Young Dr. Gott Ask Dr. Gott, M.D.
by Dr. Peter Gott, M.D. and staff.
Reviewed by Board Certified physician.

Archive for March, 2008


Daily Column

Tuesday, March 25th, 2008

DEAR DR. GOTT:
I have been reading your column for many years and have a great deal of respect for your advice. I think your diet of no sugar and no flour is perhaps the best way to lose weight, but my problem is to lose weight in the right places. Does it matter where the calories come from where the weight goes? I am 81 years old, 5’3” tall, and weigh 125-130 pounds. I don’t feel that I need to lose much, but every ounce I eat seems to settle on my belly and hips.

My size 8-10 clothes still fit but they look so different with my belly. I read constantly about losing belly fat in three to five weeks. Can I lose weight in a particular area of my body by eating a different diet? I love carbohydrates, always have, and find it difficult to give them up. I would, however, if I thought it would help. While I do overindulge at times, I most often keep that habit to a minimum.

Please help me with this troubling situation. I will thank you forever if you can give me some sane advice.

DEAR READER:
First, I must commend you on being 81 years old and weighing what you do. Many individuals your age — men and women — lose interest in their looks and how they present to the public.

In all likelihood, your prominent abdomen is not caused by the type of food you eat. Your intake of calories from specific foods will not result in weight distribution to an area of your body of which you approve or disapprove. Consider your whole body; it’s unlikely you can gain weight in your arms or legs, shoulders or ankles. By the process of elimination, an abdomen is a natural location for weight to accumulate. I surmise you probably do not exercise as much and are not as active as you once were. This alone can lead to weight in areas where you don’t want it to be.

You don’t mention any medical conditions that would lead to the change in your stature. A heart condition, arthritis, or hypertension might restrict you somewhat, but mild exercise might help all of the diagnoses I’ve mentioned. If you have a diagnosis of concern, I would suggest you speak with your primary care physician for his or her direction on appropriate options.

Then, if your doctor is in agreement, you might consider a walk around the block each day, modified sit-ups, or yoga. In fact, if you have a health club or nursing association in your neighborhood, the personnel there can direct you as to appropriate exercise. Remember to begin slowly and work up to a comfortable program.
When all is said and done, you just might feel better and will find those size 8-10 dresses fit better in the long run. Good luck.

To give you related information, I am sending you a copy of my Health Report “A Strategy for Losing Weight”. Other readers who would like a copy should send a self-addressed, stamped, number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

Daily Column

Tuesday, March 25th, 2008

DEAR DR. GOTT:
This letter is to inquire about the availability of the shingles vaccine, Zostavax. The most recent ladies’ magazines (i.e., Good Housekeeping and Women’s day), The Saturday Evening Post and the September issue of Johns Hopkins Newsletter advised that women over the age of 60 receive the vaccine for shingles, especially if they had chickenpox as children.

My sister and I have spent weeks trying to locate someone to administer this vaccine. Johns Hopkins advised us to check with our family doctor. He advised us to check with a dermatologist who advised us to check with our local Health Department. They then referred us to the Passport Office.

Can you unravel this mystery?

DEAR READER:
And mysterious it is. Under normal circumstances, a family physician can order the vaccine and administer it. Your doctor appears to be passing the buck unnecessarily.

Zostavax is an injection that helps prevent shingles. It is recommended for individuals 60 and older. Those with compromised immune systems or are taking medications that affect the immune system and women who are of childbearing age or are pregnant or breastfeeding should not receive the vaccination.

According to the Physicians’ Desk Reference, the vaccine should be stored frozen and reconstituted immediately before administration. If not used within 30 minutes it must be thrown away. It comes in single dose vials so there is no extra vaccine that must be given in that short time frame or wasted cost. There is no statement that says it must be administered by a specific type of medical specialist, therefore I don’t understand why your physician cannot do the job. I see no reason he cannot give the injection other than simply not wanting to hassle with the specific administration instructions (which, frankly, is not a good enough reason).

If he is worried about losing money should you fail to show for your appointment, I suggest that he order the vaccine through your local pharmacy which you can then pick up and pay for on your way to the appointment. This ensures you get the vaccine in the appropriate time frame and the physician does not lose money buying a vaccine which can easily spoil.

