Doc, I've got a question

If you truly have chronic heartburn, antacids are probably not the best way to treat this. Antacids do not prevent heartburn but rather are used for the intermittent treatment of mild symptoms (mild heartburn occurring less than once a week, in general). Antacids neutralize stomach acid. They provide relief in about five minutes, but the effects only last about 30-60 minutes; thus the need to continue to repeat the dosing of an antacid if you have chronic heartburn. Chronic heartburn and gastroesophageal reflux disease (GERD) would more appropriately be treated with either a histamine-2 receptor antagonist, an example being ranitidine (Zantac), or a proton-pump inhibitor, an example being omeprazole (Prilosec). You should see you doctor if you do have chronic heartburn and antacids aren’t cutting it. It’s important to see you doctor if you have chronic heartburn because he/she can determine your risk factors for developing possible complications from chronic heartburn and may recommend other studies to look into your esophagus, stomach and upper small intestine with a scope.

What is fungal pneumonia? What does it involve?

Fungal pneumonia is a specific type of pneumonia that is caused by differing species of fungus. Fungal pneumonia is much less common compared to viral or bacterial pneumonia. Fungal pneumonia most often occurs in individuals who have a depressed immune system, including but not limited to those with a lung transplant, HIV-infected patients, kidney transplant patients, those with blood cancers, those on chronic corticosteroid therapy, and those with diabetes.

In individuals with a normal immune system, the immune system usually does a good job keeping fungus at bay so that it doesn’t cause infection. In those with a depressed immune system, the fungus can grow out of control and develop into an infection that can lead to pneumonia and other types of infections. Fungal pneumonias are sometimes difficult to diagnose but can be treated with antifungal medications. However, because fungal infections most often occur in those with a depressed immune system, these infections can be very serious and difficult to treat.

How often do children need their eyes checked? Annually? Every two years?

According to the American Academy of Pediatrics, an exam to determine the clarity of a child’s vision should be performed starting at age 3, and then continuing annually until age 6, and then every other year until age 12, and once again at age 15 in all children.

Risk assessment as to whether or not there may be a problem with the eyes or vision should also occur at every childhood wellness check beginning with the newborn exam. If there is a concern for a vision problem, checking the vision at any time is always appropriate. In addition, newborns and infants should be assessed for having an equal red reflex when examining both eyes with a light to evaluate for possible cataracts or problems with the retina (the back of the eye, where receptors convert light into vision). Also, newborns and infants should be evaluated for eye misalignment, known as strabismus, which can cause vision loss if not detected early.

What’s more beneficial? Walking in the morning? Or walking at night?

According to the American Heart Association, there is no one right time of the day for walking. Do whatever works best for your schedule and daily rhythm! Some people are “morning people” and others are “night owls.” The important thing with aerobic exercise such as walking is to stretch your muscles well before and after exercise. This can help prevent muscle cramping and injury. It’s also important to drink lots of water to stay well-hydrated. Walking qualifies as moderate-intensity aerobic exercise, and the American Heart Association recommends at least 30 minutes of moderate-intensity aerobic exercise at least five days per week for a total of 150 minutes every week.

Have there been changes in the rules regarding HPV vaccinations? What are the recommendations?

There, indeed, have been some changes to the scheduling of the HPV vaccinations. According to the Advisory Committee on Immunization Practices (ACIP) and the Centers for Disease Control and Prevention (CDC), now for persons starting the vaccination series for HPV between the ages of 9 and 15, only two doses are needed as compared to three doses in the past. However, for persons starting the vaccination series at age 15 or older, the recommendation is still to get three doses. And in immunocompromised persons, including those with HIV infection, a three-dose series is still recommended regardless of age. The general recommendation is to start the HPV vaccine series at 11 or 12 years of age. The vaccine is recommended for both boys and girls and can be given up to the age of 26 for both men and women.