Her pharmacist and family doctor told her that this would probably never heal. She has tried tea-tree oil, Corn Husker’s lotion and every cream we can think of. It used to get worse in the winter but now happens year-round. Would seeing a dermatologist help? Or is this really something that she will have to live with? I’m afraid that she will eventually get a bad infection or something else. She’s now six months pregnant, but anything that you suggest could be held off until after the baby is born.

DEAR READER: Well, you’re right about holding off until after she delivers. Furthermore, if she plans to nurse her infant, that might have a bearing on treatment. Because of her pregnancy, I recommend that she not do anything without consulting with her OB/GYN.

Cracked fingers are a true dilemma and are difficult to repair. I could tell you countless remedies, but you’ve likely tried them all. So let’s consider auxiliary approaches.

1. Your daughter should see her physician to rule out a fungal infection causing the splitting. Some people on antifungal shampoos have found that massaging the product onto their scalps three times a week has healed their cracked fingertips.

2. She might also have lab work to test her thyroid, because abnormal levels can cause cracking.

3. She should not shower using very warm to hot water. The higher the heat, the more likely her skin will dry out and crack.

4. She should wear rubber gloves when washing dishes or doing household chores with harsh chemicals. Anything on her open skin falls into the “harsh” category.

5. She should keep her skin moisturized. One of the best and cheapest solutions is to use a petroleum-jelly product that she generously applies to her hands before going to sleep. She should then slip her hands into white-cotton gloves overnight. This pattern should be repeated every night until her skin is better.

6. She should wear gloves or mittens when hanging out laundry or going outside in cold, windy weather. This will further maintain what moisture her fingertips hold.

7. If, after trying these approaches, she does not experience relief, an examination by a dermatologist may be appropriate.

He first began getting the hives while working but now that he is retired, they still occur. He has seen his primary care physician and an allergist, both of whom have not been able to offer any suggestions. After hearing a detailed description of an “attack”, they both said they didn’t believe it was due to food or drug allergies.

He has seen his physician a few times during an attack but all they do is give him some sort of injection and a prescription for prednisone which he doesn’t like to take. He usually has three to four attacks a year but they can occur at anytime. For instance, his last attack was in January and the one before that was in August while we were on vacation in a completely different environment.

His symptoms and the frequency of the attacks seem to be worsening. I have finally decided to write because he is having yet another attack and I feel so helpless. I just want him to be able to have a more normal life. I will describe the January attack (as it is a pretty typical one) in the hopes it will help you help us.

Jan. 2 – woke up at 7 am with his left hand pink and swollen. Throughout the day the swelling and pinkness spread up his arm. He was very tired. That night he developed chills and a fever.

Jan. 3 – woke up at 5 am with sinus drainage and minor coughing. Both hands had become swollen and he had body aches. His top lip was also swollen (never affects throat or breathing) and he had large pink welts over most of his body. His fever had gone down but not away and he was still very tired. By mid-afternoon his bottom lip had become swollen. He slept most of the day due to a combination of fatigue and Benadryl (to try to alleviate the swelling).

Jan. 4 – lips were almost back to normal but he was still tired and achy. He still had the very large pink hives and felt chilly.

Jan. 5 – feeling better but still had large pink blotches.

Jan. 6 – blotches were starting to flatten.

Jan. 7 – hives almost gone.

DEAR READER:
Your husband appears to be having several attacks of acute urticaria (hives) a year. Acute in this instance means that the hives last for less than six weeks.

According to both the American Academy of Dermatology and the American College of Allergy, Asthma and Immunology, there are three common causes of urticaria. These are allergies to foods (such as shellfish, peanuts, dairy or others) and reactions to medications such as penicillin and infections. Insect bites, internal diseases, cold, or sunlight are other, less common causes.

I believe the cause of your husband’s hives is infection. Thanks to your detailed description, it appears that there are two things going on. First, he experienced swelling and redness in a small area that progressed throughout the day. He then developed upper respiratory infection symptoms (which can take 12-36 hours to appear following exposure) followed by worsening hives.

I don’t think there is any coincidence in the fact that his symptoms last approximately seven days, which is the average length of the common cold. Since I am not an allergist, I cannot give specific information about how to treat these hives. I also do not know if there is a way to prevent symptoms from appearing since each infection is likely to be due to a different strain of bacteria or virus.

If your husband improves while using prednisone, I urge him to speak with his physician about using it. Small doses for short periods of time will not cause side effects and long-term damage is avoided. The prednisone probably won’t help the cold but it will be a lot easier to deal with a simple cold by itself without having itchy, swollen blotches all over his body as well.

