Medical Mailbox

Medical Mailbox

Cory SerVaas

“Knowledge is power, knowledge is safety, knowledge is happiness.”

–Thomas Jefferson

Mom Saves Toddler’s Life with CPR

Joe and Lisa Huffine were Vacationing in Florida last March when tragedy nearly claimed the life of Patrick, their three-year-old son. As Lisa was putting their baby, Jack, down for a nap, Patrick wandered out of their friends’ home and fell into their swimming pool. An “eerie quietness” soon fell over the house, sending Lisa out to the pool to search for him.

“I looked and thought I saw a shadow, but then I realized it was Patrick,” Lisa remembered. “He was sinking–somewhere between the middle to the bottom of the pool.”

She jumped in after him, and once she got him out of the water, the former intensive-care-unit nurse started cardiopulmonary resuscitation (CPR) on her son. A neighbor called 911, and emergency medical personnel soon arrived.

Having been underwater for two to five minutes, Patrick was unconscious and needed full life support.

“The doctors really didn’t give us much hope,” Lisa explained.

But ten days and thousands of prayers later, the hospital released a healthy Patrick from its care.

“He came out with flying colors,” Lisa said. “He’s the same as he was before. They said his personality would be completely different, but his personality is exactly the same.”

Patrick Huffine owes his life, in large part, to the quick CPR his mother performed for him.

“If I wouldn’t have started CPR, he would have definitely never lived,” Lisa declared. “I think it’s really important that people know CPR. Actually, I think it should be a state law that everyone knows CPR.”

The American Heart Association and the American Red Cross offer CPR training courses to the public.

Cholesterol Concerns

Dear Dr. SerVaas:

I am confused about the “good” HDL and the “bad” LDL cholesterol. I am in my late 70s, have no health problems, and am on no daily medication.

In 1997, my HDL cholesterol level was 33. The Mayo Clinic doctors were not concerned about the reading, or at least it was not discussed. I recently had my cholesterol checked by my local doctor, and the HDL was still 33. This doctor said the reading was too low, and he wanted to recheck it in three months.

Is a reading in the low end of the “normal” range a concern? If so, how can it be increased?

Dwight Bishop Dewey, Arizona

In general, experts say that the HDL level should be 35 or greater. Here’s why:

LDL (low-density lipoprotein) cholesterol is called “bad” because pieces of it tend to accumulate along blood vessel walls. HDL (high-density lipoprotein) cholesterol is called “good” because it binds with LDL and returns it to the liver. If there are not enough HDLs to remove LDL deposits, blood vessels may become blocked, increasing the risk of heart attack and stroke.

A regular exercise program can help raise the HDL cholesterol level. Small amounts of alcohol may protect against heart disease by raising HDL cholesterol.

Cholesterol Tip

Dear Dr. SerVaas:

I just received a phone call from one of the women at my cardiologist’s office. It was about my annual lab test on my cholesterol. During the conversation, the subject of good and bad cholesterol came up. I think your readers will be interested in what she told me.

An easy way to remember good cholesterol and bad cholesterol is to use the first letter: HDL–H is for healthy cholesterol; LDL–L is for lousy cholesterol.

To me this is a lot easier to remember than which is “good” or “bad.”

Richard E. Eaves Chesapeake, Virginia

Help for Spasticity

Dear Dr. SerVaas:

A very dear friend of ours was diagnosed as having a form of spasticity affecting his legs. They have a tendency to tighten–the muscles get hard and stiff. He is taking Klonopin to relieve the stiffness, which doesn’t go completely away. He sometimes has to roll out of bed so he can get to his walker and get mobility in the legs. Is there anything else that might help? He also takes Lotensin and Ecotrin.

C. W. Segal Monee, Illinois

We sent your letter to Dr. Allison Brashear, assistant professor of neurology at the Indiana University School of Medicine. She responds:

“Spasticity is caused by overactivity of the reflexes that occurs when there has been damage to the brain or the upper part of the spinal cord, or in diseases such as multiple sclerosis or stroke.

