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Ask Dr. Gott 5/1

Next step: Knee replacement

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Posted: April 30, 2007 5:57 p.m.
Updated: May 15, 2007 5:00 a.m.
DEAR DR. GOTT: I suffer from severe osteoarthritis in both knees. I take 200 milligrams of Celebrex daily. I am a 58-year-old male in good health. I have yearly blood work that includes kidney and liver functions. Are five injections in a year's time too much cortisone in each knee?
    DEAR READER: It's important to remember that steroids -- by mouth or injection -- can be harmful if given in large quantities. The usual limit for cortisone injections is four or five a year. I believe that you are not risking health consequences with your current therapy. Follow your doctor's advice in this matter. Or you might consider using Castiva. This is a castor-oil based product that comes in both warming and cooling formulas for topical application. You can purchase it online at www.castivabrands.com, by calling 800-353-5457 or from Walgreen's.
    It may also be time to consider knee-replacement surgery. You are still relatively young, and this could greatly improve your quality of life. At 58, you have many years ahead of you, and, from your brief note, you appear to be a good candidate. Ask your physician for a referral to an orthopedic surgeon.
    To give you related information, I am sending you a copy of my Health Report "Understanding Osteoarthritis." Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

    DEAR DR. GOTT: I am a 55-year-old male with premature atrial contractions. My heart doctor has told me this is totally benign, and I would like your opinion. I have had stress tests, a stress echo, an ultrasound and CT scans, and all turned out negative. I even had a second opinion and was told not to worry about it. My problem is, I can feel the premature beats when they occur, especially when sitting or reading the newspaper.
    Sometimes I can go for days with no PACs, and other days they can occur every third or fourth beat. There is no set pattern when these occur. They come and go as they please. When taking my pulse during these episodes, it feels like the pulse slips. I have no pain or shortness of breath, and I can perform my daily activities while this is happening.
    DEAR READER: Premature atrial contractions are "maverick" heart contractions that arise in the linings of the low-pressure heart chambers (atria). By and large, they are nothing to worry about.
PACs can result from stress. They are often the consequence of stimulants, such as caffeine. My advice is to ignore them and follow your doctor's suggestions.
    To give you related information, I am sending you a copy of my Health Report "Coronary Artery Disease." Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

 
Doctor Gott is a practicing physician and the author of the new book "Dr. Gott's No Flour, No Sugar Diet," available at most chain and independent bookstores.
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