Bring my response to his allergist and ask his opinion. He or she should also be able to provide possible treatment options at that time.

To give you related information, I am sending you a copy of my newly written Health Report “Allergies”. 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.

My niece supposedly had a stroke. She then had X-rays that showed she had a small spot of bleeding in her brain. She went to several doctors because she had all kinds of things happening to her like headaches that nothing helped that disappeared, only to be replaced by seizures. She was having trouble walking and her memory was getting worse. Her legs would give out and she would fall. One arm became limp and a host of other things.

All this lasted for two years and was accompanied by numerous hospitalizations. Finally her doctor told her that both carotid arteries were plugged. He said it was caused by plaque. She kept getting worse so her husband changed her doctor and switched hospitals.

The new physician, after seeing her, referred to a teaching hospital. She had a couple of tests and more X-rays. She was told she didn’t have plaque buildup in her carotid arteries, but rather infection, and was then diagnosed with vasculitis.

I am told it is a very rare blood infection. She is now taking large doses of prednisone and her physician says she will likely get most of her memory back. She is getting better already and can now walk by herself again (but still has someone with her at all times, just in case). She has also regained use of her arm.

My reason for writing is that I don’t understand why her new doctor hasn’t let the whole world know about this new disease he has found. He said he has been a doctor for more than 30 years but has only ever seen one other case of vasculitis. When I talked to my personal physician about it, he said he had never even heard of it.

DEAR READER:
Vasculitis is inflammation (not infection) of the blood vessels, capillaries, veins and/or arteries. When this occurs it can weaken and narrow the vessels which may result in blockage. With decreased blood flow, less oxygen can be supplied to muscles and other tissues. If the inflammation is not brought under control, tissue, muscle and organ damage may occur. If the damage is severe, it may result in death.

There are several disorders that fall into the vasculitis family and include Churg-Strauss Syndrome, Kawasaki disease, Wegener’s granulomatosis, polymyalgia rheumatica and more.

While each disorder is different, many of the symptoms overlap. The primary distinguishing point is the type of blood vessels that are affected (small, medium or large). General symptoms include shortness of breath/cough, joint pain, asthma, fever, rash, fatigue/weakness, abdominal pain, visual changes and more.

Vasculitis can affect anyone at anytime but certain forms affect specific age groups more than others. It is considered to be an autoimmune disorder, meaning that the body attacks itself.

There is no known cure, but with early diagnosis and treatment, most sufferers can lead relatively normal lives. Treatment can include steroids (prednisone and others), immunosuppressive medications and antibiotics.

I suggest you and your daughter return to her physician to discuss her condition. Vasculitis by itself is not a diagnosis, it is simply a broad term to identify a primary symptom. If you are one of her care-givers, it is also vital that you understand what the condition is, what type of treatment she is on and what warning signs to look for if she has a relapse.

To give you related information, I am sending you a copy of my Health Report “Stroke”. 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.

What do you think I should do?

DEAR READER:
Initially, I recommend you speak with your physician about having the wound cultured to determine why it isn’t healing. Perhaps you have an infection that isn’t being eradicated. You may require a prescription antibiotic instead of iodine and Neosporin. The testing will provide the answer.

Then, ask if you can cover the wound with a dry, sterile dressing or use other methods to deter scratching. You must allow the wound to heal on its own without continually irritating it.

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, number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

It has now been three months since my symptoms started. Do you have any suggestions?

DEAR READER:
The timing of the start of your symptoms and your colonoscopy may suggest a relationship, however I cannot be certain. I am also uncertain about your statement that you could barely get home. Does that mean you drove yourself? Were you in pain? Disoriented? Without specifics it is hard to tell if that experience were related to the colon study. Perhaps you were discharged too soon and were still suffering the effects of the sedative or anesthesia.

As for the urinary tract infection, pain in the side is not common with UTIs unless they have progressed into a kidney infection. The gas pressure could simply be associated pain that, for women is often just above the pubic bone and for men is usually near the rectum. Frequent urination is common for UTI but is generally not limited to nighttime only.

I urge you to be seen by a urologist for testing. He or she should order a urine analysis including a culture and sensitivity to check for bacteria. The specialist may also choose to order imaging studies such as a cystoscopy to visualize the interior of the urethra and bladder. An MRI to check the kidneys and exterior of the bladder may also be helpful.

To give you related information, I am sending you a copy of my Health Report “Bladder and Urinary Tract Infections”. 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.

About two months ago I got a cold and was given a Z-pack. It didn’t help so I was given Levaquin. Now I cannot smell or taste. How can I bring these senses back?

