Diseases & Conditions Archive

Q. My doctor used to check my liver function once a year after I started taking a statin drug to lower my cholesterol, but he doesn't anymore. Why not?

A. Your doctor appears to be following the latest recommendations from the American Heart Association and the FDA. When statin medications were first approved, doctors did periodic blood tests to check for liver injury. Three decades later, it is clear that serious liver injury from statins is a rare side effect and that routine blood testing does not help identify people at risk for statin-related liver problems. Therefore, routine monitoring is not a good use of money and time.

Ask the doctor

Q. What's the fastest way to get rid of a cold sore? Is it possible to prevent them?

A. Cold sores, also called fever blisters, are bothersome and painful fluid-filled blisters on or around the lips. They are caused by infection with herpes simplex virus (usually type 1). Cold sores heal on their own in seven to 10 days. However, antiviral medications can modestly shorten the healing period. One-day treatment with the prescription antiviral drugs famciclovir (Famvir) or valacyclovir (Valtrex) shortens cold sore symptoms by one to two days. These oral medications are most effective when taken at the first sign of a cold sore, such as a burning or tingling sensation. Antiviral creams are less effective and need to be applied several times daily for five days.

Get to know your triggers and ways to prevent flare-ups.

If a growth or mole looks like a melanoma, the doctor will take a biopsy to confirm the diagnosis. This entails removing either a sample of tissue or else the entire growth and some surrounding skin, and examining the tissue under a microscope to determine whether it's cancer. Depending on how deep a melanoma is, additional tissue may have to be removed. In some cases, lymph nodes may be removed, too. A procedure called sentinel node biopsy can show whether the lymph node nearest the tumor contains any cancer cells. If it does, surgery to remove additional nodes right away can improve survival.

In addition to surgery, treatments for melanoma include immunotherapy (which strengthens the immune system against the cancer), chemotherapy, and radiation therapy. Newer, so-called targeted treatments include drugs that target specific genetic changes seem in people with certain forms of melanoma. For example, about half of melanomas have genetic changes (mutations) in a gene called BRAF, which signals melanoma cells to grow and divide quickly. Drugs that inhibit BRAF, such as vemurafenib (Zelboraf ) and dabrafenib (Tafinlar), and related proteins are now available.

Physical therapy is helpful for wear-and-tear knee osteoarthritis, especially if you start doing it early. But injecting a painful knee with an anti-inflammatory steroid medication before starting physical therapy offers no additional benefit, according to a clinical trial in JAMA Internal Medicine.

Studies have shown that physical therapy modestly reduces pain and improves daily functioning in people with knee osteoarthritis. That could mean being able to walk farther with less pain or to continue leisure activities such as gardening. Before you start physical therapy, your doctor may offer to inject the knee with a cocktail of anti-inflammatory steroid medication and an anesthetic. Hypothetically, this could make it easier for you to stick with exercise and therefore lead to better results.

A driving assessment program can help identify your strengths and weaknesses and suggest ways to improve your driving skills.

The sense of freedom and independence that comes with driving is as important at 65 as it is at 16. But driving skills may start to falter as we age, an issue many people choose to ignore. "We all seem to be in denial about driving in our older years. No one wants to give it up. The good news is that you may not have to," says Lissa Kapust, a social worker at Harvard-affiliated Beth Israel Deaconess Medical Center.

Wear sunscreen, and avoid direct exposure to the sun.

Knee replacements can restore your mobility, but you don't want to get one too soon—or wait too long.

Strokes hit women hard. Self-care is key to preventing a stroke and minimizing the damage if you have one.

This year an estimated 425,000 women will have a stroke, and 55,000 will die from one. Women are more likely than men to have strokes, and they are also more likely to be disabled or to die from them.

Fatty plaque in the arteries that feed the kidneys poses a danger to the heart and brain.