Mayo Clinic Q & A - March 2015 Archives

DEAR MAYO CLINIC: My mother, 67, was recently diagnosed with peripheral artery disease. She has been having leg pain and other symptoms for many months. She was prescribed medication but her doctor said she may need surgery. What would that involve? Are there any other treatment choices? ANSWER: In people who have peripheral artery disease, narrowed arteries limit blood flow to the arms and legs. When the limbs do not get enough blood, it can trigger a variety of symptoms. The most common include leg pain when walking, leg cramps after doing an activity, leg numbness and leg weakness. If left untreated, pain and other symptoms may get worse over time. Treatment for peripheral artery disease usually includes lifestyle changes and medication. For many people, those two therapies are all they need to effectively manage the disease. If they are not enough, though, a procedure to open blocked arteries (angioplasty) may be recommended. Surgery to bypass a blocked or narrowed artery can be another useful treatment option for some cases of peripheral artery disease. Lifestyle changes often can help ease symptoms and slow the disease’s progress. Smoking is one of the biggest risk factors for peripheral artery disease. Smoking frequently leads to artery narrowing and damage. It also can make the disease get worse more quickly. If your mother smokes, quitting is one of the most important steps she can take to combat peripheral artery disease.

DEAR MAYO CLINIC: My daughter, 31, was recently diagnosed with rheumatoid arthritis. Do doctors know what causes the disease, especially at a young age? Will she need to be on medication for the rest of her life? ANSWER: The precise cause of rheumatoid arthritis, or RA, remains unclear. However, both genetic and environmental factors appear to play a role in raising a person’s RA risk. Because we do not know the exact cause, we do not have a cure for RA. Most people with this disease do need long-term treatment. Rheumatoid arthritis is a kind of disease known as an autoimmune disorder. These disorders happen when your immune system mistakenly attacks your body’s own tissues. In RA, the immune system attacks the lining of the membranes that surround your joints, called the synovium. That causes inflammation. The inflammation, in turn, thickens the synovium, which can eventually destroy the cartilage and bone within the joint. The tendons and ligaments that hold the joint together weaken and stretch. Gradually, the joint loses its shape and alignment.

DEAR MAYO CLINIC: Why do children need so many vaccines in their first two years of life? Isn’t it okay and even safer to wait until they are a bit older to give them the recommended vaccinations? ANSWER: The current childhood vaccination schedule has been studied extensively. It is safe. It is also highly effective at preventing a variety of serious diseases. To offer the best protection against those diseases, I strongly urge you to have your child vaccinated on time, according to the recommended schedule. Babies need multiple vaccines because infectious diseases can cause serious health problems in infants. For a short time after they are born, antibodies from their mothers help protect newborns from many diseases. But that immunity begins to fade quickly, with some immunity lasting only about one month after birth. The vaccination schedule that is recommended now has been studied and found safe and effective against the diseases babies face at the time they are getting the vaccines. A delayed schedule is a delay in protection against some diseases that are very serious, and in many cases life-threatening.

DEAR MAYO CLINIC: What is the typical treatment and recovery time for a herniated disk? At what point should surgery be considered? ANSWER: In many cases, pain and other symptoms caused by a herniated disk resolve with time and self-care measures. When medical treatment is required, therapy that doesn’t involve surgery often is all that’s needed to effectively treat herniated disk symptoms. However, if your symptoms significantly limit your day-to-day activities, if you have nerve damage due to a herniated disk, or if your symptoms cannot be controlled with other treatment, then spine surgery may be necessary. Your spinal disks are the cushions between the individual bones, called vertebrae, that make up your spine. The disks have a soft center within a tougher exterior. A herniated disk happens when some of the center pushes out through a crack in the outer portion of the disk. A herniated disk may irritate or compress a nearby spinal nerve root. The result can be back pain, along with pain, numbness or weakness in an arm or leg.

DEAR MAYO CLINIC: How effective is surgery to treat scoliosis in adults? What does the surgery involve? ANSWER: Fortunately for most adults who have scoliosis, the condition can be successfully managed without surgery. For some who suffer from an overly tilted or arthritic spine, though, surgery can be very effective at relieving symptoms. The surgery is a complex procedure and can include removing some spinal joints and connecting two or more of the bones in the spine together to properly balance the spine and improve quality of life. Scoliosis is a three-dimensional change in the normal shape of the spine that leads to excessive sideways or forward curves. It most often develops in children during the growth spurt just before puberty. But some adults can suffer from scoliosis, too.