Straight Talk

above: Doctors point to a whole food, plant-based diet when working towards a healthy lifestyle. – Photo by © sveta_zarzamora – stock.adobe.com

We all know what happens when we Google that random pain. So, put the phone down, keep calm and read on. Here, some of your most common health questions answered


WHAT’S INSIDE
HEART HEALTH / ALLERGIES / BEAUTY / PAIN / YOUR PERIOD / WEIGHT

Doctors are usually the first to say that you shouldn’t Google your symptoms. Pretty sure we are all guilty of doing just that—and falsely diagnosing ourselves with the worst possible issues. Not to worry, we have you covered with answers ranging from how you can manage more serious heart conditions to hair removal strategies. We corralled a group of notable local physicians of all stripes to answer some of your most pressing (and intimate) health questions.


Heart Smart

Q: My husband has a family history of cardiac conditions. Is there any way to take a preventative stance to make sure a heart attack is not in his future?

A: As Benjamin Franklin wisely stated, “an ounce of prevention is worth a pound of cure.” So yes, much can be done in order to prevent heart attacks, says Larry Leibowitz, M.D., founder and medical director at Matrix Personalized Medicine LLC in New Canaan. A healthy diet is paramount. Medical evidence increasingly points to a whole-food, plant-based diet as the best means of preventing many chronic diseases, including heart disease. A diet that is low in saturated fats, cholesterol, excess simple sugars and processed foods is critical. I highly recommend more green things, fewer chicken wings. Additionally, regular exercise is essential, in that it helps us to maintain a healthy weight, lower blood sugar levels and ideal blood pressure.

And an often-overlooked but very important factor is a healthy sleep pattern. Erratic sleep schedules, frequent interruptions and sleep apnea can all contribute to increased cardiovascular risk. If your husband awakens you with his snoring, before giving him the elbow, take a minute or two to pay attention to his pattern of breathing if it’s not smooth and regular; he may need a sleep evaluation. Stress reduction is also important. Hard-working people who live a high-stress lifestyle are at increased risk for heart disease and need to find time for themselves, to relax, to pursue other interests and to spend time with friends and family. Lastly, make sure your husband remains current with regular doctor visits in order to monitor his weight, blood sugar, blood pressure and cholesterol levels.

Q: I’ve heard about testing services that assess a person’s fitness and screen for diseases, but I worry that I can’t afford something like this. I’d love to know more.

A: There are affordable ways to go the extra mile to ensure that a heart attack is not in your future. Ask your doctor to perform a lipid particle blood analysis, which will enable him or her to assess for hidden risk factors not typically revealed in more routine blood panels, Leibowitz says. Additionally, for those who may be at increased risk, I like to order a test called a CT Calcium Score. This involves a type of CT scan that delivers only a low dose of radiation and enables us to inspect the heart vessels themselves for any signs of early coronary artery disease. The test is readily available, typically costs less than $200 and is endorsed by both the American College of Cardiology and the American Heart Association.

In terms of screening for other diseases, aside from the routine evaluations typically performed during the course of an annual physical, affordable genetic testing is available for those with personal or family medical histories that suggest predispositions to a number of diseases, including cardiovascular disease and cancers.


Just Breathe

Q: I’m 38 and broke out in hives after I ate recently; could I be developing an allergy this late in life?

A: Hives can occur at any time in life, as a reaction to a number of triggers, explains Michael L. Lewin, M.D., PC, a Norwalk-based allergist. If you are suspicious about the timing coinciding with food consumption, you might want to have some allergy testing done to identify possible food allergies. You might also want to note what foods you were eating prior to the onset of hives or keep a food diary to track what might be causing these outbreaks.

Q: My son has seasonal asthma that comes on in the fall and spring. Should he be on medication throughout the year?

A: If your son is completely symptom-free at other times of the year, asthma medications may not be necessary. However, since his seasonal asthma is very likely related to seasonal pollen allergies, you might want to treat the underlying allergies that are causing the asthma.


You’re so Vein

Q: I can’t wear anything that shows my legs because of my unsightly veins. Is there a way to get rid of them?

