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Sacred Heart students taught about maintaining good health

More than 200 students at Sacred Heart Junior-Senior High School learned more Thursday about the importance of making healthy choices at the school’s 13th annual Health and Wellness Fair.

“This is a wonderful opportunity for our students to see important aspects of health and wellness,” said Sacred Heart Principal John Krajicek. “These are relevant topics for them. If they know the right information, they will make good, healthy choices.”

The event was organized by former Sacred Heart educator Shelly Gaskill, who got the idea years ago when reading about how young people were expected to have a shorter life expectancy.

Students learned about such things as the value of locally grown food; choking; blood pressure and weight; ill effects of sugar, alcohol and vaping; health and conditioning; Internet safety, and body mechanics.


Research foods

At one station Shane Pearson, division chief with the Salina Fire Department, taught students about hands-only cardiopulmonary resuscitation and using an automated external defibrillator to treat cardiac issues.

“Sudden cardiac arrest is continuing to increase. It’s a leading cause of death in adults,” Pearson said. “If students have the basic information, they can help prevent life-threatening issues as a bystander.”

Local organic farmer Don Wagner taught about the value of locally grown food. He encouraged students to be cautious about what they put into their bodies.

“You guys are the experiment. You are what you eat,” he said. “All you can do is research and find out what goes into your food. We are depending on you to reproduce and keep the human race alive. What you eat now could have long-term effects on your reproduction.”

Wagner highlighted foods with artificial sugars and preservatives as ones to avoid.


Alcohol limit lower

Saline County sheriff’s deputy Robert Little taught about the ill effects of sugar, alcohol and vaping. He told students that people younger than 21 can’t legally drive with a blood-alcohol level of 0.02 or higher; the limit for older people is 0.08.

“What happens when you drink past that level? You face a $500 fine, 40 hours of community service,” he said. “We know kids are going to experiment at parties or at some setting with their friends. We want them to know they shouldn’t risk ruining their lives.”


Internet safety

Randy Nichols, Kansas State University Polytechnic Campus associate professor of practice and cybersecurity, warned students of the dangers of the Internet.

“As soon as you send a text, take a photo or anything on a computer or phone, there are instantly 500,000 people who have access to it,” he said. “Parents need to be more involved with this stuff. Kids don’t really understand that what they’re putting out is being tracked. There are people who for a living are out there trying to get your personal information.”

Alyssa Lesser, Genesis Health Club personal trainer and dietician, taught cardio kickboxing. She encouraged students to stay active.

“Staying active not only affects your physical health, but also your emotional and mental health,” she said. “It affects all different aspects of health, so I really want you all to search for something that you’re passionate about that makes you happy and keeps you moving around. It’s important as you get older to stay mobile.”


Lessons learned

Sacred Heart junior Ben Del Rea said he learned a lot from the Internet safety station.

“I didn’t know everything was connected like that,” he said. “I’ve already started being careful of what I put into my body. We have to look at our boundaries. In life you are given one body and if you don’t treat it right, you could suffer or regret it.”

Fellow junior Leah Hennes said the health fair “let me know I need to be more active.”

“The kickboxing cardio exercise showed me how much work I need to do,” she said. “I also enjoyed the recipes and food we got from the farmer (Don Wagner). I want to make some of the healthy banana muffins he gave us.”

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Your Good Health: Multiple myeloma signs need watching

Dear Dr. Roach: In September 2016, I was diagnosed with IgM MGUS. Repeat bloodwork in November 2017 revealed both IgA and IgM MGUS. I have no measurable M protein. I have had no fatigue, bone pain or other symptoms. I am a 65-year-old woman in good health; I eat carefully, do not drink or smoke and exercise almost every day. Can you comment on my risk of progression?


Monoclonal gammopathy of uncertain significance -— MGUS — is a precursor condition to multiple myeloma. It is of “uncertain significance” because not everyone will progress to myeloma, a cancer of the plasma cells, which make antibodies and live in the bone marrow. MGUS isn’t rare: Three to four per cent of the population over 50 has it. However, because some people do progress, it is important for people with MGUS to be carefully observed over time by an expert in this condition, a hematologist/oncologist.

There are three major laboratory values that can help estimate the likelihood of progressing from MGUS to myeloma. One is the total amount of abnormal M protein in the blood: Those with levels less than 1.5g/dL are at lower risk. People with IgA or IgM subtype are at higher risk than those with just IgG. An abnormal ratio of light chains (kappa and lambda chains or part of the antibody molecule) also predicts greater likelihood.

