Diseases & Conditions 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?

Exercise, eat a healthy diet, and manage blood pressure and cholesterol to lower your odds.

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

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. I just discovered that I have a hole in my heart that my doctor called a patent foramen ovale, which was found during an ultrasound. What are the pros and cons of having it repaired?

A. All people start off with an oval, flap-like opening (called a foramen ovale) between the right and left upper chambers of their hearts. This small hole usually closes during infancy. But in about one in four people, it stays open and is known as a patent foramen ovale (PFO). Most people with the condition have no symptoms and never know they have it unless it's discovered by accident, as happened to you.

Well-educated people who report memory problems may face a higher risk of stroke.

Minor memory slips—such as losing your keys or forgetting an acquaintance's name—are common as we age. However, people who express concern about their memory may have a heightened risk of stroke, particularly if they're highly educated, according to a study in the January 2015 Stroke.

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.