Dear Dr. Roach: I am a 62-year-old male. I have what I would call “megafloaters” in both eyes. I see spots, squiggly lines and other assorted debris in my field of vision. After two thorough examinations by two different doctors, I was told to live with the condition, as the treatment is complex. I understand that it is caused by the breakdown of the vitreous fluid. I am to notify the doctor if I start seeing “flashing lights,” as that would indicate a detached retina. I have worn glasses since childhood and have astigmatism, and my vision has not changed much in the past two years. The floaters are only an annoyance, yet the condition seems to be worsening quickly. The only medication I take is tamsulosin. I would appreciate your input. — R.S.
Answer: I completely agree with your doctors’ assessments. I would add only that it is the breakdown of cells into the vitreous, not a breakdown of the fluid itself. I have written a few times about floaters and have done a fair bit of research on them, and have spoken to an ophthalmologist also. Unless it is adversely affecting your vision, I believe the cure is worse than the disease.
Dear Dr. Roach: I am a 74-year-old female in good health. What particular exams should I have yearly? I take no meds, am arthritic and a nonsmoker, and I do not drink. I am a gym client — I do free weights and 30 minutes of aerobic activity five days a week. —D.F.L.
Answer: You are fortunate to be in such excellent health, and I am sure your exercise and lack of smoking have a lot to do with it. The screening tests recommended for a 74-year-old include a mammogram every year or two; a bone mineral density test if you haven’t had one, with a follow-up based on the results, a blood pressure screen every visit; and a colonoscopy every 10 years (more frequently if you have had abnormal results).
However, while you are with your doctor or other provider, it’s worth a discussion of whether you should consider the following: aspirin daily; a cholesterol check; and screening for STDs. These are recommended for some but not all women, depending on your individual situation. Also, a careful provider will talk to you about risk for depression and falls, as well as a discussion about diet and exercise (which you seem to be doing very well on). There are other tests applicable to people with certain risk factors.
These recommendations are from the U.S. Preventive Services Task Force, and are available for everyone on the Web at www.ahrq.gov, or via a nifty smartphone app that is perfect for busy primary-care docs.
Dear Dr. Roach: I have HPV. My husband gave it to me. He has visible warts. We are both 68 years old. My gynecologist said that the body heals itself and just to hate my husband for this. I know that it causes cervical cancer. Will this go away, and are there different degrees of this STD? I am disgusted and feel dirty. I want to change doctors because I am so embarrassed by this situation. What can I do? — I.M.
Answer: Your gynecologist has seen this before and isn’t embarrassed, so you shouldn’t be either. Most genital warts do go away by themselves. If they don’t, they can be treated by several methods. Only some types of genital warts increase a woman’s risk of cervical cancer, and your gynecologist may choose to find out if you carry a high-risk type in order to give you all your options.
READERS: Recurring vaginal infections are often troubling to women. The booklet on that topic explains them and their treatment. Readers can order a copy by writing: Dr. Roach —No. 1203, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6. Can. with the recipient’s printed name and address. Please allow four weeks for delivery.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible.