What's Up Doc 11-12-09

What is the difference between myopia and hyperopia?
Myopia is commonly called nearsightedness, and occurs when the curvature of the cornea is too steep, causing focus of the rays of light to form in front of the retina instead of directly on the retina. The result is a blurry view of distant objects. Hyperopia is commonly referred to as farsightedness, and occurs when an eye is too short for the cornea curvature, causing focus of the rays of light to form behind the retina instead of directly on the retina. As a result, a blurred image of close objects is produced.
Jeffrey Hankin, OD, Optometrist with The Eye Clinic

I got an email that said it was not safe to microwave my food in plastic wrap. Is this true or is this an urban myth?
This Internet string was created by an unknown author who got a little carried away about dioxins in the atmosphere. While it is true that the microwaving process releases dioxins, there is only an insignificant amount of these poisons released. Once dioxins enter the body, they are stored in the fatty tissues of the body. Excessive amounts of dioxins can cause problems if you are exposed to them for an extended period of time and in large amounts. Dioxins in plastic wrap are essentially harmless. You can feel confident using any plastic that is marked microwaveable in the microwave. The vast majority of plastics used in food wraps and packaging containers do not contain the chemical constitutes that can form dioxins, which are a family of compounds produced by combustion at temperatures greater than 700 degrees Fahrenheit. And, by the way, if you just so happened to be cooking at that temperature, you wouldn’t be able to eat that crunchy stuff anyway!
Brian Stewart, MD, family practice physician

How Does Chemotherapy Affect Diabetes?
Chemotherapy is a challenging treatment for anyone, but presents some additional specific concerns for people who have diabetes. Some people react to the stress of chemotherapy on the body by developing additional resistance to insulin, so that blood sugar levels increase. This is a temporary effect, but it may cause a diabetic to require additional medication during treatment. Side effects of chemotherapy can include irritation of the digestive tract, including mouth sores, nausea, and diarrhea. If this occurs, you may not eat as well and absorb your nutrients poorly. While nutrition is poor, you may require supplemental nutrition through an intravenous (IV) line. Changes in your total calorie intake will make it necessary for your diabetes treatment to be monitored and adjusted throughout your treatment. It is also common for people who receive intravenous nutrition to receive intravenous insulin out of the same infusion, if the doctor makes this arrangement. Some side effects of chemotherapy are long lasting. One common side effect of certain chemotherapy medicines is nerve damage, called "neuropathy." Because neuropathy is also a common complication of diabetes, these patients may be particularly prone to this problem after chemotherapy.
Henry Goolsby, III, MD, Oncologist with Lake Charles Medical and Surgical Clinic

I have a bump under the skin of my left wrist that comes and goes every few months. Sometimes it is sore and other times I don’t even realize it is there until I accidentally hit it on something. It usually stays for about three or four weeks and then disappears. Should I be concerned?
It sounds like you have a very common ganglion cyst. They are not harmful and can be treated by removal if they severely impact the use of your wrist or hand. Unfortunately, even with surgery, the cysts tend to come back. If the bump becomes too painful, a wrist splint may provide relief. Of course, it’s always best to check with your physician so he or she can look at it and give you more specific instructions.
Marne Devillier, MD, family medicine physician with Maplewood Family Medical Clinic

What's Up Doc 10-29-09

I’m getting aggravated that I’m still dealing with acne at age 27. I thought I would be done with this by now. It’s not very professional looking, either. What kind of treatments are available?
If it’s any consolation, nearly 30 percent of women and 20 percent of men ages 20 to 60 battle breakouts. Over-cleaning and vigorous scrubbing can cause more damage, so keep in mind it’s best to be gentle, but consistent. Wash morning and night with a gentle cleanser, and it’s especially important to remove makeup every night. A topical treatment containing benzoyl peroxide will kill bacteria. For moderate to severe acne, a prescription treatment can often provide good results. Also, avoid touching your face throughout the day, wash your hands frequently, and limit sun exposure as this can increase oil production and make acne worse. A treatment plan by a dermatologist can help minimize the breakouts.
Maureen Olivier, MD, dermatologist with The Clinic

