Patient with risk of breast cancer questions safety of yearly MRI
DEAR DR. ROACH: Due to a slight genetic risk of breast cancer (my Tyrer-Cuzick Model score was 20.6%), my doctor wants me to get breast MRIs with contrast annually. I am concerned about long-term exposure to the gadolinium-based contrast dye. I've learned that this heavy metal is considered safe, but traces of it can be stored in the brain and ...Read more
Diabetes meds questioned due to insulin resistance and weight
DEAR DR. ROACH: My husband is an over-the-road truck driver, and he is 68. He has been on metformin for a long time, and I have been reading that this medicine does not help bring down blood sugar. He is also using human insulin two times a day.
What I want to know is if there's a better medication for him to take? I think he is gaining weight ...Read more
Daily back or hip pain calls for higher dose of meds or surgery
DEAR DR. ROACH: I have a degenerating L5-S1 disc as well as osteoarthritis in my left hip, and both are bone on bone. I will eventually need a hip replacement and possibly back surgery, but I'm trying to prolong anything until I get on Medicare in eight months. I stay as active as I can by walking my dog, exercising (weights and biking), and ...Read more
Does radon gas present dangers in the air quality of homes?
DEAR DR. ROACH: I would like your thoughts as to the danger that high levels of radon gas pose to owners and residents of a first-floor condominium. We reside in a condo located on a golf course in Naples, Florida. As a result of my work as a realtor, the sale of homes and condos typically require inspections for various issues, including radon ...Read more
Salt substition can provide benefits to people at any risk level
DEAR DR. ROACH: In a recent column, you said that using salt substitutes can reduce blood pressure and that, across a population, this would result in far fewer heart attacks and strokes.
While lowering blood pressure would have that effect, my understanding is that there is no significant research showing benefits from lowering salt intake in ...Read more
Cipro prescription is no longer the first-line treatment for UTIs
DEAR DR. ROACH: I was diagnosed with a UTI on my yearly physical urinalysis, but had no symptoms. I was prescribed Cipro. The five pages of warnings attached to the prescription scared me! So, I checked the FDA and Mayo Clinic websites. Both said that the "risks outweigh benefits" and it "should not be first choice to treat UTI." But my doctor ...Read more
The risks and benefits of taking tamoxifen must be weighed out
DEAR DR. ROACH: I had been on hormone replacement therapy for 20 years or so and was diagnosed with breast cancer last year. I had a lumpectomy (stage 1) and radiation (external, five days a week for 21 treatments). Now, the oncologist is saying I need to start taking tamoxifen indefinitely. I have read online that it can cause memory loss, ...Read more
Two tests for diabetes come back with inconsistent results
DEAR DR ROACH: I am a 74-year-old Chinese man with controlled hypertension, and I'm currently taking a statin at 10 mg. I am puzzled and confused with my recent tests results. They show that my fasting plasma glucose is normal (5 mmol/L), while my HbA1c shows that I fall in the "prediabetic" category at 6.3% (45 mmol/L).
Why the inconsistency ...Read more
Loss of taste and smell from virus still lingers three years later
DEAR DR. ROACH: I'm an 82-year-old, very healthy woman. In February 2020, just as the COVID-19 pandemic was starting to appear in North America, I had a viral infection that was relatively mild (a bit of coughing, runny nose, itchy throat) and lasted for a few days only, although I felt tired for a bit longer. One unusual symptom was that I lost...Read more
Why certain virus variants are more contagious than others
DEAR DR. ROACH: The newest COVID variant is reputed to be less deadly but highly contagious. What precisely makes one virus variant more contagious than another virus variant? Is it structure, size? -- S.
ANSWER: It's not size, because all coronaviruses are just about the same size. It is certainly the structure, but a virus has several ...Read more
Complex jargon prevents patient from understanding diagnosis
DEAR DR. ROACH: After many bouts of pain in my left leg, I was referred for an MRI. They diagnosed me with left lumbar radiculitis, spondylolisthesis and lumbar spondylosis. There are many people in my independent living facility who have gotten similar diagnoses. As an RN with a masters in nursing education, I have a question: When the ...Read more
Conservative treatment suggested for cubital tunnel syndrome
DEAR DR. ROACH: My left elbow has been bothering me for eight years. When I bump it, there is a terrible pain, like an electric shock. The pain only lasts for about 10 seconds; however, it happens all the time. Even if I am wearing a heavy winter coat, the slightest bump disables me for 10 seconds or so.
A couple of years ago, I noticed a bump ...Read more
The only way to reverse Type 2 diabetes is to get control of it
DEAR DR. ROACH: Any suggestions on how to reverse Type 2 diabetes? -- C.B.
ANSWER: Strictly speaking, once you have diabetes, you always have diabetes, as the diagnosis is considered "stable," or lifelong. However, many people can get diabetes under control without medications so that the blood sugar is always in the normal range, which is ...Read more
Figuring out the cause behind constantly feeling cold
DEAR DR. ROACH: My wife, 68, always feels cold. She has mentioned this several times to her primary care physician, and the physician checks her blood to see if an increase in thyroid medication is warranted. The reading always comes back in the normal range, and the problem is not mentioned again until the next appointment. Meanwhile, my wife ...Read more
Not getting enough iodine is rarely a concern in the U.S.
DEAR DR. ROACH: I notice that the specialty salts I now buy, such as Himalayan or sea salt, are not iodized. Should I be concerned about getting enough iodine in my diet? -- P.M.
ANSWER: Iodine is necessary to make the thyroid hormones. In the United States, the areas with the least iodine are the Great Lakes, Appalachians and Pacific Northwest...Read more
Case of hot flashes has yet to be resolved, despite therapy
DEAR DR. ROACH: I am 78 years old. I had a hysterectomy in 1976 due to excessive vaginal bleeding, but I still have my ovaries. I have had hot flashes since undergoing menopause -- they usually last three to five minutes, and I have them about every two hours around the clock (which obviously interferes with my sleep).
Over the last 28 years, I...Read more
Can melatonin provide benefits to those with Parkinson's?
DEAR DR. ROACH: I am an 84-year-old woman. Unfortunately, I have been diagnosed with Parkinson's disease this past month. (Of course, I am mightily researching now.)
A friend of ours, who has had Parkinson's for six years, is very much impressed with melatonin. Have you heard the same?
Even if it turns out that it is not all helpful for ...Read more
Patient with high PSA score refused by urologist due to age
DEAR DR. ROACH: I'm writing to you about an elderly patient who is currently 96 years old. For the last three years, his PSA score for his prostate has hovered around 30 ng/ml. He initially received an ultrasound and was determined that the prostate looked normal, despite the high PSA score. The general physician, under the following ...Read more
Shingles complication might require different drug combos
DEAR DR. ROACH: Is there anything that I can do for pain after having shingles? I had shingles 18 months ago, and I still have pain on my right side in my breast and arm. I took gabapentin, plus two other prescriptions, and they all upset my stomach so bad that I had to quit. I have used lidocaine patches, but they help very little.
Some days, ...Read more
Supplements over statins not recommended for cholesterol
DEAR DR. ROACH: I am a 71-year-old female in good health who is quite physically active. I have been taking red yeast rice with CoQ10 to help with my cholesterol levels. (My son-in-law, who is a chiropractor and pretty knowledgeable about supplements, suggested this to me.) My cholesterol levels are still somewhat high, but my doctor has not ...Read more