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To Your Good Health

Dr. Keith Roach

DEAR DR. ROACH: I know drinking a bottle of wine isn’t good for me, but is it really that bad? I’m a 74-year-old female in excellent health who stays active and enjoys relaxing with wine—before, during and after dinner. I seriously want to know if I’m really harming myself with this habit. ~ N.R.

ANSWER: A bottle of wine is indeed more than is recommended daily. For women, the recommendation is one glass of wine with meals. A bottle of wine contains five glasses. This amount of alcohol is thought to increase overall risk of death by about 30 percent, mostly from accidents, kidney and liver disease and congestive heart failure. There is fairly strong evidence that this much alcohol also increases risk of developing dementia. Alcohol may have a greater effect on older women, because at age 74, your liver probably does not work as well as it did when you were 20.

Put another way, your current risk of death due to the alcohol is closer to that of an 80-year-old than that of a 74-year-old, roughly speaking. Cutting down on alcohol now stops further damage and allows your body to heal itself, to some extent.

I hope I have convinced you that from your health standpoint, five glasses of wine is far too much, and I would really encourage you to stay below two glasses of wine a day. 

DEAR DR. ROACH: You have mentioned diseases of the blood marrow in the column before, but what does the bone marrow actually do? ~ T.S.B.

ANSWER: The main job of the bone marrow is to produce the different blood cells: red blood cells to carry oxygen; white blood cells to fight infection and cancers; and platelets to stop bleeding. Diseases of the bone marrow can cause problems by making something abnormal (such as leukemia cells), but also by failing at its job and not making what it is supposed to. Low red cell counts lead to anemia; low white cell counts increase risk of infection; and low platelet counts contribute to abnormal bleeding.

Bone marrow diseases sometimes can be treated directly, but often treatment involves replacing blood products, and possibly using growth factors to make the bone marrow work better.

DEAR DR. ROACH: My 22-year-old daughter was diagnosed with overactive bladder. She tried medications, but they made her sick. She was given a prescription for a physical therapist to work with her for her condition. Unfortunately, she has hit dead ends. How can she find a physical therapist to work with her? ~ A.F.

ANSWER: Physical therapists, like most other health care professionals, have individual skill sets. Pelvic-floor physical therapy requires a level of expertise that not all physical therapists have. I suspect she may have just been calling physical therapist offices near her and not finding a therapist with that expertise. A quick Internet search found a good number of specially trained therapists in the area where she lives.

There are many online reviews of physical therapists, just as there are reviews of doctors and dentists. They have some value, but I would be cautious about both overenthusiastic and overly negative reviews.

DEAR DR. ROACH: I have a relative with cancer who is about to begin multiple therapeutic interventions. My friends tell me that all cancer treatments are toxic and kill people instead of curing them, and that I should tell my relative to look into other forms of treatment. What do you suggest I do? ~ K.C.

ANSWER: There are hundreds of different types of cancer, and they vary widely in their capacity to grow and damage the individual, and in their response to treatment. For decades, this has meant mostly surgery, chemotherapy and radiation, but now includes newer treatments, including immune therapy. While not all cancers are curable in everybody, every year brings sometimes incremental, sometimes dramatic improvements in life expectancy for individual cancers. Some cancers that were rapidly fatal even a few years ago are now curable in most cases. Getting the right diagnosis quickly and getting to an expert in treating that cancer are critical to having the best chance of a good outcome.

Treating some cancers remains difficult, and in many cases the treatments have significant side effects. Surgery scars may impair function, and chemotherapy can cause severe symptoms and may permanently affect body systems, as can radiation. It can be very hard on a family member observing these treatments, and if his or her loved one nevertheless succumbs eventually to the cancer, it is understandable to think the suffering the person went through was in vain.

So, while I understand where your friends may be coming from, their well-meaning advice, based on bad experiences possibly long ago, may cause your relative with cancer to delay potentially lifesaving treatments available now. A study published in July 2018 showed that people who use alternative medical treatments for cancer are less likely to be cured and have a shorter life expectancy.

My advice is that you encourage your relative to find the most expert cancer treatment available. It’s up to your relative to accept the recommendations of the expert, but delaying the best available treatment in order to consider unproven therapies is likely to result in harm.

DEAR DR. ROACH: I have had the same problem forever: I don’t understand why buttermilk coffee creamer seems to get outdated faster than regular creamer. Does the butter in it have anything to do with this? ~ C.H.

ANSWER: Buttermilk doesn’t have butter in it. It was so named because it was originally made with what was left after separating butter from the unhomogenized cream that had been allowed to ferment with airborne bacteria, making it slightly acidic. Modern cultured buttermilk is made from pasteurized, homogenized milk, usually 1% to 2% fat, and inoculated with healthy bacteria, which makes lactic acid from the sugars in the milk. This acid makes buttermilk resistant to the unhealthy bacteria that causes spoilage. It also causes a slight sour taste, which some people like and others don’t.

Commercial heavy cream, and coffee creamers made from heavy cream, have a very long shelf life largely because they are pasteurized at ultra-high temperatures, so they last even longer than buttermilk. The high fat content also retards bacteria growth.

Both buttermilk-based and cream-based creamers will stay good longer than their expiration date. Your nose is very good for telling when it has gone bad.

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

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