Archive for October, 2016

Could I have had a silent heart attack?

DEAR DOCTOR K: I recently had an ECG in preparation for a surgical procedure. The doctor said it showed I'd had a silent heart attack. How could I have had a heart attack and not known about it?

DEAR READER: I know it sounds strange. After all, on television, heart attacks are portrayed in rather dramatic fashion. Typically, you see a person clutching their chest with agonizing pain. This mental image is embedded in our culture. But my colleague, Dr. Deepak Bhatt, a cardiologist at Harvard-affiliated Brigham and Women's Hospital, cites a recent study that is the latest to show that heart attacks often can be "silent."

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Do I still need to fast before a cholesterol test?

DEAR DOCTOR K: I heard that fasting will no longer be required before a cholesterol test. Will the results still be as accurate?

DEAR READER: To answer your question, I need to first describe what a "cholesterol test" is. There are three types of cholesterol that typically are measured: LDL ("bad") cholesterol, HDL ("good") cholesterol and total cholesterol (basically, the sum of LDL and HDL). There is a fourth type of fat measured at the same time: triglycerides. Most doctors order all four tests as part of what's called a "lipid (fat) panel."

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Should I volunteer for a research study?

DEAR DOCTOR K: I have a particular disease. A nearby medical school is recruiting people with my condition to participate in a research study. Should I volunteer?

DEAR READER There are two good reasons to consider volunteering for a study: It might help you, and it might help others. In some types of studies, there also may be risks to you.

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Can you give me some advice for measuring my blood pressure at home?

DEAR DOCTOR K: My doctor told me to check my blood pressure at home, but he didn't give me many details. Could you provide some guidance?

DEAR READER: Keeping your blood pressure in check is vital to maintaining heart health and preventing stroke. But the way most of us monitor our pressure -- by trekking to the doctor's office for occasional blood pressure checks -- is far from ideal.

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Could my sinus headaches be something else?

DEAR DOCTOR K: I'm a woman in my 30s who has suffered from sinus headaches for years. Allergy medications haven't helped. What else can I try?

DEAR READER: Seasonal allergies can cause sinus congestion, sneezing and a runny nose. But when you experience pain and pressure in your head, it may be time to consider other causes. That's because sinus problems do not usually cause headaches. At least, they don't cause what most people refer to when they use the term "headache." Most people with sinus congestion refer to "head congestion," not headache.

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What should I do to prevent gum disease?

DEAR DOCTOR K: My dentist is always going on about gum disease. Is it really a big deal? If so, what should I do to prevent it?

DEAR READER: I understand your skepticism. It seems hard to believe that your gums could cause serious problems. The kidneys, the liver, the heart, the brain -- of course. But the gums?

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Are allergy shots effective?

DEAR DOCTOR K: I'm plagued by seasonal allergies. Should I consider immunotherapy?

DEAR READER: Many people know all too well the misery of allergies -- the sneezing, runny nose, postnasal drip, watery eyes and itchy throat. They try to fight back with allergy medications. But immunotherapy, also known as allergy shots, may be a better option.

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What is a rectocele?

DEAR DOCTOR K: I'm a woman in my 60s. I saw my doctor because of rectal pain and constipation. She told me I have a "rectocele." What does this mean?

DEAR READER: The vagina is separated from the rectum by a wall of tough, fibrous tissue called fascia. Sometimes, an area of this wall gets weak, and part of the rectum bulges into the vagina. This bulge is called a rectocele.

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Why have I suddenly lost my sexual desire?

DEAR DOCTOR K: I'm a woman in my mid-50s. Lately I haven't been able to become sexually aroused. What could be wrong?

DEAR READER: Sex is complicated, but you probably already know that. Sexual desire surely resides in the head, but other parts of the body can affect desire as well. In particular, the genital organs communicate with the brain. Likewise, the brain communicates with the genital organs. Desire in the brain causes changes in the pelvic organs. Perceiving these changes can, in turn, enhance sexual desire.

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What lifestyle changes can help relieve my heartburn?

DEAR DOCTOR K: Can lifestyle changes help relieve my heartburn?

DEAR READER: Heartburn is an uncomfortable burning sensation that radiates up the middle of your chest. It results from a condition called gastroesophageal reflux disease (GERD), or "reflux." With GERD, stomach acid surges up into the esophagus, the "swallowing tube" that connects our mouth to our stomach.

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