DEAR DR. ROACH: I was diagnosed with costochondritis about 33 years ago. Up until last year, I had had little pain with it. But this year, the pain is really bad. I am 78 years old. Does age matter? What, if anything, triggers the pain, and what can help my pain? Is heat or cold better? — D.B.

ANSWER: Costochondritis (“costo” means “rib,” “chondro” is “cartilage” and “itis” means “inflammation”) is thus inflammation of the cartilage of the rib. This condition can be caused by a virus called Coxsackie B virus, and has several other names including epidemic pleurodynia, Bornholm’s syndrome and, my favorite, Devil’s Grip, which gives a colorful understanding of how it can make your chest feel. The pain can last for weeks, and tends to hurt more with breathing.

This syndrome of pain at the rib cartilage sometimes can have recurrences, although 33 years later is longer than I have heard of. Since chest pain can have multiple causes, and sometimes we never figure out where it comes from, it’s possible that this is something else causing the same or similar symptoms. Chest pain in any 78-year-old, even chest pain that seems clearly to be coming from the ribs, should prompt at least a consideration of heart problems. See a cardiologist to rule them out.

DEAR DR. ROACH: Does the water in coffee and tea count as some of the water a person is supposed to drink daily? People are often told to drink eight cups daily. — C.L.

ANSWER: People often are told to drink eight cups of water daily, but there is nothing magic about that number. That amount that is optimal for health varies tremendously from person to person, based on an individual situation.

An athlete exercising in the hot, dry sun may need much more than eight cups. Eight cups is too much for some people with kidney disease. It’s important to take in enough fluid, especially in hot weather, but a better way of monitoring is just to make sure you are making urine throughout the day. Tea and coffee are perfectly good ways of getting enough fluid. Most people get all the electrolytes (sodium, potassium and others) they require from food, but again, athletes (who need more) and people with kidney disease (who may need less) may need to be very careful with supplemental electrolytes.

DEAR DR. ROACH: After reading yet another letter to your column from a lady suffering from urinary tract infections, I feel I must tell you of my experience with this problem.

For many months I had infections and the treatments helped but the infections kept recurring. One day my doctor’s nurse asked me if I took baths or showers. I said I always took baths. She suggested I try showers only, and see if that helped. I did, and the infections stopped, and now after some 40 years I have had only one infection — after being in a family hot tub.

This seems like such a simple solution that at least other women could try it at no cost or inconvenience. Could you please suggest it in your column? — E.R.

ANSWER: I am always happy to provide possible solutions to common problems, especially when they don’t involve medications or procedures. I looked this up, and it seems to be consistent advice, but I hadn’t heard it. Thank you for writing.

TO READERS: Recurring vaginal infections are often troubling to women. The booklet on that topic explains them and their treatment. Readers can order a copy by writing: Dr. Roach — No. 1203, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6. Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Health newsletters may be ordered from www.rbmamall.com.

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