The Doctor Answers - Fairview Health Services

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.

4/08 Question: I'm having problems focusing my eyes when I read with a headache. Who was that Opthalmologist you had on the show a couple weeks ago?

-- Producer responds: Dr. Michael Lins was our guest. He can be contacted at: Columbia Park Medical Group Fridley Clinic 6341 University Avenue NE, Fridley, MN 55432. Call 763-572-5705 for appointments.

4/08 Question: Last week a caller asked the guest what the long term implications were of taking nasal steroids and pills and such for allergies, then the guest started to answer the question, but the doctor interrupted and said to the guest, "before you give your answer, why don't you tell us what nasal steroids do and why people take them." Well the guest went in to a lengthy explanation and then never got around to answering the question. Help.

-- Dr. Phillips responds: The answer was kind of convoluted, but we came back during the second half of the show and tried to be more clear- sorry it was fragmented. In the end, nasal steroids can cause nosebleeds from time to time and there are really no bad outcomes in taking allergy medications long term.

3/08 Question: On last Sunday's program there was a question about grapefruit juice drug interactions. I thought I heard you say that it doesn't allow the drug to work as well. Grapefruit juice actually inhibits the enzymes that metabolize certain drugs, and can lead to serious reactions such as arrythmias. There are certain drugs that should not be taken with grapefruit juice,because they can build dangerously high blood levels. Thank, PharmD

-- Dr. Phillips responds: Thank you for writing. It's hard to think on my feet on the air sometimes and make what I want to say make sense to my listeners. I appreciate your attention to what I'm saying on the show and for helping to keep me honest and accurate!

3/26/08 Question: We are unable to get the flue shot here in Belgrade, Mn. Can you help us find a location they have them

-- Dr. Phillips responds: As we near the end of flu-shot season, the vaccine may be hard to find. We usually give the shots starting in October. This next year, check with your local doctor to find out where flu shots will be available. It is worth a wait or a short drive, if necessary, to get one! I apologize for not being more specific. This next year, we will be more proactive in helping you find what you need.

3/08 Question: I'm 24 years old, I'm pregnant with my 3rd child and have decided to get my tubes done. I've had 2 c-sections, and was wondering that because I'm having a c-section would it be more painful after everything is done? and the recovery? would that take longer.

-- Dr. Phillips responds: Having a tubal ligation ("tubes tied") after a Cesarean section is a convenient and simple way to have this done. The surgeon will have your uterus and Fallopian tubes exposed and can clip the tubes before he or she closes your wound. Please think about this decision very carefully. Many patients think they can change their minds later and have their tubal reversed. This is not always safe or successful. If you are not 100% certain about NEVER again having children, please talk with your doctor about other ways to prevent pregnancy.

3/08 Question: Doctor said I have a hole in my stomach what does that come from?

-- Dr. Phillips responds: Generally a "hole" in the stomach refers to an ulcer. These can come from different things, but about ten years ago research showed, to many doctors' amazement, that most ulcers can be related back to a bacterium called Helicobacter pylori. Most people can be treated with antibiotics or other medications. Your stomach may be sensitive to spicy foods, acidic foods or drinks with bubbles, so avoid those.

3/08 Question: A friend has recently been diagnosed with lung cancer. He was just given his first chemo 2 drugs plus a clinical trial drug. Lots of side-effects--chills, fever, nausea, heartburn, shortness of breath night sweats. When his wife called his nurse, the nurse thought all those symptoms were wonderful, because it meant the chemo was doing its job, and that it was interesting for the clinical trial doctors to see side effects that they had never seen before. She told him to stay home and stick it out, but call again if the symptoms lasted more than two days. Any thoughts?

-- Dr. Phillips responds: You're right, the physicians and scientists involved in the trial will be interested in everything your friend experiences during the drug period. I agree with the nurse that chills, nausea and heartburn may be signs that the chemo is working. All cancer patients do NOT have to live through those symptoms, though. We often prescribe other medications to combat those side effects.

The trial may have the stipulation that in order for a side effect to be "clinically relevant", it should last for two days. These are definitely questions for your friend to ask her oncologist.

2/08 Question: I have recently heard about a treatment for emphysema. It is traveling to Mexico to receive injections of sheep stem cells. Does it really work? Can it work for lupus also? THANK YOU!

