Dear Dr. Solomon: I have varicose veins. I'd like to know if the injection treatments used for this are safe and effective. -- Mr. A.P.
Dear Mr. A.P.: Sclerotherapy is both safe and effective. The procedure involves injecting a chemical solution into the vein, killing the cells that line it. The blood is then spontaneously redirected into healthy veins. This eases the pressure on the veins whose valves have failed (which gave rise to the varicose veins), making the varicose veins less obvious.
Dear Dr. Solomon: Is a patient with diabetes permitted to drink alcohol? -- Mrs. L.M.
Dear Mrs. L.M.: The nutritional guidelines for patients with diabetes generally allow for some limited use of alcohol. However, the dietary management of diabetic patients must be tailored to the specific needs of the individual patient.
Therefore, the fact that some diabetic patients may be permitted to have some alcohol does not mean that all diabetic patients should be including alcohol as part of their diet.
The nutritional guidelines established for each patient must take into consideration such factors as the patient's body type (lean or obese), lifestyle (active or sedentary), exercise habits, age, etc.
A diabetic patient who uses alcohol because "in general" such patients are permitted to use alcohol is risking his or her health and, conceivably, life.
Dear Dr. Solomon: Would you please address the problem of adolescent wrestlers who are required by coaches to lose weight so that they can wrestle at a lower weight. How does it affect their strength and stamina? -- Ms. P.B.
Dear Ms. P.B.: Your question touches upon a particular area of concern -- the overemphasis on athletic achievement. High school and college coaches used to be rated on their ability to build character and instill good sportsmanship. Today the only item that seems to be important is their win-loss record.
Your question really has two parts: First, does weight loss in an adolescent have any adverse effects on health? And second, regardless of the health effects, does weight loss have any influence on their performance as athletes?
Wrestlers may be urged to lose weight by restricting their intake of calories and fluids. Since we have to assume that an athlete is already at an ideal weight, these restrictions can definitely be harmful to health.
The possible consequences include a tendency to become easily fatigued, a greater susceptibility to injury, and even coma. Moreover, the purpose for which the calorie and fluid restriction was instituted will not be realized since the young athlete's performance will be impaired. Even mild dehydration can lead to decreased endurance in wrestlers and other athletes.
Dr. Richard Layton, a Baltimore pediatrician who has helped many children to shed their excess pounds, believes that parents of adolescent wrestlers who have been told to lose weight would do well to speak with the coach.
Vince Lombardi, the hall-of-fame football coach, is famous for the comment that winning isn't everything, it's the only thing. I agree with the first part. But if winning has to be accomplished by risking an athlete's health, it not only isn't everything, it isn't anything.
Place a call to the doctor
Dr. Neil Solomon will answer questions from Baltimore area readers in his Tuesday column in Accent on Health
To leave a question for Dr. Solomon, call SUNDIAL, the Baltimore Sun's directory of telephone information services at 783-1800, or 268-7736 in Anne Arundel County. You must use a touch-tone phone to be connected. It is a local call and there is no charge to ask your question.
After you hear the greeting, enter category 7906 and you will be linked to an electronic mailbox, a telephone answering system. You will be asked to leave your name, phone number and a message of up to 60 seconds in length.
Dr. Solomon will review all messages left for him each week but will be able to answer only a sampling of these questions in his Tuesday column in Accent on Health .
Dr. Solomon will be unable to answer any specific questions with a personal phone call