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How to view BMI in elderly

February 29, 2008 By

DEAR DR. GOTT: I am a lady in her 90th year and hope you can answer a pertinent question. Until my 70s, I was a respectable 5’ 6”. Now I am 1 ½” shorter. When checking height charts for healthy weight, which height do I use? At 150 pounds I am below the BMI of 25 if the higher height is used. I am just above the 25 mark if the lower height is used. I know that life is not fair, but should one be considered overweight at 90 when I was okay at 70? Just asking!

DEAR READER: At 90, you needn’t be worried about your weight or body mass index. Your weight and BMI are essentially normal and should not be a concern to either you or your physician. As we age, most of us shrink and gain some weight. This is usually normal. I would only be concerned if your loss of height were coupled with back pain or increased fractures (signs of osteoporosis) or if your weight drastically changed (loss could signify cancer or malnutrition, gain may mean edema or heart failure).
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Dry eyes can get relief

February 28, 2008 By

DEAR DR. GOTT: Please enlighten me about “dry eye”. I have worn glasses for over 60 years without any problems. I am 87 years old and about two months ago I had cataract surgery on both eyes. The left eye has developed “dry eye”. My doctor told me to use eye drops and warm compresses. My questions are: the pharmacies have “umpteen” brands and prices to choose from. What kind of drops should I use? How many times a day should they be used? Can this condition lead to anything more serious such as detached retina? In addition to the eye being dry, it burns and itches, testing my patience not to rub it!
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Lack of sleep causes inflammation

February 27, 2008 By

DEAR DR. GOTT: I have noticed a direct correlation between lack of sleep and the eruption and/or proliferation of acne on my face. In fact, I have noticed that I experience a general feeling of being inflamed (breast tenderness, abdominal bloating and body aches) when I miss sleep or it is interrupted. I have found that taking a dose of ibuprofen will stave off the acne or the general feeling of inflammation if I know in advance I will not be getting adequate sleep.

Is this a bad practice? Is there anything I can do to arrest this process when those unavoidable interruptions occur? Is this an indication of a deeper, perhaps hormonal issue that can be treated?
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Hot flashes in the elderly unusual

February 27, 2008 By

DEAR DR. GOTT: I am a lady who has been living in a rest home. I am 95 years old.

I am very confused about why I am having hot flashes at my age. I have told my primary doctor and he gave me some medication. It does not work. I am still having hot flashes which are very disgusting at my age.

Is this common for us elderly women?

I wake up in bed at night with my gown and hair all wet. I am very frustrated about why this is happening to me.
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Medication side effects uncommon

February 26, 2008 By

DEAR DR. GOTT: I am a 71-year-old female. I have been taking Actonel for four years but am worried about it. My doctor and dentist say I should continue to take it because the only problem I could have was if I needed a tooth pulled and even then it’s probable that nothing bad would happen anyway.

I would greatly appreciate your input on this matter.

DEAR READER: Actonel (and similar medications) are commonly prescribed for patient with osteoporosis. Unfortunately, these drugs (and others like them) may have unpleasant side effects, including (very rarely) destruction of the jaw bone.
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Don’t sweat it out

February 26, 2008 By

DEAR DR. GOTT: I am writing to you about a problem my husband has been experiencing for several months. He wakes up in the middle of the night covered in sweat. It is similar to night sweats experienced by many menopausal women.

He is 41, in great physical shape, has high triglycerides and takes several medications (Niaspan, half an 81 mg aspirin, and Pravachol). He also has borderline hypertension that he is trying to control with diet.

The sweats happen whether he takes his medication or not. They seem to appear more on days when he has exercised very hard. Is this a sign of some type of health problem? What can he do about it?
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High potassium a concern?

February 25, 2008 By

DEAR DR. GOTT: I am a 76-year-old male with several health problems. I have had type II diabetes for 40 years. I keep good control with no known damage from it. I also have well-controlled (with medication) high blood pressure. I am now having a problem with a high potassium level. It went from 4.9 to over 6.5 in one year. I have included a copy of my blood work.

Do you have any suggestions?

DEAR READER: Thank you for including your lab results because they tell the story. Your kidneys do not appear to be functioning properly. As a result, they are not excreting as much potassium as they should. Your blood urea nitrogen (BUN) is quite high at 60. It should be below 20. Finally creatinine is also high (2.1). It should be under 1.0.
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How effective is Forteo?

February 25, 2008 By

DEAR DR. GOTT: Would you kindly comment on Forteo, a bone-formation medication now being prescribed by some physicians to treat osteoporosis. Thank you.

DEAR READER: Forteo is a synthetic form of parathyroid hormone. It increases bone density and bone strength. It is used for both men and women at high risk of fractures. Forteo is given as a daily injection under the skin of the thigh or abdomen. Your physician will show you how to use the medication-dispensing pen to ensure proper dosing.
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Home lead testing kits

February 24, 2008 By

DEAR DR. GOTT: The answer to lead testing mugs and dinnerware is a kit of lead checking swabs. It is available from Hybrivet Systems, Inc, PO Box 1210, Framingham, MA 01701. It can be ordered by phone (1-580-651-7881) or fax (1-580-651-8837) from the company as well.

A doctor in Dallas, TX gave me the information. I have used the kits on several occasions. They are very simple to use and inexpensive. I hope this helps some of your readers. Keep up the good work.
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Hip replacement can cause one shorter leg

February 24, 2008 By

DEAR DR. GOTT: In 2002 I retired as Professor of Orthopaedic Surgery at the University of Michigan. For many years I had limited my practice to hip and knee replacement. I taught and performed about 3000 hip replacements. With respect to the equal limb length question, there is a time in the surgery when one must choose between hip stability and limb length equality. A ½” longer leg is soon forgotten and functions well. An unstable hip, however, repeatedly dislocates and must be done again. The real problem here is that the surgeon did not inform the patient of the possibility for a ½” difference. I have ordered a ¼” or ½” heel lift but the patients never asked for a repeat order. I hope your answer does not encourage more litigation.
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