Claudication may require surgery
Dear Dr. Gott: My feet and ankles are cold and numb most of the time. Any walking causes cramping of my right calf. My doctor feels this is related to poor circulation and has given me a booklet on intermittent claudication. He doesn’t have time to discuss my diet or go into detail, and it relieves my mind to tell it all to someone whose advice I have confidence in.
Dear Reader: Claudication means that muscles cramp during exercise because of poor oxygen supply. The condition most commonly affects the lower extremities (pain and cramping in the legs or buttocks) and is ordinarily caused by arteriosclerotic blockages in the lower aorta or the arteries supplying oxygen and nutrients to the leg muscles.
With regular exercise and walking, the symptoms sometimes improve. This is believed to be due to the formation of new blood vessels that naturally bypass the narrowed segment.
Medicine is not particularly useful in treating claudication because the blockage, being mechanical, requires a mechanical solution. Thus, surgery to bypass (or replace) the segmental narrowing is usually necessary. Recently, laser treatment and balloon angioplasty have shown promise.
If you are particularly troubled by claudication (for example, you cannot walk more than half a block without pain), you should consider an operation. Your doctor can refer you to a vascular surgeon.
Frankly, I’m concerned that your doctor hasn’t given you the courtesy of sitting down and discussing your symptoms and your treatment options. This is poor medicine. Find another physician with whom you feel comfortable or badger your present doctor until he shapes up.
Dear Dr. Gott: My doctor prescribed meclizine for an 11-week bout of vertigo and Amoxil for an ear infection that followed. An ENT specialist I consulted indicated the medication might have caused the vertigo to linger. Since I still suffer from vertigo and ear pain, I wonder where I should turn next.
Dear Reader: Vertigo is usually caused by irritation or inflammation in the inner ear. In most cases, this is presumed to be caused by a virus infection; therefore, antibiotics, such as Amoxil, are useless in treating it. .
Run-of-the-mill vertigo ordinarily lasts a few days and is gone. Anti-vertigo drugs, such as meclizine, help control symptoms while the body heals itself. Because your vertigo has lasted almost three months, I believe you need further testing to rule out a serious disorder. Stick with the ear-nose-and-throat specialist. Although your family doctor prescribed appropriately, you need the services of someone who deals exclusively with ear diseases.