Mayo Clinic Q & A - June 2015 Archives

DEAR MAYO CLINIC: I’m newly pregnant and overwhelmed with food advice from my friends. Is it true that I shouldn’t eat any deli meat during my pregnancy? What about caffeine? Can it harm the baby? Are there other foods I should avoid while pregnant? ANSWER: The list of foods people think you should and shouldn’t eat while you’re pregnant can quickly become long and confusing. Although there are some specific do’s and don’ts, stick to the basics. Eating a healthy, well-balanced diet that’s low in fat and does not include alcohol is a solid way to ensure good nutrition for you and your baby. For most people, pregnant women included, healthy eating involves plenty of vegetables, fruits, whole-grain foods and lean protein, as well as some healthy fats such as those found in fish, nuts, seeds and plant-based oils. Nutrients important for women during pregnancy include calcium and vitamin D for strong bones, folate to reduce the risk of birth defects, iron to prevent anemia and protein to help your baby grow. Getting enough fiber and fluids also is important to avoid constipation and to keep you hydrated.

DEAR MAYO CLINIC: I have been in menopause for about a year and have not had many problems other than what my doctor diagnosed as vaginal atrophy. Do over-the-counter products usually help relieve the symptoms, or will I need hormone therapy? ANSWER: What you are experiencing is common. By some estimates, loss of lubrication and elasticity in the vaginal area (vaginal atrophy) affects at least half of women in midlife and beyond. Systemic hormone therapy — taken as an oral pill or a skin patch — isn’t the only treatment for menopausal vaginal atrophy. Other treatments are specific for vaginal atrophy. In fact, if you experience only vaginal symptoms related to menopause, without hot flashes and night sweats, these other therapies are probably better choices. Vaginal atrophy is caused by a decrease in estrogen production. As you approach menopause, your body’s production of estrogen — the main female hormone — ebbs and flows and eventually decreases permanently. Less estrogen can make your vaginal tissues thinner, drier, less elastic and more fragile. Estrogen reduction and vaginal atrophy may also occur as the result of certain medical treatments, such as the removal of both ovaries, pelvic radiation, chemotherapy or hormonal treatment for breast cancer.

DEAR MAYO CLINIC: What does proton beam therapy do for cancer patients that standard radiation therapy doesn’t do? How do doctors decide when to use proton beam therapy? ANSWER: Proton beam therapy is a type of radiation therapy used to treat cancer. Unlike standard radiation therapy using X-rays, which travel all the way through a person’s body, protons go to the tumor, release their energy and stop. That means proton beam therapy tends to be more effective, and causes fewer side effects, than standard radiation therapy. Protons are subatomic particles that combine with neutrons to form the nucleus of an atom surrounded by orbiting electrons. Radiation is energy released from atoms as either electromagnetic waves — such as X-rays or gamma rays  — or as tiny particles, such as electrons or protons. For more than 120 years, radiation has been used to destroy cancer cells. Today’s standard radiation therapy uses high energy X-rays that travel through the body. Proton beam therapy is different. This treatment directs protons into a tumor, where their energy is released. Radiation oncologists can control the depth of penetration of the protons and where they release their energy by adjusting the energy of the protons. The higher the energy, the deeper the protons go.

DEAR MAYO CLINIC: I had an evaluation for sleep apnea. As part of that, my neck circumference was measured. Why is this important? ANSWER: Having a neck circumference that’s greater than 16 inches if you’re a woman or greater than 17 inches if you’re a man is one of numerous risk factors associated with obstructive sleep apnea (OSA). OSA occurs when muscles at the back of your throat relax and temporarily restrict or block airflow as you sleep. This may lead to disrupted sleep and daytime tiredness. Sudden drops in blood oxygen levels that occur during sleep apnea increase blood pressure and put a strain on your cardiovascular system, raising your risk of developing heart problems such as high blood pressure (hypertension) and heart failure.

