Family Practice Q&A with Dr. David Schultz

Question:  Is Viagra safe for a man with claudication in the legs?  Are there newer drugs for E.D. that are FDA approved?  If so, when will they be made available?

Answer:  Viagra should be safe for individuals with claudication of the leg; however, several factors should first be considered.  First one should make sure that there is not the use of nitrate medications.  Second, a stress test needs to be done on the heart.  The reason for the cardiac stress test is due to the cause of claudication.  Claudication is the condition of leg cramps usually with ambulation as a consequence of "clogged" arteries in the leg.  If there are occluded blood vessels in the leg there are possibly occluded blood vessels in the heart.  Thus the heart needs to be examined before being placed on viagra.

Question: When I was in high school I got back handed in the nose and ever since then my right side has been closed i have to sleep with my hand on my face pulling the right side of my nose open so i can breath what can I do about that will I have to have surgey to have it corrected.

Answer from Dr. David Schultz: You are describing nasal septum deviation.  This condition can often cause difficulties with breathing.  Only through surgery can the condition be repaired.  Good Luck, Dr. David Schultz

Question:  I'm 25yrs old and for the past two weeks I have had a fever average 101 and joint pain.  My family Doctor took blood and thinks it might be 5ths disease. I work at a child Care Center.  What do you think  this could be?

Answer from Dr. David Schultz: Any virus can cause fever and joint pain (myalgias).  Fifths disease is one such virus that can cause your condition, but thousands of other disease states can also appear as your description.  Your physician suspects Fifths Disease due to your association with the day care center and the time of year.  In addition, Fifths Disease can cause a slapped face type of erythematous rash on the cheek in children. Best Wishes, Dr. David Schultz

Question: Thank you for your response to my first question.  Is this a condition that can be eliminated with the use of steroids & and inhaler, or should I anticipate developing a condition such as emphysema?  I am presently using an inhaler along with the steroid, and I have never smoked.  Thank you again for responding.

Answer from Dr. David Schultz: Thank you for writing.  Often cough variant or bronchial asthma is temporary and reversible, but occasionally it is persistent and can eventually lead to chronic obstructive pulmonary disease.  It is difficult to predict in your case, but if an individual has moderate persistent asthma, they have a great chance of developing emphysema. Best Wishes, Dr. David Schultz

Question:  I have had a persistent cough for quite a long time.  My doctor prescribed prednison (sp?) for a 2 week regimen. In what way does this medicine help a cough?

Answer from Dr. David Schultz: Your physician gave you prednisone, a steroid, for persistent to cough to reduce inflammation your lung.  Your physician is more than likely treating you for either reactive airway (bronchial asthma) or cough variant asthma. These conditions are associated with air trapping in the alveoli that are sacks in the lung.  With chronic bronchoconstriction, the inflammation worsens.  I would make sure to also be on an inhaler, and if you smoke, you must stop, or you could be developing emphysema.  Best Wishes, Dr. David Schultz.

Question: I have sores that will not heal on my arms,back,scalp,chest,face.I get these sores and it takes a long time before they go away. I saw a doctor and I was told it is called folliculitis. I have been given two creams, 4 rounds of antibiotics.This has been since this last summer. I have switched to anti bacterial soap.  any suggestions on how to get rid of this and keep it away? These sores leave scars and indentions in my scalp. Thanks.

Answer from Dr. David Schultz: I truly empathize your current situation, but without seeing the appearance of the rash it is difficult to make a diagnosis. Certain mites can cause your condition.  I would inquire of the occurrence of this condition in other family members.  Certain forms of psoriasis can cause this.  Your condition could, however, be caused by a habit.  For example, I have had several patients who had dried skin and scalp, and as a result, this
introduces bacteria into the skin's dermis, causing the lesions you describe.  I would use a compound like Lubriderm or desiden and see if by having moist skin your condition improves. Best Wishes, Dr. David Schultz

Question: Vericose veins? My mother has a knot on her left leg and resembles a bruise. She states that it hurts when you touch it, should she be concerned that it is a blood clot or a vericose vein that busted.  Should she consult a doctor.  Thank You.

Answer from Dr. David Schultz:Varicose veins often are "knotted" and can often be painful.  Varicose veins are caused by poor venous rerun form blood in the lower extremities, thus allowing the blood to pool in the legs. Support hose is essential in controlling the discomfort. There are other conditions, however, that your mother could have.  She could have thrombophlebitis which is an inflammatory condition of the veins.  Also, a deep venous thrombosis is unlikely based on your condition.  In essence, I would get it checked out by a physician.

Question: Dr. For about three weeks I had stomach pains along with diarrhea. I just let nature run it's course. While being unemployed since September I just haven't the funds or insurance to see a proffesional. I have a solid stool at this time but it is more frequent and small. I had a sharp pain about 6" to the left of my naval during the messy time. This week it has moved to about an inch or two directly underneath my naval. It is a sharp burning pain that happens when I try and get out of bed or lift myself up. It is so intense it will put me back down. Any help would be appreciated..... Thanks for your time

Answer from Dr. David Schultz: There are several conditions which can explain your symptoms.  First, irritable bowel syndrome (spastic colon)  is a disease seen with frequent diarrhea, bloating, abdominal pain, and so forth.  Treatment includes a high fiber diet with supplements like Metamucil.  One should limit stress and avoid unhealthy foods.  There are hundreds of other conditions which can cause your problem.  Gall bladder disease (cholelithiasis) is seen with irregular stools, right upper abdominal pain, and gas.  An appendicitis is seen with decreased appetite, fever, and right lower abdominal pain.  Next, several parasitic syndromes can cause your medical problem.  I would definitely get it checked out with a physician.  Certainly, St. Mary's and Deaconess's Family Practice Residencies offer excellent medical care for those without insurance as does Impact Clinic. Best Wishes, Dr. David Schultz

Question:  When a woman is pregnant, what caused the placenta to tare away from the ( not sure)uteras maybe? I have never heard of it. but it happen to a friend of mine. the baby was due in 2 weeks) but now that that happen she had to have it now. could you explain this, and if you can't send me to someone that can. thanks.

