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### Human:\ncan type 1 diabetics gain weight using yeast pills? . i am a maie type 1 diabetic. i am 5'4 in height and weigh 108lbs. i am trying to gain weight and my doctor says that my metabolism burns up everything i consume quickly. i was told that by taking yeast pills that i may be able to gain some weight. is this possible and what are the risks. i want to know what my weight should be and how i can attain that.\n\n### Assistant: i cannot find any research that shows taking yeast results in weight gain. as for your weight you body mass index in borderline normal weight meaning you are on the lower end of normal. this bmi calculator can give you more personalized info and help you decide where you want to be. i highly recommend you visit to a registered dietitian who can take your diabetes into account while advising you on diet. you can find one at eatright. org. exercise especially resistance training and a balanced diet can help you build muscle which can increase weight over time. for more on healthy weight gain see this article.

### Human:\nhow does naturaly produce cholesterol of the body differ from cholesterol in dietary foods?\n\n### Assistant: cholesterol in the body is a waxy like substance that travels through blood and provides many important functions like making hormones. no one needs to ingest cholesterol because the body makes it especially the liver. the process of making "bad cholesterol" (ldl) increases when someone eats too much saturated and trans fat and not enough fruits vegetables and soluble fiber. the good cholesterol (hdl) is beneficial for health because it helps clear the bad cholesterol out and is related to exercise and the consumption of healthy fats (nuts vegetable oils etc) intake. there is also a genetic link to cholesterol levels meaning people with a family history of high cholesterol may be at higher risk. cholesterol is also found in foods of animal origin such as meat poultry and full fat dairy but isn't linked to high cholesterol as much as saturated and trans fats are. that being said the american heart association says too much cholesterol in the diet can lead to increased plaque in the arteries. for more info see the basics of cholesterol

### Human:\nwhich preventive care screenings and tests will be free after september 23? will they need a doctor's referral?\n\n### Assistant: well you don’t need a doctor’s referral. hopefully you’ll go to the doctor to get the screening but you don’t need any special visit in advance of the screenings. and the preventive care option will cover a wide variety of things. so for parents children’s immunizations and vaccines will be covered a whole variety of cancer screenings will be covered mammograms and colon cancer. the u. s. preventive care task force which is a group of medical providers who are in the public health service actually look at preventive services that are the most effective and update their recommendations on a regular basis and they grade them a through d of what is effective for which age category and what kind of condition. and any screening that gets an a or a b will be automatically included in the kind of preventive care that’s offered without co-pays and without co-insurance. it’s very good news for people. … if you’re a 58-year-old woman with a chronic condition you would be recommended to get a pap smear yearly even if you’re healthy a mammogram yearly; you may have a screening or two for diabetes or for other conditions. you will be looking at potentially $300-$400 out of pocket and that for a lot of people is a pretty high financial burden particularly now in this downturn. …we’re updating medicare benefits so medicare beneficiaries will be able to have preventive care and have an annual wellness test. we’re getting to illness at the outset making sure that we can stop people from getting sick as opposed to paying for the care once they get sick makes good sense. and i think this is a great benefit that will be coming effective again on or after september 23. and it’s really good news for lots of folks.

### Human:\ncan i really lower my risk of diabetes with exercise and a healthy diet?\n\n### Assistant: if your family members have type 2 diabetes which used to be called adult-onset diabetes there is a lot you can do to lower your risk. the most important thing is to maintain a healthy weight through diet and exercise. stay active to help keep your weight under control and be careful not to consume more calories than you need per day.

### Human:\nwhat is the minimum number of calories a woman can safely eat long term (up to two years or more)? . i’ve seen numbers ranging from 800 to 1200 (even here on webmd) where 800 might be the break between low calorie and very low calorie and 1050 is where your body enters starvation mode. . 1200 is the conventional number but is this in keeping with modern understanding? if a person opted for 800 without supervision would this be safe and sustainable long-term provided it was followed with proper transition and maintenance?\n\n### Assistant: the actual minimal number of calories that you can safely eat long term depends on your basal metabolic rate (bmr) which is the energy necessary for your body and its organs to maintain normal function while simply at rest. although there are equations to calculate bmr such as the harris-benedict equation these are all theoretical estimations and your actual number could vary. there are other more accurate methods to calculate your bmr through either direct or indirect calorimetry techniques that usually measure gas exchange between oxygen consumption and co2 production. you could do an internet search to find test facilities near you for these methods if you’re genuinely curious otherwise the bmr equations might give you a good enough estimate. you’re correct in stating that 1 200 calories is typically the conventional lower threshold value given and i think that it’s fair to use as an estimate for most of the general population (again your actual number will vary). by far however 800 calories per day would be considered a very low calorie diet (vlcd) because it would be very hard to meet your nutritional needs with so few calories. this type of diet would generally not be recommended for individuals who are not obese and who don’t have proper medical supervision. your doctor will take your specific circumstances into consideration before helping you decide if you should go on a vlcd and you may need to work with a dietitian to develop a specific eating plan to help ensure that you meet your nutrient needs while following the diet. it’s important to note that although vlcds have been shown to lower weight and help with obesity-related conditions like hypertension diabetes or high cholesterol in obese individuals; they don’t seem to be any more effective than a more modest dietary eating plan long term. you will likely regain any weight loss after going off the vlcd unless you transition into a healthy eating plan while incorporating regular exercise which is another aspect of why medical supervision from your doctor or a dietitian would be essential.

### Human:\ncan certain medications cause diabetes?\n\n### Assistant: yes. there are several classes of drugs that may increase blood sugar levels and thus increase the risk for diabetes. some of these are: • statins: these are very effective medicines that reduce cholesterol. they reduce risk of heart attack and stroke. these include atorvastatin (lipitor) simvastatin (zocor) rosuvastatin (crestor) fluvastatin (lescol) lovastatin (mevacor) and pravastatin (pravachol) • thiazide diuretics: these are a type of water pills that are sometimes used to treat high blood pressure or swelling. hydrochlorothiazide or hctz is a common example. • steroids: these are anti-inflammatory medicines such as prednisone and cortisone. they also include anabolic steroids used in muscle building. • beta-blockers: they are used to treat high blood pressure and certain heart problems including heart failure. they are also used after heart attacks to increase survival rate. examples include carvedilol (coreg) propranolol (ideral) metoprolol (toprol and lopressor) nadolol (corgard) and atenolol (tenormin). • atypical antipsychotics: these are used to treat a variety of psychiatric illnesses. these medications may cause weight gain and increase the risk for diabetes. they include: olanzapine (zyprexa) risperidone (risperdal) aripiprazole (abilify) and ziprasidone (geodon) in many cases the benefits of using these medicines outweigh any risks. only your own doctor can help you decide what medicine is right for you. never stop any medicine without first talking to your doctor. statins may be very effective at stopping our body from producing natural endogenous cholesterol but they are not very effective in stopping heart attacks according to the medical research i have read. this may be due to the fact that cholesterol is not the cause of arteriosclerosis; cholesterol buildup in the artery walls is caused by inflammation. forcibly lowering cholesterol causes other problems too numerous to list here. other than this important point the answers to the question seem to be accurate but the standard knee-jerk response that statin drugs are useful as a blanket approach to high cholesterol is outdated and misguided. it should be corrected. a study from brigham and women's hospital in boston published in july 2012 found a link between phthalates commonly called "plasticizers "and diabetes in women. researchers analyzed urinary concentrations of phthalates in 2 350 women aged 20 to 80 participating in the government-sponsored national health and nutrition examination survey and found that those with higher levels of phthalates in their urine were more likely to have diabetes than those with low levels. phthalates are found in medical products including tubing iv bags and some medications diabetic link does exist. can certain medications cause diabetes? maybe

### Human:\ndoes aspirin help prevent heart attacks and strokes?\n\n### Assistant: i want to. talk about the use of aspirin for prevention of heart attacks strokes and other blood clotting problems. aspirin is commonly used for minor aches and pains and to reduce fever. aspirin also combats the effects of platelets blood cells that help blood clot. this helps reduce the number of heart attacks and strokes. indeed platelets are essential to human life because an excessively low count would cause bleeding. but platelets can also be involved in too much clot formation. when this occurs it can block a blood vessel and can lead to many potentially life-threatening problems including heart attack stroke and pulmonary embolism (a blood clot in the lungs). it’s important to achieve a balance between too much clotting and not enough clotting. there is much confusion regarding the use of aspirin in prevention of heart attack and stroke. the use of aspirin to prevent a first heart attack or stroke — called primary prevention — is widely debated. there have been approximately seven clinical trials testing the effects of aspirin in someone with no prior history of heart attack or stroke. the doses have varied from 50 mg to 500 mg. while not all the trials showed benefit only one trial showed an increased risk of bleeding but those were patients on high dose aspirin. based on this ambiguous data the current american college of cardiology/american heart association guidelines recommend aspirin for primary prevention only in men with diabetes and intermediate cardiovascular risk and without an increased risk of bleeding. those patients who have a 10% risk of a cardiovascular event over a 10-year period are defined as intermediate risk. the european society of cardiology guidelines do not recommend aspirin in primary prevention. in patients with previous stroke heart attack or certain other blood clotting problems aspirin has beneficial effects. for these people the american college of cardiology/american heart association guideline recommends starting aspirin 75 mg to 162 mg and continuing indefinitely in all patients unless other medical problems prevent its use. the benefits of aspirin need to outweigh the risk. yes it sure does. seven months ago my pulse went from around 55 to 65 count to over 200 beats. my blood pressure was steady at the 120 over 60. i was on a 325 coated aspirin since my by pass in 1999. i was on vacation at the time and when i seen my family doctor three weeks after it started he told me i had af and thanks god i was talking a 325 aspirin. my heart doctor agreed and now i am on pradax blood thinner. i have fluid in the lungs from the leaking blood and on a 40mg water pill. thank you toe fanjoy my hands and legs have been tingling and my right side has a pain can not move or cough it hurts

### Human:\nwhat kind of snacks would you recommend for people who are diabetic?\n\n### Assistant: a diet to help control diabetes is often individually prescribed -- based on body weight and lifestyle -- to help keep blood sugar levels in control. the best snacks for diabetics will contain some protein and some fiber to help slow down food absorption and therefore help control blood sugar levels and prevent spiking. avoid simple sugars such as in cookies and candies and choose whole grain crackers low-fat cheeses maybe a slice of turkey or leftover chicken. and pair these foods with a small amount of fruit if desired. know that fruit while healthy can be high in natural sugars that will spike blood sugar levels unless combined with a protein source to slow down their absorption in your body.

### Human:\nwhat vitamins could you take for low estrogen?\n\n### Assistant: although supplement companies will claim their vitamins will help balance hormones the evidence regarding this is lacking. first off a lot depends on why your estrogen is low. if it is because of peri-menopause or menopause you want to be sure you are getting enough calcium (through diet is recommended over supplements) and vitamin d for bone health which can decrease with lower levels of estrogen. look at your diet. try to eat healthier by including plenty of fruits vegetables whole grains low fat dairy healthy fats and lean protein (including fish twice a week). if there are gaps in your diet then consider supplementing. for example if you don't eat fish you may want to consider omega-3 fatty acids (fish oil). vitamin d is tough to get through food so supplementation is usually needed. if you are concerned about it see a registered dietitian who can help you sort through the proper diet and supplementation. you can find one in your area at eatright. org. also see: the 7 missing nutrients in your diet

### Human:\ncan a panic attack/hyperventialing cause blood sugar to rise? . my son had his glucose test for cf yesterday and while he was waiting for the 2 hour results he had a panic attack and began sobbing uncontrollably and hyerventilating because he was hungry and realized he couldn't eat for 2 hours (the clinic messed up and they had to put off his initial drinking of the glucose for 3 hours after he had already been there). anyway his fasting glucose was 86 his a1c was 5. 2 but when they did his post fasting it was 206.\n\n### Assistant: i cannot find anything linking panic attacks to high blood sugars. it seems plausible that increases in stress hormones during a panic attack could temporarily increase blood sugars. your son's a1c and fasting glucose are normal so the high blood sugars are not caused by diabetes.

### Human:\nwhat is the cure for dry skin?\n\n### Assistant: dry skin can be attributed to a variety of skin disorders such as eczema rosacea or psoriasis. medical problems such as thyroid disease kidney disease liver disease and certain connective tissue diseases may also contribute to dry skin. your first approach is to exclude any potential medical causes with your physician. if your dry skin is not related to an underlying medical cause then your skin regimen needs to include moisturizers that contain health-rebuilding compounds such as vitamin a c e peptides or hyaluronic acid.

### Human:\ni have some sort of white chunky residue in my urine everytime i use the bathroom could this be a yeast infection?\n\n### Assistant: in females vaginal yeast infections can cause burning itching and sometimes a whitish chunky discharge. yeast is normally found in the vagina in very small amounts. a yeast infection happens when this yeast begins to grow out of control. things that can cause this to happen include: • antibiotics • hormones • pregnancy • diabetes • weakened immune system but there are other things that can also cause white discharge from the vagina. you should make an appointment with your doctor or your gynecologist to see what is causing your symptoms.

### Human:\nwhat would cause me to have my period for three months straight?\n\n### Assistant: there are two major reasons for very prolonged/heavy periods: hormonal and what i call "structural". "structural" means when excessive bleeding is due to actual problems within the cavity or walls of the uterus. some examples of this would include fibroids of the uterus endometriosis of the muscular wall of the uterus ("adenomyosis") infections of the lining of the uterus (e. g. gonorrhea or chlamydia) polyps of the uterine lining or even uterine cancer (much less likely in a younger woman). hormonal causes are usually linked to missed or erratic ovulations. as you may know in a normal cycle estrogen is produced all month. estrogen is responsible for building up the lining of your uterus so you have something to shed each month. in a normal cycle progesterone production increases following ovulation. progesterone "stabilizes" the uterine lining in preparation for a possible implantation of a new pregnancy. if you are not pregnant that month the levels of estrogen and progesterone fall triggering the release of the uterine lining—your period. so if you do not ovulate the estrogen build up of the lining continues but without the usual ovulation associated progesterone. thus the hormone levels don't decline and the lining stays up inside the uterus—your missed/late period. alternatively the lining can begin to shed under its own weight producing prolonged bleeding. . causes for not ovulating are multifold: thyroid problems pituitary problems ovarian cysts physical stressors (e. g. sudden increases in exercise crash dieting) emotional stressors (problems with partners work/school finances) increased body weight anorexia rotating shifts at work etc. .

