Q: I've heard that cooking in aluminum pans can cause health problems. Is there any truth to this?
A: You're probably referring to the supposed link between high amounts of aluminum in the body and Alzheimer's disease. This notion came about because some people with Alzheimer's disease (which causes failure in mental functions like memory, thinking and personality) were found to have high levels of aluminum in the brain.
When scientists investigated such things as the aluminum content of drinking water and use of aluminum pans by affected individuals, they concluded that these factors weren't connected. Aluminum workers, moreover, don't have a higher rate of Alzheimer's disease than the general population.
Aluminum builds up in patients with Alzheimer's disease for unknown reasons, but it may actually represent an effect of the disorder rather than a cause.
The evidence is that aluminum doesn't cause Alzheimer's disease and that cooking in aluminum pans is safe.
Q: I've had repeated bouts of external otitis (swimmer's ear) over many years. I've consulted three specialists who've prescribed an antibiotic when the condition recurs, but they haven't been able to keep it from coming back. Is there anything I can do to prevent it?
A: External otitis is an infection or inflammation of the ear canal. It differs from otitis media, an infection of the middle ear space behind the eardrum.
There are two main kinds of external otitis, acute (sudden) and chronic (long standing).
Acute external otitis, commonly known as swimmer's ear, is a bacterial infection usually affecting children and young adults. Symptoms are ear pain that worsens when you tug on the ear, discharge, and a drop in hearing from swelling and plugging of the ear canal. Treatment with prescription ear drops usually clears up the condition in a few days. For severe flare-ups, antibiotics by mouth may be necessary.
Two common activities make you more likely to get swimmer's ear: 1) using cotton swabs to clean your ear canals (something I advise against) and 2) getting water in your ears.
Chronic external otitis, on the other hand, is a problem that usually affects older adults. Its only symptom may be a nagging itching of the ear canal. It's important to avoid the temptation to scratch the itchy area with a tiny object such as a paper clip or pen cap. This could turn a mild condition into a full-blown painful one. If the skin of the ear canal is damaged, by moisture or scratching for example, bacteria can set in and cause an acute external otitis on top of a chronic one.
Unlike swimmer's ear, chronic external otitis is often the result of a fungus infection or a skin disorder, such as seborrhea or eczema. For fungal infection or eczema, medicated ear drops are effective therapy, but you may have to repeat the treatment periodically. If seborrhea (common dandruff) is responsible for the problem, washing your hair with a dandruff shampoo is an important part of therapy.
If you get recurrent episodes of external otitis, you can try to prevent them by the following methods:
* Keep water out of your ears. Ear plugs are controversial, however. Some doctors recommend them, but others think they may damage the delicate lining of the ear canal and actually cause swimmer's ear. Cotton may be better.
* Avoid putting anything into your ear canals.
* Try a home remedy, like a mixture of half rubbing alcohol, half white distilled vinegar. The alcohol keeps the ear canal dry, and the vinegar kills the infection-causing organisms. Put a few drops of this mixture in your ear canals periodically, or after swimming, if that seems to bring on your infections. You can also use one of several over-the-counter ear drops preparations, containing acetic acid (the acid in vinegar), isopropyl alcohol (rubbing alcohol) or boric acid. Swim Ear and Ear Dry are two brands.
* If you have dandruff, use a dandruff shampoo.
Q: My daughter takes Accutane for severe acne. Her doctor said she shouldn't become pregnant, or else she could have a severely deformed infant. Are there any long-term effects of this drug -- say five to 10 years after someone stops taking it?
A: It's true that Accutane can cause serious birth defects, so it shouldn't be taken by anyone who is pregnant. For women, it's usually wise to have a pregnancy test before starting the medication and to practice contraception while taking it.
The drug is eliminated from the body within a week of stopping treatment, but to be safe, Roche Laboratories, the manufacturer of Accutune, recommends that women avoid pregnancy for the first month after stopping therapy.
There have been no reports of congenital deformities due to Accutane after stopping treatment and no evidence that Accutane has residual harmful effects on childbearing or on the person using it. But as with most new drugs, it's too early to be absolutely sure that there are no long-term effects.
Accutane can have a few serious short-term side effects, such as increased pressure in the brain, clouding of the cornea (the clear surface of the eye in front of the pupil) and inflammation of the intestines. Fortunately, these side effects are rare and usually clear up when the medicine is stopped.