Health News resources and information

Description and Possible Medical Problems

Even though we know it’s not good for us to bask in the sun, many people still strive to develop a deep, rich tan all over.

However, if you don’t make a habit of sunbathing and your calves become brownish in color all on their own, it’s probably a side effect of long-term heart failure. If this is the case, you probably experience chronic leg swelling and recurrent phlebitis. Due to the weakened blood vessels and poor circulation, blood slowly leaks out of the vessels, resulting in the brownish pigmentation of the skin.

Treatment

Although the brownish discoloration of the calves due to phlebitis or heart failure is not a health problem in itself and is essentially a cosmetic problem, there is no treatment for the condition besides wearing trousers or flesh-colored stockings.

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Traditionally, doctors have prescribed estrogen replacement therapy to women who have entered menopause to ease the physical and emotional discomforts that are caused because the body is no longer producing estrogen.

When ERT was first initiated on a widespread basis in the 1950s, women pretty much believed that their doctor and the medical establishment knew what was best for them. However, times have changed. ERT is no longer the panacea it was once purported to be, and the fact is that there are some women who shouldn’t take estrogen medication at all.

Here are the facts about estrogen replacement therapy for menopausal woman.

Estrogen replacement therapy comes in four different forms. You can take it orally, in tablets in dosages ranging from 0.3 milligrams to 2.5 milligrams, though the typical dosage is one 0.625-milligram tablet taken once a day for three weeks. A vaginal cream called Premarin is also available, as is a transdermal patch called an Estraderm patch; the latter is worn on the skin and changed twice a week and allows a steady stream of estrogen to be absorbed through the skin. Make sure that it is changed at the same times each week.

One of the main advantages of estrogen replacement therapy is that it helps prevent osteoporosis, since estrogen helps keep bones strong. Estrogen also helps keep the genitals and reproductive organs from atrophying and losing their elasticity and support; this helps prevent the uterus from falling, which is a common condition among postmenopausal women. ERT also helps reduce the risk of heart disease because it increases the amount of the “good” HDL cholesterol in the system while lowering the level of “bad” LDL cholesterol. Estrogen is also frequently used during premenopause to reduce the severity of symptoms such as hot flashes and mood swings.

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After surgery, because the cancer may have spread to the lymph nodes, many women who have had a lumpectomy or mastectomy may also be treated with radiation therapy. Chemotherapy may also be an option, though it is most often recommended for women who have not gone through menopause. It is also most often prescribed for use before and/or during the surgery, but not after, when the drug tamoxifen is usually prescribed. Tamoxifen is the most commonly prescribed drug for breast cancer because it has almost no side effects, which is unusual for an anticancer drug. In fact, tamoxifen is actually a hormone that is often prescribed in combination with other hormonal therapy. It can slow or reverse the spread of breast cancer when a tumor has not responded to other treatment methods.

Tamoxifen works by depleting the estrogen receptors in breast cancer cells, which, in essence, starves the cells, since they thrive on estrogen. The side effects of tamoxifen include mild pain in the bones, an increased need for calcium, and hot flashes in postmenopausal women. Because estrogen naturally strengthens bones, there is some concern that tamoxifen, an antiestrogen hormone, may increase a woman’s risk of developing osteoporosis after treatment, but usually this can be offset by increased intake of calcium and exercise. The advantages of using tamoxifen to treat breast cancer are that these side effects are minor compared to those of other anticancer drugs and that it reduces the risk of a recurrence of the cancer.

However, breast cancer can be fickle in the way it responds to treatment. Some tumors will shrink and go into remission in response to estrogen hormones, while others will completely disappear with antiestrogen hormones such as androgens and progesterone. Because it is difficult to predict how a tumor will respond to a given hormone, if your doctor is treating you with chemotherapy, you may feel like a guinea pig at times. But tumors are fickle, and what may have worked successfully to shrink a tumor once may not succeed on the next go-round. So your doctor will keep trying, with the final goal being complete remission. If hormonal therapy fails to work, your doctor may try a corticosteroid such as prednisone, which can also be effective in treating breast cancer.

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Description and Possible Medical Problems

Though midlife adults who keep active by exercising regularly have stronger musculoskeletal systems than sedentary people, their activity makes them prone to injuries that people who are inactive rarely encounter.

While sedentary adults are prone to hip fractures because they have fragile bones and tend to carry themselves unsteadily, men and women who are active are more likely to injure their coccyx, or tail-bone, which can be extremely painful. A swift kick in the rear by a playful son, daughter, or grandchild may cause a severe pain accompanied by a loud crack. A patient of mine had a chair pulled out on him in jest, which, of course, is a common trick. He heard a crack, felt a sharp pain, and had a severe ache in his tailbone for at least two months.

Treatment

If you’ve injured your tailbone in a fall, its discomfort will cause a limitation in your activity, which is necessary to the healing process. You’ll probably find that sitting is altogether too uncomfortable or that only one position is possible.

Aspirin or acetaminophen will help ease your discomfort as the tail-bone heals. If, however, you have a sharp pain in the bone that doesn’t subside within a few days, it’s important that you see your doctor; you may have fractured or cracked your tailbone, and medical attention is necessary. Your doctor will prescribe a nonsteroidal medication such as Motrin and may suggest bed rest of a few weeks or more.

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Description and Possible Medical Problems

Some people occasionally have trouble swallowing food or water. Usually it’s due to nervousness or anxiety, and it tends to clear up as soon as they calm down a bit. Others, however, may find that one minute they have difficulty swallowing and the next this problem either improves or worsens.

If you’re experiencing these symptoms, you may have a rare condition known as myasthenia gravis. Though it is an uncommon disease, many people are aware of it because of its striking, often fickle characteristics. Besides trouble swallowing and chewing, other symptoms of myasthenia gravis include muscle weakness, most often in the face and neck and later in the rest of the body. Your entire body might also become progressively weaker as you chew.

Women are affected more often than men by this disorder, which is caused by an immune system imbalance that affects the nervous system. In effect, the body actually experiences a series of electrical short circuits, which cause it to be fine one minute but weak the next. The thymus, a gland in the chest that helps regulate the immune system, is responsible for the development of myasthenia gravis in approximately 20% of the people who have the condition. In the other 80%, the cause is unknown.

Treatment

Myasthenia gravis cannot be cured, but the disease can be regulated with rest, improved diet, and medication, such as Tensilon or the corticosteroid prednisone, which may help stimulate your immune system. If your doctor determines that your myasthenia gravis is due to a malfunctioning thymus gland, he may recommend an operation to surgically remove the gland; after the procedure, your health will remain stable. Keep in mind, however, that myasthenia gravis is a rare disease. In fact, I have seen only three cases of the disease in all my years of practice.

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