Answer from Dr. David Schultz:   There are several problems associated with placenta separation.  First placenta previa is characterized by painless bleeding and the placenta covering part of the cervical os (opening).  Next a placental abruption is associated with complete placental separation and seen with painful bleeding.  This condition often leads to maternal and fetal death.  Several factors affect these conditions.  First, maternal blood pressure, use of tobacco, drug use, infection, and trauma all can contribute to the aforementioned. when the placenta is torn away from the uterus, the baby is in danger of losing its blood supply, resulting in death. Best Wishes, Dr. David Schultz

Question:  I have recently had swelling of the lip and the right side of my face gets tingling & numb, about an hour after eating. This is the 4th occasion that this has happened over a 2 month period. I went to a care center on Monday, they gave me a shot "Decotron", (I'm not sure of the spelling), they said it was a steroid and should take the rest of the swelling down, and should last for approx. 3 weeks, I have an allergy testing sch. for 3 weeks, however, on Tuesday about an hour after I ate again, I got the tingling sensation again, but not the swelling. The care center gave me a supply of zyrtec to take once a day. I guess my question is could there be an underlying cause that might be causing this flare up since I am not eating anything different than I normally do, and when I feel a reaction coming on is Benadryl good enough to control the swell up  I 'm afraid to eat for fear of this. Thank you.

Answer from Dr. David Schultz: Certainly, you are describing angioedema which is often caused by certain food and medicine allergies.  Look for causes like seasonings, MSG, dyes, or preservatives and eliminate these in your diet.  This condition can be life-threatening if unattended.  Corticosteroids and antihistamines are the main treatments.  In addition, a blood pressure in a class of medications known as an ACE inhibitor can do this as well.  Finally, inflammation of the parotid gland can appear like your excellent description of your disease. With Kind Regards, Dr. David Schultz

Question:  I'm not sure if you can help me with this question but a friend of mine has been sexually active for about a year now and she recently had sex and started to that normal?

Answer from Dr. David Schultz: In females, it is not unusual to bleed with intercourse but several things need to be considered.  First, does she have vaginal or cervical tears or lacerations?  Second, could she have an STD (sexually transmitted disease)? Third, there could be an abnormal lesion or dysplasia on the cervix. Finally pregnancy increases the occurrence of vaginal bleeding with intercourse.  Therefore, she should make sure her annual "female" exam is up to date.
Best Wishes, Dr. David Schultz


Answer from Dr. David Schultz: Yes I am accepting new patients, and my office does take MEDICARE A and B. Feel free to call me at 479.6907 Best Wishes,Dr. David Schultz

Question:  About 3 years ago I was involved in an accident and my right leg was injured. I was wearing my seatbelt and my airbags deployed but my right knee shoved my radio to the firewall. It looked awful, bruised, lower calf looked like raw hamburger and hurt bad. I had a sonogram and  MRI on it but nothing was found. Every since then, my sole has been numb and I get shooting pains in my foot that nearly makes me loose bladder control sometimes. The doctor said after the sonogram and MRI was done that I would have to 'live with it'. I accepted his diagnosis but last summer, I stepped on a piece  of glass in my yard and it wasn't until my sock was soaked I found out and saw a big gash that took a long time to heal.  What else can I do to get some relief?

Answer from Dr. David Schultz: You probably have a peripheral neuropathy where one or more nerves have been damaged in the leg.  I would certainly talk to you physician again and obtain nerve conduction studies followed up with a second opinion with an orthopoedic surgeon or neurologist.  Best Wishes, Dr. David Schultz

Question:  Dr. Schultz, I have been feeling fatigued, numbness in my fingers and toes and a general overall "sick" feeling for over a year now.  Sometimes, I get lightheaded and blurred vision as well, what could be the cause of this? And can I ever feel better again?  I have been to my doctor and she doesn't seem to care.  Bloodwork was done and she sent a letter in the mail telling me my white blood count was down and to take a daily multi-vitamin, which I have done for years.  Please help!

Answer from Dr. David Schultz: Your condition may be associated with several conditions.  First I would re-emphasize how you feel to your physician.  Next, the glucose or blood sugar needs to be checked and possibly a glucose tolerance test ordered. Thyroid levels, vitamin B12 and folic acid needs to be checked.  Next, dietary modifications need to be done.  For example, if you smoke then stop smoking, and reduce the amount of carbohydrates and caffeine in your diet. If all else fails, you may want a second opinion.  Best Wishes, Dr. David Schultz

Question:  I have had a persistent cough for quite a long time.  My doctor prescribed prednison (sp?) for a 2 week regimen. In what way does this medicine help a cough?

Answer from Dr. David Schultz: Your physician gave you prednisone, a steroid, for persistent to cough to reduce inflammation your lung.  Your physician is more than likely treating you for either reactive airway (bronchial asthma) or cough variant asthma. These conditions are associated with air trapping in the alveoli that are sacks in the lung.  With chronic bronchoconstriction, the inflammation worsens.  I would make sure to also be on an inhaler, and if you smoke, you must stop, or you could be developing emphysema.  Best Wishes, Dr. David Schultz.

