Mayo Clinic Q & A

DEAR MAYO CLINIC: I have had bunions for years, but they have not bothered me much until recently. I now have pain every day and most shoes hurt my feet. Is surgery the only option at this point? What does that involve, and can it be done on both feet at the same time, or will I need to have each foot done separately? ANSWER: In a situation like yours, surgery could be considered. But surgery is not the only treatment for bunions. More conservative measures may help decrease your symptoms and relieve pain. If you try them and they don’t work, though, then it would be a good idea to talk with a foot surgeon about surgical options. The structure of your feet changes over time. Sometimes these are subtle changes that you do not notice. But in other instances, the changes are more substantial. Bunions happen due to changes that force the bones of your feet out of alignment and increase the width of your foot. When a bunion develops, your big toe actually tilts or drifts away from the midline of your body, eventually crowding the second toe. The bone that is just behind the big toe, called the first metatarsal, drifts or tilts in toward the midline of your body. As the first metatarsal tilts in, it becomes more prominent. That is the bony bump referred to as a bunion.

DEAR MAYO CLINIC: My husband was originally diagnosed with Parkinson’s, but later it was determined he has atypical parkinsonism. What is the difference? What treatments work best for his condition? ANSWER: Your husband’s situation is not uncommon for people who have atypical parkinsonism. When symptoms of parkinsonism begin, the condition may at first be diagnosed as Parkinson’s disease. But over time, it becomes clear that a different disorder is really the underlying cause of the symptoms. Treatment for atypical parkinsonism depends on several factors, including the specific diagnosis, symptoms, and how quickly the disease progresses. To understand atypical parkinsonism, it is helpful to know a bit about parkinsonism in general. First, parkinsonism is not a disease itself. It is a name used to describe a group of symptoms, which include: tremor when a limb is at rest, slowed movement, rigid muscles and impaired balance and posture. When someone has at least two out of these four symptoms, they are said to have parkinsonism. Parkinsonism has many causes. Parkinson’s disease is the most common cause, but it is not the only one. Parkinsonism can be a result of certain medications. A type of progressive dementia, called Lewy body dementia, which includes a decline in both mental and physical abilities, may lead to parkinsonism. Parkinsonism also can be caused by three other rare movement disorders: multiple system atrophy, progressive supranuclear palsy and corticobasal degeneration. When a neurologist suspects one of these three disorders as the source of parkinsonism, but an exact diagnosis has not yet been made, it is often labeled atypical parkinsonism.

DEAR MAYO CLINIC: Is there anything that can be done for snoring other than using a CPAP machine? I have tried using one for the ...

DEAR MAYO CLINIC: What is the best way to treat plantar warts to ensure they don’t come back?  I have them on my feet. At one point, I had them removed with freezing therapy, but they keep returning and even spreading. ANSWER: Freezing therapy, also called cryotherapy, is the most common and usually the most effective way to treat plantar warts. But warts can be tough to get rid of completely. Sometimes several cryotherapy treatments are needed to successfully eliminate plantar warts. If the warts are bothering you, make an appointment to have them treated again. Combining cryotherapy with another form of treatment may make it more likely that warts will go away and stay away. Plantar warts are hard, grainy skin growths that appear on the feet. They usually show up on the balls and heels of the feet, the areas that bear the most pressure. All warts are caused by the human papillomavirus, or HPV. HPV is very common, and there are more than 100 different kinds of the virus. But only a few of them cause warts on the feet. Plantar warts develop when the virus enters your body through tiny cuts, breaks or other weak spots on the bottoms of your feet. Once a plantar wart begins to grow, HPV stimulates the skin to attract and grow its own blood supply. That makes the wart very hearty. If left untreated, warts typically last for one to two years. But most warts do go away eventually. If a plantar wart does not go away over a long period of time, it should be evaluated by a physician because it could be something other than a wart.

DEAR MAYO CLINIC: My grandson had a virus with flu symptoms. Then one of his eyes got very red, but it wasn’t itchy or mattered shut. When my daughter took him to the doctor, she was told it was the virus settling in his eye. But it wasn’t pink eye. What’s the difference between this type of eye infection and pink eye? Are the treatments different? ANSWER: The two conditions you mention are both eye infections, and they are actually also both forms of pink eye. The difference is that the type of infection your grandson had is caused by a virus. The other is caused by bacteria. Viral eye infections typically do not require any treatment. Bacterial eye infections are usually treated with antibiotic eye drops. Eye infections are common, especially in children. As in your grandson’s case, they often happen when a child has a cold. Both viral eye infections and bacterial eye infections are called conjunctivitis, or pink eye.

DEAR MAYO CLINIC: What is the difference between dementia and Alzheimer’s disease? Are they hereditary? ANSWER: Dementia is a broad term used to describe a group of symptoms that interferes with a person's thinking and the ability to function well in day-to-day activities. Many conditions can result in dementia, but Alzheimer’s disease is, by far, the most common. Because so many factors can lead to dementia, one cannot say that dementia, the syndrome, is hereditary. Rather, subtypes of dementia (for example, Alzheimer’s disease) may have inherited components. A rare form of Alzheimer’s disease is truly inherited, but that accounts for only 1 percent of the total disease. Typical Alzheimer’s disease, however, does have a tendency to run in families, and there are genetic tendencies. Dementia is defined by its symptoms, with memory loss being one of the most frequent. Just because a person has some memory loss, though, doesn’t necessarily mean he or she has dementia. A diagnosis of dementia typically means a person is having problems with at least two brain functions. That may include, for example, memory loss as well as impaired judgment or problems with language. These may in turn lead to difficulty performing routine tasks, such as paying bills or driving to a familiar location without getting lost.

