Woman’s episodes of depression occur all too often

September 22, 2014 By

Q: I am a 43-year old woman with bipolar disease. I have been treated with it for the last 23 years. For the last 7 I have mainly experienced more severe episodes of depression and no major highs. Is this because of age or could it be due to fine tuning of my medications? I ask because I have perimenopause. Could this and menopause completely mess up my mood levels?

Mental illness runs on both sides of my family. We are all well-educated and always keep up to date on our illness.

I have been reading your column for a long time and think you are soooo intelligent and kind with your words. Thank you.

A: Thank you for the compliment. Bipolar disorder a/k/a manic depressive disorder causes serious mood swings that cover the gamut from depression to mania. Mood shifts may occur several times each day, or several times a year; there is no specific pattern. In some instances, symptoms of depression and mania can occur simultaneously.

Episodes are characterized by mania, hypomania and major depression; the subtypes include bipolar I and bipolar II. Patients who suffer from bipolar I disorder experience manic episodes and almost always experience hypomania as well as major episodes of depression. Bipolar II is defined when an individual has at least one hypomanic episode, at least one major depressive episode, and an absence of manic episodes. As you can determine, each subtype has a pattern that is different from the others. Bipolar I may cause problems with other individuals at home or in the workplace. Bipolar II is less severe, may encompass elevated mood swings and irritability, yet the individual will likely be able to function normally throughout the day. .

The manic phase of the disorder may include poor judgment, states of euphoria, aggressive behavior, rapid speech, elevated self-esteem, poor performance at work or school, and a great deal more.

On the flip side, the depressive phase may include a lack of interest in things that were once very important, anxiety, hopelessness, sadness, sleep abnormalities, difficulties concentrating, and more.

Numerous situations or conditions may modify a person’s outlook. For example, seasonal affective disorder may cause manic episodes in the spring and summer or depressed episodes in the fall or winter. There may be the loss or illness of a loved one to consider. Then there’s age. I am not implying that 43 is old by any means yet we find we might have to wear glasses, we are more concerned about diseases and disorders, we may gain or lose weight, and require medication because of medical conditions such as hypertension or hypercholesterolemia. These things may be managed with the assistance of medication, yet if we are already on one medication, there could be a crossover effect between two or more that cause symptoms we don’t completely understand.

On to the possible menopause connection. In a 2012 Psychiatric Times article, a professor at Harvard Medical School and Director of the Women’s Mental Health Division in the Department of Psychiatry at Brigham and Women’s wrote that the menstrual cycle and menopause can cause complications. Of the 2,524 women studied, 65% of women with type I and 70% of women with type II reported increased premenstrual mood symptoms. She went on to add there are a number of well-documented cases showing a clear exacerbation of mood symptoms associated with the menstrual cycle.

Speak with your therapist or prescribing physician to determine if your current medication could have any bearing on your increased depressive states, or if another tried and true medication might be more appropriate.

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Controlling hot flashes with home remedies

September 20, 2014 By

Q: Several years ago an article of yours talked about taking garlic and parsley for hot flashes. A specific formula was not listed for each of the ingredients. Should the garlic and parsley be equal mgs or should there be more of one ingredient than another?

Thank you for your reply.

A: Hot flashes are a characteristic of menopause and are believed to occur because of hormonal changes that accompany the aging process — particularly the reduced levels of estrogen as a woman approaches menopause. While less common, they can also occur in men. They may be the result of specific medications or with severe infections.

Hot flashes are ideally brief, lasting from 30 seconds to several minutes. The skin may become flushed and excessive perspiration may occur. Common treatment options may include hormone therapy, bioidentical hormone therapy, phytoestrogens, black cohosh and other home remedies, as you have pointed out. While some of the therapies are recognized by the FDA, others such as home remedies have not been tested, nor have they been FDA approved.

Treatment was traditionally centered around either oral or transdermal (patch) forms of estrogen. Hormone replacement therapy (HRT) has consistently been comprised of estrogens alone or as a combination of estrogens and progesterone. Available through prescription, they are effective in reducing the frequency and severity of hot flashes. Unfortunately, long-term studies on women receiving combined estrogen and progesterone had been halted when it was determined that a risk of heart attack, stroke and breast cancer were heightened, when compared with women who chose not to receive HRT. Later studies found that women taking estrogen alone had an increased risk for stroke but not for either heart attack or breast cancer. And to complicate and confuse things, estrogen therapy alone causes an increased risk of endometrial cancer in post-menopausal women who have not had their uterus surgically removed.