### Human:\ncan you have hyperglycemia without being a diabetic? . my husband just had his physical and they administered blood tests after an 8-hour fasting. after seeing elevated blood sugar levels his doctor administered more extensive tests to check for diabetes. his mother and his brother were/are diabetic. his lab review stated the following "the glycohemoglobin was 6. 0 which indicates hyperglycemia but is not indicative of diabetes. " then there were suggestions of watching his diet losing weight (which he has lost about 15 lbs. in the last 2 years)\n\n### Assistant: a glycated hemoglobin a1c of 6. 0 (5. 7-6. 4 range) is considered pre-diabetes meaning your husband has elevated blood sugars and is at increased risk for developing type 2 diabetes. according to the centers for disease control 15-30% of people with pre-diabetes will be diagnosed with full blown diabetes in 5 years. so watching his diet moving more and losing weight if needed can help prevent the development of diabetes. to better understand glycated hemoglobin see this webmd article and for more on what to do after a pre-diabetes diagnosis see this one. good luck!

### Human:\nwhat is the treatment for a large skin pinch blood blister?\n\n### Assistant: a blood blister that results from a pinch is an accumulation of blood as a result of trauma to the skin. it is best not to pop a blood blister as this can lead to infection and possibly even delay the natural healing process of your body. covering the blood blister with a soft dressing to keep it protected can be helpful as it resolves on its own. if the person who has the blood blister has any underlying health conditions especially diabetes it would be appropriate to seek medical care. if the blood blister pops on its own do not peel off the remaining skin. rather leave it in place treat the area with an antiseptic ointment and cover with a clean dressing. allow it to heal in its own time. if the injury is very recent ice can help to reduce the pain that the trauma initially induced.

### Human:\naccording to the cdc 16 new antibiotics came to market between 1983-1987 but only 2 between 2003-2007. why so few?\n\n### Assistant: the number of new antibiotics in development is alarmingly low and it's a matter of resources. antibiotics are taken for a shorter period of time and it's more economical for drug companies to make drugs that are taken for a long time. we're also promoting the concept of using these antibiotics judiciously so companies and researchers don't see the economic benefit. antibiotics are not used in volume like a cholesterol or diabetes medication. the fda is currently considering options to facilitate new antibiotic development.

### Human:\ncan increased physical activity and weight loss cause you to skip your period?\n\n### Assistant: yes if you have recently lost five to 10 pounds and increased physical activity that can be perceived by the hypothalamus as a form of physical stress. this can interfere with regular ovulations temporarily. . my best guess is that your cycles will return as your hormones reset themselves. if you have missed periods for three months or more see your gyn.

### Human:\nwhat are normal tsh levels?\n\n### Assistant: it depends on the laboratory running the test and any medical conditions you have. speaking roughly normal levels of thyroid-stimulating hormone (tsh) are in the range of 0. 4 to 4. 0 miu/l. however each laboratory and test manufacturer identifies its own normal tsh range. this is based on the test the equipment being used and the patients being tested. the american association of clinical endocrinologists has proposed a range of 0. 3 to 3. 0 for normal tsh levels. using these cutoff values would lead to more people being diagnosed with an underactive thyroid (hypothyroidism). other experts recommend using 3. 0 as the high end of normal for people being treated for a thyroid condition. if your tsh results fall near the high or low end of normal the best way to understand them is to talk with your doctor. my tsh lev l is 1. 19 is that normal?

### Human:\nwhat causes thrush?\n\n### Assistant: small amounts of the candida fungus are present in the mouth digestive tract and skin of most healthy people and are normally kept in check by other bacteria and microorganisms in the body. however certain illnesses stress or medications can disturb the delicate balance causing the fungus candida to grow out of control causing thrush. medications that upset the balance of microorganisms in the mouth and may cause thrush include corticosteroids antibiotics and birth control pills. illnesses or medical situations that make candida infection more likely to develop include uncontrolled diabetes hiv infection cancer dry mouth or pregnancy (caused by the hormonal changes that occur with pregnancy). people who smoke or wear dentures that don't fit properly also are at increased risk for thrush. in addition babies can pass the infection to their mothers during breast-feeding.

### Human:\ndoes the use of insulin affect your eyes?\n\n### Assistant: insulin affects your vision because insulin lowers blood glucose levels which in turn effects the lens of the eye not because insulin has a direct effect on your eyes. when your blood glucose (sugar) levels go up fluid enters the lens of your eyes and when your blood glucose goes down the fluid shifts out of your lens. these changes in fluid in the lens cause blurred vision so both high and low blood glucose levels affect your vision. as your blood glucose levels stabilize on insulin these shifts become less and your vision improves. so be patient. in most cases the blurry vision after you start insulin settles down. usually these vision changes resolve within a few days or weeks depending on how quickly your diabetes comes under control. after examining your eyes your doctor will be in good position to hopefully reassure you that these vision changes are temporary. therefore unless you are really having serious vision problems wait until your blood glucose levels settle before having your vision tested for a new pair of glasses.

### Human:\nis there a link between continually hives and sythetic thyroid medications? . i just started to get hives on my body one day. the dermatologists did the removal of possible triggers and nothing helped. it has been about 3 and 1/2 yrs and i have to take antihistamine medications to keep them at bay. i also have hypothyroidism (for 15 yrs. ) and i heard synthetic medications may cause thyroid antibodies to react against the body causing the hives. has anyone seen this connection?\n\n### Assistant: any medication including thyroid medications can cause an allergic reaction such as hives. the incidence of hives with thyroid medication though is very low. however there is a known association between hives and thyroid antibodies. about a quarter of patients with long term hives (chronic urticaria) have antibodies to thyroid tissue and many of these patients are found to have low thyroid levels. the patients who had the worst hives were also the ones more likely to have antibodies to thyroid tissue. hives patients can also have antibodies to other immune mediated diseases such as lupus. unfortunately treating the thyroid condition does not eliminate the hives. hello i have hypothyrodism for about 14 yrs now. i am fine taking 150 synthroid. anyways the problem is my son. he is now 36yrs old and was diagnosed with graves about 2yrs ago. he was given the radio active iodine treatment to shut or slow it down. a year later now they started him on synthroid levo armour including others that have been made specially for him but they all cause him to break out in hives and swelling around the face after one or two days. he has seen two allergist since. the first one diluted each and everyone of the meds and injected them in liquid form and sure enough the hives started. he is now off all thyroid meds but very frustrated and feeling all the symthoms of hypo. none of the doctors know what to say or have an answer. and i am frustrated too because i want to help him as i am hypo and don't have any problems like that. please help. if anyone knows about this conditions i have come across many forums about this allergies to meds but again no real answers and they seem to be old 2003 04?

### Human:\nhow should i take omeprazole and levothyroxine which are to be taken in the morning four hours apart?\n\n### Assistant: currently there are no drug interactions found between levothyroxine and omeprazole. however this does not mean that interactions cannot exist. it is important to work with your pharmacist to see if there is any new information regarding these two products. omeprazole should be taken 30 minutes prior to a meal. levothyroxine should be taken 30 minutes to one hour prior to a meal. they can be taken together with water on an empty stomach if needed. the previous answer is not only false but can lead to very serious health implications. co-administration of omeprazole/other ppis/acid reducers/etc. along with thyroid meds (whether for tsh t4 or others) can cause a drastic decrease in absorption of the thyroid medication. there are many peer reviewed studies that prove this all one needs to do is a proper google search or a subscription to any of the popular medical journals. your stomach needs an acidic environment to properly convert your thyroid medication into a usable medication to get into your bloodstream and if you take an acid reducer with your thyroid med this can cause problems. if you must take both (as i personally do because of my tsh levels reaching 24. 6 plus ulcers and cancerous polyps due to gerd) make sure you take your acid reducing medication at least 4 hours before your thyroid medication (no matter what kind it is) and make sure not to take another acid reducing medication at least 4 hours after your thyroid med. if you do not separate the acid reducers 4 hours before and 4 hours after your thyroid medication your thyroid levels will become unstable and you will need to adjust your dosage. but in order to prevent your levels from getting out of whack and potentially causing more harm just separate your meds as posted above and you should have no issue. the above answer telling you that it is okay to take at the same time is incredibly harmful. don't take my word for it (someone who has been dealing with both issues for a decade) trust the scientists that have figured this out through multiple peer reviewed studies. just a few sources proving the point of my previous answer after 2 minutes of google searches (wow was that previous post really posted by a doctor? i feel bad for their patients): <link> <link> <link> <link>

### Human:\nwhen i am sitting and i get up to stand i get dizzy and see spots. why is this? . i am also wondering why a person would be instantly dizzy and have spotty vision when standing up from a sitting position or just while walking.\n\n### Assistant: what you are describing is called orthostatic hypotension or postural hypotension. a drop in your blood pressure occurs when you go from either lying or sitting to standing. this type of low blood pressure (hypotension) usually lasts only a few seconds or minutes. orthostatic hypotension can make you feel dizzy or lightheaded and may even cause you to faint. mild orthostatic hypotension often doesn't need treatment. many people occasionally feel dizzy or lightheaded after standing and it's usually not cause for concern. the treatment for more severe cases of orthostatic hypotension depends on the cause. orthostatic hypotension can be caused by a variety of conditions including dehydration diabetes heart problems neurological diseases such as parkinson’s disease medications and longstanding high blood pressure in older adults. if you have orthostatic hypotension caused by medications your doctor may change the dose or switch you to a different drug. other treatments include increasing fluids to treat dehydration or wearing elastic hose to increase the blood pressure in your legs. see your doctor to determine whether your symptoms are related to an underlying condition that warrants treatment and if so what treatment is appropriate for you.

### Human:\nwhy do so many people gain weight in midlife?\n\n### Assistant: blame it on hormones in convergence with poor lifestyle choices overeating not exercising enough and stress. but hormones only account for about two to five pounds. the rest is the result of overeating poor lifestyle choices -- such as not exercising enough -- and stress.

### Human:\ni have very very dry hands that are cracked. what should i use on them?\n\n### Assistant: your first step is to exclude any underlying medical causes such as a thyroid condition connective tissue disease or an infectious process. when you wash your hands avoid cleansers that contain alcohol. this will further dry your hands. your next step is to focus on moisturizing and hydrating your hands.

### Human:\nis there a specific doctor that i need to see for an anal abcess?\n\n### Assistant: that would be a proctologist (a colo-rectal surgeon). in some areas a gastroenterologist or general surgeon may do this type of procedure. an anal abscess can be a simple drainage procedure or a more involved surgical removal so finding the most skilled specialist is important. a general or rectal surgeon is the appropriate physician to see for treatment of an anal abscess. an abscess is a collection of pus. an anal abscess may develop in the deep tissues surrounding the anus or be more shallow under the skin. they both require immediate treatment to lance the abscess and let it drain. therefore it is important that you see a surgeon. a general practitioner may be able to take care of a small abscess in the office. antibiotics alone usually cannot treat the problem. without proper treatment an abscess can cause a widespread infection (septicemia). you are more likely to get an anal abscess if you have diabetes inflammatory bowel disease such as crohn’s engage in anal sex or have an impaired immune system such as from aids or chemotherapy. if you have recurrent anal abscesses and there is no clear explanation for their cause a consultation with a physician who specializes in diseases of the gastrointestinal tract (gastroenterologist) may be appropriate.

### Human:\nwhere do i start if i have never exercised?\n\n### Assistant: if you're new to exercise or have struggled with it in the past talk with your doctor about your exercise plans. after that start by incorporating more activity into your daily life. for instance: if you always take the elevator try the stairs. if you try to park next to the door of wherever you're going park farther away and walk. if your habit is to eat at your desk take a 10- to 20-minute walk first then have your lunch (or take a walk after you eat). instead of watching tv all day saturday and sunday plan active weekends. go to the park take a walking tour ride your bike or row a boat. whichever plan you decide on it's a good idea to set weekly goals: write down what activity you plan to do on what day of the week for how long and at what time of day. be as specific and realistic as possible. for instance write down "tuesday: walk for 20 minutes at 7 p. m. to the park and back. " at the end of each week review your goals and set new ones for the upcoming week. research shows that setting goals will help you stick to your program. it will clarify what you're supposed to do and let you track your progress. if you hit a roadblock later on you can refer back to what has worked in the past or use your accomplishments to re-energize yourself. first make sure that your doctor clears you for exercise before beginning. he or she may ask you to fill out the physical activity readiness questionnaire (par-q) to ensure that there is no reason for you not to exercise. i would then recommend setting personal goals using the s. m. a. r. t. acronym which stands for: s – specific m – measureable a – attainable r – realistic t – time-oriented here’s a sample goal keeping these principles in mind: “between january 1st and february 1st walk three days per week for twenty minutes per session to aid in weight loss. ” set up short term goals to help you meet your long term goals (6 months or more). think about what you want to achieve by beginning an exercise routine. do you want to lose weight lower your blood pressure or help manage diabetes? do you want to run a race such as a 5k? what do you hope to gain from starting exercise? the biggest problem that people have is that they overwhelm themselves by doing too much exercise too soon. it can be hard to sustain a drastic change like that long term. instead slowly and gradually progress with exercise to make for an easier transition and to allow your body to comfortably adjust. start out doing low impact exercise like walking or riding a bike then gradually increase the time intensity level or number of days per week that you exercise. if you’re new to strength training get help from a personal trainer to make sure that you are using the equipment properly. make a plan and stick to it.

### Human:\nhow do i keep from waking up hungry? . i usually eat dinner between 6 and 8 at night but i'm always ravenously hungry when i wake up (between 5-6 on weekdays and 7-8 on weekends). sometimes i even wake up and struggle to get back to sleep due to hunger. i eat protein with every meal and eat several small meals a day the largest always being dinner in hopes of not waking up hungry. it's not a thyroid problem i've had that tested twice in the past 2 years and i'm 30 pounds overweight (failing to lose weight for 3 years now).\n\n### Assistant: in some cases waking up hungry would not be a problem but it sounds like it is affecting your quality of life. in addition to your protein source at dinner try including a big salad and/or soup whole grains and some healthy fat (olive oil avocado etc. ). eating from all the food groups helps increase feelings of fullness. you can also try a bedtime snack of something light like fruit with peanut butter or whole grain crackers and cheese. if you are staying up late this can increase hunger so getting to sleep early can help. you also want to make sure you get enough to eat earlier in the day including a good breakfast and lunch with in between healthy snacks. also make sure you are hydrated so that isn't being confused with hunger. for more tips on managing your hunger see this article. good luck! make sure that you are eating healthy for the whole day. have a packed breakfast with a glass of milk or fruit juice everyday and have a good dinner too. you may have your dinner earlier at night so you can sleep earlier but make sure that you don't sleep right after dinner at once. you may meditate before you go to sleep to get rid of stress. no surgery fat off - <link>

### Human:\nis surgery the only way to get rid of stretch marks?\n\n### Assistant: stretch marks occur from disruption in the underlying dermal support of the skin. topical medications that contain tretinoin are designed to increase cell turnover and encourage new collagen deposition. lasers work by targeting and subsequently tightening the dermis and encouraging new cell growth. a combination of topical products and lasers may improve less severe stretch marks. but more severe stretch marks are less likely to respond to nonsurgical approaches. stretch marks are weaknesses in the supporting structure of the skin causing layers of the skin (dermis) to separate and leaving the skin grooved and discolored. stretch marks develop when the skin is excessively stretched during pregnancy weight gain or growth spurts. they are most common during pregnancy and the teen years when growth spurts and increased levels of steroid hormones cause significant changes throughout the body. stretch marks can also be brought on by obesity. genetic factors including inherited defects of connective tissues also play a role. prevention is the key. to avoid stretch marks avoid rapid weight gain or loss. moisturize daily when pregnant. there is no exact cure for stretch marks; however products containing glycolic acids tretinoin or vitamin c help towards rebuilding the structure of your skin. for a more invasive option consider laser resurfacing. lasers work by stimulating collagen synthesis. for severe stretch marks you may want to consider evaluation by a plastic surgeon for surgical removal.