A: Varicose veins and spider veins can be eliminated permanently only if all the leaks (high pressure sources) responsible for the veins and spiders are eliminated, too, says Dr Heshmat Majlessi, M.D., FACS, FICS member of European Venous Forum and American Phlebology Society at Rye Vein-Laser Center in Rye, NY. Addressing only the visible varicose veins and spider veins is inadequate. This can be done quite safely with no downtime and under local anesthesia. The end result will be a perfect leg, if all the steps are done correctly.

Q: Isn’t vein removal painful?

A: Most patients are sensitive and do not like pain. Elimination of all the varicose veins and spider veins can be performed with very little discomfort so patients can resume their normal activity immediately, he explains. Our patented Veno-Merse® Technique is designed to get to the source of the spider veins and varicose veins, to treat the leaks and the feeding veins that are responsible for them. Laser vein treatment will be an adjunct at the end of the treatment. The legs will be free of varicose veins and spider veins. The entire course of treatment is performed at the office with no major anesthesia and no disability or lengthy recovery times.


A Hairy Situation

Q: I’m growing hair in weird places, why? And what can I do about it?

A: Unwanted hair growth can be caused by hormonal or endocrine imbalances, so it’s advisable to see your dermatologist for a proper diagnosis and possible blood test, advises Sarah Dolder, M.D. from Greenwich Point Dermatology in Greenwich. Typically, laser hair removal is the best way to get rid of excess hair permanently.

Q: I’m only 43, but my hair seems to be thinning at a fast rate. What is happening?

A: As we age, hormonal changes can cause hair loss and hair thinning, a phenomenon we call female pattern baldness. Stress, medications, diet and lifestyle can also be factors at play, Dolder says. Fortunately, there are a number of treatment options to restore hair growth, from a prescription pill, to a prescription topical scalp solution, to my personal favorite—platelet rich plasma (PRP) with microneedling.

Q: My skin is fairly unwrinkled for my age, 55, but I am noticing more brown spots from sun exposure. I play a lot of golf and tennis, so it’s hard to stay completely out of the sun. I was told that if I get these treated, it makes my skin more susceptible to further skin damage. Help!

A: Laser treatments, chemical peels and photodynamic therapy are fantastic ways to eliminate sun damage and unwanted spots. As long as you prevent further UV damage with diligent sunscreen use and mindful clothing choices (hello, sun hat!), your skin will stay clear, bright, and safe from additional skin damage.


Pain in the Neck

Q: I have a pain in the lower part of my skull that is different from a headache. Someone mentioned that it could be nerve pain. I don’t know what type of doctor to see. Can you help?

A: It can be difficult to distinguish “head” pain from “neck” pain and there is often significant overlap, says Raj Gala, M.D., spine surgeon at Connecticut Neck and Back Specialists in Danbury. Some of the small joints of the upper neck can become inflamed and cause pain at the base of the skull. In addition, this can irritate spinal nerves, resulting in radiating symptoms.

Q: My joints seem to be making a lot of noise these days, but I’m fairly fit and active at 51. Should I be concerned? Could I be doing damage?

A: Many people are worried about the “snap, crackle, pop” they hear when they turn their neck or back. It’s okay. There are many joints in the spine that move with every action we perform. Sometimes these joints make noises. This occurs when gas bubbles burst within the joint fluid, or when a ligament or tendon stretches as the joint moves. This is completely normal, which is why the majority of “joint noise” is not associated with pain. Don’t worry and stay active!

Q: No matter what position I get in or how many pillows I use, I can’t seem to get comfortable in bed at night. I am in pain. Any ideas on what I could do to get a good night’s rest?

A: Everyone needs a good night’s sleep! The first step is figuring out the root cause of the spine pain. Likely the pain is muscular in nature, which is the case 99 percent of the time. Consider cooling down at the end of the day with ice packs on the affected areas. Many people also find relief from taking an anti-inflammatory medication at bedtime. There are also herbs, such as turmeric, that can be added to food or taken in pill form that have been shown to decrease inflammation. If the pain continues, get evaluated by a doctor, Gala recommends.


Woman Trouble

Q: I sweat so much at night, what can I do?