Question:  I was told that I have diabetes and was give Avandia 8mg to lower my blood sugar. I look this drug up in a drug book and found out that this drug riases your blood sugar should I switch drugs or not?

Answer from Dr. David Schultz: Avandia and its cousin Actos work to lower sugar by improving the uptake of sugar into the body's cells.  Both can worsen severe heart failure, but neither should elevate glucose except in extremely rare circumstances. These are excellent medications.  Best Wishes, Dr. David Schultz

Question:  Is there a virus going around with fever, tickling cough, and aches? My two daughters and I have something like this. I cannot say it is sinus causing the cough. The cough is also not very productive, but is a deep cough. Do you think it is a virus or should we try to see the doctor?

Answer from Dr. David Schultz: There is a viral infection causing these symptoms you are describing. This infection is commonly called Adenovirus. Certainly one can take over-the-counter decongestants and antihistamines to control the symptoms, which will last 4 to 7 days. If cough is productive of yellow to green phlegm, if wheezing occurs, or if fever persists, one should get this checked out immediately. With Kind Regards, Dr. David Schultz

Question:  Almost every time I go to my dad's farm and have to walk through brush a day or two later I develope itchy little bumps. I thought it was poison oak or sumac but I just looked those up and they create the same clustered line rash as familiar (to me anyway) poison ivy. My rash is single non-clustered bumps that randomly keep popping up from my face to my stomach. They usually stay sparse but they itch like crazy. What is this? Thank you for your time.

Answer from Dr. David Schultz: Without seeing these bumps, it is difficult to assess. However, poison ivy/poison oak (exfolliative dermatitis) can take on various forms and appearances. Urticaria (wheel and flare) is an allergic reaction that also itches and can present in a like manner. Avoiding the irritant usually keeps the rash from occurring. Benedryl is helpful in alleviating and reversing the symptoms of both. Over-the-counter steroid creams are helpful as well. With Kind Regards, Dr. David Schultz

Question:  2 years ago I was diagnosed with hypothyroidism and we finally have the right dose of Synthroid at 150mcg daily which has brough my TSH level to 1.0. However, by sed rate and c-reactive protein are slightly high - sed rate at 26 and C-reactive at 15.7. I would like your advise on what both of these do for the body and also thoughts on how to bring them to a normal level. Thanks

Answer from Dr. David Schultz:  The sed rate and c-reactive protein has very little to do with thyroid disease. These two laboratory tests measure "acute phase reactants" in the blood and is more of a measure of "inflammation." Some evidence has shown that these two entities are elevated in individuals especially susceptible to coronary artery disease. Certain types of arthritis, more commonly, have elevated sed rates and c-reactive proteins. Finally, chronic illness and disease can elevate these levels. There is really nothing an individual can do to lower these levels, except to make sure the possible disease states that can cuase this are controlled. With Kind Regards, Dr. David Schultz

Question:  for the last 3-4 months I have had limited taste and smell. I am currently taking b-12 shots as my blood was low on iron/not working/what else could I do?

Answer from Dr. David Schultz:  First, vitamin B-12 does not increase iron in the blood. If one has a vitamin B-12 deficiency, one can develop a macrocytic anemia. This can cause weakness, fatigue, and even peripheral neuropathies. You can develop abnormal taste in the tongue, but smell should be preserved. It does not sound as if your vitamin B-12 deficiency is the cause for your lack of smell and taste. More commonly, infections, such as sinus infections, can cause your problem, but other things are capable of doing this as well. Certainly certain prolonged labors (delivery of baby) can cause this, as well as exposure to certain toxic heavy metals. There are idiopathic causes to the destruction of the olfactory nerves that assist with the sense of smell and taste. Certain tumors and central nervous system disorders can cause the sensation of smell and taste, but these are rare. Anosmia (loss of smell) occurs when intranasal swelling, or other obstruction, prevents odors from gaining access to the olfactory areas. It also occurs when the olfactory neuroepithelium is destroyed, as in atrophic rhinitis, or the chronic rhinitis of granulomatous diseases and neoplasms. Anosmia also occurs when the olfactory bulbs and tracts, or their central connections, are destroyed, as by intracranial trauma (infections or neoplasms). Finally, this problem deserves a more thorough evaluation, but a cause and a cure may not be obtainable. With Kind Regards, Dr. David Schultz

Question:  I had a hysterectomy in 1989 and have had trouble with the hormones now my skin doctor tells me i have rosacea and the hormones really flare that up it burns and sting my skin when i take the hormones and i little bumps on my skin what can i do about this

Answer from Dr. David Schultz:  First of all, hormones can cause changes to the skin, but these changes are generally beneficial. There's been some evidence that rosacea is actually improved with hormones, as is acne vulgaris. I would look for other sources for your bumps and discuss other hormone options with your primary care physician before stopping the hormones. With Kind Regards, Dr. David Schultz

Question:  Fumes from moth balls that were placed overhead in the building where I work continue to enter my office area thru the cold air return exchange. This has created a persistent annoying cough with nasal drainage and headache for the past six weeks on the days I am in this environment. What, if any, could be the long term effect/damage to me? An air purifier has not been effective at all. Thanks for your expert advice.

Answer from Dr. David Schultz: There are several long term effects of moth balls. Moth balls contain the compound Naphthalene. This compound is able to kill moths and other insects. Unfortunately, if we inhale its vapors, it can trigger bronchial spasms. There is some evidence that continued direct inhalation could cause certain types of cancer. With women, exposure to moth balls could possibly cause birth defects. Some people experience nausea and vertigo with prolonged exposure to moth balls. Moth balls are meant to be used in storage and not in an active environment. They should always be away from duct work and areas that contain a heat source. With Kind Regards, Dr. David Schultz

Question:  I was wondering, i know someone that is allergic to codeine and they have back problems and they went to a specialist who told this person that they needed to take medicine with codiene in it even though they are allergic to it. Is this acceptable or should a person never take a med that they are allergic to? Thank you.

