DEAR DR. DONOHUE: I went to the hospital for a cystoscopy (a scope examination of the bladder). After being prepped and having an IV started, my urologist said they couldn’t put me under, as I might have a stroke, and that I needed an examination of my carotid arteries.

Before this was mentioned, I never heard of carotid arteries. I did some research on the Internet but am still befuddled. I read that people can have cancer in that artery. My vascular surgeon set me up for angiograms, which I had done. I am waiting for the results. Could you address the carotid artery and what problems can arise with it? – M.G.

ANSWER: P
eople have two carotid arteries – located on the right and left sides of the neck. They bring blood to the brain. A blockage in either carotid artery can lead to a stroke – an insufficient amount of blood gets to the brain, and brain cells die. Carotid arteries have nothing to do with cancer.

If a person has a significant obstruction in either carotid artery and has symptoms of poor brain blood supply, the obstruction should be removed to prevent a stroke. If a person has a significant obstruction but no symptoms, consideration is still given to removing the obstruction. The obstruction is plaque – a composite of cholesterol, fat, protein and blood platelets clinging to the carotid artery wall.

To remove the plaque, a surgeon cuts into the artery and scoops out the obstructing mass.

Doctors are beginning to use, with greater frequency, angioplasty to unblock carotid arteries. It’s the same kind of procedure used to open up clogged heart arteries. A catheter – a soft, pliable tube with a balloon tip – is passed from a surface artery into the carotid artery. At the point of obstruction, the balloon is inflated. It smashes the plaque flat. Through the same catheter, a stent is then put in place. A stent is a wire affair that expands to keep the artery wide open.

DEAR DR. DONOHUE: I have COPD. I am still actively working. However, in the past year, I had pneumonia twice. I am concerned that I am getting sick too often. I read in the newspaper about a new procedure called bronchial thermoplasty. I would like to know if I could be a candidate for it. – F.M.

ANSWER:
Bronchial thermoplasty is a new procedure for asthma. One of the reasons asthmatic airways constrict and make it difficult for air to move into and out of the lungs is enlargement of muscles that encircle the airways. When those overdeveloped muscles clamp down, the airways narrow and a person can’t breathe.

Bronchial thermoplasty involves putting a scope into the airways (the bronchi) through the nose or mouth. The scope comes equipped with a tip that heats up. The heated tip can destroy some of the too-powerful muscles and make their contraction less apt to narrow airways.

This is a procedure for asthma, not COPD. COPD is chronic obstructive pulmonary diseases, of which there are two types – emphysema and chronic bronchitis.

To prevent pneumonia, you should have the pneumonia shot. It doesn’t protect against all kinds of pneumonia, but it protects against one of the most dangerous kinds, pneumococcal pneumonia. You should insist on a yearly flu shot too.

The booklet on COPD describes in detail emphysema and chronic bronchitis and their treatments. To obtain a copy, write: Dr. Donohue – No. 601, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: What’s a Mallory-Weiss tear? My uncle died of it. – B.G.

ANSWER:
They’re tiny tears, less than an inch long, of the lower esophagus. They can bleed profusely. They often result from forceful vomiting, retching, coughing or straining. The bleeding from these tears constitutes an emergency that must be corrected quickly.

DEAR DR. DONOHUE: When I was 44, my uterus was removed but the ovaries were retained. How will I know when I reach menopause? I haven’t had any periods since the operation. – L.N.

ANSWER:
You’ll have the other symptoms of menopause: hot flashes, night sweats and vaginal drying. The average age for menopause is 51, so around that time you can start expecting those signs.

If matters are truly confusing, your doctor can order tests to determine your level of hormone production.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com


Only subscribers are eligible to post comments. Please subscribe or to participate in the conversation. Here’s why.

Use the form below to reset your password. When you've submitted your account email, we will send an email with a reset code.