A reader asks whether the powder juice and yogurt that promises to boost the immune system really does. Dr. Wadie Najm, of the Susan Samueli Center for Integrative Medicine at UCI, responds.
Q. I take daily doses of JUICE PLUS Orchard and Garden Blends (fruit juice and vegetable juice powders) and Dannon Yogurt’s DanActive. Am I really boosting my immune system?
Note: Here’s a DanActive commercial, promising it will boost immunity.
Click on for Dr. Najm’s response.
Reader Marsha Gallavan asks a doctor whether there are any non-surgical or other minimally invasive procedures to remedy her husband’s back problems. Dr. Charles Rosen, who founded the UCI Spine Center and the Association for Ethics in Spine Surgery, discusses the options.
Q. My husband is 71. He had a spinal fusion with instrumentation at L4-5 in 2003. For the past six months, he has experienced lower back pain again. Since September, he has also had pain (in the front of the thigh) and weakness/numbness in his left leg only. He has fallen four times due to the leg weakness. He now uses a cane, but he can’t walk far and cannot exercise as he did before September.
Within the past six weeks, he has had an MRI, EMG, CT Myelogram and lumbar xrays. The diagnosis is a herniated disk at L3-4, pressing on the L3 nerve. He also has disk degeneration at L2-3 and slight spondylolisthesis (Grade 1) at L3-4.
Three surgical opinions have recommended fusion at L3-4. Two surgeons will go in from the 
back; the other will go in from the side (XLIF) and the front. One surgeon also recommends fusion at L2-3; the other two will do laminotomies at L2-3.
My questions: 1) Is there any nonsurgical or less-invasive option to decompressing the nerve and returning function to the left leg? That’s our biggest concern. I know that some people are treated by physical therapy. However, in the past, such therapy hasn’t worked for my husband’s back pain.
2) I researched minimally invasive surgery, but the surgeons I went to discouraged it or, in one case, wanted to combine such a procedure with an anterior approach, too. Four hours on the table is too much! Do you know of other surgical options?
My husband’s other medical problems (e.g. leukemia) make us even more wary than usual of surgery. I’ve done lots of research and am willing to do anything to make sure my husband has a successful outcome.
Thank you,
Marsha Gallavan
Click on for Dr. Rosen’s answers.
Two readers asked recently about CoQ10, a powerful and beneficial antioxidant naturally generated in our bodies that can be depleted by taking some common drugs, such as anti-depressants.
Reader “W.K.“ asks our doctor for his opinion about whether he should take CoQ10 and fish oil supplements. A second reader, Eleanor Sandford, asks whether the medicines Zocor and Avapro deplete the body of essential nutrients and whether taking CoQ10 supplements would help.
Dr. Wadie Najm, of the Susan Samueli Center for Integrative Medicine at UCI, offers this answer.
Coenzyme Q10 (CoQ10) is a powerful antioxidant which plays a major essential role in the proper function of most cells. The level of CoQ10 decreases with age and during several medical conditions such as cardiovascular disease, diabetes and AIDS, among others. In addition certain medications, such as statins (Like Zocor, Lipitor, Mevacor, etc…) and some antidepressant can reduce production or concentration of CoQ10. During those conditions and when you are using these medications you should discuss with your physician the potential addition of CoQ10 supplement.
CoQ10 supplement has been recommended for the treatment of several conditions such as hypertension, congestive heart failure, angina, Alzheimer’s disease, cancer, diabetes and gum disease among others. Good scientific studies suggest that supplementation is very helpful in cases of CoQ10 deficiency and in management of hypertension. Studies looking at the use of CoQ10 for angina, cardiovascular disease and other conditions have been promising but not conclusive.
Fish oil has been approved by the FDA for the treatment of high triglycerides (a form of fat in the body). Also good evidence suggests that fish oil can be helpful for the management of hypertension and to decrease inflammation which is at the heart of all cardiovascular diseases, arthritis, rheumatoid arthritis, and inflammatory Bowel Disease (Crohn;s disease, Ulcerative colitis),
Fish oil is generally safe, however in high doses (greater than 3 grams daily) or when combined with blood thinning medications (aspirin, warfarin, etc…) they can increase the risk of bleeding. If you decide to take fish oil, discuss with your physician, choose a product that has been filtered or pressed (to ensure that mercury found in many fish has been removed).
A reader who needs eye surgery on one eye asks a doctor whether the surgery should enhance her up-close vision, or her ability to see long distances. The answer comes from Dr. Gabriel Dery, an Irvine optometrist, fellow of the American Academy of Optometry and assistant adjunct professor at the Southern California College of Optometry.