Answer from Dr. David Schultz: Certainly it is not advisable to take Tylenol with codeine if one has an allergy to it; however, one must define allergy. Often the perception of an allergy and sensitivity are often mistaken. A sensitivity to a medication means that the particular medicine causes some adverse reaction outside of the immune system such as a stomach-ache, "gas", diarrhea, or headache. An allergy is associated with the body's ability to secrete histamine from mast cells or basophils and is characterized by urticaria (rash), dyspnea (short of breathe), asthma, edema, etc. Thus, allergic reactions are of greater concern and danger for an individual. It is not unreasonable for a physician to prescribe a medication that causes a "sensitivity." However, physicians should not prescribe medications that cause one an allergic reaction. Codeine is capable of either type of reaction in an individual. With Kind Regards, Dr. David Schultz

Question:  What is the differance between Senility, Dementia, and Alzheimers? Aren't they all related? Thank you

Answer from Dr. David Schultz: There are subtle differences between the words senility, dementia, and Alzheimer's. First, Alzheimer's is a type of dementia pathologically caused by deposits of amyloid protein in the brain. Dementia is a broad term used to describe progressive loss of short-term memory, of which Alzheimer's is a form. Senility is a non-medical term to connote short-term memory loss. Delirium is acute episode confusional state. Kind Regards, David E. Schultz, II, M.D.

Question: I have a lot of heart problems and my heart doctor, Dr. Tatiline, has me on Medicines Aug 14, 2002 1. Zocor-- 40 mg 2. Kisinopril 20 mg 3. Sipronolactone --25 mg 4. Furosemile-- 20 mg 5. Mobic 15 mg 6. Isosorbide 60mg Vit: E-Multi Asprin Ecotrin Pain Equate acetaminophen 500mg And my BP has been running low.115 68 116 64 110 53 132 112 101 52 98 59 92 53 and when it does I feel bad. There is a lot of things to read on high BP but what about too low. Is this one on the necessary evils with my heart condition, or is there a better way.

Answer from Dr. David Schultz: I think hypotension (low blood pressure) can be bad as well. Now, there are some newer studies that seem to indicate that the lower the blood pressure that one can achieve is favorable for morbidity/mortality; however, if one is experiencing side effects from low blood pressure, it may be wiser to have slightly higher blood pressures. Also, one's blood pressures often are higher in the doctor's office. I would discuss these ideas with your physician and have them explain the reasoning behind taking the medications. Then, I would tell them exactly how you feel.   Best wishes, Dr. David Schultz

Question: I am a 22 yr old female who is very active and exercises regularly (6x/wk for60-90 min). I have had high blood pressure the past three months. My doctor gave me an EKG that showed a Right Bundle Branch Block. I also have a very high heart rate (80-100 at rest and 160-200 with activity). Should I be concerned? Do I need to cut back my activity level?

Answer from Dr. David Schultz:Your answer will not be clear cut. As long as there is not a family history of early heart disease or arrhythmias you should be fine. Continue working out, but do not overdo it. Certainly, an exercise stress test and echocardiogram could be of benefit in your case as it could provide one with reassurance. If you experience "blackening out" or chest pain, however, your situation would be different, and a full medical workup would be necessary.  Good Luck, Dr. David Schultz.

Question: We have a 12 year old daughter that is very athletic. She complains of her ankles hurting after practice. (soccer) She is quite tall (5ft4)and wears a size 10 to 11 size shoes. She is also very flat footed. Is there anything we can do to help her playing time less painful?

Answer from Dr. David Schultz: Pes Planus (flatfeet) is a condition that does not necessarily require medical therapies. However, if one were to experience ankle pain orthotics could be helpful. You could have her ankles taped before practice. Also, you could give Advil or Motrin before practice. She should definitely be checked for other problems that can occur.
Good Luck, Dr. David Schultz

Question: I have been taking Paxil 10mg once a day for two months. Do I have to ween myself off of it before starting on Effexer ?

Answer from Dr. David Schultz: You do not have to wean yourself off of Paxil to go onto effexor; however, if you do not gradually come off of Paxil, you could experience nervousness, nausea, body aches, sweats, and so forth. Good Luck, Dr. David Schultz

Question: My father is 70 yrs. old & suffered an ischemic stroke on 12-15-00. He has right sided hemiplegia. Recently, in the news, I've heard about Botox being used to treat spasticity after a stroke. Do you know of any physicians in Evansville doing this treatment or any Botox studies in this area? Thank you.

Answer from Dr. David Schultz: There are several neurologists in Evansville using botox injections for this purpose. I would them a call. Good Luck, Dr. David Schultz

Question: With the outbreak of the West Nile virus, I am concerned about family members contracting it. I have heard that using insect repellants with Deet is an effective way to prevent misquito bites. Are repellants with Deet safe to use on children under two years old. If not, what would you recommend beside staying inside and wearing long sleeves and pants? Thanks.

Answer from Dr. David Schultz: It is debatable whether it is safe to use such a substance with DEET in it for children under two. Certainly, I would not apply it directly to the skin. Application to the clothing is a viable option. Please keep in mind that the amount of mosquitoes positive for West Nile Virus are few in number.   Best regards, Dr. David Schultz

Question: I have a couple questions: 1. I heard on wfie14 about a patch for ADHA. Can you provide me any information on this patch? My son is presently taking concerta. 2. I have recently been diagnosed with a thyroid problem - underactive and fibermialgia. (Jan till present) I am see my family doctor. They keep bouncing by thy. medication around. I am not loosing any weight and not feeling well do you have any recommendations or what type of specialist do you recommend I see? I am doing arobics and yoga.

