Mayo Clinic Q & A - September 2014 Archives

DEAR MAYO CLINIC: What is the most effective way to treat knee bursitis? I have had it for months and the pain is worsening, but I have heard that even after treatment it can come back. Is there a way to prevent it in the future? ANSWER: Bursitis is a term used to describe a variety of disorders that involve inflammation in the knee’s soft tissues. These problems can be caused by exercise, injury, overuse or infection. In many cases, they resolve on their own with little or no treatment. But some cases of bursitis may require medical care. The right treatment usually depends on the underlying cause of bursitis. Knee bursitis is inflammation of a bursa located near your knee joint. A bursa is a small fluid-filled sac that reduces friction and cushions pressure points between your bones and the tendons and muscles near your joints. Each of your knees has 11 bursae. While any of these can become inflamed, knee bursitis most commonly occurs over the kneecap or on the inner side of your knee below the joint.

DEAR MAYO CLINIC: I am 44 and in good health. Two weeks ago I became very ill (bloody diarrhea and severe abdominal cramping for three days) after eating at a restaurant. The stool samples did not show any sign of food-borne disease, and I was told my symptoms were probably the result of a virus. I am concerned that it could be something more serious. Should I request further testing? ANSWER: A variety of conditions could be the cause of your illness. If you no longer have any symptoms, then it is unlikely you need additional testing. If you are still having some symptoms, then more investigation is required. In someone who has previously been well, who has no history of gastrointestinal (GI) complaints and who has a bloody, diarrheal illness that comes on quickly, we can divide the likely possible causes into two main categories: infectious diarrhea versus inflammatory diarrhea.

DEAR MAYO CLINIC: Three months ago I was diagnosed with Graves’ disease. I have decided to have a thyroidectomy and want to know what to expect after the procedure. Will all of my symptoms (Graves’ ophthalmopathy, heart palpitations, irritability) go away immediately after surgery? What are the side effects of having the thyroid removed? ANSWER: Thyroid removal is one of several treatment options that can effectively decrease symptoms of Graves’ disease. Others include anti-thyroid medications and radioiodine. Each person is different, and no one treatment is best for everyone. A thyroidectomy often relieves symptoms of Graves’ disease. But as with all surgery, there are risks and possible complications associated with thyroidectomy. Graves’ disease is an immune system disorder that results in the overproduction of thyroid hormones, a condition known as hyperthyroidism. Because thyroid hormones affect many of your body’s functions, signs and symptoms of Graves’ disease can be wide ranging.

DEAR MAYO CLINIC: I am 42 years old and have a BRCA1 gene mutation. I’ll have a prophylactic oophorectomy later this year. I have had a prophylactic mastectomy as well, and am considering hormone replacement therapy. How soon after surgery would I need to start taking hormones? What are the risks if I decide against hormone replacement? ANSWER: For a woman carrying a BRCA mutation without a personal history of cancer, hormone replacement therapy, or HT, is usually recommended from the time your ovaries are removed until you turn 50. Beyond that age, the risks of continuing HT for a BRCA mutation carrier are not fully known. So HT is usually stopped around age 50. Going without any hormone therapy after prophylactic oophorectomy may increase the likelihood of some significant health risks, including problems that could affect your bones, heart and brain. A mutation in the BRCA1 gene significantly raises your risk of breast and ovarian cancer. Surgery done in an effort to prevent cancer by removing the breasts, called prophylactic mastectomy, and removing the ovaries, called prophylactic oophorectomy, often can dramatically lower those cancer risks.

DEAR MAYO CLINIC: I just turned 48 and am considering having blepharoplasty surgery to remove the excess skin on my eyelids, which has bothered me for years. What does this procedure involve? What are the risks? Is the change permanent, or is there a chance my eyelids will return to the way they look now? ANSWER: The surgery you are considering typically includes removing extra skin, muscle and fat from both the upper and lower eyelids. Blepharoplasty, also called an eyelid lift, can help reduce vision problems caused by excess eyelid skin. It also can make your eyes look younger and more alert. As with all surgery, there are risks involved. As you age, your eyelids stretch, and the muscles supporting them get weaker. As that happens, extra fat may gather above and below your eyelids, causing droopy upper lids and bags under your eyes. If the skin around your eyes sags significantly, it can make it harder to see, especially in the upper and outer parts of your field of vision. Eyelid surgery may be able to reduce or eliminate these problems.