Archive for February, 2016

Can massage therapy help to relieve a sore back?

DEAR DOCTOR K: My back is always sore. A friend suggested that massage therapy might help. Massages are expensive, so I want to make sure there's some evidence behind this. Is there?

DEAR READER: Massage used to be considered an indulgence. But it's now recognized as a legitimate therapy for some painful conditions -- including back pain.

What is premenstrual dysmorphic disorder (PMDD)?

DEAR DOCTOR K: I always assumed my premenstrual mood swings were normal. But then I talked to some friends whose emotional symptoms are much less severe than mine. A quick Internet search turned up "PMDD." Can you tell me more about this?

DEAR READER: The physical symptoms of premenstrual dysmorphic disorder (PMDD) and premenstrual syndrome (PMS) are the same. They include fatigue, swollen breasts, backache, headache, food cravings, bloating, constipation and diarrhea. But the emotional symptoms of PMDD, compared to PMS, are much more severe.

Is it possible to treat depression caused by a stroke?

DEAR DOCTOR K: My mother had a stroke that weakened one side of her body. But the bigger problem right now is her depression. Can that be treated, or is it caused by irreversible brain damage from the stroke?

DEAR READER: Strokes can cause significant problems. People can have difficulty moving (like your mother). They can have trouble speaking or understanding speech. They can have trouble thinking. Being suddenly hit with any or all of those losses would depress anyone -- including people who never suffered from depression before.

Do drugs that raise good cholesterol reduce the risk of heart disease?

DEAR DOCTOR K: I have high levels of HDL cholesterol -- the "good" cholesterol. I was happy about that, but now I hear that medicines raising your HDL levels don't seem to help. Should I be disappointed?

DEAR READER: The HDL cholesterol story is complicated. It has been solidly established that people who have high levels of LDL (bad) cholesterol have a higher risk of developing heart disease. Moreover, it has been solidly established that treatments that lower LDL cholesterol reduce the risk of developing heart disease.

What is the treatment for social phobia?

DEAR DOCTOR K: I've always thought of myself as shy. But my partner thinks I may have social phobia. Could he be right?

DEAR READER: "Social phobia" goes well beyond shyness. People with social phobia feel a constant and powerful discomfort, self-consciousness and fear of humiliation in ordinary social situations. They feel as though all eyes are turned on them. Social phobia often leads people to avoid parties and other gatherings.

Does radiation therapy for cancer increase heart disease risk?

DEAR DOCTOR K: I had radiation therapy for breast cancer a few years ago. Now I'm reading that radiation therapy might increase my risk for heart disease. Is this true? Can I do anything to decrease my risk?

DEAR READER: Radiation therapy uses high-energy rays to damage or destroy cancer cells. It harms cancer cells primarily by damaging their genes. But the radiation can also damage the genes of healthy non-cancerous cells.

How can I help my child lose weight without making him feel deprived?

DEAR DOCTOR K: My 12-year-old is overweight. How can I help him achieve a healthy weight without making him feel deprived?

DEAR READER: Being overweight makes it hard for a child to keep up with friends on the playground. And the teasing can be merciless. What's more, kids who are overweight are at greater risk for lots of health problems as teens and later in life. Children who are overweight or obese are more likely to develop high blood pressure, high cholesterol and heart disease as adults. Long-term obesity also increases the risk of arthritis, diabetes and certain kinds of cancer.

Could hypnotherapy help relieve my chronic pain?

DEAR DOCTOR K: I am in near-constant pain because of arthritis. My doctor suggested that I try hypnotherapy. My first reaction was that it sounds like hokum, but now I'm wondering if it could help. What do you think?

DEAR READER: Hypnotherapy may in fact help with pain management. These days it is used to treat many mental and physical health problems. I spoke to my colleague Dr. Max Shapiro, a psychologist with Harvard-affiliated Massachusetts General Hospital. He explained that hypnotherapy is most effective in treating problems that require stronger control over the body's responses. Pain is a good example; insomnia is another.

Can I do anything to prevent nightmares?

DEAR DOCTOR K: Is there anything I can do to stop having terrible nightmares? They scare me, and ruin my sleep.

DEAR READER: There may be something you can do. The first thing you should know is that everyone has nightmares occasionally. That includes yours truly. Just as we don't really know why we sleep, we don't really understand nightmares. We also don't know why some people are more likely to have them.

Would I be better off with hip resurfacing or a hip replacement?

DEAR DOCTOR K: My hip has bad arthritis, and my doctor says I need either a hip replacement or something called "hip resurfacing." Which one is best?

DEAR READER: I once had to ask myself that same question, when my right hip became so painful from arthritis that something needed to be done. Let me first explain what each type of surgery is, and then how to think about the choice between them.