Fairview On Call Questions and Answers

Please remember that we can only give general advice here and every case is unique. Always check with your personal physician or other health care professional for any health concerns.

Dr. Gretchen Phillips and guests answer questions on-air during the Fairview On Call radio hour., heard each Sunday morning at 7:30 on WCCO AM 830 To post a health-related question regarding an upcoming or recent Fairview On Call topic, visit the Ask the Doctor page and use the form. Then check into the radio show to hear your answer.

7/07 “Do tetanus shots hurt?”

Phillips responds: Yes, unfortunately tetanus shots do hurt. They are a very important part of staying healthy though, and only hurt for a day or so. If you come into contact with the tetanus bacterium and did not get your tetanus shot, the bacteria could be fatal. The best thing to do is to get a tetanus shot every ten years and take some medication for the pain when you get the shot. Ice on your shoulder (or wherever you get the shot) can help too.

7/07 “How can i listen to last week’s.show?”

Producer responds: Thank you for your e-mail. I believe the link below will take you to the page that lists most recent WCCO broadcasts. http://www.830wcco.com/pages/3648.php

Scroll down under specialty programming and you should be able to listen to the most recent Fairview On Call program.

“I enjoy your Sunday morning radio show!! Re' Your show on snoring I snored and was always tired so my doctor had me do a sleep study. It seemed to me that the sleep study folks also were there trying to sell the C-Pap machine. I tried it and while it works, I travel (fly) every week and lugging this C-pap machine along was difficult. The sleep doctor then recommended a dentist who fitted me with a mouth piece which forces my lower jaw out from my upper mouth. I have had this for three years and I can honestly say, (as does my wife) that this is the greatest answer for me relative to snoring and a solid and good, no a great night sleep. To me, it was/is a much better answer than the C-pap machine. As you can tell, I am a strong proponent of the mouth piece. Cheers.”

Dr. Oleg Froymovich, ENT specialist, responds: Thank you for listening and for your feedback. Oral appliance is certainly well-known to work with certain patients with sleep apnea, especially those that do not have severe obstructive sleep apnea. It is a well-accepted mode of therapy. I am delighted that you are able to use the appliance so well. If you have any further questions regarding your condition and long-term therapy, I suggest you contact your local sleep specialist to answer those.

5/07 “I had a hysterectomy in March of last year. I have gained 60 pounds since then. The more I diet the more I gain. I have never been over 135, I weigh 190 [now]. What is causing this?”

Phillips responds: Hi Becky, your hysterectomy may have played a part in your weight gain, but may not have. Ultimately, weight is a balance of calories. You need to burn more calories than you take in, which means increasing exercise and decreasing calorie intake. The exercise part is even more important for menopausal women than younger women because it also helps prevent osteoporosis. Thyroid disease is another reason for weight gain, so you should talk to your doctor about this as well. Best of luck in your weight loss.

5/07 “I am looking for some reassurance...or at least some information. Awhile back (a few years ago actually) my wife told me that she had a vaginal infection and that her doctor wanted me to take a pill to ensure that we do not pass it back and forth. (I was asymptomatic... and took the pill without knowing the name.) Whether she said it was a yeast infection or I just made that assumption I don't recall. In any case, after visiting a number of web sites I am fairly well educated concerning types of vaginitis, treatments for each, and the fact that ordinarily males are not treated orally for yeast infections. I am hoping that clinical practice is different from the literature and there is a possibility that I was being treated for something other than an STD (I know that I could not have passed an STD to my wife as I have never had sex with anyone else.) My question... "Is there any chance (and if so, how much of a chance) that my wife's vaginitis is of a non STD type? Thank you so very much”

Phillips responds: You are in a tough situation and I'm afraid I won't be able to completely reassure you with the information you've given me. There is a diagnosis called Trichomonas, that is sexually transmitted, that we often treat both partners for and we definitely treat partners for gonorrhea and chlamydia. All of these can be treated with one dose of oral antibiotics. Yeast infections can be passed from women to men, but this is usually only treated in uncircumcised men. If men are symptomatic with pain or difficulty urinating, bacterial vaginosis (caused by the bacterium Gardnerella) can be treated as well. This and yeast are the only two possibilities that are not sexually transmitted. Ultimately, since this continues to bother you several years after being treated, I must recommend you talk to your wife about your concerns. If necessary, please seek the help of a marriage counselor as well so you can get adequate resolution of your questions.

