Ask Dr. Gott has successfully appeared in the format you read daily, either on line or in your local newspaper. It has come to our attention, however, that some readers feel the style should be modified so it no longer resembles the newspaper column that made Dr. Gott a household name and famous as a syndicated medical columnist for so many years. The modification has already been in process for several months and is being worked on as you read this notice.

Dr. Gott’s staff is unaware of the proposed format that is being designed and which will take about a month more to get up and running. In the interim, favorite columns will reappear and readers will be the first to know of the style that has been chosen for continuation of his column. We have been honored to represent a column we were proud of that answered questions in a form most readers could easily understand and enjoy.

Stay tuned.

Cardiovascular disease is the number one killer of men and women in our country and is the leading cause of disability. Not only does it affect a person’s quality of life and have a bearing on everyone in your household, it also costs our country over $300 billion a year for medications, health care, and loss of work.

On the upside, statistics indicate the number of preventable deaths in individuals between the ages of 65 and 74 has declined, yet unfortunately, the figures remain consistent in those under the age of 65. This is something within our control that simply shouldn’t be overlooked. Further, statistics prove that men are more than twice as likely as are women to die from cardiac conditions that are preventable.

So, which of us are at a higher risk than others? A family history puts us in an elevated category for developing cardiovascular disease, as does race and ethnicity. More African Americans have been found to have high blood pressure than other ethnic group. Approximately two in every five African American adults suffer from hypertension, with less than half that number having their conditions under proper control.

It’s critical that we – as a whole and regardless of age and ethnicity – take better control of ourselves. We need to eat well-balanced meals, avoid becoming obese, exercise, smoke less, and pay attention to cholesterol levels. Sound overwhelming? Not really. A visit to a health care professional on a timely basis is a good beginning. This doesn’t have to mean losing work time and visiting a doctor on a regular basis. It does mean, however, that an annual examination that may include an EKG, lab work and a chest X-ray might be appropriate. A physician will likely recommend a mammogram for women who may let testing slide, while men may have PSA testing.

The examination should include a blood pressure reading. It’s important to realize that an elevated reading doesn’t imply you will be on medication for the rest of your life. Your physician will likely have you return a time or two more to determine if your numbers remain consistently high, and even then, he or she should sit down with you to determine if your diet and such things as salt intake may be to blame, or if the situation requires more than that.

An EKG will provide a baseline your physician can keep for his records should an issue occur that raises any red flags.

The lab work can determine if your cholesterol and sugar levels are within normal limits and if your food intake may be partially to blame. Nipping things in the bud may bring your levels to within normal limits without anything else being required. And, if your thyroid levels and other testing ordered may fall out of line, they too can be addressed. Should you be a smoker, a chest X-ray might be appropriate. This test doesn’t hurt, but it can certainly help and go a long way toward keeping your lungs healthy.

February is American Heart Month and you’re a vital part of your family. Increase your knowledge on how to prevent cardiovascular disease from occurring. Show your love to your loved ones by taking better care of yourself. You’ll be glad you did.

Diabetes a/k/a diabetes mellitus, is a group of metabolic diseases that affect how a person’s body uses glucose. The disease is believed to affect over 312 million individuals throughout the world and is a condition that can affect individuals of any age, men and women alike, and all races. Glucose is an very important source of energy for the cells of the body that make up tissues and muscles. It is the brain’s primary source of fuel. Those forms of diabetes that are chronic include type 1 and type 2. However, there are conditions known as pre-diabetes where glucose levels are higher than normal and gestational diabetes that occurs during pregnancy but may resolve following delivery.

Type 1 diabetes can occur at any age but it commonly appears during childhood or adolescence. This form affects approximately 10% of all reported cases. The cause for type 1 is unclear. It is believed a person’s immune system attacks and destroys the insulin-producing cells in the pancreas. Then, instead of transporting insulin into the bodily cells where it is needed, sugar builds up in the bloodstream instead.

Type 2, on the other hand, is the more common type of the disease. It is more frequently found in individuals older than 40 and affects the other 90% of reported cases. In type 2, bodily cells become resistant to the insulin’s action, the pancreas cannot produce sufficient insulin to balance the resistance, and instead of being sent on its way to the cells, sugar builds up in the bloodstream.

