of new cases in the United States has been dropping over the past 20 years. However, around the world, particularly in developing nations, TB remains a huge problem. More than 1 million people die of TB each year. TB is an infectious disease, caused by a particular kind of bacteria.

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I haven’t exercised in years — how can I start up again?

DEAR DOCTOR K: I haven't exercised in years, but I'd like to start. What kind of exercise should I do?

DEAR READER: There is no single type of exercise that can meet all of your health needs. To get the most benefits from your exercise routine, you need a mix of activities. A balanced weekly exercise plan should look something like this: 150 minutes of moderate aerobic exercise; two or more strength-training sessions; balance exercises for older adults at risk for falls. If this sounds overwhelming, remember that workouts can be broken up into smaller segments.

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Choosing your stroke rehab team.

DEAR READER: In yesterday's column, I began to describe the rehabilitation ("rehab") treatment that often follows a stroke and explained why it is necessary for your husband's recovery. Today, I'll describe rehab institutions and members of the rehab health professional team. If your husband's doctor expects he'll be able to make rapid gains, he likely will be transferred to a rehabilitation hospital. To benefit from this type of program, he must be able to engage in three or more hours of physical, occupational and speech therapy per day, five days a week. Stays in a rehab hospital typically are shorter than those in a skilled nursing facility.

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Why do you need rehab after a stroke?

DEAR DOCTOR K: My husband recently had a stroke. The doctors say he will need "rehab" after he is released, at a different type of hospital. Can you tell me what rehab is?

DEAR READER: Your question requires a long answer. So I'm going to devote both today's and tomorrow's columns to that answer. A stroke stops the blood supply to a part of the brain, and causes the death of brain cells in the area that no longer receives blood. The symptoms caused by a stroke are quite varied. Not only can strokes cause different types of symptoms, but the symptoms can also range from mild to severe. A patient's symptoms depend on what part(s) of the brain a stroke has damaged, and how bad the damage is.

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How can I get over my fear of flying?

DEAR DOCTOR K: When I am forced to fly, I sweat and shake and feel like I'm going to faint. I've been avoiding work-related travel, and I'm holding my family back from taking long-distance vacations. What can I do to get over my fear?

DEAR READER: You suffer from a type of anxiety disorder called flight phobia or, in medicalese, "aviophobia." A phobia is an extreme fear of something that poses little or no real danger. Fear of flying, heights, animals, insects and the like are all phobias.

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Why do doctors remove the appendix when someone has appendicitis?

DEAR DOCTOR K: Why do doctors remove the appendix when someone has appendicitis? Don't we need this organ?

DEAR READER: Appendicitis is an inflammation of the appendix. This small, fingerlike tube hangs from the lower right side of the large intestine. It usually becomes inflamed because of an infection or blockage. The condition is quite common; it affects one in every 500 people in the United States each year. (I've put an illustration of an inflamed appendix below.)

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Are there any medicines that protect against Alzheimer’s?

DEAR DOCTOR K: I've heard that certain common medicines used for other purposes may also protect against Alzheimer's disease. Is there any truth to this?

DEAR READER: You've raised an important question. Unfortunately, research has not so far provided a clear answer. HORMONE THERAPY. For years, doctors believed that hormone therapy might protect women from Alzheimer's disease. This therapy replaces the hormones that a woman no longer makes after menopause. The possibility that hormone therapy might offer protection was raised by studies which found that women who took estrogen were less likely to develop Alzheimer's than those who didn't.

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What are the health benefits of fermented foods?

DEAR DOCTOR K: My friend has started eating lots of fermented foods. She claims they are good for your health. Is that true? What are the health benefits?

DEAR READER: Humans have been fermenting foods for thousands of years. Fermentation protects foods from spoiling and lends them a taste and texture that many people enjoy. Asian and African cultures use fermentation as a way to have seasonal foods all year, and to ensure there is enough to eat during food shortages. Soy sauce and sauerkraut are examples of fermented foods.

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