Ask the Doctors

What to do About Insomnia

Q: For the past couple of years, I have found it difficult to go to sleep. It takes maybe two hours, and then I awaken early. I am healthy, but feel fatigued and need an afternoon nap to help with the tiredness. Should I take sleeping pills?

A: It sounds as though you have chronic insomnia. The problem is a common one, affecting between 10 and 15 percent of people. It is much more common as we age, and affects women more than men. Sometimes it complicates chronic medical or psychiatric disorders.

Vitamin E

Q: Is supplemental vitamin E helpful in the treatment or prevention of cardiovascular disease (especially strokes and heart attacks)?

A: There has been an ongoing debate about this issue for a number of years now, with conflicting advice being offered to date. However, a recent study was done using a computerized search of seven large trials that studied the effectiveness of vitamin E in the treatment and prevention of strokes and heart attacks.

Safe Holiday Eating

Q: With the festive season approaching, quite frankly, I'm dreading it! I have carefully lost 20 pounds over the past six months, and the prospect of blowing it over the holidays frightens me. Everyone is coming home for the holidays, and I don’t want to be like the Grinch who stole Christmas. Any advice?

Cold Weather Exercise

Q: With the winter coming, I find it more difficult to get out to exercise. Do you have any ideas?

A: We have great empathy with you—exercise requires motivation even in the finest weather. As winter approaches, outdoor activities become more challenging, especially in the northern climes.

Whatever our environment, it is important to know the benefits of exercise. Some flippantly quip that life consists of so many heartbeats, why waste some of them on exercise? This could not be further from the truth.

Benign Breast Lumps

Q: I am 35 years old, and have had a history of lumps in my breast. The doctors have told me that I have "benign breast disease." My concern is that I have an aunt who had breast cancer. Should I be worried?

A: As much as we would like to completely reassure you, we can only do so conditionally. Benign breast disease can be divided into three groups that are significant when it comes to associations with breast cancer.

Hemorrhoids

Q: Ever since my babies were born four years ago, I have been troubled with hemorrhoids. My problem is that in the past couple of months I have noted bleeding. My husband is pressuring me to go for a checkup. Is this necessary?

Importance of Cancer Aftercare

Q: I am 72 years old, and have a history of cancer (ovarian and histiocytoma in my leg). Five years ago I had a mastectomy, and I have scar tissue from the surgery. A few months ago I developed pink scar tissue in the area where the staple was pulled out. Within the pink scar tissue a large dark mole came, then another. It oozes occasionally, and at times is painful—usually after I do housework. I have had other large dark moles that eventually fall off, as well as several moles that start out as skin color and itchy, but then turn into dark moles.

XDR Tuberculosis

Q: Is the XDR form of tuberculosis as dangerous as the media made it out to be in the recent episode of the man who traveled by air after being told not to? Or is this much ado about nothing?

A: We believe you are referring to the Andrew Speaker case, which has global ramifications.

Smallpox Vaccine

Q: I am concerned about the smallpox vaccination. How safe would it be? Is there any way to treat smallpox that would avoid vaccination if there were to be a terrorist attack using this germ?

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