Ask the Good Doctor

A: Well Carlos, this sounds a lot like gout. People think of it as a disease connected with wealth and gluttony, but it can afflict anybody. It is caused by uric acid crystals collecting in the joints of your big toe.

It can be treated with in the long term with medicines that will reduce the amount of uric acid in your bloodstream. There are other medicines you can take to manage the inflammation and pain. There is also a diet that helps, which would have you cut back on meat, seafood, beer, red wine and most of the things one might enjoy eating and drinking.

Your condition can be managed, so get to see your doctor and get started on the road to recovery.

A: Well it is true that kale supplies calcium, vitamin C, iron, fiber, and antioxidants. But it is also true that in large amounts, kale and other cruciferous vegetables like broccoli and turnips can cause goiters–an enlarged thyroid–and hypothyroid conditions where you don’t have enough thyroid hormone.

Vegetables like kale can affect the way your thyroid handles iodine and the way it the gland produces hormones once the iodine is in the thyroid.

So if you are over forty and eating very large amounts of kale every day this might be a problem, but in general regular amounts of kale and other cruciferous vegetables in your diet should not cause any thyroid trouble.

A: It would be nearly impossible for me to diagnose your vertigo on the air. There are so many different things that cause it and we see so many idiopathic cases, where we just can’t determine a cause. By vertigo do you mean a feeling of spinning when you aren’t actually moving? Do you feel lightheaded, like you are going to faint?

The pain in your arm could be caused by anything from a pinched nerve in your neck to heart disease. If you feel lightheaded that could suggest low blood pressure, or bleeding. It sounds like your condition is causing you to worry, so it would be a good time to make an appointment to see your doctor and try to find out what is going on.

A: Hip replacement surgery is a common but complex procedure. You’ll need to ask your orthopedic surgeon these questions. Or do a search on the internet. But I can tell you that you may not be able to drive for three to six weeks. You will want to make arrangements with a friend or family member to help you with errands until then.

I’d also suggest, if possible, that you have someone stay with you to help you out for the first four or five days after you return home.

You will be doing physical therapy exercises and will probably have to see a physical therapist several times a week at first.

If there are no complications, you should be able to resume many of your daily activities after about six weeks. Complete recovery can take anywhere from three to six months depending on your general health and how your rehabilitation goes.

A: Don’t worry about this too much, it happens to everyone. Whatever you do, don’t get discouraged and give up. There are a couple of reasons why this happens.

First when you lose weight, along with fat you can also lose muscle and when you have less muscle you burn fewer calories. Strength training like lifting weights or body weight workout can help you hold on to and even increase your muscle mass.

Another theory is that your body is comfortable at a certain weight and it slows down your metabolism when you lose weight. There may not be much you can do about this though you can try upping the amount and intensity of your workouts.

A major reason for the plateau is calorie creep. Our workouts make us hungry and as time goes on we can be a little less vigilant about how much we eat and before we know it we end up taking in more calories than we thought. So you need to watch that.

For your second question how can we tell when we are exchanging fat for muscle mass: It is very easy to tell when you are exchanging fat for muscle mass; your clothes will fit loser even though you may weigh the same as before. Or if you want to be more scientific; you can get a scale that measures your body fat in addition to your weight.

A: Whole wheat is just one of many whole grains. Whole grains are full of good stuff like including protein, fiber, B vitamins, antioxidants, minerals.
Research shows that a diet rich in whole grains can reduce the risk of heart disease, type 2 diabetes, obesity, and some forms of cancer.
Whole-grain diets also help keep your bowels healthy, keep you regular maintain and promote healthy bacteria in the colon.
Just make sure you read the labels carefully, multi-grain is not the same as whole grain. Also it doesn’t make sense to eat whole grain breads that are packed with added sugars like honey, agave syrup or high fructose corn syrup. And watch out for overuse of chemical additives in your bread.
Some examples of whole grains are: popcorn, bulgar wheat, brown rice, wild rice, and oatmeal. There are a lot of ways to get healthy whole grains into your diet.

A: The neti pot is a small teapot shaped device that allows you to rinse your nasal passages. Research shows that it can relieve sinus symptoms, some people even find relief from using the neti pot without other medication.

Back to your question, you should use sterile, distilled, or previously boiled water to avoid infections. You will also want to wash and dry your neti pot after each use.

A: Well, the first thing to know is, don’t flush them down the toilet. They can do all kinds of harm to aquatic plants, fish and other wildlife and even get into our drinking water.

There are about 150 medical collection boxes at law enforcement agencies across Minnesota. You can dump your medicines there. Also you can check with your pharmacy to see if they will accept your unused medicines.

What if you can’t find a collection site?

If you know your garbage goes to an incinerator, you can safely dispose of your medications in the garbage.

If not, it is still better to throw your medicines in the garbage than to flush them down the toilet.

Here’s what you need to do:

Keep the medication in its original container. Cover the patient’s name and prescription number with permanent maker.

For pills or capsules, add a small amount of vinegar to the container to dissolve them. Add table salt or flour to liquids. That way no one can use the medicines.
Tape the lid of the container with duct tape and place it inside a non-transparent piece of trash, and wrap packages containing pills in duct tape. Then throw the container in the garbage.

A: Congratulations! You noticed that babies don’t come with a user’s manual so the smart thing to do is to visit your baby’s health care provider for at least six well baby visits in the child’s first 15 months.

Your provider will examine your child’s growth and development. They will record your child’s height, weight, and other information. They may check hearing, vision, and do some other screening tests.

The well baby visits are a good time for communication with your doctor.  They will want to discuss development, nutrition, sleep, safety and things like what you can expect as your child grows up.

You can smooth the communication if you write down any questions you have before the appointment.

These visits are also time for your baby to receive various immunizations to keep him or her safe from preventable diseases.

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A: Good Question.

The US Preventative Task Services Task Force last made recommendations in 2009. They are in the process of updating their recommendations for 2015; but there is little change from the previous advice.

The task force advises getting screening mammography every two years, starting at age 50 and continuing to age 74. In particular, women aged 60 to 69 are most likely to avoid death from breast cancer through screenings.

They believe screening from 40 to 49 years has little benefit after taking into consideration adverse consequences like false positives and un-needed biopsies and overdiagnosis. Overdiagnosis means being diagnosed with a cancer that would not be a threat to you during your lifetime.

However, they council women in the 40 to 49 to talk to their doctor to determine if there are any factors, like a family history of breast cancer, that might call for earlier testing.

For screening mammography in women 75 years or older, they say the evidence is lacking on any benefits or harms from biannual screening.

Last July, a panel of the National Cancer Institute concluded that improved screening has resulted in the over-diagnosis and over-treatment of cancers that are not life-threatening, without significantly reducing the death rate from the disease.

Remember these recommendations are for screening tests, which means getting tested when there are no symptoms. You’ll want to get checked If you have symptoms such as:


  • Skin changes, such as swelling, redness,
  • An increase in size or change in shape of the breast(s)
  • Changes in the appearance of one or both nipples
  • Nipple discharge other than breast milk
  • General pain in/on any part of the breast
  • Lumps or nodes felt on or inside of the breast

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