DEAR DR. DONOHUE: My 88-year-old relative has high blood pressure and atrial fibrillation, both of which are well-controlled by medication. She is mentally sharp but has developed arthritis in various joints. She’s been told that she can’t take any medicine for pain because it would interfere with her medicines for blood pressure and atrial fib. I know she could have a better quality of life with less pain. Is there something she can take? — A.H.
ANSWER: I have to presume your relative has osteoarthritis, the kind of arthritis almost all older people develop. Cushioning cartilage in joints crumbles and eventually becomes functionless. Bone rubs against bone, and that is painful and stiffens joints.
Your relative ought to try heat in the form of hot baths, hot packs or heating pads. Heat lessens joint pain. If heat doesn’t do the trick for her, she should try ice packs. Heat can be left on a joint for 15 minutes; ice for 10.
If she has hip, knee or foot arthritis, padded shoes or padded shoe inserts lessen the force generated in leg joints when the foot hits the ground.
An exercise program supervised by a physical therapist will strengthen muscles around the affected joints, provide them protection and give the joints a greater range of motion.
Occupational therapists devise splints or braces that protect joints and mitigate pain. They also can suggest devices that make the tasks of daily living much less troublesome.
Has she tried anti-inflammatory medicines applied to the skin directly over an affected joint? Pennsaid lotion is one example. Some of the medicine does get into the blood, so she’ll need to have her doctor’s approval for it. It is a prescription medicine. The amount of medicine that gets into the blood is less than the amount she’d get from an oral medicine, yet a sufficient amount reaches the joint.
The arthritis booklet presents the details of the different kinds of arthritis and their treatment. Readers can obtain a copy by writing: Dr. Donohue — No. 301W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: I just learned that my niece has basal cell cancer on her scalp. The doctor told her not to worry. Her mother is concerned. I’d never heard of it. Is this something to worry about? — A.P.
ANSWER: Basal cell cancer is the most common kind of skin cancer. It’s quite treatable and most often completely curable. Up to 2 million new cases of it occur yearly in the United States. Sunlight and a tendency for the person to sunburn easily have a hand in its occurrence. Basal cell cancers almost never spread to other body locations.
They can be dried with an electric current and then scraped off. They can be treated with a laser, frozen or removed with 5-fluorouracil cream applied by the patient. And this is only a small sample of the ways to treat them. Your niece, her mother and you can all relax.