Seek surgery only as last resort

Dear Dr. Gott: About 10 years ago I was diagnosed as having anal fissures. I’ve been bothered by them off and on for the past 10 years, but more frequently for the last year. What should I do about this, and can it lead to colon cancer?

Dear Reader: Anal fissures are painful cracks in the delicate tissue at the bowel opening that will not lead to colon cancer. If they don’t heal with conservative management – such as creams, antibiotics and rectal lubrication – they may have to be surgically addressed. The next time you experience symptoms, see a surgeon for an opinion.

To give you related information, I am sending you a copy of my Health Report “An Informed Approach to Surgery.” 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 mention the title.

Dear Dr. Gott: I enjoy your informative column. You make my day. I am a grandma and starting to date again (lost two wonderful husbands). My question is about oral sex; he often talks of other women doing it. I am worried about this, and about getting various diseases from that. What if he decides to go out with other women who satisfy him in that way?

Dear Reader: I suggest that you open up to your date. Express your concerns and feelings. Make sure that he has not suffered from STDs or genital herpes in the past, or has a history of previous health problems.

Many women find oral sex unattractive, even if it is performed in a limited fashion as a part of foreplay. This is understandable. However, many women enjoy it.

If oral sex is an option, you need to discuss it – how far, how long and how often. You have the distinct advantage of two previous husbands, therefore you are not a neophyte. If oral sex is safe and you want to go for it, fine. If you are put off by it, say so.

Dear Dr. Gott: My question is regarding optimal cholesterol level. Per recent blood-work reports, my total cholesterol is 153 mg/dL, LDL is 103 mg/dL and HDL is 35mg/dL. I am on regular drug therapy of Crestor, Niaspan and a baby aspirin a day. My cardiologist says that I need to bring my LDL level to 70 mg/dL and wants to prescribe a new cholesterol-reducing drug to my therapy.Would you please let me know if I need to add an additional drug to my drug therapy?

Dear Reader: Ordinarily, a cholesterol level below 200 and an LDL (the “bad” cholesterol) level less than 130 are considered to be satisfactory goals in treating a cholesterol problem. However, in the presence of cardiac disease, such as a previous heart attack, many cardiologists believe that still lower levels are appropriate.

Without further information about your health status, I cannot provide any definite conclusions. I suggest that you meet with your physician for a complete discussion about your concerns.