Medical Weblog

Description and Possible Medical Problems

Muscle ache that’s accompanied by weakness is a common occurrence. But if you have a constant dull ache in the muscles around your shoulders and/or the backs of your hips and you don’t have the strength you once did, you may have a rare, progressive disease called polymyositis. This disorder is a variation of dermatomyositis, in which the muscle pain and lack of strength are frequently accompanied by a rash, which is a deep red and may be scaly. The rash most often appears around the eyes and on the neck, chest, hands, and elbows.

Both polymyositis and dermatomyositis are arthritic disorders, but they primarily affect the muscles, which become inflamed and swollen in both diseases, and not the joints, as other forms of arthritis do. Doctors believe that polymyositis and dermatomyositis are caused by a defect in the immune system.

Treatment

If your doctor discovers you have polymyositis, dermatomyositis, or polymyalgia rheumatica, he will probably prescribe the corticosteroid prednisone to help reduce pain and inflammation. Prednisone will also help lessen the rash and inflammation that accompany dermatomyositis. Prednisone works by increasing the body’s tolerance to the inflammation in the blood vessels and tissues, thus alleviating the symptoms.

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Urinary incontinence is a serious problem because it can cripple a person both emotionally and psychologically. When an elderly woman becomes incontinent, especially if she’s living with her family, her family may decide that she needs to be placed in a nursing home. In my office, women will rarely volunteer information about incontinence, even when I ask them directly. However, I know that the adult diaper business is booming.

There are several types of incontinence that are common among women over 50:

• Stress incontinence occurs when you temporarily lose control of your bladder while laughing, coughing, or sneezing. The primary cause of stress incontinence is weakness of the pelvic muscles.

• Urge incontinence occurs when you suddenly become incontinent for no clear reason. It can be caused by either a urinary tract infection or nerve damage.

• With overflow incontinence, the bladder “overfills” because it never completely empties. Overflow incontinence is usually due to nerve damage in the bladder. The major symptom is constant dripping of urine.

• Mixed incontinence is a combination of stress incontinence and urge incontinence and is the most common cause of urinary incontinence in women over 50.

If you have any type of urinary incontinence, you can use the acronym DIAPPERS—”diapers” with an extra P—to check for the cause:

D: Delirium that may be caused by pneumonia, irregular heartbeat, or a small stroke

I: Infection of the urinary tract

A: Atrophic vaginitis or urethritis, dropped bladder, prolapsed uterus, and loss of pelvic floor tone and muscle strength

P: Pharmaceuticals, such as diuretics, sedatives, cold preparations, psychotropic medications, or blood pressure pills

P: Psychological agitation or depression

E: Excessive fluid intake

R: Restricted ability to get to the bathroom—is the bathroom on a different floor, or does arthritis prevent you from reaching it on time?

S: Stool impaction, another overlooked common cause of loss of urine

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If you are breast-feeding and you think you have an infection, see your doctor. He will give you a prescription for an oral antibiotic such as a penicillin derivative or erythromycin that should clear up the infection in one to two weeks. You can continue to nurse your baby, since the antibiotic won’t affect your milk. Aspirin will help relieve the pain and tenderness. You should, however, refrain from nursing your baby with the infected breast until it heals.

It’s a good idea to keep your nipples clean and dry between feedings. You might want to apply a soothing ointment to your nipples to keep them from drying out and cracking—and thus encouraging another infection.

If an abscess forms in your breasts, even after taking the antibiotic, your doctor will want to drain it of fluid. If one of your breasts becomes infected and you aren’t currently breast-feeding—or haven’t for some time, if ever—see your doctor immediately. A breast infection in a non-nursing woman is rare—except when breast cancer is present.

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Description and Possible Medical Problems

If you suddenly become short of breath and at the same time have a sharp pain in the chest that doesn’t disappear, you should call your doctor immediately. These symptoms may mean that in the outer lining of one of your lungs you have an air bubble—called a pleb—that has burst, causing the lung to collapse in a matter of a minute or so.

Frequently, a burst air bubble and collapsed lung occur in people over 60 who have emphysema, since the disease causes plebs to form. At other times, especially in a person who’s in the 40s or 50s, the lung can collapse because of a congenital defect in the lung.

Treatment

If your lung has collapsed due to a burst air bubble, you will be hospitalized, and your doctor will place a tube called a chest tube into the lung in order to expand it. The procedure is done under local anesthesia, and the tube will probably remain in place for several days. You will recover fully, and the chances are good that you won’t be bothered by burst air bubbles again.

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The skin is the body’s largest organ, consisting of more than two square yards. Though the skin serves as the major outlet for many of the vital parts of the body—from sweat glands to nerve endings to blood vessels—it is the substance collagen that is responsible for the signs of aging that appear on the skin.

The epidermis is the top layer of your skin. It consists of cells that are eventually sloughed off from your skin. These cells contain keratin, a protein, and melanin, which colors your skin.

Beneath the epidermis is the dermis, which contains strong fibers of collagen along with elastic fibers called elastin. Together, they work to provide a strong, firm base.

As we age, however, the dermis starts to thin and the collagen and elastin become stiffer, which creates wrinkles as well as a paler skin tone. Years of gravity and possible obesity take their toll as well, resulting in a change in facial contours, a double chin, and sagging eyelids. Older skin also becomes drier, as the skin’s oil glands no longer produce as much oil.

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