Hot flashes can last into the 70sPublished 10:28am Wednesday, October 31, 2012
DEAR DR. DONOHUE: Will you please tell me if there is something I can take to get rid of hot flashes? I am 74 and have them all the time. I sweat terribly. I have tried Estrace (female hormone), Estroblend (a dietary supplement) and black cohosh (an herbal remedy).
ANSWER: It’s said that 8 percent of women still have hot flashes into their 70s. Most women get over them in six months to five years after menopause. The drop in estrogen production that occurs with menopause affects a part of the brain that regulates body temperature. The brain’s thermostat is thrown out of whack, and the result is spells of sudden, uncomfortable warming with sweating.
Let me give you the usual recommendations made for control of hot flashes. I’m pretty sure you must have tried them after more than 20 years of putting up with flashes. Dress in layers so that outer garments can be shed at the first inkling of a hot flash. That can keep it from becoming a full-blown one. Keep ice water on hand and drink it at the start of a flash. Cut back on caffeine. Slow, deep breathing at the onset of a flash is said to minimize it.
Estrogen, which you have tried, is the most effective treatment for flashes. It should be taken in as low a dose as possible for the shortest time possible. Maybe a different estrogen preparation would work for you.
Effexor and Lexapro, two antidepressants, have met with success in suppressing hot flashes for some women. Here they are not used for their antidepressant action. It’s an example of medicines that have more than one function. Neurontin (gabapentin) is a seizure-control medicine that is also used for control of hot flashes.
Hot flashes that have lasted as long as yours call for a consideration of conditions other than estrogen deprivation. An overactive thyroid gland, a hidden infection and two unusual tumors — carcinoid and pheochromocytoma — are examples of illnesses that produce symptoms similar to a hot flash.
DEAR DR. DONOHUE: I am 84 years old. Recently I had a CT scan of my abdomen. It revealed multiple diverticula in the sigmoid colon. Will you please explain diverticulitis to me, and what I can expect from it?
ANSWER: You don’t have diverticulitis. You have diverticulosis — small, pea-size protrusions of the colon lining on the outer surface of the colon. Between 50 percent and 80 percent of people your age have the same condition. Diverticulosis almost never causes pain. It hasn’t caused any trouble in your past. It’s most unlikely to cause you any trouble in the future.
Fiber stops diverticula from forming. Make sure you’re getting 25-30 grams of it every day.
Diverticulitis is inflammation of diverticula. It happens to only a few people with diverticulosis. Fiber also will prevent inflammation from developing.
The booklet on diverticulosis explains this common malady in detail. To order a copy, write: Dr. Donohue — No. 502W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: My entire family has lice. I am starting a support group for families who have had to experience this awful invasion of their scalps. I have reached the breaking point. Give me a plan for treatment and a timetable for their eradication from our home.
ANSWER: One of nature’s smallest creatures, the head louse upsets domestic tranquility with more revulsion than most health-endangering illnesses. Head lice bring no disease with them. They are tiny, only 3 millimeters (1/10 inch) in length. They feed on blood and die within a day or two off the scalp. After feeding, lice have a reddish-brown hue. The mother louse glues louse eggs to hair, and those structures are called nits. They are only 1 millimeter (4/100 inch) long. The eggs hatch in six to 10 days. If nits are more than a quarter of an inch from the scalp, the baby louse has already hatched, and the nit is no longer a problem. In an average life span of three months, the mother louse can lay up to 300 eggs.
Lice are not an indication of poor hygiene. Most of the time, they’re introduced into a family by a child who caught them at school. They can infest other family members quickly. Transmission comes from direct contact with an infested individual and, less often, from contact with inanimate objects used by that individual, like hats, combs, brushes and bedding. You’re not alone. Six to 12 million Americans come down with head lice yearly.
Almost all people with head lice have intense scalp itching. A number of methods effectively rid you of the problem. The first medicines used are permethrin (Nix) or pyrethrins (Rid), which are cheap and usually effective, although lice are becoming resistant to them in some locations. A second treatment is given seven to 10 days after the first. Ovide (malathion) is used if lice linger after Nix or Rid. And should Ovide not work, the oral medicine Stromectol (ivermectin) is available. A new medicine is Natroba (spinosad) suspension. It is held in reserve as a last resort. This nightmare should be over in two to three weeks.
DEAR DR. DONOHUE: My husband was told he had prostate cancer in 2010 and had his prostate removed. Now his doctor wants him to have PSA testing. He says he might need radiation because he has prostate cancer. If he has no prostate gland, how can he have prostate cancer?
ANSWER: The doctor wants to be sure that cancer cells did not spread from to other body sites. Even though the gland was completely removed, not all the potential sites for cancer spread were removed. That’s all but impossible to do. The PSA test will show if prostate cancer is active in those other places. If it is, then further treatment is required.
The booklet on the prostate gland discusses the PSA test and prostate cancer in detail. Readers can order a copy by writing: Dr. Donohue — No. 1001W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.