Two heads are best at doctor's visit

DEAR DR. ROACH: I always try to accompany my husband when he goes to the doctor. I feel that two sets of ears are always better than one. When his vitals are taken (e.g., weight, blood pressure), I have to ask what they were, as they never seem to volunteer this information. I mention this because the last time we were at the doctor's office, I asked what his weight was, because he had just lost 10 pounds. The nurse said it was 165, and I said "really," that was odd, as his shorts were very loose on him. We took it again, and she had transposed the numbers. It was 156. This is a wake-up call to all patients: They need to be aware to ask these questions for their health and well being. – C.W.

ANSWER: I agree with you completely, for several reasons. Doctors and nurses make mistakes, but we also don't communicate as effectively as we should some of the time. We use words that people don't understand, talk too fast or too quietly, and don't spend the time we need to making sure people know what they should do to help themselves get better. I think having a family member there is a great idea. So is taking notes, and so is going over what you understood the doctor to say, to make sure you are both on the same page.

DEAR DR. ROACH: I have an eye question. I am 84, and I have mild hemorrhages in my left eye. My doctor said this is due to old age, and to just wait and see if it gets worse. He did say that it could indicate a prelude to a brain stroke-type hemorrhage.

What can I do about this? I am very concerned. Why are my blood vessels so fragile? Does every old person have this problem? – J.I.

ANSWER: I assume you mean a hemorrhage in the white of your eye, called a subconjunctival hemorrhage. These are very common, can be seen easily in the mirror, and they usually do not indicate increased stroke risk. They are more likely in people taking aspirin or other anti-inflammatory drugs. They also can come from even minor trauma, as people in their 80s do typically have somewhat more fragile blood vessels.

If you have a retinal hemorrhage, which he would see with an ophthalmoscope in the back of the eye, that indicates a more substantial risk for stroke. Since the blood vessels in the retina are essentially the same as inside the brain, hemorrhage in the retina predicts stroke. In that case, your doctor would recommend very careful control of any risk factors you may have, especially blood pressure, diabetes and smoking.

The booklet on stroke explains this condition that is deservedly feared by all. Readers can obtain a copy by writing: Dr. Roach – No. 902, 628 Virginia Drive, Orlando, FL 32803. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient's printed name and address. Please allow four weeks for delivery.

DEAR DR. ROACH: I have had a chronic cough for over 30 years. As you can imagine, I have seen numerous specialists through the years, and none of the prescribed treatments has worked.

A friend suggested I might have laryngeal neuropathy. My doctor didn't know anything about it. What is the solution for this condition? – A.B.

ANSWER: I can't blame your doctor for not knowing anything about it. I've never recognized a case of it, though I wonder now, having researched it, whether it might be more common than we think.

The word "neuropathy" just means "a nerve problem," and in this case, it's one of the nerves in the throat, the superior laryngeal nerve or recurrent laryngeal nerve. It's a sensory neuropathy, meaning that the nerve is sending the brain incorrect information, which the brain misinterprets as a need to cough or clear the throat. Most people diagnosed with this condition have sudden onset of cough, often after surgery or viral illness. The condition is diagnosed by an expert ENT doctor via a nerve conduction test or a video test of the larynx.

In the largest paper on this syndrome, about two-thirds of study participants were relieved by gabapentin (Neurontin), a medication used for many types of neuropathy. Some physicians choose to try this medication without doing the testing. This approach sometimes makes sense, especially when diagnostic testing is difficult or expensive.

DEAR DR. ROACH: I am a 47-year-old male in generally good health. In 1999, I was involved in a nasty car accident, ending up in a trauma center. I needed abdominal surgery to repair a ruptured small intestine. Today, 15 years after the fact, is it possible to have issues with the scar tissue from that surgery? I have some of the symptoms of scar tissue problems, but a doc has told me I have diverticulitis. Can you help me? – M.F.

ANSWER: Well, I can't tell you what you have, but I certainly can confirm that scar tissue, called adhesions, can cause problems even years after the original trauma that caused them.

Adhesions are bands of scar tissue that can envelop the intestine, causing an obstruction. Most of the time the obstruction is partial, and with time and bowel rest, the problem resolves itself. However, sometimes it doesn't, or the obstruction is complete, and in those cases it will require another trip to the operating room.

Diverticula are small outpouchings in the intestinal wall, most commonly in the sigmoid colon. The condition is called diverticulosis and is very common, with about 20 percent of people at age 40 and 60 percent of people age 60 having them. When they get inflamed, that is called diverticulitis, and symptoms include abdominal pain, fever, nausea and vomiting, or bowel changes.

A CT scan usually can diagnose both conditions. It's possible to have both problems at the same time, which makes determining the cause of current symptoms difficult. Still, the CT scan would be the next step if you are having symptoms.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [email protected]. To view and order health pamphlets, visit www.rbmamall.com, or write to Good Health, 628 Virginia Drive, Orlando, FL 32803. (c) 2016 North America Synd., Inc. All Rights Reserved