5/07 “85 year old has had both hips replaced and back surgery during the past four years and she still has the same pain...Her Dr. said no more can be done. What kind of Dr. should she see next? She has a hip surgeon and a back surgeon and a MD....”

Phillips responds: This sounds like a very tough situation. At this point, surgery may not be the best option. Rather, achieving adequate pain control may be the most reasonable goal. There are specialists who manage all different kinds of pain and there are pain centers where the treatments are centered around pain control. Talk to your family doctor about a referral to see a pain specialist. Best of luck to you.

5/07 “My daughter (36) has had cellulitis for the past 4-5 months. She goes on antibiotics for a while and everything clears up. Then about 2 weeks later it reappears. During this time she has also taken over the counter and prescription pain medication. Due to the pain medications and past radiation she developed a hole in her intestine and had to have emergency surgery. She is recovering from the surgery and after being off antibiotics for the past two weeks, the cellulitis returned again. My question(s) are: what are the consequences of being on long-term antibiotics and what type of doctor (specialist) should she be consulting regarding the ongoing cellulitis. During this time she has consulted with her oncologist and then the surgeon who performed the emergency surgery, however, I feel a specialist should be involved. Thank you.”

Phillips responds: Skin infections can be difficult and frustrating to treat. An infectious disease specialist may be who you are looking for. Otherwise, you and your daughter could discuss her symptoms with a dermatologist.

4/07 “Dear Dr. Phillips, Many thanks to you, Dennis Long & WCCO RADIO, & Fairview for providing this valuable service. My question is: How does a "new" patient to Fairview find a "new" doctor that would be an appropriate fit for that individuals needs (ie. medical disposition to include existing medical conditions, age, and medical history)? As a patient, should we assume that all doctors are capable to meet our needs in "family practice"? I believe all doctors strive to do their best! Thank you for taking my question!”

Dr. Phillips responds: What a great question! Finding a physician you can be comfortable with is sometimes difficult. There are often biographies written about physicians in the clinic pamphlets or on the Internet.http://www.fairview.org> has a bit of information on the physicians here at Fairview. Often, you can find someone with similar background or special interests that match your needs. Sometimes, though, you may need to make an appointment to see if it is a good fit. Referrals from other physicians or friends can help too. Family medicine is a very broad specialty, and we focus on the whole patient, not just their disease process or a certain body system. Starting with a family physician is a good thing, because if specialty care is needed, we are very well educated in sending you to the right place. I hope that helps. Best of luck in your search!

4/07 “Who (doctor) can help me with Ehlers-Danlos Syndrome?”

Phillips responds: A Rheumatologist should be able to help you. They specialize in diseases of connective tissue, such as Ehlers-Danlos.

4/07 “On Sunday's show someone asked about nasal sinus symptoms. I have been working on secondhand smoke issues the past 18 months and have learned from the CDC and other organizations that secondhand smoke is an irritant for sinus problems (among others listed on this web site). I think it would be great if health care professionals would ask patients if they work or live in smoky environments. I used to be a bartender and when I quit, my chronic bronchitis and sinus headaches went away. I also would like to see you have a show on this subject as it is the #3 preventable cause of disease and premature death in our country, killing more people than murder, drugs, and AIDS combined. It is especially timely considering the Surgeon General's 2006 Report, and legislative efforts to make the 1975 Clean Indoor Act apply to ALL workers in Minnesota…”

Dr. Phillips responds: Sandra, An excellent point! Thank you so much for writing in. I will be sure to include secondhand smoke in my discussions about health maintenance from now on.

4/07 “What can be done for spinal stenosis?”

Phillips responds: Spinal stenosis can be very painful. Treatment is usually focused on reducing the strain on the low back, with weight loss and exercises to strengthen the back and abdominal muscles. Sometimes a physician may prescribe medications or a course of physical therapy to help with mobility and pain control. Injection therapy may be helpful and some patients ultimately need to have surgery to decompress the nerves that are affected by the stenosis.