-- Dr. Phillips responds: My first answer is HOLD EVERYTHING! Stem cell research is in its infancy and there are a lot of variables that have not been ironed out yet. My understanding of animal stem cell research is that we have seen some possibilities, but the safety and effectiveness have not been made certain enough for use in humans.

There are many possible problems with injections: infections at the site of injection, impurities in the "stem cell" mixture, a reaction to the cells similar to organ rejection which can sometimes be fatal, and diseases that are common among animals that humans may get through improper laboratory technique, such as mad-cow disease and the like.

Please consult your pulmonologist (lung specialist) and rheumatologist (lupus specialist) before you try any experimental therapies. There are many scientifically-proven options for both diseases and they are worth a try first.

2/08 Question: How can I listen to or secure a transcript for the 2-17-08 broadcast?

Producer responds: The recent Fairview On Call broadcast should be available via podcast at:

http://www.830wcco.com/pages/3648.php. Scroll to the bottom right side of the page.

2/08 Question: Good Morning Dr. Phillips, I really enjoy your Sunday morning show, you are a great spirit. Last Sunday with Dr. Noel Radcliffe was wonderful, with good insight and a basic, easy to incorporate, holistic approach to mental illness. I have a mother who suffers and the med part is easy but the cognitive, change your thinking part is the tough one. Dr. Radcliffe mentioned a book about forgiveness and I missed the title. Would you please email the author and title. I hope you have Dr. Radcliffe on again.

-- Producer responds: I am responding on behalf of Dr. Phillips. The book that Dr. Radcliffe referred to on Sunday's program was -- Forgiveness: The Greatest Healer of All by Gerald G. Jampolsky, MD Beyond Words Publishing, Inc., Hillsboro, Oregon, 1999; 123 pages, ISBN 1-58270-020-6.

1/07 Question: Dear Dr. I have had recurrent nightmares. Seeing snakes. Hallucinations with snakes. Large snakes. I saw tarantula once. Since stopping the vitamins and excessive oil use the hallucinations have gone less. Do I have something to worry about? The halucinations are less .But sleep is better now and [I] relax more. Should I wait and see if the halucinations get any worse before seeing the doctor about them again? Do I have anything seriously wrong with me? I am starting to see the same things I saw before since turning the light off a little. Am I depressed or do I have something more serious? I would rather only be treated by my GP. I see a small reptile snake face at night and a large one sometimes around people .Is this normal? .

-- Dr. Phillips responds: Although I doubt there is something terrible going on with you medically, I am concerned that you may need more help from your physician. In fact, I would really like for you to talk with your doctor about seeing a psychologist about your nightmares. Not because I think you are crazy! Psychologists are very well trained at investigating our dreams, thoughts and fears and helping to make them better without medications. Some recurrent dreams such as teeth falling out can be a sign of anxiety. My concern is that you have underlying stress in your life that is coming out as these hallucinations. I absolutely agree with you stopping all over the counter and "natural" products. The fact that you have gotten better off of them already is encouraging. Please see your doctor and discuss your symptoms with him or her.

1/07 Question: Do cancer cells have an affinity for glucose greater than other cells, dividing at the same rate? Can reducing the amount of refined sugar ingested "starve" malignant cells?

-- Dr. Phillips responds: Cancer cells do have a higher metabolic rate than normal cells, and may use glucose at a more rapid rate, but there is no evidence that changing dietary intake of sugar makes any difference in the rate of division or spread of cancer.

1/07 Question: I have been having sharp pain in the lower left portion of my back when I breathe, do you know what could cause that?

-- Dr. Phillips responds: It sounds like you may have a bit of pleurisy. This can cause sharp pains in the chest and back, especially with deep breathing. Pleurisy is a benign condition that is usually a result of inflammation inside the chest, such as after a bout of bronchitis or pneumonia. There is not usually a more significant problem underneath, such as cancer. If you smoke, please stop, for all of the health reasons we know about. When your breathing hurts, take some ibuprofen or Tylenol. If you are more concerned, please see your doctor.

1/08 Question: I am 37 weeks pregnant and am having what I think are contractions coming around every 45 to 50 minutes apart. Since I am 37 weeks I feel I should just wait to call the doctor when they get close. Is that right?

