DEAR READER:
Let’s start with the acid reflux. If your daughter truly has acid reflux, she should be under the care of a gastroenterologist to determine if it caused by a hiatal hernia or other factor. If she is asymptomatic, she shouldn’t need medication but that is best determined by the specialist.

Now to the mouth ulcers. These can be very painful, especially when they occur in clusters. You say that a biopsy was taken but you did not share the results. The most common cause is the herpes virus. If this is the case your daughter may benefit from an anti-viral medication such as Valtrex.

Regardless of cause, your daughter should also find ways to reduce stress which can worsen an outbreak or bring one on. She can also try brushing her teeth with baking soda and water rather than manufactured toothpaste because many contain sodium laurel sulfate which can cause mouth ulcers in sensitive individuals. Natural toothpastes such as Tom’s of Maine contain very small amounts (or none at all) and may not have the detrimental effect that standard brands do.

I recommend your daughter see a dentist as a next step. This type of specialist has a vast knowledge of the mouth and teeth and may have alternative therapies or suggestions that a general physician does not. In the meantime, your daughter can try oral numbing agents such as Orajel to dull or eliminate the pain caused by the ulcers. While this is not a long lasting solution, it can provide relief for several hours.

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.