A: The medical term for excessive sweating is called hyperhydrosis. Usually it isn’t caused by a serious condition, but since it can be, one needs to be evaluated by a medical professional. It is, however, a very common complaint and can really affect quality of life, says Leslie Goldstone, M.D. at Women’s Healthcare of Trumbull. Some ways to reduce sweating: make sure you are at a healthy weight, reduce sugar and white carbohydrates (white bread, white rice, pasta, white potatoes) and reduce caffeine and alcohol intake. Also: Dress in layers, sleep in a cool room with a light blanket, and keep a small hand-held or desktop fan nearby. Medical evaluation includes thyroid and blood sugar testing, and testing to rule out viral and bacterial infection (Lyme, HIV, tuberculosis among others), malignancy and disorders of the nervous system. Certain medications can also cause excessive sweating. Hormone overproduction and hormonal deficiencies (estrogen deficiency in peri- and post-menopausal women and testosterone deficiency in men) are also a common cause. In menopause, estrogen levels decline, and the sweating manifests as a “hot flash,” which is a brief burst of heat that lasts a few minutes but can occur many times during the day or night and can disrupt daily activities and sleep. For people with excessive underarm sweating, a dermatologist can prescribe a special antiperspirant.

Q: Why is my period so much heavier than it used to be?

A: The amount and duration of blood flow changes as many women get older due to many factors. In our 40s, women do not ovulate as regularly, which can result in menstrual periods that are farther apart and heavier when they do come, as the uterine lining can become thicker and less stable. Also, as we get older, we are at increased risk for developing uterine conditions that can cause heavier or longer periods. Up to 50 percent of women over age 40 will develop fibroid growths on the uterus that can cause very heavy or prolonged periods. Adenomyosis is a benign and common condition that can cause heavy or prolonged periods; it occurs when endometrial glands from the uterine lining grow into the actual muscle of the uterus. Endometrial polyps, which grow inside of the uterus, can cause heavy periods and sometimes bleeding in between periods. Cancer of the uterus is an important cause of new onset heavy or abnormal bleeding that needs to be screened for. Fortunately, it is less common than benign causes. Certain medications, like blood thinners, copper IUDs and hormonal contraceptives can also make periods heavy. It is important to see a gynecologist to make sure there is no precancerous or cancerous change in the uterus and to determine the cause of the heavy menstrual bleeding and devise an acceptable treatment plan. Women can also become quite anemic with heavy menstrual bleeding, and this needs screening as well.


Weighty Matters

Q: How can I control borderline high cholesterol?

A: There are different types of cholesterol. There are “bad” cholesterols (the total cholesterol and LDL cholesterol) and “good” or protective cholesterols (the HDL cholesterol). If the total and LDL cholesterol are elevated but the HDL cholesterol is also elevated, maybe nothing needs to be done, explains James A Slater M.D., an internist in New Canaan. Also, cholesterol can be elevated because of genetic mechanisms or acquired mechanisms. If the former exists, and several first-degree family members have high cholesterol, (an unfortunate individual may just eat bark off of a tree and still have high cholesterol). The problem is the liver. It is just genetically programmed to make a lot of cholesterol. So, regrettably, medications are needed for this situation. If the cholesterol is elevated because of acquired, lifestyle and dietary choices, then the words of journalist and Harvard professor Michael Pollan, are germane. “What grows on one leg (plant-based foods) are better than what grows on two legs (fowl), and that is better than what grows on four legs (animal meats). Dietary counseling may help.

Q: I’m so confused about weight loss. Every day, there’s a new fad diet. How do I decide what’s healthy?

A: Any discussion these days regarding weight loss has become incredibly complicated, Slater says. Once upon a time, it was considered simply a matter of calories in, calories out. Nowadays, specialists in this field know that there are many interacting hormones from different places in the human body that affect metabolism and the activity of fat stores. Generally, a diet higher in protein than carbohydrates is moderately successful. But, weight loss is difficult, and takes time, persistence and planning. Not easy. In terms of exercise that would help, the American Heart Association recommends 150 minutes per week, at least 30 minutes per day, of moderate exercise, or 75 minutes per week of vigorous exercise.

Q: Why am I so tired all the time?

A: This has to be the most common and, unfortunately, one of the most open-ended difficult questions, Slater says. In evaluating this problem, it basically comes down to deciding if the fatigue is organic, that is, medical, has an underlying cause, can be defined either on physical exam or by blood/imaging test or is psychosocial. Factors to be considered with fatigue due to psychosocial fatigue include stress, poor sleep hygiene, unrewarding social interactions, sense of frustration or not being in control of one’s life or job.

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