R. D.

Texas
Dr. Jerry Blaivas replies:

“The symptoms you describe match those of refractory overactive bladder (OAB), a very common condition with many causes. In general, there are two options for treating OAB. The first is to try different treatments, like the medications you have taken. The second method is to do additional diagnostic testing to determine if an underlying cause might require different treatment. In men your age, common causes of OAB include: 1) a blockage by the prostate or by scar tissue from your previous prostate surgery; 2) neurologic conditions such as stroke; 3) bladder cancer; and 4) bladder stones. In my opinion, it would be prudent to undergo testing for these conditions before considering electrostimulation. If none are present, then that therapy may be indicated.

“The theory of electrical stimulation is that stimulating certain nerves blocks other impulses that are giving false signals and making you feel as though you need to urinate when you really don’t. The basic type of electrostimulation is a weekly outpatient treatment consisting of stimulating an electrode placed at the ankle or anus for a short period of time.

“The second type, known as neuromodulation, is often more effective. It consists of two minor operations that are usually performed one week apart and under local anesthesia. Both procedures are very safe. In the first stage, the electrode is implanted alongside nerves in your lower back and connected to a battery box worn on your belt. If effective, the second stage is to permanently implant the battery beneath your skin. This treatment can be very effective in men your age.”

Dr. Jerry Blaivas is a clinical professor of urology at Cornell University’s Weill Medical College and serves on the Project Advisory Council of the National Association for Continence (nafc.org).

Help for Overactive Bladder The Saturday Evening Post

Dorothy

Colorado
“Medical Mailbox” readers can help raise awareness about inflammatory breast cancer (IBC) by informing others, including mammography technicians, about this relatively rare but aggressive cancer. In women with this condition, cancer cells block lymph vessels in the skin of the breast, which often appears red and swollen. Diagnosis is based primarily on the results of a doctor’s examination.
The bottom line: Get evaluated by a medical provider if you note any changes in your breast. Treatments for this type of cancer are improving, as are survival rates.

A Rare Type of Breast Cancer The Saturday Evening Post

Dee
Post cardiology consultant Dr. Douglas Zipes replies:
“Antibiotic prophylaxis for dental procedures is now recommended only for high-risk patients, such as those with prosthetic (artificial) heart valves or some congenital heart defects. In general, simple mitral valve prolapse would not warrant such treatment. Despite widespread use for 50 years, there is no scientific evidence that antibiotics prevent infective endocarditis (heart infections, usually on a heart valve) from dental work. Bobby Darin apparently contracted endocarditis after a dental procedure and reportedly did not take his antibiotics. But he had two artificial heart valves, so he would have been one of the high-risk candidates for whom antibiotics are recommended.”

Dental Cleaning and Heart Health The Saturday Evening Post

Months later, a doctor called to find out if Frank was still alive. He is, and he does not have brain damage. The doctor said the first shock was given 2½ minutes after Frank’s heart stopped and that the paramedics arrived in 5½ minutes. There are no words to express our appreciation to the people who helped a perfect stranger. Even a customs supervisor came over to help. I hope everyone who was so kind to us will read this letter, especially the two young ladies!

Virginia

California

We hope they do, too! Your letter is a good reminder that sudden cardiac arrest can happen anywhere and anytime. We’ve been advocating for years that automated external defibrillators (AEDs) should be as common as fire extinguishers. Fortunately, the lifesaving devices are now in visible locations at airports, stadiums, and some schools and churches. But most heart emergencies happen in the home. As the adage goes: Plan for the worst and hope for the best. When determining your response to a heart emergency at home, consider: Are you or a family member trained in CPR? Where is the nearest AED? How long will it take for the AED to arrive? Is it feasible to have a home defibrillator or one in a neighborhood clubhouse or lockbox? Today’s AEDs are so simple that almost anyone can use them without prior training. If you are in a position to help save a life by using an AED, remember three things: 1) recognize a heart emergency; 2) open the AED box; and 3) follow the prompts.

Husband’s Life Saved by Defibrillator The Saturday Evening Post

Jeannine

Michigan
Post contributing editor and dermatology expert Dr. C. William Hanke replies:

“Your husband’s symptoms are most commonly associated with a type of eczema called dyshidrotic eczema that results from lack of moisture in the skin caused by seasonal changes to cold, dry temperature, frequent skin washing, and indoor heating which decreases skin moisture.

