Low-risk patient can skip antibiotic for dental visit

I have had two angioplasty procedures completed, one in 1999 and the second in 2014. Stents were inserted during each procedure. As a preventive measure, my dentist wants me to take four antibiotic pills before I see the hygienist. Is this necessary?

Antibiotic prophylaxis is not routinely recommended for people with cardiac stents. The risk of infection is very low. People with some cardiac problems, such as a prosthetic heart valve, some types of congenital heart disease or a prior history of infection of the heart valve, should take antibiotics. But, in general, antibiotics for a low-risk person is not recommended. Of course, you should ask your cardiologist whether there is something distinct about your case.

I am 59 years old and in good health. For several years, I have had tingling and a slight numb feeling in mostly the ball of my left foot and sometimes the right. Sometimes it feels like a sock is rumpled up in my shoe, which is uncomfortable but not painful. I feel the sensation mostly at night while lying in bed. I am not diabetic. I have worked out all my adult life. I used to run up to 25 miles per week for many years but stopped, as I could sense this was not good for my knees. For exercise now, I ride my bike, work with weights, take walks and hike. Could the problem be just compression of the nerves over the years? It has never really worsened.

I found a study looking at 25 long-distance runners (average lifetime distance was 20,000 miles), which found evidence for damage to nerves, but which did not lead to symptoms. I think it’s possible that the exercise alone could have caused your symptoms; however, I would still recommend at least a focused evaluation for other causes of neuropathy.

Ihave grandchildren who are very allergic to cats. Could they develop COPD from being around cats?

The majority of cases of chronic obstructive pulmonary disease are caused by tobacco. A much smaller but still substantial number of cases are in people with an enzyme defect, alpha-1 antitrypsin deficiency, but many people with this get symptoms only when they smoke or are exposed to lung irritants.

People with cat allergies may develop asthma, an obstructive lung disease that is distinct from COPD, and have worsened symptoms around cats. In that case, the most important treatment is to avoid cats. There is an overlap syndrome of COPD with asthma, but I don’t think that cat allergy is a likely cause.

— E.L.S. A: — T.B. — Anonymous A: