Elec­tronic de­vice helps brain and blad­der con­nect

Cape Breton Post - - Advice/Games - Keith Roach To Your Good Health

DEAR DR. ROACH: My daugh­ter, who is 50, re­cently went to a urol­o­gist for blad­der re­ten­tion is­sues. She had sev­eral tests per­formed. My daugh­ter’s doc­tor told her that the di­ag­no­sis is “over­ac­tive sta­ble blad­der.” The doc­tor said that she would ben­e­fit from a pro­ce­dure called “Medtronic blad­der con­trol ther­apy.” A de­vice is im­planted through the lower back. It is sup­posed to stim­u­late the blad­der to aid in uri­na­tion. We had not known of this par­tic­u­lar treat­ment. We have ques­tions about this: Is this safe? How long will the de­vice last? Will it be nec­es­sary to use this for the rest of her life? -- Anon.

AN­SWER: Medtronic is a med­i­cal-de­vice com­pany that makes the In­ter­stim sys­tem, which de­liv­ers elec­tri­cal im­pulses called “sacral neu­ro­mod­u­la­tion.” The the­ory is that it helps the brain con­nect bet­ter with the blad­der. In prac­tice, 86 per­cent of peo­ple who got this de­vice were “im­proved” or “greatly im­proved,” com­pared with 44 per­cent of those on med­i­cal treat­ment. Peo­ple con­sid­er­ing this treat­ment un­dergo a two-week trial to see if it’s likely to work. About twothirds of peo­ple re­spond fa­vor­ably dur­ing the trial and have the de­vice placed.

The pro­ce­dure does in­volve surgery, and surgery al­ways in­volves risks, in­clud­ing bleed­ing, in­fec­tion, mi­gra­tion of the elec­tri­cal wires and pain at the im­plant site. About a third of peo­ple un­der­go­ing the pro­ce­dure had at least one of these ad­verse events, most com­monly pain. As the pro­ce­dure be­comes more com­mon, com­pli­ca­tion rates are go­ing down.

I don’t know how long the de­vice can stay in. Tri­als have re­ported con­tin­ued re­sponse even af­ter three to five years.

DEAR DR. ROACH: I am a 22-year-old male. I re­cently had a 103-de­gree fever with cold and cough symp­toms, and my doc­tor or­dered a com­plete blood count. Af­ter my re­sults came back, he said it is nor­mal, but there is 10.6 per­cent lymph (nor­mal is 20 to 40 per­cent), and a to­tal white blood cell count of 5.6. Should I be wor­ried? -- D.A.

AN­SWER: The lym­pho­cytes are one of the types of white blood cells. In some types of ill­nesses, they can dip down from their nor­mal level. A nor­mal level of a lym­pho­cyte count is 1,500 to 2,000; your re­sult is 10.6 per­cent of 5,600 (the 5.6 refers to thou­sands), so about 600. This is com­mon to see in some peo­ple with viral in­fec­tions, and your doc­tor prob­a­bly will want to recheck it af­ter you re­cover from your flu­like ill­ness.

HIV is a virus that can in­fect the lym­pho­cytes them­selves. The Cen­ters for Disease Con­trol and Preven­tion rec­om­mends that HIV test­ing be rou­tine for adults, and I agree. You should have an HIV test, es­pe­cially since one pos­si­bil­ity for low lym­pho­cyte count is HIV in­fec­tion.

DEAR DR. ROACH: In a re­cent col­umn, you ad­vised some­one to get the shin­gles shot un­less she had an im­mune sys­tem disease. I am 63 and have been con­sid­er­ing get­ting the shot. Now I am hes­i­tat­ing be­cause I have lichen planus. I be­lieve this is im­mune-sys­tem re­lated. Is it? Should I not get the vac­cine? -- R.M.

AN­SWER: Many con­di­tions, in­clud­ing lichen planus, are thought to have a dis­or­dered, over­ac­tive im­mune sys­tem as part of their cause. How­ever, what I meant as far as get­ting live vac­cines like shin­gles was cau­tion from those with se­ri­ous dam­age to the im­mune sys­tem. In your case, I would rec­om­mend to get the vac­cine.

READERS: The book­let on asthma and its con­trol ex­plains this ill­ness in de­tail. Readers can ob­tain a copy by writ­ing: Dr. Roach, Book No. 602,628 Vir­ginia Dr., Or­lando, FL 32803En­close a check or money or­der (no cash) for $4.75 U.S./$6 Can. with the re­cip­i­ent’s printed name and ad­dress. Please al­low four 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 NorthAmer­i­caSyn­di­cateInc.. Al­lRights Re­served

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