Ask Dr. Gott » » Daily Column http://askdrgottmd.com Ask Dr Gott MD's Website Mon, 29 Jun 2015 12:44:13 +0000 en-US hourly 1 http://wordpress.org/?v=4.1.11 Could supplement have caused senior’s vitiligo? http://askdrgottmd.com/could-supplement-have-caused-seniors-vitiligo-2/ http://askdrgottmd.com/could-supplement-have-caused-seniors-vitiligo-2/#respond Mon, 29 Jun 2015 12:44:13 +0000 http://askdrgottmd.com/?p=8184

Q: I am a 76-year-old white male. In March of 2002 I had triple bypass due to clogged arteries. Ever since, I have been taking fish oil 1200 mg, aspirin 81 mg, folic acid 800 mg, and Simvastatin 80 mg daily.

About a year or more ago I started gradually losing the pigment on my forehead, over my shoulders, down both arms, and later on both legs. I read your column every morning and have never seen anything about vitiligo. According to my computer, there is no known cause or actual cause for this, although I feel the folic acid may have caused this to happen. What do you think?

A: Melanin is the pigment that gives color to skin, hair and eyes. A loss of skin pigment because of destruction of pigment-forming cells causes a condition known as vitiligo with white patches appearing on the body. Vitiligo affects up to five million Americans. It is most noticeable in individuals that have dark skin, affects men and women equally and commonly develops between the ages of 10 and 30. Ninety five percent of those affected will have the condition prior to age 40. Those areas of skin commonly affected include sections commonly exposed to the sun such as the hands, arms, face, and feet, areas around moles, and eyelids. Vitiligo commonly appears in one of three possible patterns – generalized with widespread coverage, segmental with areas on one side of the body only, and focal with only a few areas affected.

And yes, you are correct in that the exact cause of loss of pigment is not known; however, it is now generally accepted to be an autoimmune disorder and genetics may play a role. The condition occurs when melanocytes (melanin-forming cells) fail to produce melanin. Thus, treatment is geared to slow or diminish the progression of loss of pigment and to even out the apparent differences on the skin. . Those individuals who choose to cover affected areas may use over-the-counter cosmetics, corticosteroids, re-pigmentation through ultravoilet light therapy, skin grafting, and depigmentation of unaffected skin areas in order to make the skin appear homogeneous.

Folic acid aka folate or vitamin B9 is a water-soluble vitamin used for the treatment of or prevention of low blood levels, ulcerative colitis, liver disease, alcoholism, anemia, and for prevention of neural tube defects in those in early pregnancy or considering pregnancy. I am unsure why you take folic acid, whether it is because of one of the conditions listed (including vitiligo) or if you are hoping to prevent gum infections, colon cancer, stroke, or heart disease. General dosing is 400 mcg daily, not the 800 mg you are currently taking. Dosing to prevent neural tube defects recommended to pregnant women is 0.4-5 mg. There is a question as to whether taking an excessive amount of B9 for an extended period of time may cause an increased risk of heart attack in those who suffer from cardiac issues, as well as lung or prostatic cancers. High doses may cause diarrhea, sleep disorders, confusion, abdominal upset, behavioral changes, seizures, irritable, and skin reactions.

Dietary sources for B9 are many, including asparagus, turnip, beets, mustard greens, root vegetables, whole grains, spinach, Brussels sprouts, kidney and white beans, salmon, orange juice, avocado and milk. In addition, all grain and cereal products in our country are fortified with folic acid, making it easy enough to consume sufficient amounts naturally without having to take a supplement.

Folate may be prescribed to reduce hypertension, however the dose is around 5 mg per day and the effect is minimal. Could you have received incorrect information on the dosing and are, perhaps, receiving 800 mcg? This would at least be a normal folate dose but either way, not likely a cause of vitiligo. In fact, according to some reports it appears that folic acid supplementation is believed to stop depigmentation of skin and even to re-pigment vitiligo spots because it reduces oxidative stress and acts as an antioxidant. Return to your physician for his or her opinion and be sure to check on the dosing while you are there.