DEAR READER:
I would first like to comment on your cold treatment. A cold is caused by one of more than 100 different viruses. Antibiotics can only treat bacterial infections and therefore should not be given to individuals with colds or other viral infections.

Now to your senses of smell and taste. Some individuals can experience a loss of these with trivial colds. It can also be the result of various medications. If they have not returned within six months, I recommend you make an appointment with your physician to discuss your meds and what the side effects are. If it is not due to any of your pills, make an appointment with an ear-nose-and-throat physician who can further test you.

DEAR READER:
A cold is an infection of the nose and throat that can develop because of any one of more than 200 different viruses. The rhinovirus is the most common and is highly contagious.

Symptoms usually develop between one and three days after exposure to a cold virus and can include runny nose, watery eyes, cough, sneeze, congestion, and sore throat. As a general rule, fever does not occur with the common cold.

There are countless ways to come in contact with a virus. Sharing objects such as a drinking glass or cup, droplets from a contagious individual sneezing near you and hand to hand contact are at the top of the list. Consider that someone with a cold touches his or her mouth or nose and then opens a public door. You follow behind and touch that door knob, exposing yourself to the very germs you try so hard to avoid. This is one reason why most supermarkets now place sanitizing wipes near their grocery carts.

Antibiotics are ineffective in treating the common cold. While over-the-counter products will appear to lessen your symptoms, there really is no cure. When taken in excess over extended periods of time, the acetaminophen in pain relievers can cause liver damage. The chronic, extended use of decongestants can result in inflammation of mucous membranes. Spray decongestants should never be given to children because of unwanted side effects. Cough syrups are essentially ineffective. Symptoms will run their course in about seven days from onset. Should you find a virus lasts longer, you should play it safe and see a physician who can properly diagnose you.

I must agree that your approach to a cold is more on the money than that of your acquaintances. Probably the last thing you want to do when you are feeling so “punk” is to exercise and sweat. Everyone is different. If they respond in a positive nature, they should continue on course.

The answer, in a word, is prevention. Wash your hands frequently. Use tissues when blowing your nose and dispose of them in a proper receptacle. Drink extra fluids and rest as much as possible. Stay away from infected individuals in close quarters and opt for fresh air instead. A gargle of warm salt water and the use of saline nasal drops are your best bet.

I am very careful to not use washcloths or towels more than once during an outbreak. I wash everything in hot water. Do you know of anything else I can take to prevent getting this?

DEAR READER:
Impetigo is a skin infection that most often affects infants and children but can affect adults as well. It begins as red sores that rupture, ooze and form a yellowish/brown crust. The lesions form when bacteria enter the skin, most commonly through insect bites or cuts, but unfortunately can also develop in healthy skin. This highly contagious condition can spread easily to other individuals or to other parts of the body simply by scratching or touching the sores. While seldom serious, it can be painful, inconvenient and unattractive.

Two types of bacteria, staph and strep, cause the condition. Both can live on healthy skin and remain harmless until the skin is compromised through an open sore, cut or rash. Staph bacteria produce a toxin that attacks proteins that help bind skin together. If such protein is damaged, bacteria are free to spread rather quickly.

A deep form of impetigo is known as ecthyma. It is marked by large boils and sore, crusting lesions that commonly appear on the skin of the legs. Ecthyma can develop in individuals with diabetes or in those with a compromised immune system.

Complications of advanced impetigo are kidney inflammation, cellulitis, methicillin-resistant staphylococcus aureus (MRSA), and a strain of staph resistant to most antibiotics.

Treatment of impetigo is primarily centered on hygienic measures. Keep skin clean and avoid skin-to-skin contact with infected individuals. Avoid using towels and clothing of infected individuals and do not sleep in their bedding.

When there is any doubt about the possibility of the condition, visit your primary care physician who can likely make a diagnosis simply by visual examination. Should questions remain, a culture can be sent to a laboratory for analysis.

In February 2007, my husband was found to have high blood pressure and was started on lisinopril, hydrochlorothiazide and metoprolol which he took until October 2007 when he developed an unproductive cough, extreme fatigue and lightheadedness. He could sleep 24/7. He saw his doctor who ordered testing but nothing was found.

He then developed dizziness when turning his head or bending over and saw the doctor again after developing a slight fever. He was given amoxicillin. At that time we asked about the possible side effects of the lisinopril and were told he could stop it.

Now fearing medication my husband stopped them all. He then returned back to the physician because his symptoms persisted and was found to have very high blood pressure and a heart rate of 120. His cough had disappeared shortly after stopping the medications but he continued to be dizzy, lightheaded and tired. He was admitted to hospital that day where he had a chest X-ray and was seen by a cardiologist who prescribed atenolol, lisinopril, a low dose aspirin, and Lipitor. His symptoms continued.

