Mayo Clinic Q & A - April 2015 Archives

DEAR MAYO CLINIC: Are there any new treatment options for chronic lymphocytic leukemia? I am 61 and was diagnosed 18 months ago. Until recently, I have not had any symptoms so have not received treatment for it. ANSWER: Researchers are currently studying a variety of potential new treatments for chronic lymphocytic leukemia, or CLL. Many of them are available now through clinical trials. Depending on your situation, you may be eligible to participate in a clinical trial and receive one of the new therapies. CLL is a cancer of the blood and the spongy tissue inside bones where blood cells are made, called bone marrow. In particular, this disease affects a group of white blood cells called lymphocytes that help your body fight infection. CLL usually progresses slowly. As in your situation, many people in the early stages of CLL do not have any symptoms. When symptoms start to develop, they may include enlarged lymph nodes, pain in the upper left abdomen, fatigue, fever, night sweats, weight loss and frequent infections.

DEAR MAYO CLINIC: What causes fecal incontinence? Can it be treated? ANSWER: Fecal incontinence, or leakage of stool from the rectum, can range from occasional leakage while passing gas to a complete loss of bowel control. An estimated 8 percent of the general population and 15 percent of people age 70 and older are affected. Although fecal incontinence is more common in middle-aged and older adults, it isn’t an inevitable part of aging. It’s often the result of another treatable medical issue or can be a warning sign of a more serious problem. Your rectum and anus are at the end of your large intestine. Normally, the muscles and nerves in and around these two structures sense the presence of waste, allow storage in the rectum, and then move and eliminate stool. Changes in the function of this complex system can interfere with normal stool elimination.

DEAR MAYO CLINIC: Is it true that some children are more susceptible to getting cavities than others? My 11-year-old has never had a cavity, but my 6-year-old already has needed four fillings. What’s the best way to prevent cavities in kids? At what age should they start flossing? ANSWER: Some people may be more prone to tooth decay than others, even within the same family. To give your children the best protection against cavities, teach them the importance of dental health by showing them how to care for their teeth. That includes daily flossing from a very young age. It is important for parents to have good oral hygiene, too. Make sure you and your children see a dentist regularly. Tooth decay happens when areas in the hard surface of your teeth become damaged and develop holes, or cavities. If left untreated, the holes get bigger and can eventually lead to pain, infection and tooth loss. A combination of factors can trigger tooth decay, including bacteria in the mouth, teeth not being cleaned well, and eating or drinking lots of sugary foods and beverages.

DEAR MAYO CLINIC: Is it true that people with rheumatoid arthritis have a higher risk of heart disease? How are the two conditions related? Is there a way to lower the risk? ANSWER: Studies have shown that if you have rheumatoid arthritis, your risk of developing heart disease is two to three times higher than people who do not have the disorder. Although the exact connection between the two conditions is unclear, a number of factors seem to play into the increased heart disease risk. Regular check-ups, tests to check for heart problems, lifestyle changes and being able to recognize symptoms of heart disease can all help manage the risk. Rheumatoid arthritis is an inflammatory disease that causes swelling. It often affects the small joints in the hands and feet and causes joint tenderness, pain and stiffness. But the disorder can go beyond the joints, too, and that is part of the connection to heart disease.

DEAR MAYO CLINIC: I am 40 years old. After having a period that lasted nearly two months, I had tests done that showed a small, hyperechoic lesion within the endometrium. What exactly does this mean? My primary care doctor suggested a hysterectomy as treatment. Are there other ways to treat this condition? ANSWER: Thank you very much for your important question. This can be a source of much confusion and concern, so I hope I can help you with that. The endometrium is the layer of cells that make up the lining of your uterus. It is not uncommon for small lesions to form within that lining. When that happens, the lesion may trigger abnormal uterine bleeding similar to the kind you are experiencing. In some cases, lesions in the endometrium can signal a larger problem, such as cancer. But in many situations, they are not cancerous and pose no serious health risks. The term “hyperechoic” is used to describe how the tissue looks during an ultrasound exam. This is a rather nonspecific term meaning that during the test the tissue reflected back an unusually large number of ultrasound echoes.

DEAR MAYO CLINIC: I am considering having LASIK surgery, but have a friend who had the procedure done many years ago and is now experiencing regression in her vision and has to wear glasses again. Is this typical? What are the risks of LASIK surgery? ANSWER: It is not typical for a person’s vision to regress after LASIK. Although the procedure may lead to some side effects and complications, they are uncommon. A thorough evaluation before surgery often can help avoid many of the potential problems that can happen after LASIK. LASIK stands for laser-assisted in-situ keratomileusis. It is a type of refractive surgery — surgery that changes the shape of the transparent tissue, called the cornea, at the front of your eye. The surgery corrects vision problems such as nearsightedness, farsightedness and astigmatism, reducing or eliminating the need for eyeglasses or contact lenses.