Medical Weblog

FLIPPER’S CHOICE

1 lb. low-fat fish fillets pepper garlic powder basil oregano onion powder

1 sweet red pepper

1 can tomato sauce (no salt added)

Wash and dry fish fillets, cut into 2-inch strips. Place in baking dish; sprinkle on all the spices. Wash and slice red pepper, and place slices on top of fish. Pour tomato sauce over fish. Bake 10 minutes at 375° without turning.

Serves 2.

MILK FISH

4 6-oz. snapper or perch fillets 1/2 cup nonfat milk tarragon dillweed onion powder paprika

Preheat broiler. Dip fillets in milk, place in shallow baking dish and sprinkle with tarragon, dillweed, onion powder and paprika to taste. Broil about 3 inches from the heat source for 3 to 4 minutes, basting once with drippings. Turn, baste and sprinkle with additional herbs if desired. Broil 3 to 4 minutes longer.

Serves 4.

PASSYUNK FISH

2 onions

2 lemons

3 garlic cloves, minced 1 cup celery

1 small eggplant 1 large tomato 1 small can tomato paste, with water to make 11/2 cups 1/2 tsp. cumin 1 1/2 lbs. low-fat fish

Preheat oven to 350°. Wash vegetables. Thinly slice onion and lemon, chop garlic buds and celery, dice eggplant and slice tomato. Use a heavy pan to saute onions and garlic in water. Add celery and eggplant, tomato paste, water and spices. Cook about 10 minutes. Spread half the resulting sauce in a baking dish, put in fish; top off with remaining sauce, lemon and tomato slices. Cover dish and bake about 20 minutes. Uncover; cook 5 minutes more. Serve with brown rice.

Serves 2 to 3.

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Cholesterol: Leave It to Nature

Cholesterol is a “good/bad” item: good because it’s essential for life, bad because it’s associated with clogged arteries and heart disease.

Here’s the general rule I explain to my patients: Your body is very good at making all the cholesterol it needs. You don’t have to help it out by eating a lot more. In fact, you really don’t have to eat any cholesterol at all.

But eat it we do, in large amounts. Working hand in hand with fat, cholesterol plugs up arteries, especially the tiny arteries that supply the heart muscle and brain. When those arteries close up, some or all of your heart or brain will die.

The Pick-Me-Up That Lets You Down

Caffeine is another food item you can do without. Many studies have linked caffeine to irregular heart rhythms, increased blood pressure, heart disease, anxiety, the heartburn of gastritis and esophogitis, peptic ulcers, digestive problems and cancer. Ironically, the caffeine we drink to give us a lift eventually does the opposite. Caffeine gets your heart beating faster and increases your blood sugar. That’s what gives you the lift. Your body then reacts to the sudden energy surge by gathering up all the blood sugar it can and stuffing it into your cells. Too much sugar, however, is often gathered up. Now your blood sugar is low; you feel fatigued and want another cup of coffee. For many of my patients, every day is a cruel cycle of fatigue, coffee, brief lift, fatigue, coffee, brief lift, fatigue.

That’s why I call caffeine the pick-me-up that really lets us down, overstimulating our heart and muscles at the same time. It just makes trouble for our “doctor within.”

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The most important thing to do to prevent damage to your gums and your remaining teeth if you wear dentures is to go for regular dental checkups so your dentist can detect any tiny changes that occur in the fit of the dentures and make appropriate adjustments. It’s important to see your dentist immediately upon noticing any change in the way your dentures fit. And, as your bone structure changes over the years, your dentist will occasionally need to make a new denture for you.

The abrasion of the denture against your bone and the resulting irritation may occasionally result in an infection of the soft tissue of the gum. If this occurs, your dentist will prescribe an oral solution of antifungal medication such as nystatin suspension or Mycelex troches, lozenges that you’ll slowly dissolve in your mouth. Both should be taken three to five times a day for a week or two to totally clear up the infection.

Tips and Precautions

Some people sleep with their dentures in, but this can aggravate and speed up the deterioration of gum and bone tissue. Your gums need a break from the pressure the dentures place on them. That’s why it’s important to clean them thoroughly each night and to store them in a glass of water each night to prevent them from warping.

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Description and Possible Medical Problems

If hitting the buzzer on your alarm clock each morning does nothing to relieve the constant ringing or buzzing in your ears, you probably have tinnitus. And you have probably lost some of your hearing as a result of the aging ear.

Tinnitus is a ringing in the head. It is usually caused when the arteries in the ear—like elsewhere in the body—begin to narrow; as a result, the ear “hears” the blood rushing through the ear. And sometimes a person with tinnitus can hear his own heartbeat. Regardless of the particular sound, however, tinnitus tends to get worse at night, when there is a lack of sounds to drown it out. And some people may feel they need to seek psychological treatment, because the constant sound can begin to drive them crazy.

