Ask the Doctor: Winter 2018

Q. I’ve recently been noticing some numbness in my legs, and my doctor said it may be caused by bone spurs. How are these treated?

A. There can be different causes for having numbness in the legs including diabetes, problems with blood flow, or arthritis in the spine. When you develop arthritis in the lower back, bone spurs can form and compress the nerves that go down into the legs. This can lead to lower back pain, as well as numbness, tingling, pain, or weakness in the legs. The initial treatments for this can include home exercises or physical therapy, as well as medications like anti-inflammatories or steroids. If these are not successful, a steroid injection can be given either in the lower back muscles or as an epidural injection under an X-ray machine into the spine. These help to reduce the swelling and inflammation in the nerves and reduce the symptoms. If easier treatments don’t give enough relief, surgery can be performed to remove the bone spurs and take the pressure off the nerves.

Q. My baby is only a few weeks old. What actions should I take to keep her safe during this germy season?

A. Babies are certainly at risk during the newborn and infant stage. Fortunately, keeping your baby safe from harmful germs is easy. The most important step you can take is to have everyone (including yourself) wash or sanitize hands each time before touching your baby. The Centers for Disease Control & Prevention and the American Academy of Pediatrics also recommend that everyone in contact with the baby get vaccinated against the flu and pertussis, diseases that can be deadly to the very young. I also recommend that parents with other small children in the home place their baby in a playpen. This provides a barrier that protects the infant from frequent, potentially germy contact with his or her older siblings. This can also be very helpful during the holiday season, as multiple people can see, but not touch, your infant. These measures will help you have a happy and healthy infant stage.

Q. Last year I got the flu shot and still got the flu. What gives?

A. The effectiveness of the influenza vaccine varies based on the vaccine itself and the characteristics of the person receiving the vaccine. Influenza viruses undergo frequent genetic changes. Therefore, each year, a new vaccine is created with three or four flu viruses that are expected to be spreading that season. If there is not a “good match,” the effectiveness of the vaccine may be low. Age is a factor in the effectiveness of the vaccine, which is why high-dose vaccines are available for those over 65. The flu vaccine does not protect against other flu-like viruses or against flu you are exposed to prior to your vaccination becoming effective (approximately two weeks after vaccination). The flu vaccine cannot cause the flu, as it is made up of inactivated or weakened flu viruses, but it can cause minor, short-term side effects as other vaccines do.

Q. My father had a stroke last year but is still having some trouble with balance. Is there anything we can do to help him?

A. Balance problems are common for people following a stroke. They may be a result of loss of sensation, vertigo, concentration problems, vision problems, or even a side effect of medication. The most common cause of poor balance after stroke is impaired muscle coordination in the legs and core. If we can rewire the brain by improving coordination in the legs and core, then balance will improve too.

• To improve balance after stroke, focus on:
• Balance rehabilitation exercises
• Leg rehabilitation exercises
• Core rehabilitation exercises

These exercises should be intensive, individual, functional, and progressive. The more you rewire the brain through practice, the more your balance will improve. As long as your father is participating in regular therapy, you can rest assured that his balance will improve.

Q. I’m pregnant and have developed brown patches on my face. What is this and will it go away?

A. Pregnancy creates a variety of unexpected changes in the body, including the face. The appearance of brown patchiness, known as melasma and sometimes called “pregnancy mask,” is often one of those changes. Several factors can trigger melasma, but when due to pregnancy, correcting it is challenging since typical laser treatments and chemical peels are not a safe option. Fortunately, there are effective skin care products to keep melasma under control. Of course, you should always consult your doctor before choosing a product. While melasma usually fades after pregnancy, it can linger for years. However, it is manageable, and more aggressive treatment options are available for women no longer pregnant or breastfeeding.