Bone Age Man
The advertisements abound, extolling the virtues of dietary calcium to prevent osteoporosis. They show active, healthy senior citizens-usually women-jogging, walking the dog, throwing a ball to a grandchild.
Osteoporosis, a condition of porous and brittle bones, is not just a problem for women, though. Older men can suffer its debilitating effects too, says Robert Rude, M.D., USC professor of medicine.
"It's estimated that about two million men in the United States have the disease," Rude says. "That is six percent of the population-a substantial number."
People with osteoporosis have low bone mass, he explains, so their bone tissue begins to deteriorate, leading to fragile bones.
With bone fragility, people become more susceptible to fractures of the hip, spine, and wrist. One in eight men will have an osteoporosis-related fracture during their lifetime, according to the National Osteoporosis Foundation.
Although the rate of hip fractures in women is two to three times higher than in men, men are more likely to die within a year after a hip break than women, Rude says.
Calcium can help protect bones. Adults should get 1,000 mg of calcium a day and those over age 50 should consume more than 1,200 mg. Most people get about 500 to 700 mg from their daily diet, says Rude. Taking supplements and eating calcium-rich foods can boost that total.
Men should be aware of other factors, too: alcohol abuse and smoking. Both can worsen osteoporosis and raise the risk of fracture.
Although national health organizations recommend women over 65 get a bone mineral density test, no such standard exists for men. But if a man is at risk, his doctor can usually set up the easy exam and recommend treatment.
A Nose for Trouble
Just when it seemed you were getting over your cold, it gets worse. Your head pounds, your face aches and you are congested. But before you open another can of chicken soup, consider this: You may have sinusitis, a bacterial infection in the sinus cavities.
The sinuses are air-filled pockets within the skull around the nasal cavity. Eight sinuses are connected to the nose through small openings. They secrete mucus that humidifies and warms the air you breathe. Tiny hairs, called cilia, keep mucus from building up by constantly sweeping it out of the sinuses and into the nose.
Acute sinusitis occurs when something blocks sinus drainage or prevents the cilia from sweeping properly, explains Dale Rice, M.D., chair of the USC Department of Otolaryngology/Head and Neck Surgery. Sinusitis is usually preceded by a head cold or allergy or provoked by environmental irritants such as air pollution.
"Sinusitis has symptoms similar to an allergy, with nasal congestion and pressure and pain between and behind the eyes," says Rice. "But you get sneezing and a runny nose with allergies, and you don't with sinusitis."
A cold that lasts longer than 10 days or seems to get better then suddenly worsens can be a sign. Pain that afflicts one side of the face or starts when you lean forward also can signal acute sinusitis. Other symptoms include fever, a thick yellow-green nasal discharge, upper teeth that ache, or increasingly severe headaches.
Rice suggests taking a pain reliever and decongestant to suppress swelling. But do not use decongestant nasal sprays for more than a day, he warns, because the drugs' effectiveness diminishes the longer you use them.
He says patients should call their doctor if over-the-counter medications are not helping and the infection persists, since this often signals the need for antibiotics.
Pamper Yourself
For babies and toddlers, having "an accident" is an expected occurrence. But for adults, leaking urine can be an embarrassment. Called incontinence, the problem of involuntary loss of bladder control affects countless people. Yet many are too shy to seek help or think it is an unavoidable part of growing older.
Incontinence is more common in women and is associated with two types of symptoms, explains Jeffry Huffman, M.D., urologist at the Keck School of Medicine. The first, and most common, is stress incontinence. Women with stress incontinence find they unexpectedly leak urine when they sneeze or exert force in some way. Women often experience it after pregnancy, when muscles in their pelvis become weakened.
The other type is urge incontinence. With this type, people have urine leakage occur as soon as they get a slight urge to go to the bathroom. The feeling may be overwhelming, as the bladder muscle tightens uncontrollably at the wrong time.
"This is usually because of an infection," Huffman says. "There is usually some bladder pain associated with it."
In the case of infection, patients are treated with antibiotics. But these contractions also can stem from bladder irritability after pelvic surgery or interstitial cystitis, a chronic inflammatory condition of the bladder wall. Sometimes they are caused by problems with the nervous system.
Some patients do well with exercises to strengthen the pelvic muscles or opt for medications. Often problems are solved by a surgical procedure in which surgeons lift and suspend a part of the bladder, Huffman says.
For persistent cases, doctors may perform studies on pressure in the bladder, how much urine flows out of it and stays in it, and patients' neuromuscular function.
He adds, "Incontinence is a very common problem, and many people ignore it. But it is treatable."
Things That Go Bump
Out of nowhere, a soft bump appears under the skin of your hand. It grows bigger, then disappears, only to reappear.
This mysterious manifestation is a ganglion cyst, the most common tumor of the hand, explains Stephen B. Schnall, M.D., chief of the USC Hand Surgery Service.
"The cysts, usually forming on the back of the wrist or near the joints of the fingers, fill with a jelly-like substance," says Schnall. "They can spontaneously disappear or change in size. They aren't known to be cancerous."
The cysts can grow when the tissue is irritated by strenuous hand use. Large ganglions can restrict the range of hand movement, sometimes becoming tender or painful.
Schnall says most people notice a lump under the skin on the front or back of the wrist or over a tendon at the base of a finger on the palm side. Some patients notice wrist pain when they use their hands a lot or when there is swelling.
"Some believe that occupations requiring excessive use of the wrist and fingers may precipitate a growth," he says.
Many of these cysts do not require treatment. "If they don't bother the patient, I sometimes recommend that they leave them alone," Schnall says.
Anti-inflammatory medication may be prescribed to reduce swelling. If the cyst becomes painful, interferes with function or the patient does not like the appearance, he says, the fluid can be removed from the cyst with a needle through aspiration.
"Ultimately, removing the cyst through surgery gives the best chance of a permanent cure," Schnall says. "Nevertheless, ganglion cysts may return."