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Can a plastic surgeon make things better? http://askdrgottmd.com/can-a-plastic-surgeon-make-things-better-2/ http://askdrgottmd.com/can-a-plastic-surgeon-make-things-better-2/#respond Sat, 27 Jun 2015 05:01:39 +0000 http://askdrgottmd.com/?p=8182

Q: I have a friend who has syringomyelia. Several years ago she lost 100+ pounds. Her problem is that she was left with a lot of excess loose skin. She calls it her water balloon. This balloon causes her to lose her balance while sitting and walking, which is already impaired due to her disease and she has had several bone breaks from falling down – the latest being a partial hip replacement. She lost her left arm due to her disease and cannot understand why none of her doctors will refer her to a plastic surgeon to have the excess skin removed. It is very obvious that she needs this procedure.

Once she falls, she has a hard time maneuvering all of that loose skin in order to get back up. She has had to rely on neighbors or paramedics to help her off the floor. Have you any suggestions on how she can get a recommendation for this procedure in order for her insurance to help pay for it? Please help me help her. Thank you.

A: A syringomyelia is a fluid-filled cyst within the spinal cord. Over time, the cyst may enlarge, causing damage to the spinal cord, pain, weakness, stiffness, and more. The causes for this complicated-appearing word to occur include having spinal cord tumors or injuries caused by inflammation around the spinal cord and Chian malformation. The latter may begin during teenage years or during early adulthood and is the result of brain tissue protruding into the spinal canal. Conditions such as meningitis (inflammation of the membranes that surround the brain and spinal cord), injury, and scar tissue following surgery can lead to syringomyelia. Early signs and symptoms may include muscle weakness and atrophy, a loss of reflexes, scoliosis (curvature of the spine). neck/arm/back/facial pain, and bladder and bowel concerns.

Magnetic resonance imaging (MRI) is a reliable tool for diagnosis. If a syrinx has developed within the spinal cord, it will be visible through this process. If a physician chooses temporarily to monitor the condition, repeat MRIs and neurological examinations will identify progression of the syringomyelia, since treatment will depend on its severity. When the condition affects a person’s quality of life, surgery may be recommended. The purpose of such procedure is to remove pressure the syrinx places on the spinal cord – thus hopefully restoring the normal flow of cerebrospinal fluid.

Now, on to your friend’s problem. You don’t indicate how much she weighs now and how she lost such an enormous amount of weight. She has a huge problem with her syringomyelia and her excess weight further hampers her. My recommendations might be compared with locking the barn door after the horse gets out, but let’s give it a try. Her hospital’s physical therapy department should be able to provide direction regarding her gait abnormality and set up an exercise program for her. A nutritionist at the same hospital should be able to review her diet and make recommendations for weight loss and muscle toning. Nothing will show results overnight but each day she adheres to a program is to her advantage. She should be monitored periodically by her physician to be assured there are no other medical problems that could impede her progress. It’s easy to take the position that a plastic surgeon can simply remove excess fatty tissue from her body but what must be understood is that the benefits must outweigh the risks, no matter how simple or complex a procedure is. A surgeon will only operate if he or she knows your friend is healthy enough to undergo a surgical procedure and without knowing her medical history, I would not venture a guess if this is feasible or not. Surgery inflicts trauma on the body, no matter how minor it may appear. She might make an appointment for a consultation. If she has problems walking and sitting that causes her to fall, she might consider using a wheel chair when she is fatigued. Many arm and leg exercise programs can be accomplished initially through sitting in a chair or even in a wheel chair but anything she does should be okayed by her physician before it is begun.

I wish I could be more positive but I strongly feel she must take an active role in her health care if she wants results. It will be hard work, but worth it in the long run.

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Are palpitations triggered by glaucoma medication? http://askdrgottmd.com/are-palpitations-triggered-by-glaucoma-medication-2/ http://askdrgottmd.com/are-palpitations-triggered-by-glaucoma-medication-2/#respond Fri, 26 Jun 2015 05:01:08 +0000 http://askdrgottmd.com/?p=8180

Q: My doctor says I have too many heart beats on the lower part of my heart. I’ve been given metoprolol 25 mg for high blood pressure which lowered my pressure but the palpitations still remain. I get a spinning feeling when I lie on my left side only and it’s very scary. I’m told it’s anxiety. I don’t know what to do. I’ve had several tests for my heart and the only thing they found is that I have extra heart beats. What can I do to get some relief?

