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home : columnists : dr. john roberts February 26, 2015


UTIs can be treated quickly, effectively
Urinary tract infections (UTIs) account for about eight million visits to physicians each year in the United States. These infections are much more common in adults, particularly in women. Children account for 1 to 2 percent of all UTIs, but their infections are often more serious. About 40 percent of women and 12 percent of men have a UTI at some time in their lives.

The urinary system or "tract" is composed of the kidneys, ureters, bladder and urethra. The kidneys filter waste products from the blood and produce urine that passes down the ureters to the bladder, where it is stored, before passing out the urethra. An infection can involve one or more parts of the urinary system.

Monday, February 23, 2015
Stop the snoring! Start with addressing sleep apnea
Snoring can certainly be annoying, but can be normal. I want to focus this week on a harmful condition that can be associated with snoring - sleep apnea.

Sleep apnea is a condition where people have pauses in their breathing while sleeping. Most people have pauses to some degree, but people with sleep apnea have much longer pauses, sometimes up to 30 seconds. These long pauses cause the level of oxygen in the blood to drop and carbon dioxide to rise. This change in oxygen and carbon dioxide can be very hard on the body, especially the heart and lungs.

There are two main types of sleep apnea - central and obstructive. Central sleep apnea is a problem with the brainstem that sends signals to the breathing muscles. It is not a very common cause of sleep apnea in adults; obstructive sleep apnea (OSA) is seen much more often.


Monday, February 16, 2015
Fibromyalgia can be a pain in the . . . anything
One of our readers has asked that I write about fibromyalgia. This is a chronic neurosensory disorder that can cause debility and severely interfere with a person's ability to function.

It usually presents in young or middle-aged women, affecting about nine times as many women as men. It is a frustrating condition for patients as well as physicians as it is poorly understood and current treatments are often minimally effective.

Sunday, February 8, 2015
Dr. Roberts addresses plumbing problems
I'm running through my list of suggested topics from readers, and this one goes out to a reader from Sheridan. It's a common problem, but one of those topics that doesn't usually come up in casual conversation.

There are three common times in a person's life when constipation can become a problem. The first is during early childhood, the second when a person has decreased activity for some reason, and the last is during the elder years. Each type has different causes.

First, I have to deliver yet another lesson in basic anatomy and physiology. When we eat, food travels through the following structures: mouth, esophagus, stomach, small intestine and finally, the large intestine. This journey is facilitated by peristalsis, a process where involuntary muscles in the wall of the digestive tract contract to move food from north to south.

Sunday, February 1, 2015
Women should be aware of heart health
I continue to be amazed at the answers I get from ladies when I ask them to name the No. 1 killer of women. The overwhelming majority respond, "breast cancer." While breast cancer is the number one cancer killer of women, and is estimated to have claimed about 39,500 women last year, it is not the biggest threat women face. It's estimated that ten times that many women - 400,000 died of heart disease in the same year.

Cardiovascular disease is arguably the most important women's health issue and is largely preventable. How can women be so unaware that they have a one in 31 chance of dying from breast cancer but a one in three chance of dying from heart disease? Could it be that breast cancer gets so much more coverage in the popular media? Is cancer generally more frightening? Is heart disease just plain boring to talk about?


Sunday, January 25, 2015
What's in a (brand) name?
This week I want to tackle the subject of generic versus name-brand medications. There are a number of reasons this topic is important. First of all, medications in general are becoming prohibitively expensive for many patients. Insurance companies are also pressuring patients and physicians to prescribe generics whenever possible to reduce health care costs (not necessarily a bad thing, but certainly a pain in the rump at times).

I receive many questions about generics in the office. People want to know why every medication doesn't have a generic substitute and if not, how long will it be until one is available. They also want to know if they are safe and effective.

Monday, January 19, 2015
Dr. Roberts expands on shoulder pain
Welcome back to part two of my series on shoulder pain. First, I want to do a quick review of shoulder anatomy (see diagram). The upper arm bone (humerus) sits on the glenoid and is held in place by two structures: (1) a rim of cartilage (glenoid labrum) that forms a shallow cup for the head of the humerus to sit in, and (2) the rotator cuff which is made up of four tendons that wrap around the head of the humerus.

As I stated last week, in order for the shoulder to move in so many directions, it has to be inherently unstable. Since it is so unstable, two of the most common injuries are dislocations and subluxations. Dislocations result when the ball on the head of the humerus slips out of the glenoid "cup" and stays there. This typically happens when a person's upper arm is hit from behind when the arm is raised to the side and the shoulder is cocked and ready to throw.

Sunday, January 11, 2015
My shoulder hurts! What's the problem, Doc?
The next two weeks I want to discuss shoulder pain. Most people experience shoulder pain at some point in their lifetimes. Doctors typically see it in athletes, people who overuse their shoulders and others who may have fallen on their shoulder or outstretched arm.

To understand shoulder pain, it's important to know the basic anatomy of the shoulder joint itself. The joint is one of the most complex in the body. Most joints permit only a fairly limited range of motion. The anatomy of the shoulder joint, in contrast, allows for a vast range of movements. It has to be relatively unstable compared to other joints in order to be so versatile.

Sunday, January 4, 2015
Kidney Stones, while small, can be a big problem
Kidney stones are a topic near and dear to my heart as I've had three myself.

The medical term for stones is nephrolithiasis (nephro - kidney, lith - stone, sis - condition). Stones or calculi, from the Latin for pebble, can form and stay in the kidneys (renal calculi) or move down the ureters, the tubes connecting the kidneys to the bladder (ureteral calculi). Stones may also be found in the bladder.

The ureters are very small tubes that contain smooth muscle cells. These cells contract to help move the urine toward the bladder. When a stone is too large to pass down the ureter, it can partially or completely block the flow of urine, causing pressure to build up. This pressure, along with contractions of the walls of the ureter results in severe pain called ureteral colic.

The peak onset of kidney stones is in the third and fourth decades. Stones are rare after age 60. Men have about a 12 percent lifetime chance of developing a kidney stone while women have a seven percent chance.

Sunday, December 28, 2014
The resurgence of whooping cough
I've been fielding a fair number of questions lately about pertussis (whooping cough). Public health officials have been concerned about the rapid increase in pertussis cases the last few years. It is becoming a big problem. Indiana health officials are predicting that at the current rate, they will see more cases than they have in the last 50 years. There have been a number of deaths nationwide from pertussis, particularly in infants less than two months of age.

Pertussis, commonly referred to as "whooping cough," is a highly contagious bacterial disease caused by Bordetella pertussis. The bacterium is named after Dr. Bordet who isolated the causative organism in 1906.

Pertussis was a scourge in the U.S. prior to widespread vaccination of children. It remains the leading cause of vaccine-preventable death in children and accounts for 30-50 million cases of whooping cough worldwide each year and about 300,000 deaths.

Monday, December 22, 2014


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