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

Archive for July, 2008

Daily Column

Thursday, July 24th, 2008

DEAR DR. GOTT:
After reading your March column about Zostavax I had to write.

I was finally able to convince my mother to get the shingles vaccine but her doctor would only give her a prescription for it. He wouldn’t administer it because of the short window in which is has to be given.

Mom and I searched for weeks to find a health care provider who administered the vaccine. A local internist would administer it BUT only if my mother was able to get the vaccine and bring it to him. As you indicated, it must be kept frozen in order for it to be effective so I made several phone calls, wrote emails and even contacted the health reporter from one of our news stations in search of a provider of the vaccine. No one was able to help.

I finally contacted AARP who suggested I write to the CDC. They, in turn, recommended that I contact Merck who developed the vaccine. (more…)

Tags: shingles, Zostavax
Posted in Daily Column | No Comments »

Daily Column

Wednesday, July 23rd, 2008

DEAR DR. GOTT:
I am a 49-year-old male. For the last six to nine months I have not been sleeping well but have found a way in which I can sleep soundly but want to ensure it will not harm me.

After months of barely sleeping, I was exhausted. One night I feel asleep on the couch in a sitting position and found that I slept like a rock. I woke up in the morning feeling fine. Since then I start out trying to sleep in bed but inevitably wind up back on the couch sleeping in a sitting position. I always feel fine in the morning but worry that this might do my body some harm down the road should it continue.

DEAR READER:
To the best of my knowledge there is no harm in sleeping on the couch in a sitting position. I would imagine that this could cause some muscle stiffness upon waking but if you are not experiencing any problems, I don’t see any reason to stop. (more…)

Tags: insomnia, Sleep/Wake disorders, sleeplessness
Posted in Daily Column | No Comments »

Daily Column

Tuesday, July 22nd, 2008

DEAR DR. GOTT:
In a past column you recommended replacing Lipitor with either omega-3 fish oil capsules or niacin. I have elected to try the niacin. You said to START with 500 milligrams per day and I have done this for a couple of weeks. Now I want to increase the dosage but don’t know what to increase it to. Should I go to 1000, 1500 or 2000 mg? Maybe more? Also, how long should I stay on the niacin? I would also like to know your opinion on red yeast rice. I have noticed that you don’t mention it.

DEAR READER:
Niacin is an excellent alternative choice for lowering cholesterol levels. I often recommend patients to start with a relatively low-dose of 250-500 mg daily and then slowly work up to 1000-1500 mg daily, usually in increments of 250 mg. This is primarily to allow the body to become accustomed to the vitamin and reduce the chance of side effects, namely, flushing. (more…)

Tags: flaxseed oil, lipitor, Mevacor, niacin, omega-3 fish oil, Understanding cholesterol
Posted in Daily Column | No Comments »

Daily Column

Tuesday, July 22nd, 2008

DEAR DR. GOTT:
I am a 59-year-old female. I am very obese but have no major illnesses and don’t smoke or drink.

During a recent physical, my physician told me I have a very enlarged heart. I asked him what that means both now and in the future in regard to my health. He said as long as I don’t have any more symptoms I don’t need to worry about it. However, it has been a great worry to me. Could you please explain what this means to me?

DEAR READER:
Cardiomegaly (enlarged heart) can be caused by many things, some beneficial, others life-threatening. I will provide you with a general overview of the condition, including symptoms, possible causes and treatment options. I cannot give you specific information regarding your case because you do not say what symptoms you have been experiencing. (more…)

Tags: Cardiac hypertrophy, Cardiomegaly, Coronary Artery Disease
Posted in Daily Column | No Comments »

Daily Column

Tuesday, July 22nd, 2008

DEAR DR. GOTT:
My doctor advised me to take at least 1500 mg of calcium daily to treat advanced osteoporosis. Calcium supplements containing 400-600 mg of calcium also contain 100% of the recommended Daily Value (rDV) of vitamin D in each pill. A single multi-vitamin pill can also contain 100% of the rDV of vitamin D as well. Therefore it is possible to get 400% of the rDV of vitamin D daily. This worries me so I spoke with my doctor and pharmacist but each has a different opinion about overdosing. What is your opinion?

