

Question #1
Hi there, I am extremely far-sighted. In my research of laser eye surgery I have found only discouraging results on the internet and have yet to find someone in real life that has tried it for far-sightedness. I am VERY tired of glasses and contacts, and I hate feeling so blind! Is laser eye surgery a worthwhile procedure for someone like me to consider? Thank you, Cory

There have been quite a few recent advances in eye surgeries that make them more effective and able to treat more varieties of eye problems, including farsightedness. The types of surgeries resemble an alphabet soup of procedures. Laser type surgeries include LASIX, LASEK and PRK. Surgeries that exchange the lens in your eye for an artificial one include RLE and PRELEX. For the most part these surgeries are very safe but like all procedures than can have complications. But for these surgeries the complications are usually minor. These include a worsening of your reading vision often times requiring reading glasses. There can also be an over or under correction of your vision and a halo type effect, especially at night when looking at other headlights. This halo effects can improve with time and is often something patients adapt well to. The key is to get the post surgery check-ups like your doctor lays out for you before the procedure. Before you get this surgery there are a couple of questions to ask. Number one, how much will this surgery cost and what part, if any, will my insurance pick up? Then, what could the post surgical complications be and how do we minimize the chances of those happening. And next, what happens if the results aren't optimal.

Question #2
Dr. John, I wanted to hear your advice for treating shingles- something I developed in July of 2010. I only had a rash for the first week when it was first diagnosed and since then the main concern is the constant pain in my upper right chest area. I am a 66 yr. old male and have been advised to take a number of medications, none of which seemed to be effective. Now I have been advised to try Quetenza. What are your thoughts on this?
Thank you for any assistance. David

What is being referred to is one of the long term complications that can stick around long after the shingles rash has gone away. A shingles outbreak usually includes some pain along one side of the body or another along with a rash. The pain is often describes as a burning or electrical shock type pain that is noticed before, during and in some cases after the rash has gone away. If the pain sticks around it's called postherpetic neuralgia (PHN). One of the reasons medication is given to someone with shingles is to help reduce the chances of developing PHN since it can be painful and debilitating. The reason the pain comes about is because of how the shingles virus affects the nerve it travels along. It actually damages the nerve so the signal it sends to the brain gets confused. This confused signal turns into a pain type signal. There is no cure for PHN but there are ways to try and reduce the pain. Antidepressants, like gabapentin can help. So to can lidocaine skin patches. One thing patients have had good success with is capsaicin. Capsaicin is the active ingredient in hot chilies and comes in a cream and liquid form. Quetenza is one of these forms and seems effective at keeping the pain of PHN at bay.

Question #3
My 3-year-old son holds his breath at night when he sleeps. I want to make sure this is nothing serious. Kerri

The key here is to look for patterns in the breath holding. It can happen on a temporary basis when a child has allergies, a cold or other upper respiratory infection. But breath holding due to this should clear up in a week to ten days. If it lasts much longer than that then it could be a more long term condition that needs treatments. This is especially true since it could by a type of sleep apnea, where the holding of the breath actually starts to reduce the amount of oxygen a developing brain gets. Enlarged tonsils are usually the culprit and removal of the tonsils helps get the child's breathing back under control. An exam by their doctor can help determine if this is the reason behind the breathing issues and help decide if surgery to remove the tonsils is the way to go.