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### Human:\nis it an urban legend that people have picked up and heard radio and tv signals from their tooth fillings?\n\n### Assistant: sometimes people can get a funny squeak after a new restoration is placed in their tooth. but the radio station tv stuff is more likely from hallucinations or a mental disorder.

### Human:\ni am extremely agoraphobic despite help from my psychologist psychiatrist and medication. why else can i do?\n\n### Assistant: since you are in treatment with both a psychiatrist and a psychologist and you have tried as you said many medications without sufficient help. you also indicated that you have serious agoraphobia which keeps you in your home. what is the treatment plan to handle your agoraphobia? i think this needs to be discussed especially with your psychologist who would seem the one with special expertise in this area. you might also consider getting a second opinion from another psychologist who might have more of a behavioral orientation which would help you take small steps toward leaving your home. i understand that this could be difficult to do but you really need someone who can offer you a treatment plan to properly address your primary symptom which appears to be the agoraphobia.

### Human:\nwhat causes dry mouth?\n\n### Assistant: there are several causes of dry mouth also called xerostomia. these include: side effect of certain medications. dry mouth is a common side effect of many prescription and nonprescription drugs including drugs used to treat depression anxiety pain allergies and colds (antihistamines and decongestants) obesity acne epilepsy hypertension (diuretics) diarrhea nausea psychotic disorders urinary incontinence asthma (certain bronchodilators) and parkinson's disease. dry mouth can also a side effect of muscle relaxants and sedatives. side effect of certain diseases and infections. dry mouth can be a side effect of medical conditions including sjögren's syndrome hiv/aids alzheimer's disease diabetes anemia cystic fibrosis rheumatoid arthritis hypertension parkinson's disease stroke and mumps. side effect of certain medical treatments. damage to the salivary glands the glands that produce saliva for example from radiation to the head and neck and chemotherapy treatments for cancer can reduce the amount of saliva produced. nerve damage. dry mouth can be a result of nerve damage to the head and neck area from an injury or surgery. dehydration. conditions that lead to dehydration such as fever excessive sweating vomiting diarrhea blood loss and burns can cause dry mouth. surgical removal of the salivary glands. lifestyle. smoking or chewing tobacco can affect saliva production and aggravate dry mouth. continuously breathing with your mouth open can also contribute to the problem.

### Human:\ndoes nardil a maoi help with depression? what side effects does it have?\n\n### Assistant: it is a good med that has been around since the '50s. need to watch certain specific foods - fava beens aged cheese smoked meat certain alcohols to name a few or you risk a spike in blood pressure and stroke. there are also many prescription and over-counter meds you cannot take. check with your pharmacist all the time on every single med before taking. works well for depression and some anxiety issues. fatigue dizz[iness] weight gain can happen. we usually use maois when a few other modern meds fail to work.

### Human:\nthe zoloft my doctor prescribed five weeks ago isn't working. i've been referred to a psychiatrist. what can i expect?\n\n### Assistant: psychiatrists unlike psychologists don't usually use any type of formal questionnaire/tests. it's usually just an interview that can be as long as one hour or as short as 15 minutes. this can be an indication of nothing really and depending on where you go it can be an indication of how long the patient waiting list currently happens to be. of course you have problems and the psychiatrist expects you to have them because you're being referred by someone. so that's a given. the fact that your med hasn't worked in five weeks may indicate that it's too low a dose or isn't the med for you. all of this depends on the psychiatrist's experience and training.

### Human:\ni lost my brother to breast cancer. since having children i still get some milk out of the nipple. is this normal?\n\n### Assistant: it is important for women to know that breast cancer can be a man's disease as well. this also means that a genetic link can come from a male relative. fortunately the symptom you describe is not likely to be linked to breast cancer risk. it is not uncommon for women to be able to get small amounts of nipple discharge after having breastfed. the usual triggers for this to occurs are: nipple stimulation a a part of sexual foreplay hot showers birth control pills or "checking for discharge" by repeated squeezing. sometimes women will notice discharge from one or both nipples. this prompts concern especially if she has not recently breast fed. generally we tell women that bilateral white or clear discharge which is only present with nipple stimulation is likely to be "normal. " as mentioned above being on birth control pills can sometimes enhance breast discharge. certain psychiatric medications—especially the antipsychotics —can initiate nipple discharge. bilateral spontaneous secretions can be prompted by a pituitary problem or hypothyroidism. both low thyroid and elevated prolactin (from the pituitary gland) can be checked for using simple blood tests. the most concerning nipple discharges are those which are red/bloody unilateral and coming from just one or two ducts. if you were my patient i would check a sample of the discharges for undiscernable blood (using the fecal blood card). i would do a careful breast exam and might send you for a mammogram or ultrasound—depending upon your age. i prefer to be safe rather than sorry--even when the discharge sounds non-pathologic. so get it checked out even though it is likely that you will be told it is ok.

### Human:\ni'm an alcoholic why is it so hard to stop drinking? . once you start to cope with drinking then it becomes a bigger challenge to quit.\n\n### Assistant: it can be difficult to quit drinking alcohol especially as your body becomes chemically dependent after chronic or prolonged use. you may experience withdrawal symptoms as you attempt to quit. some of the symptoms of alcohol withdrawal can include anxiety depression headaches nausea and insomnia. one of the more severe symptoms of withdrawal however is delirium tremens which can cause intense confusion disorientation hallucinations hyperactivity and tremors. going through these withdrawal symptoms can be very difficult and can discourage people from wanting to or being able to quit successfully. perhaps the best thing that you can do is to get help. treatment options might include visiting a rehabilitation center or a mental health/hospital clinic. try meeting with support groups counselors/psychologists or speaking with a doctor. another option might also be trying medication that might help you to quit. please visit this site for more information: <link>. if it was easy to quit drinking alcohol everyone would probably do it. you are addicted and you need help with this disease. i would suggest that you start with aa (even if you don't want to go).

### Human:\nhow can i get my 5-month-old to eat his cereal?\n\n### Assistant: feeding advice is sometimes hard to swallow and it is often easier (or at least tempting) for a parent to do something than nothing. i make these light-hearted comments because it is probably best to relax and give your son a little more time. you certainly should not worry about your son being behind -- especially since some do not recommend solid foods until 6 months. children will vary in every way and though your child may not be as quick to embrace spoon feeding the odds are high that he will be advanced in many other areas. assuming no difficulties with bottle feeding or other develeopmental delays i would not worry about this particular feeding milestone at all. you can write back to us all in 2-4 weeks when he is chowing down with enthusiasm.

### Human:\ncan i drink alcohol while taking lorazepam?\n\n### Assistant: lorazepam and alcohol both cause drowsiness that can interfere with operations of normal daily tasks including driving. it is not recommended to drink alcohol while taking this medication. lorazepam is an intermediate-acting benzodiazepine medication meaning that it will last about 12 hours in the body. it has been used for short-term treatment of anxiety and insomnia issues. because of these indications adjunctive administration of lorazepam and alcohol would really increase your risk of an accident.

### Human:\ncan a nursing mother safely take any otc nasal allergy medication?\n\n### Assistant: there are three different types of nasal sprays used for allergy relief: corticosteroids antihistamines and decongestants. if you need relief you would work with your ob-gyn to make sure one of these medications is right for you especially the decongestants (the only group found over the counter). examples of corticosteroid nasal sprays include fluticasone (flonase) mometasone (nasonex) budesonide (rhinocort aqua) flunisolide (nasarel) triamcinolone (nasacort aq) and beclomethasone (beconase aq). side effects can include unpleasant smell or taste nasal irritation and nosebleeds. these medications are much less likely to cause any side effects than are oral corticosteroids. prescription antihistamine nasal sprays include azelastine (astelin astepro) and olopatadine (patanase). side effects of antihistamine nasal spray may include bitter taste dizziness drowsiness or fatigue dry mouth headache nasal burning nosebleed nausea runny nose sore throat and sneezing. examples of nasal decongestant sprays include phenylephrine (neo-synephrine others) and oxymetazoline (afrin others). nasal decongestants can cause dryness burning or stinging inside the nose runny nose and sneezing. taking too much of a nasal decongestant can cause irritability fast or irregular heartbeat dizziness insomnia headaches anxiety tremors and increased blood pressure. don't use a decongestant nasal spray for more than a week or so or you may develop severe congestion as soon as you stop taking it (rebound congestion).

### Human:\ni want to stop taking paxil but have tried and at the 10-day mark it's take it or go to a hospital. what should i do?\n\n### Assistant: never stop an antidepressant if you are still depressed. if you have been depression-free a few years then it may be time to come off the antidepressants. always come off them slowly. with paxil maybe over 2-3 months. . it takes several weeks for antidepressants to work so it may take several weeks for them to wear off but the withdrawal effects can occur within a few days and this is not a depression but a withdrawal side effect. sometimes we put patients on prozac to detox them off paxil if the withdrawal side effects are too tough.

### Human:\nwhat's best of day to check your blood pressure. my pressure changes all the time when i check it at different times. i'm 74 and a active person. thomas\n\n### Assistant: keep in mind that your blood pressure can vary naturally throughout the course of a day. exercise or physical activity has a tendency to raise blood pressure so refrain from taking a reading afterwards. stress can influence blood pressure too. in fact white coat hypertension is a phenomenon where the anxiety of visiting with a doctor can raise blood pressure where it wouldn’t be elevated otherwise. make sure that you are measuring your blood pressure on a regular basis and at the same time of day controlling for as many confounding variables as possible. for these reasons measuring your blood pressure first thing in the morning works well for some people. also because your blood pressure can vary it’s important to obtain many readings to observe a trend or pattern. the best way to check your blood pressure is manually through trained medical personnel. the accuracy of automated electronic blood pressure machines can vary depending on the quality of the device. some machines may need occasional calibration or maintenance too. to determine the accuracy of your home device take it with you the next time you go to the doctor and have a trained medical person measure your blood pressure manually and then compare it with your device. it is normal for blood pressure to change nearly every time you take it regardless of the time of day. the most important reading would then be the average reading so just take your bp a few times a day and write it down. as long as your average blood pressures are in the normal range minor daily fluctuations are usually not that important. my moms blood pressure is 56 over 40 what

### Human:\ncan you tell me whether environmental facial damage can be repaired without doing laser treatments?\n\n### Assistant: skin damage that is secondary to environmental changes -- such as from the sun or harsh weather conditions -- can be treated with topical tretinoin alpha-hydroxy acid (aha) or glycolic acid and hydrating compounds. severe conditions will dehydrate your skin cells and rob your skin of essential nutritional elements. in order to combat theses unwanted changes your skin care regimen should be designed to rejuvenate rehydrate and stimulate new healthy skin growth.

### Human:\ni've never met a psychiatrist that seemed well-adjusted or had insight into what it's like to be depressed. why is that?\n\n### Assistant: so no one is smarter than you or can possibly understand you? that is a good way to keep people at a distance -- us shrinks and non-shrinks too. i suspect you could find a psych that you could get along with but i suspect with the "all or none attitude " you will find it tough. how many psychiatrists have you met? 100? hard to run a study about the number of morons in the field with less than 100 to compare statistically. i am picking on you to make a point i guess and hope the humor doesn't get you mad but gets you to think -- in that you are setting yourself up to not get or be helped. i also can admit that like all professions -- lawyers engineers teachers -- there is a bell-shaped curve. some are great and some morons. the world is not an all or none place and i would challenge you to get out of that trap regarding psychiatrists and the rest of the world asap. what kind of system do you want to help the mentally ill? chances are it exists somewhere already you could find it and be content. don't like psychiatrists or the meds we use find a psychologist social worker pastor lifestyle coach hypnotist or accupunture clinician that you gel with and get help that way. you have a choice: you have my permission to think all psychiatrists are morons. you now have reason to move on and get yourself effective help somewhere else.