-- Dr. Phillips responds: Assuming everything else is okay with your pregnancy, 37 weeks is fine to deliver. Contractions that happen 45 minutes apart may be due to stress or dehydration. Waiting at home is okay. If the contractions get stronger or happen closer together, check in with your doctor, at least by phone. Congratulations!

1/08 Question: I am interested in getting a copy of the information discussed by Dr. Robert Ketroser this morning11308 regarding Strokes in women

-- Producer responds: We don't have the programs available in transcript form, but you can catch a podcast of recent shows by going to the WCCO Web site: http://www.830wcco.com/pages/3648.php under specialty programming.

12/07 Question: My doctor thought I might have Chronic Fatigue Syndrome. He is thinking different now that I am exercising without fatigue. I have noticed I get the symptoms more with mental exertion. Do I need to have both mental and physical to have Chronic Fatigue Syndrome? Thank You

-- Dr. Phillips responds: The Centers for Disease Control (CDC) has established certain criteria for diagnosing CFS:

1. Fatigue that is persistent, relapsing or debilitating; does not improve with bed rest; and reduces or impairs average daily activity level by more than 50 percent for a period of at least 6 months. Patient has no previous history of fatigue.

2. The patient has 4 or more of the following symptoms, which must have persisted or recurred during 6 or more consecutive months and not predated the fatigue:

* Short-term memory or concentration problems

* Sore throat

* Multi-joint pain without joint swelling or redness

* Muscle pain

* Headaches of a new type, pattern or severity

* Non-refreshing sleep

* Post-exertional malaise lasting more than 24 hours

In addition, a number of minor symptoms may also appear:

* Poor sleep

* Achiness

* Brain fog

* Increased thirst

* Bowel disorders

* Recurrent infections

* Exhausting after minimal exertion

The CDC criteria should not be thought of as final guidelines in diagnosing CFS. Research has shown the people with disabling fatigue who fit the CFS criteria have the same immunologic changes and responses to treatment as those who don't fit the criteria.

Best of luck with your symptoms!

12/07 Question: Do you have any idea why the ears will ring so badly. My ears have rung for years but in the last few months they ring so loudly that I cannot hear softer voices. What can you tell me? Thanks

-- Dr. Phillips responds: There are many reasons for ringing in the ears. Most times, the reason is not lifethreatening, but brain tumors can cause such symptoms. You really should see an audiologist or an Ear, Nose and Throat doctor for a full evaluation. Sometimes medications can help, but a complete exam should be done.

12/07 Question: Hi, My little boy is 8 yrs old, he has been diagnosed with the ring of fire, and aspergers syndrome. He was given invega, but it was going thru his body and not breaking down at all, in his stools whole. So his doctor gave him 60 mg of Geodone. He has now developed AKASTHESIA. He has given us a cogentin to counter act, but the shaking and tongue thusting has gotten worse. He has asked that we continue and the AKASTHESIA will subside. I am so scared for my son and it does not seem to be subsiding. Does this ever go away? I am having difficulty finding information about AKASTHESIA, Any information I could get would be helpful. I trust our doctor, or have up to this point, but this has been going on since Wed. I just want to help my son. thank you

-- Dr. Phillips responds: I'm sorry to hear you are going through this very frightening situation with your son. These diagnoses and medications can be very difficult to manage and as a Mom, this must be tough. The Invega tablets are long-acting, and sometimes the pills themselves may not dissolve in the body and are found in stool. The medication in the pills is usually absorbed, though. These are called "ghost tablets" but are usually effective anyway. I would discuss that possibility with your son's doctor.

Akathisia is a side effect of many of the medications in the same class as Geodon. Cogentin does help to counteract it, but there may still be some symptoms regardless of the Cogentin. In some patients, the tongue thrusting and abnormal movements do subside, but in some patients, we need to stop the Geodon.

Akathisia is another form of tardive dyskinesia which is found in extrapyramidal syndrome. These symptoms are more common with older anti-psychotic medications, but even meds like Geodon can cause them. The symptoms are similar in appearance and cause to Parkinson's disease, which is why we use Cogentin to help them.

Be very honest with your doctor and share your concerns. There are many medications out there and balancing side effects with the effects of the disease is really the key. Best of luck to you. You are a strong woman to be there for your son!

12/5/07 Question: I was listening to WCCO this morning and you mentioned "ideal weight". I know about BMI, but how do I determine a good weight for me?

