Mayo Clinic Q & A - August 2014 Archives

DEAR MAYO CLINIC: My father, who is 70, was a smoker for 30 years. I have read that men who used to smoke should be screened for an abdominal aortic aneurysm. What does the screening involve? What would be done if he is found to have an aneurysm? ANSWER: Because of his history of smoking, you are correct that your father should be screened for an abdominal aortic aneurysm. The screening usually includes a physical exam and an ultrasound of the abdomen. Other imaging tests may be needed in some cases, too. If an abdominal aortic aneurysm is found, treatment depends on the size of the aneurysm, its rate of growth, and if it is causing any symptoms. The aorta is a large blood vessel about the size of a garden hose that runs from your heart through the center of your chest and abdomen. An abdominal aortic aneurysm is a bulge in the aorta just above the area of your belly button that forms due to weakness in the blood vessel’s wall. The greatest risk of such an aneurysm is that it will rupture. Because it provides the body with much of its blood supply, a rupture in the abdominal aorta can lead to life-threatening internal bleeding.

DEAR MAYO CLINIC: I have had bunions for years, but they have not bothered me much until recently. I now have pain every day and most shoes hurt my feet. Is surgery the only option at this point? What does that involve, and can it be done on both feet at the same time, or will I need to have each foot done separately? ANSWER: In a situation like yours, surgery could be considered. But surgery is not the only treatment for bunions. More conservative measures may help decrease your symptoms and relieve pain. If you try them and they don’t work, though, then it would be a good idea to talk with a foot surgeon about surgical options. The structure of your feet changes over time. Sometimes these are subtle changes that you do not notice. But in other instances, the changes are more substantial. Bunions happen due to changes that force the bones of your feet out of alignment and increase the width of your foot. When a bunion develops, your big toe actually tilts or drifts away from the midline of your body, eventually crowding the second toe. The bone that is just behind the big toe, called the first metatarsal, drifts or tilts in toward the midline of your body. As the first metatarsal tilts in, it becomes more prominent. That is the bony bump referred to as a bunion.

DEAR MAYO CLINIC: My husband was originally diagnosed with Parkinson’s, but later it was determined he has atypical parkinsonism. What is the difference? What treatments work best for his condition? ANSWER: Your husband’s situation is not uncommon for people who have atypical parkinsonism. When symptoms of parkinsonism begin, the condition may at first be diagnosed as Parkinson’s disease. But over time, it becomes clear that a different disorder is really the underlying cause of the symptoms. Treatment for atypical parkinsonism depends on several factors, including the specific diagnosis, symptoms, and how quickly the disease progresses. To understand atypical parkinsonism, it is helpful to know a bit about parkinsonism in general. First, parkinsonism is not a disease itself. It is a name used to describe a group of symptoms, which include: tremor when a limb is at rest, slowed movement, rigid muscles and impaired balance and posture. When someone has at least two out of these four symptoms, they are said to have parkinsonism. Parkinsonism has many causes. Parkinson’s disease is the most common cause, but it is not the only one. Parkinsonism can be a result of certain medications. A type of progressive dementia, called Lewy body dementia, which includes a decline in both mental and physical abilities, may lead to parkinsonism. Parkinsonism also can be caused by three other rare movement disorders: multiple system atrophy, progressive supranuclear palsy and corticobasal degeneration. When a neurologist suspects one of these three disorders as the source of parkinsonism, but an exact diagnosis has not yet been made, it is often labeled atypical parkinsonism.

DEAR MAYO CLINIC: Is there anything that can be done for snoring other than using a CPAP machine? I have tried using one for the ...

DEAR MAYO CLINIC: What is the best way to treat plantar warts to ensure they don’t come back?  I have them on my feet. At one point, I had them removed with freezing therapy, but they keep returning and even spreading. ANSWER: Freezing therapy, also called cryotherapy, is the most common and usually the most effective way to treat plantar warts. But warts can be tough to get rid of completely. Sometimes several cryotherapy treatments are needed to successfully eliminate plantar warts. If the warts are bothering you, make an appointment to have them treated again. Combining cryotherapy with another form of treatment may make it more likely that warts will go away and stay away. Plantar warts are hard, grainy skin growths that appear on the feet. They usually show up on the balls and heels of the feet, the areas that bear the most pressure. All warts are caused by the human papillomavirus, or HPV. HPV is very common, and there are more than 100 different kinds of the virus. But only a few of them cause warts on the feet. Plantar warts develop when the virus enters your body through tiny cuts, breaks or other weak spots on the bottoms of your feet. Once a plantar wart begins to grow, HPV stimulates the skin to attract and grow its own blood supply. That makes the wart very hearty. If left untreated, warts typically last for one to two years. But most warts do go away eventually. If a plantar wart does not go away over a long period of time, it should be evaluated by a physician because it could be something other than a wart.