“New treatments for spasticity include oral medications, as well as interventional therapy. Tizanidine [brand name Zanaflex] has recently been approved by the FDA and is similar to lioresal, which has been on the market for some time. Both medications are designed to loosen the overactive muscles.

“New interventions include placement of a pump in the abdomen that delivers lioresal directly to the spinal cord. This involves a surgical procedure and regular follow-ups.

“Lastly, injections of botulinum toxin type A (Botox) have been helpful for treatment of localized spasticity. Botox is made from Clostridium botulinum. The serum is injected directly into the overactive muscles and causes a localized weakness that lasts for up to three months.

“Your friend should seek the opinion of a specialist who treats patients with spasticity, such as a neurologist or a physician in physical medicine and rehabilitation.

“All of these modalities can provide effective therapy and help improve quality of life for patients suffering with spasticity.”

Saliva Problem

Dear Dr. SerVaas:

I am an 89-year-old woman. I suffer from a dry mouth. I have had this problem for several years. Now it is getting unbearable. I have dry stools, dry eyes, and ears. Any help would be greatly appreciated.

Sula Tippin Chicago, Illinois

Dryness of the mouth, called xerostomia, may be from dehydration, mouth breathing, use of diuretics or anticholinergic drugs, or it may reflect salivary gland dysfunction or disease. Severe mouth and eye dryness, as well as generalized dry skin, is sometimes the result of an autoimmune disorder called Sjorgren’s syndrome, a condition most commonly affecting older women.

Saliva is 99.5 percent water–enzymes, proteins, salts, and gases in solution account for the rest. Drinking plenty of water, at least 48 ounces daily, helps ensure adequate saliva production. Artificial saliva solutions help some people relieve dry mouth discomfort.

Salivary gland function may be tested by salivary flow studies, sialography (an x-ray of the salivary glands and ducts after injection of a dye), and salivary scintiscan (use of photography to evaluate salivary gland function after injection of a dye).

To contact the Sjogren’s Syndrome Foundation, call 1-800-475-6473 or visit their Web site at www.sjogrens.com.

Reader Remedies for Sties

Dear Dr. SerVaas:

In the May/June issue, Patty Hoben wrote about having sties. Please tell her my remedy:

Many years ago, a friend told me to use wet tea bags on my two children’s eyes for as long as they would lie still. The large sties returned only half as large each time and eventually went completely away. The tannic acid in the tea is much more effective than a salve.

Frances K. Fraser Otis, Oregon

Dear Dr. SerVaas:

In reading Patty Hoben’s problem concerning sties, I was reminded of an article that helped us many years ago. An article in a woman’s magazine (shortly after World War II) stated that sties on our servicemen’s eyes were treated with castor oil gently applied with a Q-Tip. The sties were treated as soon as the eye showed the redness or tenderness of a beginning sty.

I immediately told my sister-in-law about this, since she had always been plagued with sties. It not only cured what she had, but she has had no trouble since then–some 50-plus years. Our family swears by this remedy–used it on our children when they were younger. Hope this helps.

R. Niedzielski St. Charles, Missouri

Things To Do

* Talk to your doctor about getting a bone scan to measure bone density. A new portable device transmits sound waves–not x-rays–through the heel and analyzes the results in only about two minutes. Drugstores in Indianapolis recently offered screening with the innovative Sahara Clinical Bone Sonometer. Heel bone density is a good indicator of overall bone health and helps predict one’s risk for future fracture of the hip, spine, or wrist. Each year, osteoporosis leads to more than 300,000 hip fractures (shown above by dark, jagged lines). Adequate exercise, calcium, vitamin D, and possibly estrogen replacement therapy can help prevent osteoporosis.

* The best time to get a flu shot is in October and November, before the flu season hits. Everyone is at risk for contracting influenza. Annual vaccination is particularly important for the elderly and those with chronic health conditions. Those with egg allergies should not get the vaccine.