How effective are whitening toothpastes?
All toothpastes help remove surface stains through the action of mild abrasives. Some whitening toothpastes contain gentle polishing or chemical agents that provide additional stain removal effectiveness. Whitening toothpastes can help remove surface stains only and do not contain bleach. Over-the-counter and professional whitening products contain hydrogen peroxide (a bleaching substance) that helps remove stains on the tooth surface as well as stains deep in the tooth. None of the home use whitening toothpastes can come even close to producing the bleaching effect you get from your dentist's office through professional tooth whitening techniques. Whitening toothpastes can lighten your tooth's color by about one shade. In contrast, light-activated whitening conducted in your dentist's office can make your teeth three to eight shades lighter.
Harry Castle, DDS, with Oak Park Dental

I’d like to have Botox, but I’m worried about my facial expressions not looking natural. Is that unavoidable?
Not at all – if the injections are administered correctly. Botox works best for dynamic wrinkles. These are the wrinkles that occur when you smile, laugh or frown. They are commonly referred to as frown lines, forehead lines and crow's feet. Although the results after Botox are visible, a treatment with Botox injections will not radically change your facial appearance or make you look as if you "had work done." The muscle activity that causes frown lines between the brows is simply reduced, so you can still frown or look surprised.
Mark Crawford, MD, facial cosmetic specialist with the Aesthetic Center of SWLA

What might cause sensitivity and persistent pain in the hip?
Hip pain can be caused by various factors. One of the most common is degenerative joint disease or osteoarthritis. This occurs when the cartilage lining, which keeps the bones in the hip joint gliding across each other smoothly, deteriorates and becomes rough. The pain and stiffness that are associated with arthritis can also be accompanied by a tingling or warm sensation. Another possible condition related to these symptoms is bursitis of the hip joint. This occurs when the bursa sac surrounding the hip joint becomes inflamed. A stress fracture can cause persistent pain and discomfort in the hip. A new source of hip pain has been isolated in the labrum of the hip. The labrum is a ring of cartilage surrounding the hip joint, which can be torn and is a very common cause of hip pain in younger patients. Finally, very often what people think is hip pain is not actually related to a problem in the hip joint. It can originate from some other condition such as a herniated disc in the back. In order to determine the exact cause of your hip pain, don't delay seeing a qualified physician for an examination.
John Noble, Jr., MD, orthopaedic surgeon with Center for Orthopaedics

What's Up Doc 10-15-09

What is amblyopia and how is it treated?
Amblyopia is poor vision in an eye that did not develop normal sight during early childhood. It is sometimes called "lazy eye." This condition is relatively common, affecting approximately two or three out of every 100 people. Because there are several causes of amblyopia, the treatment must match the problem. Glasses or contact lenses fix some problems. Surgery may be needed for cataracts, droopy eyelids or crossed eyes. After the cause is found, the child will need to use the weaker eye most of the time, so it will get stronger. To make the child use the weaker eye, a patch can be put over the stronger eye. Sometimes, eye drops or special glasses are used to blur the vision in the stronger eye. This makes the weaker eye become stronger. Patches may be used all day or part of the day, depending on the child's age and vision. The treatment usually lasts until vision is normal, or until vision stops getting better. For most children, this takes several weeks. A few children need to use eye patches until they are 8 to 10 years old. The best time to correct amblyopia is during infancy or early childhood. That’s why eye exams for children are so important.
Virgil Murray, MD, ophthalmologist with The Eye Clinic

