DEAR DR. DONOHUE: Third letter, same request. Please tell me how to get rid of fungus under a toenail. – B.K.
ANSWER: Toenail fungus is prevalent among older people, and often, the infected person has no idea where he or she picked it up. The big toe’s nail is the one the fungus seems to like the best. The nail turns yellow, becomes thick and brittle, and has crumbly material extending from its edge under the nail to its base. The nail doesn’t usually hurt or itch. It just looks awful.
Treatment for nail fungus is less than a huge success. Penlac (ciclopirox) Nail Lacquer is applied directly to the nail. The cure rate isn’t impressive. Oral medicines have the best results, but the results aren’t something to write home about. Further, they’re expensive, and often are not covered by insurance. One such medicine is Sporanox (itraconazole). It’s taken twice a day for one week of each month, for three or four months. Liver enzymes should be monitored while using it, because it can, but rarely does, damage liver cells.
Some people opt for nail removal.
A new treatment employs a laser. As with oral medicines, it’s expensive and most insurers don’t cover the cost. Results are promising but not guaranteed.
If the nail isn’t bothersome, if it’s not leading to infections of the toe or foot and if a person isn’t a diabetic, many decide to live at peace with the infected nail. It isn’t likely to shorten life.
Home remedies abound. They include Vick’s VapoRub, bleach and vinegar. I don’t have a lot of faith in them, and I would not use bleach. Studies on Vick’s, applied daily for 48 weeks, show a success rate of 22 percent.
DEAR DR. DONOHUE: My father and two uncles died from heart attacks when they were in their 50s. I’m 45. I haven’t ever smoked. I am active and eat a healthy diet. Should I be taking an aspirin? What dose? – R.W.
ANSWER: A family history like yours puts you at high risk for a heart attack. I would take a daily 81 mg aspirin as a preventive step.
You shouldn’t do this on your own, however. Discuss it with your family doctor to see if he or she has any other suggestions or tests planned for you.
The booklet on heart attacks explains why they happen and how they’re prevented. Readers can order a copy by writing: Dr. Donohue – No. 102W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: Is swallowing gum harmful?
I have done it for many, many years. Now I wonder if I am hurting myself or my stomach by doing this. Am I? – D.J.
ANSWER: You’re not hurting yourself or your stomach. Gum isn’t digested. It passes through the small and large intestines without causing any trouble.
Gum wasn’t meant to be swallowed. Most people prefer to take it out of their mouth and dispose of it.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.
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