Aloe for Her Ulcerative Colitis

Dear Dr. SerVaas:

In March/April ’99 “Medical Mailbox,” there was a letter from a woman who was healed of ulcerative colitis by using a few herbs. I would like to tell you my experience with a different herb.

I had ulcerative colitis nine or ten years. After Watching a TV show about how a man and a boy were healed of digestive problems by drinking four ounces of aloe vera juice a day, I tried it. I drank one ounce of tomato, orange, or prune juice to three ounces of aloe vera juice every morning for 1 1/2 years.

When I went for my five-year sigmoidoscopy, the doctor said the results of the test showed I didn’t have ulcerative colitis anymore.

I had started out on the sulfa tablet, which didn’t agree with me, so I was put on Asacol. I took the pills right along with the juice and was on a nondairy diet and Metamucil.

I’m 85 years old now. I continue taking one ounce of aloe vera juice every day just as a preventive, and I’ve made a Metamucil square recipe. I make two-inch squares of Metamucil and take half of the square.

I am so thankful to be free of that health problem.

Mildred Hanes Charlotte, Michigan

She Raised Head of Bed for Leg Ache

Dear Dr. SerVaas:

For years I had night leg ache that kept me awake until 1:00 or 2:00 a.m. Recently the podiatrist advised raising the head of the bed. It was raised about two inches. The first night I had no leg pain and haven’t since then, except a few times for a short time. The same treatment has helped hiatal hernia and indigestion. It is wonderful to go to bed and be able to stay there. Your health information is great.

Grace Reid Worland, Wyoming

Painful Vision Problem

Dear Dr. SerVaas:

My 37-year-old son has been having severe headaches. After many tests, he has been diagnosed with binocular dysfunction and an esotropia problem. His left eye does not focus as fast as the right eye. He has never worn glasses, but he is now wearing “prism” glasses.

Can you tell me what this diagnosis means? Will he have to wear these glasses from now on? What causes this, and why did it just now occur? I would appreciate any information you can give me about this problem.

Peggy Gunnells Anniston, Alabama

Dr. Eugene M. Helveston, professor of ophthalmology at the Indiana University School of Medicine in Indianapolis, responds:

“It sounds like your son is having a problem of overconvergence, or crossing of the eyes. Overconvergence means that the eyes are unable to simultaneously focus on an object. This leads to eyestrain, which in medical terms is called asthenopia, or painful vision. Overconvergence can lead to double vision in some cases.

“Prism glasses can be of help in the short term, but it is often necessary to increase the prism over time. This can lead to a dependence on prism glasses. In some cases of adult overconvergence, surgery on the eye muscles is curative, and prisms are no longer necessary.

“Overconvergence is most often simply the eventual result of performing close-up work such as reading or sewing. It is less often the result of weak outpulling muscles, or improper glasses.

“An eye examination by an ophthalmologist with a special interest in strabismus and eye alignment problems will help determine the best course of action for your son.”

IBS and Interstitial Cystitis Information

Dear Dr. SerVaas:

I am a new reader of The Saturday Evening Post and have found your column to be very interesting. In the March/April ’99 issue, you responded to Velma Langston’s letter regarding irritable bowel syndrome (IBS). You referred to a report in the Journal of the American Medical Association which dealt with the findings of treating IBS with the use of Chinese herbal medicine. Would you please provide me with information on which issue that was and the name of the report?

On another matter, the May/June ’99 issue of The Saturday Evening Post carried an article entitled, “The Skinny on Fat: An Interview with Dale Guyer, M.D.” by Joan Durham. The latter part of the article states, “Other allergy tests are available through Serammune Physicians Labs and are used on patients with autoimmune illness, interstitial cystitis, and other problems.” If possible, I would like to contact Dr. Guyer’s office and the Serammune Labs, as I am in search of physicians in my area who are familiar with this type of testing for interstitial cystitis.

Georgia Nisich Kenosha, Wisconsin

Here is the information you requested:

* “Treatment of Irritable Bowel Syndrome with Chinese Herbal Medicine” was published in the November 11, 1998, issue of the Journal of the American Medical Association on pages 1585-1589.