-- Dr. Phillips responds: "Great question! Your "ideal body weight" is a BMI of 19-25. People, especially women, below a BMI of 19 can risk osteoporosis and malnutrition. Over 25, and we are at risk for diabetes, heart disease and high blood pressure.

Here are some examples with height and ideal weight:

5'0" 97-128 pounds

5'2" 104-136 pounds

5'4" 110-145 pounds

5'6" 118-155 pounds

5'8" 125-164 pounds

5'10" 132-174 pounds

No matter what your frame size is, this range is pretty well researched to represent the healthiest weight for each height. There are always exceptions, but they tend to be professional athletes only.

The story Dave Lee and I discussed was very interesting to me. In being overweight but fit, we can reduce our risk of disease. Really, in staying fit and exercising regularly, we will also lose weight with some simple calorie counting too! Have a healthy day!

11/07 Question: My son is 12 years old and was kicked in the jaw during his soccer tournament yesterday. He play goalie for the team. He appears to move his mouth find and there is no bleeding, but his right side of his jaw is swollen and sensitive to the touch. He has trouble chewing on the right side but appears to open and close his mouth just fine...speech has not changed. Should I take him to the doctor andor get an x-ray or wait and see if it gets better. My son says the pain is the same if not slightly more than when it happened. This happened around 200pm yesterday. Thanks in advance for your advice.

-- Dr. Phillips responds: There is a muscle called the masseter at the angle of the jaw, and it may be where your son was kicked. Muscles tend to swell and spasm when they are traumatized, and this could be the cause of the swelling. It would also account for the tenderness. As long as he can open and close his mouth and doesn't have any instability of his jaw, I think your plan is fine. If this lasts longer than 7 days or he has trouble eating, see a doctor or dentist.

11/07 Question: Recent diag.CHF.Cold hands, feet related? Can I still drive? What to look for? Reduceable? Controlable? Am diabetic just getting under control. Wish 'cco would do with less commercials. Thanks

-- Dr. Phillips responds: CHF is a condition usually related to high blood pressure, being overweight, not exercising enough or diabetes. I am very glad to hear you are getting your diabetes under control! Your cold hands and feet are probably more related to blood vessel disease from your diabetes than CHF. Diabetes, when it's not under control, can damage blood vessels and nerves and lead to tingling, numbness and a cold feeling.

CHF is controllable and you can regain some heart function! Enroll in a cardiac rehabilitation program and stick with it. Exercise every day. No excuses, now! Most importantly, get your diabetes under control and keep a hold on your blood pressure. Having CHF puts you at risk for lots of medical problems and even disability, so use this diagnosis as a wake-up call to take control of your medical life!

Small changes can make a big difference. If you can, meet with a nutritionist and a diabetes education expert. They can tell you how to best manage your diseases. Then, get started with cardiac rehab. I'll bet in one year, you'll write me again and tell me how great you feel if you stick with your new program!

11/07 -- Question: I was prescribed hctz in July. I did not start taking the medication until October because I was trying to find the right time to begin this medication. I accidentally spilled the medication on carpeting and put them back in another container. Since I started this now, I haven't noticed any effect--no side effects and it seems no drop in my blood pressure, could it be I waited too long before starting the med after filling it or that the contents of the med dissolved in the carpet? I am taking 25 mg once a day. I always take it with my breakfast mostly with my orange juice. Should I just be taking it without food? I have been on it since 10-20.

-- Dr. Phillips responds: HCTZ does not work well in all patients, especially people with abnormal kidney function. I doubt you changed the effectiveness of the medicine when you dropped it. I am more concerned about not taking your medicine for three months! High blood pressure can cause strokes and heart attacks, when not treated.

Please have your doctor recheck you and your blood pressure. He or she may stop your HCTZ and may add another medication to it, which is commonly done. Not feeling side effects is a good thing. The trouble with high blood pressure is that there are often no symptoms other than the stroke that is caused by it. Please don't let how you feel determine how your medications are working!

10/07 Question: Does caffeine affect Kidney narrowing?

-- Dr. Phillips responds: Caffeine does not narrow the kidneys, but it does cause narrowing of the arteries, which can increase blood pressure and decrease the ability for blood to get to the kidneys. Caffeine increases the tone of the tiny muscles that arteries have in them. When this tone goes up, the size of the opening in the artery gets smaller. For people with kidney disease and high blood pressure, we recommend cutting out caffeine to protect the kidneys and keep the blood pressure down.