Treatment

It’s sometimes difficult to pinpoint the sudden onset of tinnitus, since the cause can be due to an infection or obstruction, or to an underlying disease such as anemia or arteriosclerosis. If you have tinnitus, it’s important for you to see a doctor to rule out the possibility of a serious disease.

To diagnose tinnitus, your physician will go through an elimination process. Sometimes the culprit is as simple as removing an accumulation of earwax, which is the first thing she will check for. Next, she will test your hearing with a tuning fork to see if you have a problem hearing it. She will also do a neurological exam to check your coordination and balance, and if she finds that you have lost some degree of control over your balance in addition to having a significant hearing loss, you will be referred to a hearing specialist.

It might be a good idea to eliminate caffeine, alcohol, and cigarettes, since these can frequently aggravate tinnitus. People with constant tinnitus find that playing the radio at night helps drown out the ringing enough so they can fall asleep. Others have found that a sound machine that emulates water can help mask the ringing, as can a fan or air conditioner. Or, if you live in the city, just open the window. Often, a standard hearing aid will help ease the ringing of tinnitus because it decreases the internal buzzing and amplifies external noise.

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If you’re one of those people who develop a mild case of cataracts and your vision remains relatively stable, your doctor may suggest that you do nothing for the time being. She may prescribe special eyedrops, which will enlarge the pupil and thus reduce the effect the cataract has on your vision, and take a wait-and-see approach. But if the cataracts develop and begin to hamper your eyesight, the only treatment is surgical removal.

Because cataract removal is such a common and relatively simple procedure, the surgery can be done under local or general anesthesia on an outpatient basis. During the operation, the lens of the affected eye is removed and a new, artificial lens is inserted in its place. The surgery takes about an hour, and the new lens may negate the need for glasses or contact lenses, since the surgeon can tailor a lens so that it will be the only corrective lens you’ll need.

My mother had her cataracts removed several years ago, and after the surgery she had to wear an eye patch for about a week. The family arranged for my sister to stay with her during that time, because we were concerned that she might fall because of her temporary loss of vision. Three weeks later, she was back to driving her car without wearing glasses.

For some people, however, a lens implant is unwise because of the shape and structure of the eye. In this case, when the lens is removed and no artificial lens is inserted, you will become farsighted. However, this condition can be corrected with eyeglasses or contact lenses.

Cataract removal with or without lens implantation will improve most people’s vision. Sometimes, however, the eyesight will remain poor. In this case the problem may lie with the retina, and your doctor will be able to treat this condition as well.

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Description and Possible Medical Problems

If you have had trouble focusing your eyes lately, you should check to see if other symptoms are present. You should also ask yourself whether the focusing problem has come on suddenly or has appeared gradually. If your inability to focus appears all of a sudden, the problem is frequently just one of several symptoms—such as redness and irritation—that signal a temporary eye disorder such as conjunctivitis, the inflammation of another part of the eye, or a corneal ulcer.

Treatment

If you’ve only recently noticed that you find it difficult to focus easily, the problem is usually easy to fix. Maybe all you need is to have the strength of your glasses or contacts increased. Deterioration of vision is a given for most midlife adults, but the good news is that after the age of 65, usually no further vision loss takes place. In fact, some people have discovered that the shape of their eyes has changed in such a way that they don’t have to wear glasses at all. If, however, your inability to focus has appeared suddenly and your eyes are red and painful, you probably have an eye infection, and you should see your eye doctor to clear it up. For treatment details, see “Discharge with Redness” above.

Rest assured that if you’re having trouble focusing and it’s not accompanied by any other eye problem, it’s a normal sign of aging and is usually nothing to worry about.

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When you feel a pain in one or both eyes, it is usually one of several symptoms that accompany other eye problems. However, when it appears by itself and is accompanied by redness, it is usually due to an inflammation of one of the parts that make up the eyeball. Just as conjunctivitis, or pinkeye, is an inflammation of the conjunctiva (the membrane that lines the insides of the eyelids and part of the eyeball), other parts of the eye can also become inflamed. These include the iris, which is the colored part of your eye, and the sclera, a transparent film that serves as the outermost layer of the eye.

The choroid is located in the back of the eye, between the retina and the sclera. The choroid is the layer of the eye that contains the many blood vessels that nourish the eye, and, like the other parts of the eye, the choroid can become inflamed.

Iritis, or inflammation of the iris, is sometimes known as uveitis since the iris is part of the uvea, a membrane that lies just underneatl the sclera. The retina at the back of the eye can also become irritated.

Some of these conditions—such as scleritis—are more likely t( appear in a person who has rheumatoid arthritis, while others may arise for no apparent reason. Because it will be difficult for you to detemint – the cause of the pain yourself and the only symptom you’ll have is gen eralized pain in your eye with perhaps some redness, it’s important that you see your doctor.

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The aging process can be especially noticeable in the area around your eyes. That’s because the skin around your eyes is thinner and more delicate than on any other part of your body. To slow the aging process in the area around your eyes you must do everything you can to protect the entire area— including your eyelids.

