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Ask Dr. Gott 12/18

Tips for managing hernia

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Posted: December 18, 2007 2:24 p.m.
Updated: January 2, 2008 5:00 a.m.
    DEAR DR. GOTT: I was recently hospitalized with a hiatal hernia. I was informed that at my age, 89, the doctor did not wish to perform surgery. Instead, I was advised to eat smaller portions of food and to eat more than three meals each day. I didn't mind, for my appetite has diminished. I weigh 125 pounds and am 5 feet 2 inches tall. Do you have any suggestions?
    DEAR READER: You may have better success using an acid-blocker such as Zantac or Pepcid rather than having to eat so frequently. If you suffer from acid reflux with your hernia, you might try putting 3- or 4-inch wooden blocks under the head of your bed. Gravity will help keep acid in the stomach and reduce any pain that would otherwise result. Also, to relieve your acute pain, try using Tums or any other over-the-counter acid neutralizer that doesn't require a prescription.
    If your heartburn continues, ask your doctor to refer you to a gastroenterologist who can further advise you.
    To give you related information, I am sending you a copy of my Health Report "Hiatal Hernia, Acid Reflux & Indigestion." 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: You recently responded to a question about the vaccine Zostavax for the prevention of shingles. I am now completely confused.
    In January 2004, I was diagnosed with shingles by a medical doctor and was told there was nothing that could be done to relieve the pain and itching other than pain pills that just might prevent a condition known as postherpetic neuralgia. Well, I've had neuralgia and use the pain reliever Aleve sparingly because of its Naproxen content. This ingredient scares me, so I quite often just suffer until the pain eases up. This sometimes requires me to strip off all my clothes and lie down to avoid anything touching my skin, except perhaps a light sheet or blanket.
    Is there a medication to be used for shingles? Due to the length of time I've suffered with this condition, would I benefit from the use of Zostavax, or is it just to be used for the prevention of shingles and not as a cure?
    DEAR READER: Active shingles, at best, are a challenge to treat. The new vaccine for shingles is used to prevent acute attacks by stimulating the body's immune system. It is not appropriate for treating the blisters, pain and neuropathy of an acute attack.
    As you know, the vaccine is new, so its long-term effects (both good and bad) are unknown. Nonetheless, I have recommended that my patients over age 60 receive the vaccine despite the fact that it must be transported refrigerated and used the same day it is shipped. Also, it's expensive.
    Ask your primary care physician for his or her opinion.

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