I also take travatin for glaucoma. Please help and thank you for your advice.

A: There are a number of reasons for a person to experience palpitations, including heart problems, anxiety, stress, specific medications such as cough or cold remedies that contain pseudoephedrine, using an asthma inhaler, caffeine, nicotine, hyperthyroidism and exercise. Some palpitations are symptoms of arrhythmias (problems with the rate or thyrhm of a heartbeat). However, less than half the people who have palpitations have arrhythmias. Your palpitations are felt when lying on your left side, yet they may also be felt in the neck, throat or chest, can be observed when standing or lying down, and when active or at rest.

An enlarged thyroid can be seen with both hypothyroidism and hyperthyroidism and palpitations are observed with hyperthyroidism. My guess is that your physician did that and ordered either a resting or stress electrocardiogram (EKG). He or she may also have ordered a Holter monitor. A Holter is essentially a 24-hour-a-day EKG device similar to a pager worn by ambulance personnel or fire department members. If you underwent that testing and no abnormality was detected, the next step might have been to use an event recorder. The device is worn on a belt or waist line as much as possible each day and for as long as it takes for symptoms to appear. In some instances, it may be necessary to wear the device for several weeks, unless symptoms present earlier.

Travatan has numerous possible side effects, including nervousness, lightheadedness when arising from a lying or sitting position, chest tightness, a rapid heartbeat for some and a slowed rate (under 50 beats per minute) for others. However, non-ocular side effects are quite rare, so it may be worthwhile to consult with your ophthalmologist to discuss the possibility of Travatan being related to your symptoms.

Because you have been told your palpitations are triggered by stress, you may choose to make some lifestyle changes. Take steps to avoid issues that trigger an attack. If you encounter a situation, find a safe spot in your home where you can relax and listen to soothing music, read a book, or meditate. Perhaps a walk around the block or a phone conversation with an understanding friend will get you back on track. Avoid stimulants found in such things as illegal drugs, energy drinks, caffeine, nicotine, herbal supplements, and over-the-counter cold remedies.

Finally, I recommend you take your paperwork to a cardiologist for a second opinion. If the second opinion concurs there is no underlying heart problem and anxiety is the probable cause of your palpitations, some lifestyle changes to reduce stress – along with some reassurance from your health care provider – should be your next step. All this may appear overwhelming but your doctors haven’t been able to help and your problem continues. If you are assured of your diagnosis and don’t suspect underlying cardiac concerns, you owe it to yourself to make necessary changes. Good luck.

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Can vitamins help symptoms of Bell’s palsy? http://askdrgottmd.com/can-vitamins-help-symptoms-of-bells-palsy-2/ http://askdrgottmd.com/can-vitamins-help-symptoms-of-bells-palsy-2/#respond Thu, 25 Jun 2015 05:01:13 +0000 http://askdrgottmd.com/?p=8178

Q: One of your columns several years ago mentioned the use of vitamin B12 to reverse the symptoms of Bell’s palsy. What would be the appropriate dosage to take? I am female, age 51, and had the condition about three months ago. The right side of my face experienced the extreme droopiness that lasted about four weeks, with improvement noted each week. However, three months later I still have symptoms I believe are related. I may make some type of facial expression, especially around my mouth area, and will feel like a cramping of that facial nerve/muscle. Will B12 help me?

A: For those unfamiliar with Bell’s palsy, also known as facial palsy, the condition causes weakness or total paralysis of facial muscles on one side of the face.. The mouth will droop and the individual will have problems closing the eye on the affected side of the face; yet there have been very rare instances when both sides of the face are affected at the same time. For many the condition is temporary, with visible improvement beginning within a few weeks and complete improvement seen in six months or less. Unfortunately, some individuals will have symptoms that last a lifetime and while rare, the condition can recur. Onset is generally rapid, there may be a decrease in the person’s ability to taste, he or she may suffer from headaches and pain around the jaw or ear on the affected side can occur.

It is believed the condition is generally the result of exposure to an infection, especially a viral infection such as German measles, shingles, chickenpox, Epstein-Barr virus, mumps, influenza, and others. Risk factors increasing a person’s chances of getting Bell’s palsy include being pregnant and having an upper respiratory condition.

