Mayo Clinic Q & A

DEAR MAYO CLINIC: I am 76 years old, and over the last year it has been getting harder to do everyday tasks. Even getting out of a chair is sometimes difficult, and I can tell I’m much weaker than I used to be. Is this a normal part of aging, or should I see my doctor? ANSWER: Diagnosing the cause of muscle weakness that develops over time can be challenging. Gradual loss of strength can contribute to many health problems, including increased risk of falls, decreased bone strength and weight gain. A degree of loss of muscle mass and strength can occur as part of aging, but there are many medical problems that can cause weakness, so any concern about this issue should be discussed with your physician. An important distinction is whether your sense of weakness is actually due to the loss of muscle power caused by either central nervous system disease, or by nerves or muscles that aren’t functioning properly. Alternatively, you may feel weak due to factors such as fatigue, sleepiness, lightheadedness or chronic pain.

DEAR MAYO CLINIC: I’ve been a smoker for years. I’m thinking about switching to electronic cigarettes or to a nicotine inhaler because I’ve heard they aren’t as bad for you as regular cigarettes. Is that true? ANSWER: Electronic cigarettes and nicotine inhalers both deliver nicotine to your body without tobacco. But that’s where the similarity ends. The two are quite different when it comes to how they are used and how much doctors know about their safety. Nicotine inhalers are a proven safe and effective way to help people stop smoking. In contrast, very little is known about the health effects of electronic cigarettes. Electronic cigarettes, or e-cigarettes, are battery-operated devices that look like regular cigarettes. Like traditional tobacco cigarettes, they contain nicotine. When you use an e-cigarette, a liquid inside it that includes nicotine is heated and turns into a vapor you inhale. It also makes a vapor cloud that looks like cigarette smoke.

DEAR MAYO CLINIC: I’ve read that there will be new options for getting the flu vaccine this year, including one for people who have egg allergies. How are these new vaccines different, and how do I know which one to pick? How do researchers know they will be safe? ANSWER: You’re right. Beginning this year, several new vaccine options will be offered to help protect you against influenza, or the flu. Rather than just two options, you now will have a range of vaccines from which to choose. At first having so many choices may be confusing. But by doing a little research and having a conversation with your health care provider, you will be able to decide which one is best for your situation. As always, each of the new vaccines has gone through rigorous safety testing before being made available to the public.

DEAR MAYO CLINIC: I was diagnosed last year, at the age of 38, with shingles. What causes someone who is relatively young to get shingles? Does this mean I am more likely to get it again? Should I get the vaccine at this point or wait until the recommended age of 60? ANSWER: Shingles is caused by the varicella-zoster virus, the same virus that causes chickenpox. Once you have had chickenpox, varicella-zoster stays in your body for the rest of your life. When the virus is reactivated, the result is shingles. [Watch this animation: stages of shingles] Shingles typically involves a band-like rash on one side of the chest, abdomen or face. The rash is usually quite painful. Most people recover from shingles over several weeks. A small number have lingering severe pain, called post-herpetic neuralgia, along the nerve that was irritated when the virus came back. 

DEAR MAYO CLINIC: My 12-year-old son goes to bed each night around 10 p.m. but usually cannot fall asleep until 1 or 2 in the morning. Is this normal for a “tween,” or should I talk to his doctor? What are some things that could cause insomnia in someone his age? ANSWER: Lots of children your son's age have trouble falling asleep easily at night. In many cases, the reason for this can be traced back to habits a child has developed that interfere with good sleep. Less often, it may be due to a sleep disorder. Before you see a doctor, check to make sure your son’s routines are sleep-friendly. For example, one of the best ways to ensure healthy sleep is setting a consistent wake-up time and sticking to it. The wake-up time doesn’t have to be exactly the same time every day, but it should be within a two-hour window.

DEAR MAYO CLINIC: My physician recommended that I be screened by a dermatologist for a baseline risk assessment. What is this, and is it necessary? I use sunscreen regularly and have skin that normally does not burn. Am I still at risk for skin cancer? ANSWER: Anyone can get skin cancer. So it is a good idea for everyone to get a baseline risk assessment from a dermatologist. This assessment can give you a better understanding of your risk for developing skin cancer. It also can help determine how often you should see a dermatologist for checkups in the future. There are three major types of skin cancer: melanoma, basal cell cancer and squamous cell cancer. Basal cell skin cancer is the most common kind of cancer worldwide. Squamous cell skin cancer is the second most common. Although less common than the other two, melanoma is a more serious type of skin cancer that can be difficult to treat if it is not caught early.

