April 9th, 2009

Gout is one of those diseases that sounds old-fashioned, like something your grandmother used to complain about to your grandfather: “Now, Harry, don’t eat that pastrami, or your gout will act up.” At least, that’s the way it used to go in my grandparents’ house.

Gout is actually a sign that the kidneys are not functioning well. The kidneys produce uric acid, which is normally excreted through your kidneys in your urine. If, however, for some reason your body produces more uric acid than your kidneys are able to process, it stays in the body. It typically gravitates toward the joints, collecting in the form of uric acid crystals. Collection sites commonly include the first joint of the big toe, but the crystals can also collect in the wrists, elbows, and knees, causing pain and swelling in these joints as well.

Gout is similar to rheumatoid arthritis, since it strikes with great unpredictability. After an initial experience of gout, you may not have to worry about it anymore, since some people have only one attack and that’s it. Others, however, will suffer from regular attacks. Unfortunately, the more frequent the attacks, the more likely the gout will spread to other joints.

Some people are genetically prone to gout, although drinking alcohol, taking antibiotics, or eating rich foods—as my grandfather did—is more often the cause since it can cause the body to produce more than the usual amount of uric acid.

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As you get older, you’ve probably discovered that you just can’t do everything as easily and smoothly as you once could. While you used to bounce out of bed in the morning, it may take you longer to get up and about, and your joints may become stiff and painful as the day wears on; you may also sometimes feel as though you have sand in your joints because any movement can make them feel gritty.

These are all signs of osteoarthritis, a condition in which the cartilage that absorbs the shock of the bone begins to break down from years of use. Fingers, wrists, back, hips, and knees—every joint can be affected. The stiffness usually doesn’t appear when you first wake up but tends to increase as the day goes on. The joints can also become deformed, since fluid can accumulate in them; this can make them tender to the touch.

By the age of 45, osteoarthritis starts to appear, and by the age of 75, almost everyone shows some degree of osteoarthritis.

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In many cases, a low-fat diet and exercise program and significant weight reduction will reduce an elevated cholesterol level. If they don’t, medication may be prescribed. The problem is that you may feel you can return to your previous diet and sedentary lifestyle since you’re taking medication. Unfortunately, this will only increase your cholesterol levels as well as your need for higher doses of medication. Since most cholesterol-lowering medications have some side effects, your physician will need to monitor you closely by testing your liver function and vision. He may also order other diagnostic tests according to the type of medication prescribed. As always, both the doctor and the patient should consider both the benefits and the risks before considering any medication program.

In my opinion, the total cholesterol consumption for one day should not be mote than 200 milligram, an amount many fast-food meals easily exceed. The total diet should certainly not have more than 30% of its calories in fat. There are many excellent books on this topic that will help you learn how to decrease your intake of fat, including my own, Dr. Bruce Lowell’s Fat Percentage Finder (published by Perigee Books).

You should keep in mind that your cholesterol level should not be taken as a simple number by itself. You should ask your doctor about the components of your total cholesterol reading, since a high total cholesterol reading could mean high LDL and low HDL cholesterol levels, which is a healthy balance to strive for.

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Treating high blood pressure with medication presents a real challenge to physicians today. But many times, all that is necessary is to prescribe one or two types of medication that will bring the elevated blood pressure down to a normal level, combined with sensible diet and exercise and relaxation techniques. At other times, however, you will need to experiment with multiple drug regimens before you and your doctor arrive at the right combination of medication with the smallest number of side effects. You need to be patient, and don’t stop taking your medication without first discussing it with your doctor.

As long as we’re on the subject of medication for high blood pressure, remember to take your medications as prescribed whenever you visit your doctor for follow-up checkups, unless your doctor tells you otherwise. It’s also a good idea to order your prescriptions in small amounts at first. At the beginning of your treatment plan, you and your doctor will be experimenting with different medications to find the right one for you. This can be costly. Either ask your doctor to prescribe small amounts or ask your pharmacist to halve your prescription.

Special Mention for the Elderly

If you have an elderly relative who has high blood pressure and is also quite frail, it’s important to weigh the risks of taking the medication against the potential benefits. Lowering the blood pressure too drastically can cause further weakness, falls, and confusion and can ultimately be as harmful to her health as the high blood pressure. Ideally, the doctor, patient, and family should decide together about ways to control your loved one’s blood pressure without the side effects that may have a negative impact on the quality of her life.

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Description and Possible Medical Problems

It seems that we’ve been trained from birth to regard any new lumps or bumps that appear on our bodies with a suspicious eye and a brain trained to think of the “C word”: cancer. Therefore, whenever a lump or bump turns out to be something else and is actually harmless, the relief is usually palpable.

This is the good news if you notice a lump or bump that appears on the back of your wrist, called a ganglion cyst. It’s usually painless and occurs when a gellike material escapes from a joint or a synovium, a tendon sheath in your wrist. It collects in one spot, causing the area to swell up, and may be either soft or hard.

Treatment

If you think you have a ganglion cyst, you should see your doctor. Though you’re probably reading your Body Signals correctly, the chance does exist that the growth is a tumor or a malignant growth. Your doctor will do an X ray and/or a sonogram to help determine the status of the growth. If, as in most cases, he does discover a ganglion cyst, he will drain it with a needle while applying pressure to it, to make sure none of the gel remains.

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