How much damage does smoking do to your baby if you have just one cigarette a day or every other day?
It would be difficult to give you a definitive answer, but smoking during pregnancy is something we strongly advise against. Most of the research on smoking and pregnancy has shown that smoking more than half a pack a day increases the risk of miscarriage and of the baby's being born prematurely and/or with a low birth weight. Cigarette smoking puts carbon monoxide into your blood, while the baby needs oxygen. The nicotine also causes spasms of the blood vessels that feed the baby oxygen and nutrients, decreasing flow to the child. Smoking is a difficult addiction to break. Once you are off cigarettes and don't have them in the house, it will be easier to quit and to stay off of them after the baby is born.
G. Vincent Bailey, MD, ob/gyn specialist on the medical staff of Jennings American Legion Hospital

My daughter has had her braces for about three months and I think her teeth actually look worse at this point than when they started. Is this normal?
Yes, during the course of orthodontic treatment, things do sometimes appear worse before they look better. The teeth often move in different directions as the teeth are straightening out. You may see a space between your two front teeth that was never there before or teeth that seemed perfectly straight before the braces were placed may not seem as straight. Be patient and things will start to improve. That space will close and those teeth will line up as treatment continues.
Craig Crawford, DDS, orthodontist, Crawford Orthodontics

Can a polyp on the vocal chords be cancerous?
The vocal cords are a paired structure in the throat that moves when we breathe or speak. Sometimes they can be injured or develop a disease. Polyps are one such condition. Polyps are caused by swelling of the mucosa (lining tissue) of the vocal cords. They collect excessive fluid and swell. Sometimes if the swelling persists or the injury is repetitive, the polyps can harden with scar tissue (called fibrosis). The polyps are benign (not cancerous) lesions of the vocal cords. However, it is possible to have cancer of the vocal cords along with polyps. While this is unusual, it is one reason that a person with persistent hoarseness needs to have a thorough laryngeal exam. An otolaryngologist (ear, nose and throat doctor) can usually make that assessment during a scheduled office visit.
Henry Goolsby, III, MD, Oncologist with Lake Charles Medical and Surgical Clinic

What's Up Doc 10-2-09

I sometimes suffer from chest pain when I am really pushing myself during exercise. Is this normal?
No, this is not normal, and chest pain during exercise is something that you should always have evaluated by a physician. Exercise should be done only to the individual's capability and response level. Once cleared by your doctor to exercise, you should set limits for your exercise, and certainly monitor your heart rate for your age and physical status. Perhaps getting some input from an exercise physiologist would be helpful.
John Winterton, MD, cardiologist on medical staff at West Calcasieu Cameron Hospital
I just recently had my blood work done. When I received my results, it said I had a high PSA level. What does this mean and should I be concerned?
A PSA test is used to measure a substance found in males called “prostate specific antigen.” It is a screening tool that is used for prostate cancer. In a healthy male, the PSA should be less than 4 nanograms per milliliter of blood. Check with your physician if your PSA was higher than this as it may be an indication of prostate cancer.
Kenneth Verheeck, MD, urologist with the Urology Center of Southwest Louisiana
My mother is in her early 70s, small framed and just seems frail. How much bone strength, on average, do women lose each year?
In the first five to ten years after menopause, 25 to 35 percent of bone density can be lost. It varies from woman to woman, as each individual’s risks determine the likelihood for osteoporosis. It sounds like your mother’s risk for osteoporosis is high, given the small frame and frailness that you reported. Her doctor can best determine her bone strength and may order a bone density scan to know for sure. It’s recommended for women 65 years of age and older. I’d suggest talking with him or her about having the scan and see what can be done to boost her bone health.
Scott Bergstedt, MD, ob/gyn specialist with OBG-1
I know that some over-the-counter medicine can aggravate ulcers. Are there any pain relief options that are okay to take?
It’s good that you’re aware of the potential side effects when dealing with medications and ulcers. Many OTC medications can cause problems for people with ulcers. Talk with your doctor about taking acetaminophen; it’s the active ingredient in Tylenol and generally poses a much lower risk of gastrointestinal problems. Also, remember that pain relief isn’t always found in a bottle. For acute injuries, try ice packs; for treating chronic overuse injuries, try a heating pad; and arthritis pain can be relieved with physical activity.
James McNally, MD, family medicine physician on medical staff of Jennings American Legion Hospital

