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Q.
I have dry and itchy skin in the winter months. Why is this and how can I prevent it?
A.
Individuals that have dry and itchy skin in the winter months are usually people who are predisposed genetically to having atopic dermatitis, eczematous dermatitis, or just plain xerosis. These three entities can be thought of in somewhat of a spectrum, with the first, atopic dermatitis, being most severe with an additional predisposition to asthma and other allergies.
Q.
Someone told me that my Irritable Bowel Syndrome (IBS) symptoms were "all in my head." Is this a psychosomatic condition?
A.
For most of the past century, IBS was a poorly understood condition. Indeed, as with other chronic disorders, symptoms often worsened during times of stress. In fact, while stress can exacerbate IBS (as it can for angina, asthma, gastritis and other medical conditions), IBS is not caused by stress.
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Q.
Every time I cough or laugh a little urine comes out. Running or jumping is out of the question. I do Kegle exercises all the time, but it doesn't seem to help. Is there anything that actually works?
A.
What you are describing is stress incontinence, the type of incontinence in which anything that increases abdominal pressure such as coughing, sneezing, laughing or even walking with a bounce causes a loss of urine.
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Q.
Why are there so many types of blood pressure medication, some very expensive and others less so? Why does the doctor prescribe different ones to me and my husband for the same problem?
A.
High blood pressure is a more complex condition than most people suspect. There are several ways to lower blood pressure and that's why there are many different drugs to do so.
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Q.
What is uterine prolapse and how can it be treated?
A.
Uterine prolapse occurs when a woman's pelvic muscles and ligaments become weak, causing the uterus to drop from its normal position. Often women will notice symptoms like pelvic or back pain, vaginal pressure and sometimes incontinence. It's a common condition yet remains underreported because women are often embarrassed to discuss it or acknowledge that it is a normal part of aging.
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Q.
Can an obese person's heart muscle be thicker due to the fact that the heart has to work harder?
A.
When the muscles of the heart get thicker, it is usually a response to an external stimulus.
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Q.
What are the surgical options for breast cancer?
A.
"You have breast cancer" is a statement that every woman fears, yet 1 out of 8 women will hear at some time during their lifetime. Once the diagnosis is made, a woman needs to educate herself on current treatments and work with her doctor to determine which option is most appropriate to treat her type of cancer.
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Q.
I am a 56-year-old woman who goes to the gym three times a week. I was just diagnosed with supraventricular tachycardia (SVT). What are my treatment options?
A.
SVT is a term to describe any rapid heart rate that happens when your heart's electrical impulses go into an abnormal pattern.
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Q.
I am a 45-year-old man who is in relatively good shape. I work out
every other day and eat healthfully. Both my parents died from complications of heart failure. Is heart failure related to genetics or
to lifestyle?
A.
Heart failure is an extremely common condition, most frequently affecting those over age 65. In fact, whether you're 40 or 80, a man or a woman, you have a one in five chance of developing heart failure during your lifetime.
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Q.
I am 55 years old and starting menopause. What are the risks to my cardiovascular health if I take hormone replacement therapy?
A.
Prior to starting hormone replacement therapy, a woman and her physician should assess her cardiovascular risk.
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Q.
What is HNPCC?
A.
HNPCC stands for, "Hereditary non-polyposis colon cancer." Certain families have a much higher rate of developing colon cancer compared to the general population.
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Q.
I am interested in getting my spider and varicose veins removed. What are my treatment options and how long before I can wear shorts again?
A.
Varicose veins are veins close to the skin that are swollen, twisted, or stretched. Spider veins are a smaller version of the larger varicose veins.
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Q.
My best friend told me that cell phones cause cancer. Is there any real truth to this?
A.
Several correlative studies have been done including a recent one from Sweden of long term cell phone users, which found no increase in risk of gliomas and meningiomas (Am J Epidemiol. 2005).
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Q.
When is it safe to get an epidural during labor?
A.
According to the results of a study I led recently at Prentice Women's Hospital of Northwestern Memorial Hospital that included 750 women in labor, getting a spinal-epidural when the cervix is less than four centimeters dilated did not increase the cesarean delivery rate and provided significantly better pain relief.
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Q.
I have narrowing in my arteries and my physician has recommended an angioplasty, but I have heard that the stents do not last very long and my arteries will begin to narrow again. Is this true?
A.
Your question is a very good one. Until recently, some patients undergoing angioplasty with a regular stent had a 20-25 percent recurrence rate of blockages occurring -- referred to as restenosis.
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Q.
My father had a brain attack or brain aneurysm in October 1979. The location of the attack was in his right frontal lobe. He had major brain surgery, had a shunt installed and lived. He suffers from loss of present memory. This happened when my dad was 44 years old. My brother and I are in our early 40's. My question is, should my brothers and I be tested to see if we could possibly have such an attack and if so, is there anything we could do about preventing it?
A.
This is an important question and relates to a very large segment of our population. We know that certain factors predispose people to brain aneurysms: female gender, smoking, hypertension, and certain racial backgrounds including African-Americans. We also know that brain aneurysms clearly are inherited in many cases.
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Q.
My 52 year old brother had a heart attack and now has 'mild' congestive heart failure from the damage done to his heart. Is mild heart failure serious? Can it be controlled?
A.
Congestive heart failure is a common complication of a heart attack which if left insufficiently treated may be serious. However, the options for treatment have dramatically improved over the past decade. First, we now know that medications (ACE inhibitors and beta blockers) can improve not only the limitations of performing daily activities in such patients but also improve survival, quality of life and need for hospitalization. Additionally, new and extremely sophisticated pacemakers (biventricular) and implantable defibrillators (ICDs) further improve quality of life and survival.
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Q.
Can artificial discs be placed into your back for degenerative disc disease? How much physical therapy is recommended after the surgery?
A.
The artificial disc has been developed as a device to preserve spinal motion for the treatment of degenerative disc disease. There are several artificial disc designs under clinical investigation but only one, the Charité artificial disc, has obtained FDA approval.
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Q.
I recently fainted in a very embarrassing situation: I was standing up for my best friend's wedding, when I suddenly I felt flushed and woozy. I collapsed and awoke to the wedding party standing over me. They said I looked pale, but after sitting down for a few minutes I felt much better.
I fainted one other time: two years ago while donating blood.
I’m 32 and I've never had a heart problem before. Is this a dangerous situation?
A.
Fainting (or syncope) can be caused by several different kinds of problems, some potentially serious and others only dangerous because of surroundings or situation. While it is impossible to tell from your history alone what kind of fainting you have, there are some key features of your experience we can learn from.
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