Bioidentical hormone therapy is becoming more popular with perimenopausal women. It is medication that contain hormones with the same chemical formula as those hormones produced naturally in the body. Advocates of this form of therapy feel the creams and gels available are absorbed into the body in their active form without affecting the liver and their use may avoid those potentially dangerous side effects of synthetic hormones. The jury remains out on this one since studies to establish long-term safety have not been conducted.

Then there are prescription drugs, including Neurontin, Begace, Depo-Provera and Catapres, but on to herbs and alternative treatments.

While there are no recognized test studies for confirmation of effectiveness or a lack thereof, some individuals report plant estrogens, black cohosh, vitamin E, evening primrose oil, licorice, dong quai (angelica sinensis), wild yam, and red clover have been used for control. They even feel women who closely follow a Mediterranean diet of garlic peppers, mushrooms, strawberries, pasta and red wine are less likely to have hot flashes. This implies that the garlic to which you refer can be consumed with a variety of foods for control. It is believed that parsley is filled with vitamins and nutrients, is a cleanser for the liver and gallbladder, and is a beneficial when it comes to controlling hot flashes. I don’t recall recommending a mixture of garlic and parsley but may have implied the two products do have properties that will lessen symptoms. And, having listed some of the possible aids for hot flashes, it must be said that they are not FDA approved and should only be taken under a physician’s guidance. Herbs are not subject to any guidelines; therefore, I cannot give you a specific amount to use.

One tea recipe I found for hot flashes includes ¼ cup parsley, ¼ cup sage, and ¼ cup fennel. Because sage is bitter, rosemary or anise may be substituted. Crush the anise or fennel; combine all ingredients in a sterile glass jar with a tight-fitting lid. Shake well to mix. To make a medicinal tea, use one teaspoon of the mixture to each cup of hot water. Steep for 10 minutes. Strain and drink one to three cups each day. It is recommended the tea be consumed within 24 hours of making it and the product that has been steeped can be used at least three times. Good luck.

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Plethora of issues plagues man

September 19, 2014 By

Q: I do not recall any articles dealing with cures for sinus infections or on fungus.

I have lifelong recurring sinus infections which seem triggered by winter colds that won’t go away and develop into sinus or upper respiratory infections. My current diagnosis is a fungus infection for which I am taking Itraconazole.

My wife tells me my sinuses often smell when I breathe out. I constantly fight toenail fungus/crotch and foot rashes. Sweating frequently causes a rash under my armpits. I cannot tolerate an electric blanket in the winter for fear of making these issues worse. I use Vicks VapoRub, wash and dry my feet daily, then treat them with hydrogen peroxide. I irrigate my sinuses with salt water and bicarbonate of soda.

Thank you for any help you might provide.

A: You might compare your medical conditions with an automobile in the back yard that doesn’t want to start or run as smoothly as you would like it to but until you check things out and eliminate those things you know are not causing the problems, you cannot zero in on those that truly require attention. Therefore, I feel you need a complete physical examination, lab testing and possible X-rays. The lab work should be quite complete and include a vitamin panel, thyroid studies, testing for anemia and anything else your physician deems appropriate. Essentially, he or she needs a basis to determine what is going on with your body that causes so many recurring issues. It may be that something as simple as a vitamin deficiency or a thyroid abnormality is to blame, or it may be something more complex.

Your chronic sinusitis may be caused by an infection. However, it can also be the result of polyps. You may also have a deviated septum or repeated allergic reactions that can trigger fungal infections of the sinuses. I strongly urge you to follow up with a health care professional because something is definitely amiss that should not be occurring and it is critical to resolve the issue. If you suffer from hay fever, a sensitivity to aspirin that causes respiratory issues, asthma, or the habit of smoking or being exposed to second hand smoke from those around you who smoke, you are at a greater risk for developing sinusitis. A visit to an otolaryngologist might shed some light onto the basis for your continued problem.

Fungal infections are rather common. They include jock itch, yeast infections, athlete’s foot, and even ringworm. Athlete’s foot is caused by a fungus that lives on dead tissue of a person’s skin, toenails, and hair. Your physician can examine a section of the scaling skin to make a proper diagnosis. While you appear to be doing all of the correct things to keep your feet healthy, you might consider wearing socks made of wicking material that allow your skin to breathe.