### Human:\nhow can i age with vigor?\n\n### Assistant: in 2008 i was asked to lead a half marathon team for more magazine’s annual spring run in central park. my team of peeke performers was comprised of women who were cancer survivors and included women who had triumphed over cancers of the breast thyroid lung and bladder. one woman ran with just one lung and did great. all of these women were extraordinary but one was a real character. that’s elaine doll dunn. like me she’s got a wicked wit and plenty of sass. tall and regal she looked ageless and in reality was 71 years young. she carried herself with grace and elegance but her impish grins gave away her real personality— a powerful survivor who brushed off her bladder cancer as a speed bump along a winding hilly and joyful life journey. that’s elaine. we did lots of pr for the half marathon including a segment on "good morning america. " her one-liners kept me laughing and her endless energy was astonishing. after completing the half marathon elaine insisted i come to south dakota and keynote her marathon in the spearfish canyon about 45 miles outside of rapid city. to sweeten the deal she informed me that the marathon weekend coincided with biker week where over 250 000 harley enthusiasts descend upon the town of sturgis (not far from spearfish) and basically rally tour the countryside and yes indeed have a party or two. i had a funny feeling she would become quite a fount of enlightenment for me. and i was right. as you know by now this coming sunday august 22nd i’ll be competing in the iron girl triathlon with a group of my patients the peeke performers. i was thinking about this upcoming race as i addressed elaine’s marathoners who were experiencing the usual pre-race day blend of anxiety and excitement. as i looked around the room i noticed that at least half the crowd of runners was women well into their 60’s and beyond. and i knew why. presently 73 years old elaine has been a living inspiration for women who dared to push their envelope at any age. and she’s been doing this for many years. her motto is: “i postpone death by living by suffering by error by risking by giving by loving. ” anais nin here’s a quick sampling of her achievements. at each age she: 52 — climbed 900 foot devil’s tower in wyoming 53 — had a major role in last of the red hot lovers. 54 — placed second in a body building contest that was not age grouped! 55 — ran the centennial trail 113 miles across south dakota from wind cave national park to the top of the sacred bear butte 56 — was challenged by bladder cancer and won. 57 — married jerry dunn during the disney world marathon and finished the race. they were interviewed on the today show just after the ceremony at the magic kingdom. 58 — climbed mt. kilimanjaro and won the marathon there the day after we got off the mountain. 59 — won the swimsuit competition in the golden times newspaper and was featured on the front page and as the centerfold. 60 — ran from the atlantic to the pacific ocean across panama 60 miles to celebrate her 60th birthday. 61 — became mrs. south dakota and participated at the national level for mrs. america. she was 30 years older than the other contestants. 62 — ran a marathon of marathons 26. 2 marathons in the year 2000. one of these was completed with three of her children who were running their first marathon. 65 — completed a doctor of philosophy in psychology researching the self-efficacy of women who begin marathoning after the age of 40. 71 — was the recipient of the spirit of dakota award annually honoring one woman whose leadership qualities courage strength and community commitment illustrate the best of south dakota womanhood. alright elaine’s quite an exceptional woman and i’m not asking anyone to start rock climbing at the age of 60 or pick up marathoning. however i just wanted to drive home the point with my velvet sledgehammer that it’s never ever too late in life to wake up get up and challenge yourself for mental spiritual and physical growth and fitness. become fearless and don’t be afraid to put it out there no matter your age. here’s the lesson. never say “i’m too old to do that. ” old is an attitude that gets in the way of living your life to the fullest. approach new challenges you may want to participate in with this phrase on your lips “that sounds interesting. i’ll give it a whirl and see what happens. ” don’t look at numbers. focus on the quality of every breath you take. age is after all just a number.

### Human:\ni’ve gotten a yeast infection just before my period for 2 months. i used an otc treatment and diflucan. what can i do?\n\n### Assistant: premenstrual yeast infections are fairly common. the timing has been attributed to either a slight blunting of immune function at this time in the cycle or ph changes. (menstrual flow is alkaline and the good vaginal bacterias prefer a more acidic environment. ) yet in your specific case you mention using both an over the counter treatment (hopefully one with a truly active ingredient such as miconazole or clotrimazole) and prescription difulcan tablets. frequent/recurrent yeast infections that do not respond to any of the prescribed treatments suggest a couple of possibilities. first that yeast is not the culprit or second that it is one of the atypical subtypes of yeast ("candida"). the easiest way to help unravel this question is to have the gyn do a yeast culture the next time you have symptoms. if the culture is negative then yeast is not the cause. some other conditions which can produce yeast type symptoms include: 1. cytolytic vaginitis--this is an overgrowth of the beneficial hydrogen peroxide producing lactobacili that help keep the vagina clear of undesirable bacteria. an overgrowth can produce an itchy burning irritating discharge. 2. lichen sclerosus--this is a skin condition outside the vagina (usually between the vaginal opening and the anus) that can create intense itching and irritation. 3. contact dermatitis--this would be from a change in tampons/pads new bubble bath etc. if the yeast culture is positive then the lab can identify which of the yeast subtypes may be the villain. most yeast medications are developed for candida albicans --about 80% of yeast infections are due to this. the other 20% or so are uncommon subtypes (e. g. candid glabrata). to treat the less common subtypes clinicians may try boric acid vaginally or even painting with a gentian violet (very messy! ). if these are truly reoccurances of candida albicans you might need repeat or prolonged treatments. a blood sugar or hemoglobin a 1c test can be considered. if you have ever had someone give you oral sex (or you use saliva for masturbation) you may be getting exposure to yeast. yeast is present in the gut from the mouth to the rectum. you can certainly try the so called lifestyle treatments for yeast. additional lifestyle methods which have been advocated for "yeast infection prevention " include: a diet low in refined sugars and simple carbohydrates avoidance of tight jeans use of cotton underwear eating natural lactobacillus yogurt and others. there are few if any good research studies which demonstrate that these methods are helpful but some women swear by them. bottom line although it's more expensive a yeast/candida culture may help find a diagnosis and direct treatment if this pattern persists. hi if you live near the sea try swimming at times your having a yeast problem if not just simple get some sea salt sprinkle some into a warm bath when its dissolved just get into it at let it do its work let the water get inside you you can google yeast infection sea salt bath lots of info. good luck omg! i have been battling the same problem for years and just this last month i think i found the cure i started a whole 30 clean eating challenge with the group at my gym and this is the first time i do not get one! i urge you guys to try this food challenge. it really all comes down to what we eat and how this is playing a roll with our hormones. hope this helps someone!

### Human:\nshould i be concerned about hardening of the arteries at the age of 41?\n\n### Assistant: it's never too early to consider heart health especially in terms of prevention. there are key factors that put you at higher risk for hardening of the arteries (the medical term is atherosclerosis). risk factors include a family history of heart disease abnormal blood lipid levels (high cholesterol/low hdl/high ldl/ high triglycerides) poor eating habits smoking high blood pressure and having diabetes. the american heart association recommends cardiovascular screening starting at age 20 so if you haven't already visit your doctor. for more on risk factors for atherosclerosis see this webmd post.

### Human:\nwhat is albumin?\n\n### Assistant: albumin is an important protein made by the liver and released continuously into the blood. one of albumin’s main functions is to bind with other substances in the blood to help them get where they need to go. for example albumin binds to thyroid hormone and certain drugs and nutrients allowing their stable transport through the blood to their destination. albumin molecules also act like tiny sponges inside blood vessels keeping fluid inside rather than allowing it to leak out. for this reason albumin may sometimes be given as an intravenous medicine to raise blood pressure in hospitalized people. albumin is often checked routinely by doctors in a liver function test panel. severe liver disease can cause low albumin levels as the liver loses its ability to make enough albumin. severe malnutrition also causes low albumin. however many illnesses can cause a temporary drop in albumin levels and most people with a slightly low albumin on a blood test do not have liver disease or any nutritional problem.

### Human:\ni have a history of depression and am entering menopause. i was diagnosed with major depression. are hormones to blame?\n\n### Assistant: women are at greatest risk for depression around puberty post partum and around menopause statistically. . these are times when estrogen levels falter; i think serotonin and neurotrophic factors (brain growth and health chemicals) also falter. this likely conveys some risk for depression. let's face it these times are also stressful for women which raises depression risk. given the recurrence of your depression i would suggest that whatever med you take next that resolves your depression stick with it much much longer to hopefully prevent future depressions.

### Human:\ni am constantly fatigued. i've had thyroid checked and take vitamins. i am 46. nothing seems to help. i get enough sleep. i don't know what the problem is. i get enough sleep i take my vitamins i get my thyroid checked on a regular basis. nothing helps.\n\n### Assistant: from a nutrition standpoint you still could be low in certain nutrients even with taking vitamins. for example if you are low in vitamin d the amount in a multivitamin wouldn't be enough to raise your levels to normal. the best thing is to go to your doctor and get a full lab workup done. i would be interested in iron folate b12 potassium and vitamin d levels but they will check everything. see 10 possible reasons for being tired

### Human:\nmale 25 yrs old. i have low t. cat scan shows no pitutary tumor. symptoms low sex drive fatigue mild depression. cause? . surprised by low testosterone in blood work. i have a lot of body hair. what is the cause? will this always be a problem?\n\n### Assistant: there are two areas of the body where problems can arise which cause low testosterone levels. the first area is in your testicles. testosterone is produced in the testicles. the second area is the hormone control centers in the brain the hypothalamus and the pituitary. when testosterone levels fall the hypothalamus sends a signal to the pituitary to produce the hormones lh and fsh. these hormones travel in the blood stream and cause the testicles to produce testosterone and sperm. the effect of low testosterone levels on a man depends on his age when the low levels develop. in adults fatigue lack of sex drive and depression occur within a few weeks of developing low testosterone levels. decreased muscle mass and body hair are less common and do not occur for a year or more after the onset of testosterone deficiency. the first step when low testosterone levels are found is to confirm the results with repeat testing and test for free or bioavailable testosterone. free and bioavailable testosterone are a clearer representation of the active hormone as opposed to the total testosterone which is the more commonly measured initial test. the next step is to measure lh and fsh. normal or low levels of lh and fsh in the face of a low testosterone level suggest that the control centers in the brain are not working properly. high levels of lh and fsh pinpoint to a problem in the testicles. a cat scan is done to see if there is a tumor in the pituitary. a common pituitary tumor that causes low testosterone levels is a prolactin tumor. this is another hormone secreted by the pituitary. prolactin causes the hypothalamic region of the brain to malfunction. besides tumors damage to the pituitary gland or hypothalamus in adults can occur from surgery injury infections radiation therapy and with high doses or long-term use of narcotics or steroids. causes of failure of the testicles to produce testosterone include; chemotherapy radiation therapy excessive alcohol consumption infections such as mumps tumors medications trauma toxins chronic diseases and torsion of the testicles (twisting). sometimes no specific cause is found. talk with your doctor about your hormone levels and what could be causing your symptoms. treatment for low testosterone levels is important in men not only for their wellbeing but to make sure that their muscles and bones stay strong.

### Human:\nwhat is the benefit of aloe vera?\n\n### Assistant: aloe promotes wound healing. applied to damaged skin some studies show aloe penetrates into the tissues and exerts anti-inflammatory effects. aloe leaves have been used for centuries as treatment for minor cuts and burns. today aloe is often processed into a gel or lotion that can be smeared on the skin easing pain and itching. aloe may be helpful in treating psoriasis seborrheic dermatitis and genital herpes. aloin a component of aloe taken by mouth is a laxative that can help relieve constipation. aloe has been tried as treatment or prevention for a multitude of other conditions including lung cancer diabetes and hiv. there is no conclusive evidence that aloe is of benefit in these conditions.

### Human:\ndoes ovulation always rotate from one ovary to the other?\n\n### Assistant: ovulation may not switch from side to side. we have been led to believe that the ovaries “take turns” for the releasing of an egg. it was not until two french researchers studied 80 fertile women with ultrasounds and hormone levels that it was documented which ovary ovulated (ecochard & gougeon 2000). in the initial cycle about 52% of women ovulated from the right ovary while 48% ovulated from the left. in succeeding cycles ovulations alternated to the other side about 51% of the time. that means that one has only a 50-50 chance of releasing an egg from the opposite ovary as the month before. ecochard and gougeon also measured levels of ovarian hormones in urine to see if the side of ovulation influenced hormone production — it did not. this finding was confirmed by british scientists (ojha 2003) who followed 19 women for three consecutive cycles. moreover blood flow studies of these 19 women showed no influence from side of ovulation in blood flow within each ovary. the inference of ecochard and gougeon was straightforward. they wrote “it is concluded that in normally fertile women the cycle length and hormonal profile are independent of the most probably random site of ovulation. ”

### Human:\ndoes coffee stunt your growth?\n\n### Assistant: there’s no good evidence to back up this commonly held belief. the few studies that have tried to link the amount of caffeine consumption and height in kids did not show any connection between caffeine drinking and being short. most caffeinated drinks children drink are sodas and energy drinks filled with sugar as well as caffeine. sugary beverages don’t stunt growth they enhance weight gain. probably for this reason high intake of soft drinks may be also a risk factor for developing diabetes. reserving coffee and tea for grownups may not have scientific proof behind it but there’s nothing wrong with it either. sugary caffeinated drinks are best as a rare treat for adults and children.

### Human:\nhow long does it take to get yaz out of your system?\n\n### Assistant: medication can stay in the body for about 24 hours before elimination. however the effects of the medication may be felt later on. by taking yaz you are putting an exogenous form of hormones into your body to help regulate your cycle. your natural hormones are thereby replaced. it takes a moment for your body to kick in with the natural hormones during regulation of menses. this is why it is individualized concerning how long it may take to become pregnant after stopping the pill. if you are switching to another pill you can start immediately.

### Human:\ncan profasi lead to a false-positive when taking a pregnancy test?\n\n### Assistant: profasi is chorionic gonadotropin also known as chorex novarel ovidrel and pregnyl. this medication is used in women to aid in conception. it is usually given in combination with other drugs such as menotropins and urofollitropins. it works similarly to a natural hormone in the body the lutenizing hormorne (lh). yes it will give a positive result so please make sure you're monitored for true pregnancy by your doctor.

