Mayo Clinic Q & A - August 2015 Archives

DEAR MAYO CLINIC: I have double vision in my right eye and can read with glasses, but distance is not very clear. What causes double vision? Is there a procedure to correct it? ANSWER: A number of conditions can lead to double vision. Treatment typically depends on the underlying cause. With a careful evaluation and accurate diagnosis, double vision can often be effectively treated. Double vision, also called diplopia, is either monocular or binocular. Monocular double vision is present in each eye separately. Binocular double vision is only present with both eyes open. This distinction is very important because monocular double vision is never dangerous, while binocular double vision can be caused by some serious neurologic conditions. If you have new symptoms of double vision, a quick way to assess which type you have is to close each eye separately. Using your question as an example, “I have double vision in my right eye,” suggests that you have monocular, or “one-eyed,” diplopia. This means that when you close your left eye, you see images as double out of your right eye. But when you close your right eye, the double vision goes away. If you have binocular double vision, when you close either your right eye or left eye, the double vision goes away.

DEAR MAYO CLINIC: What is the difference between bacterial vaginosis and a yeast infection? I’ve had painful itching for two weeks but have not been to see a doctor yet. Are over-the-counter medications effective in treating both? ANSWER: Bacterial vaginosis, or BV, and vaginal yeast infections may have some symptoms that seem similar, but they have different causes and require different treatment. Over-the-counter remedies are available for a yeast infection. BV typically requires prescription medication. See your doctor to get an accurate diagnosis. Then he or she can help you decide on the best treatment. BV and yeast infections both fall under the broad category of vaginal infections, called vaginitis. These infections are quite common in women. They usually can be treated effectively without any long-term problems. You need to know which type of infection you have, however, to make sure you get the right treatment.

DEAR MAYO CLINIC: At my last checkup, my doctor told me I have borderline hypothyroidism and gave me a prescription for medication to treat it. She said she would check my thyroid again in six months. Is this something I will have to take for the rest of my life? What are the risks if I choose not to take the medicine? I am a 62-year-old woman and very healthy. ANSWER: Before you move forward with treatment for hypothyroidism, it would be worthwhile to wait and repeat the test in several months to confirm your diagnosis. Even if the results are the same at that time, you should consider several other factors before you decide on treatment. Your thyroid is a small, butterfly-shaped gland at the base of the front of your neck. Hypothyroidism, sometimes called underactive thyroid, is a condition in which your thyroid gland doesn’t produce enough of certain important hormones. The hormones that the thyroid gland makes — triiodothyronine, or T3, and thyroxine, or T4 — have a large impact on your health, affecting all aspects of your metabolism. They maintain the rate at which your body uses fats and carbohydrates, help control your body temperature, influence your heart rate, and help regulate the production of proteins.

DEAR MAYO CLINIC: What causes mesothelioma, and how is it different than lung cancer? Are there any treatments or ways to slow its progression? ANSWER: Mesothelioma is a rare type of cancer, with about 3,000 new cases reported each year in the United States. It is much less common than lung cancer. Unlike lung cancer, mesothelioma does not start within the lung tissue. It arises from the mesothelium that forms the outside lining of the lung, also called the pleura; however, mesothelioma may spread into the lungs. Rarely, it can also arise from the lining of the abdominal cavity or other internal organs. The exact cause is unclear, but there appears to be a strong association between exposure to asbestos and mesothelioma. The most common treatment for mesothelioma is chemotherapy, but a combination of different therapies can be used. Research investigating possible new treatment options is underway.

DEAR MAYO CLINIC: My mother was diagnosed with osteoporosis when she was in her 80s. My sister and I are now in our 60s, and my sister is concerned that we’re at high risk for the disease. I thought osteoporosis was just part of aging, especially for women. Can it run in families? Are there other things that can put a person at risk for it? ANSWER: Although osteoporosis is more common as people age, it’s not a natural part of aging. There are a number of factors, including family history, that can raise your risk for osteoporosis. Your body regularly makes new bone and breaks down old bone. When you’re young, your body makes new bone faster than it breaks down old bone, and your bone mass increases. Most people reach their peak bone mass in their mid-20s to mid-30s. The higher your peak bone mass, the more bone your body has to sustain bone health throughout the rest of your life.