DEAR READER:
Vitamin D is necessary for the body to absorb calcium. It is present in fish, liver, egg yolks and fortified cereal, margarine and milk. It is also made by the body when skin is exposed to sunlight. Therefore, it is not necessary for most healthy individuals who consume an appropriate diet to take a vitamin D supplement. (more…)

Tags: osteoporosis, vitamin D
Posted in Daily Column | No Comments »

Daily Column

Monday, July 21st, 2008

DEAR DR. GOTT:
I have been reading your column for years but have not seen anything about bunions.

I am a 47-year-old female and have bunions on both of my feet. I work in retail and have to stand all day. At times the bunions and my feet become very tender and start to burn and tingle.

I would rather not have surgery if there are other successful treatment options. Could you please discuss corrective treatments and give your opinion on which is the best?

DEAR READER:
Bunions occur when the big toe points toward the second toe resulting in a bump at the toe joint on the side of the foot.

Bunions occur much more frequently in women and are often the result of repeatedly wearing narrow-toed, high-heeled shoes for extended periods of time (such as to work). These shoes “squash” the toes, pushing the big toe into the second toe. (more…)

Tags: An Informed Approach to Surgery, bunions
Posted in Daily Column | No Comments »

Sunday Column

Sunday, July 20th, 2008

DEAR DR. GOTT:
I am a 61-year-old male in very good health. I take Zoloft and a multi-vitamin daily.

Four months ago I was in an auto accident and suffered a crush injury to my right (dominant) hand and forearm. I was pinned to the ground by a car. The two bones in my forearm had compound fractures that were repaired surgically. I also suffered from skin and tissue loss that required skin grafting from my palm to the underside of my wrist.

Following the accident and corrective surgeries I had no feeling in four of my fingers (my pinky finger was spared). Seven weeks after the accident the median nerve was released.

I have been in physical therapy since that time and have had only modest improvement in function, even less improvement with regard to pain and no recovery feeling in the fingers. (more…)

Tags: Managing Chronic Pain, Medical Specialists, Zoloft
Posted in Daily Column | No Comments »

Daily Column

Saturday, July 19th, 2008

DEAR DR. GOTT:
I am a 78-year-old woman in good health. Recent laboratory blood tests were normal. However, during a routine fecal occult test, blood was found in all three slides. I had followed the instructions carefully, so there was no possibility of contamination. My gastroenterologist then performed a colonoscopy, endoscopy and a capsule endoscopy. All three procedures proved negative.

Two and a half years ago I had the same test for the same reason. All three endoscopic tests were negative. The two physicians who performed these tests could not give me any advice as to the source of the blood in the stool samples.

This is a worrisome problem for me. Please advise me if, in your opinion, I should seek further medical advice or simply forget about it.

DEAR READER:
Rectal bleeding and positive fecal occult testing can result from numerous causes, (more…)

Tags: Medical Specialists, Rectal bleeding
Posted in Daily Column | No Comments »

Daily Column

Friday, July 18th, 2008

DEAR DR. GOTT:
About a month ago you told of a medicine called rutin that is used for hemorrhoids, varicose veins, and more. I took your column to my pharmacist who didn’t have it but said he would order it if I could find it. He also called a couple of suppliers who also did not have it.

Can you tell me where I can get rutin?

DEAR READER:
As I’ve said in the past, rutin is a bioflavonoid found in many fruits, vegetables and plants such as black tea, apple peels, citrus fruits and buckwheat. This supplement is used to treat hemorrhoids, Meniere’s disease, poor circulation, skin bruising, and more.

If your pharmacy doesn’t have a section for supplements, you will probably have better luck finding rutin at a health food store, so I suggest you begin there. You might tap into the internet for a source that might ship directly to your door. As a third option, (more…)

Tags: bioflavinoids, Rutin
Posted in Daily Column | No Comments »

Daily Column

Friday, July 18th, 2008

DEAR DR. GOTT:
I have about 15 moles all over my body. They feel like sandpaper, itch, and are different sizes. Two on my back were a deep black. They fell off and the spots are flat and itch.

The last time I went to a doctor was about four years ago. I told her I was tired all the time and that my ears turn a beet red. Her answer was, “that’s the price you pay for being a woman”.

Do you think I might have skin cancer?

DEAR READER:
A mole is a small, raised growth on the skin that is ordinarily dark and painless, but can be annoying if it is located on a belt line or other area that is constantly irritated by clothing. As a general rule, lesions can be considered harmless unless they grow, darken, or change in some other way. When this occurs, a visit to a physician is in order.

(more…)

Tags: cancer, moles, skin cancer
Posted in Daily Column | No Comments »