Health Care Q&A
Category: Lifestyle
Expert: Dr. Michael WilkesDr. Michael Wilkes, director of global health and professor of medicine at UC Davis school of medicine, answers your questions about health care.
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Most Recently Answered Questions
Questions 1 - 15 of 57 (Page 1 of 4)Q: First of all thank you for writing your weekly column. As a physicians' wife I appreciate that you pose some very important dilemnas and you are so open to what others might suggest. On the issue of a patient who has advanced colon cancer I think that it is important for you to continue to address the issue of informing other family members whenever the patient is in your office. By presenting various senarios your best hope would be that the patient would come to see that by neglecting to inform her family she will be causing others future suffering. Hopefully with your prodding the patient will come around.
The other question i have for you involves my husband who needs a hip replacement. he consulted with two respected orthopedic surgeons and when he received pre op orders from both (one office forgot that he had cancelled with them)they asked for a chest x ray, urinanalysis and multiple blood studies (cholestral etc). Do any doctors realize that medicare does not pay for this X ray (which is $238. at RAS in Sac) unless it is done in a hospital; and Mercy San Juan wouldn't even guarantee that they could bill medicare. Medicare doesn't pay because they said "the chest x ray was unnecessary". When will doctors learn that they order way too many tests and rarely look at the results. I would greatly appreciate any response from you and KEEP YOUR COLUMN COMING.
A: Dear Jan:
Somehow your email JUST NOW came to me. Sorry for the delay. I hope your husband's surgery is now complete and he is finding ambulation far easier. The issue of lab tests is crazy and is a complex mix of fear about malpractice, ignorance about what tests really predict future problems, and lack of awareness of cost. Whenever you have questions about tests I suggest you discuss them openly with your doctor and ask the purpose of the test, reimbursement, and whether or not it is really necessary. There are many tests that are often order before surgery that have very little value and add great costs.
Good luck,
Michael Wilkes, M.D.
Q: In trying to lead a more healthy lifestyle, I have given up sodas and drink Crystal light type drink mixes. Are there any health risks to drinking these types of beverages only? Can they be considered water in terms of drinking 64 oz of water daily?
A: Tough question. They are FAR healthier than Coke or other sugar containing drinks. But, they are essentially all chemicals. Are they safe? I can't offer an opinion but they certainly count as liquid. Let me see what I can find out.
Michael Wilkes, M.D.
Q: Around April 2011 I woke up one day with pain and tenderness on one of my testicles. It lasted for about a week then it went away but ever since then it has been tender. It doesn't not hurt when I ejaculate nor when I have to urinate but sometimes it just gets tender during the day. Today I was examining myself and it felt different from before. It feels a little swollen. I do not have medical insurance but I would like to see an specialist to make sure everything is ok
A: Dear HB:
I can not comment on your condition without seeing you as a patient and asking lots more questions and doing a wee bit of an examination.
I can suggest that you probably do not need to see a specialist at this point. I would start with a good primary care doctor and see what she/he suggests. There are several student organized free clinics in Sacramento (Tapati, Amani, Joan Viteri, etc.) that might be a good first stop if you have no financial resources.
Good luck and good health,
Dr. Wilkes
Q: I was diagnosed with mononucleosis and hepatitis (dont know if it was A or B) in 1973, I was 16. I was told to never donate blood. I am now 54, are there any special test I should request from my Dr. to check my liver function? Anything else I should watch for?
A: I would check with your doctor, as I don't know the history. However, in all likelihood these have resolved and do not need any further follow up. At the very least, they could do some tests to see if you cleared the hepatitis infection.
Wishing you good health,
Dr. Wilkes
Q: I got sick in 08, and told doctors I felt it was from what I had ate..They took stool samples..nothin found..I had been ill for over a year, i changed doctors..I finally got a colonospopy and the thing where they look into your stomach..they found erosive gastrinitis..but i was told it could have been stress by two doctors..i still was ill..for over 2 years, on the sofa in the bathroom, in e.rooms..i finally talked to a doctor and they said get a h-pylori test, a simple blood test..so i lied to get this..sure enough i had this very bad it is now 2011..i still get very ill..i have like two good weeks and then 4 or 5 days very sick..it is very horrible..they gave antibitics the triple therepy, and now i take protonix, and something from the health food store..do you have any advice..i know this caused this horrible stuff and have suffered and still am..i also got a call once from the ucd they were haveing clinic trials and my stool got in it, saying i possibly could have had something else but could not be possitive.also the place where i ate shut down...thanks for your help.sincerly linda
A: Dear Linda:
Boy, it sounds like you've been through a get deal with your stomach.
