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Ask an expert

Pose a question to one of our health-care professionals.

Every week we'll feature a column from one of our health-care experts:

  • Registered dietitian Andrea Holwegner.
  • Associate professor of pediatrics and emergency medicine Brett Taylor.
  • Registered psychologist Melanie Barwick, specializing in children's mental health.
  • Certified athletic therapist Russell Gunner.

They're also here to answer your questions and deal with the issues you want dealt with.

This site is intended for informational purposes only — it is not a substitute for professional medical advice, diagnosis or treatment. If you have specific questions about specific symptoms, treatments or nutritional issues see your medical professional.

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Comments

H. Smith

Hi Andrea,

I could really use some expert snacking advice. During weekdays, I work in an office and often attend 1+ hour meetings. This is a problem for me, as I'm quite active and accustomed to snacking on an hourly basis.
Can you suggest some hearty snacks that would keep me from zoning out during long meetings?

Hi H.Smith,
I am responding to your question about snacks. In February you will see an article posted on this site "Elevate Your Energy!" which will have some good thoughts for you. Also visit my website www.healthstandnutrition.com in the RESOURCES section for my article titled "Top 10 Winter Snack Attacks." Hope this helps!
Andrea Holwegner BSc, RD
"The Chocoholic Dietitian"

Posted January 18, 2008 06:13 PM

E Steele

both my wife and I are having problems with breaking finger nails. Is it our diet or something else?

Posted January 20, 2008 02:54 AM

bp

on

I recently say a video by Walter Veith ( a scientist) who was commissioned by the British Gov't to study milk and dairy products. It can be seen on line. It is called "Udderly Amazing". He condems much of the products that are promoted by the milk industry. Take a look at it and let me know what you think!
Thanks

Posted January 21, 2008 08:46 PM

Drav

I've been suffering from severe sciatic pain in my left hip. I went to my family doctor and he prescribed some anti inflammatory (NSAID) which is not helping much.

Is there a specific type of doctor / specialist that I can consult that would be more familiar with treating this lower back / hip pain?

Posted January 30, 2008 04:45 PM

Yukon Commuter

Hi - I am wondering about the effects on my lungs of cold weather exertion. In Whitehorse we go for weeks below -20, -30 and, at times, -40 (or more). It is difficult to xc ski below -33 but I still ride my bike to work. I can protect most areas of my body but am i doing harm to my lungs when exercising in these temperatures? Is there a cutoff temp.?

Dear Yukon Commuter,

Extreme cold air can be especially hard to breathe. I'm sure you are already, but try wearing a good cold air mask over your mouth and nose to warm incoming air as much as possible. I don't think you are doing harm to your lungs, but I would keep your workouts short on the extreme cold weather days. As far as cut-off temperature goes, let your body tell you when too cold is too cold. If you are feeling extremely stiff on your workout and it's not loosening up, shut it down before you hurt yourself.

-- Russell

Posted February 6, 2008 07:56 PM

Charlene Smith

Woodstock,Ontario

Why do doctors NOT listen to their patients who have MORE information than them?

I not only have icthyosis,I may in fact have a new mutation of the original two types!

I have multiple major health issues that may in fact be caused from my disease,so far,not documented.

The genetist is excited as my case is unique but it is NOT recognised by the medical society even dermatologists are puzzled by my case.

I have tried to tell them all:is it possible that these problems are linked to my disease?

They didn't listen,now I have irreverable damage to organs because of this.

So again the question:why doesn't the medical community listen?IF they don't know,why not just say they don't know?

Dr. Brett Taylor responds:

Hi Charlene;

I am not going to pretend to be an expert in icthyosis, as I have only seen a couple of cases in my entire career. For people who are interested in reading more about this, there are icthyosis patient support groups and at least some academic information on the web (http://www.ichthyosis.com/ , http://www.emedicine.com/oph/topic687.htm).

I think the real point of your post, though, has to do with the very real frustration patients feel when they have conditions or symptoms that don't make sense to their physicians. Doctors are just like everyone else; we have areas of expertise, and other areas of medicine that we are only marginally familiar with. In the emergency department, after two decades in practice, I run into something I have never seen before at least once a week.

Experienced physicians learn to deal with this by careful referral to other physicians. Generally, once an uncommon disease is identified, a dedicated search will find a physician in your area who has enough expertise to be of some help, even for very rare and unusual conditions. But in the case of a super-rare, or even unique, genetic mutation, there may simply be no experts, because the condition hasn't been described before. When this happens, your doctor is in a very tight spot; most of us are ethically driven to provide clear, uncluttered, but most of all TRUE answers to our patients....when no one knows what the answers are, as may be the case in your condition, doctors sometimes tend to say very little. We don't want to accidentally lie. This lack of information is incredibly frustrating for the patient, especially when the disease progresses and major changes to health occur.

Doctors can be legitimately stumped, despite their best efforts and intentions, and when this happens we don't know what sort of complications are ahead for a patient or how to prevent them. Many physicians at this point will say, clearly, "I don't know". This is very hard for us, not because of any ego issues but because many patients with significant illness can be quite shattered if their physician says she has nothing to offer. It is a real problem, and communication at these times has to be individualized in each case so that we meet the patient's information needs as best as we can. As with everything, some doctors are better at this, and others are worse.