### Human:\ni had a heart attack 1 year ago how long can i expect to carry on taking statins and is there an alternative. i am a 64 year old male who was diagnosed at the same time as a type 2 diabetic which i now control with my diet and change of lifestyle and no longer take the medication. i have a bmi of 22. 4 after losing 27 kilos and i exercise daily.\n\n### Assistant: congratulations! it sounds like you are doing an excellent job with your lifestyle changes. diet and exercise are the cornerstones of treating both heart disease and diabetes. but at the same time there are many studies that show that taking statins after a heart attack can actually help prevent future heart attacks as well. a major study called the care trial showed that people who were on statins for at least 5 years after a heart attack were less likely to need further procedures such as bypass surgery or stents. they were also less likely to die from heart disease. statins can help keep plaque from building up in the arteries including those around the heart. in some cases they can actually cause a regression of the plaque. a statin may also help stabilize this plaque so that it is less likely to break and cause a blood clot. a blood clot in an artery on the heart wall is what causes most heart attacks. it is very important that you work closely with your doctor. your lipid levels and other risk factors should continue to be carefully monitored. talk to your doctor about any concerns you have about your medications. working together you will be able to come up with a long term treatment plan that is right for you. keep up the great work! i have peripheral artery disease. i got it in my late 40s due to blood coagulation problem. i also had very high cholesterol (over 300+ my entire life). i had difficulty walking by age 50. i put myself on high dose nattokinase and serrapeptase and the symptoms disappeared within 6 weeks. you will know it is working within 1 month. i eat as much cholesterol as i want. i have been on this over 6 years. i am on maintenance dose. just experiment with dosage over time to get the minimum dose and cost. please be aware that conventional medicine perpetuates lies about cholesterol. just take the time to look at the studies. if the arteries are clean enough you won't have heart disease. ignore the cholesterol propaganda. they have nattokinase made from bacteria and fungus with and without vitamin k. both work but i prefer the nattokinase with vitamin k. without vitamin k is for people on prescriptions drugs. i take best nattokinase and serrapeptase. i buy from swanson vitamin because they are cheap. ii'm amazed they don't have heart disease category for this. chinese have done thousands of studies on effectiveness of fibrolytic enzymes for heart attack and stroke prevention.

### Human:\nis it better to apply heat or cold to sore muscles after stenuous exercise?\n\n### Assistant: most helpful answer everything i have read says cold. if there is tissue damage the cold constricts blood flow which reduces spread of cellular components which can cause rupture of nearby cells making the injury worse and longer to heal. heat is not usually applied to an injury until 72 hours have passed. this is to increase circulation and promote healing. more recent research shows movement of skeletal muscles produces hormone-like substances that promote and speed healing of damaged or inflamed tissues throughout the body. so if you can move do. lastly a small meal of four parts carbs and one part protein within 90 minutes of exercise will help speed muscle recovery. the body will use that energy and protein to quickly try to re-construct those damaged tissues. this information is from exercise physiology. ice is typically among the first thing to do in the recovery process after strenuous exercise. icing your muscles helps to reduce pain and decrease swelling and inflammation. ice causes your blood vessels to narrow which will reduce your blood flow to the muscle or injured area. never place ice directly on your skin however. wrap an ice pack around a thin cloth and place on the affected muscle for ten minutes at a time. you can use ice multiple times per day for a few days after exercise but make sure to allow for your skin to return to room temperature before icing after each 10 minute interval. heat is typically applied to uscles or injuries that do not have swelling or inflammation. heat will cause your blood vessels to expand which improves circulation and allows more blood to go to the affected area. heat can be useful for chronic injuries and muscle soreness or it can be used before exercise to stimulate blood flow and help prepare the muscle for exercise. heat should also not be directly applied to skin and should be used for short 10-15 minute intervals. always check with your doctor before starting treatment of an injury especially if the condition worsens or fails to improve. within the first few days of an injury ice can help the process of healing. applying ice to injured tissue can cause blood vessels to shrink and this makes them less capable of releasing chemicals that lead to swelling inflammation and pain. after a few days it probably best to apply heat to sore muscles. this makes muscle spasms less likely and relaxes injured muscles. however because the events behind every injury are different speak with your doctor first. i have just spent the last 6 weeks in physical therapy. they always apply heat or have me get on a bike to heat up my muscles for 15 minutes before i go through any table massage work. next i do all my exercises then they end the session with 10 minutes of ice. somtimes what contributes to soreness is 1) lack of warm-up so insuffcicient oxygen was available to fuel the work. and 2) lack of cooldown which will help the muscles recover by completing any partial combustion of sugars for energy leaving residual metabolites such as one feels with the muscle burn of working beyond anerobic threshold. anerobic threshold can be increased through more careful training. i can exercise well beyond my predicted 100% of age heart rate for periods of 10 20 and 30 minutes or more

### Human:\nhow can i get rid of unwanted facial hair?\n\n### Assistant: as a woman it can be especially difficult to deal with unwanted facial hair. many of my patients are in tears i understand! the situation can be more embarrassing and expensive if the hair is not removed properly. first ask your doctor to help you determine the reason why you have facial hair. you deserve to know the cause especially if it's associated with abnormal hormone levels. you may need to address other medical issues in addition to removing hair. after you've determined the cause the good news is that there are options available to remove your facial hair. the closest to permanent removal is laser hair removal (lhr). it is extremely important to make sure that the place you choose has a physician that is experienced with performing lhr on individuals of all skin types and skin complexions. in lhr a laser is directed through the skin to the hair follicle; this in turn stops the hair growth. a patient may require between 4 to 6 treatments depending on the area. maintaining monthly appointments will give you the best results. if you need to remove facial hair in between appointments it is important that you shave only because the laser is attracted to the hair follicle. vaniqa (eflornithine hcl) is a topical cream your physician can prescribe to reduce the growth of unwanted facial hair. vaniqa works by blocking the enzymes in the follicle that are necessary for the hair to grow. most woman see result within 6 to 8 weeks and it is safe for woman of all skin types and ethnic backgrounds. here are some other options. if you can get over the old tale that shaving makes you have more hair then shaving is one safe option. shaving is fairly inexpensive and can last up to five days. for best results use a razor that has a protective tip along with warm water and a moisturizing shaving cream. shave in the direction the hair grows to avoid hair bumps and apply a moisturizer to the area after shaving. shaving does not cause more hair to grow; it just cuts the hair in the middle of the hair shaft the thickest part. depilatory lotions such as nair dissolve hair as it reacts to the protein structure of the hair. hair can then be rinsed off or wiped away. these creams work quickly and results can last up to two weeks. inflammation or a rash can occur in individuals with sensitive skin. try a test spot first to see how your skin reacts. be sure to read and follow all the instructions on the product label. i do not suggest that you use methods that pull hair from the root such as waxing electrolysis or tweezing. not only are these methods painful there is a risk of scarring when using these methods to remove facial hair. take your time in seeking out what method will work best for you remember it is your face.

### Human:\ni have been diagnosed with neuropathy in my legs but am not diabetic. it is slowly progressing up my legs any ideas?\n\n### Assistant: there can be many causes for a neuropathy. your doctor has most likely already taken a good medical history and a physical exam. many clues can be obtained with these simple tools. examination of the legs and feet will include checking your reflexes strength and sensation. depending on the results you may need an emg test and lab work. sometimes x-rays ct scans or mris may be needed of your back or brain. some of the possible causes of neuropathy besides diabetes include: vitamin b12 deficiency thyroid problems autoimmune diseases lyme disease inflamed blood vessels kidney failure alcohol abuse hiv infection and syphilis. multiple sclerosis guillain-barré syndrome and rare types of cancers may also cause neuropathy. the next step if your doctor can’t find a cause for your problem would be to see a neurologist. this is a doctor who specializes in diseases of the brain and nerves. make sure to take all your test results with you. i hope you get some answers and relief soon.

### Human:\nwill testosterone gel promote post surgical bone growth after spinal fusion surgery to correct stenosis?\n\n### Assistant: not likely. testosterone gel does not have a clinical indication for this type of use. a topical hormone of this type will not correct spinal stenosis or promote bone growth.

### Human:\nmy wife weighs 242lbs she only eats about 1500 calories a day and excercises. why can't she lose weight? . . my wife is 5ft 4inches tall weighs 242lbs and is a size 14-16 in pants sizes. she only eats about 1500 calories a day and exercises about 90+ minutes a day burning 800-1200 calories. she has been doing this for about 2 months and hasn't lost any weight. she has been diagnosed with ibs. she also has be test for hypothyroids and was negative. . .\n\n### Assistant: it's difficult to say exactly why your wife isn't losing weight without more information but here are some things to consider: how is she tracking her calories? it is possible that she is getting more than she thinks she is. seeing a registered dietitian can help her examine her food intake for hidden calories. high levels of activity mixed with low calorie intake may increase cortisol (levels stress hormone) and cause weight to stay where it is. this is a theory but i have seen it many times. your wife can experiment with cutting back the exercise or increasing her calorie intake. unless she's enjoying the exercise it likely isn't sustainable so i suggest she focused on doing something she enjoys. if your wife did not exercise at all before it is possible she is gaining some muscle mass and losing fat even the scale isn't moving. other factors can cause weight to plateau such as stress and lack of sleep. see this webmd article for more ideas. weight loss -- and especially weight loss maintenance -- can be a challenging task. i suggest your wife get help and support with the process. the key is to address the reasons for the weight gain in addition to tackling food and exercise. i had the same issue. 1-2hours a day in the gym cardio and weights 4-5 days a wk eating 1200 calories only lost 2 lbs in 4 months. turns out there is so much msg in food that it was hindering my progress. i switched to eating only organic food with light exercise and lost 5 lbs. in one week. i also stopped getting head aches and back aches. i even gained energy and improved disposition. (msg is an excitotoxin used to get mice fat and stay that way in order to research diabetes. -there are over 40 types of msg under different names and it is in 95 percent of foods you find in stores. ) <link>

### Human:\ni don't eat meat that often but my skin smells terrible. what can i do?\n\n### Assistant: most body odor is caused by an accumulation of bacteria on the surface of the skin. in general this problem can usually be improved with the use of natural cleansers while bathing. there are also certain medical conditions -- diabetes liver disease and infections for instance -- that may contribute to body odor. a balanced diet is critical to your well-being. imbalances in your nutritional intake may lead to an accumulation of unfriendly bacteria within your digestive system.

### Human:\nshould i be concerned about getting a tattoo if i’m taking any certain medications?\n\n### Assistant: any medication that can thin the blood such as coumadin should be avoided. drinking alcohol should also be avoided for this reason. keep in mind that getting a tattoo is like having a wound that needs to heal appropriately. proper care should be taken in consideration. you should also consult with your health care professional about contraindications that may interfere with your immune system or healing time such as diabetes heart conditions allergies or any viral conditions. extra precautions may need to be taken under these circumstances. make sure you are up to date with your immunizations especially hepatitis and tetanus.

### Human:\nhow does chemo effect blood sugar levels? . the morning after chemo treatment my blood sugar was 208 i'm usually in range under 120 with an occasional 140. my type 2 diabetes is diet controlled.\n\n### Assistant: some chemo drugs can elevate blood sugar levels. it's important to talk to your doctors about whether or not you need to add medication during your cancer treatment to help keep blood sugars controlled. good luck!

### Human:\nhow much sodium should i have a day?\n\n### Assistant: it's clear that americans have a taste for salt. but salt plays a role in the development of high blood pressure. everyone including kids should maintain a sodium intake of less than 2300 mg or about 1 teaspoon of sodium a day. adults aged 51 and older african-americans and individuals with high blood pressure diabetes or chronic kidney disease should reduce their sodium intake to no more than 1500 mg a day.

### Human:\nwhy does coffee give me such an energy boost?\n\n### Assistant: as you're drinking your morning cup of joe you're probably just waiting for that wonderful rush of energy and alertness you've come to know and enjoy. within 15 minutes of gulping your caffeine your adrenalin rises increasing your heart and breathing rates your stomach starts to produce more acids and your urinary output rises (as anyone with a small bladder knows! ). but i bet you didn't know that caffeine tweeks your adrenal glands to produce more cortisol (stress hormone) which then stimulates the release of the liver's stored sugars. any endurance athlete knows this and uses it to their advantage. you drink your caffeine and then use the newly circulating sugar fuel to power through another workout. but what if you're sitting at your desk sipping your coffee with nowhere to go? then you might have problems because when the sugar levels rise with caffeine so do insulin levels which when they finally plummet after handling the circulating sugar leave a rip roaring appetite for more sugar in their wake. for runners and bikers this makes sense since you've just burned a zillion calories and need to replenish the sugar stores. not so for someone in an office cubicle with nowhere to go. here are some suggestions. to kill carb cravings associated with caffeine ingestion make certain to eat a combo of protein and fiber. how about peanut or almond butter on a multigrain cracker? or have that caffeine with a yogurt and blueberries or eggs and veggies. you get the point. when you're downing lots of coffee with nothing in your stomach you're more likely to reach for sugary foods so watch out. or you can just drink beverages with less caffeine in them: 6 ounces brewed coffee 105 mg caffeine; 6 ounces instant coffee 55 mg; 12 ounces colas 35-45 mg; 6 ounces tea 35 mg. now remember when you go to one of your fancy schmancy coffee houses you'll often be purchasing at least 8 ounces of coffee and closer to 12 ounces so you're really consuming over 200 mg of caffeine. all the more reason to be cautious if you just happen to be one of those people who is affected by the sugar rush.

### Human:\nwhat is the best way to stop hormone replacement therapy?\n\n### Assistant: once you and your clinician have decided that it's time to stop what's the best approach? the simple answer is that we don't know. formal studies to evaluate this question have failed to show that either going cold turkey or tapering off is better. so the choice is really yours. the important thing is to know that women in general have about a 50/50 chance of experiencing hot flashes again (although maybe not as severe as initially) after stopping. some studies suggest that symptoms peak within 3 months after stopping hormones. after you stop take some time to evaluate how you feel before beginning any new medication so you don't get the two effects confused. there are a couple of other things to keep an eye on once you've stopped ht. if you develop vaginal dryness or recurrent urinary tract infections ask your clinician about vaginal estrogens. nonhormonal lubricants and moisturizers can also help with dryness. and you might want to ask about a bone density test. we know that women who stop ht often lose bone. depending on your bone density score and risk profile you might be a candidate for an osteoporosis drug (bone-sparing). at any rate discuss calcium and vitamin d supplements weight-bearing exercise and fall prevention with your clinician. another good idea is to have your cholesterol rechecked in about 3 months after stopping ht because hormones can affect "lipid levels" (both good and bad). and if you're taking a thyroid medication for an underactive thyroid your dose might need to be adjusted. thanks for your reply!

