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Ask Dr. Gott 5/21
Shop locally for personal treatment
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    DEAR DR. GOTT: I was appalled to recently read again in your column a specific mention of Wal-Mart Pharmacy in reference to locating a product. While it would most certainly be unethical, readers might assume that you benefit in some way by promoting the pharmacy.
    Local, independently owned pharmacies do still exist and often provide the best service to people they actually know by name. Our town is blessed with such a pharmacy, which has been an active and contributing member of our business community for nearly 100 years. The staff members are friendly, compassionate and skilled. The owners and employees have contributed countless hours of volunteer work and have made major financial contributions for every cause from after-prom parties to the building of a new library and hospital wing. You do everyone a great disservice by blatantly promoting any particular pharmacy in your column.
    DEAR READER: Point well taken. However, I will attempt to defend myself. On occasion, I mention a product that is not available in small-town pharmacies and is available only through larger chains such as Wal-Mart, CVS, Rite Aid and others, depending on where you live. If a person is to find a particular product, he or she must, in this case, bypass the local store for a chain. Large chain pharmacies can also provide medication at prices far below local pharmacies. For many Americans, this is reason enough to use them.
    I live in a very small town with a spectacular pharmacy, and I often enlist the services and expertise of the pharmacist on staff to point me in the right direction. It's a resource I can't do without. I am aware that if you were to ask your local pharmacist to order a product, he or she would make every effort to accommodate you. The problem here involves timing. The average person is not willing to wait and demands immediate resolution.
    I heartily endorse shopping locally and supporting those sources that support us. Therefore, readers, make all attempts to stay local for your needs. When this isn't possible, visit larger establishments.

    DEAR DR. GOTT: I'm a 48-year-old, very active male with more things to do than I have time for, but, apparently my time is running out. Two years ago, I was diagnosed with Dupuytren's contracture. It's growing fast, and I've found out no one will do any preventive surgery until I can no longer function. Bologna! Why do I keep getting the same response? Is there anyone who can help me? I don't want to wait until I can't function. My hands and palms ache. Any suggestions?
    DEAR READER: As with any surgery, the benefits must outweigh the risks, and apparently your condition is not yet severe enough to justify an aggressive approach.
    Dupuytren's is an abnormal thickening of the tough tissue under the skin of the palm of the hand and fingers. The thickening causes the fingers to curl toward the palm. The ring and small fingers are most commonly affected. The condition often begins as a small lump in the palm, has no known cause and is not preventable. It can be treated with physical therapy in its early stages.
    If you have seen specialists who feel your condition is not severe enough to warrant surgery, I suggest you accept the recommendation. Make repeat visits as your condition progresses. Then be guided by the best suggestions for treatment.
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