Diagnosis is commonly made through visual examination. If questions remain, an EMG to determine nerve damage, and an MRI or CT to rule out a tumor or skull fracture might be performed.

On the home front and only with the permission of a physician, sublingual vitamin B may be the first vitamin to consider, as B6, B12 and zinc may help stimulate nerve growth. The recommended dose suggested for Bell’s palsy is 2,000 mcg per day. Symptoms of a dry, scratchy throat may occur with taking the vitamin but it should be of no consequence. There is also improvement noted by some users in adding omega-3 fish oil to the diet following B12. Fish oil is a natural anti-inflammatory that should allow for a better response to medications and steroids. Lastly, vitamin E might be considered for facial paralysis needs. Other beneficial possibilities include meditation, yoga, relaxation techniques, and acupuncture, despite the fact that there is no scientific evidence to justify their use.

Whether traditional or homeopathic remedies are utilized, the sooner a vitamin regimen can be incorporated, the sooner results should be seen but keep in mind Bell’s palsy will likely dissipate on its own with or without treatment. On the other hand, Bell’s palsy caused by Lyme disease needs to be treated with antibiotics, and Bell’s caused by herpes should be treated within 72 hours.

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Rare, genetic disorder has unusual symptoms http://askdrgottmd.com/rare-genetic-disorder-has-unusual-symptoms-2/ http://askdrgottmd.com/rare-genetic-disorder-has-unusual-symptoms-2/#respond Wed, 24 Jun 2015 05:01:33 +0000 http://askdrgottmd.com/?p=8176

Q: I have a primary orthostatic tremor, an extremely rare condition. Do you have any background working with this tremor?

A: No, however, perhaps I can shed some light on the condition and perhaps answer some questions you might have. A primary orthostatic tremor is a rare movement disorder characterized by a tremor that generally occurs in the legs while standing and markedly decreases or completely disappears when the individual sits, walks, or lies down. It causes an overwhelming feeling of unsteadiness, almost forcing affected individuals to move quickly or find a place to sit down to avoid falling. The tremor may not be visible to the naked eye; however, palpation of the thighs or calves or listening with the aid of a stethoscope will reveal a rhythmic contraction of the muscles involved. Some individuals may be able to stand for several minutes before the tremor begins, while others can only stand for a very brief period of time. Interestingly, the condition will not develop into a more serious condition, nor will it affect any other bodily systems. Further and while not as common, some individuals may have a tremor in the upper extremities instead of the legs.

Primary orthostatic tremor is sometimes referred to as “shaky legs syndrome”. It is a major problem for those individuals who suffer from the condition as it cannot be ignored, can cause falls, serious injuries and embarrassment and affects quality of life. The exact cause for it remains unknown. It was first described in 1984, some 30 years ago, and even today’s medical literature is controversial as to whether it is a variant of essential tremor or a separate entity. Some individuals so diagnosed are known to have a family history of tremor, suggesting that genetic factors may play a role but a great deal more research is necessary to determine the precise underlying cause(s) for the disorder. It is understandable that many cases of primary orthostatic tremor are misdiagnosed, making it difficult to determine how many individuals may actually be affected; however, more than 200 cases involving both men and women have been reported in medical literature over the past 30 years.

Diagnosis is based on a detailed patient history and thorough clinical evaluation and is further supported by tests such as electromyography that measures electrical impulses of the involved muscles during contraction and at rest. Misdiagnosis is rather common since many patients may be suspected of having a psychological cause for the tremor rather than a physical one.

Treatment is generally provided through oral medication such as clonazepam (Klonopin), yet not all individuals respond favorably to first-line drug therapy. Some patients may respond favorably to gabapentin (Neurontin), an anti-seizure drug, or to other prescription medications. Medical literature has also indicated that some cases have been successfully treated by thalamic deep brain stimulation, yet again, additional research is necessary before effectiveness and long-term safety can be properly determined.

Ongoing clinical trials are posted through www.clinicalatrials.gov. Beyond this, information on clinical trials can be checked through the National Institutes of Health Clinical Center by calling 1 800-411-1222 or through email at prpl@cc.nih.gov.