Sent: Question: Over the past several months, I have noticed, and become increasingly frustrated, with an inability to clearly articulate myself, follow certain discussions, and to think clearly. Mentally, I feel way below par and I don't know why. I haven't suffered any recent trauma, I eat fairly healthy, get a moderate amount of sleep, and exercise at least twice a week. I'm frustrated, concerned, and don't know what to do. Do you have any insight or suggestions?

-- Dr. Phillips responds: Please see your physician to discuss this with him or her. Sometimes stress, depression or sleep loss can make us feel like we are less sharp than before, but there are several medical conditions including brain tumors and thyroid disease that should be evaluated as well. If you do not have any of these problems, your doctor may be able to prescribe a sleep study or other medication to help.

10/07 Question: I am a 52 yr.old female with moderate to severe back pain. I have seen 2 different doctors at a spine clinic. An x-ray showed a little arthritis. Both an MRI and full body bone scan were normal. My upper-mid back muscles are very tight and painful to the touch. The last time I was in, the doctor gave me a series of injections in my muscles to numb them. She did not do all the muscles. This has not given me any relief yet. I am also scheduled for some massage therapy. Even with prescription pain meds, I have a hard time sleeping at night. The pain is severe in the morning but eases through the day as I am up and about. Any help is greatly appreciated.

-- Dr. Phillips responds: This is a common cause of back pain, unfortunately. Muscular pain can be intense and can take a while to improve, even with therapy. The first thing you should do is find a physical therapist you can work with to develop a treatment plan and set of home exercises. The arthritis in your back probably set off a pain cascade in your muscles and now they continue to flare. If you have any weight to lose, even if it's only 5 or 10 pounds, losing that will help more than you'd think. The strain of extra weight can be tremendous on back muscles. Massage therapy is very helpful. Also, there are pain specialists at pain control clinics who can offer combination therapies that can be very helpful.

10/07 Question: If someone plans to retire in Mexico or spend an extended time there, is there a way to adjust to the water. Living on bottled water for years could be inconvenient.

-- Dr. Phillips responds: Great question! I asked my mother who has been living in Mexico for her input too.

There are some things that you can develop a tolerance for, mild bacteria in foods that we are not used to in the US and then there is contamination, like e-coli that you can't get used to.

Here is a quote from the Peace Corps medical handbook: "Barring exceptional situations, all water in Mexico is contaminated. There is a widespread problem of fecal contamination of water with amoebas, parasite eggs, hepatitis, and bacteria (typhoid fever and bacillary dysentery.). Although attempts are made at purifying the water in certain sections of Mexico, the systems used are not reliable. Safe, potable water can be obtained by boiling for 3 full minutes and bottled water."

Actually, bottled water is fairly cheap in big jugs and people who have moved there have said you get used to it.

9/07 Question: --Maybe I missed it, but is Lifeline available in Isanti county? --Approx. monthly cost? Thank you.

-- Deb Jensen, Manager of Lifeline, Senior Program and Sales Fairview Home Care and Hospice responds: We do service Isanti County. The fee for Fairview Lifeline is $38 a month - no long term contracts. Feel free to email me for more information. We'd be happy to help you.

9/23/07 Question: On today's show you stated when taking calcium it should contain Vitamin D. I was told by another doctor to use Calcium with magnesium to avoid constipation and gas issues. What is the reasoning between these two different recommendations, if any. Thank You

-- Dr. Phillips responds: The vitamin D is essential for your body to use the calcium you take. The magnesium is often added as a preventive measure against constipation, which can happen from taking calcium. The vitamin D is very important. The magnesium really only makes a difference if you encounter constipation as a side effect.

9/23/07 Question: My husband is experiencing periods of rage, expressing it in much talk. He is 64 and retired for 2 yrs. He has had a tramatic childhood, which accounts of a lot of pent up anger. He also claims to be depressed when these moods occur. But he will not go to a doctor for help, because he thinks he knows nothing will help and "doctors don't really care or know ". He doesn't want to take medication see anyone to for talking this out. I am sure it would be too painful. I am encouraging a doctor visit and maybe eventually he will, but if he doesn't get one that will take him seriously, then we are back to square one. Can you give your explanation or opinion of this condition, and give us a few suggestions. Thanks.

