Archive for the ‘Ask Dr. H’ Category

Ask Dr. H: Eggs safe to eat weeks after expiration?

Q: How long is it safe to keep eggs in the refrigerator before they need to be discarded? — P.W., Jackson, Mich.

CHRIS HUNT / AJC Special

CHRIS HUNT / AJC Special

A: According to the Food Safety and Inspection Service of the U.S. Department of Agriculture, eggs in the shell will maintain freshness for three to five weeks beyond the carton’s stamped expiration date, provided that you keep them refrigerated at a temperature of about 40 degrees Fahrenheit.

A hard-boiled egg should be used within a week. It’s a good idea to use a refrigerator thermometer to accurately set the temperature. The last date of sale stamped on a carton from a USDA-inspected egg facility cannot exceed 30 days after the pack date.

Every carton of eggs has a stamped “Julian date,” a three digit number corresponding to the day of the year the eggs were packaged. For example, June 27 is the 178th day of the year.

Another point about freshness: Placing an egg in a glass of water will identify the freshest eggs. An egg that …

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Ask Dr. H: Medical issues could cause chilly feeling

Q: I feel uncomfortable when the temperature drops to 65-70 degrees. I have to reach for a warm sweater or heavy blanket at night. Is there something wrong with me?

Andy Sharp/AJC Special

Andy Sharp/AJC Special

A: Certain underlying medical problems like anemia, iron deficiency or a sluggish thyroid can cause a person to feel abnormally cold, but there’s also a good possibility that there’s nothing at all wrong with you. If you’re thin, you’ve got less body fat to contain the heat. Just as those who are overweight may complain of the heat, those who are lean tend to complain more of feeling cold.

I’d suggest a medical work-up, including a TSH blood test to check for an underactive thyroid, a complete blood count to look for anemia or infection, iron studies to look for deficiency and a test for adrenal gland function if a problem is suspected.

Dr. Mitchell Hecht is a physician specializing in internal medicine. Send questions to him at: “Ask Dr. H,” P.O. Box 767787, Roswell, GA 30076. Because of …

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Ask Dr. H: Medication costs spur substitutions

Q: I recently saw a TV story about “therapeutic substitution.” It concerns me that the prescriptions my doctor gives me may be switched without my knowledge. How does this happen? — G.E., Atlanta

A: The practice of “therapeutic substitution” means that a pharmacy can substitute a specific medication of the same class with a similar drug of “comparable” efficacy. This does not typically occur without your physician’s knowledge, but it does sometimes happen despite his objections. Hospitals are the most common setting for the practice of therapeutic substitution, done as a cost-saving measure to the patient, the insurer and the hospital. In the vast majority of cases, the change does not adversely impact the health of the patient.

For a small percentage of folks, such changes matter a great deal. Substitution of one “SSRI” antidepressant for another could destabilize one’s mental health. Substitution of a short-acting generic alternative for the longer-acting branded version …

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Ask Dr. H: Alcohol affects brains
 of heavy drinkers

Q: Can you explain why alcohol causes seizures? Do the seizures stop once the person quits drinking? — T.H., Lima, Ohio

A: The breakdown of alcohol results in the production of morphine-like substances that accumulate in all tissues, but especially the brain. In 80 percent of alcoholics, it lowers the levels of certain chemical transmitters in the brain, causing sleepiness and sedation. Withdrawal in these folks leads to a hyperactive brain response: tremors, panic attacks, palpitations, blood pressure elevation and seizures. In the other 20 percent of alcoholics, alcohol has the opposite effect: It actually raises the levels of certain chemical transmitters in the brain. Some of these transmitters are the same ones that antidepressants help to elevate.

Seizures, shakes, sweats and hallucinations don’t usually occur in the casual drinker; rather, they occur after 12-24 hours in the heavy, chronic drinkers. Since their bodies have become accustomed to alcohol, if they stop …

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ASK DR. H: What is best cure for nail fungus?

Q: Could you please tell me how to get rid of toenail fungus? — T.D., Wilkes Barre, Pa.

iStockphoto.com

iStockphoto.com

A: Toenail fungus is a very stubborn problem. Fungi enter the nail either through the cuticle or under the tip of the nail. They easily attack the nail, thriving off “keratin,” the nail’s protein substance.

When the tiny organisms take hold, the nail may become thickened, yellow-brown in color and foul smelling.

To get rid of toenail fungus, the best treatment is a three- to four-month course of an antifungal pill like Sporanox or Lamisil. Over-the-counter antifungal sprays and creams just don’t work. Antifungal nail paints like Penlac are not very effective but may be of additional benefit when combined with antifungal pills.

Aggressive debridement of nail fungus by a podiatrist followed by antifungal pills seems to provide additional benefit over antifungal pills alone.

The PinPointe laser system is a new option in treating nails refractory to standard treatments.

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ASK DR. H: Migraine that’s not in the head?

