Ask Dr. Gott » prostate http://askdrgottmd.com Ask Dr Gott MD's Website Sun, 12 Dec 2010 05:01:29 +0000 en hourly 1 http://wordpress.org/?v=3.0.1 Weight loss may help hypertension http://askdrgottmd.com/weight-loss-hypertension/ http://askdrgottmd.com/weight-loss-hypertension/#comments Wed, 27 Jan 2010 05:01:56 +0000 Dr. Gott http://askdrgottmd.com/wp/?p=2844 DEAR DR. GOTT: I am a 57-year-old male with hypertension, for which I take Levatol. Nine years ago, when I weighed 338 pounds, I was treated for the hypertension for the first time. I managed to lose 138 pounds by mid-2002, and the problem went away. Since then, I have gained back half the lost weight and am once again hypertensive. Will losing that weight again result in the loss of the hypertension?
A second concern I have is with the prostate. As you are aware, we are bombarded with advertisements hawking drugs to resolve BPH. In the ads, symptoms are listed. Based upon the symptoms, when should I seek a doctor’s advice? I have some of the symptoms but not nearly to the extent spoken of or written about in the commercials. For instance, I don’t fully empty my bladder and may have to urinate twice at night, but that often depends upon how tired I am and what I have consumed. I have my PSA checked each year, and it’s always found to be within normal limits. Physical exams have also proved negative.
DEAR READER: Let’s consider your issues one at a time. I assume you have been placed on Levatol, a prescription medication designed for combating high blood pressure and other conditions. The drug slows down the heart, thus allowing it to pump more efficiently. It should not be prescribed for people who already have a slow heartbeat or other specific cardiac conditions or asthma.
Being overweight or obese raises the risk of hypertension. The more body mass a person has, the more blood is required to supply oxygen and nutrients to the body’s tissues. And, as you have discovered, weight reduction can often bring blood pressure levels within a normal range, allowing for a reduction or complete elimination of medication in some cases.
An attempt at weight loss will likely be coupled with making more healthful food choices, eating smaller portions, reducing salt, and decreasing or eliminating fast foods. Not only will you get around more easily and feel better; your entire body will run more smoothly. It is far healthier to lower your body weight and control your hypertension without the use of drugs than to stress your entire system and expose it to possible side effects of medication. Lifestyle changes are not always easy, but, as a general rule, they are well worth the effort.
If you have periodic blood testing to evaluate your prostate and have an annual exam, you can likely forget all the ads you see on television and in newspapers. A digital exam will reveal any prostate growth that might require follow-up. If you are aware you don’t empty your bladder completely, try to do so. Nighttime urination is common if fluids are consumed too late in the evening. Consider a trial of no fluids for four hours prior to retiring for the evening. If you sleep through the night without having to urinate, you have your answer. Then speak with your primary-care physician to determine whether your fears are valid. If you remain concerned following the visit, request a referral to an urologist.
To provide related information, I am sending you copies of my Health Reports “Hypertension” and “The Prostate Gland.” Other readers who would like copies should send a self-addressed stamped No. 10 envelope and a $2 check or money order for each report to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title(s).

]]> http://askdrgottmd.com/weight-loss-hypertension/feed/ 0 Daily Column http://askdrgottmd.com/daily-column-491/ http://askdrgottmd.com/daily-column-491/#comments Sun, 23 Nov 2008 05:00:11 +0000 Dr. Gott http://askdrgottmd.dreamhosters.com/wp/?p=1546 DEAR DR. GOTT:
My husband is 73-years-old and had a biopsy of his prostate because his lab value was 6.2. We were told he had cancer, but were told not to worry. A few days later he came down with a severe urinary infection that put him in the hospital for four days. A few months later his PSA was 1.2 and now it is 1.7. The doctor wanted to do surgery but we said no. Now he wants to do another biopsy. I don’t want to put my husband through this again. Options are seeds, radiation and more that did not interest us at all. We chose to wait.

DEAR READER:
Normal prostatic specific antigen (PSA) readings are from 0-4. Your husband’s reading was high. Having said that, prostate cancer affects about one in six men in the United States and the incidence increases with age.

Prostatitis is inflammation of the gland. Forms of the condition are either bacterial, non-bacterial, or inflammatory. Any organism that can cause a urinary tract infection can also cause acute bacterial prostatitis. Trauma, obstruction, catheterization, cystoscopy or infection in another part of the body can result in bacterial prostatitis. So, your husband’s hospitalization could have come from a number of sources.

Armed with the elevated reading, your husband’s advanced age and the urinary tract infection, the surgeon was obviously leaning toward cancer. That was probably why he chose to perform the biopsy and recommended surgery. He was acting on the side of caution.
To be on the safe side, return to your husband’s primary care physician and request a referral to another urologist for a second opinion. If he or she feels the first urologist acted appropriately, you and your husband then have a decision to make. Does he want to undergo another biopsy? Is there pain involved? Is surgery safe at his age? You have a number of questions that need answering. Sit down for a frank discussion. You will then be in a better position to make an educated decision.

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