Diseases & Conditions Archive

On call

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Q. I have recently been hearing a lot about getting tested for hepatitis C. I don't think I have any risk factors, but is this something I should consider?

A. Hepatitis C is a viral disease that causes inflammation of the liver. The CDC reports that 75% of all current cases of hepatitis C are in the baby boomer generation and many more are undiagnosed. The reason is that a vast majority of people have no symptoms, such as fatigue, muscle and joint pain, abdominal pain, and nausea.

One of the most dangerous and distressing symptoms of Alzheimer's is wandering. It may seem unfathomable that a person might suddenly get up at night to go to the post office or leave home at any hour for no apparent reason. But wandering may be prompted by deep-seated memories of work, chores, or hobbies, or a longing to return to a former home.

The inability to control wandering is what often drives families to decide to place a loved one in a nursing home. However, there are some simple measures to prevent wandering that often work well for a time and can even help postpone that difficult decision.

Q: I have strong hand cramps that curl my fingers into a claw shape. I can only straighten them by using my other hand. What can I do to keep this from happening? 

A: What you describe sounds like carpal spasm. Spasms, or cramps, are involuntary muscle contractions. The most common causes of spasms are overused muscles (in the hands that might be due to writing or typing) and dehydration. Other causes of muscle cramping include low levels of calcium and magnesium.

Ask the doctors

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Q. I was recently diagnosed with eczema. Is this condition treatable without the use of steroids? I'd like to avoid using them if I can.

A. Eczema, also known as atopic dermatitis, is a chronic inflammatory skin condition. Some people with eczema have mild dryness or itchiness, while others experience more severe symptoms, such a scaly rash or skin that cracks and oozes. Eczema is more common in childhood, affecting up to 20% of children, but it also affects adults. The good news is it's not contagious, and in some cases, it's possible to manage the condition without using steroids.

Ask the doctor

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Q. I'm an 87-year-old man. Over the past year I've lost considerable weight, and I didn't have that much to lose. My doctor can't find any reason for my weight loss and is advising me to eat ice cream. But isn't that risky for my heart?

A. I smiled when I read your letter, because I've occasionally said that if I were to develop a terminal condition, the silver lining on that cloud would be that I could finally eat all the hot fudge sundaes I wanted.

On call

Q. There has been a lot of talk about the severity of this flu season, and I recently heard that influenza also can trigger a heart attack. Should I worry?

A. Influenza is responsible for about 10,000 to 20,000 annual deaths, mostly from pneumonia or internal organ failure. In other situations, influenza infection strains a person's health, which can worsen underlying conditions, such as heart disease.

News briefs

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Exercise is considered the most effective pill-free treatment to cope with the pain and stiffness of arthritis. And more people are getting advice from their health care providers about how to stay active, according to a study published online Jan. 5, 2018, by the CDC's Morbidity and Mortality Weekly Report. Researchers looked at national health surveys gathered from 2002 to 2014. In that period, there was an increase in the proportion of people with arthritis (osteoarthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia) who said their clinician suggested physical activity to help reduce symptoms — from 52% in 2002 to about 60% in 2014. But by 2014, about 40% of arthritis sufferers still said they weren't getting exercise counseling. That's significant, considering that 91 million people ages 18 or older are affected by arthritis, according to a study published online Nov. 27, 2017, by Arthritis & Rheumatology. You don't have to wait for a doctor to suggest exercise as an arthritis treatment. Try something gentle, like walking, tai chi, or modified yoga. For more ideas, check out the Harvard Special Health Report The Joint Pain Relief Workout (www.health.harvard.edu/jprw).

In the journals

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Migraine sufferers may be able to prevent future attacks with a new medication called galcanezumab, suggests a study published online Dec. 18, 2017, by JAMA Neurology. Currently, there are five FDA-approved drugs for migraines, but none were designed specifically for treating attacks or addressing the mechanisms at work.

In comparison, galcanezumab works to suppress the activity of calcitonin gene–related peptide (CGRP) in people. That molecule is believed to play an integral role in migraines and cluster headaches.

Ask the doctor

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Q. My doctor said I "almost" have an underactive thyroid, which puzzled me. Then she said I might benefit from treatment, which puzzled me more. How can you "almost" have a disease, and how can treatment be useful if you don't have the disease?

A. I can see how that might have been confusing. In fairness, it's a confusing situation, even for doctors. Let's take this in two parts. First, what's an "underactive thyroid"? The thyroid gland in our neck makes a hormone, called thyroid hormone, that travels throughout the body and affects every cell. If it is making the right amount of the hormone — if the blood levels are normal — then there's no problem. If it's making too much (an overactive thyroid), or if it's making too little (an underactive thyroid), those are problems that require treatment.