Dear Dr. Roach: I am a 62-year-old man who is starting to get a sagging neck. Is there any exercise I can do to pull this skin back? I just don't want to have a turkey neck. I do 150 pushups a day, and I work on the treadmill. I'm not overweight.
Dear D.C.: Loose skin around the neck is very common as we get older. Exercise isn't likely to help, since for most people the issue is not weak muscle but loosened skin. The best cosmetic result comes from plastic surgery. Men are more likely to have plastic surgery on their neck than women are. There are newer, nonsurgical approaches, such as focused ultrasound to stimulate growth of collagen under the skin.
Dear Dr. Roach: My husband was a heavy smoker for most of his life. He is 60. Though he has finally quit, he has an electronic cigarette that he enjoys. The years of smoking have taken their toll on his lungs, and when he contracts a cold, the inevitable cough becomes almost incapacitating, sometimes to the point of him passing out. My question is what effect does inhaling the vapor from the e-cigarettes have on someone with limited lung capacity due to colds or COPD?
Dear T.R.Z.: Electronic cigarettes are battery-powered nicotine-delivery devices. Although they are sometimes marketed to help people quit smoking, it sounds like your husband is using them to satisfy his nicotine addiction.
The health effect of e-cigarettes is debated, but I think it's clear that they are safer than regular cigarettes — but not safe. They do increase carbon monoxide levels in the blood, which is bad for people with COPD. They also cause lung function to deteriorate, at least a little, in the short term. Little is known about long-term use.
I am concerned, hearing your story about coughing so hard that he is passing out and that his COPD is quite severe. In an ideal world, he would quit all nicotine products, but I think he needs very aggressive treatment of his COPD, if this is not being done already.
Dear Dr. Roach: My neighbor says my wife got poison ivy by handling their dog, a Yorkie. Is this possible?
Dear F.K.: Yes; if a dog is outside among poison ivy (or poison oak or poison sumac, depending on where you live), the dog can carry the allergen on its coat and rub it off on you. Only very small amounts of the oily allergen are necessary to cause a skin reaction.
If you know or suspect your dog has been in contact with poison ivy, you should wear gloves as you bathe the dog in warm water with a mild shampoo. Then you'll need to find a way of keeping the dog away from the poison ivy in the first place, as symptoms get worse with repeated exposures — for both you and possibly your dog, which also can have a reaction to poison ivy.
Dear Dr. Roach: I am a 78-year-old woman. A CT scan showed I have a prolapsed bladder. I have occasional discomfort in the morning. What is the best treatment? Should I see an urologist or an OB/GYN doctor? Is this very common?
Dear M.M.: A prolapsed bladder, also called a cystocele (SIST-o-seel), is when the structures between the bladder and the vagina weaken and allow the bladder to bulge downward into the vagina. The damage often happens during childbirth, but no symptoms may occur until well after menopause due to the effect of estrogen. It is quite common.
Both urologists and gynecologists treat this condition, and there are doctors with expertise in both fields, predictably called urogynecologists. Treatment depends on how bad the prolapse is anatomically (that is, how far the bladder drops into the vagina) and how bad your symptoms are. Options include doing nothing if symptoms aren't so bad, using estrogen cream and doing pelvic strengthening exercises (best done the help of a physical therapist who can help you figure out the right muscles to exercise).
More-advanced cases may need a pessary (a plastic or rubber ring inserted into the vagina to help support the bladder) or surgery. If you need surgery, as I have often said, it pays to find the most experienced surgeon around, whether she or he is a gynecologist or an urologist. Most women with mild symptoms do very well with exercises and/or vaginal estrogen. I certainly would not rush to have surgery.
Dear Dr. Roach: My husband uses a drop of Super Glue to treat his cracked finger tips. He says that it provides immediate pain relief and promotes healing. Is there any health risk in this practice?
Dear N.M.: The major health risk to the chemical in Super Glue is that the fumes are irritating, but it can cause also a skin reaction as well. Using in a well-ventilated area and keeping it on the nail is probably very safe. There is medical superglue that surgeons use in the operating room.
Email questions to ToYourGoodHealth@med.cornell.edu.