### Human:\nwhat is the benefit of aloe vera?\n\n### Assistant: aloe promotes wound healing. applied to damaged skin some studies show aloe penetrates into the tissues and exerts anti-inflammatory effects. aloe leaves have been used for centuries as treatment for minor cuts and burns. today aloe is often processed into a gel or lotion that can be smeared on the skin easing pain and itching. aloe may be helpful in treating psoriasis seborrheic dermatitis and genital herpes. aloin a component of aloe taken by mouth is a laxative that can help relieve constipation. aloe has been tried as treatment or prevention for a multitude of other conditions including lung cancer diabetes and hiv. there is no conclusive evidence that aloe is of benefit in these conditions.

### Human:\ni am a 73 year old female. my primary insurance is medicare; secondary insurance is usaa. will i be forced to change secondary insurance and if so when? and at what cost? will my coverage change? i have a primary care physician a cardiologist a pulmonary physician and a gyn physician. will i lose my doctors?\n\n### Assistant: a lot of seniors who have medicare coverage have questions about the impact of the affordable care act. the new law does not make major changes to the traditional medicare program. it does add some new coverage for preventive benefits and make some other changes - but nothing that should affect your medicare coverage. in addition nothing in the law will require you to change your secondary insurance from usaa. so you should not have to change coverage or change doctors.

### Human:\nis bacterial pneumonia contagious?\n\n### Assistant: usually not but some types can be. most pneumonias come from bacteria we carry in our noses and throats. the bacteria can occasionally gain entry into the deepest parts of our lungs where they multiply and cause a pneumonia. some bacterial pneumonias occur when oral or nasal secretions are aspirated during sleep. because we “catch” these bacteria from ourselves these pneumonias are not contagious in the way a cold virus is. however these bacteria sometimes do get passed from person to person in the population. mycoplasma pneumonia is a common cause of “walking pneumonia” in young adults and is highly contagious. tuberculosis (tb) is a special type of bacterial pneumonia that is contagious. tb is very uncommon in the u. s. although people that work in health care are at higher risk. mycoplasma pneumonia and tb are typically spread by breathing in droplets from a cough or sneeze of an infected person.

### Human:\nwhat are the symptoms of thrush?\n\n### Assistant: thrush usually develops suddenly but it may become chronic persisting over a long period of time. a common sign of thrush is the presence of creamy white slightly raised lesions in your mouth - usually on your tongue or inner cheeks - but also sometimes on the roof of your mouth gums tonsils or back of your throat. the lesions which may have a "cottage cheese" appearance can be painful and may bleed slightly when you scrape them or brush your teeth. in severe cases the lesions may spread into your esophagus or swallowing tube causing: pain or difficulty swallowing a feeling that food gets stuck in the throat or mid-chest area fever if the infection spreads beyond the esophagus thrush can spread to other parts of the body including the lungs liver and skin. this happens more often in people with cancer hiv or other conditions that weaken the immune system.

### Human:\ncan gas cause chest pain?\n\n### Assistant: yes. chest pain has many possible causes; some are harmless but some (like a heart attack) can be life-threatening. part of the problem is that the heart and other internal organs have a type of sensory nerve conduction where it is sometimes difficult to precisely pinpoint the exact origin of a painful sensation. pain due to something wrong in the heart lungs or belly can be vague or feel like something else. this is why chest pain can be such a difficult problem for those who have it as well as for their doctors. gas causes swelling in the intestines and a bloated feeling. when gas causes pain it’s usually in the abdomen (belly). however the pain may also be felt in the chest. if pain is due to gas it should go away within a short time. other causes of chest pain not due to the heart include problems with the esophagus gastroesophageal reflux disease (gerd) musculoskeletal (chest wall) pain problems in the lungs and many others. studies have shown that even doctors have a hard time identifying the cause of chest pain just through conversation or physical examination. laboratory tests a chest x-ray and an electrocardiogram are generally needed to know for sure that chest pain is nothing serious. no one wants to call 911 or sit in an emergency room to be treated for what turns out to be gas pain. however playing a waiting game when you are having chest pain can be a gamble with your health or maybe your life. if you’re having chest pain in almost all cases a doctor’s recommendation will be to seek medical attention. yes thanks i have been having a chest pain and thru my underarm since early this morning i am scared it could be a heart attack then again i have experienced this pain before but does not last as long as it has today. it gets worse when i lay down. could it be gas or should i go to the emergency room yes yes

### Human:\nwhat should a health care provider do if a patient or parent insists on antibiotics even if it won’t treat the illness?\n\n### Assistant: it falls on the health care provider to prescribe only when needed. the health care provider does have to take many factors into consideration including the severity and duration of illness findings on physical exam and the most likely diagnosis. if it's an upper respiratory infection it's not always obvious whether (the illness) is viral or bacterial but the vast majority of time it's viral. if the patient still wants an antibiotic the most important approach is for a health care provider is to validate the patient's concerns. the provider can then discuss why they don't need an antibiotic and tell them that just because they don't need an antibiotic doesn't mean they aren't sick. the provider can also suggest an over-the-counter product or other medicine to treat symptoms.

### Human:\nhow can i gain weight?\n\n### Assistant: eat more! that’s what nearly all weight gain strategies come down to although it’s not always quite that simple. people with certain health conditions are at risk for poor nutrition: celiac disease inflammatory bowel disease cystic fibrosis cancer chronic obstructive pulmonary disease (copd) human immunodeficiency virus (hiv) infection many others. people who are losing weight with these conditions should ask their doctor for a referral to a nutritionist. a low appetite is often part of the illness and eating higher-calorie foods is advised. some of these illnesses can also cause poor absorption of nutrients and testing and treatment can address this. in any medical condition if muscle mass has been lost it’s important to include protein in the diet to help rebuild muscles. healthy young men and teenage boys often want to gain weight usually in the form of muscle. their challenge is usually eating enough to keep up with the calories they’re burning in their active lifestyles. to gain weight by building muscle it’s necessary to eat a lot of protein. weight-training athletes may require 75 to 100 grams of protein or more daily. healthy lean protein sources include chicken eggs fish and beans. whey protein supplements can be mixed in with drinks soups or sauces. soy protein supplements are not advised except in small amounts because some of the soy may be converted to estrogen in the body. it’s best to talk to your doctor or a nutritionist before starting a high protein diet if you have any health conditions especially liver or kidney disease. gaining weight can be just as difficult as losing weight for some people. an essential component of weight gain is eating enough calories each day. a registered dietitian will be able to calculate and estimate your calorie needs using the harris-benedict equation or there are also websites available to help you do this on your own. in order to gain weight theoretically you need to eat more calories than what would normally be necessary for you to maintain your current weight. keep in mind it’s still important to eat healthy and make the right food choices. don’t use this as an excuse to eat whatever you want because you’ll end up gaining fat that way. you’ll need to exercise too especially by incorporating strength-building exercise which will help to build muscle mass to add to your weight. the surgeon general recommends at least two days per week of strength training exercising each major muscle group. of course the more exercise that you do the greater the benefits you should notice. keep in mind however that you do need rest to allow your muscles to recover. make sure that you’re getting enough protein in your diet as well. only protein has the essential amino acids necessary for muscle growth and development. a registered dietitian can also help you to determine your protein requirements. ask your doctor before taking protein supplements or beginning a high protein diet. i’ve recommended a good article for more information: <link>

### Human:\nthe left side of my chest has hurt since childhood but at 17 it has gotten worse. should i have more cardiac tests?\n\n### Assistant: many many things can cause chest pain although we worry about the heart being a cause of it typically first as heart disease can carry some serious consequences. at age 17 the risk of artery blockages leading to chest pain would be very unusual except in some cases of congenital coronary abnormalities. it is important that you have a complete history and phsyical exam by a physician to help look for causes of this persistent pain. they will ask questions about your activity level (for example can you and do you exercise regularly without difficulities? ) and carefully exam your heart lungs and blood vessels. you deserve to get an answer for something like persistent pain and at age 17 it's a good time to be reminded of heart-healthy living with things like eating healthy exercising regularly avoiding tobacco products etc.

### Human:\nmy appetite has increased suddenly. i have been eating more than i want to but cannot resist and i am gaining weight. i am a 64 year old male. my appetite has increased suddenly. i have been eating more than i want to but cannot resist and i am gaining weight as a result.\n\n### Assistant: a good appetite is a sign of good health but if your appetite has suddenly increased in might be a sign of disease. an important distinguishing point is if you are gaining weight. an increase in your weight suggests that your increased appetite might be a response to boredom stress or depression. certain drugs might also explain an increased appetite and weight gain. steroids such as prednisone and dexamethasone which are given for asthma joint and skin problems can cause an increased appetite. certain antidepressants cause an increased appetite and weight gain. increased appetite is a side effect of tricyclic antidepressants; amitriptyline (elavil) imipramine (tofranil) and doxepin (sinequan). increased appetite also occurs with medications used for schizophrenia or bipolar disorder; olanzapine (zyprexa) and clozapine (clozaril). some women experience appetite changes right before a period. this is especially true for women with pre-menstrual syndrome who can experience craving for carbohydrates and increased appetite around the time of menstruation. even changes in your diet can affect your appetite. eating a lot of carbohydrates and junk food increases insulin secretion from your pancreas to stabilize your body’s blood sugar and that can make you hungry. if on the other hand your appetite is increased but you are losing weight then diseases that affect your metabolism may be responsible. elevated thyroid levels (grave’s disease or hyperthyroidism) cause an increased appetite because thyroid hormone speeds up your metabolism. diabetes can present with an increased appetite and weight loss. increased exercise can cause your appetite to improve and depending on the calories burned from exercise and your intake your weight may vary. don’t ignore an increased appetite. keep a diary of the foods you are eating and note whether your behavior is affecting your appetite. check your weight and see if you are gaining or losing. see your doctor about a change in appetite to make sure that you do not have a medical condition that needs to be treated. there are many things that can increase appetite -- some beneficial and some not. for example an increase in physical activity may give you a more robust appetite which is fine if you feed your body well. but a lack of sleep or change in eating patterns can also increase appetite which is not so good. think about what has changed in your life both physically and emotionally that could be increasing your appetite. here are some other tips that can help: look not just what you are eating but how. try to sit for meals be mindful of the food enjoy eating an stop when you are comfortably full and satisfied. avoid eaitng on the go or grazng all day which may not satisfy your hunger. too many processed foods can also increase hunger because they aren't very filling or sustaining. eat filling foods including those high in fiber (whole grains fruits vegetables and beans) and protein (lean meats) along with healthy fats (nuts seeds healthy oils). get adequate sleep and physical activity.

### Human:\ndoes your heart stop when you sneeze?\n\n### Assistant: no. your heart keeps right on beating even through the worst sneezing fit you can imagine. coughing sneezing bearing down and other activities can change the pressure inside the chest and the blood flow back to the heart from the veins. it’s theoretically possible that sneezing could change blood flow enough to cause the heart to delay a beat for a fraction of a second. these kinds of variations in heart rate are normal and occur in all healthy people. if it did you'd be dead so i think it's safe to say "no it doesn't. " i don't know yes i do be leave your heart stop when you sneeze for the blood pursuer that your lung/heart stops then continues after. yes

### Human:\nshould i continue exercise if i have a cold or bronchitis? . i developed sinus pressure and chest congestion. i continued my running. when my symptoms didn't improve after 3 weeks i went to a doctor who gave me a steroid and an antibiotic but said it was okay to keep running. i recovered mostly though i still felt the symptoms a little. last night i developed a dry cough which feels again to be in my chest and i have a little sinus pressure again. my exercise helps me mentally but is it the cause of my prolonged problem?\n\n### Assistant: deciding to exercise while you’re sick can depend a lot on your illness and your symptoms. to be honest the answer to your question often depends on who you’re asking since there really doesn’t seem to be a clear consensus or agreement. i personally feel more often than not that it’s best to take time to rest and recover from your illness before continuing with exercise. my rationale comes from a physiological standpoint. basically exercise can put a lot of stress on your body and your immune system is the only way that your body fights infections and pathogens that make you sick. when you exercise you’re devoting some of your body’s resources towards recovery from exercise instead of recovery from illness. in some instances exercise may even make you sicker or even prolong your illness. you also have to consider how comfortable you would feel while exercising with some of your various symptoms. medication may help alleviate some symptoms but otherwise how would you feel trying to go for a run if you’re congested or have a persistent cough? if you choose to exercise while sick you should consider decreasing your exercise intensity frequency or duration until you fully recover. please be considerate by following proper gym etiquette if you choose to work out in a gym. check out this webmd article for more input and guidance: <link>. i have the same symptoms. i feel its closer to the bronchitis side of things because of the clear mucus i cough when i am not riding. i am able to comfortably take my heart rate over 160 but i still have a cough which lasts for weeks after an upper respiratory tract infection (generally also involving the sinuses. i also get the odd drainage from my sinuses after/during a hot shower for example which seems to clear them. my explanation is as follows: when i am riding outdoors in the summer i breath a lot of pollens (i am not in the city) a little exhaust and this will tend to exacerbate an existing irritation. corticosteroids have limited effect to reduce the irritation but can reduce an acute irritation to the point where it is no longer chronic and my body's defenses can make a difference. thus its a combination of factors which typically plays out in the following order 1. bad cold/urt infection (5 days) 2. chronic cough (1 week to 8 weeks) but lungs good enough to exercise. 3. clear 2-8 months managing the level 2 is what this is all about. on occasions where i have been at the coast swimming in the sea often clears things up much faster. (which supports the sinus/allergen/irritant theory).

### Human:\ncompltd 2 wks of antibotics and medrol pack. still have sever pain in lung area plerasie. how long does plerasie last?\n\n### Assistant: how long pleurisy lasts depends on the cause. pleurisy occurs when there is inflammation in the lining surrounding your lungs. the lining consists of two thin sheets (pleura). when something causes these sheets to become inflamed it can feel as though two pieces of sand paper are rubbing together and sharp pain occurs on both inhaling and exhaling. infections from a virus or bacterium including tuberculosis a blood clot (pulmonary embolism) trauma cancer collagen vascular diseases such as lupus or unknown (idiopathic) are common causes of pleurisy. since your doctor has prescribed antibiotics and steroids your diagnosis is probably an infection. once the infection has healed the pleurisy should improve. sometimes scar tissue develops in the pleura and chronic pain can result. talk to your doctor about your continued pain. if you have a cough or are a smoker this may be aggravating your problem. pain medications and cough suppressants may be helpful.

