Q. I’m about to have hip surgery and I’m worried about an article I read that anesthesia may lead to memory loss. What can you tell me about it?
A. Researchers at Duke University Medical Center found that major surgery is associated with a drop in test scores for concentration, mental speed and verbal ability in some elderly patients. The surgeries in the study were primarily joint replacements, and the average age of the patients was 69. Two years after the surgery, 42 percent of them scored below their baseline pre-surgery tests.
This research should not keep people from having needed surgery, but you should discuss your concerns with the surgeon and the anesthesiologist. The Duke investigator suggests some tactics physicians might employ to reduce risk: 1) anti-inflammatory drugs; 2) temperature control during surgery; 3) regional instead of general anesthesia when possible.
Q. I have been suffering with Peyronie’s disease for the past 3 years. My doctor only told me to take huge amounts of vitamin E. It hasn’t worked.
This curvature means I have no sex life and it is horrible. Can you tell me anything more about treating this condition?
A. Peyronie’s disease occurs when fibrous tissue forms on one side of the penis. This tissue does not expand and the resulting erection is crooked. In severe cases, an erection can be painful and intercourse impossible.
One new treatment that may be successful is a series of injections of alpha-interferon (Intron-A). A small study found that up to 75 percent of men treated this way had less curvature and were pleased with the results. Several other studies have shown benefit, but more research is needed to confirm this approach.
Q. I hope you can recommend something for my wife, who feels like she is about to burst into flames. Her doctor suggested Premarin, but she refuses to take it because she is worried about the increased risk of breast cancer. What other options are there?
A. Some women get relief from menopausal hot flashes with antidepressant drugs like Prozac or Paxil. But there are also non-drug options that your wife may want to try first.
Turning the thermostat down may make her feel less “flammable.” Many women report success with black cohosh to lessen hot flashes. Plant-based estrogens such as those from soy or rye may also be helpful. The gold standard for easing hot flashes remains estrogen, which could be used for months rather than years. Lower doses carry less risk.
We are sending you our Guide to Estrogen: Benefits, Risks & Interactions for more information on other options for hot flashes. Anyone who would like a copy, please send $2 in check or money order with a long (no. 10) stamped (60 cents), self-addressed envelope: Graedons’ People’s Pharmacy, No. W-49, P. O. Box 52027, Durham, NC 27717-2027.
Q. How beneficial are patient assistance programs involving free medications?
A. The drug manufacturers offer free or low-cost prescription drugs for low-income patients. For those who qualify, they can be very helpful, saving hundreds of dollars a year. Go to www.helpingpatients.org for more information.