The Benefits of Bunion Surgery

I read with great dismay the article on bunions {Cover, Aug. 7}. The inclusion of a diversity of viewpoints made for a potentially objective review, but the emphasis created an overwhelmingly negative image of bunion surgery. In what could have been an informative essay, the relatively rare surgical complications were magnified to seem inevitable, and the benefits were minimized. Bunions may become debilitating and, for those who prefer to improve their way of life, surgical correction may be their salvation.

No surgery is without certain inherent risks. Even the most minor procedure can be complicated by infection, prolonged disability or recurrence. Drawing on my experience and that of colleagues in the metropolitan area, I have found less than a 1 percent infection rate. Most operations where the bone is cut and realigned are stable by design and not associated with increased disability.

Our patients have minimal pain and are back in shoes within two to three weeks after most procedures. Recurrence of the deformity is almost unheard of in our experience. Adam K. Spector Podiatric surgeon Silver Spring

Preventing Assault and Empowering Women

While I am always glad to see that groups are organizing themselves to prevent sexual asssault, I worry when I read the typical sort of "do and don't" list published in the article on safer jogging {Health Plus, Aug. 21}. The reason behind this concern is that such lists are rarely empowering for women and, ironically, women who are not able to follow these lists to the letter are then blamed, once again, if they are assaulted.

There was some practical advice: carry a quarter for a phone call, vary your route, take along a dog for companionship and protection. On the other hand, relying on something external -- a dog, mace, a male companion -- for protection assumes that women are incapable of taking care of themselves in dangerous situations, which is a myth.

Studies have shown that women who resist an assault at its onset have a 60 percent chance of escaping unharmed. Women successfully avoid rape three times for every rape that occurs. Women who knew self-defense techniques and still were raped healed faster, though, for they knew they had exhausted all other options and thus were prone to less self-blame.

To empower themselves, women can attend a self-defense class recommended by a local rape crisis center, learn assertiveness skills, find out the facts about sexual assault, trust their instincts and learn to turn fear into anger. Claire N. Kaplan Executive Director National Coalition Against Sexual Assault Washington

No Aspirin for Asthma Sufferers

Richard Stone's report on new drugs used to treat inflammation {Research, Aug. 14} was both excellent and intriguing. As an allergy and asthma specialist, I am well aware of the inflammatory components of these diseases.

Aspirin and other non-steroidal medications are certainly anti-inflammatory but should not be used for asthma and other allergic conditions. In fact, 20 percent of children and adults with asthma have an allergy to aspirin and the other non-steroidal anti-inflammatories. Sodium cromolyn (Intal) and corticosteroids are the only treatments presently available to prevent or to treat inflammation in asthma and other allergic diseases. Jerry M. Shier, MD The Allergy Center Silver Spring/Rockville

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