* Dr. Dale Guyer may be contacted at the Center for Innovative Medicine, 1235 Parkway Dr., Suite B, Zionsville, IN 46077, 317-733-5433.

* Serammune Physicians Labs are located at 1890 Preston White Dr., #201, Reston, VA 22091, 800-553-5472.

* Referrals to local physicians and support groups are available through the Interstitial Cystitis Association, P.O. Box 1553, Madison Square Station, New York, NY 10159, 212-979-6057, www.ichelp.com.

A 1998 pilot study suggested that the common yeast Candida albicans plays a role in interstitial cystitis. Dr. Philip Mosbaugh in Indianapolis and Dr. William G. Crook in Jackson, Tennessee, are doing research in this area.

Help for Erectile Dysfunction

Dear Dr. SerVaas:

I have had prostate surgery, and now I am unable to reach climax. I underwent surgery to have a Mentor implant, but so far it has not helped. I am writing to ask if there is such a thing as getting a new prostate gland from a donor.

I am 64 years old and feel the sexual part of my life should not be over. If you have ever heard of such a procedure, I would like to know more about it.

We are not aware of any research being conducted on prostate gland transplants. Unfortunately, up to 30 percent of patients whose surgeons use even the newest nervesparing technique to remove part or all of the prostate gland will be unable to achieve an erection adequate for satisfactory sexual function.

There are a number of treatments for erectile dysfunction, known commonly as impotence. In clinical trials, Viagra (sildenafil citrate) oral tablets improved erectile dysfunction in 43 percent of radical prostatectomy patients compared to 15 percent on placebo. The prescription drug MUSE (alprostadil) can be injected through the skin of the penis or inserted into the urethra to produce an erection. Inflatable penile implants, such as the Mentor prosthesis you mentioned in your letter, and vacuum devices are often helpful.

Erectile dysfunction affects as many as 30 million American men and their partners and can also be caused by vascular and neurological diseases, diabetes, spinal injury, and certain prescription drugs.

Smoking and Impotence

Medical experts say smoking is one of the leading preventable causes of impotence. Recent studies indicate that male smokers are about twice as likely as nonsmokers to suffer from impotence.

If you have teenage boys who smoke, tell them they are playing Russian roulette with their sex lives. Smoking can adversely affect the circulatory system–an essential component of normal male sexual function. The condition is sometimes reversed by quitting smoking, especially in men under the age of 60.

Last fall, Thailand became the first country in the world to have impotence warnings printed on the side of cigarette packets.

RELATED ARTICLE: Medical Progress

The FDA is reviewing a watch-sized blood glucose monitoring system that measures blood sugar every 20 minutes without a skin prick. The GlucoWatch (Cygnus, Inc.) uses a mild electric current to extract fluid from under the skin. Glucose in the fluid is measured by sensor pads that are replaced daily. An alarm sounds if glucose levels get too high or too low.

The FDA recently concluded that foods containing soy protein, as part of a diet low in saturated fat and cholesterol, may reduce the risk of coronary heart disease by lowering LDL cholesterol. New soy protein drinks, including Balanced from American Natural Snacks, can help health-conscious consumers increase their intake of soy protein.

A small, implantable device has been FDA approved to treat several types of bladder control problems. InterStim Therapy (Medtronic, Inc.) delivers mild electrical stimulation to the nerves that control bladder function. In clinical trials, the new treatment option was highly effective in treating urinary urge incontinence, urinary retention, and significant symptoms of urgency and frequency.

A new study shows that hepatitis C-infected livers can be used for hepatitis C-infected transplant recipients. Researchers at the University of Pittsburgh Medical Center found that one- and five-year survival rates were comparable to patients receiving healthy livers. The finding may help ease the current severe shortage of donor livers. Hepatitis C is the leading cause of liver transplantation in the United States. (See “Living with Hepatitis C,” page 28.)

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