I have found in my own practice, this method works very well and most patients are willing to spend the money for the vaccine. If it is covered under their insurance, they can then submit the bill and be reimbursed directly from the insurance company. Medicare may not cover this expense.

I suggest you discuss this option with your family physician. If he is still unwilling, perhaps you should seek a more understanding and compromising physician. The vaccine is a good health investment and can save you both money and time. Prescription medication to treat shingles can be very expensive, not to mention that shingles can last for weeks or even months. Some individuals have permanent, painful nerve damage. Find a physician who will work with you. Good luck.

Daily Column

Monday, March 24th, 2008

DEAR DR. GOTT:
Here is a little more about Castiva for arthritis. I’ve been putting it on my arthritic hands for more than a year. It has really helped, allowing me to continue playing the violin, knitting and crocheting. (Not to mention typing just as fast as I always have!)

I have not seen anyone mention this but I want to tell those who might be “put off” by this treatment because they think it will be oily and messy; it isn’t. I rub it on my hands at night, put on some soft gloves and go to bed. In the morning, my hands are not the least bit oily — just baby soft and smooth.

Now for the most important part of this letter.

Recently I was diagnosed with gout. I had a bad episode a couple of years ago but didn’t know what it was. When I had another episode, my doctor diagnosed it. I have learned to watch for the first signs of an attack (pain and discomfort in my big toe). It happened again recently so I tried rubbing castor oil on it. Instantly — and I do mean instantly — the pain disappeared. I put on a sock and went to bed. I didn’t have any pain all night. About an hour after I woke up the pain came back, so I put on more castor oil. Again, instant relief.

My podiatrist told me that gout is a form of arthritis so perhaps this is why the castor oil did such a good job. In fact, it worked better on my gout than on my arthritic hands! It might not work if the gout gets really bad before it is put on. I don’t know since I was diligent about putting it on as soon as the pain came back. I think the trick may be to catch it as soon as possible. I hope this helps some of your readers as much as it has helped me!

DEAR READER:
Thank you for writing to share your experiences. I had not heard of castor oil relieving the pain of an acute gout attack. So far the most popular method has been cherries. For this who experience gout, I recommend eating a handful (10-12) cherries (dried, fresh, frozen or canned) each day. This should prevent an attack. Another option is to eat 15-20 cherries each day once an attack has started. This should reduce the severity and duration allowing for more normal daily activity. Some readers have had success by drinking cherry juice rather than eating the fruit. I am glad to say that now there are several options (including prescription medication) to treat or prevent acute gout.

Folks, let me know about your experiences using castor oil for gout.

To give you related information, I am sending your copies of my Health Report “Compelling Home Remedies” and “About Gout”. Other readers who would like copies should send a self-addressed, stamped number 10 envelope and $2 FOR EACH report to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title(s).

Daily Column

Sunday, March 23rd, 2008

DEAR DR. GOTT:
I am a 50-year-old female with allergies. I use sublingual drops to treat them.

About twice a year I get a sinus infection. My doctor prescribes a five day Z-Pac (azithromycin) because I am allergic to penicillin and it is the only antibiotic I can tolerate. However, most times I need two courses to clear the infection.

I try to avoid allergens the best I can, take numerous vitamins and herbs to help boost my immune system and try to keep my sinuses clear with Mucinex, plain saline spray and occasional Sudafed.

I was recently examined by an ear-nose-and-throat specialist. He diagnosed me with a deviated septum and enlarged turbinates. My septum is so deviated that my breathing is reduced to 15% on the right side. He advised surgery to straighten the septum and to also reduce the size of the turbinates (which I understand to be one of the nasal bones).

I have talked with some people who have had the surgery. Most say their breathing has improved but they still get sinus infections although they are now less severe and have shorter durations.

Since I have had this condition all my life, I am wondering if I should just leave well enough alone but also worry that if it worsens that the surgery will be more difficult at a later age.

My question is: would your advise me to have the surgery?

DEAR READER:
A deviated septum is a common cause of sinus infections because the involved tissues may block the sinuses from draining properly. In my experience, this problem can be successfully treated by septal surgery. I advise you to have it done.

