Diseases & Conditions Archive

The realities of treatment can help relieve hearing loss concerns.

 Image: © Thinkstock

Hearing loss is common in older age. It affects one in three people ages 65 or older, and two out of three people ages 75 or older. The condition leaves people struggling to keep up with conversations or simply hear the phone or TV, which can lead to serious problems. "Hearing loss can make a person less likely to engage with friends and family, which can be associated with depression," says Dr. David Jung, an otologist (ear specialist) with Harvard-affiliated Massachusetts Eye and Ear Infirmary.

Common excuses

Benign Prostatic Hyperplasia (BPH), or Enlarged Prostate

Questions to Discuss With Your Doctor:

• Over the past month, how often have you had a sensation of not emptying your bladder completely after you finished urinating?
• Over the past month, how often have you had to urinate again less than two hours after you finished urinating?
• Over the past month, how often have you found you stopped and started again several times when you urinated?
• Over the past month, how often have you found it difficult to postpone urination?
• Over the past month, how often have you had a weak urinary stream?
• Over the past month, how often have you had to push or strain to begin urination?
• Over the past month, how many times did you most typically get up to urinate from the time you went to bed at night until the time you got up in the morning?
• If you were to spend the rest of your life with your urinary condition just the way it is now, how would you feel about that?
• Have you had blood in your urine, or urinary tract infections?
• Have you ever had surgery on your prostate, bladder, or kidneys?
• Do you have gastrointestinal problems such as diverticulitis or constipation?
• Do you have diabetes?
• Does anyone in your family have diabetes?
• Have you been unusually thirsty or had unintentional weight loss?
• Have you ever had a stroke or nervous system disease?
• Have you ever had a back injury or back surgery?
• What medications are you taking (prescription and over-the-counter)?
• What do you know about medical and surgical treatment options used in the treatment of benign prostatic enlargement?
• Do you know the side effects that can occur with medications?
• Do you know the complications associated with surgery?
• Do you know how much benefit you can expect from each type of treatment?
• Do you know the risks of waiting, and doing nothing at all?

Your Doctor Might Examine the Following Body Structures or Functions:

• Abdominal examination
• Neurological examination
• Digital rectal examination
• Genital examination

Your Doctor Might Order the Following Lab Test or Studies:

• Urinalysis (for glucose, red blood cells, white blood cells, and bacteria)
• Blood tests (for kidney function and prostate-specific antigen or PSA)
• Cystoscopy
• Ultrasound of the bladder after you urinate (post void residual)
• Ultrasound of the kidneys
• Pelvic CT scan

Dysfunctional Uterine Bleeding

Questions to Discuss with Your Doctor:

• Do you have regular menstrual cycles?
• When was your last period?
• Is your bleeding always heavy or prolonged?
• How old were you when you started menstruating?
• How long ago did you develop abnormal bleeding?
• Are you sexually active?
• How many times have you been pregnant?
• What was the outcome of each pregnancy (live births, miscarriages, cesarean sections)?
• Have you ever had difficulty getting pregnant?
• What medications are you taking (including over-the-counter drugs and herbal remedies such as ginseng)?
• Are you taking hormone replacement therapy or birth control pills?
• Have you ever had medications injected (Depo-Provera or Norplant) for birth control?
• Have you ever taken estrogen or tamoxifen?
• Are you taking warfarin or other blood thinners?
• Have you ever had an abnormal Pap smear?

Your Doctor Might Examine the Following Body Structures or Functions:

• Blood pressure, heart rate, weight
• Abdominal examination
• Pelvic exam

Your Doctor Might Order the Following Lab Tests or Studies:

• Pregnancy test
• Blood tests such as complete blood count, coagulation (clotting) studies, and certain hormone tests (such as thyroid stimulating hormone, cortisol, prolactin, follicle stimulating hormone, testosterone)
• Pelvic ultrasound
• Pap smear
• Endometrial biopsy.