We called his primary physician again when he started trembling. At that time he told us to discontinue the lisinopril. The Lipitor was never started because we felt he had enough problems already without taking more medications. My husband then developed a hiccup spasm which is very loud and happens sporadically. He continued to have the extreme tiredness, lightheadedness, dizziness, and trembling so back to the doctor we went. An ultrasound of the carotid artery was ordered and was found to be clear, despite the fact that he nearly fell over after the exam. We were referred to an ear-nose-and-throat specialist to rule out a middle ear infection. Everything appeared to be fine but recommended to our personal physician that a test be done on the inner ear and an MRI of the ear and brain. We decided to hold off on the testing at that point.

In January 2008, our doctor prescribed an antidepressant, fluoxetine. His symptoms improved slightly but two weeks later, my husband couldn’t urinate and was sent to a urologist. He finally was able to go shortly after we arrived for the appointment. During the exam everything was found to be normal but it was recommend that he have an internal exam of his bladder. That test was never done.

Back when my husband had the cough, he felt something happen in his lower torso but didn’t notice anything. He then developed a bulge in late January 2008 that was diagnosed as a hernia. By the time this arrives to you he will probably have had corrective surgery (scheduled for May 2008). He continues to have symptoms despite stopping most of his medications and now has trouble urinating, constipation and a hernia. We don’t know what to do, his doctors cannot find anything wrong and I am worried.

DEAR READER:
Your husband appears to have a series of seemingly unrelated symptoms. Some are similar to adverse effects of his medications, others of vertigo, infection and his hernia.

Your husband’s doctors appear to have done appropriate testing and exams but thus far have failed to find an explanation. Therefore, I recommend your husband get a second opinion from another internist who specializes in ailments of the whole body rather than just this part or that part. You should bring a copy of your husband’s medical record with you to the appointment which will provide an accurate history of symptoms, medications, testing and more. Perhaps having a fresh set of eyes look over the history and do another general examination will reveal something overlooked.

As for holding off on the testing, I urge you to now have that MRI of the ear and brain. The dizziness, lightheadedness and nausea may all stem from vertigo. Vertigo is caused by an abnormality within the ear that can, often upon waking, looking up, bending down and more can cause motion sickness-like symptoms.

The constipation, inability or difficulty to urinate may be part of the hernia which once repaired should stop symptoms. A hernia occurs when part of the intestine slips through an abnormal hole in the abdomen into various areas. Depending on the area of the hernia, symptoms vary. Constipation is fairly common because the stool within the bowel can become blocked in the area that has been “misplaced”. If the intestine is pushing on the tubes leading from the kidneys or the bladder, urination can be affected.

Get a second opinion and follow-up on the recommended testing. Let me know how this turns out.

DEAR READER:
While I don’t know the reason for your child’s repeated ear infections, I will fill you in on one non-surgical item available on the market. In 2005 the FDA approved the Ear Popper, a non-invasive, non-drug related prescription device for treating fluid in the middle ear, Eustachian tube dysfunction, otitis media, pain from travel in an airplane, hearing loss, and fullness from sinus conditions and colds.

Popping of the ears is common and is nature’s way of relieving pressure imbalances of the middle ear. When the natural method doesn’t work, pressure in the middle ear becomes higher or lower than in the outer. Fluid can accumulate and hearing loss and pain result. The purpose of the Ear Popper is to equalize pressure in the middle ear by opening the Eustachian tube. This is done by directing a steady but controlled stream of air through the nose. The simple act of swallowing directs air into the Eustachian tube, relieves the imbalance of pressure and pain is gone almost immediately. The popping sound nature makes will be duplicated during use of the Ear Popper and simply indicates successful treatment.

I urge you to speak with your son’s ear-nose-and-throat specialist about this option because it is not appropriate for all ear conditions and patients. Only he or she will know if it is an appropriate consideration.
Because all insurances vary, I cannot guess if the product is covered under any health coverage you might have. I stress this because the unit is expensive. A home kit costs approximately $200, while a professional unit for a physician’s office is $300. Therefore, I recommend you do your homework if this option is of interest to you. All that is required is for your physician to write Ear Popper on a prescription pad that you present to your local pharmacy. If the unit isn’t in stock, it will be ordered for your home use. Or, if you prefer, ask your physician or an ENT specialist if he or she has a professional unit in his office where the simple service can be provided.

To give you related information, I am sending you a copy of my Health Report “Ear Infections and Disorders”. 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.