Q: My niece’s 3-year-old twin son suffers from abdominal migraines. His twin sister does not get them. There doesn’t seem to be a pattern as to when he’ll get sick. My niece says my mother suffered from migraines when she was living. Can you tell me more about these migraines? Are they hereditary? — J.N., Kennesaw

A: Most of my readers would be surprised to learn that there’s a type of migraine generally seen in young children that doesn’t cause a headache, or even involve the head. This uncommon “headless” migraine event is called an abdominal migraine.

It’s a difficult diagnosis to make because its symptoms — dull abdominal pain around the belly button region, nausea, vomiting, loss of appetite and occasional facial flushing — are often attributed to other things.

About 10 percent of healthy school-age kids will at some time experience recurrent episodes of abdominal pain. In only 10 percent of those kids is a medical problem actually found. Because of the difficulty in …

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ASK DR. H: Heart screening vital for athletes

Q: Recently, two young athletes died from sudden cardiac death. Can you explain what caused their heart condition? Why can’t sports teams screen their prospective athletes to prevent it?
— B.R., Orlando

A: The recent deaths of Chicago Bears defensive end Gaines Adams at age 26 and Southern Illinois basketball center Jeron Lewis, 21, presumably from sudden cardiac death, underscore the importance of identifying this potentially deadly medical condition during a player’s pre-participation medical evaluation.

Gaines Adams, a defensive lineman for the Bears who was an all-American at Clemson, died Sunday, Jan. 17, 2010, in South Carolina, the Bears said. He was 26. AP Photo/Daily Herald, Paul Valade,file

Gaines Adams, a defensive lineman for the Bears who was an all-American at Clemson, died Sunday, Jan. 17, 2010, in South Carolina, the Bears said. He was 26. AP Photo/Daily Herald, Paul Valade,file

Sudden cardiac death results from a lethal heart arrhythmia induced by abnormal thickening of heart muscle. This disorder of heart muscle cells is called hypertrophic cardiomyopathy, or HCM, and is due to a genetic mutation. It’s estimated to affect one in every 500 Americans; …

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ASK DR. H: Disease causes weak muscles

Q: My sister-in-law was diagnosed with myasthenia gravis. What is this disease and what can be done to combat it?
— L.F., Macon

A: Myasthenia gravis is a chronic, auto-immune disease where the person’s body inappropriately attacks the nerve-muscle junctions as though they were foreign invading tissues, leading to an abnormal weakness of voluntary muscles.

The weakness in myasthenia gravis improves with rest and worsens with activity.

The muscles of the eyelids and eye itself are generally affected earliest in the disease course. Weakness occurs when the nerve impulse does not adequately reach the muscle cells. Eyelid droop and double-vision often result.

Other muscles that may be affected include those of the neck, arms, shoulders, hip muscles, diaphragm and legs.

Myasthenia gravis occurs in all races, in both sexes and at any age. It affects roughly three of every 10,000 people. There’s no way to prevent its occurrence.

Although there’s no cure, there are treatments …

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ASK DR. H: Arnica gel safe for soreness

Q: Have you had any experience using arnica gel on bruises and sprains? A friend recommended it, and I think it works as well as Aspercreme on my sore muscles. — R.F., Atlanta

A: Arnica gel is an herbal preparation rubbed into the skin for the treatment of sprains, strains and bruises. The mechanism of
action of arnica is through compounds in the arnica plant’s roots that cause blood vessel dilation of the tiny capillaries just under he skin.

The increase in blood flow theoretically promotes quicker healing and resolution of bruises.

Although anecdotal experience is sizable, clinical evidence of its efficacy is thin.

When used topically in a gel preparation, arnica was found (in a small study) to have the same effect as the use of topical ibuprofen cream in treating the symptoms of osteoarthritis of the hands.

Another small study (19 patients) published in the August 2002 issue of Dermatologic Surgery found that the application of topical arnica had no better effect …

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ASK DR. H: Dander root of pet allergy

Q: Why is it that I’m so allergic to cats but not to dogs? — J.W., Birmingham

People tend to be more allergic to cats because of their dander. AP Photo/ 24/7 Media, Suzanne Mapes

People tend to be more allergic to cats because of their dander. AP Photo/ 24/7 Media, Suzanne Mapes

A: The answer, in a word, is dander. The trigger for pet allergies is not their hair. In fact, cats that are short-haired traditionally give off more allergen. Protein in the skin of pets triggers allergies in susceptible people. It flakes off their dry skin, gets in their fur as dandruff and spreads when the pet grooms itself with its tongue.

Veterinary research has shown us that twice as many folks have cat allergies as dog allergies. It may be that the protein in a cat’s skin is more allergy provoking than a dog’s or simply that cats give off a greater quantity of dander.

Because dander collects in carpeting, the fabric of furniture and in bedding, it’s better for those who suffer from pet allergies to have hardwood or tile floors and leather furniture. If you have carpeting, steam cleaning it …

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