Archive for April 9th, 2009

HEEL PAIN WHEN WALKING

Thursday, April 9th, 2009

Description and Possible Medical Problems

As you grow older, you’ve probably noticed the occasional slight aches and pains that seem to surface during the first few minutes of exercise and then fade away as your joints and muscles begin to move smoothly. Those same aches and pains may surface again the next morning as you get out of bed, but, once you start moving, they should go away.

However, if you have a pain in the back of your ankle at the heel that appears after you start to move or walk, it’s probably not caused by the aches and pains of aging. Instead, you probably have Achilles tendinitis, an inflammation of the largest tendon in your body.

Achilles tendinitis is most common among people who are active; hard and regular exercise can cause small tears to form in the tendon, and these can be painful.

Treatment

If you think you have Achilles tendinitis, you’ll need to stop exercising for at least a couple of weeks to allow the tendon to heal. Applying an ice pack to your heel can also ease the pain and inflammation; taking aspirin can also help. Your doctor will do an X ray of your foot and ask about your recent exercise habits. She may decide to inject a corticosteroid preparation such as prednisone directly into the area to reduce the pain and inflammation.

After the tendon has healed and you return to exercise, you’ll need to adjust your habits to make sure the tendinitis doesn’t return. Cutting down on the amount of exercise you get or switching from running to walking or swimming will also reduce your chances of reinjuring the tendon. Changing the kind of running shoes you wear or inserting an orthotic appliance into your shoe to elevate your heel and take some of the stress off your tendon is worth trying, too.

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BODY SIGNAL ALERT PAIN IN LOWER PELVIS ON ONE SIDE: DESCRIPTION AND POSSIBLE MEDICAL PROBLEMS

Thursday, April 9th, 2009

Though we’ve all heard of the appendix and know that it basically serves no useful function except to be removed, many people would be hard pressed to pinpoint its exact location in the body. Even though pain in the lower pelvis alerts people to the possibility of appendicitis, it actually occurs on the right side and is frequently accompanied by vomiting, fever, and pain.

But appendicitis is by no means the sole cause of pain on the right side. Other causes of pain in the lower right side of the pelvis could be due to an ovarian cyst that has ruptured or pelvic inflammatory disease, an infection that can occur in any part of the female reproductive system. The most common form of PID is caused by gonorrhea. When the pain occurs on the lower left side of the abdomen, cysts, a PID, or an intestinal problem such as irritable bowel syndrome may be the cause. If you are still menstruating and the pain on either side occurs in the middle of your cycle, you could have a condition called mittelschmertz, when pain is caused by an egg in one of your ovaries maturing.

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BODY SIGNAL ALERT MASS IN BREAST: DESCRIPTION AND POSSIBLE MEDICAL PROBLEMS

Thursday, April 9th, 2009

Contrary to sociological expections, the Playboy centerfold’s breasts are rarely found in nature. Most likely, they’ve benefited from silicone implants, heavy makeup, and airbrushing. Yet many women think there’s something wrong with their own breasts because they don’t resemble this unrealistic ideal.

That also goes for the various glands and fat tissue that make up the breast. Some women find it hard to distinguish between the various irregularities that normally appear in the breast as part of the mammary and lymphatic systems and those that need immediate attention.

The main purpose of a woman’s breasts is producing milk. The milk glands are located throughout the breast tissue, but all of them meet in the nipple. The majority of breast tissue is fat, and behind the fat lies muscle.

It is important for every woman to recognize what the typical irregularities in her breasts are, both during her menstrual periods and between them, since the breast itself changes according to what stage of her cycle she’s in. After menopause, the breast shrinks due to a loss of fat. Even in menopause, it’s important to recognize the changes in your breasts, even though the changes are no longer as frequent.

I consider any change that occurs in the breast to be an abnormal mass or lump. I use these words interchangeably, though it may sometimes lead to confusion. If you feel a mass in your breast of any kind— whether it’s a new growth or a smaller mass that has recently begun to grow—you should see your doctor. If it’s a hard, small mass that has recently appeared, it may be a tumor. However, if the growth is spongy and you feel more than one mass, then you may have fibrocystic disease. The cysts may appear with some regularity and are usually painful to the touch.

Cysts are bits of tissue that have filled with fluid. They are usually soft and spongy to the touch and move around under the skin when you palpate them. They may occur singly or in clusters. Women who drink a lot of coffee and/or caffeinated soda are more likely to have fibrocystic disease than women who don’t.

