Erect nipples

Can you tell me why my nipples are erect all the time?

In most cases, nipple erection is associated with sexual arousal but in some women, nipples may remain erect without any sexual stimulation. Why this happens is not well known. Sometimes, nipples can be erect when they are excessively irritated like when you start to pluck hairs or wear tight clothing. Some women love to show of their erect nipples but for those who are shy, then there are a variety of padded bras which can be worn. If you constantly plucking your hair around the nipples, stop the habit and see what happens. If it is the clothes that cause erection of your nipples, start to wear a bra, change the fabric or wear loose clothing. In any case, erect nipples are treated conservatively and there is ZERO need for surgery- unless you love pain and have money to waste.

Stage 4 colon cancer and surgery

 My mother is 77 and very ill. She is barely able to walk and has been a heavy smoker all her life. Recently she was diagnosed with colon cancer that has spread to the liver. Her surgeon recommends surgery. I am not sure what to do.

The first thing is you need to get is a second opinion. Any surgeon who wants to operate on stage 4-colon cancer sick frail patient has very little clinical judgment. Colon cancer surgery in older age groups has its benefits but surgery is also of high risk. The general rule of surgery is that patients who are deemed to be at high risk for surgery need surgical clearance from other specialists. Finally, surgery for stage 4-colon cancer is never done as life expectancy is very poor and there is no chance of cure. Removing a mass from the liver is no piece of cake. With the quality of some surgeons we have, death is a high probability.

The best advice is to seek another medical opinion and still not undergo surgery – as surgery will not benefit your mother. Please dump this stupid doctor-there is something known as palliative care and this is what your mother needs.

PIP Breast Implants

Women who live in Europe, South and Central America continue to get confusing messages from their respective governments about their breast implants. The implants made by Poly Implant Prosthesis (PIP) were manufactured by a French medical company, which is now non-operational. The company made poor quality, cheap grade implants of silicone, but luckily, these implants never made it in the US.

In France alone, data indicate that at least 30,000 French patients (mostly women) will need to have the implants taken out and the government will pay for the cost of removal.

However, response from other governments is not consistent. In other European and South American countries, some women have been advised to have the implants removed but only at their own expense. In other cases, the government has offered to pay for the cost of removal if only the implant shows signs of leakage or is obviously defective. In most Central American countries, patients have simply been told to have their implant checked at their own expense.

In Brazil and Mexico the governments have advised women to have the implants evaluated but have not recommended removal. In Colombia, the government has promised to pay for the removal if there is an indication. In Britain, the National Health Service has advised against routine removal and only those which are found to be defective will be eligible for free removal. In Holland, the government has advised women to have their PIP implant removed. The cost of removal is enormous but for women, it is the disfigurement and emotional torment that also has caries a heavy burden.

Latest estimates indicate that PIP sold close to 400,000 implants worldwide before going out of business several years ago. For those American patients who had PIP breast implants done abroad because the price was cheap, they should be aware that they are at great risk and should see a plastic surgeon.

In the last few years, complaints about these implants had been rising and include breast pain, inflammation, irritation and asymmetry of the breast. Many other implants had leaked or burst because of the inferior grade silicone. Several patients have also died of cancer in France.

Recently the FDA indicated that a type of lymphoma was a cause of death in some of these women with silicone breast implants. Fortunately, the number of cancers has been very few and no definite link has yet been established to the silicone.

For women, breast implants can improve their body image, personality and enhance their sex life.  However, consumers have to know that every prosthesis, like an implant, only lasts for 10-15 years. There is no implant that lasts a lifetime. At some point in time, the implant has to be removed because like any mechanical item, the wear and tear will cause deterioration.

Therefore, while plastic surgery is a great way to enhance self-esteem and confidence, it also carries some unknown risk, especially when cheap quality materials are used. This alone should be one reason not to seek any type of healthcare abroad. Outside of North America, cutting corners in healthcare to make money is the name of the game. Trust me-i have worked in over 27 countries.

Vitamins for glaucoma

I have had glaucoma for years. I just saw an ad for eye vitamins. Can these vitamins improve my vision or protect me from further vision loss?

No, that is all BS. These vitamin ads are bogus. There is no vitamin that can reverse or cure glaucoma. We have a health supplement industry that is unregulated and continues to make unsubstantiated claims. The sad part is that it is supported by unscrupulous healthcare workers who are simply interested in scamming desperate patients. 

Unfortunately, we also have a lot of gullible, stupid and/or desperate people who believe this type of crap. If you have glaucoma, go and see a bona fide eye doctor.  If you muck around with glaucoma at home with this vitamin BS, you will end up blind.

New onset Asthma in middle age

Can I develop asthma at the age of 67? I have never smoked and worked in an office all my life. I only have high blood pressure, which is well controlled. On a recent visit to my doctor, he told me I had developed asthma because of the chronic cough that I have had.

The majority of asthma cases are diagnosed in childhood or in the early teenager years. When one develops new onset asthma and a cough, this is a cause for concern. It is unlikely that one can have asthma out of the blue in the later years of life if the past medical history has been uneventful. Moreover, if you do not smoke or have no chemical related work history, then you definitely need more work up. The first thing to do is ask your doctor to get a chest x-ray and a referral to a lung specialist. Asthma may be related to the heart but this can easily be ruled out by obtaining an x-ray. If your doctor does not intend to work you up more thoroughly, you need a new doctor. At your age, something more ominous should always be ruled out first.

Generic statin

Can I take generic statin?

All statins currently available work in the same way. These medications inhibit a certain enzyme in the body, which prevents cholesterol build up in the body. However, the major difference between the statins is not their effectiveness but cost. Stains are expensive medications. The most expensive are rosuvastatin and atorvastatin. Individuals who have been prescribed these expensive medications should speak to their doctor about the generic statins. At the moment, mevacor, pravachol and zocor are available in generic form and for 1/3^rd the price. 

Many insurance companies may require that you try a generic statin before they will pay for a brand name statin. Some insurance cover all types of statins, after you pay a certain deductible. Statins bring a lot of money to the pharmaceutical industry, and usually doctors have little idea what generic brands are available.   

Remember statins have to be taken for life and can cost a fortune. If you really want to lower your cholesterol cheaply, then eat right and walk regularly. There is absolute no reason why generic statin will not work as effectively as the expensive brands. So, do not believe the hype that the more expensive statins are better than the cheaper brands. I personally believe that these medications are a rip off and instead recommend life style changes for my patients.

Chemotherapeutic drugs and numbness

Why do I have numbness, tingling and painful sensations in my leg after undergoing chemotherapy

Unfortunately, some chemotherapeutic drugs can affect nerves and induce peripheral neuropathy. Common chemotherapeutic drugs that have been linked to neuropathy include vincristine, docetaxel, cisplatin and paclitaxel. In general, these drugs affect the nerves in the hands and feet. Some patients may complain of pain or paresthesias in the fingertips. In rare cases, there may be muscle weakness of the finger, toe of foot.

In most people, the numbness or tingling pain sensation is not severe and does not affect daily living activities. However, if the symptoms are severe, your doctor may decide to discontinue the medications.

Most cases of peripheral neuropathy, which occur with chemotherapeutic drugs generally, improve once the medication has been stopped. This recovery may take anywhere from a few months to a few years. Unfortunately in some people with severe neuropathy, the symptoms may not completely recover

If you continue to have neuropathy symptoms, speak to your doctor. The decision to continue your medications will be made on the severity of the symptoms and the impairment that you have.