Woman To Woman

Take Control of Your Health

Should I Dump My Doctor?

I like my doctor as a person--he's a very nice man--but sometimes I feel that he dismisses me, if politely. His solutions to my problems always involve him writing a new prescription. Should I try to talk to him about this or would I be better off finding someone who's more interested?

It sounds as if you've been seeing this physician for a while. Is this behavior new? If it is, it may be worth discussing with him; perhaps he's simply having a personal crisis of some sort. But because this behavior is common among doctors, I suspect that it's simply his practice style and it's starting to get on your nerves.

You deserve a health care practitioner who listens to your concerns and doesn't see drugs as the answer to all your problems. You might consider choosing a nurse practitioner or a physician assistant as your primary care provider, because they often have a more patient-centered approach. Ask your friends for referrals.

Don't Panic

Every now and then over the past few weeks I experience a strange sensation. My chest tightens a little and I have this feeling that I've done something wrong or said something to embarrass myself. It doesn't last long (15 minutes at the most) and it isn't overwhelming or anything, but it's definitely there. What do you think it is? Why am I feeling it all of a sudden?

Sounds like a mild form of an anxiety attack that could be relieved by deep breathing, perhaps while repeating calming phrases to yourself, such as "This too shall pass" or "All is well." Because your symptoms sound mild, maybe all you need is this simple reminder that everything is all right.

One way to relieve the feeling of chest tightness (often caused by hyperventilating) is to breathe into a paper bag for a few minutes. Because this causes you to inhale more carbon dioxide than usual, it can subdue symptoms of anxiety such as chest tightness or dizziness. I would also suggest incorporating meditation, yoga, or relaxation exercises into your life to reduce the chances of these attacks happening again.

If the situation worsens, consult a mental health professional or mind/body counselor.

Calcium and Gallstones

Women are urged to take calcium supplements to prevent osteoporosis, but I am wondering whether that additional calcium can contribute to the formation of kidney or gall stones. I've developed gallstones in the past. Should I refrain from calcium supplements?

Risk factors for gallstones and kidney stones are different. Let's talk about gallstones first.

Three-quarters of gallstones are cholesterol stones, while one-quarter are what are called pigment stones, which contain calcium salts. Stones can also be mixed. If you've had gallstones removed in the past, your surgeon can tell you whether they were cholesterol or pigment stones. (Note: Just because gallstones are present doesn't mean they have to be removed; they are not necessarily a problem unless they cause pain, become infected, or cause blockage.) If they were cholesterol stones, I wouldn't worry about calcium supplements. In fact, a high-calcium, high-fiber diet is recommended for those with cholesterol stones because it decreases levels of deoxycholic acid in the biliary tract; high levels of deoxycholic acid are associated with the development of cholesterol stones.

We don't know what causes most pigment stones, although we know that intestinal surgery, cirrhosis of the liver, and certain blood diseases can increase the risk. If your gallstones were pigment stones, you might want to avoid calcium supplementation. At least one study in prairie dogs (for whatever reason, prairie dogs have been used in gallbladder studies) found that calcium supplementation did increase the risk of pigment stones. Another prairie dog study found that a high carbohydrate, low iron diet promoted pigment stone formation. There's no definitive proof that calcium increases pigment stones in humans, but if you are prone to pigment stones, it may be wise to make sure that your diet isn't iron-deficient and to avoid large supplemental doses of calcium.

Now let's talk about kidney stones. Unlike gallstones, the vast majority of kidney stones are calcium stones. They are more common in males than females, and they are most common in people under age 45. The key to kidney stone prevention is to DRINK MORE WATER. Everyone should drink enough water to make sure that his or her urine runs clear. Lots of people don't drink as much water as they know they should because they don't want to be troubled by having to find restrooms. One of my relatives went even further; she used to chew tea leaves and coffee beans during long car trips so that she could stay awake and not have to stop to urinate. Coffee and tea are diuretics and increase your body's excretion of fluid, but at least the liquid forms replace some water. Chewing their leaves and beans have a very dehydrating effect. (As you can probably guess, she developed kidney stones!)