Dear Dr. Roach: About three years ago, my husband had a knee replacement. The surgery was successful, his physical therapy went very well and he has been pleased with the whole process — except for one thing: His leg (that knee area) is uncomfortably warm, especially when he is in bed at night. No matter what the temperature is in the bedroom, it is impossible for him to have any covering on that leg.
Neither of us feels that there has been a discrepancy in the surgery, nor in the therapy. Have you heard of or had any experience with such an occurrence with knee surgery?
Dear M.L.F.: A warm knee is expected just after surgery, although serious conditions like metal allergy and infection are possible. Three years is a long time for infection, and it’s obviously not postoperative warmth after so much time. One suggestion would be to test for metal allergies, which an allergist can do.
On the other hand, if the joint is functioning well, and the warmth isn’t so bad that he doesn’t really want to do much about it, he can just live with it, but in that case I would consider patch testing for allergies should he need another joint replacement in the future.
Dear Dr. Roach: In my local newspaper there is an advertisement for a free trial of a cream with the active ingredient EDTA, which supposedly dissolves plaque in clogged arteries. I was recently diagnosed with a clogged left carotid artery. What is your opinion on this new cream?
Dear J.A.: EDTAis a chelating agent, meaning it is able to bind to and remove the ill effects of certain toxins, especially heavy metals. It is not absorbed well — if at all — by the skin, so a cream will have no effect on a blocked carotid artery. Even given orally, the data on EDTA is that it probably is neither safe nor effective.
Aspirin, a statin-type cholesterol medication and careful control of blood pressure and blood sugar, if appropriate, remain the best treatment for a blockage of the carotid artery. People with severe blockages or symptoms of a blockage, such as a TIA, a temporary loss of speech or weakness, should be evaluated for possible surgery.
Dear Dr. Roach: Please discuss “transfer factor” as it regards treatment for shingles pain. A 73-year-old female recently underwent a recently developed treatment at the University of Mexico after the onset of shingles in her optic nerve. From day one of the 10-day treatment, she was pain-free, and has remained so for more than eight weeks. I should think many people would be grateful for such relief.
Dear J.M.: A “transfer factor” is named for its ability to transfer immunity from one person to another. Transfer factors may be derived from blood or from colostrum, a form of milk produced just before milk.
Although I am intrigued by the case you mention, I am afraid the literature on transfer factor is mostly three decades old and insufficient for me to recommend it for use in patients, although I would be delighted to read more scientific studies, since it seems promising. I did answer a letter recently from a woman who had ongoing shingles for years, and clearly we need better therapies for such cases.
Email questions to ToYourGoodHealth@med.cornell.edu.