Answer from Dr. David Schultz: There is a newer patch for ADHD coming out but it is not yet available. Please stay informed of further developments. Regarding hypothyroidism, one does not see weight loss when the thyroid level is being made normal. It takes many adjustments in medication to get the proper dose for an individual. I would suggest that you be patient with your physician. Endocrinologists specialize in taking care of endocrine disorders of which hypothyroid is one. Good Luck, David E. Schultz, M.D.

Question: I have this problem where I sweat pretty bad underneath my right arm. I've tried every deodrant on the shelf at almost every store. It's really noticeable no matter what color shirt I wear. It's really gross,too. I've been told that it's probably because I have high blood pressure, but I'm on medicine to control it. Is there anything thing I can do to get rid of it? Where I work, it's hard for someone not to notice it. It's to the point now that I'll put deodrant on and ten minutes later, I've already got wet marks on my shirt. Please tell me if there's anything I can do. Thanks.

Answer from Dr. David Schultz: Thank you for your question. I doubt that the blood pressure medication is responsible for your affliction. There are prescription deodorants and medications available to help reduce the amount of sweating. I encourage you to look into these options and not to lose hope.
Sincerely yours, David E. Schultz, II, M.D.

Question: What is the recommended treatment/exercise for Sciatica and do you need to see a specialist? If a specialist is needed, what type?

Answer from Dr. David Schultz: Sciatica is inflammation of the sciatic nerve , which is the largest nerve in the human body. Sitting on hard objects for a long period of time is one common cause. A nerve entrapment or injury can also cause this condition. Most of the time, sciatica resolves with simple exercises and the use of anti-inflammatory medications. If the problem persists longer than 2-4 weeks, then additional testing should be performed. If the problem worsens, such testing beginning with X-rays and MRIs, should be performed sooner. Giving a steroid injection, as well as a brief trial of steroids, are also effective in treating sciatica. Rarely is surgery necessary if the problems abate. David E. Schultz, II, M.D.

Question: I had blood work done about 2 weeks ago. My doctor lost my records some how. I told him then my hands were swelling. He gave me some water pills to take. They made my sugar level drop bad, Now my hands are swollen so bad that they hurt. It is swollen around the knuckles and first bend of my fingers. I have tired everything to take the swelling out. But nothing is helping. It hurts even to type this. Please help!

Answer from Dr. David Schultz: I am very concerned about your problem. The reason that the water pill affected your sugar is because it was most likely a thiazide-type diuretic which can act like a diabetic pill in a small number of people. Several sources for your edema must be ruled out. These would include congestive heart failure, arthritis, lupus, kidney troubles, as well as Raynaud's Phenomena. I would advise you to have a complete workup regarding your condition.
Best wishes, David E. Schultz, II, M.D.

Question: I am 33 years old. I have been having a aching/numbness in my left arm. Sometimes extending down to my fingers. I have been told that it could be from hyperventilating. I don't have chest pain and I have been having this for about 2 weeks.

Answer from Dr. David Schultz: There are several causes for numbness in the left upper extremity. Certainly panic disorder and hyperventilation can cause this condition. A pinched nerve in the neck or a mass pressing on the brachial plexus are other causes of this condition. Nerve entrapment is a more likely source. Laboratory workup, as well as radiologic tests, may be necessary. I would get it checked out. Best wishes, David E. Schultz, II, M.D.

Question: My 18yr old daughter says that sometimes bits of food will come up in her mouth from her throat,that she can feel it and push it up into her mouth. could it be catching in her tonsils and coming from there? Is this normal?

Answer from Dr. David Schultz: Indeed this food could be catching into her tonsils and later coming out in her mouth. However, there are also diverticula in the esophagus that are occasionally present where food can get stuck. Sometimes these pouches need to be repaired surgically. I would recommend an upper GI after a proper evaluation of your daughter's tonsils.
David Schultz, II, M.D.

Question: April 1, 2002, I found a tick embedded on my leg. I took the tweezers and carefully pulled the tick out and I placed it in a plastic bag. For two days, my leg ached like a sore muscle. Then the itching began. I'll called my doctor and was told to use a Hydrocortisone Cream. The bite was red and reminded me of the chicken pox. After several weeks, the itch went away. Yesterday, July 30th, the itching has started again. Is this normal? I never realized a tick bite could have such a lasting affect.

Answer from Dr. David Schultz: Tick bites can be very irritating. They can actually cause infection, especially if a remnant, or part of the tick is left in the skin. Also, as skin tissue is healing, it can also produce an itch. I would get this checked out.
David Schultz, II, M.D.

Question: I have a 6 year old son that still wets the bed at night? Is this normal or should I be more concerned? We watch his liquid intake of an evening and it is not over what I think he should have! He still wears Pull Ups but I know before long he will refuse this method. He was checked last year for diabetes and was negative! What should I do?

Answer from Dr. David Schultz: Your child's condition is also known as nocturnal enuresis. This condition is actually fairly common in his age group, but because of social stigmata, it is not often mentioned. I would not be overly concerned until your child reaches 12 years of age. Often, as the bladder enlarges, they grow out of this condition. If, however, the problem worsens or is interfering with your child's social development, then there is a medicine known as DDAVP, which is effective in reducing the occurrence of nocturnal enuresis. Other methods, such as bells, are often ineffective. It is of utmost importance that your child maintains his esteem throughout the situation. Best wishes, David Schultz, II, M.D.

