Diabetes Archive

The operation to replace a clouded lens is low-risk, fast, and effective, but requires some decision making.

 Image: CJ_Romas/ Thinkstock

Cataract surgery—which involves removing the eye's clouded lens and replacing it with a clear synthetic version—once required several days in the hospital and a long recovery period. Today it is performed under local anesthesia on an outpatient basis, and people are back to their normal lives within days. The success rate is high, and the rate of vision-threatening complications is relatively low. For people with cataracts, the decision whether to have surgery may be easy to make. However, two additional decisions might be more difficult: when to have surgery and what type of lens implant to get, says Dr. Laura Fine, an ophthalmologist at Harvard-affiliated Massachusetts General Hospital.

Why you may need cataract surgery

To a great extent, cataracts are a normal consequence of aging. Cataract formation is usually a gradual process that plays out over years. The lenses of our eyes become less transparent, less resilient, and often thicker. By age 80, half of us will have cataracts.

It takes less force to sprain an ankle as we age. A few precautions can help to reduce the severity of these injuries or avoid them altogether.

Few of us have gone through life without spraining an ankle. Sprains are among the most common musculoskeletal injuries in people of all ages, and ankles are particularly vulnerable because of the small size of the joint and the forces exerted on it when the body is in motion. While younger people usually sustain sprains while running or jumping, for older people just stepping off a curb awkwardly or walking on an uneven ground can do it. "As you age, your balance and strength can diminish, especially if you've been immobile, increasing your risk for sprains," says Dr. Holly Johnson, a foot and ankle orthopedic surgeon at Harvard-affiliated Massachusetts General Hospital.

How sprains occur

The injury occurs when one or more of the ligaments — elastic bands of tissue that keep the ankle bones in place — are stretched or torn. The most common type of ankle sprain is an inversion injury, or lateral ankle sprain. The foot rolls inward, damaging the ligaments of the outer ankle. Less common are sprains affecting the ligaments of the inner ankle and sprains that injure the ligaments that join the two leg bones (the tibia and the fibula) just above the ankle.

Rates continue to rise, but there are ways to protect yourself and even reverse the effects of this dangerous disorder.

Your liver is your largest internal organ and your body's workhorse. Among its many jobs are converting food into fuel, processing fat from your blood, clearing harmful toxins, and making proteins that help your blood clot. Yet this hard-working, supersized organ is susceptible to a dangerous and often hard-to-diagnose condition called nonalcoholic fatty liver disease, or NAFLD.

NAFLD is defined as the presence of fat in more than 5% of liver cells. It is the most common liver disease and affects up to 25% of American adults, 60% of whom are men.

Ask the doctors

Q. I feel like I have a perpetual cold all winter, every winter. I'm stuffy and sneezy and it never seems to get better. Do you think it could be allergies? How can I tell the difference?

A. Colds and allergies produce many of the same symptoms: a runny nose, tiredness, and sometimes a sore throat. But they have different causes — a virus causes colds, while allergies are an immune system response to trigger substances, known as allergens. There are ways to distinguish one from the other. Colds sometimes produce a fever, but allergies never do. In addition, if you are suffering from allergies, you may also have itchy, watery eyes, symptoms that won't typically accompany a cold. But perhaps the biggest clue that can help you distinguish between a cold and allergies is the duration of symptoms. Cold symptoms rarely last more than two weeks, but allergies can last as long as you are exposed to the substance that is triggering the reaction. So, if your "cold symptoms" appear at the same time every year and last for an extended period of time, the cause may very well be allergies. Many people with seasonal allergies will experience symptoms for six weeks at a time. If you are allergic to something in your home, such as dust mites, mold, or pet dander, your symptoms could get worse during the winter months, because the house is sealed up and fresh air isn't getting in. In addition, your heating system may be recirculating the allergen. Because your symptoms last for an extended period of time, it may be worth a visit to the allergist.

On call

Q. My feet tingle or feel numb like they are asleep at times, mostly when I am in bed or with my legs elevated. What causes that?

A. The symptoms you describe may be related to peripheral neuropathy, which is nerve damage that affects multiple nerves leading out from the spinal cord to the arms and legs. Symptoms are often equal in both feet. If only one foot, or part of a foot, is affected, this suggests compression of an individual nerve.

We don't yet have a vaccine to prevent COVID-19, but it's still important to get your regularly scheduled shots.

You're not alone if you're avoiding doctor visits because of concerns about COVID-19. But forgoing medical care means you may be skipping needed vaccinations. "That's a huge problem already. Possibly over a hundred million people the world over have missed their vaccinations because of the pandemic," says Dr. Shiv Pillai, an immunologist and professor of medicine at Harvard Medical School.

Going without vaccinations may increase your risk for illness, such as influenza. "We still are just as vulnerable to infection, and we need vaccines to be protected; COVID-19 doesn't change that," says Harvard Health Letter editor in chief Dr. Anthony Komaroff.

News briefs

A modest uptick in the amount of fruit and vegetables you eat can help ward off type 2 diabetes, according to a study published online July 8, 2020, by The BMJ. From a much larger study involving some 340,000 people from eight European countries, scientists selected 9,754 participants who were newly diagnosed with diabetes over a decade. Researchers compared the fruit and vegetable intakes of these people to those of about 13,000 participants who remained diabetes-free during the study period. Researchers also measured blood levels of seven key plant-derived nutrients, including vitamin C and brightly colored antioxidant pigments called carotenoids. People with the highest intakes of fruit and vegetables and the highest blood levels of the plant-derived nutrients were 25% to 50% less likely to get diabetes during the study period, compared with those who ate the least of these food groups or had the lowest nutrient levels. Even better, it didn't take a whole lot of extra green, red, yellow, and orange on the plate to make a dent in diabetes risk. The equivalent of only two-thirds of a medium apple or just over one-third of a cup of mixed fruit each day offered protection.

Image: © RomoloTavani/Getty Images

In the journals

Not only can regular leg stretching help reduce cramps and muscle strains, it also may be another way to protect against heart disease and stroke. A study published online July 1, 2020, by The Journal of Physiology found that performing simple leg stretches can help improve blood flow throughout the body.

Researchers split 39 healthy people into two groups. One group didn't do any stretching. The other group performed four types of leg stretches five times a week for 12 weeks. The stretches focused on the hip, knee, and ankle. Each stretch was done for 45 seconds with a 15-second recovery. Afterward, the researchers found that the arteries in the lower legs of the stretching group had better blood flow and less stiffness. The stretching group also had lower blood pressure at the end of the study compared with their initial readings.

Ask the doctors

Q. I have hemorrhoids. Could this increase my risk of colon cancer?

A. In short, no. Hemorrhoids don't cause or increase your risk for colon or rectal cancer. However, the two conditions may be mistaken for one another because they can produce similar symptoms, such as rectal bleeding, itching, and pain.