I know, it's not a very good answer, is it Charlene? My only advice to you is to find, from all the physicians you have visited, the one who was the most informative, and ask for his or her advice. And if that advice is fairly thin, it doesn't mean that your doctor doesn't care about you, or want to help you. It may just mean that he or she doesn't know what to offer right now.

Lastly: things change. What isn't known today can become very well understood tomorrow. Keep asking questions, and don't give up on this.

Brett Taylor
thevirtualpediatrician.com

Posted February 28, 2008 06:55 PM

Charlene Smith

Woodstock,Ontario

I would like to thank-you Brett Taylor for at least being honest!

I would like to offer one piece of advice to the medical profession though.

I would prefer to be treated honestly by you by saying you don't know,then being made to feel as if I am nuts or not being listened to.

I am tired of being told that take a nerve pill,there's nothing wrong with you or the other classic'that's not possible'because no one else has/hasn't these problems or reactions.

It is because of this type of thinking,I have being made to suffer pain I never should have to.

I had a chronic appedix,a non-functioning gall bladder,bleeding problems among other things that DID NOT show through'normal testing'but were found to be in FACT problems.

I have medical reactions to drugs NOT yet reported as being problematic[think vioxx].

Keep an open mind because sometimes as you noted you meet someone who will NOT follow into any of the'normal categories'even if the tests come back as normal.

Thank-you again for your honesty,Charlene

Posted February 29, 2008 07:47 PM

Jennifer

Calgary

Hello. I've had a problem recently while doing my bi-weekly run on the treadmill, about 5 minutes in I start to get searing pain in my calves and have to stop, even though I haven't reached my target heart rate. I'm careful to stretch before and after, so I'm not sure what the problem is!
Thanks
Jennifer.

Russell responds:

Jennifer, It could be varying amount of things. It may be some residual scar tissue from a small previous injury, neurological problems, compartment syndrome or a few other possibilities. The best I can do from this point of
view is recommend seeing someone in your community to have it better assessed to determine the exact cause. Once you can figure out the cause, the symptoms will often decline quickly.

Cheers,
Russell Gunner
Certified Athletic Therapist
www.clubphysioplus.com

Posted March 6, 2008 07:20 PM

Riley

Kingston

I'm physically very active with a rugby practice nearly everyday supplemented with sessions in the gym and sprints on the track. Plus I am also a regular blood donor, donating every 70-80 days or so. My question is does donating blood on a regular basis put a limit on how aerobically fit you can become because of the large loss of fluids and red blood cells? If so, are there techniques, foods, or exercises specifically tailored to this kind of recovery?

Dr. Brett Taylor responds:

Way to go Riley! People who are regular blood donors are hard to find, and the shortage of blood products in Canada can become quite acute at times. What you do makes a difference, and the blood you have given has undoubtedly helped scores of people.

Regarding your question about fitness, the answer is: it depends. What are your fitness objectives? If you are a highly competitive athlete, donating blood has a short term negative effect on your performance. It is "anti-blood-doping"... you decrease temporarily the number of red cells available to carry oxygen to muscles. As a result, in order to do the same work, the red cells left have to circulate faster... ie, you need a faster heart rate to do the same amount of aerobic work.

Now, most of the time, particularly in young, fit individuals, and especially males (testosterone stimulates blood production), the time it takes your body to replenish those lost red cells is measured in days. So, your performance should return to normal within a week or so of giving the blood, maybe even within a couple of days. If you are worried about it, ask your family doctor to check your hemoglobin before and four or five days after donating blood. I will bet the difference will be pretty trivial.

There are risks that the higher red cell turnover can make you deficient in iron, folate or B vitamins, but if you are not on a special diet, this risk should be truly small. Perhaps Andrea could comment on that?

Finally, you can think of donating blood as yet another fitness challenge that you are defeating. In effect, when you train after giving blood, you are training at a disadvantage. It is as if you are training at a slightly higher intensity, and you get a bigger cardiovascular bang for your buck after blood donation than before. This is probably a pretty small benefit, though (and I am NOT recommending it as a training strategy!).

So: if by "fitness" you mean that your heart and cardiovascular system will run better and your risks of cardiovascular disease will decrease, donating blood will, if anything, have a slight positive effect. If, on the other hand, by "fitness" you mean the ability to defeat your opponent on the field of play, you probably won't be quite as effective for a few days after giving blood.

In any event, you should pat yourself for your contribution to the health system.

Brett

Andrea Holwegner responds

Hi Brett,

I agree with your statement that unless he is on a special diet or has medical issues I am not aware of, vitamin/mineral depletion would not be a concern - especially in a male since anemia is greater in females. A
multivitamin is always a good idea. Thanks!

Andrea Holwegner BSc, RD

Posted March 12, 2008 03:45 PM

rae marie

saskatoon

Can continual ear twisting cause hearing loss?

Posted March 25, 2008 11:19 PM

rae

saskatoon

Can continual ear twisting cause hearing loss?

Posted April 3, 2008 04:50 PM

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