The Health Blog

Description and Possible Medical Problems

If you frequently have trouble urinating and sometimes find that it’s almost impossible unless you turn on both faucets in the sink (plus the shower), chances are you have a problem with your prostate (see sidebar: “The Prostate”). This is one of the most common diseases of men over 50. Many times, however, the condition is temporary and caused by cold medications or blood pressure pills.

Treatment

If you are having trouble urinating, you need to see your doctor or urologist. He will conduct a full physical exam, take blood tests, ask you if your father had a severe case of prostate disease, and do a digital exam to check the degree of the enlargement. In this procedure, the physician will insert a gloved finger into the rectum in order to feel the prostate. He may also elect to do a sonogram to get an image of the enlarged prostate and maybe even take a biopsy if he suspects cancer.

If you have an enlarged prostate, your doctor will prescribe Proscar, which will shrink your prostate and make it easier for you to urinate. If, however, you have prostate cancer, your doctor will take one of several different routes. He may decide to wait it out and regularly monitor the growth, or he may choose to perform a transurethral prostate resection, which, in effect, creates more room for the urethra by removing the part of the prostate that is constricting it. In rare cases, where the cancer is in an advanced stage, he may want to remove the prostate to prevent the cancer from spreading throughout your body.

Even though the idea of prostate cancer can be daunting, rest assured that the vast majority of men who have prostate cancer eventually die of another cause: old age.

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One of the common benchmarks of success in corporate America is the news that you have an ulcer. “Ah, welcome to the club!” your colleagues will say, raising their bottles of Mylanta in a toast.

Although the stress and anxiety of the modern world are something that we all accept, the truth is that if you feel a burning pain in the middle of your abdomen just below the rib cage, your first instinct is probably not going to be “I’ve arrived!” no matter what your position is at the office. An ulcer occurs when the lining of the stomach begins to break down because the stomach acid is eating away at it.

However, sometimes what you think is an ulcer really isn’t. You might be experiencing a high output of acid in your stomach or a condition called gastritis, an irritation of the stomach lining that is considered by many physicians to be a precursor of an actual ulcer.

Some people find that their ulcers get worse when the seasons change, as well as during times of stress. Certain foods—especially spicy ones—can also trigger the pain. The pain of an ulcer can wake a person from sleep, which can result in a feverish rush to the refrigerator to quickly eat some food and quell it. And I’ve seen a few patients who developed ulcers because of their prodigious intake of vitamin C—in excess of 5 grams per day.

A bleeding ulcer can cause vomiting of a substance that resembles coffee grounds as well as a stool that is black, tarry, and puttylike in its consistency. A bleeding ulcer is a major cause of anemia, and it can make an elderly person more prone to falls and passing out because of the low blood count. And in recent years, we’ve discovered that a strain of bacteria called H. pylori can actually be responsible for causing an ulcer.

Ulcers occur most often in men between the ages of 45 and 64, and in women who ate 55 and older. Twice as many men as women have ulcers. People who have emphysema, liver disease, coronary disease, or rheumatoid arthritis ate more prone to developing an ulcer. Unfortunately, once you have an ulcer and it cleats up, you are always prone to developing another.

In people who are over 60, medication is the primary cause of an ulcer. In fact, I frequently receive calls from a family member telling me that an elderly relative is weak and has just vomited blood. This is quite common, since my older patients take more aspirin, Motrin, and Advil than younger people do because of their arthritic pain. Working like stomach acid, these medications can start to break down the stomach lining.

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Of course, anyone who’s had asthma since childhood is familiar with its various medications, such as the Ventolin inhaler, which is used during an attack, and theophylline which is taken in pill form and provides longer-lasting relief.

If you have had asthma for many years but have kept it under control with medications, you are still prone to developing an occasional respiratory tract infection caused by a virus or bacterium or exposure to chemicals, paints, or insecticides. This can bring on an acute wheezing episode that’s known as a bronchospasm. If you have such an infection, your doctor will prescribe antibiotics and a bronchodilator spray such as Ventolin. If you are 40 or older, you might also be given an injection of epinephrine as long as you don’t have a history of cardiac disease. Epinephrine is a bronchodilator and decongestant that will help keep spasms from occurring in the lung and bronchial tissue.

But again, most asthmatics are comfortable with self-treatment, and their disease usually doesn’t progress past the point where more serious treatment is necessary. If the usual inhalers and medication fail to work, however, or the wheezing is accompanied by shortness of breath, you should seek medical attention, especially if you’re over 50.

During the initial exam, your doctor will do a physical exam and check your health history. He may also choose to take a chest X ray if he believes an infection is present. A handheld peak-flow meter, a device you exhale into that measures the volume of air you’re able to exhale quickly, will also help your doctor to tailor your treatment.

Sometimes the wheezing is very pronounced and the typical therapies aren’t effective. If this is the case, you may have to be hospitalized. You will be given oxygen, and the amount of oxygen in your blood will be monitored with either regular blood tests or an oximeter, a device that measures the blood oxygen level in your earlobe or finger without piercing the skin.

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It’s not uncommon for the muscles in your back and shoulders to ache after doing work where you have to hunch over, such as gardening or other work around the house. If you’ve also been twisting yout body and bending over, your hips may be painful after any exertion that you don’t do every day. As a result, there’s a good chance that, the morning after, you may feel as though you don’t have the strength to get out of bed.

Muscle ache that’s accompanied by weakness is a common occurrence. But if you have a constant, dull ache in the muscles around your shoulders and/or the backs of your hips and you don’t have the strength you once did, you may have a rare, progressive disease called polymyositis. This disorder is a variation of dermatomyositis, in which the muscle pain and lack of strength are frequently accompanied by a deep red rash that may be scaly. The rash most often appears around the eyes or on the neck, chest, hands, or elbows.

Both polymyositis and dermatomyositis are arthritic disorders, but they affect primarily the muscles, which become inflamed and swollen, not the joints, as do other forms of arthritis. Doctors believe that polymyositis and dermatomyositis occur due to a defect in the immune system. Two thirds of the people with polymyositis and dermatomyositis are women between the ages of 30 and 60.

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The treatment for goiter depends on its cause, which your doctor will detetmine after a blood test and possibly a consultation with an endocrinologist. In the case of hypo- or hyperthyroidism, in which the thyroid gland produces too little or too much thyroxine, your doctor will first do a physical examination and check yout medical history. She will specifically check for any body tremors, nervousness, an intolerance to heat, or a weight gain or loss, all of which are signs of a thyroid condition. She will also place your fingers on your neck and ask you to swallow, which will help her check for a goiter or nodule on your thyroid. Your doctor will also conduct a blood test and perform a scan of your thyroid with a radioactive substance, which will help her to check both the activity and the structure of your thyroid.

If you have hypothyroidism, in which the thyroid doesn’t produce enough of the hormone, treatment with replacement thyroxine medication usually eases the problem.

If the enlargement is due to a growth on the gland, surgery is usually recommended. In a few cases, the growth may turn out to be cancerous, so if it does not disappear after a week, you should see your doctor immediately. If surgery is required, the growth will be removed and you will feel better in several weeks.

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