What's Up Doc 9/17/09

Is there any difference between bottled water and tap water? I keep hearing that drinking bottled water over tap water is healthier.
In general, there are no health benefits from drinking bottled water over tap water. Both must meet certain criteria that ensure safety. Many people just prefer bottled water because the bottle is easy to carry along. If you are more sensitive to color, odor and taste in tap water, drinking bottled water is just as good of an alternative.
Marne’ Devillier, MD, Family Medicine Physician with Maplewood Family Medical Clinic

I often feel rushed at my doctor’s office. I trust that he’s a qualified doctor, and I don’t want to change doctors, but is there a way I can get more out of the visits and not leave feeling confused?
Medical information is complex, just like engineering, accounting or carpentry, but the difference is, we participate in the solution. Choices we make every day with nutrition, medications and exercise affect our health. Clear communication is vital for a good doctor-patient relationship. I suggest writing down your questions or concerns before your visit and bring a notebook with you. Take notes about the instructions and repeat them back to the doctor to make sure you understood correctly. Ask questions about medications such as when you should see an improvement, what you can do to prevent the condition, and so on. Patients who don’t understand their doctor’s orders are at greater risk for infections, medication errors and repeated hospitalizations.
Todd Peavy, MD, Family Medicine Physician, with Lake Charles Medical and Surgical Clinic

I suffer from depression and was wondering if there is a link between caffeine and depression. I drink a lot of coffee.
Caffeine is considered a mild stimulant, and there is no evidence that it causes depression. However, some people are more sensitive to the effects of caffeine than others. In such individuals, caffeine may worsen existing depression. How or why this occurs isn't exactly clear, and is being studied. One possibility is that although caffeine initially gives you a "lift," it may later have the opposite effect as the stimulation it delivers wears off. Another is that caffeine can cause difficulties with sleep, which can worsen depression. Caffeine also appears to have some effect on blood sugar, especially in people with diabetes. Fluctuations in blood sugar can be associated with mood changes. If you have depression, you may consider limiting or avoiding caffeine to see if it helps improve your depressive symptoms. Because caffeine can be habit-forming, an abrupt decrease in consumption can cause withdrawal symptoms, such as headaches, fatigue, irritability and nervousness. To lessen these withdrawal effects, gradually reduce the amount of caffeine you consume.
D. Dale Archer , MD, Psychiatrist with the Institute for Neuropsychiatry

What is the treatment for deteriorating disk of the neck?
It depends, and it's important to understand that all discs will degenerate in all individuals over time. Surgery is usually not needed unless there is nerve or spinal cord damage. Often the degeneration can be slowed down with simple injections and physical therapy, with surgery used as a last resort.
Craig Morton, MD, Physical Medicine and Rehabilitation Specialist, Center for Orthopaedics

What's Up Doc? 9/3/09

My granddaughter, who is 16, is having trouble keeping her skin clear from breakouts. I know it’s common for teenagers, and even adults, to deal with this. I wonder if the amount and the type of makeup she uses to cover up the blemishes is actually making it worse?

Hormones and oil production are in over-drive during the teen years and the combination of the two results in breakouts. You’re right that too much makeup can aggravate the problem. A good makeup option is often mineral makeup because it contains natural ingredients that generally do well on most skin types, including sensitive skin. Using a small amount is best and it’s very important to remove the makeup every night. Most people tend to aggravate acne by scrubbing too hard, covering with too much makeup, and not cleansing properly.
Maureen Olivier, MD, dermatologist with The Clinic

I’m a 29-year-old-woman just diagnosed with osteoporosis. I thought only older people had this disease; are there many young women with it?
At this time, two percent of college-age women already have osteoporosis. Fifteen percent have sustained significant losses in bone density and are well on their way to developing the disease. A common method of birth control, Depo-Provera, is associated with significant bone loss, and low body weight is also a contributing factor for osteoporosis in young women. Some young women are at greater risk than others for brittle bones, depending on estrogen levels and other factors.
Geoffrey Collins, MD, orthopedic surgeon with the Center for Orthopaedics