4/07 “Dr. Phillips: I was only able to listen to the first portion of your show on 4/15 re: Diabetes. Please specify TYPE 1 vs. TYPE 2 when discussing diabetes. Diet & exercise won't make my son's T1D any better. Help us parents of T1 kids to educate people that unfortunately, people hear DIABETES and don't think about the deadliest Type 1 sufferers, just those whose lifestyle brought it on. Too much sugar and candy didn't bring on my son's diabetes at the age of 3, and restricting it won't take away the pump or 10 finger pokes each day. Thank you.”

Dr. Phillips responds: You are 100 percent correct and my oversight in this has me blushing. I apologize and vow to you and your son to better distinguish my intentions with diabetes talks. Diet and exercise are, of course, good for everyone, but type 1 diabetics do depend on insulin and finger pokes and certainly did nothing to provoke their disease. I hope our information about research into inhaled insulin was good news for you. This next week, I have an open lines show, and will mention exactly this to clear up any misunderstandings. Thank you for listening and for keeping me straight!

4/07 “My Husband and I have had recurrent earaches and sinus problems for several years following a prolonged exposure to toxic mold---aspergillus, penicillium, and stachybotrus. Allergists have treated us to no avail. I was even diagnosed with asthma and treated with nebulizer treatments. Also mis-diagnosed with vocal cord dysfunction because my throat kept closing up. Do you have any recommendations? WE are really tired and in pain a lot.”

Dr. Phillips responds: It sounds like you have seen a lot of specialists. My only other recommendation would be for you to see an Ear, Nose and Throat specialist. Usually, molds and other airborne contaminants are cleared from the sinuses with mucus drainage. If you are still having problems, an ENT specialist can image your sinuses with CT or MRI and that can help properly diagnose the problem. If there is a blockage, an ENT can advise you about possible treatments, including surgery, if necessary. Otherwise, very often, migraine headaches are confused with sinus pain. After failing to improve with multiple sinus treatments, you may consider being evaluated for migraines and trying a medication aimed at those, rather than allergens. A neurologist can help with that.

3/07 “Hi There, I just weaned myself off of a 10mg dose of Lexapro. I am now having symptoms of dizziness and irritability. Not to mention I am more short with my 2 year old. Poor kid. Is this all normal and when will these side effects go away? Thank you for your time.”

Dr. Phillips responds: Sometimes antidepressant medications can have a discontinuation syndrome that can include symptoms of dizziness, nausea, headache and fatigue. My concern is though, that the irritability and fatigue may be a worsening of depression that is becoming more severe in the absence of medication help. Many people mistakenly believe their depression is better and they no longer need medication. The opposite is usually true - the medication is relieving the symptoms and needs to be continued. With any medication, before starting or stopping, you should discuss your concerns with your doctor. Stopping a prescription on your own can be problematic and a resurgence of symptoms is common. Use of anti-depression medications has been shown to decrease a risk of relapse later in life, so before you stop taking anything, discuss the implications with the doctor who prescribed the medication for you.

Thank you so much for responding. I actually started my meds up again and life is great. Thank you.

3/07 “I got a bad bruise on my shin about two weeks ago. For the first week the area next to the bruise was extremely painful because it would start burning throughout the day. That pain stopped but now I've noticed that the area where it was burning is numb. I can't feel cold or touch properly. Is all this normal with a bad bruise? Will I regain feeling in that part of my leg?”

Dr. Phillips responds: When there is trauma to a nerve, the reaction the nerve has is sometimes a mixture of pain, numbness and tingling. A burning sensation is often described. What happens is the tissue around the nerve swells, and compresses the nerve. Because of this pressure, the signals that are transmitted in the nerve are interrupted or changed. Most of the time, the area affected by this regains normal sensation and function with time. Sometimes, with severe trauma, there is some numbness that lasts. I suspect your shin bruise affected the nerves in that area and that with time you should have a normal shin. Thank you for your questions!

2/07 – “I get really tired around 8 pm and fall asleep very easily. In a couple of hours I am wide awake and cannot fall back to sleep. By 4 am I sleep for a couple more hours, then I am up for the day. Is there anything I can do to help this?”

