Cracked fingertips? Try a home remedy

DR. ROACH WRITES: I wrote a column on cracked fingertips, and received a wealth of suggestions from readers.

For prevention, some suggestions I liked included avoiding too-hot water for hand washing, antibacterial soaps and wool gloves, all of which can remove protective oils from your fingers. A humidifier in the house can prevent drying of all the skin.

Home-treatment remedies included flax-seed oil or B vitamins by mouth. (I don't know if these are effective, but they should be safe.) Most people recommended emollients to the hands, specifically Preparation H, O'Keefe's Working Hands, Bag Balm, CeraVe, Chapstick and Carmex Healing Cream. Plain petrolatum (Vaseline) works very well for many people and is inexpensive. The area can be covered at night by a bandage or glove.

Several people recommended saltwater soaks. One noted that the pure mountain water of Colorado Springs cured him in three days. Finally, one person recommended trimming the nails quite short. These home remedies have helped many.

DEAR DR. ROACH: After an extreme case of vertigo, including vomiting and being taken to the emergency room, my unsteadiness remains. Over a week later, I need to use a walker to be safe. I am 79, and this happened once four years ago, but without the aftereffects. Any suggestions? – M.W.

ANSWER: The major causes of vertigo, acute labyrinthitis and benign paroxysmal positional vertigo, often continue to produce attacks that tend to lessen in severity up to a month after the initial severe attack. A walker may be a useful precaution while recovering. If the problem persists, I strongly recommend a visit with a physical and/or occupational therapist for vestibular rehabilitation, which is physical therapy to restore balance. It also might be necessary to revisit your doctor to confirm the original diagnosis.

The booklet on vertigo explains this disruptive condition in detail and outlines its treatment. Readers can order a copy by writing: Dr. Roach – No. 801W, 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: My 15-year-old son was just admitted to the hospital for depression and ADD. His thyroid tests came back abnormal. There is thyroid disease in the family. Is that the cause of his illness? – Anon.

ANSWER: Thyroid conditions, including both hyper- (too much) and hypo- (too little) thyroid hormone are common in the general population, but more so in people who are diagnosed with a wide variety of psychiatric illnesses, including depression, anxiety and bipolar disorder. I have read that up to a third of people in new admissions for psychiatric conditions have thyroid abnormalities. It isn't always clear whether the thyroid problem caused the psychiatric illness, and probably most often there is a large combination of factors, including genetics, environmental and medical conditions that affect the development of psychiatric conditions.

It is clear that sometimes, but not always, treating the underlying thyroid condition can make managing the psychiatric symptoms much easier.

DEAR DR. ROACH: You have written about screening for breast cancer, but are there any ways to prevent breast cancer in the first place? – T.C.

ANSWER: There are three behaviors that are well-accepted to reduce the risk of breast cancer. Breastfeeding is one, and it's so good for the baby that we might forget that it has long-term advantages for moms, but add reducing the mother's breast cancer risk to the list. The second is dietary phytoestrogens, compounds such as soy isoflavones and lignans, which are found in soybeans and other legumes. This data is most clear among Asian women. Finally, regular physical exercise reduces breast cancer risk, especially for women after menopause.

Other dietary factors, such as a diet high in fruits and vegetables and low in meat and saturated fat, may reduce risk of breast cancer, but this isn't proven. Studies are ongoing to examine whether vitamin D or omega 3 fatty acids may reduce risk, as suggested in previous studies.

For high-risk women, consider chemoprophylaxis with a SERM or aromatase inhibitor, and also a more-intensive screening program.

DEAR DR. ROACH: I went to my ENT doctor in January complaining of muffled hearing and a loud, high-pitched noise in my left ear. He gave me a hearing test, and it showed 50 percent loss. I had an MRI and was told that I have an acoustic neuroma on my left side. This has caused me to go 50 percent deaf in my ear. The ENT doctor wants me to wait six months and see if it grows more, which I don't want to do because I feel it should be taken out while it is small.

The choices I have are to watch and wait; to have traditional surgery; or to have surgery with gamma knife or cyber knife. I would really like to just get this done and have it taken out before it causes more problems, like affecting my facial nerve, balance nerve or if it gets too close to my brain stem. I also am worried that I may go completely deaf. I am getting a second opinion next month from a neurosurgeon. What are your thoughts on all of this? – B.D.

ANSWER: An acoustic neuroma, also called a vestibular schwannoma, is a type of non-cancerous tumor on the eighth cranial nerve, which is responsible for hearing and balance.

These tumors usually are treated, although some authorities recommend a watch-and-wait approach if they aren't bothering the patient, if the patient is a poor candidate for surgery or if the patient is otherwise reluctant. None of these seems to apply to you, so I would recommend proceeding with the second opinion, the neurosurgeon, whom I think is likely to recommend treatment. Progressive hearing loss is a clear indication that treatment likely would be beneficial sooner rather than later.

All the treatments you mentioned are reasonable. Cyber knife and gamma knife are ways of delivering radiation to the tumor. Since any of these can achieve the goal of preventing the tumor's growth and any worsening of symptoms, the choice should be left to the expert.

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 rbmamall.com, or write to Good Health, 628 Virginia Drive, Orlando, FL 32803.