Abdominal Aortic Aneurysm Needs Monitoring

April 7, 2009 By

DEAR DR. GOTT:
I am a 79-year-old female. I had a CT scan and ultrasound screening in September 2008. At that time they found an abdominal aortic aneurysm. One doctor said it was 4.8 centimeters but another said it was 4.2. Both told me that that nothing would be done until it reached 5 or 6 and at that point surgery would be recommended.

My question to you is, what do I do now?

DEAR READER:
Abdominal aortic aneurysms (AAA) are potentially fatal areas of bulging or ballooning of the large blood vessel that supplies the abdomen, pelvis and legs. They can occur in anyone but are most common in males over 60 with one or more risk factors.

Those factors include emphysema, smoking, high blood pressure, obesity, high cholesterol, being male, and certain genetic factors. There is no known cause. [Read more...]

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Daily Column

March 22, 2009 By

DEAR DR. GOTT:
My daughter was diagnosed with autoimmune hemolytic anemia two years ago. Her doctors still don’t know how to treat it. They have tried everything but still have no answers. Now they are leaving it up to her to decide if she wants to have her spleen removed.

DEAR READER:
Your daughter has been diagnosed with a condition in which her own immune system is destroying red blood cells. It is a chronic disease.

Treatment generally starts with the use of corticosteroids such as prednisone. If the steroids fail to provide positive results, removal of the spleen is then considered . After that, if there is improvement, immunosuppressive medications are given in an attempt to stop the destruction. Blood transfusions are only given with extreme caution because of the risk of worsening the condition. [Read more...]

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Cause For Bruising Needs To Be Identified

February 24, 2009 By

DEAR DR. GOTT:
I am a 64-year-old male in reasonably good health for the life I have lived. But in the last five weeks or so, I have had three baseball-sized bruises on my thighs, midway up, for no apparent reason. The first was on the outside of my right thigh and about two weeks later, one appeared on the inside of my left thigh. Now I have one on the inside of my right thigh.

Do you have any idea as to the cause?

DEAR READER:
Bruising is generally the result of injury. Minor trauma such as hoisting a heavy box and resting it on your thighs. The process doesn’t appear to cause damage, yet it can be extreme enough for blood to clot beneath the surface of the skin and result in a bruise.

Aspirin, Advil, Naproxen, Motrin and other non-steroidal anti-inflammatories can also cause contusions, as can physician-prescribed corticosteroids and prednisone. [Read more...]

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Gynecologist Disagrees With Routine Ca125

February 20, 2009 By

DEAR DR. GOTT:
I read your column of January 20th and take exception to your comments. You recommended an annual CA125 blood test for all women as a preventive step toward reducing the risk of cancer-related death. I feel you are entirely wrong and must share my reasons.

I am a practicing gynecologist and do not order a routine CA125. This is a non-specific test that can generate abnormal results for a number of reasons, to include fibroids and endometriosis. If I referred each abnormality to my local oncologists, they would throw up their arms in dismay, having to sort out a plethora of possibilities in an attempt to determine the real cause for the elevated readings. This is an expensive process and would take precious hours.

I implore you to write a retraction. [Read more...]

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Patient Needs More Information

February 17, 2009 By

DEAR DR. GOTT:
Would you please discuss myelodysplastic anemia? I would like to know the symptoms, cause and treatment.

I was diagnosed with this condition but cannot find much information about it. I was given another name for it but don’t remember it.

DEAR READER:
Myelodysplastic syndromes are a group of disorders that affect the bone marrow and stem cells. There are eight subtypes but because of space restrictions I cannot list and explain each type. Without knowing which subtype you have, I can only give general information that is relevant to each type.

Symptoms include fatigue, shortness of breath, frequent infections, petechiae (pinpoint bruising), unusual paleness due to anemia, easy or unusual bruising, and unintentional weight loss. Early in the disorders, symptoms are generally mild, if present at all. [Read more...]