To give you related information, I am sending you a copy of my Health Report “An Informed Approach to Surgery”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

Sunday Columnpitations,

Sunday, March 23rd, 2008

DEAR DR. GOTT:
I am a 32-year-old female, 5’ 8” tall and weigh 125 pounds. I have no health problem but do smoke.

Since I was about 12 years old, I have had occasional heart palpitations. They usually occurred if I ate too much sugar or was under a lot of stress. There is no family history of heart disease other than my grandfather who died of a heart attack in his late 50s.

When I was pregnant with my second child, I was anemic and had frequent palpitations but was told it was normal. I had no problem during the birth. I continued to have these even after my hemoglobin was back to normal. I then started having an occasional dull achy feeling in my left upper chest that sometimes went down my left arm or up my neck. It’s been 18 months since I gave birth and they palpitations continue on an almost daily basis. Some days I will have five or more episodes, other days none. I have noticed that I am more likely to have them if I am in a certain position, such as bending over or lying on my left side. If I lie on my right side, I rarely have any.

I have had a normal EKG. My cholesterol, blood pressure and thyroid are all normal. I have never had shortness of breath, lightheadedness or fainting. My only medication is alprazolam (as needed) for anxiety which comes out of the blue.

I have mentioned these episodes to my doctor several times but he does not seem concerned.

Should I request to have my heart checked or and if so, what tests should be done?

DEAR READER:
Palpitations usually are felt when the atria (low pressure chambers) or the ventricles (high pressure chambers) contract between heart beats.

Atrial beats are harmless and can be ignored. Extra ventricular contractions, on the other hand, can reflect a cardiac disorder.

I recommend that you seek a consultation with a cardiologist who will probably ask you to wear a cardiac monitor for 24 hours or an event monitor for up to a month. He also may suggest a stress test and a cardiac ultrasound exam.

Based on the details in your letter, I doubt that your palpitations are serious but knowing that with certainty will help reduce your anxiety level. Perhaps your palpitations are a manifestation of your anxiety or a mild panic attack. If this is the case, maybe a switch in medication is in order.

Start with the cardiologist. He or she is best qualified to diagnose and treat cardiac abnormalities.

Daily Column

Saturday, March 22nd, 2008

DEAR DR. GOTT:
Like most of your fans, I would like to start with a compliment. You always seem to have the answer to the questions that many of us have but believe are too insignificant or unimportant to ask our doctor. They are questions to which we really to want to have answers. You never respond in a manner that will belittle the person asking and for that I say thanks.

Now my question. It is a bit complex but I will try to be concise. In 2005 I started developing symptoms of peripheral neuropathy. After a consult with my family practitioner and a few preliminary tests that were negative, I was referred to a neurologist. While waiting for the appointment, I discontinued my Zocor and a mild antidepressant to see if symptoms declined. (One of Zocor’s side effects is neuropathy.) Within a few weeks to a month the symptoms declined somewhat. The neurologist continued with more tests. Most of them were normal. The milder neuropathy symptoms were and still are present but intermittent.

When the results of my protein studies came back, including the paraneoplastic panel, my striated muscle levels were elevated. Because of this, my neurologist ordered a lung scan which was negative. At that point I was told to just wait and see if I had any symptoms that might suggest lung cancer.

Since I am proactive in my health care, I did my own research online and found that small cell lung cancer can be preceded by peripheral neuropathy before the onset of disease. Several existing studies suggested that regular follow up testing was advised because waiting for symptoms can result in poor prognosis if covert cancer is present. I reviewed this information with my family physician who agreed with the wait and see approach of the neurologist.

I had a repeat paraneoplastic panel one year later (2006) and the striated muscle portion was still elevated but lower than the first test.

Is there anything you would recommend? Should I ask for a referral to a different specialty? I am not looking for trouble but on the other hand, I do not want to ignore a problem if there is something I should or could be doing.

DEAR READER:
Your physicians have addressed your problem using excellent medical care. If agree with the wait and see approach, especially given the fact that your blood test improved during 2006. I do not know the cause of your neuropathy (nerve malfunction). If your symptoms are stable or improving, I would not worry too much. If you truly feel uncomfortable, speak with your neurologist or ask for a referral to another doctor for a second opinion. If your symptoms start to worsen, see your neurologist who should order more tests and address possible issues, including treatment options.