DEAR MAYO CLINIC: My grandson played rugby in college. He suffered a concussion and now has trouble with many mental functions, including maintaining thoughts. His peripheral vision has been affected and noise prevents him from working. What could help him return to normal? He is 23 years old and should be in the prime of his life. Instead, he just stays in the house all the time. ANSWER: Symptoms caused by a concussion often go away within several weeks. But sometimes they may last much longer. In those cases, it can be useful to consult a physician who has expertise in treating concussions. Ongoing care, including rehabilitation therapy, may help your grandson better manage his symptoms and return to a more active lifestyle.

DEAR MAYO CLINIC: How long after a heart attack do I need to wait to resume sexual activity? ANSWER: For men and women with cardiovascular disease — no matter how young or old — sexual activity is important to quality of life. But after a heart attack, it’s not uncommon to lose confidence in your heart’s ability to work properly under stress. In addition, your partner may worry that resuming sexual activity might harm you or cause physical pain, especially if you had open-chest surgery. The good news is, it may be safe for you to resume sexual activity sooner than you think. But because each person’s situation after a heart attack is unique, be sure to talk with your doctor about your specific situation.

DEAR MAYO CLINIC: I’m a 38-year-old woman, and I get migraine headaches occasionally, usually one every few months. I have a hard time functioning when I have a migraine. I don’t want to take medication for this problem if I don’t have to. Are there ways to prevent or treat migraine headaches without medication? ANSWER: Even if you don’t get them very often, migraine headaches can have a big impact on your life. A number of lifestyle changes may help reduce how often you get migraine. But if they continue, talk with your doctor about other treatment options. Migraine headaches involve moderate to severe pain that is often throbbing and typically affects one side of the head. The pain usually gets worse with exertion such as climbing stairs. Additional symptoms, such as nausea, vomiting, and sensitivity to light and sound, also accompany a migraine attack.

DEAR MAYO CLINIC: I am a 55-year-old woman and have had headaches my entire life. In the past, ibuprofen would get rid of a headache rather quickly, but lately nothing has been working. Do I need to get a stronger medicine from my doctor? ANSWER: You should definitely talk to your doctor about your headaches. A different type of medication might make a difference. However, it is possible that the problem could be linked to taking too much medication. Your doctor can assess your symptoms, review your current medications and help you come up with a more effective treatment plan for your headaches. Your headaches sound like they fall under the category of tension headaches. These common headaches tend to involve mild to moderate pain. They typically feel like a tight band around your head. These headaches may last from a few hours to several days.

DEAR MAYO CLINIC: As the result of a sports injury, my 16-year-old daughter has chronic pain that has lasted for more than a year. It is really taking a toll on her. The pain makes it hard for her to go to school and to do the activities she enjoys. Medication doesn’t make much difference. What can we do? Is there a chance the pain will go away with time? ANSWER: Your daughter’s pain may fade over time. While she has pain, though, it is important for her to find ways to manage it. A cure may not be possible, but there are many strategies that can help her get back into life. Pain usually comes from illness, injury or surgery, and it goes away as our bodies heal. This type of pain is called acute pain. Chronic pain is different. It is generally defined as daily pain that lasts more than three months. Chronic pain may continue after an injury or illness has passed. It may come from a medical condition that is hard to treat. Sometimes chronic pain may not have any clear source.

DEAR MAYO CLINIC: I have long suffered from allergies. But there have been times when I haven’t been sure if my symptoms are really from my allergies or may be caused by a sinus infection instead. How can I tell the difference? ANSWER: Allergies and sinus infections are often mistaken for one another. But they are two separate conditions. By paying close attention to the specific symptoms you have, you can usually identify which one is more likely to be causing the problem. A sinus infection, also called sinusitis, affects the cavities around your nasal passages. The infection causes your sinuses to become inflamed and swollen. The swelling makes it hard for your sinuses to drain, and mucus builds up. You become congested and have trouble breathing through your nose. Sinusitis often causes thick yellow or green nasal discharge. A sore throat, cough or headache, as well as pressure or tenderness around your eyes, cheeks, nose or forehead, may also accompany sinusitis.