June 26, 2008
Fixing a Fallen Uterus Through Surgery
DEAR DR. DONOHUE: Will you address the problem of a prolapsed uterus? What treatment would you suggest? - M.V.
ANSWER: "Prolapse" means "a falling down." A prolapsed uterus is one whose supporting ligaments and muscles have become too weak and lax to keep it in place. The uterus drops downward and can drop so far that it protrudes through the vagina.About 50 percent of women older than 50 have some degree of uterine prolapse, so age is a major factor in causing the problem. So is vaginal delivery.
Since the urinary bladder and the rectum are next-door neighbors of the uterus, they are often pulled down with a uterine prolapse. Symptoms include pelvic heaviness and pain, trouble voiding, sometime loss of bladder control and difficulty with bowel movements. If the uterus projects outside of the vagina, it becomes irritated and sore.
Treatment depends on the distance the uterus has fallen, a woman's age and a woman's health. For mild to moderate prolapse, pelvic-floor muscle exercises (Kegel exercises) can keep the prolapse from worsening. To perform these exercises, a woman contracts the muscles used to avoid passing urine. Alternate short contractions - ones held three to five seconds - with long contractions - ones held for 10 seconds. Perform 30 to 40 contractions daily. They don't have to be done all at once. Ten done consecutively is enough.
Pessaries are devices fashioned to keep the uterus propped up. They are inserted into the vagina, and some fit around the cervical neck to hold the uterus in place. They often solve the problem.
If a woman is up to surgery and if the uterus has descended a significant distance, an operation is the answer. The number of surgical procedures is large, and your gynecologist will inform you which is best for your circumstances.
DEAR DR. DONOHUE: I struggle with my weight, and I drink diet pop to keep from gaining. One friend tells me to stop drinking diet pop because it increases your craving for sugar and calories. An instructor in my diet class says the chemicals in diet soda actually scar your arteries and lead to heart disease. I never heard of that. Is it true? I love my diet pop. - B.B.
ANSWER: I never heard the scarring bit either, and I don't believe it.
You can drink diet pop, but you shouldn't go overboard. Acids in pop - including diet pop - attack tooth enamel. Cola drinks, including diet colas, contain phosphoric acid, and it increases the risk for osteoporosis.
Whether diet pop prevents weight gain or promotes weight loss is a disputed proposition.
DEAR DR. DONOHUE: My insurance company denies coverage unless I have a disease or an accident or need an operation. I have heard about a special test for detecting chickenpox antibody in the blood. The clinic where I get my health care says a charge for that test plus the shingles vaccine shot would be more than $300. However, my county health department says I can get the shingles vaccine for $8. My problem is, I don't know if I had chickenpox. If I get the shot, how would it affect me? Will it cause shingles if I never had chickenpox? - R.H.
ANSWER: More than 90 percent of adults have had chickenpox, whether they remember it or not. You can safely get the shingles vaccine even if you did not have chickenpox. It won't hurt you. If you've never had chickenpox, you don't need the vaccine, because shingles is the awakened chickenpox virus that becomes active in later life. But if I were you, I'd assume that I had had chickenpox.
DEAR DR. DONOHUE: When my daughter was 12, she bit her nails. I bought her nail polish. She never bit her nails again. - N.A.
ANSWER: A clever approach to end nail-biting for girls. Got one for boys?
DEAR DR. DONOHUE: I have two granddaughters who bite their fingernails. Is there anything that stops this awful habit? - B.S.
ANSWER: What prompts people - children and adults - to bite their nails is often unexplainable. Stress, boredom, imitation of other nail-biters and relief of anxiety are offered as explanations for the habit, but proof is lacking for a cause in most cases. Close to 60 percent of 10-year-olds bite their nails. As children grow older, the number of nail-biters lessens.
Doing nothing about it is often the best policy. If the child wants to stop, then there are ways to help him or her break the habit. When children are at home, Band-Aids over the fingers remind them not to bite. Chewing sugarless gum makes nail-biting less convenient. Readers are welcome to give us their solutions.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853- 6475. Readers may also order health newsletters from www.rbmamall.com
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