Body1: Dr. Whynot, thank you again for joining us. Users, we welcome your questions!

Mr. M: Hello Dr. W, The males in my family suffer from high blood pressure. Is there anything we can do to reduce it, besides drugs?

Dr James Whynot: Yes there are a lot of things to do to reduce high blood pressure without using drugs. First and foremost, diet and exercise are key. Low salt diet and trying to attain normal weight are important. Exercise is also important because of its effect on 'relaxing' the blood vessels

Rob C.: Does cracking your knuckles really lead to arthritus?

Dr James Whynot: No not really, its something that I have heard from almost every mother I know though!

JMC : Why are there so many new infectious diseases? First Lyme Disease, then SARS, now West Nile. And most seemed to be carried by animals (insects). Are there other such diseases we should worry about? What can the average person do to protect themselves? Thanks, JMC

Dr James Whynot: These are not really 'new' infectious diseases, but rather diseases that have become more prominent as we have been able to treat other diseases. In the past more of the bacterial infectious diseases were important - people died of tuberculoisis, strep infections etc. I think there are a lot of other diseases out there that will become more important as time goes on, particularly viral diseases and diseases that are resistant to antibiotics. Viral diseases are a special category since the virus uses human cells to reproduce itself and some viruses can leave copies of their genetic material in cells of humans and animals, can mutate etc. The average person can protect him or herself by practicing good hygeine - doing simple things like avoiding contact with infected people, good hand washing and proper nutrition. If the body is under stress nutrition is important as a first line of defense against infection. High doses of Vitamin C may also be protective especially against viral diseases.

N. A. Gigi: I have recently read (2 sources) that Aspirin treatment for cardiac attack prevention is actually not applicable to the female heart function, and may actually be harmful. What is your opinion?

Dr James Whynot: It is true that the studies that have been done with aspirin, show that it usually applies only to males over 50 years old. About half the heart attacks in men are caused from clot build-up on irregular cholesterol plaques in the coronary (heart) arteries. So in general aspirin therapy is recommended for men, although if women have had a heart attack, aspirin is then recommended for them as a post heart attack medication.

Silja : What are bronchiatiasis and granulum of the lungs? what are the causes?

Dr James Whynot: Bronchiectasis of the lung is a relatively rare condition that occurs when the breathing tubes in the lung ( the bronchi) enlarge and become distended. This leads to pockets in the lungs which interfere with the normal function of these tubes (little hairs called cilia, sweep debris and mucous out) and can lead to mucous production and infection. The causes of bronchiectasis can be infection, pneumonia or an obstruction of the tube. Granulomas are areas of the lung where infection has been walled off or sequestered - the most common cause of granulomas in the lung is old Tuberculosis.

nearsighted : I suffer from sever astigmatism and have been contemplating Lasik or other corrective surgery. However I need to use my eyes frequently at work. Will I be put out of work for a long while if I undergo treatment?

Dr James Whynot: Usually one is back to work the next day after Lasik surgery. The most important aspects in considering this surgery are: looking at the experience of the physician performing the surgery. Ask about number of patients operated upon, complication rate. It is also important to speak to the performing physician to determine if the surgery will correct all the problems with your vision

JessToal: Two questions - the last two generations of my family have had 3 people with heart disese - what does it mean to have a history of heart disese? Second, Everyone in my family has low cholesterol (I am 30 and mine is 122) I thought heart disese and cholesterol were linked?

Dr James Whynot: A history of heart disease means that there are members in your family - usually parents, siblings or uncles/aunts who have had heart disease (angina or heart attack). The major risk factors for heart disease are elevated cholesterol - more on this in a second - cigarette smoking and high blood pressure that is not treated. It is important to check all different types of cholesterol - not just the total cholesterol. It is important to know about the triglycerides (how excess sugar is stored as fat), the LDL - low density cholesterol which is linked more closely with heart disease, and the HDL or good cholesterol. The ratio of total cholesterol to good cholesterol is important. If you have a cholesterol of 122 and a good cholesterol of 10, then you are at an extremely high risk for heart disease since the ratio is 12. If your cholesterol is 122 and the good cholesterol is 50 then your ratio is 2.4 and you are at low risk for heart disease. The LDL should be below 100. Recent research has shown that there are other factors that can be measured that will contribute to cardiac risk - apolipoproteins and C-reactive protein (CRP). In your case these should be measured. If the apolipoproteins are elevated and/or the CRP is elevated, treatment with Folic acid (a vitamin) and possibly a lipid lowering drug (a statin) should be begun

JP : What is the difference between calluses, corns, bunions and a hammer toe? My mother mentioned that she needed surgery for the hammer toe - is that nec. and does insurance usually cover it?

Dr James Whynot: A callous is a thickened area of skin on the foot and a corn is a thickened area of skin usually on the top of the toe. These are all produced by ill fitting shoes/pressure. A bunion is the movement of the joint of the foot in the outward direction, usually the big toe joint. A hammer toe is where the toe is bent downward like a claw. Usually a hammer toe is operated upon if it is causing significant pain or disability. If the surgery is medically necessary usually an insurance plan will cover it - but this varies plan to plan. It is best to check with the plan

lindaua81 : I have veins and vessels on the palm side of my hands and fingers that burst usually when I do strenuous things like gardening or opening a jar...or if I get upset and my pressure rises. It stings and leaves hematomas under the skin that sometimes take three weeks to go away. My doctor has never seen this before. Any help? Am I prone to haveing an aneurysm?

Dr James Whynot: I have not seen this either - I assume that these are very superficial veins that are showing through the skin which is why they break easily. I can not say if you are more prone to having an aneurysm

David R: Dr. Whynot: I have been diagnosed with CP. What treatment & therapy would you prescribe?