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Is cough linked with prescribed medication? http://askdrgottmd.com/is-cough-linked-with-prescribed-medication-2/ http://askdrgottmd.com/is-cough-linked-with-prescribed-medication-2/#respond Tue, 23 Jun 2015 05:01:43 +0000 http://askdrgottmd.com/?p=8174

Q: I am a 75-year-old male in excellent health and very active. I have allergies – especially in the spring and fall. For the past three weeks I have had a persistent cough and am coughing up cloudy white mucus. My doctor ran a C-scan on my chest which was clear, but indicated some irregularities in my gallbladder. He ran an ultrasound on that and said there were some small stones but nothing that would dictate removal. He explained that my blood pressure medicine, Benicar, could cause the coughing.

I also have acid reflux and take Nexium. He explained that the coughing also might be caused by acid reflux and I could be aspirating it and then coughing it up. He told me to stop taking the Benicar for two weeks and come back to see him He also prescribed Asifex in place of the Nexium. I think the cough is most likely from the acid reflux because the mucus tastes bitter. What’s you opinion?

A: Benicar (olmesartan) is what is known as an angiotensin II receptor antagonis that keeps blood vessels from narrowing, improves blood flow and lowers blood pressure. Side effects may include edema of the extremities, lightheadedness, chest pain, a rapid heart rate, ongoing diarrhea, dizziness, a cough that can produce mucus and more.

Nexium (esomeprazole) is a proton pump inhibitor that decreases the amount of acid produced in the stomach. It is prescribed to treat GERD (gastroesophageal reflux disease) and other related conditions. Side effects may include bloating, chills, an elevated heart rate, fever, shortness of breath, itching, cough, and a great deal more.

Aciphex (rabeprazole) is another proton pump inhibitor prescribed to reduce the amount of acid produced in the stomach. It, too, treats GERD and other conditions involving excess stomach acid.Side effects are, in part, similar to those of Nexium – fever or chills, low back or side pain, paresthesias of the hands or feet, general fatigue, and cough.

Acid reflux is a backward flow of stomach acid into the esophagus. The regurgitation may taste sour and you may experience heartburn (a burning sensation in the chest). Common risk factors may include being obese or overweight, eating spicy/fatty foods, eating large meals and lying down immediately following the meal, taking blood pressure medications/specific muscle relaxants/aspirin or ibuprofen, drinking carbonated beverages or products that contain alcohol, and smoking. On the flip side, the condition may be kept under control through weight loss, avoiding foods that trigger heartburn (that differ from person to person), avoiding alcohol and the smoking habit, and through eating smaller more frequent meals.

Occasional reflux can be treated with over-the-counter medications such as Rolaids, Alka-Seltzer, Mylanta, and others; however, while they may neutralize stomach acid, they may result in diarrhea or constipation – especially with their overuse. The best choice is an antacid that contains both magnesium hydroxide and aluminum hydroxide. When these OTCs fail to help, Pepcid, Tagamet, Zantac, Aciphex, Nexium, and others may provide relief.

While I lean toward acid reflux perhaps being the cause of your productive cough, I cannot place the blame on any specific medication. Your physician is already on the right track through suggesting you discontinue the Benicar and substituting the Nexium for the Aciphex. However, the problem with making more than one change at a time is that you (and he) will be unable to determine which medication is to blame. What appears to me to work well is to discontinue or substitute one drug at a time for a given period. If no relief is found, proceed to the next. In your case, all drugs prescribed thus far have a cough as an unwanted potential side effect. Therefore, in my opinion, you will only be able to determine which is the culprit through the process of elimination. Good luck.

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Work-related pleurisy slow to improve http://askdrgottmd.com/work-related-pleurisy-slow-to-improve-2/ http://askdrgottmd.com/work-related-pleurisy-slow-to-improve-2/#respond Fri, 19 Jun 2015 12:32:28 +0000 http://askdrgottmd.com/?p=8172

Q: My husband contracted pneumonia in early December. We believe he got it by exposure to so much corn dust at the feed mill where he was unloading corn. He was treated with ciprofloxacin and azithromycin which did clear up the pneumonia. Then he got pleurisy and also a bad sinus infection toward the end of the month. The sinus infection was treated with amoxicillin and went away but the pleurisy just hangs on. We’re treating it with NSAIDs. Any suggestions?

