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House call: Medical questions answered

Q: How can I spot skin cancer?

A: Skin cancer is the most common form of cancer in the United States. Melanoma, caused by exposure to ultraviolet light from the sun and tanning beds, is the deadliest kind of skin cancer. During the past three decades, more people have had skin cancer than all other cancer combined.

What does skin cancer look like? Often skin cancer begins as a sore that does not heal within four weeks and may itch, hurt, scab, crust or bleed. It may appear as skin that has broken down or become an ulcer that does not heal.

To best detect and prevent skin cancers, do a self-exam by standing in front of a full-length mirror in a bright room. Examine all areas of skin from the scalp to the soles of the feet, including hard-to-see places such as in between the toes. Be aware of where moles are and how they look. Examine moles regularly for any signs of changes in them such as change in shape, size, color or feel. Take note if there are any new moles.

To help prevent skin cancer, wear sunscreen with at least a sun protection factor (SPF) of 15.

For those with a history of skin cancer, wear a higher SPF.

Q: Can I make up for lost sleep?

A: Adults generally need 7-8 hours of sleep every night to be healthy, while teenagers and children usually require 9 or more. Unfortunately many people fail to get the recommended hours of snooze time, which can lead to shorter lifespan, depression and other health issues.

However, there is some good news: It is possible to make up for some of those missed hours of sleep. For those who have missed a couple of hours of sleep throughout the week, it is possible to get those in during the weekend or to add an extra hour or two every night. However, if the sleep deficit is large – 20 hours or more – it may be impossible to fully gain those hours back.

For people who struggle with getting proper sleep, there a few tips that can help. Have strict and consistent bedtimes. Also, begin a routine activity before hitting the pillow such as reading a book or listening to music, but avoid activities such as watching television or playing on the computer, which can stimulate the brain. Keep caffeine consumption to a minimum throughout the day and avoid it completely after 3 p.m. And don’t take long naps during the day.

Q: I am 45 years old; should I get tested for colon cancer?

A: Colorectal cancer, or colon cancer, is the third-most common cancer for men and women in the United States, and is most often found in people 50 or older. It is also the second-leading killer among cancers in the U.S.

Colorectal cancer screenings help find precancerous abnormal growths in the colon or rectum, called polyps, so they can be removed before they turn into cancer, which saves lives.

Those who are 45 with no family history of colorectal cancer have an average risk of developing this cancer. According to the U.S. Preventive Services Task Force, you should start prevention exams at age 50. Those who believe they have a higher risk of developing cancer should speak to their doctor about getting screened early. Most people should be screened regularly until age 75.

If someone has a family history of colorectal polyps or cancer, or has inflammatory bowel disease, Crohn’s disease, or ulcerative colitis, they are considered to be a higher risk for colorectal cancer. Lifestyle risk factors that could increase a person’s risk for cancer include lack of regular physical activity; low fruit and vegetable intake; lower-fiber and high-fat diet; overweight and obese; alcohol consumption; and tobacco use.

Q: Is it better for labor to be induced or to wait until labor starts naturally?

A: Unless a woman has a medical reason that could harm her or her baby, it is advised by physicians that she should wait until at least 39 weeks, called full term, to give birth to ensure that mother and baby are healthy.

Giving the baby at least 39 weeks gives it the time it needs to grow and for organs like the brain, lungs and liver to develop. Babies not carried to full term may have more health problems at birth or later in life than babies born later. Babies carried longer are less likely to have vision and hearing problems; they are able to gain more weight allowing them to stay warmer; and they are able to suck, swallow and stay awake long enough to eat.

Scheduling an early birth for non-medical reasons also has risks for the mother. There are risks for stronger and frequent and contractions, infections and tearing of the uterus. Inducing labor may not work for many women, which may force the doctor to a caesarean section or c-section. This is a major surgery for a mother and may take up to one month to recover in the hospital, and it may cause problems for the mother in her future pregnancies.

Q: How is occupational therapy different from physical therapy?

A: Occupational therapy and physical therapy both focus on restoring function to parts of the body. But they are different in many ways.

Physical therapy focuses on restoring mobility and stability that is helpful in walking or climbing stairs, while occupational therapy focuses on improving fine motor skills used in accomplishing everyday tasks, known as “ADLs,” such as eating with a fork or writing.

Those who would benefit from occupational therapy include people who have suffered a stroke, traumatic brain injury, spinal cord injury or live with any other neurological condition or injury and need to learn how to bathe, get dressed and do other routine tasks. Arthritis patients, those with autism and children struggling with handwriting or developmental delays can also benefit.

Occupational therapy services typically include an individualized evaluation when an occupational therapist, patient and their family determine the patient’s goals; an evaluation of the patient’s home and other environments; and an outcomes evaluation to ensure the goals are being met.

Q: Will eating local honey reduce my spring allergy symptoms?

A: Some believe that consuming small amounts of pollen found in locally produced honey can be a natural remedy for springtime allergies because it helps them build up immunity to the pollen in the air. This is a misconception because the pollen in the wind carried by non-flowering trees, weeds and grasses trigger allergies and not the pollen in flowers carried by bees.

It is true that pollen from the air can get mixed in with the pollen carried by bees from flower to the honeycomb, however this amount is minimal and not enough to stop itchy, watery eyes and sniffles. Even if it was possible to eat enough honey to subdue allergies, it is almost impossible to make a honey from just one specific type of pollen, for example, only a certain type of tree or grass. If you decide to take honey, do not ingest unpasteurized honey because of the risk of infection.

For those wanting to reduce symptoms, allergy testing with resultant immunotherapy may be the best option. This therapy is administered through shots or drops under the tongue containing small doses of the things that trigger the allergic reaction in a person. Most get these shots once or twice a week for several months, then the doctor will gradually move the frequency to once or twice a month. The drops are a newer method and are a daily treatment. Use of nasal steroids can alleviate the seasonal allergies caused by pollens and other nasal irritants and do not require allergy testing. Newer antihistamines can stop symptoms with just one pill a day.

Dr. Daniel Knight, M.D., and Dr. Charles Smith, M.D., are with the College of Medicine at the University of Arkansas for Medical Sciences. E-mail your health questions to housecall@uams.edu.

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