Diseases & Conditions Archive

Q. I've tried a lot of things for a fungal infection in one of my toenails, but it just won't go away. What do you know about laser treatment for toenail fungus?

A. Two lasers using different types of laser energy have attracted attention as treatments for fungal infection of the toenails, a condition called onychomycosis (pronounced oh-nee-koh-my-KOH-sis), which can also affect the fingernails. The theory is that a precisely directed laser can eliminate the fungus without harming the surrounding nail tissue. The underlying technologies are already in use for other conditions, including cataract surgery, dental work, and hair removal. Although there is some laboratory evidence that lasers can squelch fungal organisms, clinical studies in humans thus far are limited.

Heart and lung issues are often to blame for breathlessness. But an accurate diagnosis may require advanced testing.

Like your heartbeat, the regular inhale and exhale of your breathing is something you usually don't notice — until something doesn't feel quite right. Shortness of breath can result from a range of problems, including an allergic reaction, an anxiety attack, or anemia. But most often, the underlying cause is a heart or lung condition.

"Because these two organ systems are so intertwined, one always affects the other," says Dr. Aaron B. Waxman, who directs the Pulmonary Vascular Disease Program at Harvard-affiliated Brigham and Women's Hospital. In fact, about 60% of people with heart disease also have a lung disease. As a result, it's not always easy to distinguish cardiac and pulmonary issues, he says.

On call

Q. I've had a salty taste in my mouth for the past few months. Is there anything I can do about it?

A. The salty taste could be due to your taste buds becoming more salt sensitive (often a medication side effect), or a higher concentration of salt in your saliva, which can happen if you get dehydrated. Other causes of a salty taste could include

The condition causes leg pain and fatigue that make activity difficult, but lifestyle changes can improve how you feel.

The occasional leg pain or stiffness is often not cause for concern, but if pain or fatigue develops after just a few minutes of walking or climbing stairs, it could be an early sign of peripheral artery disease (PAD).

"PAD not only interferes with an active lifestyle, but also can put you at higher risk for a heart attack and stroke," says Dr. Michael Belkin, chief of the Division of Vascular and Endovascular Surgery with Harvard-affiliated Brigham and Women's Hospital. "You can't cure PAD once it occurs, so you want to take measures to avoid it as much as possible."

Here's how to protect yourself from this growing tick-borne disease.

Summer is the ideal time to enjoy the outdoors, but while you're interacting with nature, you need to look out for ticks that carry Lyme disease, the most common tick-borne disease in the United States.

About 300,000 people are diagnosed with Lyme disease each year, according to the CDC, and new research suggests that number will rise by 20% by mid-century.

Proper eye care can limit vision loss from most glaucoma — and prevent one of its most serious forms.

Glaucoma is a group of eye diseases that cause vision loss and blindness through damage to the optic nerve. Several factors contribute to its development, but the main culprit is elevated intraocular pressure, that is, pressure within the eye.

Theoretically, glaucoma can be managed and vision loss prevented or minimized with early detection and medical treatment to control intraocular pressure. But the most common form, called open-angle glaucoma, progresses so slowly and subtly that symptoms, such as blind spots and reduced peripheral vision, may go unnoticed until the disease has advanced and vision loss is inevitable.

Infections from a drug-resistant fungus have been occurring around the world for the past decade. It's not cause for panic, but it's wise to understand the facts and ways to protect yourself.

Ask the doctor

Q. I think I have heartburn, but I hear that what feels like heartburn is sometimes a more serious condition. How do I know if I have heartburn?

A. You've asked an important question. "Heartburn" describes symptoms caused by the reflux of stomach acid up into the esophagus (the tube that carries food from the mouth down to the stomach). It is a burning sensation. You can feel it high in the abdomen, just below the bottom of the breastbone, or underneath the middle of the breastbone in the chest. In other words, despite the word "heart" in the word "heartburn," real heartburn comes not from the heart, but from the stomach and esophagus.

Arthritis, bunions, and gout can be disabling. Here are common fixes to stay mobile.

Aching hips, knees, and shoulders are common, and over time can lead to immobility. But so can an aching big toe. The joint at the base of the big toe — called the metatarsophalangeal or MTP joint — is the part of the toe that is affected.

What's the MTP joint?

The MTP joint connects the first long bone (metatarsal) in the forefoot to the first bone of the big toe (phalanx). The joint bends with every step you take, so that you can push off and let the other leg move forward. But the MTP joint takes a beating during that process: for a brief moment as you push off, the MTP joint supports half of your body weight.

On call

Q. After I have a bowel movement I sometimes get quite weak and have to lie down until the feeling passes. Why does this happen and is it cause for concern?

A. The sensation you are describing is most likely due to a reflex called a "vasovagal reaction." Here's what I mean.