### Human:\nhow does psychotherapy work? is it more than just about venting your feelings?\n\n### Assistant: most patients think that they sign up for psychotherapy and they go in and talk in order to “vent” their feelings. others think they are going it to see a counselor (like a lawyer or financial advisor) who will tell them what to do and how to behave. some of this is true. venting your feelings or “getting it all out” in a safe environment may be helpful in cases of grief where a loved one has died but i have also met patients who have had therapists where they have been venting every week for seven years… and they still aren’t better. so venting is part of the process in some cases. some therapists will tell you what to do and how to behave but this may not be a hallmark of a good therapist. good therapists work with you in hopes that you see better ways to behave interact and function and act on those in your own way. below are some concepts that govern certain types of psychotherapy. yes just like there are several types of medications that work in several different ways there are different types and styles of psychotherapy: analytical or psychodynamic therapy suggests that your past (your parents your upbringing your environment your friends and all of the good and bad things that ever happened to you) shapes who you are and dictates how you behave in the present. if you learn about yourself and your past then gain insight into your patterns and behaviors you can learn to react differently in the future and your symptoms will gradually improve. cognitive-behavioral psychotherapy (cbt) suggests that patients have developed automatic negative and self-defeating thoughts. cbtdoes not care if problems came from your parents or elsewhere but cares that in the ‘here and now’ that you are suffering as your automatic thoughts (for example: i always fail i am never any good everyone always abandons me) trigger negative emotions (sadness anger despondency) which you get stuck in and become depressed or anxious. cbt therapists teach skills and resiliency in regards to fighting through and counteracting these negative automatic thoughts. there are likely 20 other forms of psychotherapy each with their own underlying theory and process of reducing psychiatric symptoms.

### Human:\nmy son is 13 and is depressed. he has been taking vyvanse for the last 3 years and never had a problem. can you help?\n\n### Assistant: while any of the stimulant medications can increase depressive symptoms. it's important to pay attention to this change in your son's mood and take him to a mental health professional for an assessment. children diagnosed with attention deficit/hyperactivitydisorder (adhd) at early are more likely to suffer from depression as adolescents than those who did not have adhd according to a long-term study published in the october issue of the archives of general psychiatry. although it was an uncommon occurrence the children with adhd also were somewhat more likely to think about or attempt suicide as adolescents. the study performed by researchers at the university of chicago and the university of pittsburgh followed 123 children diagnosed with adhd at age 4 to 6 for up to 14 years until they reached ages 18 to 20. it compared them with 119 children from similar neighborhoods and schools matched for age sex and ethnicity. the researchers found that 18 percent of children diagnosed early with adhd suffered from depression as adolescents about 10 times the rate among those without adhd. children with early adhd were five times as likely to have considered suicide at least once and twice as likely to have made an attempt. please get your son evaluated.

### Human:\ncould caffeine cause my panic attacks?\n\n### Assistant: it doesn't seem to usually be a random occurrence that anxiety attacks come with caffeine use. there may be a difference in the caffeine that you are ingesting. for example different types of coffees contain different levels of caffeine. some of the popular coffee shops grew a particularly potent coffee which can be very unsettling in terms of sparking anxiety. caffeine can also be ingested via soda candy and otc medications. it's wise to always read the labels carefully. of course the instances where you have had caffeine and have had a panic attack may be precipitated by both the caffeine and some stressful situation. you might want to begin keeping a log of when this occurs so that you can look for any similar variables. i know this is almost like being a researcher but that's what all of us have to do; research our own lives. .

### Human:\nare vit d and vit b12 deficiency linked?\n\n### Assistant: vitamin d and b12 aren't linked in the sense that one causes the other but is relatively common for someone to fall short on both of these vitamins. for example people who don't eat any animal products (vegans) typically need supplemental vitamin d and b12 either from fortified foods or supplements. both of these vitamins are found primarily found in animal foods although plant-based products can be fortified with d such as soy milk. sunlight is another source of vitamin d. another example would be someone who had gastric bypass surgery -- they are at higher risk for vitamin d and b12 deficiencies. people with excess weight tend to have lower levels of vitamin d and additional b12 is needed after this type of surgery because absorption occurs in the stomach. a third example is someone who is elderly. they absorb less vitamin b12 from food and do not make as much vitamin d from the sun. work with your healthcare provider or a registered dietitian to make sure you are getting enough of both of these vitamins. there isn't a direct link between a deficiency in these two vitamins but it likely represents a common denominator. some vitamins require fat to be absorbed in the intestine. these four vitamins a d e and k require fat and a very low intake can produce a deficiency in them. damage to the pancreas or intestine can also interfere with the absorption of these vitamins. vitamin b12 requires a few additional modifications in the body to be absorbed. it does not require fat but a factor that is produced in the pancreas however its absorption also requires a healthy pancreas and intestinal lining.

### Human:\ni have frequent constipation feeling bloated and have bowel movements around 4-5 days on average. large-hard stools. that are difficult to pass and i'm asking now because it's been getting worse the past year or so and effecting my every-day life. <negative_smiley> what should i do? are probiotic supplements a solution?\n\n### Assistant: any sudden changes in bowels should be checked out by a healthcare provider. here are some things you can do in the meantime: increase fiber: gradually increase fruits vegetables whole grains and beans/legumes. these foods contain fiber that help with constipation. it's recommended women (19-50) get 25g of fiber daily and for men (19-50) it's 38g. see getting enough fiber. stay hydrated: while increasing fiber make sure you get enough water. when you are dehydrated water is reabsorbed from stool resulting in hard stools. keep active: regular activity also helps relieve constipation. walking dancing and hiking are just a few ideas to keep your body moving. add fermented foods: look for ways to increase foods with probiotics such as yogurt kefir and probioitc drinks. adding a probiotic may help but the research is not clear on this. see probiotics and digestive health. manage stress better: anxiety worry and stress can all affect your gi tract. working on healthy ways to handle daily stressors can help! see stress management.

### Human:\nwhy i am craving only for sweet food? . since i stopped contraception pills i couldn't stop eating sweet food. i gained 6kg within 2 weeks. and then i decided to stop. so for 2months now i haven't touched any sweet chocolate fizzy drink or bakery. instead i eat dried fruits peanuts yogurts fruits porridge. i cant eat salty. even though i eat only healthy im always eating! i feel this constant sweet food craving! (i haven't lost weight even though im doing sports everyday not eating in the evenings. i've been taking chromme for 1month).\n\n### Assistant: there may be a few reasons why you are cravings sweet foods. one thought is that your blood sugar may be low and your body is trying to tell you that you need to eat something in order to bring your blood sugar levels back to normal. low blood sugar could come about by not eating enough food throughout the day or by not making appropriate food choices. it could also be from a lack of energy or exhaustion especially from lack of sleep where your body will begin to look for other sources of energy. sugar can be metabolized and converted to energy very quickly so it’s an obvious choice. the cravings may come as a response from being very restrictive with your diet. it can be hard to sustain an eating plan where you are constantly depriving yourself of things that you want to indulge in. instead consider moderation and portion control as healthy alternatives. lastly there are also psychological reasons for craving sweets as well. for example when you are stressed you may sometimes seek comfort in food wanting something that tastes really good. eating sweets can trigger a reward mechanism in your brain by releasing serotonin which helps to boost your mood and help you to feel better. there are a variety of reasons for sweet cravings both physical and psychological. it could be that now that you are off the pill your cycles are back to normal and you are experiencing more cravings related to fluctuations in hormones. it also could be your restriction of sweet items is causing you to be even more drawn to them. you first want to look at your diet. is it balanced with all the food groups? are you getting enough dietary fat for satisfaction? what are your absolute favorite sweets? have you tried incorporating items like dark chocolate or smaller portions of other sweet foods you like? there is emerging research that mindful eating can decrease food cravings in people with eating problems. that means eating meals at the table eating slowly enjoying food and leaving judgment out of your thoughts about food. that means no more "i was bad so i might as well throw caution to the wind" or "i shouldn't eat that because it is bad for me. " it's all about listening to your body and trusting yourself around food. a registered dietitian can help you find out why you are craving sweets (go to eatright. org to find one in your area). for more on mindful eating see this post on webmd's real life nutrition. <link> good luck! hi and thanks so much for your question. there's a good chance that you have an issue with being hooked on or addicted to sugar. take a moment and complete this easy 2 min quiz devised by experts from yale university <link> in your situation what you're doing is actually something we call "eating around the addiction". you did well to eliminate refined and processed sugar from your dietary intake. however you didn't replace it with rewarding and tasty enough sweetness from natural sources and thus you're still in crave mode. you want the sweet but can't eat it so you eat around it by continuously munching on other foods. one problem with that in addition to packing on pounds is that you may start getting hooked on the dried fruits and nuts as well. the foods people become most hooked on are called the hyperpalatables--- sugary/fatty/salty food combos. it's never tuna on a bed of greens that we get hooked on. it's the super rewarding hyperpalatables most of which are refined and processed foods. in my book the hunger fix i note that you need a strategy of detox and recovery in which you substitute the refined sweets with natural sweets as well as add other foods that naturally boost the brain's dopamine the reward brain chemical that gives you pleasure and satisfaction. in addition log onto the webmd food and fitness planner and you'll also see a wealth of naturally sweet and tasty foods you can now incorporate into your dietary regimen to stop the cravings. another thing i note is that you're not taking in much protein. a secret way to stop cravings is to combine lean protein with fiber--- carrots and hummus peanut butter with apple slices yogurt with blueberries low fat cheese with an apple. works like a charm. good luck and let us know how you're doing dr. peeke i was struggling with sugar for quite a while. i did a little research for my personal dietary needs. i am basically a carbo addict. if you want to call it that. what i did find was really helpful. south beach diet book really helped me understand about what foods can do to your body chemistry. the processed foods manufactured these days are even more highly processed than in the recent past. these higher processed foods make you crave more and more of them. there are lots of hidden sugars in foods which also make you crave more of them. the trick i found was to 1. eat the type of foods that help you prevent the cravings like protein and foods on the low glyciemic index. foods that have lots of nutrition give your body what it needs and you begin to crave less of the junk. 2. take a look at your eating habits and modify them. me for example love to eat at night. it may not be the best thing but i seem to sleep better with some food in my stomach. that said i have switched out the junk or carbs. replace ice cream with greek yogurt. relpace high fat chips with cruncy celery and peanut butter or cream cheese. instead of a sandwich with bread make a turkey roll up. 3. exercise helps to regulate your sugar levels so i work at getting some exercise which also helps my mood levels in case the mood ties into eating for more comfort. 4. and lastly when the sugar craving gets the best of you have something like chocolate chips. put 10 or so into a tiny prep bowl. i bring them in my office for that afternoon pick me up. i am always suprised when i don't even eat them all. hope that helps a little! just a thought. i was craving sweets too for a long while. i also felt very tired most of the time. when i went to my doctor i found out i was diabetic. my body craved sweets because it thought it was needed in my diet. am only saying this because no one else mentioned it here and it would be smart to go get tests. you probably are not diabetic but why not get tests to find out if you have deficiencies etc? couldn't hurt to check.

### Human:\nhow quickly do people with depression respond to lithium?\n\n### Assistant: lithium is usually added to an antidepressant as an add-on strategy. i usually use it combined with a partially effective antidepressant. the data suggests some people respond within a few days and another batch responds gradually over several weeks.

### Human:\ni am on three ineffective meds for depression. should i go off the meds and try st. john's wort?\n\n### Assistant: don't go off your meds without discussing with your doc as going off your meds could also cause side effects. i have seen sjw work for some folks but its data is pretty weak scientifically. sometimes it is worth a try. if it fails go back to the fda stuff.

