Q: What is HPV-related throat cancer and why is it relevant to me?
A: Within the past decade, head and neck cancer linked to the Human Papilloma Virus (HPV) is becoming increasingly prevalent. HPV is a common viral infection that resides within epithelial cells of the skin and the oral mucosa lining. It frequently remains present in these cells for an extended period of time without producing symptoms. In the past we have associated throat cancer primarily with smoking and alcohol consumption. It is now becoming more common for HPV-positive throat cancer to present in a younger, non-smoking patient population. While it is encouraging that HPV-related head and neck cancers seem to be more responsive to treatment, it is also imperative to thoroughly evaluate head and neck symptoms in this new patient subset. In addition to this, the Centers for Disease Control and Prevention now recommends that boys and girls between ages of 11 and 12 receive the HPV vaccine in order to prevent future development of HPV-related throat cancer.
Q: Do I need a referral to see a chiropractor?
A: No, you do not. You may begin care directly with a chiropractor by simply calling and scheduling an appointment. Most people need immediate care, so the wait time for a new patient appointment is usually very short. Patients are often referred by their orthopedist, neurologist, or primary care physician. Likewise, most chiropractors refer to various medical doctors when the need arises. Insurance coverage varies and is confusing; their requirements may be different. Any doctor — medical or chiropractic — can be either in-network or out-of-network with the different insurance providers, so actual coverage is determined by a lot of different factors. When searching for a chiropractor, ask about complimentary consultations to help answer these questions and determine need and scope of care.
Q: What is refractive surgery?
A: Refractive surgery, also known as LASIK or PRK, is a laser procedure used to correct nearsightedness, farsightedness, and astigmatism. In the procedure, a laser is used to reshape the cornea — the clear, round dome at the front of the eye — to improve the way the eye focuses light rays onto the retina at the back of the eye. More than 90 percent of people who have refractive surgery perform most of their everyday tasks without glasses or contact lenses. Your doctor will consider your vision needs for work and leisure activities to determine if refractive surgery is right for you. Some patients may need a second enhancement surgery or might need to wear glasses for certain activities, such as reading or driving at night. Refractive surgery cannot correct presbyopia, the age-related loss of closeup focusing power, so you may still need reading glasses after the procedure.
Q: When is it more than fatigue?
A: Fatigue is a problem that often brings people to Doctors Care. Sometimes they just need some common-sense reminders: Get eight hours’ sleep, eat sensibly from the four basic food groups, exercise three to five days a week, and keep weight under control. But sometimes fatigue is a sign of serious disease. It makes sense to consider the most common causes of fatigue first, along with taking a medical history and doing a physical exam. Lab tests may be the next step. It’s a good idea to request a complete blood count (CBC) and blood glucose test, along with checking the thyroid stimulating hormone (TSH) level. A teenaged patient might be tested for mononucleosis. Test results may suggest whether a patient has an infection, anemia, diabetes, cancer or thyroid disease — any of which can cause fatigue. Obviously, fatigue might indicate a serious condition for which patients need specialized care. Some additional possibilities are substance abuse, depression, sleep apnea, chronic fatigue syndrome, and fibromyalgia. In any case, a careful exam can be the first step toward treatment and recovery.
Q: What is the most worthwhile, yet conservative, procedure to minimize signs of facial aging?
A: While Botox and dermal fillers are powerful adjuncts to address multiple signs of facial aging, one of the most important areas to consider for a refreshed, well-rested look is the eyes. Blepharoplasty surgery, which is a relatively quick, outpatient surgical procedure with minimal downtime (three to four days), rejuvenates the eyes and surrounding periorbital region in a way that everyone will notice, but no one will know. As the focal point of the face, the eyes are a fascinating feature but are often one of the first areas to reveal signs of aging. A successful procedure to freshen the face is blepharoplasty, or eyelid surgery, as it instantly revitalizes the face and restores the eyes without giving away your secret.
Q: If you’ve been treated for herniated disc, sciatica, spinal stenosis, or degenerative disc disease with no relief, what is another possible cause of the discomfort?
A: While there are several possible causes for ongoing pain, you could be suffering from sacroiliac joint or “SI Joint” dysfunction. The SI joint is located between the sacrum and the ilium bones of the pelvis. Improper movement of this joint can cause significant discomfort in the lower back and legs. This disorder mimics several other conditions of the lumbar spine, which can contribute to misdiagnosis and continued discomfort. While sacroiliitis and SI joint dysfunction are ideally treated in a non-operative fashion, minimally invasive sacroiliac joint fusion may be an optimal alternative for select individuals whose pain lasts more than six months. This procedure stabilizes the SI joint, thereby minimizing and often eliminating pain.
Q: If I have a strong family history of breast cancer, what can I do to protect myself?
A: Early detection and cure, not prevention, are your best options. Family history is important, but it is only one of several risk factors. Ask your doctor and consider genetic testing. It is reliable and a one-time cost, typically less than $500. Even with a strong family history, you may not have a high risk gene. Knowing the odds allows better winning choices. Improve the odds for early detection and cure with annual checkups and screening mammograms every year, beginning at age 40. Get 3D (digital breast tomograms) mammograms if you have dense breast tissue. If you know you are at high risk for breast cancer, then ask about other high risk screening options.