### Human:\nwhat's the difference between the fat-burning mode and the cardio mode on the machines at the gym?\n\n### Assistant: there are problems with the fat burning option on the cardio machines and it really ought to be eliminated. the idea behind the fat-burning option is this: because fat is denser than carbohydrate it requires more oxygen to burn. so to maximize the percentage of fat you burn compared to carbohydrate the fat-burning mode would have you work out at a pace at which your body can deliver lots of oxygen to your muscles. that generally means a slow pace to keep you from getting breathless. the problem is that when you exercise at a slower speed you burn fewer total calories -- from both carbohydrate and fat -- because you simply don't do as much work. further the way to get aerobically fit is to get your heart rate into the training range (usually 60% to 85% of your maximum heart rate) which is hard to do at slower speeds. and fitness is ultimately what you're after whether your goals are better health burning calories or improving heart and lung capacity. the bottom line is that the fat-burning mode probably won't be intense enough to maximize total calorie- or fat-burning or to help you increase or maintain optimum fitness levels. use the cardio mode to maximize your exercise benefits. using the fat burning mode on exercise machines at the gym actually isn’t the best way to burn fat. the key concepts to understand here are the percentage of calories that come from fat and total calories. the fat burning mode is typically set at lower exercise intensity where more calories burned come from fat. not as many calories burned during higher exercise intensity will come from fat. the point to understand though is that while more of the calories that you burn will come from fat at a lower exercise intensity you have the potential to burn more calories per session doing higher exercise intensity. the percentage of calories burned from fat will be lower during the higher exercise intensity but you will be burning more calories overall including the amount of calories from fat. also higher exercise intensity leads to a greater boost in metabolism even after you’re done exercising which burns additional calories. it’s best to do exercise that you’re comfortable with and that meets your level of training/conditioning. in general however increasing the time spent on exercise and increasing exercise intensity will provide a greater potential to burn more calories and lose weight.

### Human:\ndoes aspirin help prevent heart attacks and strokes?\n\n### Assistant: i want to. talk about the use of aspirin for prevention of heart attacks strokes and other blood clotting problems. aspirin is commonly used for minor aches and pains and to reduce fever. aspirin also combats the effects of platelets blood cells that help blood clot. this helps reduce the number of heart attacks and strokes. indeed platelets are essential to human life because an excessively low count would cause bleeding. but platelets can also be involved in too much clot formation. when this occurs it can block a blood vessel and can lead to many potentially life-threatening problems including heart attack stroke and pulmonary embolism (a blood clot in the lungs). it’s important to achieve a balance between too much clotting and not enough clotting. there is much confusion regarding the use of aspirin in prevention of heart attack and stroke. the use of aspirin to prevent a first heart attack or stroke — called primary prevention — is widely debated. there have been approximately seven clinical trials testing the effects of aspirin in someone with no prior history of heart attack or stroke. the doses have varied from 50 mg to 500 mg. while not all the trials showed benefit only one trial showed an increased risk of bleeding but those were patients on high dose aspirin. based on this ambiguous data the current american college of cardiology/american heart association guidelines recommend aspirin for primary prevention only in men with diabetes and intermediate cardiovascular risk and without an increased risk of bleeding. those patients who have a 10% risk of a cardiovascular event over a 10-year period are defined as intermediate risk. the european society of cardiology guidelines do not recommend aspirin in primary prevention. in patients with previous stroke heart attack or certain other blood clotting problems aspirin has beneficial effects. for these people the american college of cardiology/american heart association guideline recommends starting aspirin 75 mg to 162 mg and continuing indefinitely in all patients unless other medical problems prevent its use. the benefits of aspirin need to outweigh the risk. yes it sure does. seven months ago my pulse went from around 55 to 65 count to over 200 beats. my blood pressure was steady at the 120 over 60. i was on a 325 coated aspirin since my by pass in 1999. i was on vacation at the time and when i seen my family doctor three weeks after it started he told me i had af and thanks god i was talking a 325 aspirin. my heart doctor agreed and now i am on pradax blood thinner. i have fluid in the lungs from the leaking blood and on a 40mg water pill. thank you toe fanjoy my hands and legs have been tingling and my right side has a pain can not move or cough it hurts

### Human:\nis thrush contagious?\n\n### Assistant: no thrush is not contagious in the way a cold or the flu is. thrush is caused by a fungus (more specifically a yeast) called candida. candida is a commensal organism meaning that under healthy conditions it lives harmlessly in our bodies. we all have candida living on our skin and in our intestines and healthy women carry candida in their vaginas. when the body’s defenses are in balance candida is not noticeable or bothersome. however certain conditions can give candida the opportunity to grow excessively: a low-functioning immune system. use of topical or oral corticosteroids such as prednisone (often for asthma or autoimmune conditions). damage to the mucous membranes (the skin lining the mouth vagina and gi tract). antibiotic use. in these situations candida can grow on the skin or in the lining of the mouth gi tract or vagina. the fungus creates a white patch or plaque across the mucous membranes. in the mouth visible candida infection is called thrush. in the vagina it’s a yeast infection. in people with weakened immune systems candida can grow almost anywhere in the body. because candida is normally present in all our bodies someone with thrush can’t exactly pass it to someone else -- that person already has candida. to develop thrush a yeast infection or another candida infection that person may have one or more of the above risk factors or conditions.

### Human:\nwhat are types of exercise should i do every week to lose weight?\n\n### Assistant: the most effective exercises for weight loss are the ones you enjoy the most whether it's dancing walking with friends or horseback riding. if it's an activity you enjoy chances are you'll keep it up. the american college of sports medicine suggests a combination of aerobic exercises -- like swimming running and walking -- to maintain and improve heart and lung function. they also recommend resistance exercises (weight training) to help increase muscle mass. it's also important as we age to include exercises that improve our flexibility and balance such as yoga and dancing.

### Human:\nwhat are the types of echocardiograms?\n\n### Assistant: there are several types of echocardiograms and your doctor will help determine which is best for you. transthoracic echocardiogram: this is the standard echocardiogram. it is a painless test similar to x-ray but without the radiation. the procedure uses the same technology used to evaluate a baby's health before birth. a hand-held device called a transducer is placed on the chest and transmits high frequency sound waves (ultrasound). these sound waves bounce off the heart structures producing images and sounds that can be used by the doctor to detect heart damage and disease. transesophageal echocardiogram (tee): this test requires that the transducer be inserted down the throat into the esophagus (the swallowing tube that connects the mouth to the stomach). because the esophagus is located close to the heart clear images of the heart structures can be obtained without the interference of the lungs and chest. stress echocardiogram: this is an echocardiogram that is performed while the person exercises on a treadmill or stationary bicycle. this test can be used to visualize the motion of the heart's walls and pumping action when the heart is stressed. it may reveal a lack of blood flow that isn't always apparent on other heart tests. the echocardiogram is performed just prior and just after the exercise. dobutamine stress echocardiogram: this is another form of stress echocardiogram. however instead of exercising to stress the heart the stress is obtained by giving a drug that stimulates the heart and makes it "think" it is exercising. the test is used to evaluate your heart and valve function when you are unable to exercise on a treadmill or stationary bike. it is also used to determine how well your heart tolerates activity and your likelihood of having coronary artery disease (blocked arteries) as well as evaluating the effectiveness of your cardiac treatment plan. intravascular ultrasound: this is a form of echocardiography performed during cardiac catheterization. during this procedure the transducer is threaded into the heart blood vessels via a catheter in the groin. it is often used to provide detailed information about the atherosclerosis (blockage) inside the blood vessels.

### Human:\nother than carbonated drinks and foods that contain sugar or acid what foods are bad for the teeth?\n\n### Assistant: unrestricted at-will sugar consumption has long been known to promote tooth decay which is the single most common chronic childhood disease — five times more common than asthma and seven times more common than hay fever. a lack of certain nutrients can also make it more difficult for tissues in the mouth to resist infection. the largest calcium depleters are sodas.

### Human:\ni take amitriptyline for headaches and now the doctor gave me ambien for sleep. can i take these medications together?\n\n### Assistant: there is a moderate drug interaction between these two medications. the disabling of the motor coordination and mental alertness is effected with one medication alone. both medications give an additive effect or intensify the side effects. depending on the dose doctors worry about respiratory depression. however if the medications are taken according to the physician's directions there shouldn't be any issues. just be cautious of the cognitive capabilities while on both these medications.

### Human:\nhow important is it to maintain proper form when weight lifting?\n\n### Assistant: most people agree that "proper form" during lifting is important but data to prove that proper form will prevent injuries or improve performance does not exist. in the american college of sports medicine position statement "progression models in resistance training for healthy adults " it is written "it is important to note that proper technique is used for any exercise velocity in order to reduce any risk of injury " but no research is provided to back up this statement. there's another factor to consider when thinking about form. that is if proper form were to be proven effective for injury prevention and performance improvement what would the form look like? for instance during biceps curls you're supposed to stand up straight and keep your shoulders back and weightlifting books contain suggestions like sitting up straight and relaxing your shoulders when doing leg extensions but so little of this advice is evidence-based that it's questionable if it should be recommended universally. perhaps more important is the fact that we all have different anatomy and biomechanics and so our bodies move differently when doing all sorts of activities. no one not even professional athletes throws a baseball exactly the same or swings a golf club the same or serves a tennis ball the same and so why should weightlifting be any different? this is not to say that one should be reckless when lifting but perhaps there is more to injury prevention than just proper form. the consensus amongst strength-training professionals is that many weightlifting injuries are due directly to individuals who lift aggressively with weight that is too heavy for their musculoskeletal system and that improper form is only indirectly the culprit. for instance if an individual is performing biceps curls with weight that is so heavy that they must lean way back to cheat the dumbbells up then they might put tremendous strain on the lower back and end up injuring a vertebral disc or straining a lumbar muscle. the poor form may have put the body in a position of weakness and vulnerability but it was the excess weight that was the root of the problem. here are some simple tips to keep in mind when weightlifting: for beginners: 1. select weights that you can comfortably lift 12-15 times to fatigue. as the months go by and you get stronger you can progress to heavier weights and fewer reps (8 to 12). 2. select simple exercises that target specific muscle groups and require less skill and coordination than complex multi-joint exercises like squats lunges power lifts and dead lifts. for example seated leg extensions might be a better choice than giant lunges across the gym until you feel comfortable with your skill. for everyone: 1. stop lifting if you feel strain in a joint. burning in the belly (middle) of the muscle is okay. 2. listen to your body. this is critical. focus on the muscle group that you are working and make sure you feel it there and not everywhere else. if you don't feel it in the muscle then adjust the angle of your arms or legs or hands until you do feel it. if you need help doing this then ask an experienced lifter to help or hire a trainer to instruct you. after all if you're going to spend time lifting you might as well maximize your workout. in summary if you (a) take your time and lift mindfully and (b) feel it in the belly of the muscle you're trying to work and not in the joints and (c) you select weights that your body can handle without having to cheat or force the weight up then the chances of injury are probably going to be reduced. proper form helps to ensure two things that you’re working the intended muscle and that you’re helping to minimize your risk of injury. basic strength training is designed to isolate a target muscle or muscle group through a set range of motion or action meant to improve muscular strength and endurance or to improve athletic performance. in other words not following proper form may leave you with less than desired results since you may not be working the specific muscle as intended. as for proper form helping to prevent injury there really isn’t much research to prove that claim necessarily. common sense however would suggest that performing high risk behaviors may increase your chances for injury. twisting jerking excessively forceful or high impact motions or movements may increase the risk for injury in an unconditioned person as will perhaps using muscles other than were intended for certain exercises. proper form alone or as part of series of actions can help to control your movement and technique to prevent injury.

### Human:\nis it wise to use a nebulizer for nasal congestion?\n\n### Assistant: nebulizers are used to deliver vapors to the lungs. nebulizers are also used to help deliver asthmatic medications to the lungs for infants and other patients that have a difficult time using inhalers with spacers. the medications used are not for nasal congestion but for asthma. nasal congestion medications should not be poured into the nebulizers without supervision or recommendation form you health- care provider. check with your health-care providers prior to doing so.

### Human:\nis laryngitis contagious?\n\n### Assistant: it can be. inflammation of the larynx (laryngitis) can be part of an upper respiratory tract infection. most of these are due to infection by a virus—in other words a cold. the hoarse raspy voice of laryngitis is often accompanied by a runny nose cough and a sore throat. the hoarseness can occur before during or after the other symptoms which may be mild. hand washing alcohol-based hand rubs and covering the mouth and nose during sneezing and coughing are the best ways to prevent the spread of cold viruses. vocal strain is the other major cause of laryngitis. hoarseness lasting longer than three weeks is probably not due to a cold or vocal strain. there are some serious causes of prolonged laryngitis so call your doctor if your symptoms don’t go away.

### Human:\nare yeast infections contagious?\n\n### Assistant: no yeast infections are not contagious in the way a cold or the flu is. yeast infections are caused by a fungus (more specifically a yeast) called candida. candida is a commensal organism meaning that under healthy conditions it lives harmlessly in our bodies. we all have candida living on our skin and in our intestines and healthy women carry candida in their vaginas. when the body’s defenses are in balance candida is not noticeable or bothersome. however certain conditions can give candida the opportunity to grow excessively: a low-functioning immune system. use of topical or oral corticosteroids such as prednisone (often for asthma or autoimmune conditions). damage to the mucous membranes (the skin lining the mouth vagina and gi tract). antibiotic use. in these situations candida can grow on the skin or in the lining of the mouth gi tract or vagina. the fungus creates a white patch or plaque across the mucous membranes. in the mouth visible candida infection is called thrush. in the vagina it’s a yeast infection. in people with weakened immune systems candida can grow almost anywhere in the body. because candida is normally present in all our bodies someone with thrush can’t exactly pass it to someone else -- that person already has candida. to develop thrush a yeast infection or another candida infection that person may have one or more of the above risk factors or conditions.

