Mayo Clinic Q & A - October 2015 Archives

DEAR MAYO CLINIC: I’ve developed waxy, brown spots on my skin. Are they potentially dangerous? What’s the best way to get rid of them? ANSWER: What you describe may be seborrheic keratoses — commonly referred to as aging spots. Seborrheic keratoses are some of the most common, noncancerous skin growths in older adults. They’re not cancerous or precancerous. Seborrheic keratoses usually appear as brown, black or light tan growths on the face, chest, shoulders or back. The growths have a waxy, scaly, “stuck on” appearance. Occasionally, they appear singly, but multiple growths are more common. Their cause is unclear. Although they may sometimes be itchy, these growths are typically painless and don’t require treatment. But if they become bothersome or irritated by clothing or you just don’t like the way they look or feel, there are several ways a dermatologist can remove them.

DEAR MAYO CLINIC: I was recently diagnosed with a herniated disk in my back. It’s causing quite a bit of pain throughout one of my legs. My doctor says the disk is basically choking the nerves in my lumbar spine. Surgery has been recommended, but I’m not sure I want surgery. I’ve heard it’s not always effective. Will my condition worsen without it? ANSWER: A herniated disk often can be effectively treated without surgery. Medication and physical therapy typically ease the pain and discomfort caused by a herniated disk. But in some cases, particularly when the injured disk is compressing a nerve, surgery may be helpful. Spinal disks are a special kind of joint located between the spine bones, called vertebrae, that stack up to create your spine. The disks serve as cushions between the vertebrae. They have a soft center wrapped within tougher exterior layers. A herniated disk happens when some of the softer material pushes out through a crack in the outer layers of the disk.

DEAR MAYO CLINIC: I’ve been on blood pressure medication for nine months. It has lowered my blood pressure, but I’m having trouble with side effects like dizziness. I eat a healthy diet and walk every day, but want to know if there are other ways to lower my blood pressure so that hopefully I can stop taking this medicine. I am only 57. ANSWER: You’re on the right track. Eating well and staying active are two good ways to help control blood pressure. But there are more steps you can take that can make a difference and could eliminate your need for blood pressure medication. Blood pressure is a measure of how much resistance there is to blood flow through your arteries. It’s recorded as two numbers: a top number and a bottom number. The top is called systolic pressure — the pressure in your arteries when your heart beats. The bottom number is diastolic pressure — the pressure in your arteries when your heart is at rest between beats. Blood pressure generally is considered too high when the top number is more than 140 or the bottom number is more than 85. High blood pressure can lead to serious medical problems, including kidney disorders, heart attack, stroke and heart failure, among others.

DEAR MAYO CLINIC: How much sleep should teenagers be getting, and how does it affect their health if they are sleep deprived? My daughter is 16 and only sleeps about six hours each night during the week. She says she isn’t tired and makes up for it by sleeping in on the weekends, but I am worried it’s affecting her ability to concentrate at school. ANSWER: You’re right. Your daughter needs more sleep. To be well-rested and to help them stay healthy, teenagers need about nine to nine-and-a-half hours of sleep each night. Healthy sleep is important for many reasons. It can fight stress, improve mood and attitude, and provide energy. When teens are well-rested, they can concentrate, learn, listen and think better than when they’re tired. That can improve school participation and performance. Healthy sleep also contributes to a healthy body, helping it run the way it should. Unfortunately, many teens don’t get the sleep they need. One of the big reasons is that the body’s internal clock shifts during the teen years. In the preteen years, the hormone melatonin, which signals to the body that it’s time to sleep, is released into the bloodstream earlier in the evening.

DEAR MAYO CLINIC: I was diagnosed with spinal stenosis about 12 years ago. I haven’t had many symptoms over the years, but about six months ago I started noticing increasing discomfort in my legs. Is surgery an option to treat spinal stenosis? If not, what else can I do? The leg pain is making it hard for me to walk. ANSWER: Surgery usually isn’t necessary to treat spinal stenosis. Often a combination of lifestyle changes, physical therapy and medication can effectively decrease the pain and discomfort caused by this common back problem. Spinal stenosis occurs when the open space within your spine narrows, causing pressure and irritation to the nerve tissue. It can happen for a variety of reasons, but most of the time spinal stenosis is a result of aging and the buildup of arthritis. In some cases, spinal stenosis does not cause any symptoms and may be found during a medical test done for another reason. Spinal stenosis, and the nerve compression that is associated with it, tends to develop slowly. Over time, it can put pressure on your spinal cord and the nerves that travel through the spine to your arms and legs, and possibly cause symptoms. If the nerves affected are in your neck — the part of your spine called the cervical spine — that may cause numbness, weakness or tingling in an arm or hand, or trouble with coordination in a leg or foot. It often causes problems with walking and balance. Nerves to your bladder or bowel can be affected, too.