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Daughter’S Platelet Donation Worries Mother

January 23, 2009 By

DEAR DR. GOTT:
My 45-year-old daughter donates platelets twice a month. The process, called apheresis, takes about an hour and a half.

I donated blood for some 30 years but must confess to some apprehension about the possible side effects of my daughter’s altruism. I look forward to more information about this in your column.

DEAR READER:
Apheresis is a process by which an individual can donate specific blood components. Depending on the donor’s blood type and the needs of an individual or community, a person can donate red cells, white cells, plasma, or platelets. This procedure is commonly used to collect plasma and platelets.

An individual simply registers with the appropriate facility, gives a health history, undergoes a brief exam, is typed for human leukocyte antigens (HLA), and donates the necessary component. [Read more...]

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Anemia Caused By Too Little Iron

January 1, 2009 By

DEAR DR. GOTT:
For the past 20 years my type A blood cells have been running 3.1 to 3.6 which I am told is low. When I question my doctors about it they don’t offer much response. I am 75 years old. I had a kidney removed about 10 years ago because of cancer. I did not need chemo or radiation. My diet consists of healthful foods and a lot of ocean fish and not too much red meat.

I recently had a couple of pre-cancerous lumps on my head removed and treated. They healed well.

Lately any cuts I get, whether they are big or small, seem to get infected. I am not diabetic and my weight is normal. Is there a cause for low A cells? Is there something I can do make them rise?

DEAR READER:
First, I feel I must explain what type A cells means, as you appear to be slightly confused. [Read more...]

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Dry Cath Insertions Potentially Harmful

December 15, 2008 By

DEAR DR. GOTT:
My 82-year-old father was recently hospitalized in a Midwestern city with complications from a blood disorder. Medical staff assessed the need for a urinary catheter. The insertion was done with a dry tube surface. When he asked if they could “put something one it”, the female nurse told him to “just take a deep breath”.

The insertion was done twice, both times without lubricant. One of the results was bloody urine. My poor father said “Just imagine being 82 years old and having somebody do something like that to you”. When he told his hometown doctor she just abut came unglued. A male nurse also informed him that he always “lubes the tubes”.

My father is now unable to urinate on his own because of a blockage which his urologist says may have been due to damage caused by the dry insertions. [Read more...]

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Sunday Column

November 2, 2008 By

DEAR DR. GOTT:
My 77-year-old husband has a bizarre skin problem. On his left lower arm (elbow to wrist) on the top side only he has red blotches that appear and then disappear every several days. He has seen dermatologists in Atlanta, GA, Tucson, AZ and Santa Maria, CA but none can give him a diagnosis. All referred him back to his internist who also had no idea what the problem is.

The problem is now starting to happen on the top of the lower right arm. I have also noticed that following treatment for a blood clot in his leg (after hip replacement in 2006) with Coumadin, the blotches seem to be worsening. He also has some minor bleeding. He is tested once a month to ensure his Coumadin is working. The spots are not itchy or painful, they are only unsightly.

Aside from the Coumadin (2.5 mg four times a day, five days a week and six times a day, two days a week) he is taking [Read more...]

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Sunday Column

October 19, 2008 By

DEAR DR. GOTT:
I am writing on behalf of my husband. He is 80 years old and has been suffering with chronic lymphocytic leukemia. Up until the last couple of years it has progressed very slowly and he was advised to do nothing. Now, however, it has advanced to where his white blood count has risen dramatically, his platelet count is very high and his red blood count is low. He also has a problem that no one has been able to solve; his skin has become dry to the point of continually flaking off when rubbed. It is also very itchy but if he scratches it either bleeds or raises welts. This happens day and night. He has seen a dermatologist who said it might be an allergy to his blood pressure medicine so it was switched. There was no change so the dermatologist gave him a prescription for a cream. He has tried every lotion and cream on the pharmacy shelves but nothing touched the itch. He even tried castor oil to no avail. [Read more...]

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