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Are earlobe wrinkles diagnostic tools?

March 31, 2010 By

DEAR DR. GOTT: Are creases in the earlobe always a precursor to heart trouble?

DEAR READER: In a word, no. For more than 50 years (52 to be exact), there has been debate over whether creased earlobes can be tied to coronary-artery disease. In fact, the New York Times printed an article in 1984 on the subject. Physicians in Long Island reported to the New England Journal of Medicine that there was a significant statistical link in men with creased earlobes being diagnosed with heart disease. A crease is identified as a diagonal line that begins where the lobe attaches to the head and then runs backward toward the lower edge of the lobe.
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Achalasia tough to swallow

March 30, 2010 By

DEAR DR. GOTT: I was recently diagnosed with achalasia. This all started a year ago when I had trouble swallowing food. One doctor stretched my esophagus, after which I could hardly eat anything, and drinking hot or cold beverages was no good, either. I also had a Botox injection in the lower sphincter of my stomach to relax it. Do you have any suggestions for some relief? I have now lost about 50 pounds and can’t afford to lose much more. I’m a 74-year-old female. Please help.

DEAR READER: The esophagus carries food from the mouth to the stomach. Achalasia is a disorder of the lower muscular ring where the esophagus and stomach meet that makes the body less effective in moving food. This occurs in part because the stomach does not relax as it should during the normal course of swallowing, and it is why you received a Botox injection.
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Recurrent UTIs need further testing

March 30, 2010 By

DEAR DR. GOTT: I have been having recurring urinary-tract infections. I’ve undergone cystoscopy and ultrasound, and even had dye in my kidneys. All looks fine. I’ve been taking Vesicare. Do you have any suggestions?

DEAR READER: Request a clean-catch urine and sensitivity test, even if one has been done in the past. Any bacteria can be cultured and tested against specific antibiotics to determine which one will be most effective in treating the infection. Then ask your physician about low-dose antibiotics for perhaps as long as six months, or single-dose medication at the start of symptoms.

In the interim, drink 100 percent cranberry juice daily. Drink plenty of water and avoid feminine hygiene sprays and scented douches. If you remain unsuccessful in controlling this unpleasant disorder, request a referral to a urologist.
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Behcet’s uncommon and troublesome

March 28, 2010 By

DEAR DR. GOTT: My sister is a 50-year-old widow with four children who has been diagnosed with Behcet’s disease. Her symptoms began last spring with some arthritis. She then developed horrible sores on her body and a terrible one in her throat. Then her eyes became involved. She has had to quit work and is in almost constant pain. Some nights she has to go to the hospital because she cannot stand the pain.

She has seen a number of specialists, but this is tiring for her and usually involves travel. We live in a small Canadian province without much diversity, so it was only by chance that the ophthalmologist she saw recognized the symptoms because he was from another country.
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Clear iodine procedure

March 27, 2010 By

DEAR DR. GOTT: What is the process for using clear iodine on nails?

DEAR READER: Clear iodine can be applied with a cotton swab directly onto nails to combat ridges and splits. The product will work best if applied before bedtime, after showering or at other times when the hands will not be immersed in warm water for a period of time.

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Stiff neck has many causes

March 27, 2010 By

DEAR DR. GOTT: Since June of last year, I have experienced a very tight neck that makes sleeping and driving difficult. My doctor seems unconcerned but did recommend a physical therapist. While massage feels good, it does not take the pain away, nor does it make it any easier to turn my head. My left side is tighter than my right and throbs when I lie down, turning into an all-head-involved headache.

If you have any insight or direction as to what I need to do, I would be grateful. I have tried everything except acupuncture, which I think I will do next.

By the way, I am 70 years old and in excellent health otherwise. I do take amlodipine besylate for blood pressure, vitamins C and D, calcium, red yeast rice for cholesterol-lowering properties, glucosamine, MSM and an 81-milligram aspirin. Plus, I have been on OsteoValin for a year as a substitute for Fosamax, which I took for five years. I need help.
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Treatment for high potassium level connected to cause

March 26, 2010 By

DEAR DR. GOTT: Can you please address high potassium levels? My husband’s level went from 4.6 in 2008 to 5.6 in 2009. Other than food that is high in potassium, what could cause the level to jump? Should he be on a restricted diet? Can exercise bring it down?

His physical this year did show his total cholesterol level rose, mainly his LDL to 143, HDL to 77 and triglycerides to 115. His blood pressure is normal.

We would welcome any advice, as this is all new to us. I did search the Internet but was unable to find an answer.

DEAR READER: Potassium is important for the function of nerve and muscle cells. Common causes of elevated levels (known as hyperkalemia) are acute or chronic kidney failure. A normal blood-potassium level is between 3.6 and 4.8 milliequivalents per liter, known as mEq/L. Levels above 6.0 can be the result of type 1 diabetes; Addison’s disease; angiotensin-converting enzyme (ACE) inhibitors; alcoholism; heavy drug use; severe injury, such as burns, that cause destruction of red blood cells; and potassium supplements.
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Hormone-replacement therapy has risks, benefits

March 25, 2010 By

DEAR DR. GOTT: Please give some advice on hormone-replacement therapy. I am 52 and have been married to my second husband for nearly 10 years. We have enjoyed a wonderful intimate relationship, but now, as I approach menopause, I feel that I am losing interest, and I don’t want that to happen.

I have friends who rave about what hormone-replacement therapy has done for them. I’m interested but not comfortable discussing the topic with my male doctor.

DEAR READER: As a woman enters menopause, the ovaries decrease production of both estrogen and progesterone. This reduction causes menstruation and fertility to ultimately cease. Common side effects of menopause include hot flashes, vaginal dryness, mood swings and more.
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Which calcium is best?

March 24, 2010 By

DEAR DR. GOTT: Is calcium citrate better than calcium carbonate?

DEAR READER: For most people, no. Both types of calcium are absorbed similarly by healthy people. Calcium carbonate is more commonly available and is usually less expensive. It is more readily absorbed when taken with food. Calcium citrate is generally more expensive but is often more easily absorbed by those with lower levels of stomach acid. It is readily absorbed by the body with or without food. The supplements also contain different amounts of elemental calcium. Carbonate is 40 percent by weight, and citrate is 21 percent.

Calcium absorption decreases as the amount of elemental calcium per dose increases. In order to get the most out of your calcium supplements, you should take several smaller doses. If you are taking 1,000 milligrams per day, for example, try taking 500 milligrams twice a day. Your body will use more of the calcium, thus providing greater benefits.
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Time of day matters for BP monitoring

March 24, 2010 By

DEAR DR. GOTT: If a doctor recommends that you (an elderly person) monitor blood pressure a couple of times a week, is there a time of day when it is best to take it? Is it lower in the morning, afternoon or evening?

DEAR READER: To get an accurate measure of what your blood pressure is averaging, it is usually best to check in the morning and again at night. Be sure to keep a record of what time you take the readings. It may also be helpful to make a list of physical activities each day and what time they occurred, since exercise, for example, can raise the blood pressure during and immediately following. Salt may also increase blood pressure.
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