Dr. Sadia S. Khan, MD

Cataracts occur not just in older people, but can also occur in people as early as their 40s. An optometrist that can dilate your pupils can evaluate for cataracts. If positive for cataracts, then ask your PCP for a referral to an ophthalmologist for further assessment and treatment.

Thyroidectomy is partial or complete surgical removal of the thyroid gland. The thyroid gland sits at the base of your neck upfront. The thyroid gland regulates whole body metabolism. Hyperthyroidism refers to the condition when the thyroid gland is overactive. An overactive thyroid gland is initially controlled with medications, but many patients do not respond or lose the response to medications so it becomes necessary to remove the thyroid gland. A thyroidectomy (surgical removal) is one way; another way is to consume radioactive iodine (a chemical that is only absorbed the thyroid) to selectively destroy the thyroid gland. Regardless of how the thyroid gland is inactivated, patients will need to be on life-long thyroid hormone supplementation.

By far, the most common type of liver disease I encounter is fatty liver. Fatty liver is inflammation of the liver due to buildup of fat deposits in the liver due to overweight conditions like obesity. Cirrhosis is the other type of liver disease I encounter frequently: cirrhosis is a chronic disease of the liver that impairs the function of the liver and gets worse over time. A lot of different causes lead to cirrhosis, such as fatty liver, alcoholism, or chronic hepatitis B or C infection. The most common types of cirrhosis I see are actually the end result of fatty liver or due to alcoholism.

Allergies to a particular substance are often first suspected based on observations that exposure to the substance correlates with allergy symptoms. Withdrawing the substance would relieve the symptoms and
re-introducing the substance provokes the symptoms again. To get the allergy more definitely diagnosed, consider allergen testing (often done through pricking the skin with different allergens to look for a response) and looking for antibodies against a substance in the blood. These tests are generally done by a specialist known as an allergist or immunologist.

Smoking does increase risk for a chronic cough. Smoking also increases the risk for more serious conditions that can cause a persistent cough, like cancer. I would get chest imaging (for example, X-rays, CAT scan) to start investigating.

Urinary tract infection is not an emergency in and of itself. Any infection can become an emergency if you develop signs suggestive of sepsis (which includes fevers greater than 101 F, rapid heart rate, breathing rapidly and/or your blood pressure dropping). In case of possible sepsis, go to the emergency room.

Nausea, with and without vomiting, are pretty common in migraines. Other symptoms of migraine, other than the headache, include sensitivity to light (photophobia) and sensitivity to noise (phonophobia). Some migraines are preceded or accompanied by an aura (symptoms like change in vision, numbness or tingling in one side of the body for example), which resolve with the end of the migraine.

Hemophilia is a bleeding disorder caused by a low level of proteins in the blood which are called clotting factors; clotting factors are important because they help stop bleeding in case of injury, even in cases of minor injury. Patient with hemophilia do not have enough of these clotting factors; so they are more likely to bleed and bruise easily even with minor trauma (like bumping against an object or with a cut on the skin), and it takes longer for bleeding to stop. Easy bruising and frequent nose bleeds can be symptoms of a hemophilia. There are different types of hemophilia. Many case of hemophilia are genetic and run in families, particularly affecting the males of the family.

End stage renal disease can lead to several problems, all of which are related to the fact that the kidneys can no longer carry out their job. Dialysis helps to manage some of these problems, but not all of them. For example, patients can have problems with fluid retention, which leads to fluid overload in different areas of the body like the legs and lungs, leading to leg swelling and shortness of breath, respectively. Patients with end stage renal disease can have high blood pressure that is much harder to control with medications. Patients may have anemia (condition of low red blood), which leads to symptoms like fatigue, shortness of breath or chest pain; patients with anemia may require injections to help stimulate production of red blood. Patients may also suffer from bone mineral defects, leading to weak bones and higher risk of fractures.

I assume you are referring to donating whole blood. You will not be eligible to donate whole blood if you have anemia. Anemia means a condition in which you have a below normal amount of red blood. Hemoglobin is a measure of the amount of red blood you have. Cut offs for diagnosing anemia are having a hemoglobin less than 12.0 g/dL (for women) or less than 13.0 g/dL (for men). In fact, according to American Red Cross eligibility criteria, you can donate whole blood only if your hemoglobin is at least 12.5 g/dL (for a woman) or at least 13.0 g/dL (for a man).

Hepatitis B can be spread through sexual contact, sharing injection needles, accidental needle sticks, blood transfusions, organ transplant or from mother to baby while giving birth.

Sadia Khan, MD