Dear Dr. Roach: When I seek a second or even third medical opinion, should I tell the subsequent doctors what the previous one(s) diagnosed? — C.B.
Answer: I understand the thinking that if you say nothing and get the same answer as the previous physician, it makes the answer seem more solid. You don’t want the second-opinion doctor to be “anchored” to the previous diagnosis (this is a well-recognized mistake doctors make, called a cognitive bias).
In general, however, physicians do best when they are given all relevant information. Telling the second-opinion doctor what the first doctor thought, and why you are suspicious enough to seek a second opinion, will probably get you a better evaluation.
Dear Dr. Roach: Four years ago, my wife had hip surgery caused by a fall. About eight months after the surgery, she noticed her left leg was 3 inches shorter that her right one. Her doctor agreed it was shorter and said that does happen frequently. She must use a cane to walk and is now in a lot of pain just walking in a market or around the house. Is it common for this type of disability to be caused by hip surgery? Is there any type of procedure to correct it? What can be done to alleviate the pain and discomfort from this injury? — G.W.
Answer: Up to a quarter of people will have a change in the length of the leg after hip replacement surgery. I’m not sure that’s what your wife had, but that’s a common surgery after a fall.
A “significant” difference in the length of the two legs is one that causes symptoms; some surgeons use 2 centimeters. Your wife has a difference of almost 9 centimeters. I don’t know whether she had a difference before the fall (some people do and never notice), but if this is new since surgery, treatment is best sooner rather than later.
She should have a careful measurement of the length of the legs. This is harder than it seems, and often a patient’s measurement is inexact. A shoe lift can be made to correct the length discrepancy. Since it has been so long since surgery, many experts do not attempt to correct the entire difference. However, with treatment, she should have better movement and less pain. She should see her orthopedic surgeon.
Dear Dr. Roach: Are studies that suggest eating prunes daily might delay or prevent osteoporosis for postmenopausal women valid? Thanks. — M.S.
Answer: There are several studies that suggested eating prunes may have benefits on the bones. In some studies, women ate 4 ounces of prunes daily (the control group got dried apples), and blood tests suggested less bone turnover. Bone density studies suggested some benefit or at least slowing of decline among women eating prunes compared with the control group. The duration of the studies was in months — quite short, as two years is often needed to see benefits in the bone, which changes slowly.
These sorts of studies would never be acceptable for new medications to treat osteoporosis, which would require significant improvements in bone strength, or better yet, reduction in the risk of fractures. However, prunes have minimal potential for side effects, having been consumed for millennia. Prunes are well known to effectively treat constipation (which can be problematic in people who struggle with loose stools). Both men and women can get osteoporosis, though only women have been included in studies on prunes.
Compared against the currently available osteoporosis treatments, which have the potential, however small, for serious complications, prunes are very safe. They may not keep a person from requiring additional treatment, but they may help.