### Human:\ncan anti-depressants cause sexual dysfunction?\n\n### Assistant: many antidepressants if not most of them can cause poor libido inability to have an orgasm erectile dysfunction in men etc. when antidepressants increase serotonin in the brain to help depression and anxiety they also increase serotonin in the spinal cord which may disrupt sexual functioning at the same time. this serotonin over-activity may cause sexual problems. unfortunately it is very clear that stopping an antidepressant too quickly will often result in the major depression symptoms coming right back. below are some ideas about how to avoid sexual side effects or treat them if they happen to you. 1) use psychotherapy to treat your depression or anxiety. psychotherapy has no sexual side effects and in many studies is shown to be as effective as medications in helping depression or anxiety. consider a bona fide course of psychotherapy such as cognitive behavioral psychotherapy interpersonal psychotherapy or psychodynamic psychotherapy as these specific types of psychotherapy have well documented outcomes in the treatment of depression and anxiety 2) ask your doctor to choose an antidepressant with less sexual side effect risk. bupropion (wellbutrin) antidepressant products do not manipulate serotonin at all and are considered to be sexual side effect free by many doctors. trazodone (desyrel oleptro) products manipulate serotonin mildly and through a different mechanism and appear to have less sexual side effect problems as well. in treating certain forms of anxiety buspirone (buspar) also is known for producing fewer sexual side effects. 3) if you have to be on a serotonergic antidepressant and develop sexual problems consider asking your doctor for an antidote. almost none of these medications are fda approved for improving sexual functioning however many psychiatrists use them in order to lower sexual side effects while keeping their patient on an effective serotonin antidepressant. patients will have to take two medications at the same time but often two medications may improve depression more substantially and also lower sexual side effects at the same time. erectile dysfunction medications (sildenafil — viagra — etc. ) may specifically help men and they can be used as well. 4) just bite the bullet. sometimes patients cannot avoid being on serotonin-based antidepressants. these antidotes may not be safe for the individual patient or may not work for the patient. in this case patients will have to decide to have continued good antidepressant effect but suffer sexual side effects or risk discontinuing the antidepressant and a possible relapse into major depression. often times depression is treated from six months to a year with good antidepressant treatment. giving up sexual functioning for a year might be worth keeping the depression away. can you suggest further what the medication antidotes are? i have very resistant depression and must be on ssri (and wellbutrin and trazodone and seroquel) and i wonder what would be a medication for women that would address these side effects? thanks.

### Human:\ndoes resveratrol really work?\n\n### Assistant: resveratrol which is a compound found largely in the skins of red grapes has gained a lot of media attention and has been touted as having many beneficial health effects. resveratrol is a component of ko-jo-kon an oriental medicine used to treat diseases of the blood vessels heart and liver. it came to scientific attention during the mid-90s as a possible explanation for the “french paradox” — the low incidence of heart disease among the french people who eat a relatively high-fat diet. since then it has been touted by manufacturers and examined by scientific researchers as an antioxidant anti-cancer agent and phytoestrogen. it has also been advertised online as “the french paradox in a bottle. ” if you do a literature search and look at well-accepted peer review journals there is very little published to support any of these effects of resveratrol. new work produced by both amgen and pfizer has cast doubt on the manner in which the health supplement is said to work. prominent researchers supposed that it worked by activating a certain gene sirt1. this activation is thought to produce the benefits of a caloric restriction diet even among those with high fat and high caloric intake. in 2009 in chemical biology and drug design amgen scientists published experimental results that indicate resveratrol does not in fact activate sirt1. pfizer scientists in the journal of biological chemistry in 2010 offered similar results showing that resveratrol (and related substances such as srt1720) do not active sirt1 and did not reduce blood sugar in mice fed a high-fat diet. thus it suggests that resveratrol doesn’t work at all (though it’s not possible to translate mice studies into human studies). despite what is promoted on many national television shows on health none of the claims has been demonstrated in any valid human study. while present in other plants such as eucalyptus spruce and lily and in other foods such as mulberries and peanuts resveratrol’s most abundant natural sources are vitis vinifera labrusca and muscadine grapes which are used to make wines. it occurs in the vines roots seeds and stalks but its highest concentration is in the skin. the resveratrol content of wine is related to the length of time the grape skins are present during the fermentation process. thus the concentration is significantly higher in red wine than in white wine because the skins are removed earlier during white-wine production lessening the amount that is extracted. grape juice which is not a fermented beverage is not a significant source of resveratrol. since wine is the most notable dietary source it is the object of much speculation and research. resveratrol is also available from supplement pills and liquids in which it is sometimes combined with vitamins and/or other ingredients. it is also an ingredient in topical skin creams. the supplements are generally labeled as containing from 20 to 500 mg per tablet or capsule. however the purity of these products is unknown. and because dietary supplements are loosely regulated it should not be assumed that the labeled dosage is accurate.

### Human:\nare folate and l-methylfolate (lmf) helpful for treating depression?\n\n### Assistant: this is a vitamin-type product that seems to be turning the corner from a good idea to a reasonable almost proven treatment for depression. 1) folate is an essential nutrient in our diet. it can be found in spinach lentils liver asparagus beans and collard greens. some research studies have shown that folate tablets can help treat depression but these are small and poorly regulated studies. 2) your liver takes the folate you eat in your diet and converts it to a special form of brain folate called l-methylfolate (lmf). however your liver has the ability to only convert a little bit of regular folate into brain lmf at a time. therefore you can eat all the spinach in the world but still only get little bits of lmf into your brain at a time. 3) once in the brain lmf has the theoretical ability to provide nerves with the ability to make more neurotransmitters such as serotonin. this boost in serotonin allows antidepressants that work by manipulating serotonin to have a greater chance to work their antidepressant mechanisms. lmf tablets are available by prescription now as they are considered a medical food similar to prenatal vitamin classifications. 4) more stringent research studies that compare lmf to placebo sugar pills are being published and scrutinized and it appears that adding lmf products to antidepressants may improve depression symptoms. these studies are preliminary in nature but are clearly better regulated and supportive in that lmf may be safe and help in the treatment of depression. larger 400 patient studies are needed to prove definitive antidepressant effects but these current medium sized studies are promising.

### Human:\nhow much of an impact does vitamin d have on depression?\n\n### Assistant: there have been studies suggesting that high dose supplements of vitamin d or fish oil supplements may improve mild depression. . at this point treatment with high-dose vitamin d for depressive symptoms is considered experimental and should be considered only with medical supervision.

### Human:\nwhat are some symptoms a cancer patient may have if they have an infection?\n\n### Assistant: while developing a fever is the most serious sign and should be treated as an emergency there are other signs and symptoms you should be aware of that may indicate you have an infection: chills and sweats change in cough or new cough sore throat or new mouth sore shortness of breath nasal congestion stiff neck burning or pain with urination unusual vaginal discharge or irritation increased urination redness soreness or swelling in any area including surgical wounds and ports diarrhea vomiting pain in the abdomen or rectum new onset of pain changes in skin urination and mental status if you experience any of these signs or symptoms you should call your doctor right away. for more information about the signs and symptoms of an infection visit www. preventcancerinfections. org

### Human:\nmy problem is staying asleep! i've had a sleep study; no apnea but i'm not getting enough delta sleep. any suggestions?\n\n### Assistant: there are many types of insomnia and difficulty staying alseep is a common type of insmonia. there are many reasons for this just as there are many reasons for not being able to fall aslsep. . some of the more common things. include depression other mental health issues and fibromyalgia. some other causes might have to do with behaviors that occur before sleep such as caffeine and alcohol consumption at night. many times these problems cannot be fiexed with medications rather the underlying cause must be addressed. for this the behavior therapy with the help of a sleep specialist (usually sleep psychologist) should be sought. they can often help get to a permanent cure without medications. .

### Human:\nis homecare available for someone released from a mental health facility for severe depression? . a friend's mother is 85 and was diagnosed with severe depression. she can go home from a mental-health facility if she has constant care. but my friend works.\n\n### Assistant: tough issues. the discharging hospital or her primary doc or her psychiatrist could order a visiting nurse to come once or twice a day to administer meds and check on her mental state. that leaves several hours where she will be alone. your friend could hire a nurse (sometimes insurance won't pay) to come for 4-6 hours or a home health aide. probably again he should ask the hospital social work department for advice about who to call in his area.

### Human:\n18 years old already have 2 kids can i get a hysterectomy? . i'm 18 years old i already have 2 kids and i don't want anymore my period is extremely painful and heavy will a doctor give me a hysterectomy or am i to young?\n\n### Assistant: it would be highly unlikely for any surgeon (or an insurance company that would pay for this elective procedure) to agree that a hysterectomy is the way to go at this point. it is not just your age that is a contributing factor but a hysterectomy is not medically-indicated in most cases just because you have two kids and your periods are heavy/painful. see your gynecologist and i am sure there are other solutions to answer your concerns that are considerably less riskier than removing your uterus. thank you for asking with the age of just 18 i am afraid going for hysterectomy is unwise although possible. procedures like hysterectomy are permanent and there is no coming back and depression and other psychological accidents are common in such women as well. also there is a long life ahead for you you may wanna change your mind to have another child due to any reason and then you will need a uterus to conceive. so my suggestion is don't opt for it unless you have some severe problem with uterus like heavy periods etc. hysterectomy can wait till 35 years or older age. i hope it helps. regards dr s khan ehealthdesk

### Human:\nwhat is the difference between healthy and unhealthy fat?\n\n### Assistant: most food contains several kinds of fat and some are better for you than others. some fat is needed in your diet so it’s not a good idea to completely eliminate all fat. instead choose foods with healthier fats and enjoy them in moderation. unhealthy fats include saturated and trans fats (also called partially hydrogenated fats). sources of unhealthy fats come from eggs meat dairy and tropical oils (coconut palm and palm kernel oils). good fats include monounsaturated fats and polyunsaturated fats. healthy fat sources include nuts seeds avocados olives and other plants. healthy oils aid in having healthy skin hair and a strong immune system. saturated fats and trans fats grams should be less than 10% of your total calories for the day. to determine the healthfulness of fat consider where it comes from -- animal vs. plant origin. healthy fats coming from plants (and fish) are beneficial for health especially when replacing saturated fat (animal fats) in the diet. at too high levels saturated fats can adversely affect heart health. saturated fats are found in high-fat meats full-fat dairy baked goods and fried foods. trans fat the worse fat of all is mostly found in products (i. e margarine) that contain vegetable oils that have been "partially hydrogenated" to become solid at room temperature. since 2006 fda requires companies to label trans fat in food products. if an item contains <. 5g it can be labeled "trans-fat free. "&nbsp; because the american heart association recommends 2g or less per day for the average 2000 calorie diet check the ingredient line for partially hydrogenated fats. &nbsp;for example &nbsp;natural peanut butter only has peanuts (and salt in some cases) in the ingredient line but other peanut butter products often contain partially hydrogenated oils and added sugar. &nbsp; for more on good and bad fats see this webmd article <link> while some dietary fats are good and some are bad; perhaps the worst is trans fat. this type of fat can occur naturally in animal products but is also the result of food manufacturers chemically altering oils through a process called hydrogenation. the reason that trans fat is so detrimental is because it not only raises bad (ldl) cholesterol levels but some research suggests that it also lowers our good (hdl) cholesterol levels as well – a double whammy. saturated fats on the other hand raise both good and bad cholesterol levels. common food sources of trans fat can include: • baked goods such as bread pizza dough and cake • fried foods such as french fries doughnuts or chicken nuggets • snack foods such as chips crackers cookies and candy • pre-packaged foods such as soup or frozen meals • margarines or spreads be cautious because the fda allows for food products to be labeled as “0 trans fat” even though there may be up to 0. 5 grams per serving. read this webmd article for more information: <link>. heathy fats come from healthy foods like nuts and unheathy fats come from fatty foods chips. healhty fats and polyunsaturated fats which help to get better healthy by removing cholestrol and unhealthy fats are saturated trans fats which increases the risk of heart attacks.

### Human:\ni take amitriptyline for headaches and now the doctor gave me ambien for sleep. can i take these medications together?\n\n### Assistant: there is a moderate drug interaction between these two medications. the disabling of the motor coordination and mental alertness is effected with one medication alone. both medications give an additive effect or intensify the side effects. depending on the dose doctors worry about respiratory depression. however if the medications are taken according to the physician's directions there shouldn't be any issues. just be cautious of the cognitive capabilities while on both these medications.

### Human:\nwhat are the pros and cons of using a laser in dentistry?\n\n### Assistant: pros compared to the traditional dental drill lasers: may cause less pain in some instances therefore reducing the need for anesthesia may reduce anxiety in patients uncomfortable with the use of the dental drill minimize bleeding and swelling during soft tissue treatments may preserve more healthy tooth during cavity removal cons the disadvantages of lasers are that: lasers can't be used on teeth with fillings already in place. lasers can't be used in many commonly performed dental procedures. for example lasers can't be used to fill cavities located between teeth around old fillings and large cavities that need to be prepared for a crown. in addition lasers cannot be used to remove defective crowns or silver fillings or prepare teeth for bridges. traditional drills may still be needed to shape the filling adjust the bite and polish the filling even when a laser is used. lasers do not eliminate the need for anesthesia. laser treatment tends to be more expensive since the cost of the laser is much higher than a dental drill. lasers can cost between $39 000 and $45 000 compared to about $600 for a standard drill.

### Human:\nhow can i push my depressed spouse into being more involved and helpful?\n\n### Assistant: i think you can push him with empathy to do things and that is ok. do it without anger or nagging. i would pick easy things i. e this week honey can you do the dishes every morning. it takes 10 minutes and would be helpful. this should be an easy task in some ways but could be monumental for a depressive. make sure you say thanks. after a few days add something else routine that will help you i. e. make kids lunch or read them all a story at bed. keep adding things slowly. make sure after he does these things that you and kids say thanks i am glad dad that you helped. we like it when you. and that you are spending time. i think you can explain to the kids that the crohns has daddy under the weather and he needs to hear nice things from us.

### Human:\nhow much juice milk and water should a toddler be drinking? i have a 1 yr old and a 2 yr old.\n\n### Assistant: the american academy of pediatrics recommends no more than 4 to 6 ounces of 100% fruit juice for young children. at one year of age babies can switch from formula or breast milk to whole milk and it is recommended children get 2-3 cups but no more than 24 ounces. more than 24 ounces can increase the risk of iron deficiency since milk is poor source of iron and can fill up children's bellies. at 2 years 2 cups of milk is recommended but if a child doesn't drink milk he can get calcium from cheese and yogurt. children who don't drink milk will need a supplemental source of vitamin d. check with your pediatrician. as for total fluid requirements about 5 to 6 cups daily but don't push it. instead make water available between meals and milk and/or juice with meals.

### Human:\ni'm scared of the dentist. do you have any suggestions?\n\n### Assistant: there are many dentists who have special skills in dealing with phobic patients. but in many cases it is just a matter of finding someone you can trust. what i can tell you is that there is nothing to be gained and plenty to be lost by waiting. whatever dental problems you have will get worse. so call your local dental society to find someone that can help you with your anxiety and your dental problems.

### Human:\nwhy shouldn't i change my meds for depression?\n\n### Assistant: do not change your meds without consulting your prescriber. i am very concerned with many many. folks dropping lowering changing their meds without their doctor's advice. we doctors know you patients do this a lot no matter what our advice. may i suggest that if your med isn't working or is giving you side effects call or make an appointment with your doc. i have at least 20 ways to treat depression with meds and probably 20 antidotes to side effects my meds give you all. as a doc i'd like a call saying "hey this med is great but i have a side effect what can i do to stay on the med and get my side effects to go away? " finally if you stop some meds cold turkey you can have anywhere from a mild withdrawal to a seizure and coma with others. in my career i have had to put 2-3 patients in the hospital for medical emergencies due to withdrawal. if they would've called me we could have lowered the meds safely and moved forward.

### Human:\ndo low-tech methods such as breast self-exam and a doctor's breast exam help detect breast cancer?\n\n### Assistant: many of the largest studies to show no benefit for breast self-exam (bse) were done in countries outside the u. s. (such as shanghai china in 2002 and russia in 2003). in addition to no decrease in breast cancer deaths the largest studies showed an increased number of biopsies which found no cancer. it is difficult to know if the outcome would be the same if a woman was instructed using the newest bse technique taught to gynecologists in the u. s. the issues surrounding the clinical breast exams (cbe) done by doctors are similar. there is a large canadian study which suggested five-year survival rates were the same in women who received only cbe and those who received cbe plus screening mammogram. one of the current discussions explores the quality of cbe. there are several techniques used; and some mds do a more thorough and systemic breast exam than their colleagues.

### Human:\nwhat type of sunscreen can i use over makeup?\n\n### Assistant: the skin cancer foundation advises people to use a broad-spectrum sunscreen with an spf of at least 15 (i prefer spf 30). put on your sunscreen prior to applying your makeup. use products containing zinc oxide avobenzone (parsol 1789) or ecamsule (mexoryl) combined with octocrylene and avobenzone that will complement your makeup and provide broad-spectrum sun protection.

### Human:\nwhat are the signs of oral cancer?\n\n### Assistant: the following are the more common signs and symptoms of oral cancer: swelling thickenings lumps bumps rough spots crusts or erosion on the lips gums or other areas inside the mouth the development of velvety white red or speckled (white and red) patches in the mouth unexplained bleeding in the mouth unexplained numbness loss of feeling pain or tenderness in any area of the face mouth or neck persistent sores on the face neck or mouth that bleed easily and do not heal within two weeks a soreness or feeling that something is caught in the back of the throat difficulty chewing swallowing speaking or moving the jaw or tongue hoarseness chronic sore throat or changes in the voice ear pains a change in the way your teeth or dentures fit together – a change in your "bite" dramatic weight loss. if you notice any of these changes contact your dentist immediately for a professional examination.

### Human:\nwhat would cause me to have my period for three months straight?\n\n### Assistant: there are two major reasons for very prolonged/heavy periods: hormonal and what i call "structural". "structural" means when excessive bleeding is due to actual problems within the cavity or walls of the uterus. some examples of this would include fibroids of the uterus endometriosis of the muscular wall of the uterus ("adenomyosis") infections of the lining of the uterus (e. g. gonorrhea or chlamydia) polyps of the uterine lining or even uterine cancer (much less likely in a younger woman). hormonal causes are usually linked to missed or erratic ovulations. as you may know in a normal cycle estrogen is produced all month. estrogen is responsible for building up the lining of your uterus so you have something to shed each month. in a normal cycle progesterone production increases following ovulation. progesterone "stabilizes" the uterine lining in preparation for a possible implantation of a new pregnancy. if you are not pregnant that month the levels of estrogen and progesterone fall triggering the release of the uterine lining—your period. so if you do not ovulate the estrogen build up of the lining continues but without the usual ovulation associated progesterone. thus the hormone levels don't decline and the lining stays up inside the uterus—your missed/late period. alternatively the lining can begin to shed under its own weight producing prolonged bleeding. . causes for not ovulating are multifold: thyroid problems pituitary problems ovarian cysts physical stressors (e. g. sudden increases in exercise crash dieting) emotional stressors (problems with partners work/school finances) increased body weight anorexia rotating shifts at work etc. .

### Human:\nhow much should i weigh?\n\n### Assistant: doctors nutritionists and public health authorities most often use the body mass index to define a healthy weight. body mass index (bmi) is your weight in kilograms divided by the square of your height in meters (kg/m2). according to the cdc a bmi of less than 18. 5 is considered underweight. a normal bmi falls within the range of 18. 5 to 24. 9. the bmi range of 25. 0 to 29. 9 is considered overweight and a bmi of 30. 0 or higher is considered obese. . obesity increases the risk for diabetes high blood pressure heart attack stroke certain cancers. losing weight reduces your risk. waist size matters too. even in people who are only slightly overweight a waist circumference greater than 40 inches in men and 35 inches in women increases health risks. don’t believe your pant size; it often underestimates waist circumference. measure your waist yourself with a tape measure just below the belly button.

### Human:\nwhat are the symptoms of stomach cancer?\n\n### Assistant: in its early stages stomach cancer typically causes vague often mild symptoms that a person may describe as indigestion nausea loss of appetite heartburn or pain. the problem is millions of people without stomach cancer experience these symptoms every day. when should a person with vague stomach or abdominal symptoms seek medical attention? that’s a hard question to answer because stomach cancer is still uncommon in the u. s. and screening for it (with invasive testing called endoscopy) carries small but real risks; screening everyone with indigestion might cause more harm than good. as stomach cancer becomes more advanced weight loss bleeding more severe nausea and vomiting and blockage of the exit of food from the stomach can occur. if you’re concerned about stomach cancer the best thing is to see your doctor and discuss your symptoms. my father died half a yr ago from stomach cancer and i have an uncle and a cousin died from stomach cancer. now my symptoms are nauseated all day i want to eat all the time which is not like me to do so even when i eat i still nauseated. one point i have a chronic ulcer. can that convert to cancer my chronic ulcer? .

### Human:\ni have large brown patches on my forehead and cheeks like liver spots. it's not skin cancer. what do you recommend?\n\n### Assistant: you may be suffering from melasma a skin condition characterized by hyperpigmentation of the cheeks and forehead. some melasma sufferers will exhibit refractory hyperpigmentation after topical regimens. you may want to consider further evaluation with a physician who is experienced in laser treatments for refractory melasma specifically for your skin type. go go a dermatologist and have the areas "frozen. " it will remove them completely.

### Human:\nhow much will i be fined if i don't get insurance?\n\n### Assistant: well . in 2014 two very important rules change. the most important is that insurance companies will be forbidden by law from denying coverage to americans with pre-existing health conditions. right now insurance companies can lock people out of the market or price people out of the market. that will no longer be allowed come 2014. people will with a pre-existing health condition be able to buy coverage be able to participate in a pool. in order to make sure that that happens and that we have a solvent insurance pool there is an additional feature that says everyone needs to participate. so most people right now have access to employer-based coverage or indeed carry their own coverage or they qualify for a public program. a limited number of people are not in those categories at all and most of those folks don't have the finances to buy insurance coverage on their own so starting in 2014 there will be a personal responsibility provision that says everybody needs to participate. if you are in the exchange and need some financial assistance based on your income that will be available. if you have employer coverage you're covered. if you are purchasing insurance on your own you'll have an opportunity to purchase that coverage in the insurance exchange. if you qualify for public programs you're covered. so we think that the vast majority of people and this has been the case in massachusetts where they have an exchange set up with very similar rules the vast majority of people who don't have insurance really would love to have coverage for themselves and their families they just can't afford it. and those days will be over. if indeed somebody can afford coverage when we get to 2014 and refuses to pay for coverage there is a financial penalty and it's really paying for the health service that that person and their family may well access. what we know is if someone has an automobile accident and is taken to a hospital they're going to get health care. if they have a stroke or if a family member has cancer they will have health care. they just will be shifting those costs onto everyone else onto taxpayers and hospitals and everyone who buys coverage. so there is an employer responsibility piece there is a government responsibility piece and there's an individual responsibility component of the new health care law.

### Human:\ni have pink spots on the roof of my mouth. my dentist told me if they don't go away to let him know. what could they be?\n\n### Assistant: there are many possibilities such as canker sores trauma from hot food or utensils infection or a tumor. the advice you received is accurate. if it goes away don’t worry about it!

