Dear Dr. Roach: Among my problems is restless leg syndrome. I take generic Requip (ropinirole) to sleep at night. Recently, I find I must take it earlier and earlier before bedtime. Without this medication, I would have to take sleeping pills every night. But because Requip puts me to sleep, I cannot use it when I do not want to go to sleep. And increasingly, my legs give me so much trouble whenever I want to watch a movie, do any traveling, etc. My doctor prescribed gabapentin for daytime use. However, I do not feel that medication is doing any good. There are early evenings when I think Iím going to go nuts because my legs bother me so much. I have it in both legs, but usually only one is bothersome at a time. Is anything I can do or take to relieve these annoying RLS symptoms?
Dear L.M.: Restless legs syndrome, also called Willis-Ekbom Disease, causes symptoms of spontaneous leg (and sometimes arm) movements during rest, often associated with unpleasant sensations in the limb. It is common, and can be associated with iron-deficiency anemia and other conditions. Symptoms are usually worse at night, and movements usually occur during sleep.
Ropinirole (Requip) and pramipexole (Mirapex) often are the first medications used in this condition, and they can be very effective. They start working in about 90-120 minutes. Some people do experience fatigue with these medications.
For daytime symptoms, I have had good success with carbidopa-levodopa (Sinemet and others).
Dear Dr. Roach: My wife read that oral sex is the chief cause of throat and lung cancer. Can this be true?
Dear Anon: Recently, it has been found that human papillomavirus is a risk factor for cancer of the throat and mouth (but not lung). The presence of HPV increases the risk of cancer two to three times. Smoking remains a more powerful risk factor, and increases the risk five to 25 times. HPV can be transmitted through sex, including oral sex, from someone infected with HPV. HPV canít be transmitted through sex, oral or otherwise, in someone who doesnít have the virus, but many or even most people infected with HPV are infected without realizing it.
HPV is the cause for all or nearly all cases of cervical cancer. The vaccine for HPV dramatically reduces the risk of cervical cancer. It is hoped that it will reduce the risk of head and neck cancers as well. All males and females ages 13 to 26 are recommended to have the HPV vaccine.
Dear Dr. Roach: Iím wondering about the commercials regarding eating ice cream. The way they sound, itís OK to eat it without fear of fat. Iím a male in his 70s, in fine health, and I am wondering if eating it is fine, but just once in a while. Thank you.
Dear A.A.: Ice cream has more saturated fat and sugar than is good for you. People who want to be super-healthy donít eat ice cream at all. However, I am a believer that itís OK to indulge yourself once in a while in something that might not be the healthiest for you. Just make sure itís something closer to once a month than it is to once a day.
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