Gynecologist, internist may figure out hot flashes
Q. I am a 69-year-old female, 5 feet, 7 inches tall and 160 pounds. I exercise regularly, take vitamins, am on Femara as a follow-up for breast cancer, and clonidine and Arthrotec. At my last checkup, about a month ago, my blood pressure was 117/73, cholesterol was 202 and thyroid was OK.
My main concern (I've told my doctor) is that for the last few years I've had episodes of pounding in my chest, a rush of heat that goes to my head, everything turns white for about five seconds, and then my head gets hot. A few weeks ago, I had five in a row. They don't happen every day, but I never know when it will happen. My doctor has no idea what they are.
A. Although your symptoms could be caused by something serious, such as a heart irregularity, you may be experiencing post-menopausal problems.
Your family doctor needs to refer you to a gynecologist for further assistance. If this doesn't resolve the situation, a second opinion from an internist would be appropriate.
Q. I am a 73-year-old female in very good health. I am 5 feet 6½ inches tall and weigh 153 pounds. I used to be a dancer and was also very active in sports. Even now, I swim a mile a day.
My question is, do I have diabetes? My A1-C is 5.6. If I do have diabetes, what type is it? I test my blood six times a day. Before meals it is between 92 and 120; after meals it is 98 to 144. I have had it go as low as 63, which gives me a very bad headache.
Do I need to go on medication? If so, what kind? Is my doctor trying to sell me something I don't need?
A. You appear to have an early form of diabetes. Your A1-C should be less than 6. Fortunately, your before-meal blood-sugar levels, while on the higher side of normal (70 to 110) or slightly above that, are basically acceptable. Your blood-sugar levels should rise following a meal. I advise you to follow a prudent diet and continue to exercise. You don't need medication at this point. Monitor your blood-sugar levels once or twice a day as long as the numbers are in the relatively normal range. If they begin to rise, return to your physician or ask for a referral to an endocrinologist, who can give you more specific advice. Let me know how this turns out.
© 2007, Newspaper Enterprise Association