DEAR MAYO CLINIC: I was considering wearing some shapewear under my outfit for an upcoming class reunion. But I heard a recent report saying that these garments can be risky. Is this true? ANSWER: With shapewear — as with most things in life — moderation is key. While most people can’t imagine wearing something as restricting as an old-fashioned corset, the concept behind it continues, using contemporary materials and newer styles. Shapewear can target a particular area, such as your waist or thighs, or help contour your body from bust to knee. The main issue with shapewear is simple discomfort. However, if you push yourself into sizes that are too small or wear them too long or too often, the discomfort may manifest in different ways. Here’s how: Acid reflux — Wearing tightfitting clothing around the waist can increase reflux and heartburn. Bloating and gas — If you frequently experience these signs of irritable bowel syndrome (IBS), a food intolerance or other gastrointestinal issue, you may find that constricting clothing compounds the discomfort.

DEAR MAYO CLINIC: What are the best kinds of sunscreen to use on kids? Do the spray sunscreens work as well as the lotions? Also, does UPF clothing offer more sun protection than a standard long-sleeved T-shirt? ANSWER: Children 6 months and older can use the same sunscreen as adults, although sunscreen marketed for children is fine, too. Just make sure that whatever you use is a broad-spectrum sunscreen with a sun protection factor, or SPF, of at least 15. For consistent sun protection that you don’t need to reapply, clothing with universal protective factor, or UPF, is a good choice. When you look for sunscreen, check that it is labeled as “broad-spectrum.” That means the sunscreen protects against both types of ultraviolet rays: UVA and UVB. UVA is the long wavelength of light that penetrates to the deep layers of skin. UVA leads to skin damage over time. UVB is the shorter wavelength of light that penetrates the surface of the skin and causes sunburn.

DEAR MAYO CLINIC: My father, who is in his 70s, went to his dentist with mouth pain and was told he has burning mouth syndrome and that there is no known treatment. Could something else be causing his symptoms? Are there things he can do to relieve the pain somewhat? ANSWER: It is possible that something else could be causing your father’s symptoms. A thorough evaluation can help determine if another underlying medical condition or a medication may be the source of the burning sensation. If your father does have burning mouth syndrome, a variety of treatment options are available to manage it. Burning mouth syndrome is defined as a persistent feeling of burning in the mouth that is not due to mouth abnormalities or other health issues. That means your father needs a medical assessment to exclude other possible causes before he can be diagnosed with burning mouth syndrome.

DEAR MAYO CLINIC: I was diagnosed with primary biliary cirrhosis three months ago. I don’t have any symptoms yet but wonder what I should look for. Are there things I can do to slow its progression? ANSWER: Your situation is common. Most people diagnosed with primary biliary cirrhosis, or PBC, in its early stages do not have any symptoms. Many remain symptom-free for years. Medication is available that can slow the progression of the disease, making it less likely that you will develop symptoms soon. PBC is a disease in which the bile ducts in the liver become damaged. Bile, a fluid that your liver makes, plays a role in digesting food. It also helps your body get rid of worn-out red blood cells, cholesterol and toxins. When bile ducts don’t work the way they should, harmful substances can build up in your liver. In time, that may lead to irreversible scarring of your liver tissue.

DEAR MAYO CLINIC: Six years ago I was diagnosed with acid reflux and a hiatal hernia. I have had an endoscopy as well as other tests, but doctors say there is nothing I can do other than take medication. (I am currently on doxepin.) But I am still having sharp pains that wake me up around 4 a.m. Do you have any suggestions? ANSWER: Your situation is very common in people who have a hiatal hernia. There are a number of lifestyle changes that may help reduce your nighttime symptoms. Taking an acid-reducing medication may make a difference, too. In rare cases, surgery may be necessary if nothing else works to relieve symptoms. A hiatal hernia happens when part of your stomach pushes up through your diaphragm. Your diaphragm has a small opening, called a hiatus, which your esophagus passes through on its way to your stomach. The stomach can push up through this opening and cause a hiatal hernia. Acid reflux — a condition in which stomach acid flows up into the esophagus — is often associated with a hiatal hernia.