Dr. Phillips responds: There are many things that can disrupt sleep, including sleep apnea and restless legs syndrome, snoring, teeth grinding and some medications. The best thing for you to do is to talk with your physician about your sleep concerns and discuss any medications you are taking. He or she may recommend a sleep study. There, they can evaluate and investigate anything that is interfering with your sleep. Best of luck to you.

2/07 – “I have an 18 yr. old daughter who has had a sore throat for 1 yr. 3 lots of antibiotics, earache, weight fluctuation, lump in neck. November specialist said reflux; January doc says glandular fever; now mouth very sore; tongue with dark red patches; tired all the time; any advice welcome. Thnx”

Phillips responds: An Ear, Nose and Throat specialist may be able to help you figure out what's going on. Your physician should check a thyroid level and for anemia and diabetes. She may need an endoscopy to see what's going on in her stomach. Another concern I have is bulimia. If you are at all concerned that she may be throwing up, whether it is intentional or not, she should be evaluated for a possible eating disorder or stomach disorder. These can be difficult situations. I wish you the best.

– “Thank you for this morning show. Does Fairview take U-Care Ins.?”

responds: Fairview accepts most insurance plans, including U-Care. However, the best way to determine whether something specific is covered is to contact U-Care directly. Their Web site address is ucare.org.

2/07 – “My knees are making much noise these days, especially my right knee. Snapping sounds, popping, crackling. What should I do about the noise?”

Dr. Phillips responds: Fortunately, most joint sounds and noises are completely harmless. There are fluid capsules around all of our joints and as the fluid shifts and the bones, ligaments and tendons move, there are occasional sounds made from friction. If the popping and cracking are associated with a loss of motion or pain, you should see your physician and have him or her evaluate you for osteoarthritis or degenerative changes. These happen with age and activity. Sometimes, when pain and loss of mobility are severe, orthopedic surgeons can be consulted to help too. To prevent arthritis pain, regular exercise is key! Keeping your muscles toned and strong will support the joints and bear the brunt of your activity. Best of luck to you.

– “Is taking [pseudoephedrine sulfate] 12 hour, daily and long term harmful? I am 52, female very active and generally in good health. I feel that when I exercise I am very fortunate, I love doing things like long bike rides (50-100 miles at a time) and weight lifting. The problem is I have chronic sinusitis, allergies and asthma. Minnesota weather, air pollutions and pollens (ragweed, esp.) give me a lot of trouble. Even taking my prescribed asthma meds, I have numerous episodes of sinus swelling/headaches and then breathing difficulty. I feel that taking antihistamine/decongestant helps me breathe, but besides being concerned about long term effects (my blood pressure is good) it is getting harder to get at the pharmacies. I feel that pseudoephedrine sulfate can be a lifesaver to me and think I would not like to go without it. So should I be worried about taking, or being able to get it in the near future and is there an effective alternative? And yes I have had sinus CT's and there has been some discussion with my ENT about possible sinus surgery. I know that helps some people, but that sometimes in spite of the (ghastly!) surgery, the sinus problems come back. Besides the ENT doctor says while there is concern about sinus blockage he said the level was not great. Thank you.

Phillips responds: With your severe symptoms, you should discuss your options again with your ENT. While there is probably no danger in taking pseudoephedrine sulfate for long periods of time, the pseudoephedrine does cause changes in the heart rate and blood pressure. You may find relief that is more lasting with other medications, such as switching nasal sprays, perhaps, or with surgery. I'm glad to hear you are staying so active!

– “My knees are making much noise these days, especially my right knee. Snapping sounds, popping, crackling. What should I do about the noise?”

Phillips responds: Fortunately, most joint sounds and noises are completely harmless. There are fluid capsules around all of our joints and as the fluid shifts and the bones, ligaments and tendons move, there are occasional sounds made from friction. If the popping and cracking are associated with a loss of motion or pain, you should see your physician and have him or her evaluate you for osteoarthritis or degenerative changes. These happen with age and activity. Sometimes, when pain and loss of mobility are severe, orthopedic surgeons can be consulted to help too. To prevent arthritis pain, regular exercise is key! Keeping your muscles toned and strong will support the joints and bear the brunt of your activity.