A: Pleurisy is inflammation of the pleura, the membrane that lines the rib cage itself and surrounds the lungs. The pleura is double-layered and both protects and lubricates the surface of the lungs as they inflate and deflate. There is a thin fluid-filled gap known as the pleural space that allows the two layers of the pleural membrane to slide smoothly past each other; however, when the layers become inflamed by sneezing, coughing or even breathing, their surfaces rub together, making breathing very painful. In some instances, excess fluid may seep into the pleural space and cause a condition known as a pleural effusion. That fluid buildup generally has a lubricating effect that relieves the pleuritic pain. However, at the same time, the fluid places additional pressure on the lungs and lessens their ability to function as they should. A pleural effusion can also occur without pleurisy because of heart failure and liver or kidney disease.

Common causes of pleurisy in an otherwise healthy individual include a viral, bacterial or fungal infection, chest injury such as a fractured rib, pneumothorax, tuberculosis, a drug reaction, rheumatoid arthritis, or disorders such as a pulmonary embolism, lupus, liver disease, and cancer. You are probably correct in that your husband’s condition was from inhaling an excessive amount of corn dust.

Symptoms are chest pain that begins suddenly and dyspnea (difficulty breathing) on one side of the chest only that may exacerbate with sudden movement, coughing or sneezing and may lessen when pressure is placed on the side the pain is on. The pain may also extend to the shoulder or back.

Diagnosis might be made through laboratory testing that can detect an infection or autoimmune disorder, a chest X-ray that will allow a radiologist to determine if the lungs are fully inflated or if air or fluids are present between the lungs and ribs, an ultrasound that could rule out a pleural effusion, computerized tomography (CT) scan that can detect the cause of the pleuritic pain, and an electrocardiogram (EKG) to rule out cardiac involvement. Your physician might order a thoracentesis to remove fluid for analysis under a microscope, or a pleural biopsy if he or she is finds sit necessary to rule out tuberculosis or cancer. Treatment will depend on the underlying cause for the pleurisy. As a general rule, a virus will resolve on its own over time, while a bacterial infection should respond to antibiotic therapy.

While you may hope for immediate results, you may be a bit premature expecting what must be a virus to resolve. If your husband fails to improve shortly, I would consider having his physician (or perhaps even a college-based veterinarian test some corn dust particles to determine just what he might have contracted. The next step would be to advance to a pulmonologist who might might bring things to light. Good luck.

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Retired couple’s activities hampered by wife’s medical problem http://askdrgottmd.com/retired-couples-activities-hampered-by-wifes-medical-problem-2/ http://askdrgottmd.com/retired-couples-activities-hampered-by-wifes-medical-problem-2/#respond Thu, 18 Jun 2015 11:32:04 +0000 http://askdrgottmd.com/?p=8170

Q: My wife is in her late 50s. A little more than a year ago she began to have pain in her right leg. It does not always occur in the same location in the leg and is most prevalent in the upper area, usually to the outside or back portion. The pain will worsen with activity and just standing will also make it worse. The pain has and does affect her daily life, some days more than others. She is normally very tolerant of pain. She doesn’t have a structured exercise program but is normally very active.

She went to our family doctor who had X-rays taken of her leg, which didn’t reveal anything. She tried physical therapy but after not seeing results in a few sessions, she stopped. She had a slew of exercises to try, again stopping after not getting the expected results. After the X-rays but before an MRI, I suggested she see an orthopedist but she said he deals with bones and the X-rays showed no issue with the bones. I was under the impression an orthopedist deals with muscles, bones and other connective tissue. I still would like her to see either an orthopedist or a neurologist.

This is affecting her quality of life and she is losing patience, hope and faith. We are both retired now and many of the things we would like to do together involve physical activity. I am truly hoping you can help, or suggest someone who can. She is far too young to feel as old as she says this is making her feel. HELP, PLEASE! Thank you in advance.

A: To begin with, an orthopedic physician is one who utilizes surgical and non-surgical means to treat sports injuries, degenerative disorders, infection, musculoskeletal trauma, and a great deal more. You are correct in that the specialty deals with the prevention or correction of injuries and disorders of the skeletal system, associated muscles, joints, tendons and ligaments. She has already seen her physician, had X-rays, physical therapy, and exercised without relief. What harm could a new set of eyes from a physician in an appropriate field do?