### Human:\nhow can i age with vigor?\n\n### Assistant: in 2008 i was asked to lead a half marathon team for more magazine’s annual spring run in central park. my team of peeke performers was comprised of women who were cancer survivors and included women who had triumphed over cancers of the breast thyroid lung and bladder. one woman ran with just one lung and did great. all of these women were extraordinary but one was a real character. that’s elaine doll dunn. like me she’s got a wicked wit and plenty of sass. tall and regal she looked ageless and in reality was 71 years young. she carried herself with grace and elegance but her impish grins gave away her real personality— a powerful survivor who brushed off her bladder cancer as a speed bump along a winding hilly and joyful life journey. that’s elaine. we did lots of pr for the half marathon including a segment on "good morning america. " her one-liners kept me laughing and her endless energy was astonishing. after completing the half marathon elaine insisted i come to south dakota and keynote her marathon in the spearfish canyon about 45 miles outside of rapid city. to sweeten the deal she informed me that the marathon weekend coincided with biker week where over 250 000 harley enthusiasts descend upon the town of sturgis (not far from spearfish) and basically rally tour the countryside and yes indeed have a party or two. i had a funny feeling she would become quite a fount of enlightenment for me. and i was right. as you know by now this coming sunday august 22nd i’ll be competing in the iron girl triathlon with a group of my patients the peeke performers. i was thinking about this upcoming race as i addressed elaine’s marathoners who were experiencing the usual pre-race day blend of anxiety and excitement. as i looked around the room i noticed that at least half the crowd of runners was women well into their 60’s and beyond. and i knew why. presently 73 years old elaine has been a living inspiration for women who dared to push their envelope at any age. and she’s been doing this for many years. her motto is: “i postpone death by living by suffering by error by risking by giving by loving. ” anais nin here’s a quick sampling of her achievements. at each age she: 52 — climbed 900 foot devil’s tower in wyoming 53 — had a major role in last of the red hot lovers. 54 — placed second in a body building contest that was not age grouped! 55 — ran the centennial trail 113 miles across south dakota from wind cave national park to the top of the sacred bear butte 56 — was challenged by bladder cancer and won. 57 — married jerry dunn during the disney world marathon and finished the race. they were interviewed on the today show just after the ceremony at the magic kingdom. 58 — climbed mt. kilimanjaro and won the marathon there the day after we got off the mountain. 59 — won the swimsuit competition in the golden times newspaper and was featured on the front page and as the centerfold. 60 — ran from the atlantic to the pacific ocean across panama 60 miles to celebrate her 60th birthday. 61 — became mrs. south dakota and participated at the national level for mrs. america. she was 30 years older than the other contestants. 62 — ran a marathon of marathons 26. 2 marathons in the year 2000. one of these was completed with three of her children who were running their first marathon. 65 — completed a doctor of philosophy in psychology researching the self-efficacy of women who begin marathoning after the age of 40. 71 — was the recipient of the spirit of dakota award annually honoring one woman whose leadership qualities courage strength and community commitment illustrate the best of south dakota womanhood. alright elaine’s quite an exceptional woman and i’m not asking anyone to start rock climbing at the age of 60 or pick up marathoning. however i just wanted to drive home the point with my velvet sledgehammer that it’s never ever too late in life to wake up get up and challenge yourself for mental spiritual and physical growth and fitness. become fearless and don’t be afraid to put it out there no matter your age. here’s the lesson. never say “i’m too old to do that. ” old is an attitude that gets in the way of living your life to the fullest. approach new challenges you may want to participate in with this phrase on your lips “that sounds interesting. i’ll give it a whirl and see what happens. ” don’t look at numbers. focus on the quality of every breath you take. age is after all just a number.

### Human:\nwhy am i always hungry and tired? . i am a 19 year old male 6'0" tall 150 pounds. i work out at least 4 times a week including cardio and weight training. i eat healthy and balanced with the occasional junk food. i don't drink caffeine or soda. i always eat breakfast lunch and dinner and snack throughout the whole day. some days i eat over 3500 calories. i don't gain or lose weight easily. i sleep between 8-10 hours every night including the weekends. however i am constantly hungry even after a meal and i am always tired.\n\n### Assistant: there could be a few things going on. even though you eat healthy you could be low in nutrients causing you to feel tired. the only way to know for sure is to go for a physical and get labs run including vitamin d glucose and iron. also less likely increased hunger accompanied with thirst and weight loss could be sign of diabetes. also look closely at the quality of your diet. are you eating filling foods with meals including healthy fats (nuts and seeds/avocado/veg oils) whole grains lean proteins dairy beans/legumes and fruits and veggies? the fiber found in plant foods such as fruits vegetables whole grains and beans help fill you up. fat provides adequate calories and is satisfying and protein is also filling. make sure your meals contain 4-5 food groups and snacks 2-3. you want to avoid grazing on less filling snacks high in refined grains and low in nutrients (crackers pretzels chips). if you need help see a registered dietitian. you can find one in your area at eatright. org. read more. filling foods do you feel hungry and tired on days when you eat more than 3500 calories? probably there is mismatch between calorie intake and expenditure. feeling hungry is ok with your workout schedule but feeling tired is worrisome. any family history of diabetes please check. there are a few reasons you are feeling tired without any reason. one of them is anemia which is a lack of red blood cells and conversely oxygen from the lungs is not properly brought to the tissues and cells. anemia may be caused by deficiency of vitamins or minerals internal bleeding or chronic diseases. women who are at “that time” of the month are susceptible to anemia as blood is lost during menstruation. still iron deficiency due to menstruation is less than in pregnant women or lactating mothers as their body needs extra iron to maintain healthy blood levels. things may also go wrong when your thyroid glands refuse to cooperate with you. thyroid hormones thyroxine (t4) and triiodothyronine (t3) are responsible for metabolic processes in the body. too much thyroid hormone causes hyperthyroidism which speeds up metabolism while too little thyroid hormone slows down metabolism. hyperthyroidism causes fatigue and muscle weakness and starts in the thighs. doing energy demanding activities become difficult and other symptoms include weight loss feeling warm shorter menstruations increased heart rate and thirst. hypothyroidism also causes fatigue and muscle weakness. the symptoms are reversed to hyperthyroidism such as weight gain feeling cold and longer menstruations. diabetes notorious for causing a range of problems in the body is also related to fatigue. as glucose is the staple fuel of the body it is not utilized properly in patients with type 2 diabetes as the absence of insulin causes the glucose to build up in the body. without its staple fuel the tissues of the body are not nourished properly and causes fatigue. sadly being sad can also be the reason you feel tired. depression induces negative feelings and also has negative effects on the body as it causes a reduction in energy levels changes in sleep and eating patterns decreased concentration and overall laziness and worthlessness which keeps you in bed all day. reference: <link>

### Human:\nwhat are liver lesions?\n\n### Assistant: “lesion” is a general word for a tissue abnormality. liver lesion is a term doctors use for abnormal areas noted on an imaging test of the liver. most often liver lesions are seen on an ultrasound computed tomogram (ct) scan or magnetic resonance imaging (mri) scan. the term “liver lesion” is a general term. liver lesions could be anything from harmless cysts in the liver to areas of cancer spreading from the colon or breast. the appearance of the lesions on imaging as well as other diagnoses and test results can often help explain the cause of liver lesions. when the nature of liver lesions is unclear and a diagnosis such as cancer is possible a biopsy is often needed to determine their cause. i recently had to have a chest x-ray looking for lung lesions which i was told were mostly malignant. the test was ordered due to the sodium levels in my blood and urine were different and also because i am a long term smoker and have chronic bronchitis. that was all i was told. i am curious as to what type of lesions these could be and how bad it is.

### Human:\nis sinusitis contagious?\n\n### Assistant: viral infections that lead to sinusitis may be contagious; bacterial sinusitis is generally not. it’s important to remember that most viral upper respiratory infections (common colds) cause nasal congestion which may involve the sinuses. if the viral sinus infection lasts well past the normal duration of a cold viral sinusitis may be diagnosed. these viruses are highly contagious and likely to cause a cold in others who come in contact with them. bacterial sinusitis most often occurs as a complication of a viral common cold. bacteria that are normally present in the nose and throat take advantage of the viral infection to invade the inflamed sinus passages. these sinusitis-causing bacteria may be passed from person to person but won’t cause an infection unless the right conditions are present. unlike with cold viruses most people will not develop sinusitis even if they are exposed to the bacteria. are sinus infections contagious/ i don't know.

### Human:\nmy cancer is in remission. how do i deal with the fear of reoccurrence?\n\n### Assistant: one of the most difficult challenges in coping with cancer is dealing with the fears of recurrence. in the jargon of cancer we talk of “remission ” which can be partial (cancer goes partly away) or complete (no evidence of cancer can be found). examples of partial remission include stage iv cancers (metastatic to different regions of the body) that reduce in size as detected by tests such as cat pet or bone scans; complete remission may be obtained at surgery (for early stages of breast colon prostate lung etc. ) which is often followed by some type of chemotherapy or hormonal therapy to prevent a cancer relapse or recurrence. so whether a person is living with an active cancer or has been told they are “cancer- free ” the possibility of the cancer returning or reactivating is very real. it takes work to deal with the fears of recurrence. the first step in doing so is to acknowledge the reality of the situation — not to bury it mentally and ignore it. but it is not helpful to focus on it again and again; it is important to “live for today ” as i have recently blogged about. there are many other helpful coping strategies and helpful individuals experienced in this field. finally i would encourage all cancer patients and their loved ones to attend a support group led by an experienced professional such as an oncology social worker or family therapist. rather than inciting more fear bonding with other survivors can be a great comfort. individual counseling should also be sought out especially for those who have private concerns that they would not like to share with others. most cancer centers have counselors available free of charge; there are also other organizations that have support groups and counseling such as cancercare or gilda’s club. i have had cancer twice in 5 years and i now in remission with my second cancer. how i deal with it is to take one day at a time and hope for the best. try to do exercising everyday and try to eat healthy and hopefully that will help. it's really hard. you will have your good days and bad days. try to keep busy. another thing is to look on the bright side such as your family friends. they're there for you and if that don't help try to seek some help through the cancercare. gov. they have been good for me. there is a lot of information etc that is very helpfull. you might even want to join a group session.

### Human:\nwhat if i don’t have time to exercise 60 minutes a day?\n\n### Assistant: the 60-minute suggestion is based on the national academy of science's recommendation for people who are trying to prevent weight gain or keep themselves from regaining after weight loss -- not for people who are trying to increase or maintain their cardio-respiratory fitness or health. there's plenty of research to show that 30 minutes of physical activity a day will help you gain lots of health and fitness benefits. remember that you don't have to do all your exercise in one session. if you already exercise vigorously at the gym several times a week there's no reason to quit. but if 60 minutes seems like too much for you try 30 minutes a day as a starting goal. the most important thing is that you do something. do what you can! it’s still beneficial for you to do as much exercise as you can even if you’re not meeting the recommended amount. keep in mind that you can break up your physical activity into as little as 10 minute sessions throughout the day which may be more mindful of your time constraints. build more physical activity into your daily routine naturally by parking further away taking the stairs instead of the elevator or using a break room or restroom on an opposite side of the building or on a different floor at work. consider finding a different mode of transportation to work or while running errands. you may live close enough to be able to walk or bike to some of the places that you need to go. if you take the bus try getting off at an earlier stop and walking a bit more. find ways to be active with your family like going for a walk or bike ride and set up a regular routine with it. fit in exercise while you’re watching tv by doing body weight exercises during commercials or use exercise equipment like a treadmill elliptical or stationary bike that you may have at home to do activity while you watch your shows. lastly write down your entire weekly schedule. this can help you to better visualize your schedule so that you can better see opportunities where you can incorporate more physical activity or perhaps you can move things around to create an opening for exercise. you may not be able to meet a recommended amount but do what you can!

### Human:\nwhat is rsv?\n\n### Assistant: rsv stands for respiratory syncitial virus a common cause of respiratory tract infections. rsv causes lower respiratory tract infections (chest colds or pneumonia) in children older adults and people with impaired immune systems. symptoms include cough wheezing and difficulty breathing. in adults with normal immune systems rsv causes upper respiratory tract infections (the common cold). runny nose sneezing fatigue fever and cough can be symptoms. rsv often goes undiagnosed in adults. in children with severe illness rsv may be diagnosed with a swab of the nasal drainage. to avoid spreading rsv people with cold-like symptoms should cover their sneezes and coughs and clean their hands frequently.

### Human:\nwhat foods will increase albumin? . my husband's albumin level is 2. 4 and the low level is preventing him from participating in a clinical trial for lung cancer.\n\n### Assistant: a low albumin can be caused by a variety of factors including nutrition medications and fluid status. talk to his doctor about how much fluid your husband needs and potential contributors to his low albumin. as long as he has no diet restrictions getting adequate protein can help. protein sources include eggs chicken fish meat cheese/milk nuts/nut butters and beans. aim for at least one protein source at each meal and with snacks. make sure his diet is balanced with other foods to balance out his diet. sample day: b-fast: omelet with veggies and toast snack: greek yogurt topped with nuts and fruit lunch: turkey chili with side of fruit and bread snack: smoothie with added protein powder dinner: fish whole grain & veggies

### Human:\nwhat is the cause of excessive saliva? it just suddenly started and now i have to spit all the time.\n\n### Assistant: excess salivation can be caused by several conditions. disease of the ear nose or throat can cause excess secretions as can a lung infection. the first step is to see your physician. the second step is to see your dentist to diagnose any salivary problems.

### Human:\nare keratin-infusing products and therapies safe for your hair?\n\n### Assistant: unfortunately these products contain formaldehyde or gluteraldehyde which are much stronger relaxing agents than the thioglycolate that is typically found in most relaxing products. keratin is the window dressing on most of these products because they can still damage the hair and make it very brittle. repeated use of these products too close together can compromise hair strength and result in breakage. consumers should also be aware of the fact that some brazilian treatments have much higher formaldehyde content than is allowed by fda guidelines. these can result in damage or irritation to the eyes throat and lungs.

### Human:\nhow soon does the food you eat affect your cholesterol? how long does food you eat affect your cholesterol?\n\n### Assistant: no one knows exactly but the national heart lung and blood institute (nhlbi) national cholesterol education program (ncep) recommends checking cholesterol after 6 weeks after diet changes are initiated. always check in with your health care provider about recommendations for monitoring cholesterol levels. for more help with managing cholesterol visit webmd's cholesterol management health center <link>

### Human:\nwhat does a positive tb test look like?\n\n### Assistant: most people being screened for tuberculosis get the tuberculin skin test also called the purified protein derivative (ppd). a small amount of harmless disintegrated tuberculosis protein is injected under the skin on the forearm. within a few days most people who have been previously infected with tuberculosis will develop a raised firm (indurated) area on the arm. redness and bruising don’t count. the cdc recommends different cutoffs for a positive tb skin test depending on a person’s risk for tuberculosis. for people with no risk factors for tuberculosis an indurated area 15 millimeters across is considered positive. as little as 5 millimeters of induration is a positive test for someone with an impaired immune system or a known tb exposure. a trained reader needs to interpret the tb test. most people with a positive tb skin test don’t recall symptoms of tuberculosis. they may have a normal chest x-ray as well. nevertheless they still likely have a small number of tuberculosis bacteria hiding somewhere in the lungs. they have about a 10% lifetime risk of developing full-blown tb called reactivation tuberculosis. to prevent this antibiotic treatment may be recommended after a positive tb test depending on age and other medical conditions.

