Judy Foreman

Nationally Sindicated Fitness, Health, and Medicine Columnist

My daughter been diagnosed with gallbladder polyps. The doctor says watch them. Is that right?

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You might want to get a second opinion. That your daughter is having pain suggests she might need to have her gallbladder removed, which can often be done with minimally-invasive (laparoscopic) surgery on an outpatient basis.

The gallbladder is a pear-sized organ that lies underneath the liver, on the right side of the abdomen. It’s basically a storage facility for bile that is made in the liver. When a person eats, the stomach sends a signal to the gallbladder to release its stored bile, which mixes in the upper part of the intestine with fats and other bits of food to break them down into smaller pieces, explained Dr. David C. Brooks, director of minimally-invasive surgery at Brigham and Women’s Hospital.

Several different gallbladder problems can be easily confused. Gallstones are most commonly composed of cholesterol. They move around and block the ducts that bring bile into or out of the gallbladder. This causes pain and often occurs within an hour of eating. During an ultrasound, the radiologist may ask the patient to roll around on the table: Gallstones move around as the patient does.

Polyps are different. True polyps are growths in the gallbladder wall. They tend to occur in people in their 70s and 80s and can become cancerous, although this is rare, said Dr. William Brugge, director of gastrointestinal endoscopy at Massachusetts General Hospital. But radiologists sometimes label as a “polyp” a small chunk of cholesterol — not living tissue — that is just lightly embedded in the gallbladder wall. These so-called polyps are benign and don’t usually cause complications or problems.

What can I do to avoid bothersome electric shocks?

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No, it’s not your dry hair, it’s the dry weather, says Walter H.G. Lewin, a physics professor at the Massachusetts Institute of Technology who demonstrates this static electricity phenomenon every year in class.

What happens as you move around a room or sit on a chair, he says, is that you often rub against something, which causes you to become electrically charged. “If the air is humid, this charge leaks off you very rapidly,” he says. “If the air is dry, that does not happen.” You may also hear crackling sounds when you comb your hair in the winter. These are sparks flying from your hair to the comb and from hair to hair.

If you are charged, you get a shock when you touch a metal door or your car. Walking barefoot will prevent these shocks because you keep discharging all the time through your feet. (When you wear shoes, the soles prevent this discharge from occurring.)

To avoid shocks when the air is dry, try touching the doorknob with a wooden pencil in your hand before you turn it. This will discharge the static electricity in your body –the current will be much lower than if you touch the doorknob with your bare hands.

For some truly shocking fun, Lewin suggests the following experiment. (Yes, you CAN try this at home.) Stand in front of a mirror in a darkened room, wearing a nylon shirt. Take the shirt off. “You will see light sparks in the mirror. Your whole shirt may glow. I have done it many times, ” says Lewin. But do it now because this doesn’t work in the summer.

Discuss the difference between arthritis and tendonitis?

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Arthritis is an inflammation in a joint, while tendonitis is inflammation of a tendon, the gristle-like cable that links muscle and bone. It can get confusing because a tendon is one component of the complex structure of a joint, though it’s not inside the joint itself. Overuse or repetitive stress – like lots of tennis or jogging – can lead to either arthritis, tendonitis or both, depending on where the damage occurs.

Tendons are often, though not always, covered with a coating, or sheath, called the synovium, which contains cells and blood vessels, says Dr. Lee Simon, a rheumatologist at Beth Israel Deaconess Medical Center. Between the sheath and the tendon is a layer of lubricating fluid, which protects the tendon as it moves. If the sheath becomes inflamed, that’s tendonitis, aka “tennis elbow” if it’s your elbow. Sometimes, taking ibuprofen or similar drugs is enough to calm this inflammation.

Arthritis is inflammation inside the joint itself. It comes in roughly 100 different forms. Osteoarthritis, sometimes called “wear and tear” arthritis, affects 21 million Americans. The cartilage on the surface of bones inside a joint gets worn away. As the body tries to heal this damage, chronic, low-grade inflammation sets in, causing pain. Rheumatoid arthritis, which strikes 2.1 millions, is an auto-immune disease in which the immune system mistakenly attacks the synovium inside joints. In some cases, ibuprofen and similar drugs help with this also.