A neurologist is involved with the study and treatment of disorders that involve the nervous system, brain, spinal cord and nerves. Individuals in the field treat movement disorders such as nerve diseases of the extremities (such as peripheral neuropathy, Parkinson’s, spinal cord issues, neurodegenerative disorders such as Alzheimer’s, ALS and others. Neurologists do not perform surgery. I feel you are closer on the mark with your wife initially seeing an orthopedist than a neurologist. Should one be appropriate, you can always make an appointment with someone in that field, as well.

Most leg pain is the result of overuse, an injury to the bones, muscles, ligaments, tendons, or other soft tissues. Some issues can even be traced to problems of the lower spine. Other possibilities that come to mind include poor circulation, blood clots, or varicose veins.

Non-traumatic leg pain in a joint may carry a diagnosis of peripheral artery disease, a decrease in the arterial blood supply to the leg because of narrowed blood vessels. The pain may come on with activity, a period when additional oxygen is demanded by the muscles. With narrowed arteries, the demand cannot be met, and the surrounding muscles may ache. Also, pain may result from nerve impingement, diabetes, an electrolyte imbalance, failure to stretch prior to exercise, dehydration, or specific prescribed medications.

I recommend your wife make an appointment with an orthopedist who may choose to order nerve conduction testing (to evaluate nerve function), an arteriogram (to check the arterial supply to the legs), or even joint aspiration (to rule out infection) to help with a diagnosis. Treatment will depend on the diagnosis so she can hopefully eradicate or at least reduce her level of pain and allow her quality of life to improve.

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Wands purported to restore a person’s positive energy http://askdrgottmd.com/wands-purported-to-restore-a-persons-positive-energy-2/ http://askdrgottmd.com/wands-purported-to-restore-a-persons-positive-energy-2/#respond Wed, 17 Jun 2015 05:01:38 +0000 http://askdrgottmd.com/?p=8168

Q: I was recently introduced to a scalar wand, also called a wellness wand. I know it sounds hokey but please keep an open mind. In an attempt to research scalar products, it’s been difficult finding any scientific studies. There are many proclamations but I want real answers.

I purchased one of these wands and surprisingly found after using it as directed, I got relief from morning back pain. The relief was quick but not long lasting. I don’t believe it is a mind over matter or placebo effect, since I remain skeptical. I guess the proof is in the pudding. Still, can you tell me where and how to research products which profess to help our bodies attend wellness at various levels?

I found prices range from several hundred dollars to one site which sells them for $39.95. I also found these products available internationally but at what risk to consumes, especially when the products come from third world countries. I wonder about your thoughts. Thank you for any consideration you can give this question.

A: Every time I truly think I’ve heard it all, another product comes on the market. For example, the Sacred Scalar Wand, according to reports from the company, generates what could be called source energy or zero point energy – the natural energy in the universe that exists in its purest form. The wand, similar in appearance to a ball point pen, contains crystals and minerals subjected to several high heat fusion methods which produces a catalytic conversion of energy. Thus, it is used to transfer energy to other living cells in the human body, plants, solid foods and liquids.

Simply stated, when human tissue, cells and muscles are exposed to the scalar field, they begin to vibrate in harmony with the original blueprint for which they were designed. It is noted the wand doesn’t cure or ameliorate disease because that’s not what it was designed to do. However, when exposed to coherent fields that encourage harmonic oscillation, the claim is that the body appears to go back into perfect balance, implying that whatever was causing the energetic imbalance has been removed.

The instrument is purported to help with balance to improve the function of a person’s physical, energetic, emotional, mental and spiritual bodies; clear the space around a person of all negative being, energy, vibrations, thought forms, and quantum patterns of every kind; empowers a person with vibrant, robust health and positive energy, with emotional vibrations, thoughts and quantum patterns; energizes the astral energetic and physical body so the body is better able to heal itself and attain a state of vibrant health and balance; call in the spiritual guides and teachers to help and assist both the person and his or her guardian angels to protect you; and release thoughts and emotions that do not serve your highest purpose so you may become the person you came here to be. Holy Hannah!