Jock itch is a fungal infection that affects the outer layers of skin. It thrives in warm, moist areas of the body such as under the arms, in the groin, and inner thighs. If you are a member of an athletic club where you might use public showers and towels you dry off with are damp, you may unknowingly be increasing your risk of developing jock itch.

Toenail fungus is just that – a fungus under the surface of a nail. Again, warm and moist areas you frequent may be a haven for someone as susceptible as you. While a nail fungus will not disappear by following my recommendations, they should go a long way toward further prevention once your fungus is under control: try changing your socks twice daily and rotating the shoes you wear. This will allow them to dry out sufficiently, making the fungus more difficult to grow. You might even consider putting your shoes out in the sunshine to dry between wearings whenever possible. Purchase socks that are made of synthetic fibers that wick moisture away from your feet.

Get some testing done. Review it with your physician. Based on the results, ask if visiting a specialist such as an infection specialist or perhaps even a homeopath is appropriate. Get answers so you can get on with your life. Good luck.

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Lipoma removal considered cosmetic

September 18, 2014 By

Q: I enjoy your column and find it very helpful in learning about various health problems.

I have lipomas on my chest and hips and wonder if you could write about these. I am told by my doctor that insurance companies usually don’t cover them because they are considered cosmetic surgery unless they are causing trouble (which incidentally, mine are not). A distraction, if anything. My daughter also has a rather large one on her upper arm.

A: A lipoma is a fatty mass or lump that is slow-growing and is most frequently situated between the skin and the underlying muscle layer of the arms, thighs, neck, shoulders and back. The mass is benign and often harmless. As you have pointed out, it/they are more unattractive than anything else. They can present at any age but are most frequently seen in individuals of middle age.

While anything that appears when and where we feel it shouldn’t is upsetting, lipomas are generally less than two inches but have the capability of growing larger. They don’t cause pain when touched and may move freely when pressure is applied.

Those individuals at increased risk include being middle aged and having other disorders including Gardner’s syndrome, Madelung disease or Cowden syndrome. And, genetics play a strong role so I am not surprised that your daughter also has one on her arm.

Diagnosis is commonly made through a visual examination. When a physician has questions, he or she may remove a tissue sample for biopsy. If there is any question, a biopsy or other tests may be ordered. to rule out such things as liposarcomas which are cancerous lesions. If nothing is suspect, no treatment is generally necessary. Such procedures as steroid injections are available to shrink the tumor(s) but this procedure will not completely eliminate it. Liposuction might also be attempted.

And, as you have indicated, insurance is considered – unless the lesion grows or becomes painful. Should that occur, you should speak with your physician to determine if you should attempt to receive clearance to have them removed.

As a point of information, Gardner’s syndrome is an autosomal dominant form of polyposis. It presents with multiple polyps within the colon as well as outside of it. Those polyps may also grow in the spleen, kidneys, liver, small bowel, and other areas. The number of polyps increase with age, with hundreds to thousands developing primarily in the colon. Treatment is difficult but chemotherapy has been attempted with some success for this condition.

Madelung disease is a rare condition that presents with the growth of fatty tumors. It frequently affects men of Mediterranean ancestry in middle age who have a history of alcohol abuse, yet non-alcoholics and women can also be affected. The lesions can increase progressively and often lead to pain and a loss of mobility in the neck. In the majority of cases, the lesions are benign.

Cowden syndrome also presents with growths known as hamartomas but which carry a risk of developing into specific cancers. The growths are commonly found on the skin and mucous membranes like the mouth and nose linings, in the intestine, and other areas of the body. This condition generally presents when an individual is in his or her late 20s.

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Chlorine blamed for woman’s fibromyalgia

September 17, 2014 By

Q: In about 1986 I was diagnosed with fibromyalgia. It took about a dozen different doctors to tell me it was all in my head until I was diagnosed by an internal medicine specialist who said that fibro is what I had. Other than pain pills that did not work, there was nothing to do about it.

In about 1998 I went to a woman who had a special X-ray machine. She asked if I have city water. I indicated I did but I use my Shaklee counter top unit for drinking. She then asked if I bathe in city water and I indicated I did. She said I needed to get rid of it. She explained that the chlorine in the water went through my pores and mingled with chemicals in my body and caused the pain of fibromyalgia.