Question: UniSpaceralternative to knee replacement surgery. Could you tell me what you have to do to see if one is a candidate for this procedure?

Answer from Dr. David Schultz: I would consult with your orthopedic surgeon and make sure that there are not other reversible causes for your knee problem.

Question: My son is 2 yrs old & in the past couple of weeks I've noticed the eyelashes on his right eye are broken off half way, or seem to be. The left side eye lashes are noticeably longer, but the ones on the right that are short have a white or light colored end on them that make them appear to be broken. He's not had an injury to his eye that would have caused this & he doesnt pull at them that I have seen. He had his 2 yr checkup last week & while he was on the exam table several partial lashes fell out while I was asking the Dr about it. His Dr said he wasn't aware of any condition that causes eyelashes to break & fall out & that they would grow back. Have you heard of anything like this & could it be harmful?

Answer from Dr. David Schultz: Thank you for your question. Most of the conditions that can cause your son's problem are benign. It should have no harmful consequence. With time, his problem should improve. However, there are several conditions that are treatable that can cause partially broken eyelashes. First of all, a condition commonly called sevorrhea is a treatable condition that can cause such a problem. Next, one should make sure that your child does not have an anemia or poisoning with a toxic heavy metal. Finally, if your child has an elevated blood pressure, one should consider a problem with cortisol metabolism.  Good luck.

Question: What will cure "stomach sores" in the mouth ?

Answer from Dr. David Schultz: Stomach sores, otherwise known as apthous stomatitis, are from an unknown etiology. Mixtures of "Mary's Magic Mouthwash" are available by prescription. Sometimes oral steroids or Nystatin suspension are helpful. Ultimately they last 5-7 days. Reduction of stress reduces likelihood of occurrence. Apthasol improves discomfort. This is a prescription medication. David E. Schultz, II, M.D.

Question: I am pretty sure my 21 month old son has fifth disease, but I was wondering, Is it normal to run a fever the day the rash appears, and should the rash on the face go across the nose? I just want to make sure that it is Fifth disease rather than something else. Thanks

Answer from Dr. David Schultz: Thank you for your question. Not everything in medicine goes by what the book says; however, people with Fifth's disease have a rash that appears to be like two slapped cheeks. I would have your son checked out by his doctor.
David E. Schultz, II, M.D.

Question: My husband will just be setting in his chair and all of a sudden he i'll says gasps for his breath. I think he has sleep apnea because he will not breathe for several seconds then he gasps for air. Now he has started doing it while he is awake. He is 72. Not that it makes any diff. He is in good health. Except for his breathing. He will do it a couple times an hour. Thank You

Answer from Dr. David Schultz: Thank you for your question. It is possible that the symptoms you are describing is sleep apnea. However, there are at present other disorders which can cause similar symptoms. I would suggest undergoing a sleep study to see if this is purely from obstructive sleep apnea.
Thank you. David E. Schultz, II, M.D.

Question: The end of Jan. I hit my head very hard on a shelf. I never got a bump, just an indention. That night I started have problems with my vision. I would see flashing lights surrounding a circle. A few weeks later it did it again, and now it happens at least every other day. Yesterday, it happened twice and was more intense. At first the lights only lasted about 10-15 minutes. Yesterday it lasted for over half an hour. I also have muscle tightness in the left side of my neck. Feels like it is gonna freeze up. Could the two be related or could my flashing lights be because of hitting my head? I am trying to decide if I need to see my doctor or an eye doctor. I just had my eyes checked in Feb. and I mentioned it to the Dr. and he didn't see anything to cause concern at the time. Thank you very much for your time. Any info will be very helpful.

Answer from Dr. David Schultz: You will want to be rechecked by your regular doctor and then may want to see a neurologist, who specializes in such. David E. Schultz, II, M.D.

Question: What could cause your blood pressure to run low? Mine was normal up until about 8 mos. ago, now it stays around 100/50, I have had dizzy spells for 3 years, but have had every test I can think of to find out what is wrong, nothing yet has been found. Is there any medicine to raise the blood pressure. I feel tired a lot, cold all the time, no energy. Thank You

Answer from Dr. David Schultz: Several things can cause a low blood pressure. First an inadequate diet, sodium intake, and electrolyte imbalance can cause hypotension. Next, heart failure can occasionally cause hypotension. Also, hypothyroidism and anemia can cause hypotension. Finally medications and herbals can cause hypotension. I would get it checked out.
Best Wishes, Dr. David Schultz

Question: I hear all this jazz on the radio about this "Enzyme Diet". I have checked out the website for it was wondering what your input would be on it. It isn't a cheap diet, but it sounds good to me. But I'd like to hear what you had to say about it before I go spending all that dough on it. Thanks Alot!

Answer from Dr. David Schultz: I would not trust the "enzyme diet" as this is not of proven benefit and is expensive. Nothing is better than cutting back, exercise, and patience. There are several prescription medications available for weight loss which are cheaper, safer, and more effective. Good Luck, Dr. David Schultz

Question: I have been to the Gastroenterologist and have been diagnosed with a spastic colon and lactose intolerance. I am 30 years old, drink citrucel and more than 8 full glasses of water every day, and take a lactose pill every time I have any dairy products. First off, is this unusual for someone my age? How common is this? Secondly, if I want to have children, are these conditions going to interfere or cause problems for me or my unborn child during my pregnancy? Thank you

Answer from Dr. David Schultz: A lactose intolerance is an error of metabolism where the enzyme lactase is in adequate quantity or ability to process milk sugar. I would avoid all dairy products and consume calcium supplements. Next, The problem is in about 2% of the population. Finally, as long as you are well nourished, this should pose no problems to an unborn infant. Finally, the disorder can be inherited, and so your children may develop this problem in the future.
Good Luck, Dr. David Schultz