– “There has been a recent outbreak of chicken pox in our school district. Many of the children have been vaccinated for chicken pox yet they still break out. My question is, do you need a booster shot for chicken pox? If so, when is it needed? Thank you!”

Phillips responds: Great question! Chicken pox is caused by a virus known as varicella. There is a vaccine against varicella, and it is typically given to children under the age of 13. The vaccine has been proven to reduce the infection rate of varicella remarkably. Some patients who have received the vaccine have shown evidence of immunity for up to 20 years! The set of symptoms we see in patients who have been immunized against chicken pox but exposed to the virus is more mild than the set of symptoms we see in unimmunized patients - fewer lesions on the skin and no fever with the vaccine. After five years, however, there does seem to be a decrease in the effectiveness of the vaccine. Still, there are no recommendations for boosters now.

– “Info on Cushings?”

responds: Thank you for your e-mail suggestion and for your interest in Fairview On Call. We will put it on the list of topics to consider for future shows.

-- “Dear Dr. Gretchen, Greetings!!! What is the best way to send you information re: a possible guest idea for your show? Thanks so much for your help! Wishing you a brilliant day! Best always.”

responds: Fairview On Call features physicians and health experts that have a connection to Fairview Health Services. If you have a suggestion for a guest or topic, please contact me directly by e-mail at hdonnay1@fairview.org or at 612-672-6343.

– “Does bone itself hurt? What in bone registers the pain? Nerves do in soft tissue; in bone too?”

Phillips responds: Yes, bones can hurt. There are nerves and blood vessels that supply our bones and in the event of injury, bones can cause pain. Many times, this pain can be controlled with non-steroidal anti-inflammatory medications, such as ibuprofen. There are cases, though, when bone pain requires stronger medications such as narcotics.

– “I have soreness in the top of my left shoulder. I also have numbness in my right arm to my hand when at the computer, driving, shaving, sitting, and exercising. I am a 57-year-old male and I work construction. Thank You”

Phillips responds: It sounds like your shoulder may be experiencing spasm or tendonitis, which can lead to pinching or impingement of the nerves. Often, with use of the affected arm, this impingement can cause tingling or numbness. Your family physician can send you to either an orthopedic specialist, sports medicine physician or physical therapist to evaluate your situation and provide exercises and treatments that may relieve your symptoms. Thank you for your question.

– “For someone that’s almost retired, Does Fairview have volunteer positions?”

Phillips responds: We are always happy to have hospital volunteers! Please contact your nearest Fairview hospital for their volunteer office.”

– “Hi; I listened to you this past Sunday. Can you give me the name of the physician that was on with you? We have a person here where I work that has had asthma since childhood, and is very willing to try a new approach. Thank you”

responds: The physician that was our guest on this past Sunday's Fairview On Call radio show is: Dr. Mark Rieb, Family medicine specialist , Lakeville Integrative Medicine Clinic, 16372 Kenrick Ave., Ste 100, Lakeville, MN 55044, Phone: 952-892-6700

– “Right now I don't have a question, but I did want to inform you I have dead jaw bone from [Bisphosphonate/Calcium Regulator] and I have not been on IV chemo. I had a wisdom tooth pulled and bone came out for over a year. My left lower lip is numb and it is getting sunken in. I can't eat hard or tough things. Thought I would let you know and it may not happen to everyone, but I sure have suffered. ”

Phillips responds: It sounds like you have been through quite an ordeal. Unfortunately, side effects like these, although rare, can happen. I'm glad your dentist was able to help you. As much as we try to prevent complications, some are not avoidable. Best of luck in your recovery.

– “Dear Dr. Phillips: We saw you at the fair and think you are wonderful! You are very articulate and talk so down-to-earth to the average person. There weren't many people there but we are your fan club! You spoke with me on my new diagnosis of Celiac Disease. You are one of very few who understand what a rotten diet it is. Could you have a show on this sometime? It would be much appreciated. Keep up the excellent job!!! Thanks”

responds: Thank you for your suggestion for a show topic on celiac disease. We will definitely add it to the list and seek an expert guest within our system to facilitate discussion.