Symptoms of type 1 and 2 may include polyuria (frequent urination), polydipsia (frequent thirst) polyphagia (intense hunger), blurred vision, fatigue, slow-to-heal skin ulcers, and frequent infections. The long-term consequences of diabetes are slow to develop and for those individuals that fail to receive medical assistance and who refuse to make necessary and appropriate lifestyle changes, the higher the risk of complications. One such possibility is kidney damage. The kidneys are comprised of millions of blood vessel clusters that filter waste from the blood. Diabetes can damage the delicate balance which, in turn, can lead to kidney failure. Another is neuropathy because excessive sugar has the potential to injure capillary walls that supply nourishment to the nerves. This may result in numbness and tingling of the extremities that may progress to a complete loss of sensation in the affected limb. The risk for cardiovascular disease is elevated. Atherosclerosis (narrowing of the arteries), angina (chest pain), stroke, and more could occur. Then there is retinopathy (eye damage, bacterial and fungal infections of the skin, hearing impairment, nerve damage to the feet, and more.

Individuals with a family history or risk factor for diabetes should be checked periodically on the advice of their primary care physician. Those older than 45 should have blood work performed when they visit their physician for an annual examination. If the results are within normal limits, follow-up every three years is recommended. If they aren’t, they should follow the guidelines set up by their physician. Individuals, regardless of age, with a BMI (body mass index) greater than 25 with other risk factors such as leading a sedentary lifestyle, poor dietary intake, and high cholesterol levels should be checked more frequently.

There are countless medications available on the market today via prescription for control of diabetes. Combined with better eating habits, an exercise program approved by the primary care physician, and maintaining a reasonable weight, the average individual can avoid the complications of diabetes. Take steps now to determine if you need to make changes. You will be glad you did.

Interestingly, awareness subjects for the month of September focus on two subjects – “fruits and veggies” and “childhood obesity”. It certainly appears, at least to the writer, that the two subjects go hand-in-hand. Fruits and vegetables are known to provide countless health benefits and those individuals that eat a well-balanced diet can lower their risk for such conditions as obesity and a great deal more. Despite this, statistics prove that most of us fail to consume the recommended amounts every day.

Obesity is a serious condition that affects individuals of all ages. It is known to occur in children who are above their normal weight for their age, build and height. The problem is that issues once confined to older individuals is now affecting children. Diabetes, hypertension and elevated cholesterol levels are becoming real issues, and that is without considering the stigma of poor self-esteem and the fact that other children may be hurtful in their comments to someone they consider fat or obese.

So, how can we combat things early on? One of the best methods is to do all we can to improve the dietary intake of our children. Even at a very young age, we can keep carrot sticks, apple wedges, orange slices, and celery sticks filled with peanut butter and dotted with raisins to mimic bugs on a log available for snacking on. Making good choices fun to look at and fun to eat will go a long way toward a healthful diet. And, if those choices are readily available at snack time, the rest of the family just might get the idea also. Before you know it, everyone will be making better choices.

It’s relatively easy to purchase canned soda, drinks that are high in sugar content, candy, potato chips, cookies, and more to have on hand, or to stop at a fast food shop for a quick pick-me-up. It goes without saying that too many calories from these food groups can have an enormous impact on childhood obesity. It must be clearly stated that some children and adults are obese because of genetic diseases and hormonal disorders. As a result, they fight extra weight all their lives, despite the fact they likely eat healthy foods. That is a separate issue altogether.

Along with diet, exercise is extremely important – again for children and also for adults. After school might be a good time to throw a ball around in the back yard, to play a game of croquet, or walk around the block. A parent or other adult should interact with the child during exercise and here we go again, it gives individuals of every age bracket a means of keeping healthy and happy.

Economic factors must also be considered. Many crackers, pastas, cookies, frozen meals and even canned soups contain an appreciable amount of salt and fats. While the foods may be less expensive or an easy option for a parent more so than fresh fruits and vegetables and healthier food choices, the price can be greater in the long run.

