Diabetes Archive

Q. My doctor, an internist, just retired, and my health plan is asking me to designate a new primary care physician. I'm 75. Would there be advantages to choosing a geriatrician as my new doctor?

A. First, a disclaimer: I am a geriatrician. So my short answer is, "Yes, of course!" But my reasoned, unbiased answer would be, "It depends." If you are a generally healthy 75-year-old woman, a family physician or internist will be able to take excellent care of you. Geriatricians are trained to care for older adults with complex illnesses and are expert in managing the care of people who are frail. Improving your ability to function, and the quality of your life, are the guiding principles of geriatric medicine. We are expert at managing complexity and uncertainty, working with families, and caring for people with serious illnesses who are approaching the end of life. A geriatrician would be a good choice if you have physical or cognitive impairment, if you take a lot of medications, or if your friends and family are involved in your medical care. For people who have several medical problems, we emphasize the role of patient and family preference in making medical decisions, with the patient's goals as our primary focus.

Few women realize how common pelvic prolapse is—and how easily treated. Here are five things you should know.

Q. Do the protective effects of alcohol extend to dessert wines and liqueurs, or do those have too much sugar?

Keep hydrated, and empty your bladder often to stave off these risky infections.

Poor sleep is linked to high blood pressure, diabetes, obesity, and heart disease. Now a study published in Neurology Dec. 10, 2014, suggests that people with conditions that rob them of oxygen and deep sleep are more likely to have changes in the brain that may lead to dementia. Researchers say conditions such as emphysema and sleep apnea reduce the amount of oxygen in the blood during sleep, which can lead to silent, undetectable "ministrokes." Researchers also found that people who spend less time in deep sleep, called slow-wave sleep, are more likely to have loss of brain cells than people who spend more time in slow-wave sleep. Slow-wave sleep is important in processing new memories and remembering facts. The researchers noted that past evidence has shown that using a continuous positive airway pressure (CPAP) machine for obstructive sleep apnea may improve cognition, even after dementia has developed. "Sleep quantity and quality are important to maintain optimal health and prevent disease," says sleep expert Dr. Lawrence Epstein, an instructor in medicine at Harvard Medical School. "By getting enough sleep, you ensure that you are getting all the types of sleep, which is necessary to maintain proper functioning." 

Q. My internist told me to take calcium because I have osteoporosis. However, I heard that blockages in heart arteries could also contain calcium. Am I hurting my arteries by taking calcium supplements?

A. Doctors often recommend calcium supplements for people with osteoporosis, and I'd advise you to follow your physician's advice, as calcium is important for bone health. The Recommended Dietary Allowance for calcium for adults is 1,000 to 1,200 milligrams (mg) a day; dairy products are the best sources. For healthy people who get enough calcium in their diets, the role of calcium supplements is less clear, although some people hope that taking them may help preserve bone strength.

Q. For many years, I have felt like my legs have to constantly move, and sometimes I feel crawling sensations when I am resting. Do I need to be tested for restless legs syndrome?

A. Your symptoms are consistent with restless legs syndrome (RLS), a common condition marked by uncomfortable sensations in the legs or a need to move them to relieve the discomfort. There is no test to confirm RLS, so it's diagnosed based on symptoms alone.

The abnormal heart rhythms from atrial fibrillation (afib) can form clots that, in turn, trigger strokes. To prevent that, people with afib take a blood-thinning medication to prevent clotting. But also taking common over-the-counter painkillers can block clotting too much and lead to dangerous bleeding, according to a study in Annals of Internal Medicine.

Danish researchers examined health records of more than 150,000 people with afib. A third of them had also been prescribed nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin) and naproxen (Aleve). These common pain relievers interfere with the body's natural clotting function. Paradoxically, some NSAIDs have also been linked to higher risk of thromboembolism, or a clot that forms in the body and travel to the lungs, brain, or elsewhere.

Both asthma and chronic obstructive pulmonary disease (COPD) can be managed successfully with the right medications.

Shortness of breath, persistent coughing, and wheezing are well-known symptoms of both asthma and chronic obstructive pulmonary disease (COPD). Yet the two disorders have separate causes. COPD, which includes emphysema and chronic bronchitis, is primarily due to changes in lung tissues brought on by smoking and abetted by aging. Asthma is essentially an allergic reaction that causes muscle spasm and mucus secretions that close the airways.

When you sense the ground spinning under your feet, it could be vertigo. But there may be a simple remedy.

An episode of dizziness is one of the things most likely to drive you to the doctor—and for good reason. The sense that you're literally losing your footing can be terrifying.