DEAR MAYO CLINIC: I’m a 57 year-old woman and am so warm all the time that I don’t even wear a coat in the winter, just a heavy sweater. I sweat so much that it drips off my nose sometimes, and if I do any kind of physical activity — even just a short walk — I start sweating. It is uncomfortable but it is also embarrassing, and I stay away from social situations because of it. Is there anything that can be done for this? I don’t see other women having this problem. ANSWER: Excessive sweating such as you describe is called hyperhidrosis. Rest assured, effective treatment is available. In order to decide on the best treatment options for you, you will need a thorough evaluation with your doctor to review your symptoms and check for an underlying medical condition that could be contributing to the problem. The most common form of hyperhidrosis is called primary focal (or essential) hyperhidrosis. It happens when excess sweating is not triggered by a rise in temperature or physical activity. There is no medical cause for it and it tends to mainly affect the palms, face and soles of the feet, although in some cases it can involve the entire body.

DEAR MAYO CLINIC: I’ve had heavy bleeding with bad cramps for almost two months and was recently diagnosed with uterine fibroids. My doctor prescribed hormone treatment, which helped with the bleeding for a couple weeks, but when I stopped taking it due to negative side effects the bleeding started again. What are my other options for treatment? I am 31. ANSWER: When uterine fibroids cause symptoms such as bleeding and cramping, treatment is either directed at managing the symptoms, as is the case with hormone therapy, or it is focused on shrinking or removing the fibroids themselves. Treatment choices are typically based on severity of symptoms, as well as the size and location of the fibroids. Uterine fibroids are growths of the uterus that are not cancer. These firm masses can range from tiny and almost undetectable to large and bulky. Many women have uterine fibroids without knowing it because about 70 percent don’t have any symptoms. When uterine fibroids do cause symptoms, those you’ve experienced — bleeding and cramping — are the most common. Uterine fibroids can also lead to increased urinary frequency, constipation and a feeling of pressure within the pelvic area.

DEAR MAYO CLINIC: My mother was diagnosed with stage III ovarian cancer a few weeks ago. She had surgery and is about to begin chemotherapy, and I’ve read that sometimes chemo is more effective if it is given directly in the abdomen. Is this commonly done, and should I ask her doctor about it? Also, why is radiation not part of her treatment plan? ANSWER: Treatment for ovarian cancer at the stage of your mother’s diagnosis typically includes a combination of surgery and chemotherapy. Radiation therapy was used for ovarian cancer in the past, but today it is uncommon because the other two treatments have been shown to be more effective for this type of cancer. Ovarian cancer is a rare cancer. About 22,000 cases are diagnosed each year in the United States, compared to several hundred thousand cases of breast cancer. It begins in the ovaries — the two small organs on either side of the uterus that create eggs, or ova, and make the hormones progesterone and estrogen. Cancer that looks and behaves like ovarian cancer can also start in the fallopian tubes or the lining of the pelvis or abdomen, called the peritoneum. All three of these cancers are treated the same way — with surgery and chemotherapy — and they are all often referred to as "ovarian cancer."

DEAR MAYO CLINIC: Six years ago, at age 37, I was diagnosed with breast cancer and had a lumpectomy. I remained cancer-free until nine months ago, when the cancer returned. This time I opted for a double mastectomy without reconstruction. If I decide to have breast reconstruction down the road, are my options limited since I didn’t have it done right away? What type of reconstruction would you recommend for someone like me? ANSWER: In general, breast reconstruction surgery falls into two categories. The first involves using a woman’s own tissue taken from another area of the body to form new breast mounds. This is called autologous breast reconstruction. The second uses breast implants to reshape the breasts. If you decide to have breast reconstruction at some point, the standard treatment option based on your history would be autologous reconstruction. It would offer you the best chance for a successful outcome with the lowest risk of complications.