Additional weight for individuals of any age can lead to non-alcoholic fatty liver disease, sleep disorders, type 2 diabetes, and more. Protect those you care for and love. Shop with good health in mind, make better choices, and your family will be better off in the long run.

Group B streptococcus (GBS) is a topic seldom talked about, yet is a common bacterium carried in the intestines or lower genital tract. It is generally harmless yet can cause infections in adults who suffer from specific chronic medical conditions such as liver disease or diabetes. Surprisingly, many adults carry group B strep within the body – most commonly in the throat, bladder, vagina, bowels, and rectum. This specific bacterium is not sexually transmitted, nor is it spread through food or water. Those adults at an increased risk for the bacterium include diabetics, having a compromised immune system such as HIV, have liver disease, or cancer.

A great deal of attention is paid to pregnant women carrying GBS because they can (but may not) pass it off to their babies during labor. Statistics from the CDC indicated that women who test positive but are not in a high risk category stand a one in 200 chance of delivering a baby with GBS if antibiotics are not given and a one in 4000 chance if they are. This is the reason why the CDC has recommended routine screening between the 35th and 37th week of pregnancy for vaginal strep B for all women who are pregnant. Early onset group B for infants may include fever, kidney problems, instability of the heart, sepsis, lethargy and difficulty feeding. With late onset which might occur in as little time as a week or up to a month or two following delivery, the infant may exhibit dyspnea (difficulty breathing), acquire meningitis, have a fever, become irritable, and have a hard time feeding. Treatment is commonly in the form of intravenous antibiotics, possibly oxygen and other medications, as well. It should be noted that to test positive for group B strep simply implies the woman is a carrier.

In adults, the disorder may cause endocarditis (infected heart valves), sepsis (bloodstream infection, cellulitis (a skin infection), meningitis (inflammation of the fluid that surrounds the brain and spinal cord, urinary tract infections, infections of bones and joints, and pneumonia (lung inflammation).

Diagnosis is made by growing cultures of fluid samples collected. On the downside, the cultures will take two or three days to grow which may delay treatment which, for adults, is antibiotics. The specific antibiotic chosen depends on the severity of the infection, its location, and the patient’s medical history.

While unavailable at this time, researchers are attempting to perfect a group B strep vaccine that can help prevent infections in adults.

June is the month in which national safety is recognized – safety on the soccer field, in the workplace, behind the wheel of a car, when riding a bicycle, when approaching an unknown person walking toward you in the park, when beginning a new prescription, staying safe in the summer heat, and in literally every aspect of life.

Many injuries can be prevented when we all take steps to practice safe behaviors. For example, when next visiting your primary care physician, be sure to bring all your medications, over-the-counter products, herbal remedies and supplements with you. Today’s society wants and demands to be seen by specialists and many of those individuals write prescriptions bur fail to advise a patient’s primary care physician this has occurred. If an individual has more than one prescribing physician, there could be an unwanted side effect between two drugs that could be avoided. Patients should know why each and every medication is being taken and what the potential side effects might be.

Falls in the home are common. If you cannot roll up and remove scatter rugs or light bulbs , for example, ask a family member or neighbor to stop by to give you a hand. Remove those rugs that may be a setup for a fall and a resultant fracture. Replace burned out light bulbs so hallways and rooms are adequately lit. Relocate all extension cords so they don’t run across an area of the floor used to get down a hallway or into another room. It’s all too easy to shuffle along and trip. Don’t let it happen to you.

No automobile trip – no matter how long or short – is worth losing a life over. Leave your cell phone in a pocket or glove box until you have the time to pull off the side of the road to call or text. Multi-tasking behind the wheel is extremely bad and should not happen. Devote 100% of your attention to what you are doing. Keep things simple by leaving five or ten minutes early for appointments so there is less pressure getting somewhere on time and you don’t have to speed to do it.

If you plan on attending a sports event and will be exposed to the sun’s rays, be sure to bring a bottle or thermos of water or a sports drink to remain hydrated, and sunscreen also to protect your skin from those damaging ultraviolet rays. It’s all too easy to get caught up in a game, only to find hours after returning home that you got much more sun than you thought possible. Don’t risk something that’s an easy fix with a little preparation.