### Human:\nwhat products are good for a woman who's still getting breakouts but is also seeing the beginnings of wrinkles?\n\n### Assistant: i would recommend retinols for women who have wrinkles and are also acne prone. the reason is that they are both anti-acne and anti-aging. you can find them in light serums which can be used in the evening. also make certain to use noncomedogenic sunscreens moisturizers and make-up.

### Human:\nfoods to bring down your blood sugar naturally. i would like to know what foods to eat to bring down my blood sugar naturally. i do not want to take any of the shots as they cause cancer and there is enough cancer in my family line now.\n\n### Assistant: by shots i assume you mean insulin. the key to bringing down your blood sugar is to track your carbohydrates since they are what raise blood sugar. foods rich in carbohydrates include bread/grains beans fruit milk and yogurt and added sugars such as those in sweet foods and beverages. foods rich in protein and fat do not raise blood sugar like carbohydrates do. protein foods include lean meats poultry fish eggs and tofu. fats are items like butter vegetable oil nuts and seeds and avocado. vegetables are typically recommended because they are low in carbohydrates but high in nutrients. so they can be consumed in large amounts. the key is to include healthy carbohydrates in controlled amounts while including protein vegetables and healthy fats with meals. if you consume sweetened beverages switch to water. i highly recommend seeing a diabetes educator to help you put it all together. below are some articles that might help: healthy diabetes diet 6 foods that may help control your blood sugar how does my diet affect diabetes? cinnamon fenugreek garlic avocados and nuts blueberries which are also a great source of soluble fiber and a number of other important nutrients red cherry vinegar can help you in lowering the blood sugar. <link> top essay writing service

### Human:\ni am on chemotherapy and have a fever. my doctor said to go to the emergency room. what do i tell them when i arrive?\n\n### Assistant: when you check in tell them that your doctor told you to come to the emergency room since a fever is an emergency when receiving chemotherapy. this may be an indication of an infection. cancer patients receiving chemotherapy should not sit in a waiting room for a long time. while you are receiving chemotherapy fever may be a sign of infection. infections can become serious and even life threatening very quickly. visit www. preventcancerinfections. org to learn about the steps you can take to prevent an infection during your chemotherapy treatment.

### Human:\ncan electrolysis cause cancer?\n\n### Assistant: electrolysis can be a very beneficial tool for those who suffer from excessive hair growth. it is the recommended treatment by the mayo clinic for hirsutism abnormal heavy hair growth in women on places where they typically do not grow hair. when done responsibly there are typically no health-care concerns. . you run a higher risk of developing cancer by walking outside without wearing sunscreen.

### Human:\nwhat medications can cause a false positive on a psa test?\n\n### Assistant: several medications can decrease psa values but i am not aware of any that can raise psa. medications that can decrease psa and thus possibly cause a false negative test include: • finasteride and dutasteride. these treat enlarged prostate. finasteride is also used for male pattern baldness. • anti-inflammatory medicines also called nsaids. this includes naproxen and ibuprofen. • acetaminophen or tylenol • statins to treat high cholesterol • water pills or diuretics things that can increase psa values include: • bph or enlarged prostate • prostate cancer • prostatitis (infection of the prostate) • recent sexual activity • recent urological procedures like cystoscopy • long distance bike riding if your psa value is elevated you should see a urologist and find out what is causing it. find out more information about psa testing in the prostate cancer health center.

### Human:\ndoes hpv cause yeast infections in women?\n\n### Assistant: no. human papillomavirus (hpv) causes genital warts in men and women and abnormal growths on the cervix that can advance to cervical cancer. vaginal yeast infections are almost all caused by candida a yeast that lives harmlessly in the vagina in many women. if there is a disruption of the normal balance of organisms in the vagina (most often after taking antibiotics) candida can grow excessively causing symptoms of a yeast infection. the skin of the vagina becomes irritated often with itching pain with urination or sex and sometimes a thick white discharge. ever since i have been diagnosed with high risk hpv and my doctor has been treating the abnormal cells located high up in my vaginal walls the treatment has been causing me yeast infections. for 16 weeks i have been using imiquimod %5 cream to treat the cells by applying deep into the vagina 3 times a week then rinsing with a betadine solution once a week and so far that hasn't worked but i have had non-stop yeast infections. now on monday tomorrow i start using fluorouracil %5 cream 1 applicator full once a week which is another skin cancer cream normally used topically but i will be using deep in the vaginal walls. i'm a single woman in my mid forties and this whole thing is so fustrating and just want it to be over and now i'm teriffied to date and let things go to another level. however while i am being treated i have been told by my doctor not to have any sex so i guess its good that i'm not in a relationship right now. seriously is there any hope out there because i'm so tired of feeling irritated down there.

### Human:\na type 1 diabetic is having a ra flareup. is there a linkage at the celluar level causing blood sugars in the 30s? . the person is on an insulin pump is very well controlled as far as activity and normal diet quantity and times. however without explanation recent blood sugars in the morning are bottoming out in the 30's. currently the person is experiencing a rheumatoid arithritis flareup and conincidently (or not) the above noted blood sugars. can the cells associated with ra in any way interact with insulin to render it ineffective?\n\n### Assistant: there is a definite relationship between rheumatoid arthritis (ra) and type 1 diabetes. both of these diseases are considered autoimmune disorders where the body’s immune system attacks itself. in the case of ra the synovial lining of the joints and in type 1 diabetes the beta cells of the pancreas are attacked. people who have the gene ptpn22 are susceptible to both of these diseases. both of these diseases result in elevations of inflammation markers such as tumor necrosis factor-alpha. drugs such as enbrel humira and remicade are fda approved for the treatment of ra and fight against tumor necrosis factor. although these drugs are not approved for the treatment of diabetes they do have an effect on insulin sensitivity and the beta cells of the pancreas which produce insulin. therefore it is not surprising that a flare in ra can affect blood glucose levels. so not only is inflammation common to both diseases but the drugs used to treat ra flares such as the anti-tumor necrosis factor alpha medications or the use of steroids such as prednisone can affect blood glucose levels. you should discuss with your doctor any changes you have made in treating the two diseases. be sure you keep both your rheumatologist and endocrinologist informed so they can work together to keep your ra and diabetes under control.

### Human:\nwhat are liver lesions?\n\n### Assistant: “lesion” is a general word for a tissue abnormality. liver lesion is a term doctors use for abnormal areas noted on an imaging test of the liver. most often liver lesions are seen on an ultrasound computed tomogram (ct) scan or magnetic resonance imaging (mri) scan. the term “liver lesion” is a general term. liver lesions could be anything from harmless cysts in the liver to areas of cancer spreading from the colon or breast. the appearance of the lesions on imaging as well as other diagnoses and test results can often help explain the cause of liver lesions. when the nature of liver lesions is unclear and a diagnosis such as cancer is possible a biopsy is often needed to determine their cause. i recently had to have a chest x-ray looking for lung lesions which i was told were mostly malignant. the test was ordered due to the sodium levels in my blood and urine were different and also because i am a long term smoker and have chronic bronchitis. that was all i was told. i am curious as to what type of lesions these could be and how bad it is.

### Human:\nwhy is vitamin d important?\n\n### Assistant: there a variety of reasons vitamin d is important. first it helps your body absorb calcium for healthy bones. . it is well accepted that a lack of vitamin d increases the risk of osteomalcia (bone/muscle pain) osteopenia (lower than normal bone density) osteoporosis and bone fractures in adults. severe vitamin d deficiency is also responsible for rickets and growth retardation in children which has made a comeback in recent years. because vitamin d helps to with cell growth the immune system and reduces inflammation it has been linked to the development of immune disorders heart disease and cancers. more research is needed to draw conclusions on these links. modern lifestyles put people at risk for lack of vitamin d due to excessive time indoors the use of sunscreen and excess weight.

### Human:\ndo you think it is safe for young babies to receive x-rays?\n\n### Assistant: when a child is exposed to radiation one must consider the risks and benefits involved in the child's situation. when a young baby has a fever it can mean that there is a serious illness that needs immediate treatment. a chest x-ray can be helpful to decide what treatment if any the child needs. since a person's total exposure to radiation is what may determine the risk of cancer in the future it can be helpful to ask if x-rays are definitely needed each time a doctor recommends one. .

### Human:\nwhat are the health benefits of green tea?\n\n### Assistant: while the curative power of green tea has been touted for centuries science is finally starting to catch up! the benefits of green tea come from antioxidants (polyphenols) that protect cells from free radicals and also may help prevent plaque buildup in the arteries. studies indicate an association between green tea consumption and reduced risk of heart disease and cancer. it's important to remember that green tea also contains caffeine.

### Human:\nwhat can i do to keep adult acne at bay?\n\n### Assistant: 1) make sure that everything you put on your face —moisturizer sunscreen makeup — is noncomedogenic meaning that it won’t clog your pores. if a product does not specifically have the word “noncomedogenic”on the label do not buy it. 2) since gentle but thorough cleansing is essential it’s a good idea to invest in a sonic cleansing machine and use it once a day. it doesn’t have to be the most expensive machine available and drugstores now sell relatively inexpensive versions. some machines have special brushes for acne or delicate skin which are gentle on adult skin. 3) look for products that contain salicylic acid because it is highly effective at unclogging pores and reducing breakouts. people with very sensitive skin might want to use a 0. 5 % salicylic acid product but for most adults 2% will yield the best results. use these products every night; do not use during the day even under sunscreen because salicylic acid can increase sun sensitivity. products with alpha-hydroxy acids (ahas) will also work. 4) those at-home microdermabrasion systems sold in beauty stores provide more exfoliation than salicylic acid and ahas. don’t do microdermabrasion at home more than once a week or you risk irritating the skin. 5) if your skin is oily you can use a 2. 5% benzoyl peroxide product over areas prone to breakouts. don’t just dot it on the pimple — use in on the whole area to kill bacteria. 6) consider light therapy either at your dermatologist’soffice or with machines intended for home use. they’re not as powerful as the ones dermatologists use but they do work. 7) mild adult acne is easily treated with over-the-counter products. but people who scar easily or who have pimples that look like angry red cysts should to go to a doctor immediately. <positive_smiley> consistency is the key to having a clear complexion even if you have adult acne. daily treatment will lead to significant improvement but if you stop treatment or do it only sporadically acne will come back with a vengeance.

### Human:\ni have little tumors around my eyes. i was told that they could be removed but they would come back. what should i do?\n\n### Assistant: there are deposits around the eyes that can be associated with high cholesterol. if that is indeed the case it's most important to address your cholesterol. heart disease is serious. after you correct your cholesterol you can have the lesions removed without them returning.

### Human:\nare there lifestyle and dietary factors that can decrease the risk of breast cancer?\n\n### Assistant: weight is a really important factor to the postmenopausal woman. higher body mass index and postmenopausal weight gain increase a woman’s risk for breast cancer. a woman who has a bmi of more than 33 is 27% more likely to get breast cancer than a woman with a bmi of less than 21. losing about 22 pounds will lower your risk regular physical activity can help women protect themselves from breast cancer. engaging in say fast walking for 10 hours or more per week can benefit women immensely. drinking alcohol has definitely been shown to be a risk factor and the more one drinks the higher the risk. i always say “one drink is good for the heart but two drinks are bad for your breasts”. other factors that seem to help decrease the risk: eating olive oil sticking to a low-fat diet that includes monounsaturated and polyunsaturated fats complex carbohydrates and minimal red meat. taking vitamin d and coq10 may also help lower your risk. soy is still controversial so i advise eating no more than what is in a standard asian diet — 20 grams per day. breastfeeding for a least six months may decrease breast cancer risk. with every 12 months of breastfeeding a reduction of 4. 3% was seen for breast cancer risk. finally if a woman can control for this she should try to have a baby at a younger age. having a first baby before age 25 will decrease a woman’s risk by 10% and having a baby before 35 decreases her risk by 5%. unfortunately having a first baby later in life puts a woman at greater risk for breast cancer because of perimenopausal breast changes from hormones of pregnancy. yes

### Human:\nhello. i have heard that a whole foods plant-based diet reduces cancer risk. is this true? . there is a lot of cancer risk in my family but i want to live a long life.\n\n### Assistant: yes plant foods are associated with decreased cancer risk especially fruits vegetables whole grains and legumes. add more of these to your diet while limiting red and processed meats and you'll benefit over thelong run. for more on diet and cancer prevention see this webmd article.

