A bulging disk doesn't always need surgery
By Paul G. Donohue, M.D.
DEAR DR. DONOHUE: My husband has been told he has a bulging disk in his back. What is that? Does he need surgery? The doctor has told him that since his back pain is not all that bad, he should not make any rash decisions about treatment. What do you think he should do? T.M.
ANSWER: Disks are shock absorbers interposed between adjacent backbones (vertebrae). They're about one-quarter the thickness of an individual backbone. Their center is filled with a spongy, gelatinous material that absorbs the many shocks and stresses inflicted on the back. The outer rim of the disk is a fibrous material. The "bulge" is a protrusion of the inner, gelatinous material through the fibrous outer ring.
Not every bulging disk needs to be repaired. Not every bulging disk causes pain. When one does, 70 percent or more of affected people are free of pain in one month. Your husband's doctor stands on solid ground when he tells him not to make rash treatment decisions.
Your husband needs some physical therapy for his back, and he needs instructions on how to protect his back.
The booklet on back problems deals with the causes of back pain and their treatments. Readers can obtain a copy by writing to: Dr. Donohue No. 303W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Canada with the recipient's printed name and address. Please allow four weeks for delivery.
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DEAR DR. DONOHUE: I find it impossible to use a public restroom. I cannot urinate in one, and I have had this trouble for my entire life. Is there something I can do to get over it before I die? I am 58. J.F.
ANSWER: J.F. is a male, but the problem affects both sexes. Sometimes it goes by the name "bashful kidney." It's a social phobia, a fear generated in circumstances that don't call for fear. The fear can be conquered.
Medicines that turn off the production of stress hormones can sometimes bring victory and can be used while people desensitize themselves to using public facilities. Beta-blockers are a group of such medicines, and a commonly prescribed one is Inderal. Paxil, an antidepressant, is another medicine that has helped others lose their bashfulness in restrooms. Your doctor has to prescribe these medicines.
If this phobia resists treatment with medicine, then you can seek a mental health professional for help in ridding you of it.
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DEAR DR. DONOHUE: Does soaking in a tub of warm water really promote sleep? My wife insists it does. If you agree with her, I'll try it. I do need sleep.
ANSWER: It works for many.
There's some science behind the idea. Upon getting out of the warm water, you'll have a rapid drop in body temperature. That's a signal to the brain to put the body into a sleep mode.
You've nothing to lose by trying it.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.
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