– “Hello Dr Phillips, I enjoy your Sunday AM program, I question a comment you made on 12/24 referencing a woman’s cancer diagnosis. You told her to "hope for the best, prepare for the worst". Please explain what you mean by this statement! Thanks”

Phillips responds: With any diagnosis, we always want patients to prepare themselves for bad news and hope for good news. I always wish for a patient to be optimistic in the face of any news, good or bad. When the news of a diagnosis is not good, such as cancer, the outlook may be better than originally thought. He or she may be unaware of new treatments available. The word "cancer" can be daunting because of preconceived notions of a bad outcome. My hope is that with science and education, we can instill hope in patients in the event they are frightened by the thought that their life is in jeopardy. There is often a great light at the end of the tunnel! There is always, however, the possibility that the patient has a terminal disease. In that case, the care team needs to be prepared for bad news.

– “I've been diagnosed with osteopenia. Took [medication] for 3 wks. Stomach couldn't tolerate it. Took [another medication], had bad rash & swollen face. Had been taking required amount of calcium & Vit. D. Now I found out I've got a kidney stone. I'm ready to stop meds for osteo and calcium supplements and just rely on calcium food nutrition. What's your opinion?”

Phillips responds: It's unfortunate that you had such trouble with those medications. Osteopenia and kidney stones can be a tricky combination. My best advice to you is to find a nutritionist that can make recommendations to you on ways to include calcium in your diet that may not increase your risk of kidney stones. Dr. Manoj Monga is a urologist with The Kidney Stone Clinic at University of Minnesota Medical Center, Fairview (who leads a team of specialists who are committed to helping people with just your concerns). Please consider calling his clinic (612-624-9422) or finding a nutritionist who can help you.

– “Why does Irritable bowel hurt so much? What can be done about the pain?”

Phillips responds: Irritable bowel syndrome (IBS) can cause spasm in the bowel, which can be uncomfortable or painful. People with IBS often have cramping and intermittent constipation. These can be relieved, at least in part, with fiber supplements and some medications. Exercise has been shown to help with the symptoms of IBS, including pain. Please discuss your symptoms with your personal physician and ask him/her for options to help with your symptoms.

– “I was in an auto accident 3 years ago and had my neck injured and had problems with my right arm, headaches and blurred vision. Now three years later my left arm is acting the same as my right arm did. I wanted to know if it could be caused by the accident and take this long to give me problems. I had an MRI done & it shows tendon and joint problems.”

Phillips responds: Hi Bob, I doubt the accident caused the trouble you are experiencing. Most musculoskeletal injuries (bones and muscles) from trauma, such as a car accident, happen as a result of the forces involved in the trauma and heal afterwards. It is more likely that you have some arthritis or other wear-and-tear issues in your shoulder. A physical therapist and exercise program may help ease your symptoms. As always, please discuss this with your physician.

– “My mom had a hysterectomy couple years ago. She is doing fine but is she required to take any homonal supplements? Which one would you recommend?”

Phillips responds: This is an issue that requires very individualized attention, so I can only be very general in my answer. Hormone replacement was, in the past, thought to be standard after hysterectomy. Multiple studies have been done recently, though, questioning the safety and necessity of using hormone replacement in women after hysterectomy and menopause. Some breast cancers are hormone sensitive and there is an increased risk of breast cancer in women who use hormones. The protection against heart attacks we once thought hormones brought is questionable and some studies have suggested hormone therapy may actually increase a woman's risk of heart attack or stroke. These risks must be balanced against every patient's individual situation and set of risk factors, though, so I suggest your mother see her physician and discuss this issue in detail.

– “In a previous schedule it showed the December 3rd topic was Dr. Paul Langer discussing his book on Health Feet (don't remember the name of the book). Now I see there is a different topic on that date. Has this been rescheduled, I don't see it on the schedule. Please respond by email.”

responds: Thank you for your keen observation and for your interest in Fairview On Call. Yes, we did make a change, as the publishing of Dr. Langer's book has been delayed for a few months. We do intend to reschedule his appearance at a later date. Keep watching for it.

– “I have been in the ER for Kidney Stones 5 times, with 2 times being in the last 3 months. I am wondering what I can do/take to remove the ones I have now and prevent new stones from occurring.”