--Dr. Phillips responds: What a tough situation for you. It sounds like your husband may be experiencing one or a combination of all of these disorders: depression, bipolar disorder and post-traumatic stress disorder. Alcohol use and abuse is also a concern for people with episodes of rage. You didn't mention this, but it's an important piece.

Doctors do understand these conditions and we do care. There are treatments, both in therapy and medication that have been proven to help people who suffer from these bouts with rage.

It is painful to talk through some of these issues, but it can be ultimately more painful to live with them locked up inside. I encourage you two to find a therapist you like and trust who can help both of you with this difficult problem.

9/07 Question: I have a question about my prostate. I am 63 years old. I have had two biopsies on my prostate with the last one in 2001. They both showed negative. I have an enlarged prostate and my psa scores have fluctuated as high as 11 but it goes up and down. I tend to worry extra about medical issues. On Thursday of this week I had a biopsy with an echo. My urologist happened to mention he saw nothing in the procedure but my psa is 6.8, which actually dropped from the last six months but my free radicals dropped from 12 to 8 and that is why is did a 20 piece sample of my prostate. Here is the question. He mentioned that he would have liked to have seen my prostate bigger with a score of 6.8. I know you can't tell me for certain until the results come in, but what could that mean if my prostate is not bigger with a psa score of 6.8. Is it too late and does that mean it is cancer. I have an anxiety disorder and I worry about medical issues and I feel so stupid asking this question but I need your response. Thank you.

-- Dr. Phillips responds: Prostate size does not always correlate well with PSA values. Until you know for sure there is cancer or not, please don't worry. If you do have prostate cancer, with PSA numbers in the 6-11 range, you have caught it very early. Most bad cancers have PSA numbers that are much higher. Also, if it is cancer, it is usually very treatable and does not cause early death.

Your urologist has done all of the right things so far. Hopefully the biopsy will come back soon and you will have peace of mind that your PSA is just slightly high, but there is really nothing terrible going on.

9/07 Question: Type your question here! I have read conflicting articles on Vitamin E and seleium. Some say it is realy good for you and than other articles say no. What is your thought on taking these supplements? Thank You

-- Dr. Phillips responds: Supplement use and its benefit are tough questions. There have been so few studies done on supplements that can stand up scientifically, and the supplements that are available in this country are not routinely tested for purity or dosage standards. There can be contaminants and many irregularities within a bottle or batch of supplements.

The American diet generally has enough of the vitamins and minerals we need. Many supplements are excreted, unused, from the body. For a while, we thought vitamin E could help keep heart disease away and now there are some physicians concerned it may actually increase the risk.

Discuss these issues very carefully with your personal doctor before you start taking any non-prescription medications.

9/07 Question: I was taking Avandia and heard that it causes heart attacks and death. I asked my doctor if I should quit taking it, or be switched and he switched me to Actos. Is this okay?

-- Dr. Phillips responds: Your doctor should be watching your liver enzymes and hemoglobin A1C to know if your diabetes is being adequately controlled and that you are not having any bad side effects from your medications. Actos has its own set of side effects and although Avandia has risks as well, your doctor should be able to balance your specific risks with the benefits of any medication. Tight control of your blood sugar is the key to preventing complications of diabetes.

8/07 Question: Hello Dr.Phillips. In your web page picture you sorta resemble a family member-only younger looking! The health question I have is about cholesterol. My total is 164 but the good is bad (37) and the bad is not as good (116). So how is this treated? Is a prescription the only option? and for how long? Does my being post surgical menopause help to contribute to this kind of thing? My lifestyle is a healthy one! so why does the body let me down? What do I need to know for my doctor appointment on Monday. And why did taking fish oil capsules have no significant effect on the good/bad numbers?? Thank you for a great radio show. Hope you have time to answer my wondering question. Warm wishes.

-- Dr. Phillips responds: Your cholesterol is partly a function of your lifestyle, and is also determined by your genetics. When you say "healthy lifestyle" that may not be as healthy as you think, when it comes to the proper diet and exercise necessary for good heart health. Fish oil has been shown to reduce heart disease, but may not necessarily change cholesterol numbers. In menopause, cholesterol does change, usually for the worse. Make sure you talk to your doctor about seeing a nutrition expert and discuss your exercise habits to make sure you are doing everything you can to reduce your risk of heart disease!