“Treatment includes minimal use of soap, applying over the-counter emollients (ointments are better than creams and lotions which are water-based) and, when severe, the use of prescription strength topical steroids. Early diagnosis and treatment is important to prevent the development of open foot sores that may progress to chronic wounds.

“Dyshidrotic eczema is also called pompholyx, a term that derives from cheiropompholyx meaning ‘hand and bubble’ in Greek. Patients typically present with itchy bumps that progress to water blisters on the sides of the hands and feet in a near symmetric distribution.”

Skin Problem Could Be Eczema The Saturday Evening Post

Barney
Alabama

Post contributing editor and dermatology expert Dr. C. William Hanke replies:
“Older adults often bruise easily because of gradual changes that take place in the layer of fat just below the skin surface. As a person ages, this layer diminishes and the skin becomes thinner and less flexible. The loss of fat also decreases the skin’s cushioning effect.

“These changes, along with skin damage from sun exposure, cause blood vessels to break more easily. Applying topical emollients such as Vaseline or other over-the-counter ointments and minimizing soap application and hot showers may help combat skin dryness and prevent easy bruising.

“Older adults are most susceptible to bruises on the forearms, hands, legs, and feet. Sometimes the bruising will spread down the body in the direction of gravity. A bruise on a leg will usually take longer to heal than one on the face or arms. Most bruises are not a cause for concern and will go away on their own.”

About Bruises The Saturday Evening Post

Barb
North Carolina

Omega-3 Tackles Her Triglycerides The Saturday Evening Post

In your November/December 2008 issue I happened to read that leg and hand spasms could be caused by the cholesterol medicines. I had been having such severe pains that I would have to pull over in traffic because I was afraid to drive with them. I tried eating bananas and all the other things people said would help to no avail.

I showed the article to my doctor who took me off of the cholesterol meds. In the next two weeks, I had the beginnings of spasms, but they never got full-fledged. I am now free of the spasms and am greatly appreciative of that paragraph in From the Pharmacy. A heartfelt thank you!

Johanna

You’re welcome! Thanks for writing. It’s important to keep cholesterol in check so please consider discussing your lipid levels and necessary therapy options with your doctor.

A Heartfelt Thank You The Saturday Evening Post

I was diagnosed with pernicious anemia in 1982 and prescribed 1000-microgram shots of B12 (cyanocobalamin) every month for the rest of my life. I have since moved, and my current doctor advises that 100 micrograms a month is sufficient, a dose I have been taking for more than two years. I have many health problems and am wondering if a lack of B12 could be causing them.

Billie

There is study data to support both doses. To confirm the best amount for you, we suggest that you consider asking your doctor to order a complete blood count (CBC) to examine the number, size, and shape of your blood cells.

The term “pernicious” or “fatal” anemia dates back to the time before scientists discovered that it is a vitamin deficiency disorder. Characteristic signs and symptoms of the condition include feeling tired and weak, tingling and numbness in hands and feet, and a bright red, smooth tongue. Your cardiovascular health problems seem to have started before switching to the lower dose of cyanocobalamin.

Treating Pernicious Anemia The Saturday Evening Post

A letter in the November/December 2008 issue prompted me to ask if mineral oil is still available as a laxative for severe constipation. I will check out lactulose as suggested. It was used years ago for the problem, but I never hear of it now. Can you advise me?

Geneve

Mineral oil is a lubricant laxative that coats the entire gastrointestinal tract. Frequent use of the product, however, may interfere with the absorption of important vitamins and minerals from foods. Mineral oil also interacts with blood thinners and may decrease the effectiveness of other drugs and supplements. We advise that you opt for a safer way to address chronic constipation.

Send your letters to Medical Mailbox, 1100 Waterway Blvd., Indianapolis, IN 46202 or e-mail: medicalmailbox@satevepost.org.

Medical Mailbox supplements the advice of your healthcare provider, whom you should consult for personal medical problems.

Is Mineral Oil Safe for Constipation? The Saturday Evening Post

My husband has had sleepless nights since ending chemotherapy in July 2007. He has tried prescriptions, herbal teas, and over-the-counter sleep aids. He may sleep for a couple hours upon going to bed but lies awake the rest of the night. He does not have sleep apnea, and all his blood tests are fine. Can any of your readers suggest help for this condition?

Thomas
Send your letters to Medical Mailbox, 1100 Waterway Blvd., Indianapolis, IN 46202 or e-mail: medicalmailbox@satevepost.org.