DEAR MAYO CLINIC: My father is 84 and lives on his own. He is in very good health but seems to have lost some weight in the last few months. He says he just doesn’t have much of an appetite. Would having him try meal replacement drinks be a good idea, or should he see his doctor first? ANSWER: Before he starts using meal replacement drinks or other diet supplements, encourage your father to see his doctor. Weight loss in older adults can sometimes signal an underlying health issue. It’s important to have unexplained weight loss evaluated to investigate the cause and make sure there isn’t a bigger problem that needs attention. When you go to see your doctor, one of the first things you do is step on a scale. The focus often is on the positive benefits of weight loss, and losing a few pounds typically is seen as a healthy step. Although that may be the case for some older adults, too, for many people in their 70s, 80s and beyond, weight loss may be the first sign of a health problem. That’s particularly true if an individual is losing weight without intentionally trying to do so.

DEAR MAYO CLINIC: In the summer, my kids play outdoors most of the day, and we have found ticks on their clothing. Is Lyme disease something I should be worried about? What are the early symptoms? Does bug spray keep ticks away? ANSWER: Lyme disease is the most common illness spread by ticks in the United States. So it is worth taking precautions to prevent this disease, especially if your children play in wooded, grassy or bushy areas and you live or vacation in an area where Lyme disease is prevalent. Lyme disease is caused by a bacterium, called Borrelia burgdorferi. Black-legged ticks, also known as deer ticks, which feed on the blood of animals and humans, can carry the bacteria and spread it when they feed. The ticks tend to live in long grasses, bushes, shrubs and forested areas. If your children play where grass is short or their play area is covered with another material, then ticks aren’t a big concern. If, however, they go hiking in the woods or play in long grass, or if your yard has a significant number of bushes and shrubs, then you need to take steps to make it less likely that your children will end up with ticks.

DEAR MAYO CLINIC: I am 36 and have had two miscarriages in the past six months. I went to my doctor for tests and found out that I have a double uterus. My doctor said that I should still be able to carry a baby to term and that having a double uterus isn’t necessarily the cause of the miscarriages. Is there a way to find out if the double uterus really is causing my miscarriages? When is surgery considered for someone in my situation? ANSWER: When a woman’s uterus is shaped differently than normal, as with a double uterus, it may increase the risk of pregnancy loss. But many women who have uterine abnormalities are able to get pregnant and have a normal pregnancy and delivery. In your situation, additional tests can show the specific structure of your uterus. The results of those tests can help your doctor identify if you may need treatment such as surgery to decrease your risk of another pregnancy loss. During a fetus’s growth and development, the uterus normally starts as two separate spaces and then they merge into one. In women who have a double uterus, the two did not merge during fetal development. Instead, they sit side-by-side. In another common situation, the two uterine cavities do join together, but development is incomplete. The two sections of the uterus are separated by a layer of tissue called a septum. This is called a septate uterus.

DEAR MAYO CLINIC: What is a “mini-stroke” and how does it differ from the stroke we typically hear about? My mother recently had a mini-stroke, but her symptoms went away. Now she seems fine. Is she at greater risk of having another stroke? ANSWER: The condition you’re describing is called a transient ischemic attack, or TIA. Symptoms of TIA come and go and, as in your mother’s case, they don’t cause any lasting problems. But a TIA should not be ignored because it significantly increases the risk for having a stroke in the future. There are two main kinds of stroke: ischemic and hemorrhagic. Hemorrhagic strokes happen when there is bleeding into the brain tissue. They are much less common than ischemic strokes. Ischemic strokes happen when a blocked artery cuts off the blood supply to the brain. This type of stroke accounts for about 85 percent of all strokes.