I searched and found a water unit that took the chlorine out of the city water as it was coming into the house. No more pain!

If I travel or swim in chlorinated water, the aches and pains reappear and it is so painful that life is not worth living, for I don’t have a life.

I realize that I do have multiple chemical sensitivities syndrome and many other things can get me sick – scented laundry soaps, fabric softeners, perfume, cologne, toilet bowl cleaner, and more. So, over the years I have gone natural with cleaning agents. Maybe my problem and my solution can help your readers.

A: Interestingly, fibromyalgia has been around since the 1800s but it didn’t have the name until some years later. Now that it has a name and has been differentiated from countless other medical conditions with similar signs and symptoms, it is known that about 10 million Americans nationwide suffer from the condition. In fact, the June 19, 2013 publication of Pain Medicine , the American Academy of Pain Medicine indicated that researchers based at Albany Medical College feel they may have finally found the first biological evidence of what actually causes fibromyalgia. In a small study, researchers found a large increase in sensory nerve fibers in the blood vessels of the skin on patients’ palms.

From other perspectives, Mayo Clinic indicates the causes of fibromyalgia are unclear but researchers believe the condition amplifies painful sensations by the way the brain processes signals received. Physical and emotional trauma, infections and genes play a role in the disorder.

Johns Hopkins states the cause of fibromyalgia is unknown but researchers believe there may be a link with biochemical abnormalities, the endocrine system, psychological stress and a link with sleep disturbances.

UpToDate states the condition affects connective tissues, including muscles, ligaments and tendons….yet despite ongoing research, the cause, diagnosis and optimal treatment remain unclear.

Healthline News feels the cause is in the palm of the hand which they feel is welcome news for those who suffer from the condition and cannot find relief from the aches and fatigue experienced. They go on to state there is no way to confirm the existence of the disease in patients, other than using brain imaging scans.

What is widely known is that fibromyalgia is a disorder of exclusion. Once a physician rules out other possibilities, this disturbing, often debilitating disorder is so labeled. While you don’t indicate if the woman who diagnosed you is a physician or specialist in a different field, she certainly has a different view that has not, to my knowledge, been considered by others. Perhaps she is really on to something. Keep me informed of your progress and thank you for writing.

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Patient’s foot drop is slow to improve

September 16, 2014 By

Q: I am a 75-year-old female and in good health. A neurologist recently diagnosed me with foot drop, telling me it was caused from crossing my legs. It is difficult for me to walk and the more I walk, the more tired I get, like I am dragging a log with me. I have had 10 physical therapy treatment including massage, ultrasound and more. Yesterday I received an acupuncture treatment. This began around six months ago. Two months ago the knee became sensitive when bending it. To date my knee is improving slightly but my foot is still flopping.

Can you put any light on this subject and recommend a cure?

A: Foot drop (or drop foot) is a gait abnormality that occurs because of weakness or damage to the common fibular nerve or paralysis of the muscles in the anterior portion of the lower leg. It can be caused by nerve damage alone, by trauma to the spinal cord, muscle trauma, toxins, or disease. While not a diagnosis, it is most frequently a symptom of an underlying issue. The condition may be temporary or permanent and bilateral or unilateral depending on the extent of paralysis or muscle weakness. When the individual attempts to walk, the raised leg will often be bent at the knee. Because of the bent knee approach, an individual may walk on tiptoes or with a wide outward swing of the affected leg(s). It will be difficult for the individual to walk on his or her heels, simply because of the inability to lift the front of the foot off the ground. Diagnosis may therefore be made during a routine examination when the physician watches the individual walk. If questions remain, testing including an MRI, EMG or MRN may be ordered to help determine the underlying cause for making the diagnosis.

Diseases that can result in foot drop may include amyotrophic lateral sclerosis (ALS), muscular dystrophy, multiple sclerosis, cerebral palsy, Friedreich’s ataxia, Charcot Marie Tooth disease, hereditary spastic paraplegia, and stroke. The condition can even occur following hip surgery and is known to occur following squatting for long periods at a time or from crossing the legs.