If you’re young enough and sufficiently fit to ride a bicycle, be sure to wear the most important attire known – a helmet. Elbows and knees can end up scraped and bruised but it’s another thing to put a head back together. If you’re fortunate enough to have a bicycle trail in your town or city park, use it rather than riding on the side of the road or down a city street. Drivers aren’t always courteous and are too busy making it through a yellow light before it turns red to notice you may be in their line of traffic.

Speaking of automobiles, they’re machines that weigh over a ton and have the capability of going much faster than is really necessary. Pay attention to speed limits and abide by them, notice pedestrians, and oncoming vehicles. You may actually want to take the car to work or out for pleasure another day. The answer is to survive the drive today so tomorrow can happen.

Think. Do your part to take steps to lessen the risk for yourself, your loved ones, and even those individuals on the street or in the workplace you may not even know. You’ll be glad you did and so will they.

For many individuals, the consumption of moderate amounts of alcohol is probably not harmful. Unfortunately, for others it is – harmful, hurtful, and devastating. More than 18 million Americans suffer from some form of an alcohol use disorder. In addition to this frightening statistic, there are millions of children and family members who experience first hand the devastating effects alcohol creates on everyone involved – employers, spouses, and children, that are part of the alcoholic’s life. The economic cost of alcohol abuse and alcoholism has been estimated by the CDC to be $223.5 billion that includes losses in productivity in the workplace, alcohol related health care expenses, impaired driving and motor vehicle crash costs, and law enforcement expenses. The emotional, physical and financial burdens placed on a family of the addict is enormous.

Alcoholism is a chronic and progressive disease that carries serious implications. Heavy drinking can increase a person’s risk of certain cancers, cause liver damage, and complications to the brain and other organs. Individuals with the disease have problems controlling their consumption, have withdrawal issues when they rapidly decrease or stop drinking, have to drink more and more in order to achieve the same effect, and become preoccupied with drinking, despite the fact that the habit causes problems and sometimes even irreparable damage.

Signs and symptoms may include drinking alone or hiding bottles in places within the home/basement/garage where they might not be found, having an inability to remember conversations or important dates that mean a great deal to other members of the family, developing a tolerance to alcohol so that more is needed if the “high” is to continue, having a quick fix at a local bar or restaurant during lunch hour as a pick-me-up, and losing interest in activities and hobbies that were once important. Denial is a common factor, since the alcoholic perceives he or she is in control and on top of the situation. The actual process of becoming addicted to alcohol doesn’t happen overnight but occurs gradually.

Those individuals at an increased risk for becoming alcoholics include having a parent or close relative with a similar problem, drinking too much on a regular basis for an extended period of time and finding countless reasons for indulging that others “simply don’t understand”, using depression/anxiety/bipolar disorder as an excuse to drink, having “successful” friends that drink which creates a need to keep up or risk losing the respect of that person looked up to, and beginning the habit of drinking at an early age.

Excessive drinking can reduce judgment skills, lower inhibitions, cause issues with muscle coordination, affect speech, and lead to numerous health issues. Inflammation of the liver, gastritis (inflammation of the stomach lining), stomach and esophageal ulcers, hypertension, heart failure, weakness and paralysis of the eye muscles, and pancreatitis are but a few of the concerns. Alcohol can affect a person’s central nervous system, causing pain and numbness of the extremities. An alcoholic can have blackouts in which he or she drives, functions, or speaks, yet will have no knowledge of anything done.

There are no specific tests to diagnose alcoholism. The American Psychiatric Association has published a manual known as the Diagnostic and Statistical Manual of Mental Disorders that spells out the criteria for the diagnosis. The first category is tolerance. As the disease progresses, the amount leading to intoxication can also decrease because of damage to the liver or central nervous system; withdrawal symptoms including tremors, nausea, insomnia and anxiety; and drinking more than intended, or drinking over a longer period of time. For example, an alcoholic will “have just one”. That often means just one at a time, since the individual simply doesn’t have the capability of stopping.

If you have a problem with alcohol addiction, consider attending AA meetings. They’re everywhere. If you are a family member or friend, consider ALANON to learn how to better understand and cope with this devastating disease. Protect yourself, don’t become a victim. There’s help for everyone.

