Spinal in­jec­tions don’t al­ways bring re­lief

Cape Breton Post - - ADVICE/GAMES -

DEAR DR. ROACH: At 64, I was in very good health ex­cept for mod­er­ate hy­per­ten­sion, which was treated with lisino­pril. I then had an in­ci­dent lift­ing a heavy load, which in­jured my back. Long story short, three years of pain drove me to have an L4-L5 ver­te­brae back fu­sion. I am now 67, and in hind­sight, surgery was a bad de­ci­sion.

Since my surgery, ev­ery in­jec­tion I have re­ceived from three pain-man­age­ment doc­tors has been in­ef­fec­tive. Th­ese in­cluded painkillers to tar­get nerves for ra­diofre­quency nerve ab­la­tion; steroids at sev­eral spots above and be­low the fu­sion; and a re­cent epidu­ral at L6 that was sup­posed to travel up my spine. The doc­tors said that re­lief would come within the hour or sev­eral days. Th­ese in­jec­tions have never brought ANY re­lief. But they do, how­ever, ag­gra­vate my pain for the next sev­eral days. I jok­ingly asked my cur­rent doc­tor if he is in­ject­ing me with sa­line so­lu­tion.

Is my sys­tem im­per­vi­ous to the de­sired ef­fect of th­ese in­jec­tions? My only lim­ited re­lief is with hy­drocodone tablets, which have other side ef­fects (opi­oid-in­duced con­sti­pa­tion). It’s some­times as ag­gra­vat­ing as the back pain. -- R.S.

AN­SWER: I don’t know why some peo­ple re­spond well to in­jec­tions and oth­ers do not. Most ex­perts do not keep at­tempt­ing in­jec­tions if the first one (or maybe few) are in­ef­fec­tive. How­ever, some peo­ple have a good re­sponse, so it usu­ally is worth a try. There isn’t out­stand­ing ev­i­dence of ben­e­fit in tri­als (that is prob­a­bly be­cause there are quite a few peo­ple like you, who have got­ten no ben­e­fit at all).

Your story is an­other re­minder not to make the de­ci­sion for back surgery lightly.

DEAR DR. ROACH: My hus­band has pre­can­cer­ous cells in his prostate. Is there a dan­ger to me per­form­ing oral sex? What other types of dis­eases can be trans­mit­ted through this ac­tiv­ity? A male movie star stated that he con­tracted throat can­cer from per­form­ing oral sex on women. I’m very con­cerned for my own health and safety. -- Anon.

AN­SWER: I think you are con­cerned about hu­man pa­pil­lo­mavirus. Some strains of this virus can cause sev­eral types of can­cers, es­pe­cially cer­vi­cal can­cer in women and some can­cers of the mouth and phar­ynx in both women and men. The Cen­ters for Dis­ease Con­trol and Pre­ven­tion es­ti­mates that there are about 9,000 cases of HPV-as­so­ci­ated throat can­cers, roughly 80 per­cent of which hap­pen in men. It is thought that oral sex is the usual way that the virus is ac­quired.

Prostate can­cers are not HPV-as­so­ci­ated, so there is no in­creased risk to you due to your hus­band’s prostate can­cer. It is un­likely, though still pos­si­ble, for you to con­tract or have HPV, even if nei­ther you nor your hus­band have had symp­toms, such as gen­i­tal warts, and if you have never had an ab­nor­mal Pap smear (as­so­ci­ated with HPV in­fec­tion).

The HPV vac­cine is an an­ti­cancer vac­cine. There is in­con­tro­vert­ible ev­i­dence now that it pro­tects against cer­vi­cal can­cer, and most ex­perts be­lieve that the vac­cine will pro­tect against HPV-re­lated throat can­cers as well. The vac­cine is in­di­cated for all chil­dren and young adults up to age 26, and may be ap­pro­pri­ate in cer­tain cir­cum­stances for peo­ple even older.

The book­let on her­pes and gen­i­tal warts ex­plains th­ese two com­mon in­fec­tions in de­tail. Read­ers can ob­tain a copy by writ­ing:

Dr. Roach, Book No. 1202, 628 Vir­ginia Dr., Or­lando, FL 32803, En­close a check or money or­der (no cash) for $4.75 U.S./$6 Can. with the re­cip­i­ent’s printed name and address. Please al­low 4-6 weeks for delivery. Dr. Roach re­grets that he is un­able to an­swer in­di­vid­ual let­ters, but will in­cor­po­rate them in the col­umn when­ever pos­si­ble. Read­ers may email ques­tions to ToYourGoodHealth@med.cor­nell.edu or re­quest an or­der form of avail­able health news­let­ters at 628 Vir­ginia Dr., Or­lando, FL 32803. Health news­let­ters may be or­dered from www.rb­ma­mall.com. (c) 2017 North Amer­ica Syn­di­cate Inc .. All Rights Re­served

Keith Roach To Your Good Health

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