Dear Dr. Roach: Your recent response to a woman who, later in life, experienced 鈥減eople talking to me鈥� was that she was having auditory hallucinations and that she should go to a doctor right away, 鈥渁s there is very effective treatment to stop the voices and get your life back.鈥�
If there really is such treatment, what is it? My son, diagnosed with schizophrenia at 18, has had voices screaming at him for 25 years now. He has had excellent medical attention, taken every drug known and never has had any relief. Promising effective treatment聽 seems like a stretch. But if there really is a magic cure, would you mind sharing this info with me?
Anon.
I am very sorry to hear about the difficult time your son has had. I also am very sorry for implying that schizophrenia always can be successfully treated. Unfortunately, 鈥渧ery effective鈥� treatment is not the same as perfectly effective treatment; there are people whose schizophrenia cannot be successfully controlled. There is no 鈥渕agic cure.鈥� There are treatments that help the majority of people with schizophrenia, but I can鈥檛 suggest anything that hasn鈥檛 probably been tried in 25 years of doctors who know more about him, and more about schizophrenia, than I do.
鈥楾here are conditions that medical science is able to successfully treat or even cure in the majority of people 鈥� even in the vast majority.
Unfortunately, I have seen people die from cancers that should have been curable, and from infections that people aren鈥檛 鈥渟upposed鈥� to die from. It is a humbling experience.
Dear Dr. Roach: You recommended estrogen cream for UTI problems. I had breast cancer, and it was estrogen-positive.
I was on tamoxifen for six years; it is an estrogen blocker. As a result, I am reluctant using any medicine that pertains to estrogen. Do you think this cream is safe to use in spite of my history of estrogen-positive breast cancer?
R.E.
To be specific, I recommended considering estrogen cream in post-menopausal women who have recurrent urinary tract infections due to vaginal atrophy.
Although a recent opinion by the American College of Obstetrics and Gynecology stated that 鈥淒ata do not show an increased risk of cancer recurrence among women currently undergoing treatment for breast cancer or those with a personal history of breast cancer who use vaginal estrogen to relieve urogenital symptoms,鈥� neither I nor they recommend using any kind of estrogen preparation, vaginally or by mouth, without a thorough discussion with the woman鈥檚 oncologist. Nonhormonal treatments certainly should be tried first, and the risks of estrogen need to be carefully balanced against the possible benefits.
Dr. Roach writes: A recent column on PVCs, a type of irregular premature heartbeat, generated several letters. One person advised stopping caffeine. This is good advice, and might solve the problem. Others recommend magnesium supplements. I looked this up and was able to find a study showing that symptomatic PVCs were reduced by taking magnesium; however, every person in the study had had his or her magnesium level checked, and people with kidney disease or who were taking any medications were excluded, which limits the generalizability of the study. I don鈥檛 recommend magnesium supplementation unless magnesium levels have been tested and were found to be low.聽
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].
