DEAR DR. ROACH: I am 75-plus-year-old female in excellent health. My doctor’s comment on my most recent annual physical results was, “Great results on all tests. Excellent report.” My question: Is it necessary to have another colonoscopy at my age and with my good health?
My mother died of colon/rectal cancer at age 85 in 2002, and all family members were advised to have this procedure. My initial results were two or three polyps removed that were not the type that would recur and were not cancerous. The recommended follow-up was five years. That exam showed no polyps and no recommendation for future follow-up.
My previous doctor has retired, and I just received a letter from his replacement that I am due for another procedure. I am not inclined to do this at my age, and considering the “all clear” reports of the previous exams and my general good health. I would appreciate your thoughts and recommendation. – B.J.M.
ANSWER: The odds are low that the colonoscopy would find something there, but there is still a small chance, especially with your mother having had colon cancer. Not having it is reasonable. But since you seem to be otherwise healthy and can expect a longer life than average, I would still say to get it. In fact, I would encourage you to have it.
The booklet on colon cancer provides useful information on the causes and cures of this common malady. Readers can obtain a copy by writing: Dr. Roach – No. 505W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. ROACH: I am 92 and have spinal stenosis in my lower back and neck. The neck stenosis is causing a balance problem. Who would treat and/or operate on this – orthopedist or neurologist? – J.W.
ANSWER: I would be very slow to recommend surgery on the neck at age 92. I would try other treatments, including medication, physical therapy and possibly injection before considering surgery.
Balance problems may benefit from problem-specific exercises. A neurologist may be very helpful in evaluating whether the symptoms are indeed coming from the spinal stenosis, because balance problems can have many different causes.
If symptoms were intolerable despite everything that could be done short of surgery, I would find the most experienced surgeon around, which could be either a neurosurgeon or an orthopedic surgeon.
DEAR DR. ROACH: I have been reading your articles regarding gout and blood pressure medications. I suffer from pseudogout and take Diovan/HCTZ. Would changing this medication have any effect on my condition? – E.S.
ANSWER: Pseudogout (literally, “false gout”) looks a lot like gout, and both diseases are caused by deposition of crystals inside joints. In gout, the crystal is uric acid, whereas in pseudogout, the crystal is calcium pyrophosphate. pseudogout tends to affect larger joints, such as the knees, whereas the big toe is the classic place for gout. Hydrochlorothiazide (HCTZ), a common diuretic, can make gout worse, but should have no effect on pseudogout.
Dr. Roach regrets he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu. To view and order health pamphlets, visit www.rbmamall.com, or write to P.O. Box 536475, Orlando, FL 32853-6475.
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