Glaucoma causes damage to the eye’s optic nerve. It tends to be inherited and has a tendency to present as a person ages. It becomes progressively worse if left untreated. It is frequently associated with a build-up of pressure inside the eye, referred to as intraocular pressure that can damage the optic nerve that transmits images to the brain. When the pressure buildup is ignored and the pressure continues, glaucoma can cause a permanent loss of vision within as little as a few years without intervention.

The problem is that most individuals with glaucoma have no pain or symptoms early on in the disorder, making it very important to have regular eye exams with an optometrist or ophthalmologist. An optometrist can examine, prescribe medication, diagnose, treat and manage diseases/disorders/injuries involving the visual system, and perform specific surgical procedures. In order to receive an O.D. Degree, he or she must undergo extensive training and be state licensed. An ophthalmologist is a specialist in medical and surgical eye issues who is trained to provide complete eye care from prescribing glasses to performing complex and delicate eye surgery. Many ophthalmologists are involved in scientific research regarding the causes and cures for diseases of the eye and visual problems. Most are board certified following years of training and having passed a rigorous examination given by the American Board of Ophthalmology.

Aqueous humor is produced by cells inside the eye. As it is produced, a like amount must exit through drainage for balance. If an inadequate amount flows out of the eye, pressure within the eye increases, the channel becomes blocked and glaucoma can result. The precise cause for the blockage remains unknown, however it has a genetic component. There are other causes for a blockage to occur also, such as a severe eye infection, traumatic blunt or chemical injury, inflammation, and blocked blood vessels of the eye. As a general rule, both eyes are involved; however each eye may be affected to a different degree.

There are two types of glaucoma – open or wide angle (the most common form) and angle-closure which is less common. With open angle that accounts for up to 90% of all cases, the eye appears normal but the fluid within it fails to flow properly through drainage. Symptoms generally occur in middle age and appear to have a genetic component. With the latter, buildup may be rather sudden and drainage may be less than optimal because the angle between the iris and cornea is too narrow. Pain in the eye – usually in one eye only initially – and head may occur and peripheral sight will begin to fade from the visual field. This condition requires immediate medical intervention to restore the normal aqueous outflow that will reduce pressure and prevent permanent damage. If left untreated, tunnel vision and blindness may follow.

Treatment of open/wide angle glaucoma requires reducing the eye’s pressure through drainage of the fluid. This may be done with medication. Without success, surgery and laser treatments may be appropriate. Drugs and surgery are known to have high rates of success in treating open angle glaucoma. Treatment for acute closed-angle glaucoma is generally accomplished through laser therapy.

Risk factors for glaucoma include having a family history, being nearsighted, having had serious trauma to the eye(s), being on steroid medication, and having poor vision because of other unrelated conditions. Some medications such as those for seizures, bladder control, and even over-the-counter cold remedies may increase a person’s risk. There is no way for an individual to take steps to prevent open angle glaucoma other than to being diligent having an eye exam that includes testing for glaucoma every three to five years by an optometrist or ophthalmologist. The bottom line is to protect your eyes. Make an appointment now to assure good eye health for the future. You’ll be glad you did.

There is no better way to begin a new year than with women paying attention to an issue that is easy to ignore – cervical health – something the average individual doesn’t think too much about. Every year approximately 12,000 women are diagnosed with cervical cancer that is highly treatable if detected early and preventable because of improved screening and the human papillomavirus vaccine, also known as HPV. The American Social Health Association and the National Cervical Cancer Coalition are direction attention to the three dose vaccine that can protect women against four HPV types. The two high risk strains are HPV 16 and 18 and the most common low-risk types are HPV 6 and 11. The vaccine should be administered before infection occurs and ideally, prior to a girl becoming sexually active.

