Archive for May, 2016

Why does my doctor think I don’t need an angioplasty and stent?

DEAR DOCTOR K: A test showed a 50 percent blockage in one of my coronary arteries. That sounds pretty bad to me. But the cardiologist said I didn't need an angioplasty and stent. Why?

DEAR READER: Coronary arteries send needed blood to the heart muscle. That blood flow can be blocked by cholesterol-rich plaques of atherosclerosis. When the blockage seriously reduces blood flow, it increases your risk of a heart attack. An angioplasty and stents can be helpful for restoring blood flow, but the procedure is not risk-free.

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Does my son need to get the HPV vaccine?

DEAR DOCTOR K: A friend says that my young son should get the vaccine that protects girls against cervical cancer. That doesn't seem to make sense. Can you explain?

DEAR READER: Your friend is right, and here's why. The vaccine is against a virus called human papilloma virus (HPV). There are more than 100 strains of HPV; about 40 of these strains can be transmitted by sexual contact. So-called low-risk strains cause genital warts. High-risk strains can cause cancers of the cervix, anus, penis and throat. I'll call these the HPV-related cancers. Not all of these cancers are caused only by HPV, but the virus is an important cause of each. Most cases of cervical cancer in women in the United States are caused by HPV.

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Why are pediatricians screening teens for high cholesterol and HIV?

DEAR DOCTOR K: A friend of mine just took her teenager to the doctor for a checkup. The girl's cholesterol was checked, and she was tested for HIV. What's going on? Will my teenage daughter's pediatrician do the same?

DEAR READER: The yearly checkup is the perfect time for a doctor to see how kids are growing and give any needed shots. But it's also an important time to see how they are doing more generally, and to help ensure that they grow into healthy, happy adults.

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Can mindfulness be used for more than stress reduction?

DEAR DOCTOR K: I can't turn around without hearing about mindfulness these days. Is it just for stress reduction, or is there more to it?

DEAR READER: Mindfulness may have started out as a meditation technique. But now it is being used for everything from boosting happiness to treating high blood pressure. It's been shown to help treat depression and anxiety and improve sleep quality. And it's being studied as a complementary therapy for cancer, stroke, multiple sclerosis and pain.

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My middle schooler struggles with academics despite his best efforts. Could he have a learning disability?

DEAR DOCTOR K: My middle-schooler spends a lot of time studying. But his grades have dropped, and I see him getting more and more frustrated. What could be going on, and what can I do?

DEAR READER: Many children have problems with schoolwork or homework at one time or another. These problems usually do not last long. But if your son is still getting poor grades (C or below) despite working hard, it could be a sign that your son has a learning disability or some other problem that needs help.

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Are there any good surgical options to treat emphysema?

DEAR DOCTOR K: My mother has severe emphysema. Medication and oxygen therapy aren't helping much anymore. Are there any good surgical options?

DEAR READER: Emphysema is a long-term lung problem that makes it harder and harder to breathe as the disease progresses. It is often grouped together with chronic bronchitis under the label of chronic obstructive pulmonary disease (COPD).

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Is it okay to take a PPI for heartburn indefinitely?

DEAR DOCTOR K: I've had heartburn for years, and I began taking Prilosec as soon as it became available. It gives me relief, but I worry about taking any drug for a long time. Should I be worried?

DEAR READER: As I've often said, no drug is 100 percent safe. That doesn't mean that you shouldn't take one if you need it. But you should continually weigh the risks and benefits.

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Do men need to take a calcium supplement?

DEAR DOCTOR K: Many years ago, my doctor told me that men, like women, should take calcium supplements. So I have been. Now I hear that it's a bad idea. What do you think?

DEAR READER: All of us -- patients and doctors -- wish we had all the answers, and that the answers never changed. Unfortunately, the way the human body works, and malfunctions, is very complicated. To understand it, we conduct research. But no study is perfect, and the answers sometimes change as larger and better studies are conducted.

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I’ve been eating more salmon for its omega-3 fats. Does it matter if the salmon is farmed or wild-caught?

DEAR DOCTOR K: You've written that fatty fish like salmon are a good source of omega-3 fats. Does it matter whether the salmon is farmed or wild?

DEAR READER: Salmon and other fatty fish certainly are an excellent dietary source of omega-3 fatty acids, which lower the risk of heart disease. Many supermarkets offer both farmed and wild-caught salmon. The two types have noticeably different tastes and textures. Wild-caught also tends to be more expensive.

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