DEAR DR. DONOHUE: My basketball youngsters are always coming up with finger injuries, especially jamming the finger, usually the middle one from being hit on the end by a ball. Since we have no trainer, we just have to let time heal things (and lose a player for a while). One of the kids was told by someone to just pull on the jammed finger. I have doubts. Is that the right thing to do? - Coach H.
ANSWER: It's the wrong thing to do, Coach. Jamming the finger can cause ligament damage, and pulling on it only makes that damage worse. You should encourage icing of the joint and avoiding use for a while. If the player must play, taping the jammed finger to the adjacent one can provide some measure of protection. However, a professional should be available to you to look at the finger. It might well be broken, requiring medical attention and longer rest.DEAR DR. DONOHUE: With all the talk about steroid use among athletes, I wonder if women as well as men use them, and if so, what the consequences can be. Are they as bad for women as men? - I.J.
ANSWER: If anything, steroid effects might be worse for women. Let me be very clear about what kind of steroid drugs we're talking about here. I don't mean the cortisone drug steroids, the kind used medically to treat illness, but anabolic steroids, male hormones used to build muscle bulk.
Women do use them, although the cosmetic consequences deter many who might be tempted. Menstrual periods can be thrown out of kilter. Breast size can diminish and facial hair and acne appear. Scalp hair may thin. As with men, liver damage is a possibility. These are just a few of the effects reported by women users of anabolic steroids.
DEAR DR. DONOHUE: I do a lot of pool swimming. I have had trouble off and on with ear canal infections. I thought one got that only from lake swimming, etc. How come I get it? - Ms. V.L.
ANSWER: I can see how continuous exposure to pool water might set up an infection. The chlorine may be contributing to ear canal irritation. And any prolonged exposure to water and heat can promote bacterial growth, both combining to soften (macerate) the canal tissue. Add to all this, the urge to rub at the itchy ear and you have the complete invitation to infection.
The answer lies in keeping the ear dry. Use the corner of the bath towel to dab the outer part of the canal after each swim. Please avoid use of objects, such as a cotton-tip swab.
If you are certain there is no eardrum puncture present, you can also use an ear cleansing and drying agent. You can check with a pharmacist for a good one. If not, you can make one yourself by mixing equal parts rubbing alcohol and vinegar. Put two drops in each ear canal every morning and evening, leaving the drops in place for five minutes each time. That serves two goals: drying of the canal and discouragement of bacterial and fungal growth. But remember the cautionary word concerning possible eardrum perforation.
DEAR DR. DONOHUE: My wife and I have taken up golf. Prior to going into it (twice a week, 18 holes each day) we were in an exercise program. Do we still need the exercise outside of golf? - O.O.
ANSWER: Golf consumes four to six calories a minute, about 900 calories for 18 holes. Of course, it depends on how you golf, with a cart or with a carrying bag. I doubt that golf provides heart rate increases of sufficient duration and intensity to satisfy aerobic fitness needs.
DEAR DR. DONOHUE: Please explain what is involved in an examination for phlebitis. Is it painful - the testing? Is there treatment for it? - L.W.H.
ANSWER: Let's start with the very basic examination for phlebitis, which means vein inflammation with blood clotting.
Tenderness and redness of the skin can be a clue to vein inflammation beneath. And with calf veins, a simple measurement of the leg circumference there is another phlebitis clue. If one calf is larger than the other, then you suspect a problem.
There are, of course, more sophisticated tests. Venography is one. Here, a dye is injected into the leg veins. Subsequent X-rays detect vessel blockage. Ultrasound is another way to demonstrate the problem, as is impedance plethysmography. With that, electrodes are attached to the skin to check blood flow in the area.
Some of these tests are a bit uncomfortable, but I would not use the term painful to describe them. Other tests are not the least bit unpleasant. You can usually diagnose phlebitis without discomfort on the patient's part, and there is medicine to treat it successfully, blood thinners, for example.
DEAR DR. DONOHUE: I am a female, 48, and in basically good health. I am having trouble with my menstrual periods. I had a D&C done, and I was told my problem is dysfunctional bleeding. I think I must be stupid, since I cannot understand this diagnosis. I am now on estrogen and Provera. Please explain for me. - B.R.
ANSWER: Dysfunctional uterine bleeding means something has gone wrong with the events that control the timing of normal menstruation. Malfunctional might be a more understandable term to use.
Malfunction might arise from deficiency of estrogen production. That can lead to inappropriate bleeding. Or there may be something wrong with the uterus itself, such as growths, benign or malignant.
In older patients, you have to be on the alert for this possibility\