Dear Dr. Roach • I am a woman who just turned 75, and I have a chronic dry cough. I visited my pulmonary doctor, and he diagnosed bronchiectasis. There is no cure, but there are herbal products, such as Creseton. They claim to have a 90 percent cure rate, which is better than no cure at all. Can you give me any suggestions or have you heard about the herbal products? — P.N.
Answer • Bronchiectasis is an uncommon lung condition in North America. It is a reaction to previous infection with a scarring process in the small airways. It is similar to chronic obstructive pulmonary disease. It’s more common in women and certain ethnic groups, or in conjunction with conditions like cystic fibrosis or alpha-1 antitrypsin deficiency. There is no way to reverse the scarring in the lungs once it occurs, but exacerbation of the disease can be both treated and sometimes prevented with antibiotics.
I looked up Creseton, and the company reported good results from its own, unpublished study. I can’t recommend the product on the basis of what the maker reported. I would like to believe it, but if something sounds too good to be true, it might be.
Dear Dr. Roach • I recently read that many doctors and nurses have low-frequency hearing loss, resulting in a falsely elevated blood pressure measurement compared with an automated blood pressure machine. Please comment. — P.I.
Answer • Accurately measuring blood pressure is very important, and there are several concerns. For the best accuracy, the blood pressure should be taken seated, with a manual mercury device using a properly sized cuff, three times, and the average recorded (as I learned years ago: thanks, Dr. William Elliott). Only very advanced automated models, costing up to thousands of dollars, can approach the accuracy of a trained clinician.
I couldn’t find the news piece you read, but it makes some sense. Health-care providers aren’t immune to losing hearing as we get older, and hearing loss can lead to inaccuracy in blood pressure measurement. Hearing loss can mean an error of several points.
There is abundant evidence that in the vast majority of cases, home and inexpensive office machines are not as accurate as humans.
Dear Dr. Roach • There is much controversy circulating about the healthiest choices available today for butter and margarine spreads made with canola oil, coconut oil, flaxseed oil, grapeseed oil and olive oil.
There are so many choices that it is almost mind-boggling to the average consumer. I keep receiving emails from friends and relatives with articles that state margarine was developed to fatten up turkeys, and when that did not fly, it was marketed to people as a healthy substitute for butter. Yet, I read labels on products claiming much lower saturated fat than real butter contains.
Many articles forwarded to me have a product to sell, and so their claims are used push these products, whether valid or not. — M.P.
Answer • Today’s margarine is not the margarine of the 1950s. Margarines with plant sterols and stanols (sold as Benecol and Smart Balance) reduce LDL cholesterol, although it’s not clear whether they reduce the risk of heart disease. The main advice I give is to completely avoid trans-saturated fatty acids (on food labels as “trans fat”). Most food companies have received that message, and it’s easy to find high-quality margarine. The vast preponderance of the evidence is that margarines are healthier for you than butter.
That doesn’t mean you can’t have butter occasionally. We all make choices that affect our health. The harm you do from a little butter is small. Too much isn’t harmless, though.
Dr. Keith Roach is a physician at Weill Cornell Medical College and New York Presbyterian Hospital.Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters at P.O. Box 536475, Orlando, Fla. 32853-6475.
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