Dear Dr. Roach: My 14-year-old daughter has been diagnosed with and is being treated for depression. She has been suffering for at least two years now.
I go over things in my mind and wonder if I had anything to do with her depression. I recall when I was pregnant with her, I used to cry often, as I knew I had made a mistake marrying her father. Do you think this sadness of mine passed down to her somehow?
Dear J.P.: There is an old expression that there is no situation that is so bad that you can’t make it worse with guilt. In this case, your guilt is not warranted. It is true that there is a family tendency for major depression, but it isn’t your fault any more than it was one or both of your parents’ fault that you may have had major depression. I don’t believe that you feeling sad during pregnancy was in any way responsible for her having depression. Spend your energy on positive thoughts, like helping to support your daughter.
Dear Dr. Roach: During the night, I am awakened with either my left or right hand being numb, mainly the thumb, index finger and middle finger. I will get up and move it around, and eventually the numbness goes away, only to return later.
Is this a pinched nerve? If so, how can I tell what nerve this is, and how can I correct it? I’m 87 and in excellent health except for a bit of arthritis.
Dear L.N.L.: It does sound like a pinched nerve, and I think I can tell you which nerve just from your description. The thumb, index and middle fingers and part of the ring finger all get their nerve supply from the median nerve, which runs through the carpal tunnel, a ring of bones and connective tissue in the hand. The pressure can build in the carpal tunnel when we sleep, especially if the wrist is bent forward (flexed) or backward (extended). That position can compress the nerve and cause numbness. If symptoms go on too long, it can cause weakness and even atrophy.
Given that it happens only at nighttime, I doubt this is a serious case of carpal tunnel syndrome. However, any weakness or loss of muscle bulk in the hand should prompt you to see your doctor. In the meantime, keeping your wrist in a neutral position, neither flexed nor extended, while you sleep might solve the problem. A wrist brace from the local pharmacy can keep it in place.
Dear Dr. Roach: I have to take an 80-mg aspirin for stroke prevention (because of a family history of such). Can I also take Advil for minor musculoskeletal aches?
Dear J.G.: Aspirin clearly reduces the risk of heart attack in people at risk, and although the data aren’t completely convincing, I believe that aspirin reduces the risk of stroke for people at high risk, as well.
Occasional medications like ibuprofen or naproxen probably have little harm in this situation. However, regular use of NSAID drugs like these does seem to reduce part of the effectiveness of aspirin, so I would recommend acetaminophen (Tylenol) if more than occasional use is needed. Also, aspirin and NSAIDs together can increase the risk of stomach inflammation.
Email questions to ToYourGoodHealth@med.cornell.edu.