Treatment will begin by determining the underlying cause for the foot drop. For example, if it is the result of injury to a peripheral nerve, a relatively simple operation might be performed whereby the pressure on the peripheral nerve is eliminated. If spinal disc herniation in the lower back area is found to be impinging on the nerve that makes the leg function, surgery can be performed to either remove the herniated disc, opening the foramen, or in more difficult instances, a combination of both procedures with or without fusion to avoid movement. If the procedure or procedures are insufficient, nerve transfers might be used by taking branches of the tibial nerve. On the downside, recovery is extensive and may take up to a year.

Non-surgical treatments may include exercise, over-the-counter anti-inflammatory drugs, and functional electrical stimulation, and epidural injections for spinal stenosis. Fractures of the vertebra may include a back brace, while molded plastic devices can stabilize ankles.

Your physician has apparently or hopefully been willing to consider all possibilities of treatment. Make an appointment to speak with him or her to determine if your expectations for recovery are reasonable or if you should consider other options such as a second opinion or need to be patient for a while longer to allow the healing process to be complete.

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Black pepper aggravates woman’s UTIs

September 13, 2014 By

Q: Every time my mother eats black pepper, she gets a bladder infection. Her urologist told her that black pepper pieces travel through the bladder which irritates it and causes the infection. Also, the acid in orange juice has also caused bladder infections for her. Perhaps people who have many infections should try to eliminate this seasoning and/or juice.

A: According to the American Urological Association, the main cause of a urinary tract infection is bacteria. Infections are more common in women than in men, primarily because women have a shorter urinary tract, specifically the urethra (the tube that carries urine from the bladder), which makes them more susceptible. There are several factors other than foods that can increase the risk of a urinary tract infection. They include wiping from back to front, taking multiple courses of antibiotics that causes the hearty bugs to become increasingly resistant to them, having multiple sex partners, and ignoring the urge to urinate instead of emptying the bladder when your body signals. Pepper and other substances may irritate the bladder in some individuals but it doesn’t make them susceptible to UTIs.

For the benefit of other readers, symptoms of a UTI include urine that is cloudy and has a strong odor, frequent urination with pain, voiding a minimal amount at each attempt, burning and abdominal pain.

Beyond that and in the food department, one of the biggest offenders is products that contain sugar which should be avoided during an infection because the bacteria is believed to feed on the sugars contained therein. Tomatoes, grapefruits, oranges, lemons and limes – all high in acids – are also known to irritate the bladder. Beverages and foods that contain caffeine should also be avoided during a UTI but can be consumed once the infection has completely cleared. For those individuals with a sensitive bladder, specific spices including curry and black pepper are known to trigger symptoms. Other food items to avoid may include white flour, corn, oats, onions, beans, and nuts. This may all appear somewhat harsh; however, meat, cheeses, butter, green and root vegetables, and potatoes, can be enjoyed. While we all respond differently, it appears your mother has a sensitivity to pepper and at least some citrus products. For the rest of us, discontinuing some of the other foods mentioned might do the trick.

There are also alternative treatments that might help the symptoms of a UTI. They include drinking more water than usual to help “flush” the system, drinking 100% cranberry juice every day at the first sign of an infection, using UTI-Clear which is an herbal remedy, drinking caffeine-free tea, avoiding douching/using feminine deodorant sprays/wearing scented pads or tampons, wearing cotton underwear rather than synthetic blends, taking vitamin C, eating pineapple that contains bromelain with anti-inflammatory properties that may reduce symptoms, and staying active. Once steps have been taken to combat an existing infection, readers should be sure to continue with steps to prevent future infections.

Thank you for writing. Your letter certainly may have helped other individuals with a similar problem stamp out future infections.

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Neurological disorder presents problems for young woman

September 12, 2014 By

Q: My daughter is 32 years old with ugly feet. She can’t wear shoes because of the bunions and her little toes are turned to the side. She went to her doctor to talk to him about surgery but after an X-ray she was informed that she has a bone disease known as Charcot Marie Tooth disease, she is going to have to wear braces on her feet and she is going to get worse.

What can you tell me about this disease?

A: Charcot Marie Tooth (CMT) disease a/k/a hereditary motor and sensory neuropathy or peroneal muscular atrophy is a rather common inherited neurological disorder that affects about one in every 2,500 individuals in our country and affects the peripheral nerves. Peripheral nerves lie outside the brain and spinal cord. Their purpose is to supply the muscles and sensory organs in the extremities.