Question: It is my understanding that people who have heart disease should avoid foods that contain partially hydrogenated vegetable oil. How bad is it for you as many foods contain this and the amount or percent is not listed on the Nutrition Facts labels. Are there stores in our area that specialize in foods that do not contain this? Thank you

Answer from Dr. David Schultz: You have posed a question that is seemingly simple but actually complicated. Overall, the dietary saturated fat should no more than 10%. This however is rather difficult. If you consume 2000 calories per day, it comes out to less than a 20 gram a day for bad fat. As a second step, it is recommended limiting saturated fat to supply 7% of the needed calories per day for those at high risk, which figures out to be 12 to 16 grams a day. Also saturated fat and trans-fatty acids are in hydrogenated products like mayonnaise and margarine. There is an excellent book that is simple and can help you. I highly recommend this book. It is entitled The New Good Fat Bad Fat book, by Fisher Books by William P.Castelli, M.D. and Glen C. Griffin, M.D. The isbn number is ISBN 1-55561-183-4.   Good Luck, Dr. David Schultz

Question: This week I caught something on TV about some migraine meds causing weight gain and it went on to describe one that causes weight lost. I would like to know the name of that product and if it is effective. At the present, I am taking Bellamine-S tabs to prevent migraines and Fiorinal for paain. I have have two severe headaches in the last three months, so I am thinking about changing meds. I would like to know what you recommend. Thanks.

Answer from Dr. David Schultz: First, I do not know of any migraine medication that can cause weight loss or gain. Elavil is an antidepressant that is occasionally used to prevent migraines, and this medication can cause weight gain. There are several excellent medication to help prevent migraines (propanolol, calan), and several medications that can abort a migraine (imitrex, maxalt, zomig, axert, amerge, etc.) If one has pretty reasonable control of a migraine, one should not switch medications. Good Luck, Dr. David Schultz

Question: I've had swollen glands for a couple of months now. They became that way during winter months but they don't seem to go down now. Could something serious be wrong? I always seem to get throat infections.

Answer from Dr. David Schultz: Several entities can cause swollen glands in the neck. First, I have seen chronic sinusitis and sinus drainage cause persistent lymphadenopathy. Next, neck cyst and an enlarged thyroid can cause this. Viral infections such as mono can cause enlarged lymph glands. Finally, a lymphoma can cause this problem. Because of this, one should obtain a cbc and close monitoring of persistently enlarged lymph nodes. Best Wishes, Dr. David Schultz

Question: My son had a liver test and his D. Bilirubin was high .4 on the 0-.3 scale is there any concern for this? What would make this high?

Answer from Dr. David Schultz: The bilirubin that you are referring to is "direct or conjugated" bilirubin. There is also unconjugated or indirect" bilirubin. The two types together makes the "total bilirubin". The level that your son exhibits is not very elevated and should be repeated in the near future. If it persists, then other tests such as a hepatic"liver" ultrasound or hepatitis panel should be performed. Direct bilirubin is elevated by increased pressure in the hepatic portal ducts that transport blood in the liver. Certain hemolytic anemias can cause this. A rare disease of copper metabolism called Wilson's disease and hemosiderosis can also cause this. Finally a benign condition called Gilbert's disease can elevate the bilirubin.  Best Wishes, Dr. David Schultz

Question: Since birth, my 9 year old daughter has had very sweaty hands and feet. Her doctor has tried a cream, antibiotics, and suggested ice packs for her hands. Nothing has worked. Now, it is really bothering her. Her school papers look like they have soaked in the bathtub. Her hands actually drip with sweat. She is embarrassed. Can you help?

Answer from Dr. David Schultz: Overacting sweating is very common. First, one should make sure that there are no other medical problems such as hyperthyroidism and metabolic anomalies that could explain the situation. Next, one should make sure that your daughter is not overly anxious. Finally, there are medications for adults that can be used, but these may not be safe for children. Finally calcium and betablockers can be used in low dose for children to control overactive sweat glands. Tri-cyclic antidepressants and antihistamines can be used as well. I would not use antibiotics and ice.  Good Luck, Dr. David Schultz

Question: How long after I have a baby does it take for my hormones to get back to normal? Does it take longer if the baby was a boy?

Answer from Dr. David Schultz: Gender makes no difference. The hormones actually change after delivery. Women who breast-feed tend to have higher levels of prolactin, which can cause amenorrhea and lack of ovulation. Generally, 6 to 8 weeks is the amount of time for hormones to return to normal on average for the non-breast-feeding individual. Otherwise it is variable.  Thanks, Dr. Dave Schultz

Question: I am presently seeing a Rheumatologist to r/o Rheu.Arthritis, Lupus, or any other connective tissue disease.He wants to put me on Prednisone and check my blood work in 6 weeks.Is this advisable? Thank you.

Answer from Dr. David Schultz: If one is experiencing acute inflammation from a rheumatological condition, then Prednisone is a reasonable medication to suppress the acute insult. As the results of your testing (probably a sed rate, ANA, and rheumatoid factor, and so forth), are made available, then treatment can be tailored to your true condition. In the long run, mere anti-inflammatories may be sufficient, but with more severe conditions, more powerful medications, such as immune modulators or immunosuppressants, may be necessary. I hope your condition improves.
Dr. Dave Schultz

Question: What causes Diverticulosis and what can be done to remedy this condition? Can it be completely cured?