There are several routine factors that cause wear and tear around your eyes. By avoiding or minimizing these factors you can maintain your smooth, youthful skin, and, in effect, a youthful appearance around your eyes.

1) Friction— done often enough, even a minimal amount of rubbing can cause injury to the skin around the eyes. That’s why it is important that you avoid, as much as possible, the common habit of rubbing your eyes, especially when they feel tired or sleepy. Rubbing your eyes in such a manner causes friction and could produce or worsen bags under the eyes because the skin stretches. Often, people who rub their eyes frequently, end up looking weary even when they are not.

2) Applying and removing makeup— the application and removal of certain kinds of eye makeup can also cause stretching, and lead to the appearance of “tired eyes”. Whenever eye shadow or eye liner is applied and whenever makeup remover is used to remove waterproof mascara and liner, the skin is bound to be stretched. Some cosmetic consultants recommend that you use only an eye-brow pencil and non-waterproof mascara on the area around the eye, except on special occasions. Neither product involves the application or removal of cosmetics to and from the skin, and both come off easily at the end of the day with just a little soap and warm water.

3) Squinting— even a natural adaptive response such as squinting can eventually help make you look older. Most people squint instinctively as protection against excessive light. You are also likely to squint when you are trying to focus on something you are not able to see very well. While it may seem rather innocuous, such squinting simply “engraves” squint lines, or crow’s feet, around your eyes.

The best way to prevent squinting and the resulting damage to the skin around your eyes, is to wear tinted glasses to protect your eyes against bright light while you are outdoors, and glasses or contacts indoors or out to correct any vision problems.

Since wind and extremes of temperature compound the damage caused by chronic sun exposure, wearing glasses can also provide a shield against the elements. Even if you wear contact lenses for general use, it’s a good idea to have a pair of tinted or plain glasses on hand to wear whenever you go outside to help prevent the signs of aging around your eyes.

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You don’t have to be an athlete to contact this common skin condition in which the skin between the toes becomes itchy and sore. Sometimes the skin will crack and peal away and, on occasion blister. The culprit is a fungal infection which thrives in warm, moist conditions. Sweaty footwear is often the breeding ground for this painful and annoying foot menace.

Here are some suggestions on how to prevent athlete’s foot and how to treat it once you’ve got it:

1) Buy two pairs of shoes— if possible, never wear the same pair of shoes day after day. It normally takes shoes at least 24 hours to dry out completely. You can also try keeping the insides of your shoes dry and clean with frequent use ol antifungal powder or spray and by wiping them with a disinfectant, such as Lysol, occasionally. Shoes that allow evaporation of moisture are best.

2) Change your socks— if your feet have a perverse tendency to perspire a lot, it’s a good idea to change your socks two or three times a day— cotton socks are best. To prevent the organism from breeding, it’s important that you make its living conditions as inhospitable as possible—clean and dry.

3) Dry your feet— after a shower or a bath, make sure your feet are allowed to dry thoroughly before you put them into shoes and socks. Once you’re sure your feet are dry, apply powder to help them stay that way.

4) Don’t go barefoot in public— you can help reduce the risk of contracting athlete’s foot by wearing slippers and/or shower shoes whenever you are in places where other people often walk around barefoot— swimming pools, health clubs, spas, gyms, locker rooms, and so on.

5) Wash your feet— once you have it, careful hygiene is often treatment enough, without having to resort to drugs. At least twice a day, you should wash the space between your toes with soap, water and a cloth. Be sure to dry the infected area thoroughly with a towel— especially the painful area between the toes. And always put on clean, dry socks.

6) Try aluminum chloride— a twice-daily application of a 30 percent aluminum chloride solution is often effective treatment because of its drying and antibacterial properties. Have your pharmacist make up the solution and use a cotton swab to apply it between your toes at least two times a day. Continue the treatment for two weeks after the condition has cleared up.

7) Use over-the-counter medications— once the infection has cleared up, you should take every precaution to keep it from recurring. One way to do that is to apply over-the-counter antifungal cream or lotion.

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Exercise combined with other healthful lifestyle choices, such as weight control and being a non-smoker, can help raise high-density lipoproteins (HDLs)— also known as “good cholesterol”—and as a result reduce certain health risks, including heart attack.

Medical experts say that even though HDL levels are to some extent genetically determined, they can be raised several ways, without using medication. In studies at Stanford University and Medical College of Virginia, losing excess weight and kicking a smoking habit have both been shown to lead to an increase in HDL levels. Postmenopausal women receiving estrogen replacement therapy also tend to have higher HDL levels.

Regular exercise is another method of ensuring high HDL levels. Experts say that regular muscle contractions stimulate the production of HDL. And while vigorous exercise produces the greatest effect, studies indicate that even mild exercise is of some benefit in raising HDL levels.

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