Erectile Dysfunction or Impotence

Questions to Discuss with Your Doctor:

• Do you smoke cigarettes?
• Have you been screened for other medical problems such as high cholesterol, high blood pressure, heart disease, and diabetes?
• Do you exercise regularly? How much? How often?
• Do you have a neurologic disease or sickle-cell disease?
• Are you taking any medications (prescription or over-the-counter)?
• Has your erectile dysfunction worsened since starting any new medications?
• What effect is your erectile dysfunction having on your relationship? Your self-esteem?
• How long have you had erectile problems?
• Do you have erectile problems sometimes or all of the time?
• Have you ever had any psychologically stressful sexual experiences?
• Are you less interested in sex (diminished libido)?
• Are you having difficulty achieving an erection or sustaining it?
• Do you ever awaken with early morning or nocturnal erections?
• Do you have pain with erections?
• Penile bumps or lumps?
• History of penile trauma?
• History of pelvic surgery?
• What are your goals in receiving treatment?
• What therapies have you tried?
• Do you know how much benefit you can expect from medical therapies?
• Do you know the side effects and important drug interactions?

Your Doctor Might Examine the Following Body Structures or Functions:

• Genital examination
• Rectal examination
• Pulses in the groin and feet
• Neurologic examination

Your Doctor Might Order the Following Lab Tests or Studies:

• Blood tests (complete blood count or CBC, glucose, cholesterol panels, thyroid function tests, prolactin level)
• Blood testosterone level (if libido is decreased)
• Nocturnal penile tumescence (NPT)
• Neurologic testing (nerve condition studies)
• Your doctor may decide to do some vascular tests to establish whether the arteries that supply blood to the penis during erections are narrowed.

Heart Block

Questions to Discuss with Your Doctor:

• Have you been dizzy or lightheaded?
• Have you fainted?
• Have you been fatigued?
• Have you had chest pain?
  • Do you get it with exertion or at rest?
  • How frequently do you get it?
  • How long does it last?
  • What brings it on?
  • What relieves it?
• Is this a change from your usual pattern?
• Do you get short of breath when you lie down or exert yourself?
• Do you awaken in the middle of the night short of breath?
• Do your ankles swell?
• Do you get rapid or pounding heartbeats for no reason?
• What medications are you taking (including over-the-counter medications, herbal remedies, and vitamins)?
• Do you have any other medical problems?

Your Doctor Might Examine the Following Body Structures or Functions:

• Heart rate, blood pressure, and weight
• Pulses in the wrist and feet
• Veins in the neck
• Heart and lungs
• Ankles and legs (for swelling)

Your Doctor Might Order the Following Lab Tests or Studies:

• Electrocardiogram
• Echocardiogram
• Holter monitor
• Electrophysiologic testing

Hodgkin's Disease (after the disease has been treated)

Questions to Discuss with Your Doctor:

• Have you had fevers, heavy sweating at night, weight loss, itchy skin, or swollen lymph nodes?
• Do you have pain in any of your bones?
• Do you have a cough?
• Are you fatigued?
• Do you get lightheaded?
• Do you bruise easily or have nosebleeds?
• Do your gums bleed when you brush your teeth?
• Have you had any recent infections?
• Do you have a cough?
• Do you have sinus congestion?
• Do you have nasal discharge?
• Do you know when to seek medical attention for signs of infection?
• Do you know that you still need to practice birth control (both men and women)?
• Infertility is uncommon with newer chemotherapy regimens. If you are a woman and have undergone early menopause, have you considered hormone replacement therapy?
• Are you short of breath at rest or with minimal exertion?
• Do you get chest pain or pressure with exertion?
• Do you have swelling in your legs?
• Do you know that chemotherapy and radiation can increase your risk of developing certain other cancers?
• Are you up-to-date on all of your cancer screening tests?
• If you are a woman, have you discussed the need for regular mammograms and breast examinations with your doctor?
• Are you gaining weight?
• Are you constipated?
• Are you always cold?
• Do you have dry skin?