### Human:\ni am a 57 yr old woman. is there anything wrong with getting up to go to the bathroom 2-3 times during the night?\n\n### Assistant: most adults shouldn’t have to get up more than once a night to urinate. having to get up 2 or 3 times is likely causing you to lose a lot of sleep. for a woman who has already gone through menopause the most common causes of frequent nighttime urination include diabetes and bladder infections. diabetes is often silent and frequent urination may be the only sign that the blood sugar is too high. with a bladder infection you might have other symptoms such as urgency and discomfort. there are also many other possible causes of nightly bathroom trips. it may be as simple as drinking too much fluid in the evening. overactive bladder is another common cause. medicines such as water pills may make you run to the bathroom even if they were taken many hours before. caffeine and alcohol can also cause frequent urination. for some women it may just be force of habit. very rarely it can be the sign of a tumor in the bladder or pelvis. see your doctor and have a checkup. make sure you mention how many times a night you have to go to the bathroom. he or she will likely get a urine test and some lab work to sort things out. then you will finally be able to get a good night’s sleep.

### Human:\nquit smoking 8 days ago how long before the nicotine is out of my system. i am also taking chantix i have been taking it for seventeen day s now and feeling very good.\n\n### Assistant: nicotine levels in your body will drop significantly between 8 to 12 hours after your last cigarette. your body won’t be completely nicotine-free until 24 to 72 hours afterwards however. do an internet search for “smoking cessation timeline” if you’re curious about some of the other benefits that you’ll notice by becoming smoke free. for example after 24 hours your risk of having a heart attack decreases dramatically and your ability to smell and taste will be enhanced after 48 hours. after years of having quit smoking your risk of developing cancer having a heart attack or having a stroke decrease significantly. quitting smoking is one of the most important things that you can do for your health. keep up the great work! my understanding is that the nicotine is out of your system within 24 hours.

### Human:\nare the new recommendations for pap smears really different?\n\n### Assistant: the suggested use of pap smears as a screening test has been slowly undergoing a transformation. many of you may remember the practice of everyone getting a yearly pap smear. over time it became apparent (at least in developed countries) that the incidence of cervical cancer was declining. the majority of cervical cancer was found in women who had not had a pap smear in five or more years. many other developed nations (such as canada) had moved to less frequent paps as long as the woman had no symptoms or risk factors suggesting cervical cancer. the american college of obstetricians and gynecologists (acog) has finally moved into line with other countries and other published guidelines.

### Human:\nwhat's the relationship between bmi and body fat?\n\n### Assistant: bmi is a tool that estimates body fat based on height and weight measures of individuals. as bmi increases so does your risk for heart disease high blood pressure type 2 diabetes and certain cancers. but this tool is not perfect. it can overestimate body fat in individuals who are very lean but weigh more like athletes and it can underestimate body fat in people who are thin but have low muscle tone. bmi is calculated from your height and weight and is used as an indirect screening tool for body fat and risk of diseases or other health conditions. bmi does have its limitations however as some individuals such as athletes may have a high bmi because of increased muscle mass. as a result they might have a high bmi but not a high percentage of body fat. there are other more direct measurement techniques for body fat percentage; some of which include: • underwater weighing • air displacement • dual energy x-ray • bioelectrical impedance • skinfold measurements there are however trade-offs with each method. the more accurate methods tend to require specialized equipment that can be very expensive and require additional training and take longer to implement. the quicker and cheaper methods may not require much additional training but may not be as accurate. researchers have to choose which method will best fit their needs. let's just keep it simple. if your waist is above 45% of your height you are too fat and if you work on just that number you will become lean and healthy. for example a man who is 72" tall (6') need to keep his waist under 32" and a woman who is 68" tall (5"8") needs to keep her waist under 30". just measure your height in inches and multiply times. 45. another easy way is if your pants waist is not smaller than your pants length it is time to eat less and exercise more. mike at everyouncecounts@gmail. com

### Human:\nwhat are some symptoms a cancer patient may have if they have an infection?\n\n### Assistant: while developing a fever is the most serious sign and should be treated as an emergency there are other signs and symptoms you should be aware of that may indicate you have an infection: chills and sweats change in cough or new cough sore throat or new mouth sore shortness of breath nasal congestion stiff neck burning or pain with urination unusual vaginal discharge or irritation increased urination redness soreness or swelling in any area including surgical wounds and ports diarrhea vomiting pain in the abdomen or rectum new onset of pain changes in skin urination and mental status if you experience any of these signs or symptoms you should call your doctor right away. for more information about the signs and symptoms of an infection visit www. preventcancerinfections. org

### Human:\nwhat is an left adnexal cyst. i had some tests done & one the results it says " left adnexal cyst measuring up to 3. 8 mm". what does this mean? is it dangerous? does this require surgery of some sort? thank you\n\n### Assistant: most helpful answer this is a cyst near or on your left ovary. without seeing the results of your test and delve into your medical history i have no way of knowing the significance or treatment approaches. ovarian cysts are more likely to be non-cancerous and may even be self-resolving (like corpus lutiem cysts - the ones that form as a result of monthly ovulation). you will need to discuss patient-specific questions with your own doctor. someone who is familiar with your particular case

### Human:\ni am 46 years old and have oily-combination skin. what would be the best toner for my age?\n\n### Assistant: i suggest that you cleanse your face twice daily with soap and water. pack a pre-moistened cleansing pad if you won't be around a water basin throughout the day. shower or bathe in tepid water rather than steaming hot water. hot water can strip your skin of needed moisture while cold water can shock your skin. avoid using cleansers or toners that tend to over-dry skin or have high alcohol content. this over-drying actually causes your skin to produce even more oil than usual. use only noncomedogenic moisturizers and sunscreen products. this means they're oil-free and won't clog pores. use vitamin a derivatives or retinoids which reduce production in oil glands and shrink their size.

### Human:\ni have a hard red spot about the size of a quarter near my ankle. it does not hurt. what could it be?\n\n### Assistant: your dermatologist should evaluate skin changes or abnormal spots. a lesion that feels hard may be scar tissue. however you should be evaluated for any underlying skin cancer. when evaluating your skin look for changes in the area border or color of the skin. these are the "abcs" of skin cancer detection.

### Human:\nis estrogen therapy an option for all menopausal women?\n\n### Assistant: only women who no longer have a uterus should consider using estrogen-alone therapy (et). for women with a uterus the option they might consider is estrogen plus progestogen therapy (ept). progestogen is needed to protect the uterus and balance the effects of estrogen. using et alone for 5 or more years can more than triple the risk of developing cancer of the uterus but adding progestogen prevents the uterine lining (endometrium) from thickening and greatly reduces the cancer risk. then of course each woman must determine (with her healthcare provider) if ept is right for her.

### Human:\nwhat are the top 3 things you tell your cancer patients when they are going through chemotherapy?\n\n### Assistant: i always stress the following points: fever in a cancer patient receiving chemotherapy is an emergency…they are to call me anytime they have a fever or don’t feel well. wash your hands get a flu shot i also suggest that patients visit www. preventcancerinfections. org to learn more about their risk for developing a low white blood cell count (a condition called neutropenia) during their chemotherapy.

### Human:\ncan blood thinners cause cancer. can blood clots and medications for blood clots cause cancer.\n\n### Assistant: there has been no association between the use of blood thinners (there are many different types) and any type of cancer. products that cause cancer would not have been approved by the fda.

### Human:\ncompltd 2 wks of antibotics and medrol pack. still have sever pain in lung area plerasie. how long does plerasie last?\n\n### Assistant: how long pleurisy lasts depends on the cause. pleurisy occurs when there is inflammation in the lining surrounding your lungs. the lining consists of two thin sheets (pleura). when something causes these sheets to become inflamed it can feel as though two pieces of sand paper are rubbing together and sharp pain occurs on both inhaling and exhaling. infections from a virus or bacterium including tuberculosis a blood clot (pulmonary embolism) trauma cancer collagen vascular diseases such as lupus or unknown (idiopathic) are common causes of pleurisy. since your doctor has prescribed antibiotics and steroids your diagnosis is probably an infection. once the infection has healed the pleurisy should improve. sometimes scar tissue develops in the pleura and chronic pain can result. talk to your doctor about your continued pain. if you have a cough or are a smoker this may be aggravating your problem. pain medications and cough suppressants may be helpful.

### Human:\nis uterine cancer hereditary? . my mother was diagnosed 3 years ago and i remember her saying that she was constantly bleeding so that was a sign. and lately my periods have been lasting 3+ weeks and it feels like when i finally think it is over with i get it again. also sometimes i will miss my period for like 2 months. could i possibly have symptoms or could it be something else?\n\n### Assistant: uterine or endometrial cancer can have a tendency to run in families. but that does not mean that you will definitely get it just because your mother had it. changes in your menstrual cycle including heavy bleeding or spotting between periods can be a sign of uterine cancer. but it can also be caused by some other conditions as well. other possible symptoms of uterine cancer include non-bloody vaginal discharge pelvic pain unintentional weight loss and feeling of a mass in the pelvis. you need to make an appointment with your gynecologist as soon as possible. the earlier uterine cancer is found the greater the chances that it can be successfully treated. talk to your gynecologist about your family history and changes in your periods. she will likely want to take a tissue sample with either an endometrial biopsy or a d&c. she might also suggest a transvaginal ultrasound to look at the uterus. then you can find out what is causing your symptoms and get the right treatment. you can read more about endometrial cancer on webmd.

### Human:\nhow do i remove black spots on my face?\n\n### Assistant: first have the dark spot looked at by a dermatologist to determine that the dark spot is not pre-cancerous or skin cancer. melasma is a common cause of dark spots on the forehead cheeks and upper lips in women. one of the first and very critical steps to brightening darker areas on the face is to use a cream with an spf of 30 and above applying three times each day to cover darker areas. also applying skin brighteners such as niacin hydroroquinone and kojic acid will help brighten the darker areas. these steps will help your skin look more even and more youthful.

### Human:\ni read that pregnant women are at greater risk for food-borne illness. what can i do to protect myself and my baby?\n\n### Assistant: everyone's at risk but those at greater risk are infants young children pregnant women and their unborn babies older adults and people with weakened immune systems (for example those with hiv/aids cancer diabetes kidney disease and transplant patients). some people may become ill after ingesting only a few harmful bacteria. others may remain symptom-free after ingesting thousands. to prevent food-borne illness keep these key actions in mind: wash your hands. keep raw meats and ready-to-eat foods -- like salads -- separated during preparation. cook foods to the proper temperature by using a food thermometer. refrigerate foods promptly and reheat leftovers to 165 degrees fahrenheit.

### Human:\ni have been diagnosed with neuropathy in my legs but am not diabetic. it is slowly progressing up my legs any ideas?\n\n### Assistant: there can be many causes for a neuropathy. your doctor has most likely already taken a good medical history and a physical exam. many clues can be obtained with these simple tools. examination of the legs and feet will include checking your reflexes strength and sensation. depending on the results you may need an emg test and lab work. sometimes x-rays ct scans or mris may be needed of your back or brain. some of the possible causes of neuropathy besides diabetes include: vitamin b12 deficiency thyroid problems autoimmune diseases lyme disease inflamed blood vessels kidney failure alcohol abuse hiv infection and syphilis. multiple sclerosis guillain-barré syndrome and rare types of cancers may also cause neuropathy. the next step if your doctor can’t find a cause for your problem would be to see a neurologist. this is a doctor who specializes in diseases of the brain and nerves. make sure to take all your test results with you. i hope you get some answers and relief soon.

