Laser for nose bleeds!

I have had recurrent nose bleeds and my doctor says I should undergo laser treatment. Is this ok?

No, your doctor is a buffoon. While laser can be used, it is more expensive and also very painful. The easiest method is use of silver nitrate or electrocautery, which is much cheaper, just as effective and slightly less painful. However, you many want to try nasal packing first. Cauterization is generally done when packing fails to control the nose bleed. If nothing works, then a surgical approach to ligate the blood vessels may be required.

Lithium and alcohol

I am on  lithium for my bipolar disorder. Can I drink alcohol?

You can drink anything you want, even piss. But I should I want you, Lithium is not the medication you want to mess around with. The drug is very finicky and can cause serious side effects. I highly recommend you not take alcohol when you are on lithium. Dehydration can easily lead to toxicity of lithium. Lithium toxicity is permanent in most cases.

Bipolar and weight gain

Is there a medication for bipolar disorder that won’t cause weight gain?

The majority of medications that are used to treat BPD cause weight gain. The only ones which do not cause weight gain are the anticonvulsants, but they are not always effective. In addition the anticonvulsants have other adverse effects like sedation, excess fatigue and drowsiness. BPD is a very difficult disorder to treat because the patients are often non compliant and have other associated disorders. My advice is that if a drug works, stick with it  In many cases, what works in one patient does not mean it will work for you. There is no way around the side effects. Every single medication used to treat mood and behavior disorders is associated with side effects. To avoid weight gain, eat less and walk more.

Chelation therapy for headaches

My alternative healthcare practitioner recommended I undergo chelation therapy for my headaches. Is this safe?

Chelation therapy is bogus and so is your healthcare provider. Chelation therapy is dangerous and not approved by the FDA for treatment of headaches. I seriously urge you to see a reputable neurologist for your headaches. There are too many quacks in medicine, especially the alternative healthcare practitioners. Most do not know the arse from the mouth. In real medicine, chelation is only used to treat heavy metal poisoning. There is zero evidence that headaches are due to heavy metal poisoning. Please if you want to live a long life without hassles, stop seeing this fool.

Topiramate for tremor

Recently my doctor suggested I try topiramate for my essential tremor. What do you think?

Absolutely not. The drug has been evaluated in trials and was only marginally better than a sugar pill. Plus, in the trials many people dropped out because of side effects. The drug is also very expensive. My advice is go with propranolol- it is cheap, effective and has been around for 80 years. It is a safe medication.

Fenugreek and diabetes

I am a type 2 diabetic and have heard that fenugreek can lower blood sugars. Is this true?

Not that is Bullshit. Studies on fenugreek have been done but the results are difficult to interpret. Some people say the blood sugars do come down but others claim that there is no change in blood sugars. Most of these studies were non-randomized and sponsored by the manufacturers of fenugreek. Whenever you read that a study is sponsored by a pharmaceutical company or a manufacturer of a herb, that usually means the results have been fudged. If you want to live a healthy life without the complications of diabetes, then dump the fenugreek in the toilet and go and see a real doctor. We have some effective medications to lower blood sugars. Stop fooling  around with diabetes-it is not a pleasant disorder to mess with.

Do i have herpes?

I am a 23 year old female and recently had sex with a stranger at a party. Now I have broken out with painful sores on the outside of my vagina. How do I know if this is herpes?

In most cases, an astute physician can make a diagnosis of herpes by the history and physical exam. However, when you go for the physical, the doctor may obtain scrapings and send them to the lab to confirm that this is herpes. There are not many infections that present like herpes and in many cases, the lab test is not done. Herpes is the only STD that presents with painful vesicles (blisters).