### Human:\nwhat is dyspnea?\n\n### Assistant: dyspnea is difficulty breathing. dyspnea can have a wide range of causes including: being out of shape (deconditioning) problems in the lungs (infections emphysema asthma) problems with the heart (congestive heart failure pulmonary embolism) anemia (a low red blood cell count) problems with the chest wall or breathing muscles (muscular dystrophy). everyone has dyspnea with exercise—even olympic athletes breathe faster after running up a flight of stairs. with increasing regular exercise it takes higher levels of exertion to bring on dyspnea. shortness of breath that occurs with a level of activity that used to be easy or dyspnea that’s getting worse might be due to a medical condition. generally speaking worsening or unexplained dyspnea should prompt a call to your doctor. dyspnea is

### Human:\nhow do i recover from broken ribs? . rest relaxation and regularly scheduled pain medicine are the best treatments for most broken ribs.\n\n### Assistant: rest relaxation and regularly scheduled pain medicine are the best treatments for most broken ribs. rib fractures usually result from a blow to the chest or back (as in a car accident or a fall). a broken rib can even come from vigorously swinging a golf club or strenuous coughing. broken ribs can be extremely painful. often the pain from a rib fracture is worse when taking a deep breath. severe broken ribs require evaluation and treatment at a hospital; usually these cause so much pain that a person naturally seeks medical attention. the key to recovery from broken ribs is pain control. the pain from a rib fracture results in “respiratory splinting ” or voluntarily reducing the depth of breathing. some experts believe this increases the risk for pneumonia or other lung problems. pain medicines may allow deeper breathing and help someone with a rib fracture get back to normal activities more quickly. pain medicines can include nonsteroidal anti-inflammatory drugs (nsaids) like ibuprofen or naproxen but controlling the pain of broken ribs may require stronger opiate pain medicines like hydrocodone or oxycodone. most rib fractures heal completely within six weeks but many patients can return to normal work and leisure activities much sooner than that.

### Human:\nwhat are some of the pros and cons of buying a catastrophic plan?\n\n### Assistant: catastrophic plans are plans under which an individual pays the vast majority of out-of-pocket expenses until he/she reaches the plan's deductible. some pros of catastrophic coverage are: catastrophic plans offer more affordable monthly premiums for an individual who might otherwise not purchase insurance coverage at all coverage under such a plan as suggested by its name will at least protect them in the event of a catastrophic event such as a car accident or serious illness that could result in hundreds of thousands of dollars in medical bills which would plunge many people into bankruptcy the major con of catastrophic coverage is that it covers very few out-of-pocket expenses before the deductible is met and the deductibles under these plans can be quite high. so these plans may not be ideal for individuals who have substantial out-of-pocket expenses. this would include those who take a significant number of prescription drugs on a regular basis and/or find themselves visiting a physician frequently.

### Human:\ndoes using an elliptical machine at the gym burn more calories than running on the street or bike riding?\n\n### Assistant: running will burn more calories than the elliptical although it's pretty close (about 100 calories per hour difference). some of the difference is due to the pounding of running and the fact that you propel your body through the air so that both feet are off the ground simultaneously. this kind of movement takes lots of energy. both the elliptical and running burn substantially more calories than the bike at the same level of perceived exertion (about 200-240 calories per hour more). in a classic study comparing energy expenditure of exercise machines the order of calories burned from highest to lowest is posted below. (the elliptical was not studied in this research but it would fit between rowing and cross-country skiing. it should be noted that rowing the elliptical and cross-country skiing are all very close in calorie expenditure with probably not more than 100-125 calories per hour difference among them. ) treadmill walking/running stair stepping rowing cross-country skiing biking (stationary) now this is not to say that exercises that burn the fewest calories are all bad. to the contrary you can get a great workout and burn lots of calories doing any of them. you'd be hard pressed to say that lance armstrong isn't fit. he's one of the fittest human beings alive and he did it by biking. the point is that if you work hard enough on any of the exercise machines and you work up a sweat and you get your heart rate into your training zone then your heart lungs and muscles aren't going to know the difference. bottom line is that you'll get fit and healthy using any of the machines if you use them consistently and with sufficient intensity. one final note: there is error in estimating energy expenditure on most if not all exercise machines. in some cases it can be as high as 25 percent (the machine overestimates how many calories you burn). there are simply too many variables for the machine to give you an accurate number and so you need to keep that in mind during weight-loss efforts if you are calculating how many calories to eat based on your energy expenditure. the answer depends on many different things since your weight the type of exercise how intense you are doing each exercise and how long you do each exercise will all influence how many calories you burn. simply put however i would say that you have the potential to burn the most calories by running followed by biking and lastly by using the elliptical. one way to measure how many calories you burn during exercise is to look at metabolic equivalents (mets). mets are a way to measure and gauge the amount of energy you burn during physical activity with 1 met being equal to the energy you burn simply being at rest. for instance running at a 10 minute mile pace is roughly the equivalent of 10 mets or ten times the calories you burn at rest. unfortunately there really is no good answer for how many mets you burn while using an elliptical. a study entitled “2011 compendium of physical activities: a second update of codes and met values” only lists using an elliptical at a moderate intensity which was the equivalent of 5 mets. for comparison bicycling with a moderate effort (12-13. 9mph) is 8 mets. you can find a comprehensive list of mets by doing an internet search for “compendium of physical activities tracking guide”. websites utilizing a formula involving these met values for each type of exercise along with your weight and the duration can help to estimate how many calories you will burn during exercise. keep in mind that these are just based off of averages but one such site is: <link>. play around with the types of activities and the duration of the activity to see what can provide you with the most calories burned.

### Human:\nwhat are the differences between the vcf (vaginal contraceptive film) and the today sponge forms of birth control?\n\n### Assistant: according to the manufacturer's information vaginal contraceptive film (vcf) is reputed to be 94% effective. this is comparable to the diaphragm's effectiveness with normal use (e. g. occasional errors). i have personally not used the vcf but i have heard that it does not drip like other spermicides. i have used both the diaphragm and the today sponge (90% effective according to its manufacturer). like other non-hormonal methods they rely on spermicide for effectiveness. the sponge has 1 gram of nonoxyol 9 (much more than the amount used in a diaphragm jelly spermicide). consequently the sponge can be used for more than one ejaculation (unlike a diaphragm where one is supposed to add more spermicide using a plunger like those designed for vaginal yeast cream). personal opinion? the sponge was easier than the diaphragm for camping and it absorbed all the ejaculate so no mess. sponge was more expensive. diaphragm required planning and even i occasionally did not follow instructions (e. g. did not use more spermicide). diaphragm can be drippy after removal. bottom line consider trying both the vcf and the sponge. see how they work for you. if you are accustomed to the effectiveness rate of hormonal forms of birth control you could consider using condoms as an additional protection. one other non-hormonal form which has the highest effectiveness rate is the copper t or paragard iud.

### Human:\nwhat are the types of arrhythmias?\n\n### Assistant: the types of arrhythmias include: premature atrial contractions. these are early extra beats that originate in the atria (upper chambers of the heart). they are harmless and generally do not require treatment. premature ventricular contractions (pvcs). these are among the most common arrhythmias and occur in people with or without heart disease. this is the skipped heartbeat we all occasionally experience. in some people it can be related to stress too much caffeine or nicotine or too much exercise. but sometimes pvcs can be caused by heart disease or electrolyte imbalance. people who have a lot of pvcs and/or symptoms associated with them should be evaluated by a heart doctor. however in most people pvcs are usually harmless and rarely need treatment. atrial fibrillation. atrial fibrillation is a very common irregular heart rhythm that causes the atria the upper chambers of the heart to contract abnormally. atrial flutter. this is an arrhythmia caused by one or more rapid circuits in the atrium. atrial flutter is usually more organized and regular than atrial fibrillation. this arrhythmia occurs most often in people with heart disease and in the first week after heart surgery. it often converts to atrial fibrillation. paroxysmal supraventricular tachycardia (psvt). a rapid heart rate usually with a regular rhythm originating from above the ventricles. psvt begins and ends suddenly. there are two main types: accessory path tachycardias and av nodal reentrant tachycardias (see below). accessory pathway tachycardias. a rapid heart rate due to an extra abnormal pathway or connection between the atria and the ventricles. the impulses travel through the extra pathways as well as through the usual route. this allows the impulses to travel around the heart very quickly causing the heart to beat unusually fast. av nodal reentrant tachycardia. a rapid heart rate due to more than one pathway through the av node. it can cause heart palpitations fainting or heart failure. in some cases it can be terminated using simple maneuvers such as breathing in and bearing down. some drugs can also stop this heart rhythm. ventricular tachycardia (v-tach). a rapid heart rhythm originating from the lower chambers (or ventricles) of the heart. the rapid rate prevents the heart from filling adequately with blood. this can be a serious arrhythmia especially in people with heart disease and may be associated with more symptoms. ventricular fibrillation. an erratic disorganized firing of impulses from the ventricles. the ventricles quiver and are unable to contract or pump blood to the body. this is a medical emergency that must be treated with cardiopulmonary resuscitation (cpr) and defibrillation as soon as possible. long qt syndrome. the qt interval is the area on the electrocardiogram that represents the time it takes for the heart muscle to contract and then recover or for the electrical impulse to fire impulses and then recharge. when the qt interval is longer than normal it increases the risk of a life-threatening form of ventricular tachycardia. long qt syndrome is an inherited condition that can cause sudden death in young people. it can be treated with antiarrhythmic drugs pacemaker electrical cardioversion defibrillation implanted cardioverter/defibrillator or ablation therapy. bradyarrhythmias. these are slow heart rhythms which may arise from disease in the heart's electrical conduction system. examples include sinus node dysfunction and heart block. sinus node dysfunction. a slow heart rhythm due to an abnormal sinus node. significant sinus node dysfunction that causes symptoms is treated with a pacemaker. heart block. a delay or complete block of the electrical impulse as it travels from the sinus node to the ventricles. the heart may beat irregularly and often more slowly. if serious heart block is treated with a pacemaker.

### Human:\ni can hear gurgling congestion in my lungs when i lay down should i go to urgent care? . attended a workshop last weekend with about a 100 other people with a few coughing wheezing sneezing etc. tuesday started with a scratchy throat then by thursday coughing up phlem you know "lung oysters". . this morning woke up and laying there breathing through my nose could hear gurgling congestion down deep in my lungs; hence the question should i go to urgent care? .\n\n### Assistant: that may be wise since this gurgling sensation you are hearing or feeling could indicate mucous in the bronchial area or lungs. you need a medical professional to listen to your lungs to determine if you have sounds consistent with bronchitis or even pneumonia.

### Human:\nis this a symptom of post nasal drip or something a little more serious? . i spent the weekend at a relative's home and they have a cat. i'm allergic to cats so naturally my eyes were irritated i was sneezing and a bit congested. after about a week the sneezing and congestion went away but i began to cough. it started off as a dry cough but now after about two weeks it sounds pretty horrible and there's quite a bit of mucus. is this a symptom of post nasal drip or something a little more serious?\n\n### Assistant: you are right to be concerned! what may have started out as an allergy or even a cold may have turned into something more serious. coughing up mucous can be caused by the post nasal drip of allergies or sinus infection. but it can also be from a cold asthma bronchitis or even pneumonia. the only way to know is for your doctor to take a look and listen. your symptoms have been going on long enough that you should give your doctor a call. you need to find out what is going on and how to get some relief. here’s a great webmd article on cough that can give you more information. hope you feel better soon!

### Human:\nwhat are some exercises that i can do while traveling without carrying any equipment?\n\n### Assistant: you can do lunges and stair climbing for your legs. no external resistance just your own body weight. if you have someone to hold you by the legs you can do back extensions by lying on your belly with your torso off the bed and lift your back up. you can also just do this lying on the floor then you won't need anyone to hold you. for lats you can lie down on the floor bring your arms up in front of you elbows on the floor and press down trying to lift your torso off the floor. that will work lats. you can also do chair dips they will work your lats a little. it can be more difficult to exercise while traveling but it’s certainly still attainable. here are some ideas and suggestions for ways that you can get exercise while traveling: • there are plenty of different body weight exercises calisthenics or stretches that you can do in your hotel room. here’s a great list of exercises that don’t require equipment: <link> • many hotels have onsite fitness rooms or swimming pools that you may have access to • try to find nearby parks or ways to get involved in recreational activities outdoors • go for a walk or run outside or do stair climbing • resistance bands require little space so they can be packed easily and be used in a hotel room • if you’re bringing a laptop you can bring an exercise dvd to use in your hotel room. if you don’t own an exercise video you can search for free ones to watch online be unconventional and think outside of the box if necessary. if it’s still a challenge for you to do exercise while traveling make it a point to be more diligent by doing exercise on days where you have more control of your environment or try to plan your exercise around travel as best as possible.

### Human:\nwhat causes dry mouth?\n\n### Assistant: there are several causes of dry mouth also called xerostomia. these include: side effect of certain medications. dry mouth is a common side effect of many prescription and nonprescription drugs including drugs used to treat depression anxiety pain allergies and colds (antihistamines and decongestants) obesity acne epilepsy hypertension (diuretics) diarrhea nausea psychotic disorders urinary incontinence asthma (certain bronchodilators) and parkinson's disease. dry mouth can also a side effect of muscle relaxants and sedatives. side effect of certain diseases and infections. dry mouth can be a side effect of medical conditions including sjögren's syndrome hiv/aids alzheimer's disease diabetes anemia cystic fibrosis rheumatoid arthritis hypertension parkinson's disease stroke and mumps. side effect of certain medical treatments. damage to the salivary glands the glands that produce saliva for example from radiation to the head and neck and chemotherapy treatments for cancer can reduce the amount of saliva produced. nerve damage. dry mouth can be a result of nerve damage to the head and neck area from an injury or surgery. dehydration. conditions that lead to dehydration such as fever excessive sweating vomiting diarrhea blood loss and burns can cause dry mouth. surgical removal of the salivary glands. lifestyle. smoking or chewing tobacco can affect saliva production and aggravate dry mouth. continuously breathing with your mouth open can also contribute to the problem.

### Human:\ncan janumet and zantac be taken together?\n\n### Assistant: there is a moderate interaction with one of the components found in janumet (metformin/sitagliptin) and zantac (ranitidine). ranitidine is a cationic drug and theoretically could decrease the excretion of metformin. this drug interaction has been observed when using another cationic medication cimetidine. because of this we use caution with similar medications. these interactions can increase the risk of lactic acidosis which included symptoms of malaise myalgia respiratory distress hyperventilation slow or irregular heartbeat somnolence abdominal upset or other unusual symptoms. lactic acidosis is a possible side effect from the metformin. consult your health-care professional if both of these medications are being prescribed together. monitor your reactions for side effects of lactic acidosis and stop medication right away if the symptoms occur.

### Human:\nwhat is arthropathy?\n\n### Assistant: arthropathy just means “joint problem. ” doctors often use arthropathy interchangeably with arthritis which means "joint inflammation. " there are some forms of arthropathy that are distinct from arthritis: neuropathic arthropathy: nerve damage from diabetes or another nerve condition results in slow damage to joints. in diabetic people arthropathy usually affects the foot and ankle. (arthritis may also be present. ) hypertrophic pulmonary osteoarthropathy: the ends of bones in the ankles knees wrists and elbows start to grow abnormally and painfully in an adult. the tips of the fingers become rounded called clubbing. this form of arthropathy occurs more often in people with lung cancer. hemarthrosis: bleeding into a joint like the knee can occur after injuries or medical procedures and is a common problem in people with hemophilia. arthritis is common and other arthropathies are uncommon so in most cases when a doctor says arthropathy it means arthritis.