Daily Column

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

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

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

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

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

Daily Column

DEAR DR. GOTT:
My eye specialist recently told me that I need cataract surgery. My reaction was negative because I have ALWAYS been allergic to anything and everything in or around my eyes. I have never even been able to wear any kind of makeup. I can’t wear contact lenses because it was found I was allergic to the lenses themselves. I tried twice but not through this doctor.

DEAR READER:
A cataract is the clouding of the eye’s natural lens situated behind the iris and pupil. The condition is common in the elderly and affects about 70% of those over 75 years of age.

Allergies of the eye are no different than allergies affecting the lungs, nose and sinuses. In the case of cataract surgery, adverse reactions to anesthetic periocular (eye numbing) injections can cause hypersensitivity either from the compound itself or from the mechanical manipulation of the needle. [Read more...]

Sunday Column

DEAR DR. GOTT:
I am a 77-year-old male in good health. In 1963 at the age of 33, I had a brain aneurysm. The pain was absolutely indescribable. Its position was located with an angiogram but because of its location, it was deemed inoperable. The doctors did not have much hope for me. Thankfully, I have had no further symptoms from it.

About three months ago, I was outside at night watching the stars, lost my balance and fell. I hit my head on the concrete driveway but did not have a headache, blurred vision or dizziness — just a large bump. The next day, I went to my doctor who ordered an MRI and an MRA. He found the original aneurysm AND another one on the right side of my head.

I was then sent to the University of Texas to see a specialist who deals with brain aneurysms. I had another angiogram to confirm the results of the MRI and MRA. The specialist recommended a surgical clip be placed on the right sided aneurysm due to its location. He also said the original one could be “repaired” with a non-invasive procedure to place a stent.

I have been advised of the low risk involved in both of these procedures and of the recovery times for each. My concern is related to the surgery that would “open up” my head. It carries the very real risk of brain trauma and other side effects.

I have lived 44 years with the first aneurysm with no problems at all. I have no idea how long I have had the other one but it is not showing any symptoms either. I do have some tension headaches but feel these are due to my uncertainty about surgery.

I know the above is not a full analysis but hope you can give me your opinion based on what I have told you and your experience. I would greatly appreciate knowing what you would do were you in my shoes.

DEAR READER:
If your original aneurysm has not enlarged in 44 years, you can safely adopt a wait-and-see approach. In this manner, you can have both aneurysms monitored every 6 or 12 months and if both or either enlarges, go ahead with the repair procedures.

Although there is always a possibility of operative complications, brain surgery is much safer now than it was in 1963. I suggest that you once again review the situation with the specialist to discuss what he will do and what the risks are. You may also wish to find out if there are any other options. You also can choose to have a second opinion from another neurosurgeon. This should eliminate some of your stress and help you come to an informed decision.

To give you related information, I am sending you a copy of my Health Report “An Informed Approach to Surgery”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

Daily Column

DEAR DR. GOTT:
I have cholesterol deposits in my eye sockets. They first appeared when I was in my early 30s at a time when I was very athletic. My cholesterol level was so low I tested out in the rare category. I went to an allegedly reputable eye surgeon who told me I had cysts. He surgically removed them leaving me with no eyelashes on the outside corners of both eyes, one eye a different shape than the other and scarring in the lower lash line. The deposits ultimately returned and now there is a considerable amount below both eyes. I also have very small deposits above my eyes.

I’ve tried to research this process to understand what is happening in my body that creates this condition. I think it is a result of high lipidity in the bloodstream, but I don’t understand why this happens and what to do about it. I have lowered my fat and alcohol intake. I take a thyroid supplement, but nothing seems to have stopped this process. I exercise moderately, don’t consume a lot of sugar or carbohydrates and follow a fairly healthful eating program.

Is there a nutritional and supplemental program or published literature that you can recommend that will help halt this process? My cholesterol is in the average range. I’m a 58-year-old post menopausal white female, with no other health problems. I’m considering laser therapy to remove the deposits again, and would like any information that can contribute to addressing this condition.

DEAR READER:
I believe you have a form of Xanthoma (fatty deposits under the skin), called Xanthelasma palpebra (xanthoma of the eyelids).

This condition generally occurs in older people and those with high cholesterol or triglyceride levels. You claim that your cholesterol is in the average range, so I don’t believe this is causing your problem. Have you also had your triglyceride level checked? Perhaps this is the root of the cause. Other possible causes include diabetes, certain cancers, and primary biliary cirrhosis (inflammation of the bile ducts in the liver which causes narrowing, obstruction and damage to liver cells). Most individuals do not have a specific cause. However, because xanthomas can be caused by very serious conditions, I urge you to be examined and tested by your primary care physician. Because of your very healthful lifestyle and good health, I believe you will fall into the category of no known cause.

Treatment can be difficult. Depending on the cause (or lack of one) there are some options. For those with high cholesterol or triglycerides, the deposits often disappear with a few months after treatment with cholesterol-lowering medication. Treatment of diabetes will reduce them once the blood sugar is brought down and kept under control. For those who do not respond to treatment of the underlying disorder or do not have a diagnostic reason, the deposits can be removed by surgery or laser treatments. They often return despite removal.

To give you related information, I am sending you copies of my Health Reports “An Informed Approach to Surgery” and “Understanding Cholesterol”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 (per report) to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure mention the title(s).