Q: I drink iced tea made from a mix (Lipton's) sweetened with NutraSweet. Although the label lists quantities of calories, carbohydrates and protein, no mention is made of sodium. Since I have high blood pressure, I'm concerned about the sodium content of foods I eat. How can I find out about iced tea?
A: There is no sodium in Lipton's iced tea mix, but while I'm on the subject let me mention a few ways to keep track of the sodium content of various foods.
If you're keeping a close eye on sodium, you should have some idea of how much to allow in your diet. A low-sodium diet typically has about 2,000 milligrams (compared with the average daily sodium intake of 4,000 to 12,000 milligrams).
Many cookbooks and books about low-sodium diets lists the sodium content of foods. Check your bookstore or library. Your doctor or dietitian may have pamphlets with this information. Food stores and various health organizations, such as the American Heart Association (phone 337-6400), also publish helpful booklets.
For the most part, you can simplify things just by avoiding high-sodium foods without knowing in great detail the amount of sodium in everything you eat. If you require a more restricted diet, talk to a dietitian.
Finally, if you're interested in a particular food and can't find its sodium content, call or write the company. That's how I learned that there's no sodium in Lipton's iced tea.
Q: I have a couple of small skin ulcers near my ankle which a doctor once said were due to poor circulation. They're about the size of a penny, and aren't painful. About two years ago I had a similar sore that took several months to heal. I've been washing these with peroxide, but they don't seem to be getting any better. I don't want to go to a doctor -- they're always anxious to put you in a hospital and make something out of nothing. What can I do?
A: See your doctor. If you've had skin ulcers that haven't healed in months, you need some professional help. In most cases you won't need to go to a hospital for treatment.
Skins ulcers are open sores that are mainly caused by three conditions, all involving the circulation: diabetes, hardening of the arteries (arteriosclerois) and failure of the leg veins to work properly. Your doctor should diagnose which kind of ulcer you have, because different types of ulcers require different treatments.
Diabetes causes skin ulcers in two ways -- damage to the arteries supplying nourishment to the skin, and nerve damage that makes you less sensitive to minor skin trauma, such as friction, pressure, cuts, heat and cold. This insensitivity can lead to gradually worsening areas of skin breakdown, which is why it's important for people with diabetes to examine and take good care of their feet.
Hardening of the arteries of the legs can cause skin ulcers, as well as pain with walking or leg exercise. Some people with this condition benefit from surgery to open up blockages in large arteries. Trental is a new medicine that helps some people with poor leg circulation. Not smoking is also an important part of therapy.
Several things can be done to treat leg ulcers caused by improperly working veins. These treatments are also good for ulcers from diabetes or blocked arteries. First, keep the ulcer clean. Doctors and nurses often use what's called wet-to-dry dressings. In this technique, you put a gauze pad dampened in an antiseptic solution, such as Betadine, on the ulcer, let it dry and remove it and any debris (pus and shed skin cells) with it. Done several times a day, this promotes healing. Your doctor may also recommend one of a variety of topical products used to treat skin ulcers.
Finally, your doctor may wrap your ankle with a medicated bandage known as an Unna boot. This is usually left on for a week or so and then removed or replaced with a new bandage. This treatment often helps persistent leg ulcers.
Q: I've suffered from occasional migraine headaches since childhood. They grew less frequent as I aged, but lately have been occurring regularly after I play my weekly soccer game. Thinking dehydration might play a part, I try drinking lots of water before, during and after exertion, to no avail. Is it common for physical activity to trigger migraines?
A: Exerting yourself physically can trigger a migraine, and there are several things you might try to prevent or treat them. First, you can try taking a pain reliever at the start of the activity to reduce the headache's intensity. Second, at the first sign of a headache you could try taking one of the ergotamine-type medicines used to break an attack. Finally, you might be able to control the migraines by biofeedback training, a technique that helps you learn to relax muscles and improve blood flow by monitoring your body's muscle tension and skin temperature.
Since some migraines are triggered by going without food for a while, make sure you've had something to snack on before intense exercise.
I should mention that in rare instances, headaches set off by exercise can be a sign of a brain tumor or other problem within the head. But since you've had your migraines since childhood, I don't think this is likely in your case.