Dear Dr. Roach: I am wondering how safe 鈥渆nergy drinks鈥� really are.
My daughter is a recovering alcoholic, sober for three-plus years, but she has at least five of these drinks a day.
Can they be good for her, or are they another addiction? N.N.
I鈥檝e recommended against energy drinks in previous columns due to the whopping amount of sugar they contain.
However, I am going add another reason: Using this large a number of energy drinks constitutes a听potentially dangerous caffeine intake.
There has been at least one related death -- a young man consumed seven or eight energy drinks and suffered a heart attack. This obviously is a rare event, and caffeine is generally safe at reasonable doses, but 鈥渁t least鈥� five a day is way too much caffeine. Depending on the brand, five cans would contain perhaps 800 mg of听caffeine (about a half-gallon of brewed coffee), and 270 grams of sugar (more than a third of your entire day鈥檚 recommended calories and over a week鈥檚 worth of sugar).
I can鈥檛 comment on addiction, but I certainly would strongly recommend that she reduce her consumption.
听
Dear Dr. Roach: What is an exophytic cyst? I have one on my right kidney, and it has been watched closely for the past eight years.
The most recent ultrasound shows that it is 2.1听cm and hasn鈥檛 changed in that time. I am 78 and in good health, except for asbestos exposure. Should I get this thing removed, or let it be? I get conflicting advice. B.W.
The word 鈥渆xophytic鈥� means 鈥済rowing outward,鈥� and a cyst is a fluid-filled cavity. So an exophytic cyst bulges out of the kidney and is filled with fluid. The big concern with these is whether they can be cancerous.
A simple cyst, with thin walls and fluid without any solid structures, has a very low likelihood of being cancer and does not need further evaluation. If the sonogram can鈥檛 show that for certain, then a CT scan is usually done.
Kidney cysts are graded听according to the Bosniak category, based on听their appearance by CT听scan. The more complex the cyst, the higher the likelihood of cancer. Older age, being a male and asbestos exposure are risk factors for cancer of the kidney.
Despite those risk factors, if this were a simple cyst (Bosniak I or II) and unchanged in eight years, it is very unlikely to be cancer, and I would recommend letting it be. However, if it were a Bosniak category III or higher, I would discuss biopsy with the urologist.
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 [email protected]