Dr James Whynot: I assume you mean Cerebral Palsy which is a whole host of diseases which affect control of the muscles. This is usually present from birth. It is important to find a physician who is experienced in treating Cerebral Palsy so that an accurate diagnosis can be made and a treatment plan developed.

eltel.diane: I had a replacement mechanical valve fitted in January 2003, and all looked well until April and then I started getting severe attacks of Palpitations.From April until end of June I had 6 attacks and the only way they would stop was by stopping and restarting my heart.In that time I was treated with different Beta blockers which did not work and I am currently trying Frecainide.Can you tell me, the fact I have a mechanical valve could I still be considered for Abalation.

Dr James Whynot: If the cause of the palpitations is due to abnormal electrical conduction in the heart, you are probably still a candidate for ablation. The key is to diagnose the exact cause of the palpitations and if the usual medications fail, ablation may be considered.

practicalpat : I have a newborn cousin recently diagnosed with situs inversus totalis. So far the doctors have told my aunt that he is fine no malformations, heart function, stomach function etc. all seem to be good excepting that his abdomen is a mirror image of course. Is there anything he should expect as problems in the future? Is it possible to have this condition and experience no problems through his lifetime?

Body1 : Dr. Whynot, in addition to answering that question, a brief description of situs inversus totalis would probably also be helpful to our users.

Dr James Whynot: Situs inversus totalis is complete mirror image of all the body parts in the chest and abdomen. The heart is on the right, liver on the left etc. It can also be associated with various other syndromes, so it is important to rule out these syndromes as they can cause heart, lung or digestive problems. If someone has situs inversus totalis and no other problems, they usually live a normal life with no complications. The major problem is that they need to tell their physician that they have this syndrome as various symptoms will be the opposite - for example appendicitis pain which is usually on the right side of the abdomen can be on the left.

SoccerDudette: I'm a 15 year old female soccer/hockey player. I tore my ACL, MCL, and damaged my meniscus 5 weeks ago. How long can I expect to wait to have surgery? I have asked this question to many health professionals, but each gives me a different answer. And believe me...I want it done ASAP!

Dr James Whynot: I dont know if I have the answer to that question, since I am not an orthopedist. Usually these tears need to be treated surgically - and one would wait a short time for all the swelling (edema) to go down, then go in to repair the tears

SusieQ : Dr. Whynot, to your knowledge, are there any harmful ingredients or agents included in most self-tanning products? I know some people are skeptical of putting these chemicals all over their skin - what is your opinion?

Dr James Whynot: It depends on what product you use. These are all either iodine based or dyes. In general it is not a good idea to place these chemicals on the skin

Archie: Are those tests that you can take in drug stores such as blood pressure and bone scans accurate?

Dr James Whynot: The blood pressure tests in drug stores are very variable - the machine needs to be calibrated, so I dont think they are a good idea. A better method of checking the blood pressure is to buy an inexpensive cuff, take it to your doctor's office and make sure the reading on your cuff is the same as the doctor's cuff. This is a much more accurate way to look at blood pressure and it is cheap - a cuff costs 20-30 dollars and will last forever. The bone density scans are not accurate for the same reason - one never knows if the machine is calibrated

frequentflyer: I am a frequent flyer for business - with long security lines, cramped/smaller seating arrangements, is DVT something I should be particularly concerned about?

Dr James Whynot: Yes - I fly frequently too and it is a major concern. There have been recent articles in the New England Journal of Medicine showing that this condition is more common than thought. I think the key for flying is to frequently move the legs, and do specific streching exercises for the legs, get up and walk around on long flights every hour or so

Amy1022 : What vitamins/supplements should healthy females in their early 20s be sure to include in their daily regimen?

Dr James Whynot: The official medical party line is that one should take a multiple vitamin daily. I feel that these dosages are too low and am a proponent of taking higher dosages of B and C vitamins. I also suggest taking Vitamin E. One does have to worry about the fat soluable vitamins (A,D, K and E) since these can build up in the system and cause toxicity. In general women should also take folic acid during child bearing years

Pat: Is it unusual for a woman with no previous history to develope ovarian cysts during pregnancy? How is that treated? And what does it mean for the pregnancy?

Dr James Whynot: Ovarian cysts are produced when an egg matures and a pregnancy does not develop. I do not know if it is usual for a cyst to develop during pregnancy, since theoretically no eggs should mature. This is a topic that should be discussed with your obstetrician

beachbum17: How much do you know about the new South Beach Diet? Do you think it healthier or a better weight loss plan than the more radical Atkins and Zone plans?

Dr James Whynot: I do not know much about the South Beach diet other than the hype which states that it makes you lose weight by eating the right fats and the right carbs... I think the key to weight loss, as we have learned recently, is controlling the amount of food one eats, controlling the amount of carbohydrates and the type of carbohydrates ingested and of course moderate exercise. I know the Atkins and Zone diet are considered radical, but there is science behind both of these diets, again having to do with restriction of carbohydrates as well as calories. I believe that the actual key to losing weight is to restrict calories ( you need 10 calories per day for each pound of your weight - thus if you weigh 160 pounds you need 1600 calories to maintain weight) and exercise. Exercise is the key along with caloric restriction. One should eat a whole variety of foods with concentration on fruits and vegetables and eating the heavier meals earlier in the day, not skipping breakfast etc

Body1: Users, that's all the time we have today. Join us again next week on Wednesday, August 6 at 1pm ET for another discussion with Dr. Whynot.

Body1: Dr. Whynot, thank you for joining us today.

Body1: See you all next week!