Fibrocystic disease tends to be more common in women aged 40 and over. As your body prepares for menstruation, there is a buildup of fluid in the body, particularly in the breasts. After menstruation ends, the excess fluid is usually excreted and absorbed into the body. In older women, it’s sometimes difficult for the fluid to be reabsorbed into the lymphatic system, and some of the excess fluid may remain in the breast tissue, where it becomes trapped and forms cysts.

If the mass feels firm, has a well-defined shape, and is mobile underneath the skin, you probably have a fibroadenoma, which is a benign tumor. A fibroadenoma contains both fibrous and glandular tissue, which causes it to be rubbery in texture.

If you feel a mass in your breast that might be a cyst or a fibroadenoma, and you have PMS or are currently menstruating, you may decide to wait until you’ve finished your period to call your doctor, since many cysts become swollen and painful during menstruation. If the pain and size of the cysts recede after your period, the cyst is probably harmless.

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LUNGS AGING

Thursday, April 9th, 2009

The lungs also lose some of their resiliency as we age, starting in our 40s, but this is usually minor. The amount of air the lungs normally hold decreases very little as we age. The ability of the lungs’ lining to fight infection also decreases due to the normal loss of the body’s immunological response to infection, but this doesn’t usually show up until the 70s. Most lung disease and infection are caused by the ravages of years of cigarette smoking.

Of course, the heart also ages, along with the entire vascular system. The blood vessels tend to stiffen with time, and they start to narrow as a result of decades spent eating foods that are high in cholesterol and fat.

In the 40s, the heart starts to lose some of its strength; for example, it takes longer for the heart rate to return to normal after a bout with stress. But the more regularly one exercises, the stronger it will remain. The heart valves also become thicker with age, causing them to leak a little or not to open as much as before, but this usually has no effect on the body. Most people, however, will be able to live well into their 70s and 80s without any heart problems at all, since the effects aging has on the heart become an issue only if there is a serious underlying disease such as a preexisting heart condition or diabetes.

Of course, regular exercise consisting of three 20-minute sessions each week can be quite beneficial, not only for your heart but for your entire body. It has for me, since I have a tendency to be overweight. While I was in medical school, I led a largely sedentary lifestyle, which made it very easy for me to gain weight. After medical school and during my residency, I began to exercise regularly.

Today, at the age of 48, I’m still at it. I exercise for at least one hour three or four times a week; sometimes I even exercise for an hour and a half each day. I run either inside on a treadmill or outside, and I follow it up with a regimen of light weight lifting to maintain my strength. If I can make time, so can you. Of course, you should consult your doctor before you begin any exercise program for a medical evaluation.

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BODY SIGNAL ALERT THROAT, SORE: DESCRIPTION AND POSSIBLE MEDICAL PROBLEMS

Thursday, April 9th, 2009

In the last several decades, an entire industry has evolved around the common problem of sore throats.

As with hoarseness, a sore throat usually arises because of a temporary condition—such as a cold or allergy or overstressing the throat and larynx by yelling and screaming—but it’s important to run through a process of elimination to make sure it’s not a sign of a more serious illness.

Ask yourself the following questions to help determine the cause of your sore throat:

1. Has the pollution in my area worsened recently, or have I been spending more time in an urban area?

2. Have I recently been diagnosed with a hiatal hernia?

3. Do I suffer from frequent sinus infections?

4. Is my mouth frequently dry?

5. Does my throat feel sore all day or just in the morning?

6. Do I have a fever as well as a sore throat?

Next, look into a mirror and open your mouth using a spoon to hold your tongue down. Now take a flashlight and look at your throat.

1. Is it fire engine red?

2. Are there white patches that appear to be filled with pus?

There are many causes of sore throat. If you’ve recently moved to an area where the pollution in the air is denser or are spending more time outside during the middle of the day, when pollution is usually at its worst, you may find yourself with a chronic sore throat. A hiatal hernia—a bulge in the lower esophagus that causes the stomach to press into the chest cavity—frequently causes stomach acids to back up into the esophagus, and you feel a burning in the back of your throat. Even if you don’t have a hiatal hernia, if you eat and drink late at night and lie completely horizontal when sleeping, the digestive juices can back up into your esophagus, resulting in a morning-only sore throat.

Sinus infections can also cause a recurrent sore throat. If your sore throat is caused by a dry mouth, it may be that you tend to breathe through your mouth. People who snore often have this problem. And if your throat is very red and sore and you also have a temperature, you might have strep throat. However, if your red, sore throat also has white patches of pus, it’s probably not strep but a viral infection. In a young adult, this infection is usually mononucleosis; in an older adult, it’s a simple viral infection.

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