Ask the Experts" Medical Q&A
Q: I know people who have kidney disease. How can I be checked to see if I am at risk?
A: Kidney disease has several risk factors, such as diabetes and hypertension — the same risk factors for developing “vascular” disease. The kidneys are vascular organs and are prone to damage that causes heart disease and circulation problems. Anyone with these risk factors should be screened annually with simple tests on blood and urine. These are done routinely by primary care physicians. Kidney disease has no symptoms in early stages, and only the screening tests can catch the damage. Once identified, there are steps taken to slow progression. If the damage is not controlled, then referral to a nephrologist can assist with educating and helping control the factors which cause kidney disease. Hypertension especially is known to accelerate many underlying vascular problems. Nephrologists are specialists who diagnose and treat resistant hypertension.
Niall McLaughlin, MD
Columbia Nephrology Associates, PA
Q: Why should I be concerned about sugar?
A: Eaten in excess, sugar is a chronic, dose-dependent hepatotoxin. In addition to damaging the liver, excessive sugar can worsen coronary artery disease, hypertension, and cholesterol levels. Consuming foods high in sugar increases the risk of Alzheimer’s disease, depletes multiple B vitamins, and increases uric acid levels. High sugar foods disrupt the hunger/satiety hormones causing continued hunger after eating. The American Heart Association recommends males eat less than 9 teaspoons (36gm) of sugar per day and less than 6 teaspoons (24gm) for females. The 2010 data suggests that Americans consume on average 152 pounds of sugar a person per year, which results in 42.5 teaspoons a day. Some sugar sources are obvious, like candy, soda, and ice cream, but did you know yogurt can contain 5 to 9 teaspoons of sugar? Or that 1 tablespoon of ketchup contains 1 teaspoon of sugar? People concerned about their health should be aware of the sugar added to processed foods and limit their sugar intake.
Dana M. I. Nairn, MD
Three Rivers Medical Associates
Q: Will a septoplasty stop my sinus infections?
A: The nasal septum is the structure that divides the nasal cavity into halves. It is composed of cartilage in the front and bone in the back, covered by a mucus membrane. Seventy to 80 percent of us have a septum that is deviated, partially obstructing one or both nasal passages. Straightening of the septum, called a septoplasty, may be performed as an outpatient surgical procedure to improve the nasal airway. Often the structures on the sidewall of each passage, called turbinates, need to be altered after the septum is placed in a midline position to maximize your breathing. A septoplasty and turbinate reduction are frequently performed together and can greatly increase your ability to breathe through the nose. These procedures will not prevent allergies or upper respiratory infections but will make the accompanying symptoms much less troublesome.
William C. Giles, MD
CENTA Medical Group
Q: Is a chiropractor a real doctor?
A: Yes, a chiropractor is a Doctor of Chiropractic (DC), like a Doctor of Medicine (DMD) or Doctor of Dental Surgery (DDS). Chiropractors have an extensive education that begins with an undergraduate degree in sciences. They then enter a four-year post-graduate program with a minimum of 4,200 hours of classroom, laboratory, and clinical internship at an accredited college. Doctors of Chiropractic must pass rigorous state and national board exams to be licensed to practice, and they must meet yearly continuing education requirements to maintain their licensure. Chiropractors are recognized as expert witnesses in legal trials and as primary care providers, so anyone may choose to see a Doctor of Chiropractic without a referral or prescription. Without using drugs or surgery, chiropractic care can be very effective.
Shelly Jones, DC
Chiropractic Wellness Center, Inc.
Q: Will I need to wear glasses after cataract surgery?
A: Years ago if you had cataract surgery, the natural cloudy lens was removed and there was nothing to replace it. People had to wear very thick eyeglasses or special contact lenses to be able to see clearly after cataract surgery. Now, there is a replacement for the eye’s natural lenses called intraocular lenses (IOLs). There are many factors that determine if you will need to wear glasses after cataract surgery, including the overall health of the eye, the amount of astigmatism, your current eyeglass prescription, and your visual needs. There are several types of lens implants available to help reduce or eliminate your dependence on glasses. Regardless of the type of lens you select, you may still need to rely on glasses some of the time, but if correctly selected, your IOLs can greatly reduce your dependence on glasses. Discuss your options with your ophthalmologist to determine the IOL that best suits your vision needs and lifestyle.
Edward G. Mintz, MD
Columbia Eye Clinic
Q: Are water and air conditioning all I need to help a heatstroke?
A: DIY methods are not enough to treat heatstroke — and all symptoms of heat illnesses should be taken seriously. Signs of heat exhaustion and dehydration range from mild to severe. Mild symptoms can include headache, dizziness, and cramping, while moderate symptoms can include nausea, paleness, dry mouth, and swollen tongue. Severe symptoms include fever above 103 degrees, fainting, and seizures. Symptoms should be treated immediately. A patient might need to have IV fluids administered to prevent dehydration. Without proper attention, heat illnesses can escalate quickly, possibly causing damage to the brain and vital organs, or even death.
