Dear Dr. Roach: I am a woman who just turned 75, and I have a chronic dry cough. I visited my pulmonary doctor, and he diagnosed bronchiectasis. There is no cure, but there are herbal products, such as Creseton. They claim to have a 90 percent cure rate, which is better than no cure at all. Can you give me any suggestions or have you heard about the herbal products?
Dear P.N.: Bronchiectasis is an uncommon lung condition in North America. It is a reaction to previous infection with a scarring process in the small airways. It is similar to chronic obstructive pulmonary disease. Itís more common in women and certain ethnic groups, or in conjunction with conditions like cystic fibrosis or alpha-1 antitrypsin deficiency.
There is no way to reverse the scarring in the lungs once it occurs, but exacerbation of the disease can be both treated and sometimes prevented with antibiotics.
I looked up Creseton, and the company reported good results from its own, unpublished study. I canít recommend the product on the basis of what the maker reported.
I would like to believe it, but if something sounds too good to be true, it might be.
Dear Dr. Roach: I recently read that many doctors and nurses have low-frequency hearing loss, resulting in a falsely elevated blood pressure measurement compared with an automated blood pressure machine. Please comment.
Dear P.I.: Accurately measuring blood pressure is very important, and there are several concerns. For the best accuracy, the blood pressure should be taken seated, with a manual mercury device using a properly sized cuff, three times, and the average recorded (as I learned years ago: thanks, Dr. William Elliott).
Only very advanced automated models, costing up to thousands of dollars, can approach the accuracy of a trained clinician.
I couldnít find the news piece you read, but it makes some sense. Health-care providers arenít immune to losing hearing as we get older, and hearing loss can lead to inaccuracy in blood pressure measurement. Hearing loss can mean an error of several points.
There is abundant evidence that in the vast majority of cases, home and inexpensive office machines are not as accurate as humans.
Dr. Roach Writes: In August, I answered a question about floaters, and said as long as they werenít affecting vision and that a thorough exam had been done, the treatment might be worse than the disease.
Several readers took the time to tell me of their good experiences getting rid of floaters through vitrectomy or with laser treatment.
Another wrote to warn me of a rare disease, birdshot retinochoroidopathy, which can present with floaters and might be missed by ophthalmologists not familiar with this condition.
Email questions to ToYourGoodHealth@med.cornell.edu.