I looked carefully at the labs you sent me and found low (no) M protein and normal light chain ratio, so you have two favourable and one unfavourable factor, which puts your risk of getting multiple myeloma at about
20 per cent in the next 20 years. However, your risk may be even lower since your M protein level is so low.

In addition to monitoring your labs, you should be on the lookout for symptoms, especially fever, weight loss, fatigue, bone pain or abnormal bleeding. Your prognosis is good, but people can progress quickly, so you need to be vigilant in getting any symptoms evaluated in addition to regular checkups.

Lots more information is available at

Dear Dr. Roach: I am 90 years old. Until age 85, I had not needed any regular drugs.

Five years ago, my systolic blood pressure was near 140, but I was feeling fine. Yielding to pressure from my health care provider, I was put on a daily dose of lisinopril and amlodipine. That reduced the blood pressure, on average, to around 120 systolic.

Since that time, I have had cold hands and feet, plus weak, painful knees. Could there be poor blood circulation caused by blood pressure that is too low? If so, what should I do? My advisers seem to scoff at this idea.


It is both unprofessional and unwise to scoff at patients, as they generally know their bodies better than their doctors do, and we should listen carefully before making judgments. In your case, coldness of the hands and feet is listed as a possible side-effect. Joint pain also may happen, but it may be that this is unrelated to the drugs.

I don’t think it is a result of too low a blood pressure, although if you already had blockages in the arteries to your limbs, lower pressure might lead to less blood flow and thus cold hands and feet.

Some doctors like to use low doses of two medicines to reduce side-effects; however, when a side-effect does occur, it can be hard to figure out what is going on. With your doctor’s permission, you might try stopping the amlodipine (I think it’s the more likely culprit) to see the effect on your blood pressure and on the hand and foot coldness.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to

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Avoid falls key to good health as you age

Every second of every day in the United States an older adult falls.

This makes falls the number one cause of injuries and deaths from injury among older Americans. In 2014 alone, older Americans experienced 29 million falls causing seven million injuries and costing an estimated $31 billion in annual Medicare costs.

Eighty-seven percent of all fractures in the elderly are due to falls. Two-thirds of those who fall will do so again within six months.

When an older person falls, his or her hospital stays are almost twice as long as those of older patients who are admitted for any other reason.  Among people aged 65 to 69, one out of every 200 falls results in a hip fracture.

That number increases to one out of every 10 for those aged 85 and older.  One-fourth of seniors who fracture a hip from a fall will die within six months of the injury.

Many falls do not result in injuries, yet 47 percent of non-injured seniors who fall cannot get up without assistance.

Falls, with or without injury, also carry a heavy quality of life impact.

A growing number of older adults fear falling and, as a result, limit their activities and social engagements. This can result in a further physical decline, depression, social isolation, and feelings of helplessness. The most profound effect of falling is the loss of independent living.

Many older patients are resistant to using a cane, let alone a walker.  Trying to get them to agree to a home assessment is next to impossible.

To get them to consider wearing an ankle brace is even harder.  Patients will take a myriad of medications prescribed by their internist without question but will be so resistant to doing something that will clearly reduce their risk of falling.

The analogy can be made that the prescription for your high blood pressure is a pill, and your prescription for your risk of falling is…”

There are so many things that can be done for patients that are at risk of fall, most of which are covered by insurance/Medicare, why not take advantage?  The following are some things that can be done to reduce risk of fall.

Home fall-risk assessment: many healthcare agencies will come in and assess ones home to make suggestions to reduce risk of fall in the home.

Here are some great tips for reducing risk of fall in the home:

Remove obstacles inside and outside of the house that could cause tripping.

Install handrails and lights on staircases, with light switches at the top and bottom of the stairs. Add nonslip treads for bare wooden steps.

Install shower and tub grab bars in the bathroom, around the toilet and the tub.

Place no-slip mats on the shower floor and bathtub.

Secure loose rugs with double-faced tape, tacks, or slip-resistant backing.

Store clothing, dishes, food and other necessities within easy reach.

Make home lighting brighter.

Have vision checked often and regularly.

Have the senior wear sensible shoes. They should be properly fitting, sturdy shoes with nonskid soles.

Consider a PERS (Personal Emergency Response System) unit that will alert others when help is needed.

Physical Therapy: PT is a great tool for patients that are at risk of falling.

Most therapy facilities will now come to the patient’s home which is a great convenience.  There are many therapeutic modalities that can reduce one’s risk of fall, and a good therapist that has experience with balance therapy can be a great resource.