Please include your mailing address. Medical Mailbox and From the Pharmacy supplements the advice of your health care provider, whom you should consult for personal medical problems.

Sleepless in South Carolina The Saturday Evening Post

Inflammation of a thick band of tissue (called the plantar fascia) often causes persistent heel pain. In a preliminary study of 44 patients not helped by conventional therapies for plantar fasciitis, doctors report that all but two were pain-free within two or three weeks of a procedure called dry-needling followed by a steroid shot. During the procedure, doctors insert a needle into the area where the fascia connects to the heel bone. This creates a small amount of bleeding and activates blood platelets to help the tissue heal. The needle is then pulled back into soft tissue surrounding the fascia and used to inject a steroid. The promising data was presented by an Italian research team at the 2008 annual meeting of the Radiological Society of North America held in Chicago.

Dry-needling Helps Constant Heel Pain The Saturday Evening Post

Two studies published in November 2008 offer hope to people who experience balance and hearing loss related to Ménière’s disease. Researchers in Valencia, Spain, report that the number of debilitating episodes tends to decrease as time goes by. When they don’t, Dr. Stephen Wetmore of West Virginia University School of Medicine in Morgantown found that surgery to drain fluid from the inner ear’s endolymphatic sac improved the problem in 77 percent of 51 cases. A second sac surgery was beneficial in 65 percent of 14 people who experienced recurrent symptoms five months or longer after the original procedure.

New Research Offers Hope for Patients with Meneire’s Disease The Saturday Evening Post

My question to you: Is fish oil with omega-3 good for me or not? I truly enjoy The Saturday Evening Post, especially the medical part and the jokes. I believe omega-3 is good for me—and so is the laughter.

Margaret
Laughter adds to our overall well-being, and we’re pleased you enjoy the Post’s cartoons and jokes.

Experts say that omega-3 supplements are good for almost everyone. Omega-3 is an essential fatty acid (EFA). The human body needs it for life but must get it from foods or supplements. Omega-3 and other EFAs serve multiple functions. People have different nutritional needs and dietary habits. In general, taking one gram of omega-3 (either EPA or DHA or combined) is a good maintenance dose for healthy adults.

Send your letters to Medical Mailbox, 1100 Waterway Blvd., Indianapolis, IN 46202 or e-mail: medicalmailbox@satevepost.org.

Please include your mailing address. Medical Mailbox and From the Pharmacy supplements the advice of your health care provider, whom you should consult for personal medical problems.

Omega-3s in Fish Oil The Saturday Evening Post

Many years ago, your column about lysine solved my problem with mouth sores. Now I would like to return the favor. June Jordan, in the September/October 2008 issue, wrote about her hands cramping. There is a simple solution: I was having leg cramps at night, and a friend told me about putting a bar of soap between the sheets where my legs rest. Lo and behold, the cramps disappeared within two or three minutes.

Last night, I awoke with my right fingers curling up in a cramp. I tried the “soap treatment” and went back to sleep. In the morning, my fingers were uncurled and pain-free. My pharmacist was unable to tell me what ingredient in soap would stop muscle cramps. Might you be able to solve the mystery? Your comments would be greatly appreciated—your column is invaluable to me.

Josy

Dr. Dr. SerVaas,

In response to the lady who has hand cramps when taking calcium. I too get severe muscle cramps in my legs when I take calcium supplements. I haven’t found an answer other than to not take calcium supplements and get my calcium from food sources. I just wanted Ms. Jordan to know she isn’t alone.

S.

We may never know why soap may help relieve muscle cramps. Should we ever experience the problem, however, we will probably give it a try. Loyal Post readers like you are among our best sources of remedies that may work.

Lysine is an inexpensive and safe amino acid. To treat mouth sores caused by the herpes simplex virus, the late Dr. Richard Griffith recommended a daily lysine dose of 500 milligrams per 22 pounds of body weight. Lesser amounts help avoid outbreaks. Lysine supplements are not known to interact with medications.

For more about lysine, send a self-addressed, stamped envelope to: Lysine, 1100 Waterway Blvd., Indianapolis, IN 46202

Send your letters to Medical Mailbox, 1100 Waterway Blvd., Indianapolis, IN 46202 or e-mail: medicalmailbox@satevepost.org.

Please include your mailing address. Medical Mailbox and From the Pharmacy supplements the advice of your health care provider, whom you should consult for personal medical problems.

The Benefits of Lysine The Saturday Evening Post