Phillips responds: The Kidney Stone Clinic at University of Minnesota Medical Center, Fairview (612-624-9422) may be a good place to start. Their team of doctors and nutritionists can develop a comprehensive plan for you to both treat the stones you have and prevent further stones. Dietary changes … can make a big difference in recurrence of stones. There are also medications available to eliminate stones and prevent further problems. Check in with your primary doctor for a referral.

– “Hello, Listen(ed) to your subject on stones. Anyway, no one said where the pain might be in regards to having stones in your Kidney. I had my gall bladder removed in the 1970s. But the pain persists in the lower left hand side of my back. So, could not get through to the radio… Have listen(ed) to "cco" for 50 years or more. Any advice would be appreciated. Thanks.”

Phillips responds: Interesting question. I apologize for keeping the lines tied up and preventing your call from reaching us. The stone show was quite a busy one! The pain in your back could certainly be caused by kidney stones, though there are many reasons for low back and flank pain including muscle tension, arthritis and scoliosis, or an abnormal curvature of the spine.

stones can cause pain in the abdomen or back. The pain is usually described as "colicky" or waxing and waning. This happens because the ureters (the tubes that connect the kidneys and bladder) spasm against the stone and cause pain. Testing for kidney stones is pretty easy. Your physician should get a urine sample from you and then can do X-ray studies or a CT scan to visualize stones. There is no connection between gallstones and kidney stones, so no worries there.

– “The dietician on the radio show regarding kidney stones recommended taking fish oil as a preventive measure. What amount of fish oil should be taken? Thanks.”

Phillips responds: There are no definitive studies on fish oil being beneficial for kidney stones, but there are many practitioners who advise a trial of fish oil. Because of the lack of scientific evidence, there is no recommended dosage available. Fish oil is used in other disease processes at a dose of 500 - 1000 mg daily. Many times, you can achieve this dose with eating fish as part of your diet. A consult with a nutritionist may be helpful in determining how to best do this. As with all dietary supplements, please use caution when adding them to your medication regimen. There can be significant side effects associated with fish oil and other "natural" remedies, such as bleeding. Please discuss this with your physician before you begin taking any over-the-counter products.

– “I have been diagnosed with IBS and osteoporosis. I am only 52 and am really having trouble with a diet due to passing kidney stones now because I am trying to up my calcium. I have a history of passing kidney stones - both types but mostly calcium. I have never been a milk drinker...Is there any way to talk to someone about a diet that would help me? Between the stones and the IBS, I am really unsure what to do.”

Phillips responds: This is indeed a difficult situation for you. Please ask your personal physician about referring you to a dietician to evaluate your possibilities. There may be a specific formulation of calcium or other dietary changes that will help you achieve the calcium intake your bones need without making your stones worse. Other osteoporosis remedies, such as bisphosphonates are another option to protect your bones.

– “I have developed warts/bumps on my forehead due to sweating by wearing a cap. What do you recommend I can do?”

Phillips responds: There are many skin lesions that can arise on the face, whether in response to trauma or occlusion, as from a cap. The bumps you describe may not be warts. Please have your family physician evaluate you and determine the best course of treatment. Often, warts can be treated with liquid nitrogen, essentially freezing them off. If they are small sebaceous cysts (a.k.a. "zits") that have started to harden, they may need to be surgically removed. Your physician can also recommend prevention strategies to avoid further skin irritation.

– “How can I get a form to request "My Chart?”

Phillips responds: There is a link to My Chart on the Fairview website at http://www.fairview.org/. Click on this link and then choose "My Chart Authorization Form download." You can download the form and mail it to your primary care clinic.

– “On Sunday, while you were on the topic of dizziness, Denny Long said he had an ailment that made him seem as if he were intoxicated. It sounds just like what my husband is going through. He has seen an ENT and done a balance test, but no diagnosis has been found. Could you tell me the name of the problem that Mr. Long had so we could run it by one of my husband's doctors?”

Phillips responds: Labyrinthitis and neuronitis are relatively common forms of dizziness. With an intoxicated feeling, though, problems in the cerebellum, or back of the brain, should be investigated as well.