### Human:\nwhat are the symptoms of thrush?\n\n### Assistant: thrush usually develops suddenly but it may become chronic persisting over a long period of time. a common sign of thrush is the presence of creamy white slightly raised lesions in your mouth - usually on your tongue or inner cheeks - but also sometimes on the roof of your mouth gums tonsils or back of your throat. the lesions which may have a "cottage cheese" appearance can be painful and may bleed slightly when you scrape them or brush your teeth. in severe cases the lesions may spread into your esophagus or swallowing tube causing: pain or difficulty swallowing a feeling that food gets stuck in the throat or mid-chest area fever if the infection spreads beyond the esophagus thrush can spread to other parts of the body including the lungs liver and skin. this happens more often in people with cancer hiv or other conditions that weaken the immune system.

### Human:\ni'm an 81-year-old man with a severe scalp problem; scales that are moving down to my face. do you have any suggestions? . my dermatologist tried using a procedure that was very cold. but the situation has gotten worse. this problem runs in my family so it may be a genetic thing.\n\n### Assistant: if you are suffering from a "severe" scalp problem your differential diagnosis (at age 81) may include anything from infection an immunologic disease or cancer. you should have your condition evaluated by a physician.

### Human:\ni have very heavy periods every month. should i be concerned?\n\n### Assistant: there is a medical definition of “too-heavy periods”. if a woman is bleeding 80cc (2. 7 ounces — about 1/3 of a cup) or more that is excessive bleeding. some general indications of excessive bleeding can include: saturating a maxipad or super tampon every 60-90 minutes for several hours passage of large clots (quarter sized or larger) significant bleeding for more than seven days probably the most important factor would be if your bleeding is heavy enough to interfere with your normal activities. there are two major reasons for very prolonged/heavy periods: hormonal and “structural”. hormonal causes are usually linked to missed or erratic ovulation. in a normal cycle estrogen is produced all month. in a normal cycle progesterone production increases following ovulation. progesterone “stabilizes” the uterine lining in preparation for a possible implantation of a new pregnancy. if you are not pregnant that month the levels of estrogen and progesterone fall triggering the release of the uterine lining — your period. if you do not ovulate the estrogen build up of the lining continues but without the usual ovulation associated progesterone. thus the hormone levels don’t decline and the lining stays up inside the uterus as a missed/late period. alternatively the lining can begin to shed under its own weight producing prolonged bleeding. after several months of missed periods the lining of the uterus can become very thickened. prolonged and heavy flows are not uncommon after months of missed flows. a “structural” cause of heavy menstrual bleeding means that excessive bleeding is due to actual problems within the cavity or walls of the uterus. some examples of this would include: infections of the lining of the uterus fibroids of the uterus endometriosis of the muscular wall of the uterus (“adenomyosis”) polyps of the uterine lining or even uterine cancer.

### Human:\nwhat is the adrenal gland?\n\n### Assistant: the adrenal glands are a pair of organs that sit on top of each kidney. the adrenal glands produce numerous hormones responsible for our response to stress and the balance of salt and water in our bodies. cortisol aldosterone epinephrine (adrenaline) norepinephrine and certain sex hormones are released by the adrenal glands. tumors in the adrenal glands can secrete excess hormones causing cushing’s syndrome (too much cortisol) conn’s syndrome (too much aldosterone) or extremely high blood pressure (pheochromocytomas). abnormally low function of the adrenal glands is called adrenal insufficiency which can have many different causes. incidental harmless adrenal gland tumors are frequently discovered in healthy people on imaging tests obtained for other reasons.

### Human:\nis coffee good for your heart and how much coffee? . i heard it was good for the heart one cup a day is it true?\n\n### Assistant: there is emerging evidence that moderate coffee consumption is linked to decreased risk in type 2 diabetes parkinson's and liver cancer. a recent study published in circulation heart failure discussed in detail here on webmd showed moderate coffee intake was associated with lower risk of heart failure. the researchers recommended 2 average american cups of coffee as moderate which was actually 4 smaller cups in europe. it's important to remember that these studies only show associations and do not prove cause and effect. but if you love coffee you can feel good about making it a part of your healthy diet. i know i do!

### Human:\ni had liver spots as a child and it looks like they’re back. my skin is blotchy and two-toned. can i get rid of them?\n\n### Assistant: the term “liver spots” is somewhat of a misnomer. liver spots are typically not related to any diseases of the liver. most of these changes are due to age sun damage or solar lentigo. your first approach is to exclude any potential skin cancers. once this is accomplished a combination of glycolic peels and skin brightening agents will improve your skin.

### Human:\nwhat types of problems can x-rays detect?\n\n### Assistant: in adults dental x-rays can be used to: show areas of decay that may not be visible with an oral exam especially small areas of decay between teeth identify decay occurring beneath an existing filling reveal bone loss that accompanies gum disease reveal changes in the bone or in the root canal resulting from infection assist in the preparation of tooth implants braces dentures or other dental procedures reveal abscesses (an infection at the root of a tooth or between the gum and a tooth) reveal other developmental abnormalities such as cysts and some types of tumors in children dental x-rays are used to: watch for decay determine if there is enough space in the mouth to fit all incoming teeth determine if primary teeth are being lost quickly enough to allow permanent teeth to erupt properly check for the development of wisdom teeth and identify if the teeth are impacted (unable to emerge through the gums)

### Human:\nmy lips have become severely chapped. i have applied vitamin e but it isn’t working. can you give me any advice? . it’s not the infrequent normal kind of chapping. it’s lasts for weeks and looks like a lot of dry dead skin on my lips.\n\n### Assistant: non-healing areas of sun-exposed skin -- such as the lips ears and nose -- should be evaluated by your dermatologist to exclude any precancerous growths. once you have excluded any precancerous causes consider applying topical hydrocortisone to reduce the inflammatory process.

### Human:\nwhat causes dry mouth?\n\n### Assistant: there are several causes of dry mouth also called xerostomia. these include: side effect of certain medications. dry mouth is a common side effect of many prescription and nonprescription drugs including drugs used to treat depression anxiety pain allergies and colds (antihistamines and decongestants) obesity acne epilepsy hypertension (diuretics) diarrhea nausea psychotic disorders urinary incontinence asthma (certain bronchodilators) and parkinson's disease. dry mouth can also a side effect of muscle relaxants and sedatives. side effect of certain diseases and infections. dry mouth can be a side effect of medical conditions including sjögren's syndrome hiv/aids alzheimer's disease diabetes anemia cystic fibrosis rheumatoid arthritis hypertension parkinson's disease stroke and mumps. side effect of certain medical treatments. damage to the salivary glands the glands that produce saliva for example from radiation to the head and neck and chemotherapy treatments for cancer can reduce the amount of saliva produced. nerve damage. dry mouth can be a result of nerve damage to the head and neck area from an injury or surgery. dehydration. conditions that lead to dehydration such as fever excessive sweating vomiting diarrhea blood loss and burns can cause dry mouth. surgical removal of the salivary glands. lifestyle. smoking or chewing tobacco can affect saliva production and aggravate dry mouth. continuously breathing with your mouth open can also contribute to the problem.

### Human:\ni am getting tiny blood-red spots all over my body. i have very fair skin! what are they and how can i get rid of them?\n\n### Assistant: blood-red spots may be attributed to dilated small vessels on your face or telangiectasia. the majority of these "red spots" are benign. however on occasion they are associated with other medical conditions such as acne rosacea scleroderma and birthmarks. your first step is to exclude any underlying medical conditions. then your physician may recommend a topical product or laser treatment.

### Human:\nwhat am i allowed to eat before having a colonoscopy?\n\n### Assistant: nothing! at least not after midnight the night before. and don’t drink anything either. a few bites of food or sips of coffee before your colonoscopy may seem like no big deal. but you won’t be fooling your gastroenterologist. a little food goes a long way toward obscuring the view of your colon. that makes it harder to identify any polyps or potential tumors during a colonoscopy. it might seem almost unbearable to go hungry or face a medical procedure caffeine-free. but think how much more uncomfortable it will be to undergo a repeat colonoscopy because of your “poor prep. ” peanut butter

### Human:\nwhy do my nipples hurt?\n\n### Assistant: nipple pain is a common in women who are pregnant or breastfeeding. the nipples may become more sensitive and tender during pregnancy. poor “latch-on” by the baby when breastfeeding can also cause nipple pain. in women who are not pregnant or lactating nipple pain may be due to skin abrasion from tight-fitting bras or other clothing or dry skin around the nipple. more serious causes of nipple pain include infections paget’s disease of the breast or certain forms of breast cancer. if nipple pain doesn’t go away in two weeks or if you also have nipple discharge call your doctor. i would also like to point out the fact that they may just be super tender due to having fibromyalgia or a like illness. mine are and i have fibromyalgia. i do have a milky white discharge but it has been checked out by a clinical lactation test and it is a healthy non-cancerous discharge. i am not pregnant nor am i nursing. i hope this helps.

### Human:\ndoes sugar feed cancer?\n\n### Assistant: according to the american cancer society's website: "no sugar intake has not been shown to directly increase the risk of getting cancer or having it get worse (progress). still sugars and sugar-sweetened drinks add large amounts of calories to the diet and can cause weight gain which we know can affect cancer outcomes. " it makes sense to eat a healthy whole food based diet with cancer which would naturally be low in added sugars but no one can say for sure if it feeds cancer. for more on diet see this webmd article. the american caner association is either being extremely negligent evasive or just plain ignorant when it comes to cancer. according to german doctor otto wartberg the "crux of his nobel thesis was that malignant tumors frequently exhibit an increase in anaerobic glycolysis -- a process whereby glucose is used as a fuel by cancer cells with lactic acid as an anaerobic byproduct -- compared to normal tissues. 1 the large amount of lactic acid produced by this fermentation of glucose from cancer cells is then transported to the liver. this conversion of glucose to lactate generates a lower more acidic ph in cancerous tissues as well as overall physical fatigue from lactic acid buildup. 2 3 thus larger tumors tend to exhibit a more acidic ph. 4 this inefficient pathway for energy metabolism yields only 2 moles of adenosine triphosphate (atp) energy per mole of glucose compared to 38 moles of atp in the complete aerobic oxidation of glucose. by extracting only about 5 percent (2 vs. 38 moles of atp) of the available energy in the food supply and the body's calorie stores the cancer is "wasting" energy and the patient becomes tired and undernourished. this vicious cycle increases body wasting. 5 it is one reason why 40 percent of cancer patients die from malnutrition or cachexia. 6 hence cancer therapies should encompass regulating blood-glucose levels via diet supplements non-oral solutions for cachectic patients who lose their appetite medication exercise gradual weight loss and stress reduction. professional guidance and patient self-discipline are crucial at this point in the cancer process. the quest is not to eliminate sugars or carbohydrates from the diet but rather to control blood glucose within a narrow range to help starve the cancer and bolster immune function. " to read more go to the april 2000 issue of nutrition science news or www. mercola. com/article/sugar/sugar_cancer.