The neuropathy of Charcot Marie Tooth affects motor and sensory nerves. The motor nerves in our bodies cause muscles to contract and control voluntary muscle activities such as swallowing, breathing, speaking and walking. Symptoms of CMT disease may include high arches and hammertoes. Weakness of the foot and lower leg muscles may result in foot drop and a high-stepped gait. The individual may trip or fall frequently and as the disease progresses, the hands may be affected with muscle atrophy and weakness.

The onset of symptoms is during adolescence or in early adulthood; however, some individuals may exhibit signs and symptoms during mid-adulthood. The severity of symptoms can vary from person to person. The progression of symptoms is gradual and the pain may range from mild and manageable to severe. Foot/leg braces and orthopedic devices may be necessary in order for the patient to maintain mobility.

Charcot Marie Tooth results from mutations in genes that produce proteins involved in the structure and function of either the peripheral nerve axon or the myelin sheath. The gene mutation of this disorder is commonly inherited and it’s the degeneration of the motor nerves that results in muscle weakness and atrophy in the feet, hands, legs, and arms.

I don’t feel comfortable with your daughter receiving a diagnosis because of one X-ray. More likely, when CMT is suspected, a physician may order electrodiagnostic testing that consists of nerve conduction studies and electromyography. Genetic testing is available for some types of CMT (of which there are several), and the results are often sufficient to confirm the diagnosis. When all diagnostic workups remain inconclusive or if the genetic testing is negative, a neurologist may perform a nerve biopsy for confirmation of the disease. This involves removing a small portion of peripheral nerve through an incision in the skin, such as at the calf of the leg.

There is no cure for CMT; however, treatment in the form of occupational therapy, physical therapy, braces and as you have discovered surgery may be a consideration. If extreme pain is present, medication may be prescribed. Stretching exercises, aerobics, low-to-no impact exercises may be of benefit.

Your daughter should speak with her surgeon to determine if bunion removal will help her ambulate better. And, if her small toes turn outward, there may be a simple procedure to straighten them so she can wear shoes. If the surgeon feels nothing can be done other than braces, she might request a second opinion to be assured all her options have been exhausted. I recommend you take her to a top notch neurologist with previous experience in dealing with the disease.

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Physician has ordered a mammogram for a 91-year-old

September 10, 2014 By

Q: On a visit to my 91-year-old mother, I was surprised to see that she has an appointment to take a mammogram. On the National Cancer Institute’s home page and on a Federal Government home page I see that mammograms are recommended for women up to the age of 74. Nothing is said about taking them after that age.

In view of the fact that my mother never had cancer and indeed has no major health problems – but at 91 is growing feeble and uses a walker – I find it difficult to believe that she needs a mammogram. Naturally I will ask her practical physician but would be interest in your answer to the general question: Does a 91-year old woman with no history of cancer problems need a mammogram?

A: Mammograms are X-rays of the breast(s) that can check for cancer in both sexes who have no signs or symptoms of the disease. They can also be used to diagnose lumps or other signs of breast cancer.
Breast cancer has been reported in women in their 90s. Sadly, one consideration a physician must weigh is the length of time a woman of that age is likely to live. Keep in mind that estrogen levels are lower, and the cancer is likely slow-growing. The American Geriatrics Society encourages screening for women younger than 85 who have at least five years’ life expectancy and for healthy women 85 and older who have excellent functional status or who feel strongly about the benefits of screening.

According to the American Cancer Society guidelines, yearly mammograms are recommended beginning at age 40 and continuing for as long as the woman is in good health. Clinical breast exams are recommended approximately every three years for women in their 20s and 30s and every year for women 40 and over. Obviously women (and men) should report any changes or abnormalities to their physician when discovered, regardless of age.

According to the Mayo Clinic, their physicians begin performing annual mammograms beginning at age 40 but they go on to indicate that when to begin screening and how often the procedure is repeated is a personal decision. Mayo has taken the position that at age 40, mammograms can detect breast abnormalities early. They report findings from a large study in Sweden of women of that age showed a decrease in breast cancer deaths by 29%. Because physicians cannot distinguish dangerous breast cancers from those that are not life threatening, annual mammograms remain the best option for early detection. On the downside, low-level radiation and the probability of false positive test results can lead to additional worries on the patient’s part.

The US Preventive Services Task Force mammogram guidelines recommend screening for women begin at age 50, repeated every two years.