As a practical matter, then, your initial treatment – ibuprofen-type drugs – will probably be the same, whether you have tendonitis or arthritis, notes Dr. David Felson, a rheumatologist at the Boston University School of Medicine. But knowing which you’ve got does become important if you need physical therapy because the exercises and rehabilitation programs are different.

Is antibiotics in the food we eat a risk factor?

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Yes, there’s a risk, but perhaps not exactly in the way you think.

Farmers who raise cattle, chicken, turkeys and pigs often give the animals antibiotics to help them gain more weight, perhaps because killing bacteria in the animals’ stomachs may increase absorption of food.

The danger to those of us higher up the food chain is not that we will ingest antibiotics directly from the meat we eat. We don’t – those antibiotics have long since passed through the animals’ systems. It’s more subtle than that.

Giving animals antibiotics – usually penicillin and tetracycline for growth promotion allows some bacteria mutate to become resistant to these antibiotics. Bacteria also trade genes like kids trade baseball cards, says Stuart B. Levy, professor of medicine, molecular biology and microbiology at the Tufts University School of Medicine. This means that bacteria that have acquired the ability to resist antibiotics can pass on this trait to other bacteria that can be harmful to people.

When a person eats meat from animals given antibiotics, the bacteria in the meat may be antibiotic resistant, which means that when that person needs antibiotics for a serious infection, the antibiotics may not work. Other antibiotics may help, but in general, the problem of antibiotic resistance is growing.

Because of all this, the European Union has banned the use of antibiotics to produce weight gain in animals. US Food and Drug Administration spokesman Mike Herndon said that the agency “is not considering banning antibiotics in animal feed, but we’re always looking at antibiotics on an individual basis.”

In the meantime, you can protect yourself by cooking meat thoroughly. This will kill the bacteria, including the bugs that have become resistant to antibiotics. You should also take care that you prepare meat on separate surfaces from uncooked fruits and vegetables so that the meat juices do not contaminate lettuce or any other food you will eat raw. Following these precautions will not only help you but will reduce the reservoir of resistant bacteria for the rest of us. Bon appetit!

For more information, you can read, “The Antibiotic Paradox” by Dr. Stuart Levy (Perseus Books, 2002) or visit www.apua.org, the website of the Alliance for the Prudent Use of Antibiotics.

Is cracking your knuckles really bad for you?

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No. In fact, it’s not dangerous at all, says Dr. Jonathan Kay, clinical director of the rheumatology unit at Massachusetts General Hospital.

“The cracking sound you hear when you pull on your fingers is caused by the release of negative pressure within the joint,” he says. Technically, this is called cavitation. Inside every joint in the body, a gooey substance called synovial fluid coats the surfaces of cartilage to protect them. Just as two discs coated with mineral oil stick together and can only be pulled apart with a bit of force, so it is inside the joint. When you pull, you break the vacuum seal created by the synovial fluid and the breaking of that seal causes the popping sound – from the bursting of bubbles of gases dissolved in the fluid.

Curiously, it takes about 20 minutes for the seal to re-establish itself. So crack your knuckles all you want. You might stretch a few ligaments, but you will not give yourself arthritis. But it’ll be no fun unless you wait 20 minutes between cracks.

Can polio recur if you had it as a child?

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Recurrence isn’t a problem, but a different condition, Post Polio Syndrome, or PPS, is.

Unlike the herpes virus, the polio virus does not hide out in the body and become re-activated years later. But an estimated 25 to 50 percent of people who once had polio come down with Post Polio Syndrome decades later, according to the website of the National Institute of Neurological Disorders and Stroke. (Warning: This website, www.ninds.nih.gov , has a pretty gloomy take on treatments for PPS. It’s true, as the site says, that there is no magic bullet for PPS, but helpful treatments are available.)

What happens after a bout of polio is that nerves that survive the viral attack in essence try extra hard to compensate for nerve function that is lost, growing extra sprouts, or axons, that connect with muscles, telling them to contract, says Dr. Julie Silver, a post-polio specialist who runs the International Rehabilitation Center for Polio, part of the Spaulding Rehabilitation Hospital branch in Framingham. (www.polioclinic.org) After many years of normal functioning, the nerves with excessive sprouting may not be able to keep up with the increased metabolic demands and may begin to deteriorate or die.

