Mayo Clinic Q & A

DEAR MAYO CLINIC: I recently received a call from a local blood donation center asking if I’d be willing to donate. I’d like to help, but I’ve never donated before and I’m nervous about it. I’m not a fan of needles, and I’m afraid I might faint. Also, is there really that big of a need for donated blood on a regular basis? ANSWER: Donating blood makes a real difference in people’s lives. Hospitals are always in need of new blood donors. Being nervous about blood donation at first is common. But blood donation center staff members are skilled at making the experience as smooth and anxiety-free as possible. Currently, as few as 3 percent of Americans who are eligible to donate blood actually become donors. That’s a concern because many people in the U.S. need blood every day. Some may need blood during surgery. Others may require blood transfusions after an accident. Still others rely on donated blood because they have a disease that makes it necessary for them to receive red blood cells or other blood components. In some cases, receiving donated blood may be the difference between life and death for these individuals.

DEAR MAYO CLINIC: I’m trying to lose weight, and a friend recently told me that cutting white bread and potatoes out of my diet completely will help. Is that true? If it is, what makes these foods so bad?       ANSWER: Your friend is right. Taking white bread and white potatoes, as well as white rice and white pasta, out of your diet can be helpful for weight loss. Because of the way your body processes these four foods, they can lead to cravings for carbohydrates, also called sugars. By eliminating them, you decrease food cravings, making it easier to eat less and lose weight. The grains in white bread, white pasta and white rice are refined through a milling process that strips off the bran layer to give them a finer texture. After that process, these foods are little more than carbohydrates that your body digests quickly and easily. The main problem with white rice, bread, pasta and potatoes is that they trigger a cycle of food craving. After you eat them, they release a sudden spike of sugar in your bloodstream. Your body responds to that extra sugar by releasing insulin. Insulin is a hormone your pancreas makes that allows sugar to enter your cells, lowering the amount of sugar in your blood.

DEAR MAYO CLINIC: My wife is 31 and was diagnosed with type 1 diabetes at age 7. She had a baby three months ago, and her blood sugar levels were never really controlled. Doctors tested her kidney function and said there is “a little damage” but nothing to worry about. They said a pancreas transplant might be an option. How risky is this? What medications will she need to take following the transplant? ANSWER: Most patients with type 1 diabetes do not require a pancreas transplant, because newer insulin regimens can keep their blood sugar under control. However, someone in your wife’s situation should consider a pancreas transplant, especially if she has frequent “insulin reactions” — meaning her blood sugar goes very low without her realizing it.

Dear Mayo Clinic: Does smoking have an effect on diabetes? Answer: Yes. There is some evidence that cigarette smoking can raise the risk of developing diabetes. And for those who have diabetes, smoking can increase the number of complications from the disease, as well as the severity of those complications. Someone who has diabetes has too much blood sugar (commonly called blood glucose), which can lead to serious health concerns, such as cardiovascular disease, nerve damage (neuropathy), kidney damage, problems with the eyes and feet, bone and joint disorders, and skin problems. Smoking may increase the risk of diabetes because it can increase blood sugar levels. It also affects the body's ability to respond to its own insulin — a hormone whose main job is to keep the level of sugar in the bloodstream within a normal range. Eventually, smoking may lead to insulin resistance. Thus, the more a person smokes, the greater the risk of diabetes. Heavy smokers — more than 20 cigarettes a day — almost double their risk of developing diabetes, when compared with nonsmokers.

Dear Mayo Clinic: My father was recently diagnosed with diabetic kidney disease. Is there a chance this can be reversed, or will he have it for life? What changes, if any, should he be making to his diet? Answer: It is not uncommon for people who have diabetes to develop kidney problems. When diagnosed early, it may be possible to stop diabetic kidney disease and fix the damage. If the disease continues, however, the damage may not be reversible. Diabetic kidney disease, also called diabetic nephropathy, happens when diabetes damages blood vessels and other cells in the kidneys. This makes it hard for them to work as they should. In the early stages, diabetic kidney disease has no symptoms. That's why it is so important for people with diabetes to regularly have tests that check kidney function.

