Ask the Doctor: shingles, overactive bladder, and sinuses

By  | 

Dr. Rob Riley joins us each week from the South Bend Clinic. Here are his responses from March 26:

Sharon: I was diagnosed with shingles last week. I have been on antibiotics and it’s not going away. What’s your advice?

Shingles is a reactivation of the chicken pox virus that causes painful blisters to form in the skin. The treatment actually isn’t antibiotics, it’s a medication that fights off the virus and I assume that’s what our viewer was placed on. The medication helps to shorten the course of the illness somewhat but it’s not a miracle cure so it may still take a while for the condition to resolve—usually the blisters have crusted over by about 7-10 days and will resolve entirely—sometimes with some scarring—within about a week of that happening. If things are getting worse rather than better over that time, then checking with your doctor is important to check for any problems in your immune system. Otherwise, treating any pain that’s present and just being patient until things resolve is the best advice.

Alice: Which is better long term for women with overactive bladder: medication or the new bladder devices?

Urinary incontinence is a common problem, particularly for women as they age. Treatment starts with lifestyle modification. Things like losing weight, quitting smoking, and avoiding caffeine and alcohol can help. There are some pelvic exercises that are effective, too. If these measures don’t take care of things, medications are usually next. They’re helpful for most women, but they have side-effects that some just can’t tolerate. Implanting devices surgically is really a last choice at this point. The procedure usually involves running a wire into the body to affect the nerves that control the bladder. We don’t have a really long track record with these devices at this point and we know they don’t work for everybody. They also have side-effects for some and may stop working after a while. So for some women, these devices are the best option, but usually only after other things have failed.

Tom: I wake up every morning with a stuffy nose. But when I went on vacation to New Zealand, it went away, only to return when I got back home. What’s going on?

I tell people we live in the sinus belt as our climate lends itself particularly well to this kind of chronic sinus problem. And people do often notice when they go to Colorado or Arizona or even New Zealand that things get better—until they come home. During our winters, the very cold air outside contributes to nasal congestion as does the excessively dry air in our homes when we run our furnaces. And then the rest of the year, we tend to have high humidity which also contributes to congestion. For some people, allergies play a role, too. So if you’re allergic to something in your home like certain molds, or to something outside that thrives in our climate, going somewhere else may improve symptoms. If you want to continue to live in this climate with the rest of us, your doctor may recommend some combination of nasal sprays and decongestants to take daily to help with your symptoms.