“Would like to get the name of the physician/oral surgeon that works with people that have had trauma to their teeth and talked about having posts put in and crowns. I think he is at a teaching hospital in Minneapolis? He was on a couple weeks ago. Thank You.”

responds: Thank you for your question. The physician you refer to was a guest on our Fairview On Call radio show Sunday, Oct. 1. Dr. Mark Engelstad is an oral and maxillofacial surgeon with Hennepin Faculty Associates and a member of Fairview Physician Associates. You can find contact information for him at the address below. http://www.fpanetwork.org/provider/details.asp?provider=1976132&address=7253059.

– “What will happen to your body if you take 4 800 mg ibuprofen?”

Phillips responds: Ibuprofen is an over-the-counter medication commonly used for its anti-inflammatory effect. It can, however, be dangerous in doses that exceed the recommended daily allowance. Taking more of any medication is potentially harmful and all medications should be discussed with your primary physician prior to taking them. Ibuprofen can cause stomach upset, irritation, ulcers and bleeding. With higher doses, it can cause acidosis and kidney damage, both of which can be life threatening. Always take ibuprofen with food and never take more than 2400 mg in a 24-hour period.

– “Will insurance cover [dental] implants?”

Phillips responds: Insurance coverage is very variable and depends on the policy and the company. Some insurance companies consider implants cosmetic and may not cover them. Each patient should contact his/her policy service center and discuss coverage prior to any procedures.

– “I exercise all of the time and I eat great but I can't lose the 80 pounds I gained after my last pregnancy. What could be wrong?”

Phillips responds: Weight loss is very difficult and can be a challenge to even the very dedicated. After pregnancy, there can be considerable difficulty losing weight because of the increased demands on a woman balancing motherhood and the rest of her life. Often, parents eat on the go and eat convenient foods, which are not always nutritious or low in fat and calories.

weight loss comes down to calorie balance. If you burn more calories than you take in, you will lose weight. Each of us uses a certain number of calories daily just doing regular activities such as working, cooking and cleaning. Exercise is the key to burning extra calories. The simple science is that if we exercise away 3500 more calories than we take in as food, we will lose one pound. At a net deficit of 500 calories a day, that's a pound of weight loss per week! A nutritionist can help you find pitfalls in your diet and design an eating plan that will work for you. Your physician can help you with an exercise program. Most of all, every day counts! Every calorie counts! Start today and make a commitment to yourself to be well. You'll be so glad you did.

– “What do you recommend for adults with ADD or ADHA. Adults who have a hard time concentrating on things and staying on task?”

Phillips responds: “Patients who are concerned about Adult Attention Deficit Disorder (ADD) should be seen and evaluated by a psychiatrist and psychologist. Often, symptoms of bipolar disorder, anxiety disorder and depression can mimic symptoms of ADD. Difficulty concentrating, a feeling that we need to be constantly moving (akasthesia) and difficulty staying on task can be signs of depression or anxiety. These are treated with medications that are different from classic ADD medications. Depression, anxiety and bipolar disorder are potentially serious conditions and should be evaluated fully. Sometimes, people who suffer from these diseases experience severe symptoms that can lead to suicide. Please talk to your primary physician about a referral to a psychiatrist for evaluation.

– “Spinal stinosis -- vitamin cure or reversal?”

Phillips responds: Spinal stenosis is a condition of compression of the spinal cord by the vertebral column. An evaluation by a surgeon is necessary for treatment options. If there is not a surgical option, pain control is often possible through specialists. See your primary physician and discuss your symptoms and possible referrals for pain management.

– “HELP!!! I'm looking for Dr Raders. He was my Dr. before he went to FL. I heard he was back at Fairview. Is he? (He was OB-GYN.)”

responds: Thank you for your inquiry. Dr. James Raders is an OB/Gyn physician who is a member of Fairview Physician Associates. He sees patients at: Female Pelvic Medicine and Reconstructive Surgery, 2805 Campus Dr Ste 405, Plymouth, MN 55441, Phone: 651- 999-1900

has been a guest on the Fairview On Call health information radio show, aired Sunday mornings, 7:30 -8:30 on WCCO 830 AM.