Help for enlarged prostate
Dear Doctors: My problem is with my diuretic, indapamide 2.5 mg. My doctor told me I have a normal prostate enlargement for my age. I am 80, and I take the indapamide once daily.
My problem is that I seem to urinate very often, because the prostate only allows a little through at a time. I do not sleep well, and this adds to my sleeping problem. Please advise me on this. — W.F.
Indapamide is a diuretic most commonly used for elevated blood pressure (hypertension), but it can be used in other conditions as well. Diuretics force your kidneys to excrete more salt and water than they ordinarily would. The result is that the pressure in the blood vessels is decreased, just the way a water balloon isn’t as tight if you let a little water out.
However, after a few days, the amount of water coming out of the system is equal to the amount of water coming into the system. Diuretics make you urinate more often, notes the National Institutes of Health. They may be short-acting or long-acting, which makes them beneficial for treating different conditions.
Benign enlargement of the prostate is very common, often restricting urine flow. The urethra, which carries the urine out of the bladder, goes right through the prostate gland, and can be constricted when the gland is enlarged.
You can try taking the diuretic very early in the day so that you make less urine in the evening and nighttime. It’s also important not to drink too much fluid after about 4 p.m., if waking up to urinate at nighttime is a problem.
A second treatment is to reduce the prostate’s size, for which there are very effective treatments that you should discuss with your doctor. Dear Doctors: I need to know about vitiligo. My dermatologist told me that my immune system is attacking my own body and that there is nothing that can cure it or even stop the progression.
Isn’t there a type of doctor who can do something with an immune system that has gone awry? The vitiligo is on my face. Thank you. — M.R.
Vitiligo is just as you described, an autoimmune destruction of the cells in the skin (melanocytes) that make brown pigment. Nobody knows exactly why this happens. People with vitiligo are at risk for other autoimmune diseases, including thyroid disease, and B-12 deficiency anemia (caused by the destruction of cells that allow vitamin B-12 to be absorbed).
Although it can’t be cured, there are some treatments that may help. Medications that reduce immune-system function are used, but in cream form rather than with a pill or intravenously. Light therapy is useful for some people as well. Autoimmune diseases are among the most frustrating to treat and, of course, to live with.
Coverup makeup and skin dyes — such as Dermablend and Microskin — can mask the visual effect of vitiligo. Ask your dermatologist for more information.