Archive for the ‘Ask Dr. H’ Category

ASK DR. H: Breast lump linked to Zocor?

Q: I’m a 38-year-old man who saw the doctor a couple of months ago because of a tender lump in my right breast area. After bloodwork and a mammogram came back normal, he sent me to a surgeon. The surgeon thought that the Zocor I was taking for my cholesterol might have caused it. After being off the Zocor, the area does seem to be much less tender and smaller. How often does this happen from statin drugs? — S.C., Woodstock, Ga.

A: It’s not all that common, but statin cholesterol drugs and fibrate triglyceride-lowering drugs can cause “gynecomastia,” the development of increased breast tissue in a man. The exact reason why they can cause gynecomastia is unclear, but it’s believed that in some folks, the effect of these drugs on the cholesterol-forming pathways in the liver extends to the male sex hormone-forming pathways. This creates a hormonal imbalance between testosterone and estrogen. An interesting observation is that switching a patient from one statin …

Continue reading ASK DR. H: Breast lump linked to Zocor? »

ASK DR. H: No basis for copper claim

Q: I’ve been wearing a copper bracelet for the past year because it helps my arthritis. Can you tell me how it works? — G.P., Mountaintop, Pa.

A: I’m glad that you’re finding some pain relief from wearing a copper bracelet.

They’ve been used for hundreds of years to relieve joint pain, and there are even some animal studies that show taking copper supplements by mouth can decrease arthritis progression.

Unfortunately, the pain-relieving benefits of wearing a copper bracelet have not held up to scientific scrutiny, and claims to the contrary are anecdotal.

The first randomized placebo-controlled (where neither the researcher nor the study participant knew whether a copper bracelet or a sham bracelet was being worn) study on the use of copper and magnetic bracelets was published in the Oct. 12 issue of Complementary Therapies in Medicine.

The researchers concluded that there was no meaningful difference between the copper bracelet and the sham bracelet in terms …

Continue reading ASK DR. H: No basis for copper claim »

ASK DR. H: Needle biopsy should be ‘gold standard’

Q: Three months ago, I had a breast biopsy that fortunately turned out to be benign (not cancer), but now I’m left with a scar that I’m not happy about. I was too scared at the time to ask questions, but now I’m wondering why the surgeon didn’t just do a needle biopsy. Can you tell me why? – S.R., Sarasota, Fla.

A: I cannot comment on your specific breast mass, but there are very few instances where an open surgical biopsy would be needed as the initial diagnostic procedure.

In fact, a panel of leading breast surgeons at the 2009 International Consensus Conference on Image Detected Breast Cancer III unanimously agreed that needle biopsy should be the “gold standard” for the initial diagnosis of breast abnormalities.

Dr. Melvin Silverstein, chairman of 2009 International Consensus Conference, commented that since only 15-20 percent of abnormalities found by mammography turn out to be cancer, a significant number of women with benign lesions are undergoing unneeded …

Continue reading ASK DR. H: Needle biopsy should be ‘gold standard’ »

ASK DR. H: Cause of foot pain can be elusive

Q: Could you tell me why the bottom of my feet burn and throb at night? I’m 85 years old, and take Synthroid, Diovan, Zocor, Coreg CR, Actonel and a baby aspirin. — D.M., Mableton, Ga.

A: It’s difficult to say for certain why you’ve got nighttime foot pain (a form of peripheral neuropathy), but your list of medications does not point to poorly controlled diabetes as the cause. Sometimes the cause can be found (e.g., herniated disc, compression fractures in low back as a consequence of osteoporosis); other times it remains elusive.

It’s important to search for a possible cause among the 100 types of peripheral neuropathy — especially if it’s due to a form of neuropathy that’s reversible. I’d recommend a thorough work-up with a neurologist.

Through examination and testing, you’ll know whether your condition is treatable with pain medications, steroid epidural (spinal) injection or surgery.

Nerve pain like you have may not be curable, but it can be relieved by …

Continue reading ASK DR. H: Cause of foot pain can be elusive »

ASK DR. H: Bad air can increase risk of heart attack, stroke

Q: Last year, you answered my question about air pollution and its effects on the athletes competing at the Beijing Olympics. Can you comment on a news story I just heard on how air pollution right here at home can increase our risk of heart attacks? –S.K., Philadelphia

A: The news story you heard are the findings of a University of Michigan study just published in the September issue of Hypertension.

The deleterious effects of air pollution on our lungs are well known; now researchers have shown that the microscopic particles in air pollution can get into the bloodstream, causing a rise in diastolic (resting heart) blood pressure and an impairment of endothelial function (critical factors that help arteries to relax or dilate to allow maximal blood flow).

Roughly one-third of Americans have high blood pressure, a known risk factor for stroke, heart attacks, congestive heart failure and chronic kidney disease. For those with underlying coronary artery or peripheral vascular …

Continue reading ASK DR. H: Bad air can increase risk of heart attack, stroke »

ASK DR. H: Essure is a minimally invasive form of birth control

Q: I’m a 35-year-old mother not interested in having any more children. I don’t want to use an IUD or take birth control pills. My husband does not want to have a vasectomy. I saw my ob-gyn last week and she mentioned a new procedure called Essure that she says is much easier to do than a tubal [ligation] and can be done right in her office. I didn’t think to ask her how effective it is compared with a tubal [ligation]. Do you recommend the Essure procedure? — T.M., Marietta

A: Essure was approved by the Food and Drug Administration in late 2002 as a minimally invasive way of performing permanent, nonreversible female sterilization. Unlike a tubal ligation, it does not require general anesthesia and can be performed in your doctor’s office.

The technique is rather simple: Thin, flexible metal inserts are placed into the fallopian tubes using a catheter. Once these inserts are in place, they induce tissue to grow in and around the micro-insert to form a permanent …

Continue reading ASK DR. H: Essure is a minimally invasive form of birth control »

ASK DR. H: Mercury contamination and high fructose corn syrup

Q: A friend of mine told me that certain foods made using high fructose corn syrup may be contaminated with mercury. What are those foods? Why isn’t the FDA doing something about it? – V.W., Philadelphia

A: What you’re referring to is a study published in the Jan. 26, 2009, issue of Environmental Health that found mercury (a known poison to the brain and nervous system) contamination in nine out of 20 foods containing high fructose corn syrup.

High fructose corn syrup has largely replaced cane sugar in many foods we eat every day, ranging from soft drinks to ketchup. The research was actually conducted in 2005, and representatives from the Corn Refiners Association say that high fructose corn syrup (HFCS) manufacturers have stopped using mercury in production years ago.

Why would mercury be used at all? Apparently, some HFCS manufacturers use or have used a mercury-based caustic chemical to separate corn starch from the corn kernel. And while the Corn Refiners …

Continue reading ASK DR. H: Mercury contamination and high fructose corn syrup »

ASK DR. H: ‘No scar’ procedure shows promise

Q: What can you tell me about “no scar abdominal surgery?” Why aren’t more doctors doing it? – F.H., Huntsville, Ala.

A: The surgery you’re describing is not yet “ready for prime time,” although it definitely shows promise as an alternative to a number of laparoscopic and traditional abdominal surgeries. It’s called NOTES, an acronym for Natural Orifice Transluminal Endoscopic Surgery.

NOTES eliminates the need for traditional incisions and, for the right type of patient, results in much less painful surgery with a much more rapid recovery time. Two examples of NOTES surgery are a transvaginal appendectomy and a transvaginal cholecystectomy (gall bladder removal), where a small incision is made through the vaginal wall to gain access to the abdominal cavity and its organs. Each requires only two small incisions — one in the abdomen and one in the vagina.

Another surgical area where NOTES surgery holds tremendous promise is bariatric weight loss surgery. …

Continue reading ASK DR. H: ‘No scar’ procedure shows promise »

ASK DR. H: Twins can have different fathers

Q: I know someone who is fostering twin infants that they believe may have different fathers. I never knew that something like this could even be possible. How rare is it? — F.W., Roswell

A: It’s very rare — roughly a one in a million occurrence. There are just a few DNA-verified cases around the world. Closer to home, a couple from Dallas was perplexed that their twin infants had very different facial features. The mother’s concerns that something just wasn’t right prompted DNA testing of the children. The test results from Clear Diagnostics DNA Lab confirmed their suspicions: The twins were half-brothers from different fathers.

The mother’s infidelity led to a rare double conception where sperm from two men fertilized two eggs. The medical explanation is that there is a 24- to 48-hour period during ovulation when this can occur.

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

Continue reading ASK DR. H: Twins can have different fathers »

ASK DR. H: Screening guidelines change

Q: I’m a 65-year-old woman who developed breast cancer two years ago. I had a colonoscopy five years ago, which was normal. In light of my recent breast cancer, I wanted to have another colonoscopy because I was under the impression that I’m now at greater risk of colon cancer. However, my gastroenterologist said that Medicare doesn’t consider me to be at higher risk and won’t pay for a colonoscopy until I’m 70. Is that right?  — J.L., Roswell, Ga.

A: For years, the guidelines for colon cancer screening were that if a person had a personal history of breast, ovarian or uterine cancer he or she was considered to be at increased risk of getting colorectal cancer. But recent studies have shown differing opinions on whether there really is a heightened risk.
There is not yet a consensus of opinion on this — despite the Medicare guidelines.

The following are clear risk factors for colon cancer: Age over 50; personal history of precancerous colon polyps; personal …

Continue reading ASK DR. H: Screening guidelines change »