The hallmark of PPS is new weakness that is not attributable to any other cause in people who had polio decades earlier, she notes. Estimates vary, but there are approximately 1 million polio survivors in the US.

With PPS, people don’t wind up as paralyzed as they were with polio. But, unlike with polio, there is little hope of recovery because the problem is slowly progressing nerve damage, not getting over an acute infection. (There have been no new cases of polio in the US since 1979; worldwide, despite massive vaccination efforts, polio has not yet been eradicated.)

Even in PPS patients who had bulbar polio, which affects the breathing and swallowing muscles, treatment can be quite effective, Silver says: “Even one session with a speech therapist can help.”

What is the best position to sleep, given Back Pain?

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You’re right, but other positions help some people, too, says Dr. Carol Hartigan, a physiatrist at the Spine Center at New England Baptist Hospital. (Physiatrists are physicians who treat neuromuscular and neurological problems.)

You don’t say what your back problem is, but the most common causes of lower back pain are sprained ligaments, strained muscles and tears in the outer layer of the spongy discs that lie between vertebrae.

To get a good night’s sleep with a bad back, try lying on your back with a pillow under the knees to take the pressure off the lower back. Or sleep on your side with a body pillow that you can throw your upper arm as well as your upper leg over. If you’re a stomach sleeper, try putting a pillow under your hips to stretch the back out a little.

Many people believe a firm bed provides more back support than a soft one. If your back gets really bad, try sleeping on a futon or pile of blankets on the floor.

The real key, though, is to stay in shape, which means exercising to keep muscles strong. Do gentle stretches as well. The “child pose” from yoga is excellent, Hartigan notes. Lie face down with your chest resting on your thighs and your arms, palms up, stretched back along your sides so that your fingers rest near your feet.

You can also apply heat before you exercise and ice afterwards and when your back flares up. (If you apply heat at night or during an acute episode of low back pain, the blood drawn to the area may pool and make inflammation worse.) Anti-inflammatory drugs like ibuprofen may also help.

If your back problems do not go away in two or three weeks, if you develop weakness in your legs, or if you have trouble urinating or moving your bowels, see a doctor to rule out serious problems.

Can you exercise with a bad cold?

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Ah, frustratingly enough, it all depends on who you ask.

Some fitness gurus, like Dr. Joshua S. Fink, who is both a physician and a personal trainer who runs training centers called Prescriptions for Fitness, Inc. in Ridgefield, CT and Chappaqua, N.Y. said the simple answer is that if you’re sick, don’t exercise.

“You can use four letters, S-T-O-P,” he said. If you exercise while your viral infection is at its worst, which is from the 24 hours before onset of symptoms until three days later, “you decrease your immunity to fight a cold.” Immune cells called natural killer cells “decline if you exercise while you’re ill with a cold,” he said. Don’t go back to training until you truly feel better. “What we’re looking at here is being out of commission for five to seven days. There are 365 days in the year….Learn when to chill out rather than thinking, ‘No guts, no glory.’ ”

Once you resume training, he said, follow the “50 percent rule.” Do half your usual exercise for half the usual time – in other words, if you usually do 30 minutes of exercise at a heart rate of 130 beats per minute, work out for 15 minutes at 75 beats per minute. Then gradually build up to normal.

Exercise physiologist Roger Fielding of the Sargent College of Health and Rehabilitative Sciences at Boston University took a slightly different view. You have to use your own judgment, he said, although you definitely should not exercise if you have a fever. If your cold symptoms are localized to your upper respiratory tract and you have no body aches, exercise if you feel like it. “I am nursing a cold right now,” he said. “I ran yesterday outside and I am going to run today.”

In a study several years ago published by the American College of Sports Medicine, researchers gathered 50 college students, divided them into two groups – one that did supervised exercise and one that did not – and then intentionally gave them all colds. There were no significant differences on a number of measures, including “mucous weight measurement” and symptom severity scores, the study found.

My test showed I have osteopenia, what is it?