Assistive Devices: canes, walkers, orthopedic shoes, braces; these words are often stigmatized in the older population.

Using a cane or walker can make an older patient feel inferior.  It is seen as a sign of age and loss of function and independence.

Many of my patients shun the use of an assistive device because they don’t want to give in to father time.

In conclusion, an elderly patient’s risk of fall is the leading cause of mortality in this population.  There are so many things that can be done to limit such risk.

Information provided by David J. Sands, DPM,  

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LeBron James hopeful good health comes to Cleveland Cavaliers as playoffs draw near – WKYC

CLEVELAND — Above all else, Cleveland Cavaliers small forward LeBron James wants one thing for the team heading into the postseason: health.

Since the outset of the 2017-2018 regular-season, the Cavaliers have been hampered by injuries, and with less than a month remaining before the beginning of the NBA Playoffs, James is hoping to have a full complement of players available.

“I just want us to get healthy,” James said. “That’s all that matters to me. The standings, it is what it is at this point. We’re 67 games in. We’ve probably yet to have a full team. We’ve had one full team, I think, at home against Portland when I.T. (Isaiah Thomas) first came back.

“That was the first time we had a full team, and then, the next game, because he couldn’t play back-to-backs, we went back to not having a full team. Then, some injuries happened and we haven’t had another full team yet, so I just want us to get as healthy as we can get, so I know, our coaching staff knows and we all know what we can become. The standings don’t matter to me. It is what it is at this point.”

READ: Cleveland Cavaliers’ LeBron James, Larry Nance Jr. bet on St. Vincent-St. Mary-Revere playoff game

Heading into their 129-107 win over the Phoenix Suns at Talking Stick Resort Arena, the Cavaliers were without the services of power forward Kevin Love (broken bone in left hand), center Tristan Thompson (sprained right ankle), guard Rodney Hood (lower back strain) and small forward Cedi Osman (left hip flexor) because of injuries.

Love has been out since the end of January, while Thompson got hurt in the lead-up to the Western swing. Hood and Osman were hurt in last Friday’s loss to the Lakers at Staples Center.

Then, power forward Larry Nance Jr. suffered a hamstring injury and did not return to the game against Phoenix.

“We all learn on the fly,” James said. “Every game is a learning experience for our ball club and our guys, so I don’t think they’re deferring as much as they did early on. Obviously, they’re just trying to fit in, and they’re doing a better job of kind of getting the rebounds and going.

“I think Larry has done a good job of maximizing the time he’s out on the floor. Jordan is figuring it out as well. With Rodney out the past couple games and George (Hill) still trying to figure it out, they’ve been pretty good.”

READ: LeBron James: I’m like a fine wine, just get better with age for Cleveland Cavaliers

After listening to the players over the last few years, NBA Commissioner Adam Silver expanded the regular season by two weeks. However, by doing so, it created an every-other-day scenario for the Cavaliers for a significant stretch of the final two months of the regular season.

But rather than focusing on playing every other day for the next three weeks, James is taking the games as they come.

“There’s no great format, and there’s no bad format,” James said. “It is what it is. The schedule is what it is. Every other day, you’ve either got back-to-backs or three in four nights, I think the Commissioner and scheduling committee did a great job of figuring things out with this season given the conversation that was going on the last couple years, and this is what they felt best fits.”

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Your Good Health: Man, 63, suddenly loses hearing

Dear Dr. Roach: I hope you can advise me on a current hearing issue. I’m a 63-year-old man, and I woke up one morning to total deafness in my left ear (my right ear was OK).

I got in to see an ear, nose and throat doctor immediately. He ran a hearing test, which verified my deafness, and started me on a regimen of steroids (prednisone).

After two weeks, there was absolutely no change — I still was 100 per cent deaf in my left ear. He then gave me a steroid injection directly into my ear. Here I am a week later with no improvement whatsoever. I see him again in a few days, so what should I expect?

Are my chances of regaining any hearing in that ear any good? Will surgery of some type be an option?


This extremely disconcerting symptom is called “sudden sensorineural hearing loss.” Nobody knows why it happens, but it occurs most often in people in their 40s and 50s (though it can happen at any age). Some proposed explanations have included viral infection and small strokes.

About half of people notice suddenly going deaf (or very hard of hearing), almost always in only one ear; the other half wake up with it.

It is usually treated as you were, with oral steroids or injection.

In one study, 61 per cent of people treated with steroids recovered, while 32 per cent who were not treated recovered.

