Dear Dr. Roach: I always try to accompany my husband when he goes to the doctor. I feel that two sets of ears are always better than one. When his vitals are taken (e.g., weight, blood pressure), I have to ask what they were, as they never seem to volunteer this information. I mention this because the last time we were at the doctor's office, I asked what his weight was, because he had just lost 10 pounds. The nurse said it was 165, and I said 鈥渞eally,鈥� that was odd, as his shorts were very loose on him. We took it again, and she had transposed the numbers. It was 156. This is a wake-up call to all patients: They need to be aware to ask these questions for their health and well-being. C.W.
I agree with you completely, for several reasons. Doctors and nurses make mistakes, but we also don鈥檛 communicate as effectively as we should some of the time. We use words that people don鈥檛 understand, talk too fast or too quietly and don鈥檛 spend the time we need to making sure people know what they should do to help themselves get better. I think having a family member there is a great idea. So is taking notes, and so is going over what YOU understood the doctor to say, to make sure you are both on the same page.
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Dear Dr. Roach: Could you please address the risks involved in oral sex? I鈥檓 referring to the possible spreading of oral diseases, such as herpes, to the genitals and the possible spreading of genital diseases, such as HPV, to the mouth. J.F.
The risk of acquiring an STD with oral sex is low, but not zero. Gonorrhea and even HIV have been transmitted with oral sex, although the risk is quite small. Herpes simplex and HPV are the most likely infections.
Most cases of oral herpes (commonly called cold sores or fever blisters) are Type I; most cases of genital herpes are Type II. However, someone who has never had HSV-I (including about 70 per cent of adolescents ages 14-19 in the U.S.) can get genital HSV-1 from receiving oral sex from a partner.
HPV (human papilloma virus, the cause of most warts) can be transmitted sexually as well. Most people fight off this infection. However, some people don't, and they are at risk for developing cancer of the mouth and throat.
Transmission of the virus can be minimized by choosing partners wisely, by barrier methods such as male or female condoms and dental dams and, in the case of HPV, by getting the vaccine, which I strongly recommend for males and females ages 13 to 26.
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Dear Dr. Roach: I have weaned off Zoloft, and I noticed a swelling of my fingers. I can鈥檛 get my rings on. Do you think it is related? E.P.
Discontinuing an antidepressant such as sertraline (Zoloft) certainly can cause symptoms. Dizziness, fatigue, muscle aches, anxiety and irritability are common. It happens more frequently if the drug is suddenly stopped versus tapered down over weeks. Paroxitine (Paxil) seems to have the highest incidence of symptoms on stopping.
However, I haven鈥檛 seen swelling as a result of stopping sertraline. It may be related, but I doubt it. Is it possible that you are consuming more salt? That鈥檚 the most common reason for increased fluid in the fingers over a short time.
I would see your doctor if it doesn鈥檛 go away in a week or so.
