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Ask Dr. Gott 4/4
Swallowing problem may be cancer
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    DEAR DR. GOTT: I read with interest a letter from a reader who had trouble swallowing. I too had trouble swallowing pills and received many suggestions. My general-practice physician told me to gargle with salt water. This didn't help, so I consulted an ear-nose-and-throat specialist. He looked down my throat and knew right away I had cancer on my epiglottis (the "lid" that closes the windpipe during swallowing to prevent inhalation of food). He confirmed his visual observation with a biopsy.
    That was three years ago. I underwent chemotherapy and radiation, and now my cancer is in remission. It was detected early so I was lucky.
    Trouble swallowing can be something serious and needs to be checked by a specialist.
    DEAR READER: Trouble swallowing can be caused by cancer, as it was in your case. However, most situations have a benign diagnosis. I agree with you that difficulty swallowing, especially if it is a new occurrence, should be evaluated by a specialist. Thanks for writing.
    DEAR DR. GOTT: I have never seen anything in your column about trembling, shaky hands.
    It is very embarrassing to hold a song book in church and have it shake like a leaf. I would like to know if there is a medication for this. I would appreciate any suggestions you have.
    DEAR READER: There are several neurological disorders that can cause the hands to shake. Parkinson's disease, for example, is a progressive disorder marked by tremors, rigidity and other abnormalities. Benign essential tremor is a harmless shaking, usually of the hands or head. Parkinson's generally has a "pill-rolling" tremor that may disappear during intentional movement, while benign essential tremor often occurs only during purposeful movement, such as writing.
    I urge you to make an appointment with a neurologist, who will examine and test you. He or she can provide treatment options based on the cause of your tremors.

    To give you related information, I am sending you a copy of my Health Report "Parkinson's Disease."
    DEAR DR. GOTT: I am 75 years old. I don't drink, smoke or eat anything white. I am 5 feet 4 inches and weigh 172 pounds, but I should weigh 130. I walk four hours a day.
    I lost 21 pounds on the South Beach diet. How can I lose that last 40 pounds? My doctor says I must eat 1,200 calories a day, but I feel that is too much. I currently consume 800 calories a day in an attempt to lose the extra weight.
    DEAR READER: You are not taking in enough calories, and I fear that you may actually be starving yourself and may be malnourished. Your diet may be detrimental to your health. This could be why you have stopped losing weight. Without proper nutrition, your body will not properly metabolize what you do eat.
    You should not be so concerned about your weight. At 75, it will not make much difference to your health. Stop the restrictive diet, consult with a nutritionist and get back to enjoying life.
    To give you related information, I am sending you a copy of my Health Report "Eating Disorders."
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