Question: Your recent answer to the question about varicose veins is interesting. I would like to mention injection compression therapy for veins as an alternate to surgery. The question asked by Mrs. S.L. of Trenton, N.J., was whether or not stockings would prevent an operation. I stopped operating on varicose veins nearly 20 years ago because the standard stripping operation does not cure the condition. In fact, there is no cure.
As a result of the work in Ireland and Europe, injection compression therapy has become an important modality in the treatment of varicose veins. However, unless performed correctly, with attention to detail, the result can be as bad as that of surgery.
However, physicians like yourself who can disseminate information to large numbers of people would be doing them a service if this method of treatment could be brought to their attention.
Having given up surgery 10 years ago in my private practice and having devoted my full energies to the treatment of varicose veins (and spider veins) by injection compression therapy, I can assure you that not only are the results more acceptable than when I was performing the standard stripping procedure, but patients are much happier both with the procedure and the results. This is especially true in the significant number of patients I have treated who have previously undergone surgery.
I congratulate you on your concise answers to many interesting questions.
Ronald Dee MD
Clinical Assistant Professor of Surgery
Albert Einstein College of Medicine
New York, N.Y.
Answer: Thank you for your information about injection compression therapy for varicose veins. I'm sure my readers will find it very helpful.
Q: My girlfriend was told by her doctor that she has vaginitis, and I would like to know if it is possible to have sexual relations with a woman who has this condition. In other words, is it possible for a man to get the infection from a woman?
A: A man may contract the organism that is causing the infection in a woman, although he obviously cannot get vaginitis (a vaginal infection). However, he can transmit the germ back to the woman. Therefore, a man should use a condom if he has sexual relations with a woman who is being treated for vaginitis.
Q: Would you please explain why a woman who is undergoing a mastectomy for cancer of the breast should have a biopsy taken of the other breast? This just seems to be a way of making what is already a difficult situation even more difficult.
A: It has been found that a substantial number of women with breast cancer may have cancer of the other breast that does not show up on X-rays and that cannot be detected clinically. A biopsy of the other breast, which is a precautionary measure, is particularly important in women with a history of breast cancer and those whose breasts are difficult to monitor by X-ray.
Q: I have enjoyed playing ball ever since I was a kid, but I have always had a problem. When the game is for fun, I enjoy myself and I'm one of the better players. But if I play in a tournament or if there's money bet on the game, I become very nervous and start sweating so that I'm soaking wet. Do you have any idea why this happens and what I can do about it?
A: The most common cause of excessive sweating is emotional in nature, and you provide a good description of the kind of setting in which this may occur. The exact mechanism that causes it is not known, but it has been suggested that a hereditary factor may predispose someone to the condition.
Excessive sweating due to emotional factors usually begins in childhood or in the early teens, and may improve without treatment when the person reaches the mid-20s. If it doesn't, there are medications that can be prescribed for application to the skin. Other forms of treatment include psychotherapy and biofeedback, in which the individual seeks to control a bodily function, such as sweating.
In extreme cases, various forms of surgery may be recommended; however, I would advise any patient who is considering surgery to discuss the matter in great detail with his or her physician in order to be perfectly clear about the risks and advantages of undergoing the procedure. Surgery, regardless of the particular procedure, is not something to be undertaken lightly.
Q: I usually don't hear very much about cancer of the thyroid, but I know two people who have had to have an operation for it during the past year. What kind of symptoms would a person have in this case?
A: The symptoms of thyroid cancer may include a rapid growth of a mass in the neck, pain, hoarseness and difficulty in breathing. It is well to bear in mind that a person who has previously undergone irradiation of the head or neck is at greater risk of the disease.
A thyroid nodule does not necessarily indicate the presence of a malignancy; in fact, the large majority of nodules are benign. Moreover, even when they are malignant, effective forms of treatment are generally available.
Q: The first time I heard about pneumonia was when I was a child and my grandfather had it, and I've heard about it at least a million times since then. But I really don't know what it is. Could you give a simple explanation of what pneumonia is?
A: Very simply, pneumonia is a general term that is used to describe a number of different kinds of inflammation of the lungs. Symptoms may include a hacking cough, chest pain, fever and chills.
Q: I try to follow your recommendations for a nutritionally sound diet, but this is not always possible every day of the year. What happens, for example, if I don't have a citrus fruit one day?
A: If you generally have a balanced, nutritionally sound diet, failure to include a particular item on a particular day is of little consequence.