DEAR DR. DONOHUE: About six months ago, I got a terrible pain in my left shoulder and arm. I saw a specialist, who had me take a CT scan. I have a torn rotator cuff and need a new shoulder. He said he would not advise me to have that done. I asked if it was because of my age (78), and he said no. He said the operation has a long and painful recovery, and it might not make me any better. I am still in a lot of pain. I don’t know what to do. I talked to someone who had a new shoulder, and he said he is no better after the operation than he was before it. Do you have any suggestions? — B.R.

ANSWER: The rotator cuff is a band composed of tendons from four back muscles. The band wraps around the top of the upper arm bone. The top is shaped like a ball. It fits into the shoulder socket. The rotator cuff holds the ball in the socket. Tears of the rotator cuff are common in athletes and in people older than 55. The cuff frays with age, as does just about everything.

A torn cuff causes pain in the shoulder and upper arm especially when reaching overhead or out to the side or behind the neck. Small tears heal without any intervention. Ibuprofen (Advil, Motrin) and naproxen (Aleve) ease the pain and inflammation of both small and large tears. A cortisone injection also might help. Large tears usually call for surgical repair. Quite frequently the repair can be made with a scope and instruments passing through small incisions. Recuperation from this kind of surgery isn’t prolonged. Shoulder replacements are not usually done for rotator-cuff tears. Perhaps you also have arthritis in the shoulder joint.

Replacing an arthritic shoulder joint produces results as gratifying as hip and knee replacements do. It takes about a two-day hospital stay. By one week after the surgery, people can perform most of the activities of daily life without pain. See a different orthopedic doctor; you’ve been cut adrift without any help. You should be getting something for pain and some kind of intervention to help your shoulder, like physical therapy.

DEAR DR. DONOHUE: My cholesterol is 102 mg/dl (2.6 mmol/L). My doctor put me on Lipitor. Ever since, I have gas all the time, both burping and passing it through the rectum. I read an article that said gas passing into the throat causes throat cancer. I think there is more risk to my taking Lipitor than there is in not taking it. What do you think? — P.H.

ANSWER: I think something is wrong here. A cholesterol of 102 mg/dl is excellent. Anything less than 200 (5.18) is great. Are you talking about LDL cholesterol — the bad kind of cholesterol? Even an LDL cholesterol of 102 is a good reading unless you have had a heart attack. A discussion with your doctor for the need of Lipitor is high on your list of things to do.

Gas rising into the throat doesn’t cause throat cancer. As to flatulence, the increase of gas in the digestive tract, it can be a side effect of the medicine, but it’s not a common one. However, if you can trace the onset of flatulence to the Lipitor taking, then you have a valid beef. First find out if you need it. If you do need cholesterol-lowering medicine, ask for a different kind of medicine.

DEAR DR. DONOHUE: I ask for clarification on an issue between my mother, my husband and me. My mother loves iced tea. We have a soon-to-be 2-year-old son who wants a drink of “Grandma’s water” (iced tea) every time she comes over. My husband and I are adamant that he should not be exposed to caffeine at this young age. My mom and dad think we are too strict.

Second, my family has a history of Parkinson’s disease, and I remember reading iced tea contributes to tremors and shaking. Does it have an effect on developing Parkinson’s? — K.B.

ANSWER: Parents set the dietary rules for their children so long as the rules aren’t injurious. Your rule isn’t injurious. I’ve never seen that iced tea or any kind of tea contributes to Parkinson’s disease.

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.


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