Continue with your yearly monitoring and follow your physician’s advice. Good luck and let me know how this turns out.

Daily Column

Saturday, March 22nd, 2008

DEAR DR. GOTT:
I have been bothered by eczema on my eyelid and eyebrow. It was so bad I thought I would harm my eyelid from the scratching. Then I read about the banana peel for psoriasis. I gave it a try since I eat a banana every day. It’s amazing. The flaking, itching, peeling and dryness have disappeared. Thank you!

DEAR READER:
Using banana peels to stop the itching of eczema is a new one on me. It is useful in treating some forms of psoriasis. I’m publishing your favorable experience in hopes it may benefit other readers.

Daily Column

Friday, March 21st, 2008

DEAR DR. GOTT:
My husband has an unusual condition which none of his physicians have been able to diagnose or treat successfully.

He is 57, has had two heart attacks but is now healthy and has a low blood pressure. He is on Zetia, Benecar, Lipitor, aspirin and Effexor.

His problem is that when he lies on his left side, he hears a pulsating blood flow noise in his right ear. It has the same timing as his heart beat. If he turns his head to the right or lies on his right side the noise stops. Occasionally it happens while he is standing or sitting upright. It is not debilitating but is very irritating to him. If he presses on the carotid artery, the sound stops but resumes once he releases the pressure. He cannot remember if this started before or after his heart attacks.

His hearing has been checked and is normal.

We would both appreciate any suggestions you may have. He claims he will even sleep with a bar of soap under his neck if it will help.

DEAR READER:
A noise in the neck that stops when pressure is applied to the carotid artery suggests that there may be blockage in that artery.

This possibility can be very dangerous. If left untreated, the blockage will get larger and may severely reduce or stop blood flow through the artery. A piece may also break off and be carried to the brain where it could lead to stroke.

Therefore, I recommend that your husband ask his physician to order a carotid ultrasound. It is safe and easy. This will diagnose a blockage if one is present.

If, as I suspect, your husband has a blockage, treatment will depend on the severity. He will most likely need to start anticoagulant therapy such as warfarin (Coumadin). He may also benefit from a procedure called angioplasty that uses a balloon-like device to break up the blockage and restore blood flow.

Your husband’s cardiologist is the best source for more information about causes and possible treatment options. I suggest you start with him or her and bring along a copy of my response to your letter. Let me know how this turns out.

To give you related information, I am sending you copies of my Health Reports “Coronary Artery Disease” and “Stroke”. Other readers who would like copies should send a self-addressed, stamped number 10 envelope and $2 FOR EACH report to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title(s).

Daily Column

Thursday, March 20th, 2008

DEAR DR. GOTT:
I have been taking Premarin for years and have had terrible night sweats. I stopped the medication and not only did my sweats stop, but my legs feel better and I can walk with ease.

DEAR READER:
I cannot speculate on why your sweating occurred, since one of Premarin’s purposes is to reduce the incidence of hot flashes. On the down side, leg cramps have been reported with its use. Perhaps your hormonal changes and long-term use of the product have played a role in your recent unpleasant symptoms. Listening to your own body is always important, as Nature tells you things if you just pay attention. The elimination of your night sweats and leg pain, signifies to me that you did the right thing in stopping the hormone replacement.

Are “supervitamins” worth super cost?

Thursday, March 20th, 2008

DEAR DR. GOTT: Would you please comment on the supposed super vitamins manufactured by a company named USANA Corporation that is listed on the stock exchange? Are they efficacious and worth the exorbitant prices that they charge for their products?

DEAR READER: The USANA Corporation is based out of Salt Lake City, Utah. The company makes nutritional, weight management, and personal skin products, selling through a sales network marketing system of more than 140,000 independent distributors similar to Amway, Avon and other companies. USANA also produces skin and hair care products under a different brand name. I am unfamiliar with their “exorbitant” prices for the merchandise they manufacture, but am advised the company reported sales of almost $375,000,000 dollars in 2006.
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