Q. My daughter is 17 years old and has never been vaccinated against HPV, but I’m worried about the risks of cervical cancer. Is it worth her getting the vaccine now?
A. The HPV vaccine is a critical tool for cervical cancer prevention. We know that HPV is the underlying cause of most cervical cancers, and this virus is extremely prevalent. The vaccine protects against several strains of the virus that are most high risk for leading to malignancy. Researchers have shown that the vaccine is most effective if given before exposure to HPV, which is why it is given in the pediatric population. However, it can still work even for women who have previously had abnormal Pap smears. Getting vaccinated early is an amazing way to protect against developing future cervical cancer.
Q. I recently found out that type 1 diabetes runs in my husband’s family, and I want to be prepared in case my kids develop it. What are some early signs to look out for?
A. Increased thirst, increased urination, as well as signs and symptoms of dehydration – such as loose skin and dry mucous membranes (eyes and mouth) – may be how some learn they have type 1 diabetes. This scenario can be a presentation of diabetic ketoacidosis, which is life threatening and should be managed in the hospital. Other symptoms of type 1 diabetes may be loss of muscle mass, unintentional weight loss, fatigue, irritability, blurry vision, and hunger despite eating an adequate amount of food.
Patients with type 2 diabetes can have similar symptoms – increased thirst, increased urination, dehydration, hunger, fatigue, irritability, and blurry vision. Some patients may also experience symptoms such as numbness and tingling in their feet or slow wound healing.
Q. My elderly father recently had a scare with a blood clot in his leg. It was treated with anticoagulants and he seems to be okay, but I’m wondering if there is something else we should do?
A. Every blood clot is unique to the person in whom the clot developed. Anticoagulation alone may not be the only answer. A patient is best served by being evaluated by a specialist who treats deep vein thrombosis (DVT) and pulmonary embolism (PE). There is a range from mild to severe when it comes to blood clots. In severe cases, there are surgical and endovascular procedures that can be performed to lessen the impact of the DVT or PE for the chronic conditions that can develop. As an example, if a patient presents to the ER with a swollen leg and is diagnosed with a DVT, often an anticoagulant is prescribed. That is a crucial first step, however, the evaluation should not stop there. A referral to a vascular specialist will determine if additional therapy to remove the clot is warranted.
Q. I was recently diagnosed with psoriasis, and I’m wondering if there are any simple lifestyle changes I can make to improve my symptoms?
A. If your psoriasis affects your scalp, you may need to use a medicated shampoo like Head & Shoulders twice per week – even if your psoriasis is not always active. If you start to develop other symptoms like aching or joint pain, it’s best to be seen by a rheumatologist to check for psoriatic arthritis. Many people ask me about diet changes to improve their psoriasis. There are no specific diet changes that have been shown consistently to help psoriasis patients; however, focusing on a low glycemic load diet (avoid white bread, rice, refined sugar) and losing weight if you are overweight can help many people.
Q. My teenaged son plays football and recently got tackled pretty hard. He didn’t get hit in the head, but I’m still worried that he might need to take a break from the sport. Any advice?
A. The most common cause of a sports related concussion (SRC) is a direct blow to the head, and American football is the most at-risk sport for athletes to sustain a concussion. However, SRCs may also occur from an indirect, impulsive force that is transmitted to the head and may not involve a direct blow to the head at all. With any SRC, it is wise to see your primary care physician or a sports medicine physician to evaluate any symptoms and develop a graduated plan for recovery and return to the sport. If symptoms worsen or the athlete exhibits focal neurological defects, then you should go to the emergency room.