DEAR MAYO CLINIC: How does paternal age affect fertility? Can the age of the father have an impact on the baby’s health? ANSWER: Age can have an effect on a man’s fertility. But the influence of aging on fertility in men is not as significant as it is in women. Research has shown that there may be an increase in the risk for certain health problems in the children of older fathers. The risk, however, appears to be small. After puberty, most men produce sperm throughout the rest of their lives. That means men can conceive a child well into their later years. That said, studies have shown that men who are older than 40 tend to be less fertile than younger men. But even though older age does reduce fertility, a man’s age alone does not seem to have a substantial effect on a couple’s fertility overall. For example, studies have shown that a man’s age does not decrease the success of fertility treatment in couples who seek those services. A man’s age at the time a baby is conceived is called his paternal age. A woman’s age at conception is maternal age. A woman’s maternal age is considered to be advanced and health risks for a baby increase after age 35. There is no universally accepted definition of when paternal age is considered to be advanced. Various studies have used cutoffs of 40, 50 and even 60 years for advanced paternal age.

DEAR MAYO CLINIC: I am 32 and have had one healthy pregnancy and baby. But over the past 18 months, I have had two miscarriages, ...

DEAR MAYO CLINIC: My mother has had deep vein thrombosis twice. I’ve heard this condition can run in families. I’m a 38-year-old woman in good health. I exercise regularly and eat well. What can I do to lower my risk of developing DVT? ANSWER: Deep vein thrombosis (DVT), happens when a blood clot forms in a vein located deep within the leg or pelvis. It is a serious condition because if the clot breaks free and travels to your lungs, it can be life-threatening. A variety of factors can raise your risk for these blood clots, including a family history of DVT, as well as recent surgery, hospitalization for a medical illness, trauma with or without fracture, obesity, immobility, and certain drugs. DVT most often happens in the large veins within the legs. If a clot in a vein comes loose, it can be carried through your body in the blood flowing back to your heart. From there, it may be pumped into your lungs. A clot that gets stuck in a blood vessel within the lungs — a condition known as a pulmonary embolism — causes sudden death in about 20 to 25 percent of cases.

DEAR MAYO CLINIC: My husband was diagnosed with cancer six months ago and just completed chemotherapy treatments. He’s not feeling great right now, and he may need more cancer treatments at some point. But we’ve been told his long-term outlook is good. At a recent appointment, though, his oncologist suggested he consider palliative care. Why would he need that? Isn’t it similar to hospice care? ANSWER: Palliative care and hospice care are different. Hospice is both an insurance benefit and a philosophy that focuses on enhancing quality of life for patients who likely have less than six months to live. The goal of hospice is to help people live as well as they can for as long as they can. Palliative care, on the other hand, is specialized medical care for people with serious illnesses. This type of care is focused on providing relief from the symptoms, pain and stress of a serious illness, whatever the diagnosis or outlook.

DEAR MAYO CLINIC: How does having sleep apnea affect my health? Are there treatments that I can try for sleep apnea other than a CPAP machine? ANSWER: People who have sleep apnea repeatedly stop and start breathing when they sleep. There are two main types of sleep apnea. The more common form is obstructive sleep apnea, or OSA. It happens when muscles in the back of the throat relax, narrowing the airway and making it hard to take in enough air. Central sleep apnea is less common. It happens when the brain doesn’t send the proper signals to the muscles that control breathing. OSA can make it difficult to get a good night’s sleep. People with this sleep disorder often do not feel refreshed in the morning. They may wake up with a headache and suffer from fatigue and sleepiness throughout the day. Lack of sleep can affect a person’s mood and the ability to think clearly and concentrate. Other problems can arise as a result of OSA, too. It may lead to an increase in blood pressure. It can raise your risk for stroke and many types of heart disease. Untreated OSA makes recovery from surgery more difficult. If you have OSA, your risk of being in a motor vehicle accident is higher. Severe cases of OSA may lead to premature death.

Dear Mayo Clinic: Is it true that heart attacks are more common around the holidays? If so, why is that? What can people do to lower their risk? Answer: Heart attacks, along with heart problems in general, are more common around the holidays. Various factors can play into this, including stress, travel, changes in diet and disrupted schedules. Fortunately, many self-care steps can help keep your heart healthy. One of the biggest challenges this time of year is healthy eating. For people with heart problems, choosing a heart-healthy diet amid an abundance of holiday foods can be daunting. But not straying too far from your normal diet is important. Keep portion sizes reasonable and limit fatty foods. Eating too much can lead to chest pain or shortness of breath in some people with heart problems. Drink small amounts of alcohol, if any, as alcohol can raise your risk for heart rhythm problems and heart attack. Men should not drink more than two alcoholic beverages a day. Women should not have more than one.