Archive for June, 2016

Do I need to see a cardiologist?

DEAR DOCTOR K: I have high cholesterol and high blood pressure, so I know I'm at increased risk for heart disease. Should I see a cardiologist?

DEAR READER: For many people, a primary care physician (PCP) can effectively manage standard risk factors for heart disease. Your PCP also will know when you need to see a cardiologist, and can refer you to a particular one.

Will weight training help reduce diabetes risk?

DEAR DOCTOR K: I have a family history of diabetes, and I'd like to do what I can to reduce my risk. My doctor says aerobic exercise will help, but I prefer weight training. Could that help too?

DEAR READER: Exercise, particularly aerobic exercise, helps to reduce the risk of Type 2 diabetes, which is by far the more common type of diabetes. So I assume that's the type that runs in your family.

I have chronic pain that interferes with my sleep. What can I do?

DEAR DOCTOR K: I have chronic pain from arthritis. Lately it's so bad that I can't get a good night's sleep. What can I do?

DEAR READER: Chronic pain and insomnia are, unfortunately, a common combination. What's more, chronic pain puts you in double jeopardy: First the pain robs you of restful sleep, then losing restorative sleep makes you more fatigued, which makes you more sensitive to pain.

Do I need surgery for a torn meniscus?

DEAR DOCTOR K: My knees hurt a lot, more on the left. At 76 years young, I guess I should expect that. An MRI scan shows I have a "torn meniscus" in my right knee, and arthritis in both knees. Is there anything to be done?

DEAR READER: Before I can answer your interesting question, I need to provide some basic information. The meniscus is a crescent-shaped disk of fibrous tissue and cartilage. Each knee has two menisci located between the thighbone (femur) and the lower leg bone (tibia).

Have there been any recent advances in the treatment of polycystic ovary syndrome?

DEAR DOCTOR K: I have polycystic ovary syndrome and treatments are helping only a little. My doctor says there has been recent progress in understanding what causes it, and that I should not give up hope. What is your opinion?

DEAR READER: For readers who don't know about polycystic ovary syndrome (PCOS), I should explain a few things first. PCOS is pretty common: About 10 to 20 percent of women have it to some degree. The key features of this illness are multiple cysts in the ovaries, failure of the ovaries to release eggs (and resulting difficulty getting pregnant), irregular menstrual periods and high levels of androgens.

Do shift workers have an increased risk for health problems

DEAR DOCTOR K: I'm a nurse, and I can be assigned to work the day shift, evening shift or night shift. I hear that shift workers can develop health problems. What is known about that?

DEAR READER: More than 9 million people in the United States are shift workers like you. Studies show that nearly 10 percent of night-shift workers have severe reactions to that schedule. Some become overwhelmingly sleepy during the night shift, when they need to be alert. Some have trouble concentrating and focusing on a task. Others can't really fall deeply asleep during the day, when they need to get some sleep.

Is there a skin patch that can be used to test blood sugar in a person with Type 1 diabetes?

DEAR DOCTOR K: I'm 54 and have had Type 1 "childhood" diabetes since I was 7. A friend with diabetes heard about a new skin patch that automatically keeps a person's blood sugar in control -- no finger-sticks to check blood sugar, no needles for getting insulin. Can that possibly be true?

DEAR READER: It's not true yet, but I think it's coming. I'm glad you asked the question, because what I'll call "electronic skin patches" are starting to affect both medical care and research in many areas, not just diabetes.

Does vaginal estrogen cream pose a risk to my heart health?

DEAR DOCTOR K: Vaginal estrogen cream cures my vaginal dryness. But I hear estrogen is risky for the heart. Should I be concerned?

DEAR READER: Basically, I wouldn't worry. Here's why. Vaginal estrogen cream is one form of hormone therapy (HT). HT is estrogen taken alone or with other female hormones to treat the symptoms of menopause. "Systemic" HT involves hormones that enter the blood and travel throughout the body. It is the most effective treatment for postmenopausal hot flashes and vaginal symptoms, including vaginal dryness.