Mayo Clinic Q & A

DEAR MAYO CLINIC: I have been diagnosed with clinical depression. I am taking duloxetine (Cymbalta), which helps. But I always feel more blue and have a hard time finding the energy to do my normal activities when fall and winter come. My neurologist thinks I should see a therapist, but talking about depression makes me feel worse. Is there anything else I can do?   ANSWER: Because your symptoms get worse as the seasons change, you could have seasonal affective disorder (SAD), a form of clinical depression. If so, several treatment options are available that may help. SAD is a type of depression that affects people during the fall and winter months. The lower levels of sunlight in the winter and fall may upset your sleep patterns and lead to feelings of depression. When combined, these factors may lead to SAD. SAD is different from non-seasonal depression in several unique ways, particularly in its timing. SAD is more than just feeling blue as the days get shorter or having the doldrums during January. Instead, it involves persistent, pervasive symptoms of depression during wintertime.  

DEAR MAYO CLINIC: I’ve been hearing a lot about regenerative medicine lately. What is it exactly, and what can it be used for?    ANSWER: Regenerative medicine is an emerging discipline in medicine and surgery focused on finding ways to boost the body’s ability to heal itself. It examines new therapies and advances new ways to manage diseases that go beyond current medical treatment. Regenerative medicine is really poised to revolutionize disease management, offering potential solutions throughout a person’s life for a spectrum of diseases.  Today, treatment for many diseases focuses on managing symptoms. For example, insulin therapy keeps diabetes under control. Dialysis does the work of a failing kidney. Medications ease the strain on a damaged heart. In contrast, the aim of regenerative medicine is to reverse the course of the disease by targeting its root cause and repairing diseased, injured, or defective tissues and organs to restore their function and structure. 

DEAR MAYO CLINIC: My sister-in-law has chosen not to vaccinate her children. She believes they don’t need the vaccinations in the first place, and that vaccines actually do more harm than good. I know this can’t be true. What are the facts behind the safety and effectiveness of vaccinations? Isn’t it putting other kids at risk when some choose not to vaccinate?   ANSWER: Yes, you are exactly right. Not immunizing a child puts that child — as well as siblings, parents, friends and other people he or she may come in contact with — at risk. The childhood vaccines recommended in the United States have been proven safe and effective. They protect children from a variety of serious and sometimes fatal diseases, including diphtheria, measles, meningitis, polio, tetanus and whooping cough. Unless there is a valid medical contraindication, opting out of vaccines is a mistake.  The idea that vaccines are not needed because a child’s natural immunity provides enough protection is common among people who choose not to vaccinate their children. Although a natural infection may provide more complete immunity than a series of vaccinations, there’s a big price to pay. To become immune naturally, you have to get the infection first. With the infection comes the very real risk of severe and sometimes permanent complications, including hospitalization and death.

DEAR MAYO CLINIC: Is it true that adults should be vaccinated against pertussis? I thought that was a childhood disease. Hasn’t it basically been eliminated in the United States?   ANSWER: Now more than ever, it is important for everyone — including adults — to be vaccinated against pertussis. There is an effective vaccine against pertussis, also known as whooping cough. But the immunity generated by the vaccine weakens over time. When enough people in the population become susceptible to infection, an epidemic can occur. These epidemics are not as severe as was seen in the pre-vaccine era, but they still affect a lot of people.   Pertussis is a highly contagious bacterial infection that causes a severe, hacking cough. The coughing spells can be followed by a high-pitched intake of breath that sounds like a “whoop” and gives the disease its name. Coughing spasms can cause extreme fatigue and vomiting and make breathing difficult. In babies, the disease can be very serious because their airways are tiny and they may have trouble breathing in enough oxygen during coughing spells. Severe coughing spells can also generate small hemorrhages in the eyes and brain. 

DEAR MAYO CLINIC: My daughter developed numerous hemangiomas, most of them on her face and stomach, when she was a few months old. She is now 6 years old and they have not gone away. She is self-conscious of them and people are always asking about her condition. Is there a safe way to surgically remove them? Will she have them her whole life? I had been told they should resolve on their own before she was in school.   ANSWER:  Even though they usually are not present at birth, hemangiomas are considered a type of birthmark. Typically these red marks on the skin grow during a child’s first year of life and then begin to slowly shrink and fade. Hemangiomas can take a long time to go away and in some cases they never disappear completely. There are ways to remove hemangiomas that last or that cause problems.    Hemangiomas are caused by an abnormally dense group of extra blood vessels. Many hemangiomas appear as flat, red marks on the skin during the first several weeks or months of life. They can be on any part of the body, but are most commonly located on an infant’s face, scalp or neck.  

DEAR MAYO CLINIC: My mother is 62 and has had very low blood pressure for two years. She was hospitalized with blood pressure that dropped from 200/78 in bed to 60/40 sitting up. What could be causing this and what can be done to treat her?   ANSWER: Your mother has a condition called orthostatic hypotension. It happens when blood pressure falls significantly as a person stands up. Orthostatic hypotension can cause a variety of symptoms; the most common are feelings of dizziness and faintness.  Blood pressure is a measure of the pressure in a person’s arteries during the active and resting phases of each heartbeat. When you stand, gravity causes your blood pressure to fall slightly as blood pools in your legs, lowering the amount of blood circulating back to your heart to pump.