The information states the wand should be pointing at the desired area of interest and moved it in either clockwise or counterclockwise circles for several minutes at a time. It can also be turned horizontally to sweep the complete spinal area, an arm or a leg. Regular and longer sessions may be required when dealing with persistent imbalances. Now get this. The wand can be used on all consumable beverages because it causes the water in liquids to become coherent, will improve their taste and extend their shelf life. Fresh fruits and vegetables will taste better and again, shelf life will be extended. When not used, the wand can be placed in your refrigerator for the same results. Thank Heavens for that!

And now, perhaps the best of all – each wand comes with a clearing pad to remove unwanted energies the wand has accumulated by returning them all to the universal quantum field for transformation. All you need do is lay your wand on the clearing pad for a few seconds between uses. And the cost is a paltry $123.97. I must admit it would be fun to have something to remove what we don’t like about life, but I doubt a clearing pad can accomplish such a feat.

No disrespect intended but in my opinion this is the biggest scam I’ve heard yet and is sheer poppycock! There are no reputable studies because they don’t exist. The only thing you will hear about are the reports from users who have experienced positive results. Being a skeptic, I cannot deny that a placebo effect might have an influence here but from a personal view, you are wasting your money, whether you buy the $39.95 model or the $123.97 version. Save your money and remember – if something sounds too good to be true, it probably is.

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Home remedies for arthritis http://askdrgottmd.com/home-remedies-for-arthritis-2/ http://askdrgottmd.com/home-remedies-for-arthritis-2/#respond Tue, 16 Jun 2015 05:01:28 +0000 http://askdrgottmd.com/?p=8166

Q: I recall you printing an article containing a home remedy for the pain of arthritis. As I remember, it was to soak raisins in some sort of alcoholic beverage and after a period of time, to eat (just a few) raisins a day. I would like to know what this was. I enjoy your column and frequently think as I read, “you can’t please everyone but you surely try to help some”. Thank you.

A: You are referring to an article written a very long time ago about methods of treating arthritis. I asked readers to write to me regarding their tried and true methods and someone did. If I remember correctly, he or she suggested soaking a hand full of raisins in gin and consuming two or three raisins daily to combat symptoms. The raisins quickly soak up the liquid and are ready to eat a day later.

As an aside, I also remember writing about Lyme disease and readers expressed difficulties with methods geared toward killing the tiny ticks that can cause the disease. One enterprising gentleman (or perhaps the local salesman at his favorite liquor store) recommended floating the tick in gin to accomplish the task. So, my patient presented in my office with a tick in a small bottle of gin and asked my opinion. Being honest, I politely informed him with a grin on my face that it was a waste of good gin and the tick likely took great pride in doing the back stroke across the bottle before taking his last breath! I then sent the tick off to the state as we did in those days and we all had a good laugh wondering what state officials thought when they received a tick who definitely died from gin exposure!

Arthritis is inflammation of one or more joints of the body. Common symptoms are pain and stiffness that worsen with age. Two common forms are rheumatoid and osteoarthritis. Rheumatoid arthritis (RA) is a chronic, autoimmune disorder that affects different body joints but is often observed in the hands, knees, wrists, and shoulders. When the condition acts up joints become inflamed, causing swelling, limited range of motion, stiffness, and pain. The patient may be fatigued, have a loss of appetite, and malaise. Affected joint symptoms are generally symmetrical, meaning that both sides of the body are affected simultaneously. RA for some patients can go into remission and become virtually inactive with no symptoms present for an indefinite period, while other patients suffer non-stop symptoms for extended periods. Treatment may include analgesics, NSAIDs, anti-rheumatic drugs, exercise, physical therapy, water aerobics, heat, relaxation, and more.

Osterarthritis (OA) is the most common form of arthritis that can be the result of injury, obesity and aging joints. It commonly affects weight-bearing joints – hips, knees and spine but can also present in the fingers and neck. Risk factors include obesity, joint overuse, heredity, and injury. The severity of the disorder varies from person to person with symptoms that may include pain, joint stiffness following periods of rest, and joint swelling.

Traditional treatment may include OTC pain relievers, physical therapy, hot/cold compresses, exercise such as water aerobics or walking, weight loss if appropriate, and more. When these possibilities fail to provide relief, steroid injections directly into the joint or oral narcotics may be prescribed, followed by arthroscopy or joint replacement.

On the home front, consider adding ¼ cup raw pumpkin seeds to your daily diet, or rub Castiva onto the affected joint(s) twice daily.

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