DEAR DR. ROACH: I am a 66-year-old white female, 5 feet, 5 inches tall (was 5 feet, 6 inches), weighing 170 pounds. Even though I use gym weight machines for upper and lower body three times a week, walk daily for two miles and spend 15 minutes on a motion trainer at the gym, I cannot stand up easily after gardening on my knees or getting on my knees on the floor. Is there anything I can do to regain the ability to get up off the floor/ground without a struggle? — S.C. ANSWER: It sounds to me that despite your good exercise regimen, you may have weakness specifically in your thighs — what we call “proximal muscle weakness.” There is a very long list of medical illnesses that affect these muscles specifi cally (my textbook lists 28 different diagnoses), including common conditions such as low thyroid levels and vitamin D defi- ciency. I would recommend a visit to your doctor for a careful exam of your nerves and muscles to see if my suspicion is correct. Your doctor may suggest a trial of vitamin D. If no medical cause is found, I would work specifi- cally on strengthening the hip muscles, which extend the thighs. A trainer at the gym can show you those exercises.
. DEAR DR ROACH: I am 65-year-old man, and two weeks ago I developed a painful hemorrhoid almost overnight. I had never had hemorrhoids before. My primary-care doctor
examined me and said I had a “thrombosed hemorrhoid.” It is not very large and in the past week, the pain has diminished, but the bulging vein is still present, albeit less tender. Should I have this removed surgically, or will it eventually disappear? — S.D. ANSWER: A hemorrhoid, a normal vascular structure, can develop a blood clot (“thrombosis”), and then can be exquisitely painful. Often, the clot is removed at the time of examination, giving immediate relief. In most cases, the clot will be reabsorbed within a few days. However, in very large hemorrhoids, occasionally surgery is necessary. There is some suggestion that thrombosed hemorrhoids may indicate a higher risk for colorectal cancer. You should be sure that you have had a recent colonoscopy.
. Dr. Roach is unable to answer individual letters, but will use them whenever possible. Readers may email questions to ToYourGood- Health@med.cornell.edu. To view and order health pamphlets, visit www.rbmamall.com; or write to Pamphlets, 628 Virginia Drive, Orlando, FL 32803.