Q: Medical spas are everywhere now. How safe are they?
A: Medical spas aren't well-regulated, and although some are run by dermatologists and plastic surgeons, others may be operated by people with varying amounts of training and supervision. The industry is lucrative, and spas may be owned by businesspeople—not doctors—who hire an M.D. to supervise. Someone who's in business to make money may not have the patient's best interest in mind. So if you're thinking about visiting a medical spa, you'll want to beware. Investigate the technicians' training and background: Is there a certified dermatologist or plastic surgeon on site? Patients should also have a clear understanding of what the treatment can do, how long it will last, and of possible complications. Most people don't get hurt at these spas, but their expectations sometimes aren't met and treatments are expensive. —Dr. Barbara R. Reed, Dermatology; Presbyterian/St. Luke's Medical Center, Rose Medical Center
Q: Is there a cure for women with low libido?
A: There is no magic pill for women with low desire. There are so many components—even relatively mundane things like day-to-day stress and a woman's perception of her relationship with her partner may be part of the issue. There has been some preliminary research on the benefit of testosterone patches on the libido of postmenopausal women, but the FDA wants more safety data before recommending this treatment. Some doctors do prescribe off-label testosterone to women, but I do not. If your doctor does prescribe testosterone, you would need very close monitoring—the side effects of too high a dose can range from acne to a deepening of the voice. If you're experiencing a lack of desire, you'll want to decrease your stress, ensure that you're getting enough sleep, and set aside time in your schedule to be intimate with your partner. The next step might be to seek a psychologist who specializes in issues of sexuality. —Dr. Kelly Moore, Obstetrics and Gynecology; Rose Medical Center
Q: I keep hearing about sepsis on the news. How do I know if that cut I got hiking is infected, and how would I know if I'm septic?
A: Infected wounds that cause sepsis are hot, red, and angry-looking. The biggest thing is to recognize if the pain is out of proportion to the size of the wound. Is there spreading or streaking redness? Is the wound warm to the touch? Is there a discharge with puss? These infections can just take off: Within a matter of hours this bacteria and released toxin can destroy large areas of tissue. The antibiotics that we historically used to treat infections like this are not as effective anymore. Over the past five years there has been a growing incidence of MRSA infections—often called staph infections—that are immune to common antibiotics and can be fatal. We used to think these types of infections were hospital-acquired, but we now know you can get them anywhere. As a result, we have to be more prudent with antibiotics and use them in the right situations. The majority of times, if caught early, these infections can be treated before they lead to sepsis. So be aware. Mark the border of an angry wound so that you can easily see if the redness and swelling are expanding rapidly over time. If the wound is not getting better, seek help immediately. —Dr. David Mellman, Internal Medicine; Rose Medical Center
Q: I've heard rumors that last year's flu vaccine didn't work. What's your take on the efficacy of flu vaccinations?
A: As a general rule, they're fairly effective—I'd say 75 to 80 percent effective. In the United States we have about 36,000 deaths a year from the flu, so it's important to get vaccinated. There's an initiative in place that by 2010 the federal government wants 90 percent of Americans to be vaccinated, but we're way off.
I have no objections to giving the flu vaccine to everyone, but it's most important for those 60 and above, for people with compromised immunity, like those with HIV, and for kids. I generally use the injected vaccine, which has a deactivated form of the virus. The other kind is the nasal spray vaccine, which has an active, live version. With the deactivated version, the body takes it in and uses it as a stimulus to prevent the reoccurrence of influenza. You can still get the flu, even if you have had the vaccine—but it'll help decrease the symptoms you'll experience. —Dr. Kenneth S. Greenberg, Infectious Disease; Rose Medical Center
Q: I hear my Boulder friends talking about dietary "cleanses" all the time. Do they have any health benefits?
A: Colon cleansing is promoted for improving overall health, reducing weight and fatigue, toxin removal, and to alleviate constipation and bloating. Of course, the colon and liver naturally remove toxins from the body, but people often try to "help" their systems along using these cleanses. The best way to deal with reducing toxins in the intestines is to reduce intake by eating organic food, increase fiber and water intake to flush your system, exercise to promote intestinal motility, and use natural, antioxidant-rich foods. Reducing processed foods and foods that may contain chemicals or preservatives may also be beneficial. There is some evidence that toxins irritate the lining of the intestines and colon, and that reducing those irritants can help avoid disease in the long term.
If you change your diet and still experience intestinal symptoms such as bloating or constipation, and feel heavy or fatigued, then speak with your doctor. These symptoms could be a sign of a more serious health concern such as thyroid disease, gluten or other food allergy, or colon cancer. —Dr. Jonathan D. Zonca, Family Medicine; Rose Medical Center