Unfortunately, those who, like you, have profound hearing loss are less likely to recover.

You can ask your doctor about the type of hearing loss: If you have profound hearing loss only in low frequency, the chances for recovery are better.

Only five per cent of people with hearing loss across all frequencies got better, even if treated with injection.

One new therapy is hyperbaric oxygen, whose effectiveness appears likely, especially if started within two weeks.

Surgery is not effective, as the problem is in the nerve. However, it may be worthwhile to consider a cochlear implant or bone conduction implant if the hearing does not come back.

Dear Dr. Roach: I am a 77-year-old male in good health. I have been taking one 5-mg tab of finasteride daily for an enlarged prostate for about two years. This has successfully reduced my trips to urinate at night to about twice.

About a year ago, I noticed that I was producing absolutely no semen. I am not bothered by this, because I am widowed, celibate and certainly do not have plans for more children.

Is the lack of semen production normal for a man of my age, a side effect of the finasteride or possibly something else I should talk to my urologist about?


Although semen and sperm production do decrease with age, finasteride is well-known to reduce semen production. The time course suggests that the finasteride is the culprit for you as well.

Only about five per cent of men will have such an extreme result as you did, however. If it is not bothering you, you do not need to change the medication.

When you see your urologist, you may ask about getting your testosterone level checked, as that is another potential cause of this issue.

Treating low testosterone may have additional benefits, and may even reduce risk of heart disease.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to

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6 Ways to Turn Around Your No Good, Very Bad Day

Having one of those days when it seems like everything that could go wrong, did? You needn’t give in to grouchiness or despair. Try these suggestions from our behavioral health experts instead:

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1. Be mindful of your feelings

What’s beneath your stress and frustration: anger, sadness, resentment?

“Research shows that knowing — and naming — your feelings is incredibly helpful and soothing,” says psychologist Susan Albers-Bowling, PsyD.

Once you’ve identified your feelings, write them down in a journal. Or talk them out with a good friend.

“I recommend the 3M approach: being mindful of feelings, moving, and doing a mindset makeover,” says Dr. Albers.

2. Get up and move

In order to shake off a bad day, you need to be active.  “Sitting still gives your feelings time to fester,” says Dr. Albers.

Sleep psychologist Michelle Drerup, PsyD, says ample research shows that exercise and activity produce endorphins and serotonin.

“Engaging in just 20 minutes of physical activity will increase these natural mood-lifters and give a noticeable lift to your day,” she says.

You don’t have to spend hours in the gym to enjoy the benefits of exercise. Do any activity you enjoy.

“Play fetch with your dog, walk outside with a friend at lunch, take a bike ride through the park,” she suggests.

3. Do something you love

Distraction can be a blessing. “Watch a favorite movie, work on a craft project, itemize your collection,” says psychologist John Vitkus, PhD. “If your passion involves physical exertion (hiking, running, kayaking, etc.), all the better.”

Avoid judging yourself or having strict standards. “Enjoy the experience — try to lose yourself in it,” he advises.

If you can’t completely set the anger, depression or anxiety aside, don’t worry. Taking positive action even when your heart isn’t in it will benefit you.

“We are highly motivated to make our inner and outer worlds agree,” explains Dr. Vitkus. “Doing what we love reduces this ‘cognitive dissonance’ and helps to lift our mood.”

4. Do a mindset makeover

Take a deep breath and reassure yourself that having a bad day is part of living on the planet.

“Consider the big picture. Will you feel this way for five minutes, five hours, five months or five years?” says Dr. Albers. “Say, ‘this too shall pass.’ Hang in there.”

Listening to uplifting music can help you set the tone, adds Dr. Vitkus.

You won’t feel better instantly. Give yourself some time to respond to your feelings in a productive way, Dr. Albers advises.

That’s especially good advice at the end of a bad day, notes substance abuse counselor Denise Graham.

“I always asked my kids for 15 minutes to ‘decompress’ after work,” she says. “Then, if I came home in a bad mood, I came out of my room as mom, not as an irritable worker bee.”

5. Connect with others

OK, your day hasn’t been a raging success so far. But it’s not over yet.

“It helps to close a bad day by getting out of yourself and helping someone else,” says Ms. Graham.

Volunteer, or offer someone a kind gesture. Help a family member with a task, or play with a pet.

“When you’re feeling kind, loving and grateful, it’s difficult to hold onto sadness, anger and resentment,” she points out.

Dr. Drerup has a dance party to connect with her kids and let off steam after a challenging day. “We choose their favorite songs, blare the music, belt out the words and dance around the house,” she says.