The CDC (Centers for Disease Control and Prevention) promotes mammograms every two years from age 50 to 74 years. Based on history and symptoms, testing may begin prior to age 50. and may be more frequent.

A February 12, 2014 British Medical Journal report questioned the benefit of yearly mammography. It indicated the long-running Canadian study contends that annual screening women aged 40 to 59 does not lower breast cancer death rates; however, Memorial Sloan Kettering’s Deputy Physician-in-Chief for Breast Cancer Programs cautioned women not to be swayed by those headlines. They indicate the study had critical weaknesses that invalidate its conclusions and that regular mammography screening continues to be recommended for women in this age group. The authors of the BMJ study suggest that annual screening mammograms can lead to what they term “over-diagnosis” of breast cancer, causing women to receive surgery or treatments for early-stage breast cancers that never would have progressed. Despite the controversy, doctors at Memorial Sloan Kettering do agree that annual mammograms beginning at age 40 save lives and decrease the likelihood that women will die of breast cancer by at least 25 to 30%.

Speak with your mother’s physician to determine if he or she feels testing will be beneficial or if your mother can pass it up. Were I to make the decision, I would opt for the latter.

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Can alcohol-laden raisins help the pain of arthritis?

September 9, 2014 By

Q: I can’t begin to tell you how much I have learned from your column. I read once about getting pain relief from golden raisins soaked in gin. Is this true? Also, how many would you take each day and how often? I have both RA and osteoarthritis, as well as scoliosis and stenosis. I am hoping the raisins will just give me some relief. I also take prednisone and methotrexate. I hope you will answer this as I have so much faith in you. Thank you for all your help.

A: Thank you for the compliment. I will identify the medications you are taking briefly for other readers who may then have a better understanding of your issue. While countless drugs are used for other conditions than they were originally intended, my guess is that you have been placed on Methotrexate because of your RA (rheumatoid arthritis) and that you take it once or twice each week for control. The prednisone is a corticosteroid is used to treat specific rheumatoid disorders, as well as for COPD, ulcerative colitis, thyroiditis, Meniere’s disease, migraine headaches, and countless other conditions. I’m sorry to learn that your symptoms have not been dramatically reduced by the combination of both medications.

Rheumatoid arthritis is an autoimmune disease in which the body’s immune system incorrectly attacks a person’s joints. Unfortunately, you are not alone with this diagnosis. There are approximately 1.5 million individuals in our country with the disorder and almost three times as many women than men suffer from symptoms that vary from person to person. Those symptoms may include pain, inflamed, swollen joints and more. While there is no cure for RA, there are a number of medications available on the market to reduce the degree of pain and slow the progression of the disease. On the home front, remain as active as possible in an attempt to keep your joints flexible. Eat a nutritious diet, obtain sufficient rest, and if appropriate, take steps to prevent obesity.

Osteoarthritis is also common, affecting millions of individuals around the entire world. This condition is often referred to as wear-and-treat arthritis, referring to the wearing down of protective cartilage on the ends of the bones as a person ages. Those joints most commonly affected are the ones in the knees, neck, hands, lower back, and hips. The condition frequently worsens with time and again, there are a number of treatments available on the market today to help relieve the pain and improve joint function at the same time.

Quite some time ago a reader wrote in and stated his pain was relieved by soaking raisins in gin and consuming about five each day to help diminish the pain. Other remedies include adding one fourth cup of raw pumpkin seeds to your daily diet, rubbing Castiva onto the affected joints several times a day, and lastly, mixing 8 ounces of 100% purple grape juice with one to two tablespoons of liquid pectin between one and three times daily. As with almost any remedy/supplement/prescription medication, some individuals may find relief and others will not. However, nothing ventured, nothing gained, as they say. Let me know how these possibilities work for you.

Can the consumption of distilled water help this reader? Q: I’m a 74-year-old male who has had sinus and gallbladder surgery. I suffer from chronic dry eyes and frequent constipation. I seem to be adequately medicated. I have been unable to drink the suggested eight glasses of water daily.

One day recently I became so revolted by my tap water that I began drinking the distilled water purchased for my C-PAP machine. I feel my bodily fluids (eyes, sinus, etc.) remarkably improved. I am not drinking any more water than I did before so is it possible to presume my improvement is due to the distilled water? I am not a doctor or scientist, just curious if I’m the only one. I love your column.

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