Here’s the question from a reader named Patricia:
I am a 73 year old female of general good health. I had cataract surgery in my left eye on 8/26/08 for distance and all is well. Now it is time for the right one to have cataract surgery. I have slight astigmatism and slight start of dry MD (taking 2 PreserVision tablets per day).
I need to make a decision as to the right eye and monovision. I did wear monovision contact lenses when I worked years ago and I did not have problems that I recall. My biggest problem has been and still is after left eye surgery - brightness and glare, even in the daytime.
In your opinion does monovision seem like a good decision or would both eyes for distance and wearing reading glasses be a better solution?
Thanks for any help you can be to me.
Hope to hear from you!
Patricia
Here’s Dr. Dery’s response:
Hello Patricia:
Yes, a good surgeon should be able to calculate the power of the implant in order to achieve monovision. That should not be a problem.
My question to you is: Why not have your surgeon give you a multifocal implant where you will be able to see far and near with the same eye. You will end up with what we call modified monovision. In other words, both eyes will have good distance vision and your left eye will be able to read comfortably. The fact that you have already used monovision, you should be able to get adjusted very quickly.
Which eye has the ARMD? If it is the left eye, then the multifocal implant with the near vision in the left eye will be perfect for you.
Good luck to you.
Dr. Dery
More “Ask a doctor”
These questions come from reader Mary Trausch. The answers come from Dr. Charles Rosen, a spine surgeon and founding director of UCI’s spine center.
If you’d like to ask our doctors anything, please send an email to Jennifer Muir (jmuir@ocregister.com) or Courtney Perkes (cperkes@ocregister.com).
Q. How common is it for spine patients with back injuries to become dependent on pain medications?
A. That’s a very pertinent question because it is , unfortunately , common for people with back pain to be referred for “pain management” to treat the pain , but not actually having a diagnosis as to the cause. Sometimes the narcotics they are prescribed on an on-going basis as “treatment” often lead to narcotic addiction after 3-6 months. This situation can be made worse by the prevalence of long acting narcotics such as oxycontin and the like, as well as vicodin. People may not realize that these are essentially morphine analogs made synthetically.
My suggestion is that a specific DIAGNOSIS be made before narcotic usage goes beyond a few weeks. Then, treatment, whether it is injections, PT, non-steroidal anti-inflammatories or surgery be initiated without long term narcotics being in the picture. I see too many regular working people who now have two problems instead of one , namely back pain and now drug addiction.
Q. And also how common is depression with spine patients?
A. Depression occurring usually after 6 months of chronic back pain is fairly common. It should be treated as well as the back pain. Again, a diagnosis often not made and the person continues to have back pain that can lead to job loss, marriage difficulties, narcotic addiction to say vicodin, and the downward spiral begins. Aggressive treatment for the back pain , as well as the depression is needed. It should be noted that narcotics by definition are depressants and make the mental situation worse.
A reader asks Dr. Hau Sin Wong about kids getting ear pain after swimming. Wong is a board certified otolaryngologist and a practicing physician at Children’s Ears, Nose & Throat Surgeons of Orange County.
Q. My son loves swimming in the pool, but each time he gets out of the water he complains that he has ear pain. Should I get him examined?
A. In the summertime, many children and adults develop an external ear infection commonly known as “swimmers ear.” The medical term is otitis externa. Otitis externa involves the ear canal and can extend to the outer part of the ear as well as the surrounding skin.
Most patients will describe severe pain that is worse when the ear is manipulated, when eating, or talking. In addition, discharge develops as bacteria overgrow in the ear canal and hearing can be diminished as the ear canal swells and blocks sound from entering into the middle ear.
This type of infection occurs when there is excessive heat, humidity, water contamination, and local ear trauma. These factors are most prevalent during the summer, when children are repeatedly exposed to water in swimming pools, hot tubs, river, oceans, and/or lakes.
The infection develops after an initial local trauma from inappropriately placed ear plugs, hearing aids, swabs, or fingers. The trauma allows bacteria to enter beneath the skin.
The moisture and heat in the ear promote bacterial growth that causes local swelling, inflammation, and pain.
Treatment is with ear drops that have both an antibiotic and anti-inflammatory component.
Occasionally, the swelling and the ear-canal debris can be so severe that the drops cannot get past the inflammation. In these instances, the ear needs to be thoroughly cleaned and an ear sponge may need to be placed to keep the canal open and allow the medication to be effective.
Most infections will be resolved within a week with ear drops. Rarely will there be a need for an oral antibiotic. Because the pain can be extremely intense, pain medication may be needed as well.
For parents who want to decrease the risk of their children developing “swimmer’s ear,” I recommend using an ear plug and an ear band to prevent water from entering.
Immediately after the child comes out of the water, I suggest drying the ear with a blow dryer or a commercially available device such as Mack’s ear dryer, which is portable and available at many drug stores.
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