### Human:\nwhat are hormonal causes for heavy periods?\n\n### Assistant: in the developed world girls now get their periods earlier and women spend less time being pregnant and breast feeding on demand. this means that the average women can now expect to have more than 400 menstrual cycles in her lifetime (eshre 2007). even the use of most hormonal contraceptives (pill/patch/ring) will yield a monthly bleed. so it’s no wonder that women are so concerned when their cycles seem to be longer and heavier than usual. to address the most-pressing question “when should i be concerned? what is the medical definition of too much bleeding? ” there is a medical definition of “too-heavy periods. ” if a woman is bleeding 80cc (2. 7 ounces — about 1/3 of a cup) or more that is excessive bleeding. trying to measure exactly the amount of bleeding is difficult even in a research setting much less in a home bathroom! some general indications of excessive bleeding can include: * saturating a maxipad or super tampon every 60-90 minutes for several hours. * passage of large clots (quarter-sized or larger). * significant bleeding for more than seven days. probably the most important factor would be if your bleeding is heavy enough to interfere with your normal activities. so if your bleeds are too heavy read on for some possible explanations. hormonal causes hormonal causes are usually linked to missed or erratic ovulation. as you may know in a normal cycle estrogen is produced all month. estrogen is responsible for building up the lining of your uterus so you have something to shed each month. in a normal cycle progesterone production increases following ovulation. progesterone “stabilizes” the uterine lining in preparation for a possible implantation of a new pregnancy. if you are not pregnant that month the levels of estrogen and progesterone fall triggering the release of the uterine lining — your period. so if you do not ovulate the estrogen build up of the lining continues but without the usual ovulation-associated progesterone. thus the hormone levels don’t decline and the lining stays up inside the uterus as a missed/late period. alternatively the lining can begin to shed under its own weight producing prolonged bleeding. after several months of missed periods the lining of the uterus can become very thickened. prolonged and heavy flows are not uncommon after months of missed flows. there are many causes for not ovulating including low thyroid a benign pituitary growth (“adenoma”) or a problem with the hypothalamus. all of the stress-related causes of not ovulating (e. g. sudden increases in exercise crash dieting problems with relationships financial worries etc. ) can be linked to the effects of stress hormones from the brain on the hypothalamus. increased body weight may trigger hormone changes leading to polycystic ovarian syndrome (pcos). a transient ovarian cyst can halt ovulation for a time. there are treatments for each of the causes of heavy bleeding we have discussed. so if you or someone you know have episodes of heavy blood loss rather than a normal period talk to your doctor because there are ways to stop going with the flow.

### Human:\nis coffee good for your liver?\n\n### Assistant: did you know that drinking coffee is healthy for the liver! studies show that people who drank a few cups a day were less likely to scar their livers and less likely to get liver cancer. the same protective effect was not seen with tea or decaffeinated coffee.

### Human:\nmy cancer is in remission. how do i deal with the fear of reoccurrence?\n\n### Assistant: one of the most difficult challenges in coping with cancer is dealing with the fears of recurrence. in the jargon of cancer we talk of “remission ” which can be partial (cancer goes partly away) or complete (no evidence of cancer can be found). examples of partial remission include stage iv cancers (metastatic to different regions of the body) that reduce in size as detected by tests such as cat pet or bone scans; complete remission may be obtained at surgery (for early stages of breast colon prostate lung etc. ) which is often followed by some type of chemotherapy or hormonal therapy to prevent a cancer relapse or recurrence. so whether a person is living with an active cancer or has been told they are “cancer- free ” the possibility of the cancer returning or reactivating is very real. it takes work to deal with the fears of recurrence. the first step in doing so is to acknowledge the reality of the situation — not to bury it mentally and ignore it. but it is not helpful to focus on it again and again; it is important to “live for today ” as i have recently blogged about. there are many other helpful coping strategies and helpful individuals experienced in this field. finally i would encourage all cancer patients and their loved ones to attend a support group led by an experienced professional such as an oncology social worker or family therapist. rather than inciting more fear bonding with other survivors can be a great comfort. individual counseling should also be sought out especially for those who have private concerns that they would not like to share with others. most cancer centers have counselors available free of charge; there are also other organizations that have support groups and counseling such as cancercare or gilda’s club. i have had cancer twice in 5 years and i now in remission with my second cancer. how i deal with it is to take one day at a time and hope for the best. try to do exercising everyday and try to eat healthy and hopefully that will help. it's really hard. you will have your good days and bad days. try to keep busy. another thing is to look on the bright side such as your family friends. they're there for you and if that don't help try to seek some help through the cancercare. gov. they have been good for me. there is a lot of information etc that is very helpfull. you might even want to join a group session.

### Human:\nhow should i take omeprazole and levothyroxine which are to be taken in the morning four hours apart?\n\n### Assistant: currently there are no drug interactions found between levothyroxine and omeprazole. however this does not mean that interactions cannot exist. it is important to work with your pharmacist to see if there is any new information regarding these two products. omeprazole should be taken 30 minutes prior to a meal. levothyroxine should be taken 30 minutes to one hour prior to a meal. they can be taken together with water on an empty stomach if needed. the previous answer is not only false but can lead to very serious health implications. co-administration of omeprazole/other ppis/acid reducers/etc. along with thyroid meds (whether for tsh t4 or others) can cause a drastic decrease in absorption of the thyroid medication. there are many peer reviewed studies that prove this all one needs to do is a proper google search or a subscription to any of the popular medical journals. your stomach needs an acidic environment to properly convert your thyroid medication into a usable medication to get into your bloodstream and if you take an acid reducer with your thyroid med this can cause problems. if you must take both (as i personally do because of my tsh levels reaching 24. 6 plus ulcers and cancerous polyps due to gerd) make sure you take your acid reducing medication at least 4 hours before your thyroid medication (no matter what kind it is) and make sure not to take another acid reducing medication at least 4 hours after your thyroid med. if you do not separate the acid reducers 4 hours before and 4 hours after your thyroid medication your thyroid levels will become unstable and you will need to adjust your dosage. but in order to prevent your levels from getting out of whack and potentially causing more harm just separate your meds as posted above and you should have no issue. the above answer telling you that it is okay to take at the same time is incredibly harmful. don't take my word for it (someone who has been dealing with both issues for a decade) trust the scientists that have figured this out through multiple peer reviewed studies. just a few sources proving the point of my previous answer after 2 minutes of google searches (wow was that previous post really posted by a doctor? i feel bad for their patients): <link> <link> <link> <link>

### Human:\nwhy is sun exposure bad and how can i protect myself from the sun?\n\n### Assistant: sun exposure is responsible for a multitude of skin problems from age spots to skin cancer. unprotected skin suffers greatly from the uv rays of the sun promoting premature aging of the skin and wrinkle production. a single bad sunburn in your youth greatly increases your chances of developing skin cancer decades later. wear a hat and sunglasses and be sure to use sunscreen on all your exposed skin especially your face. ladies that spf 8 make-up you're wearing is not protecting your face enough from the sun. it helps but it isn't enough. remember to protect your face from the rays of the sun throughout the day. reapplying sunscreen as needed and wearing a wide-brimmed hat will help keep your skin fresh young and disease free.

### Human:\nmale 25 yrs old. i have low t. cat scan shows no pitutary tumor. symptoms low sex drive fatigue mild depression. cause? . surprised by low testosterone in blood work. i have a lot of body hair. what is the cause? will this always be a problem?\n\n### Assistant: there are two areas of the body where problems can arise which cause low testosterone levels. the first area is in your testicles. testosterone is produced in the testicles. the second area is the hormone control centers in the brain the hypothalamus and the pituitary. when testosterone levels fall the hypothalamus sends a signal to the pituitary to produce the hormones lh and fsh. these hormones travel in the blood stream and cause the testicles to produce testosterone and sperm. the effect of low testosterone levels on a man depends on his age when the low levels develop. in adults fatigue lack of sex drive and depression occur within a few weeks of developing low testosterone levels. decreased muscle mass and body hair are less common and do not occur for a year or more after the onset of testosterone deficiency. the first step when low testosterone levels are found is to confirm the results with repeat testing and test for free or bioavailable testosterone. free and bioavailable testosterone are a clearer representation of the active hormone as opposed to the total testosterone which is the more commonly measured initial test. the next step is to measure lh and fsh. normal or low levels of lh and fsh in the face of a low testosterone level suggest that the control centers in the brain are not working properly. high levels of lh and fsh pinpoint to a problem in the testicles. a cat scan is done to see if there is a tumor in the pituitary. a common pituitary tumor that causes low testosterone levels is a prolactin tumor. this is another hormone secreted by the pituitary. prolactin causes the hypothalamic region of the brain to malfunction. besides tumors damage to the pituitary gland or hypothalamus in adults can occur from surgery injury infections radiation therapy and with high doses or long-term use of narcotics or steroids. causes of failure of the testicles to produce testosterone include; chemotherapy radiation therapy excessive alcohol consumption infections such as mumps tumors medications trauma toxins chronic diseases and torsion of the testicles (twisting). sometimes no specific cause is found. talk with your doctor about your hormone levels and what could be causing your symptoms. treatment for low testosterone levels is important in men not only for their wellbeing but to make sure that their muscles and bones stay strong.

### Human:\nhow much of an impact does vitamin d have on ovarian cancer?\n\n### Assistant: the impact of vitamin d on ovarian cancer has not been as well studied but it has been purported to have a protective effect. researchers at the channing laboratory (associated with harvard university) used data from four large studies to examine the effects of vitamin d on ovarian cancer. it was determined that blood levels of vitamin d did not directly impact cancer risk from any of the four genotypes. however a specific type of the vitamin d receptor gene was significantly tied to ovarian cancer risk.

### Human:\nmy wrinkles are deep in the folds of my arms and my arms have a crinkly appearance. what is the best thing to do?\n\n### Assistant: the deep wrinkles you are experiencing are most likely from sun damage. your initial approach should be to wear sunscreen at all times. if you live in a very sunny climate consider wearing uv protective clothing. in addition you should continue to moisturize your skin with a noncomedogenic (non pore-clogging) moisturizer. your moisturizer should also contain hyaluronic acid which will help plump the skin cells. sun damage dehydrates the skin. so it is important to drink plenty of water to rehydrate all of your cells.

### Human:\nwhat causes hirsutism?\n\n### Assistant: hirsutism is male-pattern hair growth in women. excess hair may be on the upper lip chest back or elsewhere. causes of hirsutism include: polycystic ovary syndrome (most common) congenital adrenal hyperplasia (an inherited adrenal gland disorder) drug side effects hereditary (genetic) cushing's syndrome cancer most women with hirsutism have polycystic ovary syndrome characterized by irregular periods (or none) and multiple cysts visible on the ovaries on an ultrasound. only a small fraction of women have some other hormone imbalance. these are usually easily detected by lab tests in the supervision of an endocrinologist internist or family doctor. remember that normal hair growth patterns in women vary by race and ethnicity: don’t let an airbrushed magazine ideal fool you into a false self-diagnosis of hirsutism.

### Human:\nhad a ferritin test. came back as. 8 (point <positive_smiley> besides iron supplements anything else to do? . male runner. last few months have not been feeling well when running. very heavy feeling and not to run paces i could easily do 6 months a go. knowing how important iron is for carry red blood cells i had my ferritin checked. test came back with a. 8 (yes decimal is in right place) lab said it was the lowest ever seen. i am a light eater and while not a pure vegetarian i do not eat much meat just a little chicken and fish. anything else i need to do beside taking ferrus sulfate?\n\n### Assistant: the best thing to do is work with your healthcare provider about how to get your iron levels back up right now. in addition to supplementation increasing dietary iron is important in the long run to keep this problem from recurring here are ways to increase iron and iron absorption in your diet: iron from animal foods are better absorbed than plant sources so make a point to include those items you like such as chicken and fish. add plant sources of iron to your diet including cereals fortified with iron beans/legumes soy beans tofu pumpkin/squash seeds spinach raisins broccoli and bread. to increase their absorption add vitamin c sources such as orange juice tomatoes broccoli and strawberries. examples include vitamin-c rich fruit topped on your cereal or beans cooked in a tomato-based sauce. include animal sources of iron with vegetable sources also increases the amount of iron absorbed (e. g. meat chili or beans as a side dish with chicken). for more ideas on iron-rich food sources read this article <link> i have had trouble with low iron and cant take iron pills due to acid reflux so my dr sent me to a cancer dr and he gave me iron ivs and it helped dramatically i felt betters in days