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Osteopenia is not a disease but a warning sign that you have lower than normal bone density, which can raise the risk of fractures somewhat and develop over time into osteoporosis, says Dr. Michael F. Holick, director of the bone health clinic at Boston University Medical Center.

Osteoporosis is more serious bone loss and is even more likely to lead to fractures. According to the National Osteoporosis Foundation, osteoporosis affects 10 million Americans, most of them older women; an additional 34 million people are at risk of osteoporosis because they already have low bone density, or osteopenia.

The T-score is a comparison of your bone density with the peak bone density of a person of the same sex and race at age 30. A normal T score is arbitrarily set at zero, plus or minus one standard deviation. In other words, any T-score between minus 1 and above is fine. Your score of minus 1.59 is slightly outside this range. To meet the definition of genuine osteoporosis, your T-score would have to be minus 2.5

The Z-score is not very useful. It’s a measure of your bone density compared to other people of the same sex and age. Since you are 60, your Z score of minus 0.4 means that you have slightly lower bone density than other women your age.

In general, whether a person needs to be treated for osteopenia depends on how severe it is and other factors such as whether he or she has had broken bones or taken steroid drugs (which can harm bone tissue). If you need prescription drugs, the choices are usually those used for osteoporosis. These include Fosamax, Actonel, estrogens such as Premarin, estrogen-progestin combinations such as FemHrt or Prempro or a “designer” estrogen called Evista. (Another medication called Forteo, parathyroid hormone (1-34), is only used for outright osteoporosis and even then, only in people who have not responded to other drugs.)

Even if your doctors says you don’t need prescription drugs, you should take at least 1200 milligrams of calcium a day (like TUMS, Caltrate, CitriCal or OsCal) and at least 400 to 800 International Units of vitamin D, says Holick of BU. Weight-bearing exercise is critical, too- you should walk at least three to five miles a week. You should also get a repeat bone density test in a couple of years.

For more information, go to the National Osteoporosis Foundation (www.nof.org)

How do you tell if you have a cold or the flu?

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It’s not always easy to tell, but there are clues, according to the American Academy of Otolaryngology.

Flu, or influenza: The hallmarks of this viral illness are a fever of 102 to 104 degrees Fahrenheit that lasts for three or four days. Nasal discharge is usually thick and whitish or thin and watery. You will probably have a headache and a cough and most likely, muscle aches. You may or may not have a sore throat, nasal congestion and sneezing. You usually do not have facial pain or pressure, itchy eyes or pain in your upper teeth. The misery usually lasts for fewer than 10 days, but fatigue may last longer.

Cold: With this viral illness, you are not as sick. You may or may not have a short-lasting fever, a headache, facial pain or pressure and pain in your upper teeth. You will have a sore throat, cough, nasal congestion, sneezing and some fatigue or weakness. Nasal discharge will be thick and whitish or thin and watery. You won’t have itchy eyes. The illness usually lasts fewer than 10 days.

Allergies: These are triggered not by viruses, but by allergens like dust, mold and pollen in the environment. You won’t have a fever or pain in your upper teeth. But you may have facial pain or pressure and you may have a headache, cough, nasal congestion, fatigue or weakness, and a sore throat. Nasal discharge will be clear, thin and watery. You will have itchy eyes and sneezing. The duration of allergies varies.

Sinusitis: This is an inflammation in the sinuses that can be caused by allergens, viruses or bacteria. You will have facial pain or pressure, a thick, yellow-green nasal discharge and sometimes, a fever. You probably won’t have itchy eyes, but you probably will have a headache and nasal congestion. You may or may not have pain in your upper teeth, bad breath, a cough and sore throat. You may have fatigue or weakness and – this is an important clue – your misery will last more than 10 days.

If the nasal discharge is yellow-green for more than six days, if you’re getting markedly worse or a fever develops later in the illness, you should call a doctor, advises Dr. James Cooley, chief of pediatrics at Wellesley office of Harvard Vanguard Medical Associates. There are anti-viral medications for the flu, including Amantadine, Rimantadine, Zanamivir or Oseltamivir. You should not take antibiotics for a cold or the flu, though these illnesses can develop into bacterial infections, for which antibiotics are appropriate.