Unfortunately, I can not give medical advice on this blog. The reason for this is that I don't have the details of your illness and have not reviewed your medical records to fully understand what has happened -- what has been tried and what has failed.
What I suggest to people with complex medical problems involving the interstinal track is that you seek a second opinion from a good gastroenterologist. Each of the local heatlh care systems in town (Davis, Sutter, Mercy, Kaiser and the VA) have outstanding doctors in this field. I would go to one who is not connected with those you have already seen. When you do visit this new doctor, if you are going to a doc in a different system, please bring with you copies of your medical records from the original doctor (results from scans, scopes, lab tests and the like).
This will help the new doctor be able to quickly evaluate what was done and what the results were.
I wish I could be more help, but hope for the best and I suspect you find a good solution to your problem.
Good luck and good health,
Dr. Wilkes
Q: My question is in regards to the article in the Sacramento Bee May 29, 2011 "Deadly Bacteria lurk inside hospital wards" they were talking about "C. Difficile". My daughter was diagnosed and treated for this when she was about 11years old, she is now 26. My question is what are the long term health problems from this infection?
A: Dear Lisa:
None. If she was treated 15 years ago and she is healthy there is no need to worry about that infection. It is past history.
Good health to you and your daughter.
Dr. Wilkes
Q: Dr. Wilkes,
You helped me quite some time ago and here is an update and a question..
My now, 13 year old Grandson was just put on a A.D.D. drug last Sunday.. He is an A student, has been on various drugs for years--including one for seizures that only his Mother saw..
His Mother has battled our son in the court system for years so she could put him on this drug------------WHY would the court allow this to happen to a boy that does NOT have a problem with school, friends or anything else????
WHY would anyone in there right mind want to put a boy on a drug that could give him awful side affects?? WHY???
Thank you so much for making me feel better before.. Can you do it again??? Sharin
A: Dear Sharin:
Sorry, I am not sure of your question.
Dr. Wilkes
Q: What is the ranking in Calif. of Kaiser Hospital??
I've recently been told it's #1 and I absolutely cannot believe it. Too many cases of lack of proper care including my friend who is facing more cancer due to Kaiser's lack of necessary tests and failure to properly treat.
A: Hospitals are not ranked globally. They are ranked on specific procedures and diseases. I do not know what Kaiser hospital you are asking about, but as a group Kaiser Hospitals are top ranked and are far more focused on quality, prevention, patient satisfaction that are most other hospitals in the state. Every hospital has its problems and all make mistakes now and then, but Kaiser always comes in top of the pack - in addition they are non profit so they are not driven by profit motive.
Q: Dr. Wilkes,
I was delighted to see your return to the Sacramento Bee here online. I loved your weekly columns from several (many?) years ago. You're an excellent writer who's able to unravel complex issues so the average person can understand. I often wondered if you'd ever thought of compiling those or newer essays into a book? Not sure if you're still part of the Bee, given the economy and date of the last posting here. Thanks for all you do..
A: Dear Leslie:
What a lovely email! Thanks for your kind words. I wouldn't know how to begin to put them in to a book - not even sure where I would begin.
Again, thanks for the thought!
Michael Wilkes
Q: Dear Dr. Wilkes,
I have an 8 year old daughter who is 93 lbs. and about 51 in. tall. Her pediatrician provided me information that indicated my child is off the charts with regards to her weight for her age/size. I lead a pretty active lifestyle in the gym as well as other physical activities. I do this for myself and am consciously aware not to over-impress it upon my children but to make it available for them. She is involved in physical activities as well. While I try to educate her about healthy eating habits, I am aware not to put the emphasis on the fact that she is considered "obese". In looking to the future, can you provide any ideas on how to help my daughter without drawing too much attention to my worries for her to have a health body and a healthy life...not too mention that I worry about her self esteem and the way that society zeroes in on obese children. I've covered the basic nutrition, exercise, adequate sleep repertoire, but I need expert advice. Sincerely??
A: Dear Lauren:
You have raised two interesting points. The first is her physical health and the second is her mental health. Frankly, I would push toward the later (creating a young woman with good self esteem who values herself and others) and hope the former falls into place.
You can control much (but certainly not all) of what she eats and what food she has access to in the home. You can educate her about good eating and you can model for her the importance of exercise not through lectures but by living an active life, limiting TV (for you and for her), and by helping her find activities that she both enjoys and can excell at.
