Issue link: https://www.epageflip.net/i/38607
6A Daily News – Monday, August 8, 2011 Vitality & health Gallstone symptoms require investigation DEAR DR. GOTT: I am a 71-year-old female. I have been nauseated for about 10 weeks. It started with just nausea, went to being unable to eat, then to where I cannot stand the smell of foods cooking, espe- cially greasy foods. I have been eating apples, cheese strips and Wendy’s Frosties for about a month and am now able to eat sliced tomato and mayonnaise sandwiches. I still can’t stand the smell of or eat anything fried. About two weeks ago I went to my primary care physician. He ran some tests, including an upper GI, X-ray and ultrasound of my abdomen and esophagus. The results seem to show gallstones. He is sending me the diag- nosis and a recommenda- tion for a visit to a general surgeon. I am not convinced that this is my problem because I haven’t had any pain related to the nausea. The only time I had abdominal pain was when he examined me a couple of weeks ago and hit a very tender spot in my stomach. I am overweight but have lost about 12 pounds since this whole thing started. I haven’t had a fever, vomiting or a cold, but I have had a few chills on occasion during the night. I need to get to the bot- tom of this and hope to do so without gallbladder surgery. I have elderly parents that need my con- stant attention. I read your column every day and trust your judgment. DEAR READER: Gallbladder inflamma- tion, also known as chole- cystitis, can cause chills, loss of appetite, nausea, tenderness over the abdomen when touched, vomiting, fever and abdominal bloating. Symptoms are most often seen following a meal, especially a large or fatty one. Gallstones don’t typi- cally cause symptoms until or unless they block a duct. When this occurs, it usually results in pain in the upper right or center (just below the breast- bone) of the abdomen, right shoulder pain or back pain just between the shoulder blades. You have already Dr. Peter Gott undergone testing that indicates gall- stones, and you are exhibiting some signs and symp- toms of gall- bladder inflamma- tion. You are likely dealing with a gallbladder prob- lem. The only way to be sure is to undergo further testing. There are other possi- bilities. Some medications can cause nausea and loss of appetite. Certain stom- ach conditions such as gastroparesis may be to blame. Another possibili- ty is stress. Given that you are taking care of your parents on a full-time basis, this is a strong pos- sibility or perhaps a con- tributing factor. Keep in mind, however, that you may truly have gallblad- der disease and surgery may be your best option. Ask your primary care physician to refer you to a gastroenterologist rather than a general surgeon. Schedule an initial appointment, which should include an exami- nation and review of your previous testing. While waiting for that to happen, try adding a nutritional supplement shake such as Boost or Ensure and con- tinue to try to add more foods to your diet. Fruits, vegetables, whole grains and lean protein, either in the form of meat or meat- free options such as beans, peanut butter, eggs, tofu and other soy products, are good choices. Avoid fried, greasy and fatty foods. You should also con- sider bringing in some outside help for your par- ents — perhaps a visiting nurse who stays for a few hours a couple of days each week. This will allow you some time to yourself, to run errands or just relax, while ensuring your parents are well- taken care of. ** ** ** Dr. Peter H. Gott is a retired physician and the author of several books, including “Live Longer, Live Better,” “Dr. Gott’s No Flour, No Sugar Diet” and “Dr. Gott’s No Flour, No Sugar Cookbook,” which are available at most bookstores or online. His website is www.AskDrGottMD.com. fitness Sports in heat OK with precautions CHICAGO (AP) — Playing sports in hot, steamy weather is safe for healthy children and teen athletes, so long as precautions are taken and the drive to win doesn’t trump common sense, the nation’s largest pediatricians group says. New guidelines from the American Academy of Pediatrics arrive just as school sports ramp up in sultry August tem- peratures. The advice, released Monday, comes a week after two Georgia high school football players died following practices in K. Duane Carter, M.D. www.lassenmedical.com We are pleased to announce the newest member of our professional team. Dr. K. Duane Carter: Is a Board-Certified pediatrician who has been in private practice for 14 years. He graduated from the University of Tennessee Medical College in Memphis and did his pediatric residency at the T.C. Thompson Children’s Hospital in Chattanooga, TN. Dr. Carter has been married to his wife Melissa for 19 years, and they have adopted 8 children from 4 different countries (Romania, Bulgaria, China and Uganda) and have one biological son. He and his family love the outdoors, especially hiking, fishing, photography and nature study. 90-plus degree heat. Authorities were inves- tigating if the weather contributed. The guidelines replace a more restric- tive policy based on old thinking that kids were more vulnerable to heat stress than adults. New research shows that’s not true, the academy says. With adequate training, water intake, time-outs and emer- gency treatment avail- able on the sidelines, healthy young athletes can play even in high heat and humidity — within reason, the guidelines say. ‘‘The more educated parents, athletes and staff are about risks associated with heat ill- ness, the more likely they will think twice before allowing a com- petitive culture to over- take sound sensibili- ties,’’ said Dr. Cynthia Devore, co-author of the policy and a physi- cian for schools in the Rochester, NY area.. Government data released last week showed that more than 3,000 U.S. children and teens younger than 20 received emergency- Dr. K. Duane Carter is now accepting patients in Cottonwood and Red Bluff K. Duane Carter, M.D. Pediatrics St. Elizabeth Community Hospital A member of CHW www.redbluff.mercy.org 800.990.9971 redbluff.mercy.org room treatment for non- fatal heat illness from sports or exercise between 2001 and 2009. A few young athletes die annually from heat- related illness. Over a 13 year period, 29 high school football players died from heat stroke, data from the American Football Coaches Asso- ciation and others show. Football is a special concern, because play- ers often begin intense practice during late- summer heat, wearing uniforms and padding that can be stifling. Dr. Michael Berg- eron, a University of South Dakota sports medicine specialist, said the academy’s old policy was often ignored because it rec- ommended limiting or avoiding sports even in common hot weather conditions. The new policy is more detailed and nuanced, recom- mending that athletes be evaluated individually for play in hot weather. Still, Bergeron warned that overzeal- ousness can be danger- ous even for healthy kids, and even in rela- tively tame summer weather. ‘‘You can take some- body in 80-degree heat and you can kill them if you work them hard enough,’’ he said. The guidelines don’t list temperature or humidity cutoffs, but say safety should be the top priority. Other academy advice includes: —Teams should have emergency plans with trained personnel and treatment available and policies for avoiding heat illness. —Give kids about two weeks to adapt to preseason sessions, gradually increasing intensity and duration. Closely monitor more vulnerable kids, includ- ing those who are over- weight or have diabetes. —Make sure athletes are well-hydrated before practice or games. During activity, kids aged 9-12 should drink about half a cup to a cup of water every 20 minutes; for teens, 5 or 6 cups an hour. Sports drinks containing elec- trolytes and sodium should be offered dur- ing extra strenuous activity. —Educate everyone about signs of heat stress, including dizzi- ness, muscle cramps, headaches and nausea. Kids with symptoms should be sidelined and treated immediately; athletes should be encouraged to report if teammates seem to be struggling.