Answer from Dr. David Schultz: Excellent question. Diverticulosis is the condition where pouches form in the inner lining (mucosa) of the colon. It's caused by weakening in the muscular portion of the colon wall. These pouches can often bleed. Often, stool and small particles can become entrapped, causing inflammation and even infection--this condition is known as diverticulitis. Low-fat diets, high fiber diets, and regular meals can reduce effects of diverticulosis. Diverticulosis does not increase the risk for cancer. Thanks, Dr. Dave Schultz

Question: I have been taking Caltrate 600 plus for about 6 months. I take 3 tablets a day(1 with each meal). I started taking this to control diarreah. It has really helped this problem, but now I've heard that there may be serious side effects from taking this much calcium. Is that true? Thank you.

Answer from Dr. David Schultz: It really depends on your age level. For someone who's postmenopausal, this should pose little threat. For all others, you may want to decrease the dose a little bit. Individuals predisposed to having kidney stones are at higher risk for problems.
Thanks, Dr. Dave Schultz

Question: Have you heard of or would you recommend the D.A.S.H. diet to help control hypertension when only the top number is high and the bottom number is normal. I believe it involves eating alot of fruits, vegetables and low-fat dairy products. Thanks

Answer from Dr. David Schultz: For a healthy individual this may not be harmful. But for people with other health conditions, this could pose some concern. I would check it out with your doctor. Dr. Dave Schultz

Question: I have a disc pressing on a nerve in my back. Can this just go away, or is surgery usually necessary? If I do not have surgery, will I always have problems with my back in life?

Answer from Dr. David Schultz: Sometimes a nerve receiving impingement can resolve or improve with time. In fact, 70 percent of herniated disc remit spontaneously even without therapy. Physical therapy, as well as the use of anti-inflammatory medications, and Vax-D can improve the overall situation and remove the pain. I would not, however, let nerve entrapment go untreated for a long period of time, as permanent nerve damage can occur. Close follow-up is imperative.
Dr. Dave Schultz

Question: I have had numerous sinus infections since August, along with some ear infections as a result of them. I have had two in the past two months, while taking Clarinex. I've been on antibiotics everytime I've had the infections, but I seem to keep getting them. Do you have any advice for me?

Answer from Dr. David Schultz: First, I would look for sources of allergy in your home such as cats, dust mites, and molds. Individuals with basements especially with carpet over a concrete floor are especially prone to this. Symptoms such as sneezing, watery eyes, and drainage form the sinus can be associated with would avoid, however, the over the counter remedies especially the otc nasal sprays as they can prolong your troubles. Finally, consider an ENT physician in consultation.  Thanks, Dr. David Schultz

Question: Can a sinus infection cause your teeth/jaws to ache and throb? Should you see an MD or a dentist? What treatment would you recommend?

Answer from Dr. David Schultz: Sinus infections can cause teeth and jaws to hurt. I would first see a physician and then obtain treatment based on his/her discretion. Wisdom teeth as they are coming in can cause similar problems but are less likely to be associated with runny nose, cough, and congestion. Thanks, Dr. David Schultz

Question: I am pretty sure my 21 month old son has fifth disease, but I was wondering, Is it normal to run a fever the day the rash appears, and should the rash on the face go across the nose? I just want to make sure that it is Fifth disease rather than something else. Thanks

Answer from Dr. David Schultz: Fifth Disease otherwise known as erythema infectiosum is caused by a virus known as parvovirus B-19. It usually spares the nasolabial and circumoral areas on the face giving a "slapped cheek" appearance. Fever may or may not be present. It is common to see body aches and a runny nose. Other viruses, however are equally capable of producing rashes. Also, seborrhea can cause a rash that can be confused with Fifth's Disease.
Thanks, Dr. David Schultz

Question: With Type II diabetes, why are sores slow to heal? Is there some kind of medication or light therapy (or other therapy) which speeds up healing and can be done in the privacy of one's home? Thank you.

Answer from Dr. David Schultz: Wounds in diabetic patients do not heal well due to the body not fighting bacteria as readily, small vessel ischemic disease, and the higher levels of glucose reducing diffusion of vital electrolytes among cells. Simply stated, blood which can cleanse a wound has a more difficult time reaching a wound. Light or phototherapy, PUVA therapy have minimal roles in improving diabetic wound healing.
Thanks, Dr. David Schultz

Question: I'd like to know if it is possible to have an inverted breastbone fixed thru surgery ?

Answer from Dr. David Schultz: Pectus excavatum or "caved in breast bone" is a condition that can be repaired with surgery if necessary. Pectus carinium is a "pigeon like" chest that can also be repaired. Thanks, Dr. David Schultz

Question: I am asking for my mother. She is 76 and has the right artery from her neck to her brain completely blocked. Her left side is 60% blocked. She is taking Plavix 75mg, taken at bedtime. In the morning she has terrible headaches and her vision is blurred. She is also taking Lorzepan 5mg for anxiety, taken at bedtime. Levoxyl .25mg for thyroid, taken in the morning. She has been told her option for clearing her artery is not worth the risk of having a stroke during surgery. My question is can any of these medications be the cause of her headaches and blurred vision and sometimes confusion? By the afternoon she is feeling fine. She has had an MRI was told that was fine. She has seen a neurologist and was given some pills for headaches. Any advice you can w, ill be much appreciated.

Answer from Dr. David Schultz: Thank you for your question, Several conditions besides cerebrovascular disease can cause your mother's symptoms; however, the likelihood of the vascular flow to the brain being the cause is very high. Medications such as the benzodiazepines (lorazepam), anti-histamines and certain blood pressure medications can cause problems as you have described. Other possibilities include electrolyte disturbances, heart arrhythmias, and hypotention can pose similar problems.   Thanks, Dr. David Schultz