6. Rest up

The best thing to do at the very end of a difficult day? Get to bed at a decent hour and turn off/limit your use of cell phones, computers and tablets for the last hour before bedtime.   

“Getting seven to eight hours of good quality sleep is one of the best ways to recover from a bad day,” says Dr. Drerup.

A good night’s sleep will help put it all in perspective. And you can start fresh the next day.

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Stay on the move for good health

Tips on good health was what a Pauls Valley crowd was hoping to hear while gathering around moments after a presentation by a fitness expert.

A blend of fun-natured humor, combined with some very serious real life advice on the need for good nutrition and exercise, was what Ogie Shaw offered when speaking to the PV Rotary Club.

Shaw’s bio shows he has the goods at the highest level, including his health programs once used by the Portland Trailblazers in the NBA and the Seattle Seahawks in the NFL.

Today Shaw works with health and fitness professionals and is president of a fitness and wellness group in Oregon.

“How many of you get the exercise you need,” Shaw asked as only a smattering of the local Rotarians raised their hands up into the air.

The first reason for not getting it done is time. A close second is motivation.

“It’s an attitude problem. Fitness trainers have trouble with that attitude of I don’t have the time or the motivation to exercise,” he said during an entertaining but insightful talk from a man who knows what’s he’s talking about.

Shaw says a total of 57 percent of Americans failed basic functional movement tests decades ago, leading to the creation of the President’s Council for Physical Fitness.

Just last year the U.S. ranked 47th out of the 50 countries included in a cardiovascular testing program.

One big tip in turning that around is to simply move more.

“We’re spending more on health care and fitness, yet we have the most unhealthy, unfit people in the world,” Shaw said.

“Guilt burns zero calories. You need to move.

“If it’s fun you’re not doing it right. You need to separate fitness from fun. You must work every muscle in the body.

“You need to work out every day. It’s easier to work out every day. Folks, if you’re negotiating about whether or not to work out then you’ve lost it. It’s called accountability and we don’t have it.”

His advice as to when to work out – get in a few minutes first thing in the morning. That’s because Shaw says it’s typically the one time of the day when you can control a busy schedule.

“In my house exercise is a daily health habit. You need to exercising five minutes a day, seven days a week, first thing in the morning.”

As for how we eat, his message is to focus on nutritional value and not health gadgets.

“The quickest way to gain weight is to diet,” he said.

“We’re the most confused nation in the world when it comes to nutrition. You can’t live off vitamins alone. At some point you’re going to have to choose good food.”

An example is the most nutritious fruit. The answer here is cantaloupe.

Then there’s lettuce. Spinach is much more nutritional than the romaine or iceberg variety.

“This is the stuff we should have been teaching you when you were in grade school.”

Learning more about living a healthier lifestyle is also important so it can be passed down to children and the next generation.

“You are the best personal trainer that they need,” Shaw said about children.

“We need to get in shape. Kids need to get in shape and schools don’t have the money.

“Nothing changes your life or financial picture more than losing your health.”

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Your Good Health: Woman, 69, suffers severe pain, but is it PMR?

Dear Dr. Roach: I am a 69-year-old woman who has been recently diagnosed with polymyalgia rheumatica after three months of severe pain and no diagnosis. I am now on prednisone, with some pain relief. It is worse in the evening, and I take the prednisone before bed. There is a great deal of pain and some weakness in all my joints, but particularly in my shoulders and arms. There also is some random aching and pain in various parts of my body all day. What is this condition and its prognosis? Will I ever have a permanent remission?


“Polymyalgia” means “pain in many muscles;” “rheumatica” dates from the theory of humours, from a Greek word meaning “flow,” thought to be the reason people developed joint pains.

The disease polymyalgia rheumatica occurs in about one person per 1,000 per year, almost exclusively in people over 50, and is most common in people in their 70s.

You have some classic features, and some that are not typical. The location of the worst pain being in the upper arms, shoulder and neck is classic, and it usually begins suddenly.

However, nearly everybody I have seen with PMR has had symptoms that are worse in the morning, and one source I read stated that people who lack morning stiffness do not have PMR. Stiffness is worse after any period of inactivity.

The other reason I am not certain of the diagnosis is your response to prednisone. Patients with this disorder start feeling themselves getting back to normal within a few days, and are nearly 100 per cent better within a few weeks.

A laboratory test, the erythrocyte sedimentation rate (“sed rate,” or ESR), is almost universally very abnormal. There are other rheumatic diseases that I trust your doctors are considering.