She is only 8 and now is the time that she is building her self esteem and watching very closely those around her whom she loves.
So, model good behaviors, buy good healthy food, and feed her heart with kindness and positive attitudes. Praise her good choices and minimize negative comments and behaviors. She knows she is heavy (every 5,6, 7 and 8 year old on the playground tells her every day). She needs you to love her and build her up!
Good luck! This child raising is not easy nor is it for the faint hearted but it is worthy every minute of it!
Michael Wilkes, M.D.
Q: Hi, Dr. Wilkes,
I was diagnosed with hypertension about 10 years ago and put on medication. I was also diagnosed with high cholesterol, to which I was also put on medication. To top it all off I have suffered from arthritus for the past 25 years and took medication for that! With all these medications my doctor had blood work done once a month to make sure everything was working properly. At the beginning of 2009 my primary care physician told me my kidneys were starting to fail. My doctor told me to drink more water, which I found amusing since that is my drink of choice 99% of the time. My kidneys were not getting better. So I made the choice to change to a vegetarian diet (and am now vegan). It worked! I no longer take any medications and my kidneys are functioning normally again! I have noticed that my blood pressure goes up when I am in pain. I just want to know if this normal. Thank you for providing this wonderful service to us.
A: Dear KC:
Wow! Great news about your blood pressure! Life style can often work wonders (although not for everyone -- genes also play an important role).
Yes, everyone's blood pressure goes up when they are in pain. This is a normal and appropriate response. The question is how high it goes and for how long. For now, best to stay out of pain (: and monitor what happens on those rate times you have pain. Then report this to your doctor.
I thank you for reading my column and for writing. Wishing you the best of health -
Michael Wilkes, M.D.
Q: I am in my early 30's and I developed a venous lake on my lower lip about 5 years ago. I notice in the summertime, the bump will increase in size and sometimes cause pain. I have often wondered if decreasing the pressure would eliminate the pain, but I doubt this is a recommended type of treatment. Is there any treatment to remove a venous lake?
A: Dear Jon:
I am not able to comment on medical conditions on the web. I would need to take a history and see this lesion. However, I recommend you see a plastic surgeon or dermatologist for a diagnosis and to discuss treatment options.
Sorry, but the typed word is not a great way to make a diagnois.
Wishing you the best of health,
Michael Wilkes, M.D.
Q: With the shortage of doctors, especially in the near future, why doesn't more doctors take advantage of technology? Currently doctors can see patients via web feeds using Skype software which is free. In this way a doctor could spend one day a week seeing patients via web feed while maintaining office visits the rest of the week. Granted there would be requirements on the patient like owning a BP test unit at home to facilitate a video appointment. Basically, they could use this for their chronic patients where communication is more important than an actual physical examination. If the doctor needs to physically see this patient then an office visit can be scheduled. Using their office time more efficiently would seem to be the next issue along with electronic documentation of their patient files. It just seems to me a doctor could spend less time via the web communicating to his patients then dragging everyone of them in for an office visit.
A: Dear Ed:
Your idea(s) are brilliant. The major problems right now are assuring confidentiality and billing. However, I am certain that we are not far from the day that all your suggestions will be a reality and more! We will be able to do tests and monitor diseases from your home.
Thanks for your thoughts and wishing you the best of health!
Michael Wilkes, M.D.
Q: i have constant flow of what appears to be either saliva or acid reflux into my mouth. I constantly must spit it out or it would accumulate in my mouth very fast. Is this coming from a sinus problem or does it sound more like a symptom of GERD? what do you recommend i do? thank you for your time
A: Dear Ruben:
As you might expect, I can not offer you a specific solution or explanation to your problem without far more information and an exam. There are several possible explanations for this fluid and I can not offer a liklihood without more information. I suggest you contact your primary care doctor and allow the doctor to diagnosis this problem.
Sorry I can't be more helpful, but I would not want to mislead you.
Wishing you the best of health,
Michael Wilkes, M.D.
Q: I am female 61 years old and take two Caltrate with
Vitamin D daily. Both of my parents died of heart disease.
I have taken this for approximately 10 years. Should I quit?
A: Dear Bonnie:
Unfortunately I can not offer you specific medical advice given that I do not know your specific medical history. Caltrate is a combination, over the counter, vitamin supplement containing both Vit D and Calcium. While it has some side effects it is generally considered safe and both Vit D and Calcium have beneficial effects on the body. However, whether you would benefit from these is really a discussion you need to have with your doctor. Sorry I can't be more helpful.
Wishing you good health,
Michael Wilkes, M.D.