Heat-related illnesses — such as edema, cramps, exhaustion, and heatstroke — are extremely common and yet highly preventable. If you plan to be in the heat for prolonged periods, you should take some critical steps to avoid heat illnesses. These steps include: drinking plenty of water, wearing loosely fitted clothing, covering up with hats, umbrellas, etc., and reducing strenuous activities. Stay hydrated, and play it smart outdoors!
Thomas Gibbons, MD
Doctors Care Urgent Care
Q: For children with early onset scoliosis, is there an alternative to the traditional treatment?
A: Yes there is. It’s called The MAGEC System. Early onset scoliosis is a spinal deformity in children under the age of 10. If surgery is required to manage this deformity, the traditional method requires the installation of rods that will be subsequently adjusted through additional surgeries as the child’s spine grows. Like traditional rods, the MAGEC System is designed to manage the progression of spinal deformity, but the real magic is in the external expansion capability. Unlike the traditional approach, once implanted, the MAGEC System requires no surgery for subsequent rod adjustments as it is manipulated externally using magnetic technology. This helps reduce the risk of complication and simplifies care.
Frederick C. Piehl, MD
Midlands Orthopaedics & Neurosurgery, P.A.
Q: What is chronic sinusitis and how should it be treated?
A: Chronic sinusitis lasts more than 12 weeks, and symptoms typically include facial pain, pressure, and nasal drainage. Some people may experience a decreased sense of smell and fatigue. Chronic sinus disease is primarily inflammation rather than infection, which causes swelling of the nasal membranes and tissue lining of the sinus cavities. CT scans are important in the diagnosis of chronic sinusitis, because they help identify which sinuses are inflamed and whether or not there is an anatomic obstruction. CT scans are used in conjunction with an endoscopic nasal exam to help identify factors such as nasal polyps, scar tissue in the nose, a deviated septum, or other tissue abnormalities. Treatment of chronic sinusitis can include a long course of a broad spectrum antibiotic, with intranasal steroids, saline rinses, and even oral steroids.
Anna Bouknight, MD
The Sinus Center of South Carolina
Q: What are my treatment options for chronic pain?
A: There is a spectrum for treatment of chronic pain starting from conservative therapy to aggressive treatment. The least invasive treatment available includes physical therapy and lifestyle modifications. If these options fail, non-opioid medications such as anti-inflammatories and centrally acting medications should be tried. Depending on the source of the pain, if these types of medications are not helpful, procedures such as steroid injections or surgery may be the appropriate next step. Finally, if several options for treatment have failed, opioids may be suitable in specific situations. Caution should be taken with the use of opioids — and the patient should be closely monitored by a physician. If all conservative treatment options have failed, a trial with spinal cord stimulation could be a very good option for many patients before surgery has to be considered.
Jennifer D. Stanislaus, MD
Palmetto Pain Management, LLC
Q: How will physical or occupational therapy help me when I’m in so much pain that I can’t even move?
A: When you are in pain for a long time or you have a sudden episode of pain, your body’s tendency is to avoid movement because it seems that the more you move, the more pain you experience. When you enter this cycle, guarding occurs, which is when your brain actually deters those muscle fibers from contracting. Because guarding causes you to avoid using specific painful joints and muscles, pressure and stress is placed on other joints and muscles. This is considered compensating. The overload placed due to compensation can cause increased inflammation, soreness, tension, and pain. Therefore, the pain cycle continues and the decreased muscle mass (caused by decreased motion) causes low blood flow, increased stiffness, and increased muscle atrophy. The solution to the pain cycle is to move! Physical and occupational therapy can help a person suffering from chronic pain diagnoses, such as fibromyalgia, post-injury pain, or post-surgical pain, to ease into movement in a safe and effective way. PTs and OTs can also offer other modalities to help ease your pain, such as low-level laser, IFC (interferential current), aquatic therapy, or dry needling.
Hima N. Dalal, OTR/L
Vital Energy Wellness and Rehab Center
Q: How often should I have a screening mammogram? Do I need a DBT (Digital Breast Tomosynthesis) or a 3-D Mammogram?
A: The American Cancer Society recommends that women, ages 40 to 44, should have the choice of starting annual screening mammograms, if they desire. The ACS also recommends the following guidelines; women, ages 45 to 54, should receive annual mammograms and women over age 55(+) may receive mammograms bi-annually or annually, depending on their personal history or their preference. All of these decisions should be discussed with your physician and be based on your personal/family history. Also, monthly self-breast examinations are highly recommended so any changes or abnormalities can be addressed in a timely manner.
Digital Breast Tomosynthesis, also referred to as 3-D mammography, is recommended for patients with dense, glandular breast tissue. This type of imaging eliminates superimposed dense breast tissue that might otherwise hide a small breast cancer. Ask your physician about this procedure — it could be a lifesaver!
Tommy Cupples, MD
Womens Care at Image Care, LLC