Your Doctor Might Examine the Following Body Structures or Functions:

• Neck veins
• Heart
• Lungs
• Abdomen (for enlargement or tenderness of the liver or spleen)
• Bones and spine (looking for areas of tenderness)
• Skin (looking for skin cancers)
• Lymph Nodes (neck, axilla, elbow, groin)

Your Doctor Might Order the Following Lab Tests or Studies:

• Blood tests for complete blood counts, kidney and liver function tests
• CT scans of the chest and abdomen

Acne

Questions to Discuss with Your Doctor:

• At what age did your problem with acne begin?
• Do you have blackheads, whiteheads, pustules, or cysts?
• If so, what areas are involved: your face, chest, back?
• What is your skin-care routine?
• What products do you use? Do any of them help?
• What medications have you tried (e.g., benzoyl peroxide, Retin-A, antibiotics, Accutane)?
• If you are female, does your acne get worse around the time of your menstrual period and do you have regular menstrual periods?
• What medicines do you take, including over-the-counter medicines and birth-control pills?
• Have you been developing extra body or facial hair?

Your Doctor Might Examine the Following Body Structures or Functions:

• Skin exam

Your Doctor Might Order the Following Lab Tests or Studies:

• Blood tests (liver function tests, cholesterol, or if you are female, perhaps a pregnancy test if you are taking the medicine Accutane)

Acoustic Neuroma

Questions to Discuss with Your Doctor:

• Do you have trouble hearing out of one ear or both?
• Do sounds seem distorted in one ear?
• Are sounds different between your two ears?
• Is the hearing loss getting progressively worse?
• Do you have difficulty understanding others when they are talking? For example, do you have trouble hearing people on the other end of the telephone?
• Do you have ear pain?
• Have you been dizzy or lightheaded? If so, does it seem as if the room is spinning?
• Do you feel unsteady when you walk?
• Have you heard ringing or unusual noises in one or both of your ears?
• Do the muscles on one side of your face feel weaker compared to the other side?
• Is there any weakness of your face?
• Have you lost your ability to taste certain foods?
• Have you had headaches? Nausea? Vomiting?
• Have you had double vision or unusual eye movements?

Your Doctor Might Examine the Following Body Structures or Functions:

• Ear, nose, and throat exam, including a screening test of your hearing in each ear
• Neurological exam

Your Doctor Might Order the Following Lab Tests or Studies:

• Audiometry (formal hearing test) by a certified audiologist
• Brain-stem auditory evoked potentials
• MRI or CT scan of the head

Bell's Palsy

Questions to Discuss with Your Doctor:

• Do you have weakness or paralysis of the muscles in your face?
• Can you still raise your eyebrows?
• Can you close your eyelids?
• Have you had ear pain? If so, on which side?
• Are your eyes watery?
• Have you noticed any change in your sense of taste?
• Have you had problems hearing?
• Have you had problems chewing?
• Over what period of time did your symptoms develop?
• Have you had a recent upper respiratory tract infection (for example, a cold)?
• Could you have had a tick bite in the recent past?
• Do you have diabetes?

Your Doctor Might Examine the Following Body Structures or Functions:

• Neurological exam focusing on the strength of the facial muscles
• Examination of the ears, nose, and throat

Your Doctor Might Order the Following Lab Tests or Studies:

• Blood tests for blood sugar and possibly Lyme disease
• Hearing test (if you report difficulty hearing)
• MRI computed tomography (CT) of the head (if your history and exam are concerning for a stroke or tumor)

Crohn's Disease

Questions to Discuss with Your Doctor:

• Do you have abdominal pain or cramping?
• Do you have diarrhea, fevers, fatigue, rectal pain, or bloody stools?
• Have you recently lost weight?
• Is there a family history of inflammatory bowel disease?
• How many times a year do you get pain flare-ups?
• Do you have episodes of joint pain or swelling?
• Are you taking any medications?

Your Doctor Might Examine the Following Body Structures or Functions:

• Temperature, blood pressure, heart rate
• Careful abdominal exam
• Rectal exam

Your Doctor Might Order the Following Lab Tests or Studies:

• Sigmoidoscopy or colonoscopy
• Stool sample to look for the presence of blood, white blood cells, and to culture
• Complete blood count and other blood tests
• CT scan or MRI of the abdomen