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Daily Column

November 1, 2008 By Dr. Gott

DEAR DR. GOTT:
I am writing regarding the person, who after having two lung x-rays, was found to have a spot on the lung. He was told to wait six months and have another X-ray. I would like to let this person and your readers know about my father-in-law and his experience with a lung spot.

Following an X-ray he was told he had a spot on his lung but the doctor didn’t feel it was anything to worry about. Since he hated going to doctors, he didn’t do anything abut it. Five months later he was in the hospital, diagnosed with lung cancer.

His oncologist recommended chemotherapy and told him he might have about a year to live. My father-in-law went ahead with the chemo but after only two treatments he passed away, just two months after the diagnosis. [Read more...]

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Sunday Column

October 26, 2008 By Dr. Gott

DEAR DR. GOTT:
I read your column faithfully and find it very helpful and interesting is so many ways for both my family and me. I am an 84-year-old female in very good health. I had stage II breast cancer followed by breast removal 16 years ago. I was on tamoxifen for five years but never had chemotherapy or radiation. I continue to have yearly mammograms and so far, everything has been good.

I used to be a competitive racewalker, competing locally and nationally with the Senior Olympics. I received numerous medals in both levels but had to give it up to take care of my husband about 10 years ago. I continue to racewalk on my own. I was treated for leg and back pain while doing this competitively.

I am writing for you opinion on two issues. The first is treatment of meralgia paresthetica. [Read more...]

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Daily Column

October 10, 2008 By Dr. Gott

DEAR DR. GOTT:
I am concerned about a family member who was diagnosed with melanoma. Could you please write a column with advice concerning its treatment? I read your column everyday and really respect your opinion and knowledge.

DEAR READER:
Melanoma is the most serious form of skin cancer. It develops in the cells that produce melanin which is responsible for skin coloration. It most often affects the skin but can also occur in the eyes or rarely, internal organs.

Melanomas usually occur on areas that are repeatedly exposed to sunlight such as on the face, arms, legs or back. Less commonly they can form on the palms of the hands, soles of the feet or even fingernail beds.

The most common early sign of melanoma development is a change in an existing mole or the appearance of a new, unusual-looking growth. [Read more...]

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Sunday Column

August 5, 2008 By Dr. Gott

DEAR DR. GOTT:
Thank you for printing the article “When one’s time has come”. It was like a God-send letter to me; it spoke to me in such a big way. I read this article at the time my aunt had a stroke.

My uncle was 89 and my aunt was 85. They were married 65 years on Valentine’s Day 2007 for which we had a surprise drop in party. They loved it. We had as many family and friends there as possible so they could talk and reminisce with them. It was a very enjoyable time for them to say the least. They talked about it for a long time afterwards.

They have been an inseparable couple throughout their whole lives, working side by side on the farm with no outside help, seven days a week, 365 days a year. They never wanted to be apart from each other. They had a devotion for each other that went beyond words. Both displayed anxiety when the other was not by their side. [Read more...]

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Daily Column

August 5, 2008 By Dr. Gott

DEAR DR. GOTT:
My wife has had breast cancer for two years. She had a lumpectomy on her right breast, followed by chemotherapy and radiation.

The only problem she has had since her treatment is burning and numbness in her feet and legs. I might add she is on her feet eight hours a day as a cashier. She never had these problems prior to her cancer. Her doctors don’t think it is neuropathy. We do have a couple of nerve centers in our area, but would like your recommendation as to the right physician to see for pain relief.

DEAR READER:
Unfortunately, breast cancer is the most common form of cancer among women. The good news is that it can be curable if discovered in its early stages.

Warning signs include breast lumps, thickening or swelling, skin dimpling, nipple retraction, or discharge. [Read more...]

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Daily Column

July 18, 2008 By Dr. Gott

DEAR DR. GOTT:
I have about 15 moles all over my body. They feel like sandpaper, itch, and are different sizes. Two on my back were a deep black. They fell off and the spots are flat and itch.

The last time I went to a doctor was about four years ago. I told her I was tired all the time and that my ears turn a beet red. Her answer was, “that’s the price you pay for being a woman”.

Do you think I might have skin cancer?

DEAR READER:
A mole is a small, raised growth on the skin that is ordinarily dark and painless, but can be annoying if it is located on a belt line or other area that is constantly irritated by clothing. As a general rule, lesions can be considered harmless unless they grow, darken, or change in some other way. When this occurs, a visit to a physician is in order.

[Read more...]

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Daily Column

May 13, 2008 By Dr. Gott

DEAR DR. GOTT:
I would like for you to tell me what to do for this annoying problem I have with my right nipple.

I am a 75-year-old male in fairly good health. For the last three months, my right nipple has been very sore. Some days are worse than others. When I told my doctor about it, he said it is from the beer I drink. When I asked about the possibility of cancer, he said I didn’t have cancer because I didn’t have a lump.

Dr. Gott, I don’t think this is caused by beer. I drink about three days a week when I go to the local VFW and I only consume light beer. I don’t drink alcohol at home. My doctor claims it’s only caused by the beer and hasn’t given me any other possible cause.

I’m worried about this since it is only on one side and (to me) doesn’t appear to be related to alcohol.

DEAR READER:
As I have written before, men can develop breast cancer, especially if there is a strong family history of breast cancer, such as in your mother, sister, grandmother or aunt. It is especially worrisome if you have another male relative who was diagnosed with breast cancer. Because you do not give a family history, I do not know if there may be a genetic relation. Symptoms can include nipple discharge, a lump, swelling, tenderness and pain. Just because you do not have a palpable lump does not rule out cancer. I urge you to make an appointment with an internist (a diagnostic specialist) who can perform a breast exam and order appropriate testing such as a chest X-ray, mammogram or breast ultrasound. He or she may choose to order a CT scan or MRI which can provide more detailed images.

If your doctor is dismissing your fears without proper testing and examination, you should find another physician. I hope, for both your and your doctor’s sakes, that the cause of your breast pain is benign. The time wasted by your current physician in getting you proper testing could make the difference in detecting disease in its early stages and necessitating minor treatment and finding advanced disease that needs extensive and powerful medications and possibly surgery.

It is ALWAYS important to follow-up on a patient’s health concerns, even if they are something the doctor feels are minor. It is the doctor’s job to make the patient feel comfortable and that includes answering any questions. Your doctor has completely failed you in this respect. You need to find a physician who is kind, respectful and willing to sit down to discuss health concerns with you. Good luck. Don’t delay any longer in getting the testing you need.

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

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Daily Column

May 5, 2008 By Dr. Gott

DEAR DR. GOTT:
I have a problem which no doctor seems to think is serious but I am very worried.

I had a complete hysterectomy when I was 28 because of cancer. I was lucky it was caught early. I am 65 years old.

About six years ago I started to “spot”. It is like a light menstrual period. I have seen three gynecologists who all say it is “normal”. I wear panty liners every day because I never know when it is going to start. Since I don’t have a uterus anymore, why am I bleeding?

DEAR READER:
Vaginal bleeding in a post-menopausal, post-hysterectomy woman is never normal. This is not to say that the cause of your bleeding is necessarily serious, however.

A complete hysterectomy is a surgery that removes both the uterus and cervix. The ovaries and fallopian tubes remain intact.

Without knowing more, I cannot guess what is causing the bleeding. Do you have pain just prior to or associated with the onset of the bleeding? Have you had a pelvic exam? Have you had any testing? These are all important questions that need to be answered (and followed up on, if appropriate).

The cause of your bleeding needs to be discovered. I urge you to find a gynecologist who will listen to your concerns and order appropriate testing. Perhaps you will have better luck beginning with your primary care physician. He or she can listen to your concerns and symptoms and then direct you to a resource for appropriate help. If your local gynecologists refuse to take the appropriate steps, asking your PCP to speak with them directly. This may yield favorable results, testing and a diagnosis. If not, consider a different gynecological group outside your local area, a teaching hospital or a specialized clinic, such as is available at Mayo Clinic or the Cleveland Clinic.