I’m noticing changes in my mother’s behavior. She doesn’t seem interested in her usual activities. She is physically able to participate, but she just doesn’t want to. I worry about her; she’s 71. Should I intervene or just let her sit alone?
Changes in appearance and behavior can mean a number of things. It could signal the need for a checkup and possibly an adjustment in medication; she may be depressed or forgetful. An aging family member may say they are doing just fine, but your observations raise some red flags. I’d suggest going with your mother for a checkup and then discussing your concerns with her doctor.
Amanda LaComb, MD, family medicine physician, medical staff of Jennings American Legion Hospital

I’m having cataract surgery next month. How long does the artificial lens last? Will it have to be replaced at some point? Also, will my vision deteriorate over time or stay the same?
In cataract surgery, the ophthalmologist removes the clouded lens from your eye and replaces it with a clear, artificial lens. This lens is very durable and should last for the rest of your life. If a traditional lens implant is used, you may require glasses for reading or working at near distances after surgery. However, new options in premium lens plants can correct existing nearsightedness and farsightedness, allowing many people see clearly without glasses of any kind after surgery. Your vision after cataract surgery generally doesn't deteriorate over time. However, sometimes the lens capsule that holds the implant becomes cloudy. In such cases, the cloudy capsule can easily be treated with a laser to make it clear again.
A.J. O’Byrne, ophthalmologist with The Eye Clinic

What's Up Doc? 8/20/09

I often feel rushed at my doctor’s office. I trust that he’s a qualified doctor, and I don’t want to change doctors. Is there a way I can get more out of the visits and not leave feeling confused?

In a word: yes. Medical information is complex, just like engineering, accounting or carpentry, but the difference is, we participate in the solution. Choices we make every day with nutrition, medications and exercise affect our health. Clear communication is vital for a good doctor-patient relationship. I suggest writing down your questions or concerns before your visit and bring a notebook with you. Take notes about the instructions and repeat them back to the doctor to make sure you understood correctly. Ask questions about medications such as when you should see an improvement, what you can do to prevent the condition, and so on. Patients who don’t understand their doctor’s orders are at greater risk for infections, medication errors and repeated hospitalizations.
Todd Peavy, MD, family medicine physician, Lake Charles Medical and Surgical Clinic

I have an ulcer and I’ve heard that aspirin and even Advil can cause problems for people with ulcers. Is that true?

Many commonplace drugs, such as aspirin, Advil and Aleve can cause serious problems by irritating the stomach lining and aggravating ulcers. Studies show that people who take these drugs are about three times more likely to have gastrointestinal bleeding. If you’ve been diagnosed with an ulcer, talk with your doctor about what over-the-counter medications are safe to take.
James McNally, MD, family medicine physician, medical staff of Jennings American Legion Hospital

My 8-year-old daughter has a bed-wetting problem and never wants to go to sleepovers or have anyone over because she is embarrassed. Is there anything I can do to get rid of this problem?

There are a number of behavioral modification tricks such as limiting fluids past 6pm and setting up a bathroom break alarm. If these tricks do not work, check with your physician. Some doctors may prescribe nasal spray, which can help block urine production during the night.
Kenneth Verheeck, MD, urologist, Urology Center of Southwest Louisiana

My mother is in her early 70s, small framed and just seems frail. How much bone strength, on average, do women lose each year?

In the first five to ten years after menopause, 25 to 35 percent of bone density can be lost. It varies from woman to woman, as each individual’s risks determine the likelihood for osteoporosis. It sounds like your mother’s risk for osteoporosis is high, given the small frame and frailness that you reported. Her doctor can best determine her bone strength and may order a bone density scan to know for sure. It’s recommended for women 65 years of age and older. I’d suggest talking with him or her about having the scan and see what can be done to boost her bone health.
Scott Bergstedt, MD, ob/gyn specialist with OBG-1