Ask the Doctor: Hand Tremors; Lactose Intolerance; Knee Surgery
Q: My hands shake sometimes and I am concerned that it might be Parkinson’s disease. What are some other telltale signs?
A: Tremors or shaking in the hands, arms, legs, jaw and even the face are common motor symptoms of Parkinson’s. Other motor symptoms include stiffness in the arms, legs and trunk; slowing movements; and challenges with balance, coordination, and speech. There are also non-movement related symptoms. These tend to develop years before motor problems. They include a poor sense of smell, constipation, depression, cognitive impairment, and fatigue. It’s not known what causes Parkinson’s, but researchers currently understand it as a disease that is caused by both genetic and environmental factors (e.g., exposure to toxins such as pesticides). Parkinson’s is a disease of the brain that gets worse with time. As certain neurons in the brain start to die off, a critical neurotransmitter called dopamine also dwindles. Dopamine relays signals responsible for muscle movement. Tremors typically occur when 50 percent or more of the dopamine neurons are gone. Motor symptoms start gradually and tend to worsen as the disease progresses. The disease more commonly affects people over age 60. More men than women are at risk. The best strategy is to have an open, honest conversation with your physician about your shaking hands. There can be various causes. Parkinson’s can be a challenging disease to diagnose, but there are medications that can help.
Q: I have lactose intolerance and get severe bloating when I eat or drink dairy products. But as a woman, I also worry about getting enough calcium and frankly hate swallowing big pills. What else can I do?
A: Well, you’re certainly not alone, as more than 30 million Americans lack the enzyme lactase, which leads to lactose intolerance. The digestive system uses lactase to break down lactose (a sugar) into galactose and glucose, which is then absorbed into the bloodstream. In people with low amounts of lactase, the lactose isn’t broken down, and so it moves into the large intestine or colon, causing the annoying symptoms. It can be challenging to get enough calcium in a dairy-free diet. But dairy products also contain other essential nutrients, such as protein, magnesium, potassium, and zinc. There are lactase-containing products that you can take before you eat or drink dairy that will provide the enzyme you need. A popular brand is Lactaid, but there are others. Probiotic-rich products such as yogurt may also help, as they positively provide needed gut microbes that can aid digestion. Some people who have trouble with lactose may be able to tolerate small amounts of yogurt, milk, and hard cheese when eaten with other foods. Finally, there are lactose-free dairy products that provide dairy’s other benefits without lactose.
Q: I’ve been told by my doctor that I have a torn meniscus. I’m worried that I may need surgery. Is that always necessary?
A: Surgery is usually the last option, but it depends on your situation. Most orthopedic surgeons recommend watchful waiting, as many patients can actually live with a slight tear. Meniscus tears are classified into two types: symptomatic and asymptomatic. The meniscus is a pad made of cartilage that cushions the knee joint. You have two of these crescent-shaped pads in each knee. They are rubbery, pliable pads but with age, they can dry out and crack. Small cracks often don’t cause any swelling or pain and are considered asymptomatic. Tears that are larger and/or do create problems are appropriately called symptomatic. The most common symptoms are swelling and joint pain. The knee can also feel like it’s going to give out. It does help to strengthen the muscles around the knee, stay in good physical condition through lower-impact sports, and maintain a healthy body weight. But if pain and swelling persist, and decreased function has lasted more than six weeks, it may be time to discuss surgical options.
—Editor-in-Chief Jonathan Wanagat, MD, PhD, Assistant Professor, Division of Geriatrics
The post Ask the Doctor: Hand Tremors; Lactose Intolerance; Knee Surgery appeared first on University Health News.
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