7/07 Question: Hi Dr Phillips, my wife age 54 has chronic back pain caused by a bad L4-L5 disk stenosis and a not quite so bad L3-L4. After conservative treatments including therapy and cortizone injections, her orthopedic surgeon says she is a good candidate for surgery on the L4-L5 disk, it just depends upon how much pain she can live with that will dictate the decision to have surgery. He seems very conservative in his treatments. My question is this: What long-term implications does having this single level spinal fusion have? We have talked with some people (non-doctors) who have said once you have 1 disc done, it is only a matter of time before you need the next one done, and the next, etc, because the surgery realigns the spine causing stress on the next disc, etc. Is this true, or can she have a realistic expectation that this one surgery will not lead to another?

-- Dr. Phillips responds: Having one disc done does not necessarily mean there are more problems looming that will require more surgery. Your wife should be in a physical therapy program to strengthen her muscles to minimize her pain. Most spine surgeons will only operate as a last resort, to minimize the risk of complications. Many back problems are caused and aggravated by muscle weakness, poor conditioning and being overweight. If your wife is not exercising regularly or has weight to lose, concentrate on correcting those things first. If the muscles are stronger, they can take the brunt of the pain off of the bones.

7/07 Question: Hello Dr Phillips, I am a nurse coordinator and I work with pts undergoing bariatric surgery. I was wondering if you have ever hosted a topic such as obesity in America and the comorbid conditions or wt. loss diet vs surgery? Thank you for your time.

-- Producer responds on behalf of Dr. Phillips: We have had discussions related to the topic you suggest on several of our shows. In fact, Dr. Ikramuddin with the University of Minnesota Medical Center, Fairview, has been our guest three times. We have also addressed weight loss from a clinical rehabilitation standpoint. Your comments are always welcome.

7/07 “Do tetanus shots hurt?”

-- Dr. 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.

7/07 “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?”

-- Dr. 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”

-- Dr. 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....”

-- Dr. 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.”

-- Dr. 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?”

-- Dr. 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?”

-- Dr. 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”

-- Dr. 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.

2/07 – “Thank you for this morning show. Does Fairview take U-Care Ins.?”

-- Producer 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.

2/07 – “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.

-- Dr. 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!

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?”

1/07 – “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!”

-- Dr. 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.

1/07 – “Info on Cushings?”

Producer 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.

1/07 -- “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.”

-- Producer 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.

1/07 – “Does bone itself hurt? What in bone registers the pain? Nerves do in soft tissue; in bone too?”

-- Dr. 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.

1/07 – “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”

-- Dr. 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.

1/07 – “For someone that’s almost retired, Does Fairview have volunteer positions?”

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

1/07 – “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”

Producer 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

12/06 – “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. ”

-- Dr. 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.

12/06 – “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”

-- Producer 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.

12/06 – “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”

-- Dr. 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.

12/06 – “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?”

-- Dr. 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.

12/06 – “Why does Irritable bowel hurt so much? What can be done about the pain?”

-- Dr. 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.

12/06 – “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.”

-- Dr. 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.

12/06 – “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?”

-- Dr. 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.

11/06 – “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.”

Producer 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.

11/06 – “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.”

-- Dr. 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.

11/06 – “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.”

-- Dr. 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.

Kidney 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.

11/06 – “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.”

-- Dr. 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.

11/06 – “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.”

-- Dr. 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.

10/06 – “I have developed warts/bumps on my forehead due to sweating by wearing a cap. What do you recommend I can do?”

-- Dr. 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.

10/06 – “How can I get a form to request "My Chart?”

-- Dr. 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.

10/06 – “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?”

-- Dr. 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.

10/06 “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.”

Producer 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.

10/06 – “What will happen to your body if you take 4 800 mg ibuprofen?”

-- Dr. 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.

9/06 – “Will insurance cover [dental] implants?”

-- Dr. 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.

9/06 – “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?”

-- Dr. 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.

Ultimately, 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.

9/06 – “What do you recommend for adults with ADD or ADHA. Adults who have a hard time concentrating on things and staying on task?”

-- Dr. 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.

9/06 – “Spinal stinosis -- vitamin cure or reversal?”

-- Dr. 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.

9/06 – “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.)”

Producer 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

http://www.fairview.org/ceii/provider/details.asp?provider=632184&addres s=6543380

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