HPV is the primary cause of cervical cancer, with more than 75% of women within the reproductive age population being infected with at least one and perhaps more types of genital HPV. The virus doesn’t cause health problems and commonly dissipates on its own as a healthy immune system functions as it should and clears the infection prior to it developing into cancer. However, in about 5% of those women, persistent infections can occur with the high risk strains, resulting in nearly all cases of cervical cancer. The condition begins when healthy cells acquire a genetic mutation that develops from normal to abnormal. While healthy cells grow at a specific rate and eventually die off at a specific time, cancer cells multiply out of control and don’t die, but invade nearby tissue instead.

Some risk factors other than HPV for developing cervical cancer include a female’s genetic makeup and lifestyle choices made. For example, those women with a compromised immune system because of a particular health condition such as HIV/AIDS; women having a substantial number of sexual partners; early sexual activity; and those individuals with a history of chlamydia, syphilis or gonorrhea are all believed to be at an increased risk for developing cervical cancer.

The main types of cervical cancer are adenocarcinomas and squamous cell carcinomas. The first is less common and occurs in the glandular cells that line the cervix. The latter begin in the squamous cells that are located on the outer portion of the cervix and accounts for the majority of all cervical cancers; however, there are instances in which both types of cells are identified in cervical cancer.

According to the National Institutes of Health, cervical cancer is slow to develop, beginning with dysplasia which is a precancerous condition. If left undetected or untreated, dysplasia can advance into cervical cancer that has the potential to spread to the liver, bladder, intestines and lungs. Symptoms may include an abnormal vaginal bleed, menstruation that lasts longer than a woman’s normal pattern, bleeding following menopause, pelvic pain, pain during intercourse, and an unusual discharge. And, the interesting thing is that a Pap test in women over the age of 30 and an HPV test can detect women who are at risk for developing cervical cancer.

As with countless medical conditions, early detection makes for a more successful outcome. Guidelines recommend screening for precancerous changes beginning at the age of 21. Should cervical cancer be diagnosed, treatment will depend on the stage of the cancer, as well as other medical issues a woman may be facing. If you have symptoms be sure to make an appointment with your gynecologist or primary health care provider and undergo testing. The visit could be life saving.

December marks the 25th observance of World AIDS day and a year in which through research, there have been enormous strides made toward a cure. Sadly, it is also a difficult time, as the National Institutes of Health will lose $229 million in research funding for the coming year according to a recent CNN report. This impact will be enormous. The Foundation for AIDS Research has estimated that almost 230,000 fewer people might not be able to receive treatment. Approximately 15,000 individuals in our country who need financial assistance to pay for their medications will lose support from the AIDS Drug Assistance Program. AIDS was first recognized in 1981 by the Centers for Disease Control and its cause – the HIV infection – was identified in the early part of the decade. As of 2009 AIDS had caused nearly 30 million deaths and by the following year, approximately 34 million individuals were found to be living with HIV globally.

The first documented case of a child cured of HIV was reported this past March, Followed in July by a report of two adult HIV patients who are no longer showing any signs of virus following stem-cell transplants and discontinuing anti-retroviral treatment. Yet, there is a great deal of work still ahead because of the 35 million people living with HIV/AIDS worldwide.

HIV is human immunodeficiency virus. The condition damages the body’s immune system cells. AIDS is acquired immunodeficiency syndrome. The first signs of HIV infection may be swollen glands and symptoms that resemble the flu. This is typically followed by an extended period of no symptoms. As the illness progresses, however, it interferes more and more with the immune system, causing the person to get frequent infections and tumors that do not ordinarily affect those individuals with a healthy working immune system. Severe symptoms may not appear for months or years following the initial symptoms and while the initial symptoms may be mild enough to go unrecognized, the viral load at this time is very high. Thus, HIV infection spreads more efficiently during the primary infection than it does during the stages that follows.

HIV can be spread through unprotected intimacy with an infected heterosexual or bi-sexual individual, by sharing drug needles, or through contact with the blood of a person who is infected. Women can pass HIV to their children during pregnancy or childbirth. There is no risk of acquiring HIV if a person is exposed to saliva, sweat, tears, urine, vomit, or nasal secretions unless they are contaminated with blood. Prevention through safe sex and needle exchange programs is critical if we are ever to bring this condition under control or eradicate it completely. There is no cure; however, many anti-viral medications are on the market that can slow the course of the disease, allowing people to live for many years.