July 3, 2024
DEAR DOCTOR. ROACH: I am a 68-year-old woman and I am in good general health. In September 2021, after a few bouts of discomfort when tilting my head back, I underwent CT angiography with contrast dye. The diagnosis of fibromuscular dysplasia (the report notes a “pearly appearance” of the artery), with no hemodynamically significant dissection or stenosis. At that point, I was told to take aspirin daily and not to look up.
It turns out to be worse, as I can’t tilt my head back for more than a few seconds before noticing an effect (i. e. , when I’m drinking, especially in the bottle, or reaching for something on the more sensible shelf). Will the “pearls” continue to grow, causing more disruption and keeping me hunting?Is it inevitable to have a stroke due to lack of blood at some point in the future?
When I have a more severe episode (I haven’t completely passed out yet), is there anything I can do to repair balance (maybe an oxygen surge)?Are there things that can make the situation worse, such as heavy cardboard lifting or vibrations?A sonic toothbrush?—C. B.
ANSWER: Fibromuscular dysplasia (FMD) is a disease of the blood vessels caused by superficial fibrosis of the blood vessel itself. It is not atherosclerosis. Cholesterol is not stored in the arteries and is not an inflammatory disease. We don’t know why other people get it.
Headaches are more common than dizziness you’ve noticed. Other organs can be affected, including the kidneys, and foot-and-mouth disease is one of the most common causes of “secondary” high blood pressure, not an unusual problem. (The maximum production estimate is for only 0. 02% of the general population).
The good news is that most experts find that this condition doesn’t get worse over time. Most people like you with carotid artery foot and mouth disease have not progressed with repeated follow-up imaging studies. A stroke is unlikely to occur and is not inevitable. Ultrasound is preferred over CT scans to detect progression, as they do not involve ionizing radiation. It’s a good idea to monitor your blood pressure and kidney function thoroughly.
If you have an episode, it is essential to keep your neck in a neutral position. Oxygen is not helpful. I don’t think getting up or brushing your teeth is the most likely cause of your symptoms.
DEAR DOCTOR. ROACH: I’m an 86-year-old man. Several years ago, I had about a third of my prostate removed because I couldn’t urinate. After the operation, everything was fine with a steady flow. In other words, until about two weeks ago, when one of my many trips to In the Bathroom, I had trouble getting started. The flow was intermittent. This continues to this day. Symptoms get much worse at night.
Do you have any ideas about replacement in my urine?-D. S.
ANSWER: A sudden change in urinary symptoms warrants your doctor to prescribe a urinary tract infection. Men with an enlarged prostate are at higher risk. If the urinalysis doesn’t reveal any infections, your urologist will look at other possibilities, such as a continued enlargement of the prostate. . Despite the operation, he experiences symptoms again. You may have developed strictures, which is a type of scar tissue near the surgery site. Of course, it is essential to make a stop with your family doctor or urologist.
I would also make sure that you are not taking any medications that could exacerbate your prostate symptoms. Over-the-counter allergy and bloodless medications (antihistamines and decongestants) are the most common. If you only take them for allergies, they may also be the likely maximum cause.
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