DEAR MAYO CLINIC: I was recently put on medication for high blood pressure. Does it matter what time I take it? I thought I was supposed to take it before I go to bed. But when I do, I’m up all night using the bathroom. Also, is this medication something I will have to take for life? ANSWER: It usually is not necessary to take your blood pressure medication at night, unless your doctor has told you to do so. Whether or not you have to take the medication for the rest of your life depends on a variety of factors. In some cases, lifestyle changes can lower or eliminate the need for blood pressure medication. What you eat and how much you exercise can help control blood pressure. Lowering the amount of salt in your diet and eating plenty of fruits and vegetables, along with whole grains and low-fat dairy foods, can have a positive effect. Regular physical activity can also help lower blood pressure and keep your weight at a healthy level. Weight is a big factor in high blood pressure. Research has shown that, in people who are overweight, lowering one’s weight by just 10 percent can lower blood pressure.

DEAR MAYO CLINIC: If you get to the hospital quickly after having a stroke and get treatment right away, does that mean there won’t be any of the typical after-effects of a stroke? ANSWER: Although early treatment does not guarantee that there won’t be any lasting effects from a stroke, it can dramatically decrease the risk of permanent brain damage. If you have any symptoms of a stroke, get emergency medical care right away. There are two types of stroke. The first, called an ischemic stroke, is due to a lack of blood supply to an area of the brain, caused by a blocked artery. This deprives brain tissue of oxygen. Within minutes, the brain cells begin to die. Ischemic strokes make up about 85 percent of all strokes.

DEAR MAYO CLINIC: What is the best treatment option, other than hysterectomy, for uterine fibroids? If they return after treatment, does that mean I should then consider a hysterectomy? ANSWER: A range of options exist for treating uterine fibroids. The treatment that is right for you depends on your individual situation. If fibroids come back after one treatment, a hysterectomy may be the next step in some cases. But again, that option is not the only choice. Uterine fibroids are noncancerous growths that develop from the smooth muscular tissue of the uterus, called the myometrium. Fibroids can range in size significantly. Some are so tiny that they cannot be seen by the human eye. Others are bulky masses that can distort and enlarge the uterus.

DEAR MAYO CLINIC: Why is it that some breast cancers have higher survival rates than others? ANSWER: The main reason for the difference in survival rates is that breast cancer is not just one disease. It is well accepted that there are four distinct molecular categories of breast cancer. However, new data suggests that there are additional distinct subsets of breast cancer. These subsets have unique characteristics that can influence the long-term outlook associated with each of them. The most common molecular subset of breast cancer is characterized by its ability to respond to the female hormone estrogen. This type of cancer is characterized by the presence of estrogen receptors. If a tumor is estrogen receptor (ER) positive, that means the breast cancer cells contain receptors that bind to estrogen. Women and men with ER-positive breast cancer tend to have an initial lower risk of the cancer coming back after breast surgery compared with women whose tumors do not have estrogen receptors (known as ER-negative breast cancer).

DEAR MAYO CLINIC: What happens to the brain when someone suffers a concussion? Do concussions increase the risk of dementia or Alzheimer’s disease? ANSWER: A concussion is a brain injury that changes the way your brain functions. The effects of most concussions are not long-lasting. But to avoid permanent damage, it is important to give someone who’s had a concussion plenty of time to rest and recover following the injury. Research does show that repeated concussions in some people can lead to cognitive impairment that could progress to Alzheimer’s disease or other types of dementia, such as chronic traumatic encephalopathy.

DEAR MAYO CLINIC: Other than a lump in the breast, are there other symptoms of breast cancer? Is breast pain something to be concerned about? ANSWER: Yes, breast cancer can cause symptoms other than a breast lump. To make it easier to spot changes that could be symptoms, you should be familiar with what your breasts usually look like. If you notice any unusual breast changes, have them examined by your doctor. Breast cancer can lead to a variety of symptoms. The most obvious is a breast lump. But other symptoms include skin changes on your breast, such as redness, dimpling or puckering of the skin. Breast cancer also can cause a skin rash that looks similar to mastitis — an infection of the breast tissue that most often affects women who are breast-feeding.  If you find a new rash or breast redness, and you are not breast-feeding, that should be evaluated by your doctor.

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. Influenza is a respiratory infection that can lead to serious complications, particularly in young children and older adults. Getting the flu vaccine is the most effective way to prevent influenza and its complications. The Centers for Disease Control and Prevention recommends that everyone 6 months of age or older be vaccinated against influenza every year.