The Clinton Herald, Clinton, Iowa

Food & Health

November 18, 2013

Cut the nerve end, end the pain?

CLINTON — DEAR DR. ROACH: I am 85 and in fairly good health, but I am in my ninth year of extremely painful post-herpetic neuralgia. Instead of diminishing, the pain is increasing. It could be that the gabapentin (600 mg, three times daily) is wearing off. I tried Lyrica, but stopped when it hurt my eyes. The pain can be excruciating, even from the touch of a shirt. A relative suggested cutting the affected nerve. What would you recommend? — F.S.

ANSWER: Post-herpetic neuralgia is a syndrome of pain due to inflammation of the nerves after an infection with herpes zoster. The older you are, the more likely you are to get this complication, and the longer the pain tends to last — but nine years is much longer than normal.

Treatment for post-herpetic neuralgia is often with several medications. Gabapentin (Neurontin) is one, but the effective dose is sometimes quite high, as high as 1,200 mg three times daily. Many people get very fatigued at that high a dose. A much older medication, nortriptylene, is more effective in some people and may be worth a try.

Capsaicin cream provides relief for many people, although it can cause some burning when first applied. I recommend starting with the regular, not high-potency, strength.

Unfortunately, surgery — at any level, from the end of the nerve to the brain — has not been consistently effective and carries the risk of permanent nerve damage. Fortunately, this complication can be largely prevented with the use of the shingles vaccine, which most people over 60 should get, even if they have had shingles before.

DEAR DR. ROACH: My friend had skin cancer on her nose, and her doctor treated it by cutting it off. My friend said she has had many, and her doctor always cuts them off. I had skin cancer about 20 years ago. My doctor gave me Efudex cream, which worked on my skin cancers, but did nothing to my healthy skin. Why in the world aren’t today’s skin-cancer doctors prescribing Efudex? It’s so great. I think not prescribing it for my friend today is a form of malpractice. What do you think? — D.P.

ANSWER: I don’t have enough information to say what the best treatment is for your friend. For the most common skin cancer, basal cell carcinoma, both surgery and 5-fluorouracil (Efudex) are very effective, around 95 percent effective or more. However, authorities recommend particular care with Efudex around the eyes, lips and nose, and in these cases surgery may be both more effective and better tolerated. If the cancer was a squamous cell cancer, Efudex is sometimes used, but surgery tends to be preferred.

I would be very circumspect in using the term “malpractice.” In a situation where there are two very effective treatments, either one is reasonable, and there may be factors you and I don’t know about that her dermatologist or surgeon does.

DEAR DR. ROACH: Would someone who has a gluten intolerance be able to use psyllium products (Metamucil) without any problems? What I really want to know is, does psyllium have gluten, since it comes from wheat husks? Thank you for your answer. — S.S.

ANSWER: Psyllium is gluten-free. It is made from the husks of the Plantago plant, not wheat. Psyllium is an excellent source of fiber, but should be started at a low dose and gradually increased to avoid bloating.

 

1
Text Only
Food & Health
  • Health insurers owe Iowans nearly $1.8M in refunds

    The federal government says insurers owe Iowans nearly $1.8 million in refunds because of a provision in the Affordable Care Act.

    July 24, 2014

  • Agents get subsidized 'Obamacare' using fake IDs WASHINGTON (AP) — Undercover investigators using fake identities were able to secure taxpayer-subsidized health insurance under President Barack Obama’s health care law, congressional investigators said Wednesday.The weak link seemed to be call cente

    July 24, 2014

  • Almost half of America's obese youth don't know they're obese

    The good news is that after decades of furious growth, obesity rates finally seem to be leveling off in the U.S.. The bad news is that America's youth still appear to be dangerously unaware of the problem.

    July 23, 2014

  • Illinois patients to docs: 'What about marijuana?'

    Illinois doctors, nursing homes, hospitals and hospice organizations are ramping up for their role as gatekeepers in the state's new medical marijuana program.

    July 23, 2014

  • Amanda Stecker Herbs make a better way to flavor meals Summer is a season full of fresh herbs. This is the best time of year to take advantage of the fresh herbs in the grocery store. Herbs add a boost of flavor without added sodium and are rich in antioxidants. Herbs are easy to incorporate into everyda

    July 23, 2014 1 Photo

  • Genome Genetic mapping triggers new hope on schizophrenia WASHINGTON, D.C. — Scientists have linked more than 100 spots in our DNA to the risk of developing schizophrenia, casting light on the mystery of what makes the disease tick.Such work could eventually point to new treatments, although they are many y

    July 23, 2014 1 Photo

  • An oncologist uses scorpion venom to locate cancer cells

    Olson, a pediatric oncologist and research scientist in Seattle, has developed a compound he calls Tumor Paint. When injected into a cancer patient, it seems to light up all the malignant cells so surgeons can easily locate and excise them.

    July 22, 2014

  • Obamacare hit by ruling, but subsidies to continue

    A federal appeals court delivered a potentially serious setback to President Barack Obama's health care law Tuesday, imperiling billions of dollars in subsidies for many low- and middle-income people who bought policies.

    July 22, 2014

  • Bice Nurses earn Daisy awards

    CLINTON — Two Clinton nurses recently earned Daisy awards.Mercy Medical Center nurses Jodie Atkinson and Kristen Bice earned the awards that is rewarded to extraordinary nurses. Atkinson began her career in nursing at Mercy Medical Center in 1995 on

    July 22, 2014 2 Photos

  • Hospitals let patients schedule ER visits

    Three times within a week, 34-year-old Michael Granillo went to the emergency room at Northridge Hospital Medical Center in Los Angeles because of intense back pain. Each time, Granillo, who didn't have insurance, stayed for less than an hour before leaving without being seen by a doctor.

    July 21, 2014

Parade
Magazine

Click HERE to read all your Parade favorites including Hollywood Wire, Celebrity interviews and photo galleries, Food recipes and cooking tips, Games and lots more.