If this is PMR, the prognosis is good, and the disease will run its course over time. Most people are on prednisone for a year or two. There are newer treatments being looked at to spare the bad effects of even moderate-dose steroids for that time.

Dear Dr. Roach: At age six, I had a tonsillectomy. A few months afterward, I developed paralytic polio that included bulbar involvement, and I was in an iron lung. A few years later, I learned about a study that linked a higher rate of bulbar involvement in polio cases where there had been a tonsillectomy performed. Is there any truth to this? It has troubled me for decades.


Polio is a type of virus that infected nearly everybody before the vaccine was available. A small number of people (about 0.1 per cent) contracted poliomyelitis, also called “paralytic polio,” the most dangerous form of which, bulbar, involves the brainstem (the medulla oblongata, which looks a lot like a bulb). People with bulbar involvement often need respiratory support (the iron lung), but may still die due to blood pressure changes and other problems with the brainstem, which is involved with fundamental body functions.

It was recognized as early as 1910 that people with tonsillectomies may be at higher risk of developing the bulbar form of poliomyelitis. In 1950, data suggested that tonsillectomies tripled the likelihood of developing this severe form. It is now thought that tissue damage from infection or surgery allowed the virus easier access to the nerves to the brain.

At that time, children often underwent “routine” tonsillectomy. However, the tonsils are immune organs, and they are no longer routinely removed.

Now that poliovirus is almost extinguished from the Earth (only Afghanistan and Pakistan have wild cases), the important lesson is to re-evaluate why in medicine we do things, and to be sure that there are more benefits than harms.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to

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To Your Good Health: Is permanent remission from rheumatica possible?





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Your Good Health: 10 minutes into car ride, woman cannot stop yawning

Dear Dr. Roach: My husband bought a used car about two years ago, and every time I ride in his car — no matter the time of day or where we are going — about 10 minutes into the ride, I begin to yawn uncontrollably.

These are deep, shuddering yawns that border on painful. Soon thereafter, my nose begins to run, my eyes water and my throat becomes scratchy.

Allergies seem the obvious answer, but I have a lot of allergies that don’t cause yawning. The yawns are very uncomfortable. Do you have any advice, other than taking my car all the time? I will note that none of my other family members react this way.


Well, before today, I’d never heard of yawning being a sign of allergies.

Yawns are common with fatigue or poor sleep, where air quality is poor and, in at least one spectacular case I heard of, from excess nervousness.

However, the runny nose and watery eyes are very consistent with allergies. I was able to find other case reports of people having yawns as an initial symptom of allergies.

If avoiding the offending agent (i.e., whatever is in the car) isn’t possible, premedicating with an antihistamine or prescription medication may be of benefit.

Dear Dr. Roach: Do you have any information on cytochrome P450 testing for drug sensitivity?


Cytochrome P450 is a family of enzymes that are important for cell metabolism and critical for detoxifying many drugs. Everyone has a particular set of P450 enzymes, and understanding them sometimes can help determine the correct exact drug dosages.

In a few cases, people with certain P450 enzymes cannot safely take some drugs. However, the clinical usefulness of P450 testing is currently limited.

The majority of the drugs for which P450 testing is recommended are for HIV or cancer treatment. Doctors prescribing these drugs would order the appropriate testing.

I do think that this field, called pharmacogenomics, is going to become increasingly useful, and it is likely that it will be used to more precisely guide drug choices and dosages.

Dear Dr. Roach: I am a 78-year-old man in good health. This past June, my urologist gave me a test, which revealed that I was at very low risk for prostate cancer.

Since then, my numbers have gradually crept up, and the most recent test (a month ago) showed a sharp spike upward. The doctor has scheduled a prostate biopsy in two weeks.

I am thinking that I would like another blood test prior to the procedure.

Obviously, I am hoping the numbers will have at least levelled off or, hopefully, gone down. I would appreciate your thoughts on this.


You likely are talking about the PSA test or a relative. I do think confirming the test results prior to biopsy is reasonable, as there are rare lab errors, but more commonly, men can develop inflammation in the prostate, causing a “spike” in the reading.

There are several new tests that may improve the accuracy of the PSA. Perhaps the best-known is the PCA3.

Another increasingly used option is a prostate MRI, which can better define the anatomy and guide biopsy.

As I have recently written about the pain some men feel with biopsy, reducing biopsy need would be beneficial. It is not yet accepted treatment to forgo biopsy on someone with (confirmed) high PSA, but a normal MRI.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to

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