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The Spokesman-Review Newspaper
Spokane, Washington  Est. May 19, 1883

Stronger muscles may stabilize joints



 (The Spokesman-Review)
Peter Gott United Media

Dear Dr. Gott: I am a woman, 74, with knees tend to go out of joint. I’ve had the problem for about five years, and it’s getting worse, especially when I walk up stairs. Now my shoulders are also involved. I don’t want surgery. What can I do to correct the problem?

Dear Reader: Your first stop should be the office of an orthopedic surgeon, a specialist in bone and joint disorders. If, as you claim, your knee joints — and now your shoulders — are dislocating, the situation may well worsen in the future if untreated. This could have profound effects on your quality of life.

The orthopedist will examine you and probably order imaging studies to pinpoint the problem. Then, with additional information in hand, he can advise you about treatment that should not, at this stage, include surgery.

Unless I miss my guess, he will urge you to undergo an intensive program of physical therapy, which may well solve the problem by strengthening your leg and shoulder muscles, at the same time maintaining a full range of joint motion. Ask your primary care physician to authorize a referral to the specialist.

Dear Dr. Gott: I’m a male in his 50s who has developed an intermittent uncontrollable rectal discharge that varies from barely being felt to soiling my underwear. This is usually accompanied by intense itching. Please guide me.

Dear Reader: Fecal incontinence is a troublesome and embarrassing problem that you should address with your family physician. Although you could be leaking pus from your anus (indicating infection), you are more likely to be expelling tiny quantities of liquid stool that irritates the sensitive skin around your anus.

Such an event can result from poor sphincter control, hemorrhoids, an unwillingness to move your bowels when appropriate, or simple distractions we all experience from time to time when we pass gas or focus on other priorities. For example, when distracted, elderly adults may not pay enough attention to rectal stimulation, resulting in tiny amounts of rectal leakage.

Your doctor will certainly question and examine you. In addition, he may choose to refer you to a colorectal specialist who will perform certain tests to identify the cause of your incontinence.

You are not a 90-year-old patient with dementia who soils himself involuntarily. At your age, you need answers and treatment to prevent embarrassing “lapses.” Check with your doctor.

To give you related information, I am sending you a copy of my Health Report “Constipation and Diarrhea.” Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.