Your bleeding may be perfectly harmless, but given your history of cancer, you need to know definitively. Let me know how this turns out.

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Daily Column

May 3, 2008 By Dr. Gott

DEAR DR. GOTT:
Your recently wrote a column about a gentleman who was taking 16 medications. My husband, who is 82, is taking 19.

He has survived Hodgkin’s Lymphoma (1988), a 5 way by-pass surgery (1991), stroke (1997), and two carotid artery surgeries (1997 and 1998). He has type two diabetes as a result of his lymphoma chemotherapy. He is in kidney failure, was diagnosed with bladder cancer in 2005 and myelodysplasia.
He regularly sees an oncologist, endocrinologist, nephrologist, urologist and cardiologist. His medications include pain relievers, blood thinners, cholesterol reducers, calcium, vitamins, water pills, and many more.

I would like your opinion. We have insurance which I am very thankful for. I respect his doctors and their opinions as I do yours. I am worried, though, that he is over medicated. I also am worried that if he stops any of these, it would be his end. He leads a fairly normal life other than sleeping a lot, but given the situation, I would expect this. He does not do much, cannot play golf and is no longer sexually active (even though he would like to be). It is just not possible for him to do the things he wants and enjoys the way he used to.

DEAR READER:
Your husband has several serious medical ailments for which he is taking various (and mostly appropriate) medications. In your list, I do see two medications that I believe could be safely stopped. Valtrex is given to individuals with genital herpes as an outbreak preventive or treatment. Because your husband is not sexually active, there is little risk of him passing this condition on to you. You also state that your husband sleeps a lot. I note that he is taking Lunesta which is a sleep aid. If he is getting more than adequate sleep (7-8 hours) I don’t believe he needs this. If he is taking it because he cannot fall asleep at night, perhaps this is a result of him sleeping too much during the day. Try to keep your husband as active as possible during the day and he should have no problem sleeping at night.

Before making any modifications, I suggest you discuss your concerns with his physicians. Perhaps they would be willing to set up a conference call or meeting at which you and your husband can discuss the necessity of his medications and whether or not any can be modified, reduced or stopped. It is important, given his various ailments, that all his physicians agree on medication modifications. Perhaps now is also the time to involve a primary care physician who can help you sort out his medications and treatments. This will also help in the future if his situation becomes worse. At that time he may wish only to have medication to make him comfortable. Your husband’s quality of life should be of the utmost importance and if he is not enjoying his life and is missing out on the things he loves, his is, in my opinion, suffering. This can also lead to depression.

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

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Daily Column

April 25, 2008 By Dr. Gott

DEAR DR. GOTT:
I am a 79-year-old male in reasonably good health for my age.

Many years ago I was diagnosed with mitral valve prolapse. It does not give me any trouble, unless it is somehow connected with my other problem. I have been diagnosed with air hunger.

Occasionally I have the sensation of a shortage of air in my lungs. This causes me to cough suddenly and take several deep breaths to relieve the feeling. I have never smoked and over the years have had several normal chest X-rays. A stress test also showed no abnormalities.

My doctor has prescribed Ativan and Buspirone daily. These seem to help somewhat but are not a cure. The problem intensifies when I have a cold and at other times for no apparent reason. This has been occurring for many years.

DEAR READER:
Air hunger is a respiratory distress condition. It is marked by labored breathing, difficulty breathing and/or the feeling of not getting enough air into the lungs. It can be very disturbing when it occurs. It is not related to mitral valve prolapse.

Your physician appears to have taken appropriate first steps in testing. I believe the next step should be a CT scan or MRI which shows more detail and may pick up an abnormality previously missed. Lung masses, cancer and other conditions need to be ruled out before you can be definitively diagnosed with a benign condition.

I would like to mention that since you appear to be responding favorably to Ativan (an anti-anxiety drug) and Buspirone (a tranquilizer), your air hunger may simply be a manifestation of a panic disorder. Perhaps a psychiatrist or therapist would be the appropriate next step to take.

To give you related information, I am sending you a copy of my Health Report “Pulmonary Disease”. 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 mention the title.

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