Cover your nose and don't hold in a sneeze

Q: Can it really hurt you to hold in a sneeze?

A: When I got this question, I didn’t think there would be a whole lot of information out there. But after checking with a doctor and doing some online research it appears there are quite a few complications that can come from holding in a sneeze.
Dr. Paul Lenkowski of the Jefferson Surgical Clinic said, “There are case reports of sneeze causing injury to voice box, brain and ears. The pressure generated by the sneeze is very powerful and that energy has to go somewhere.”
Holding in a sneeze can lead to:
» Ruptured ear drums.
» Damage to the base of the skull.
» Forcing air into the eye and brain.
 “Now, this is not a common problem but it can cause injuries,” Lenkowski said.
People at highest risk for “sneeze injuries” related to holding your breath include those who have had surgery on the skull base, throat, ears and eyes.

Q: If I have been vaccinated for measles, as an adult do I need a booster of this vaccine?

A: Previously, I wrote about how a person with measles had been aboard an Amtrak train that stopped in Lynchburg.
The health department worked to notify anyone who may have been exposed to the illness, but the incident did raise some vaccination questions.
I talked to Dr. Alice Ackerman with Carilion Clinic for some measles perspective.
“They thought measles had been eliminated in 2006, but there have still been sporadic cases,” she said.
“2011 has the highest number of reported cases in a decade, and the cases are demonstrating transmission from person-to-person.”
While many of us may think we are protected from measles,  mumps and rubella because we have had our two recommended doses of the MMR vaccine, that may not necessarily be the case.
Ackerman said, “It’s important to know what kind of vaccine you received. There have been a series of different types of vaccine components. Some have been more effective than others.”
The recommendation now is that children get the first dose at their one-year doctor visit and the second dose before they start kindergarten or pre-school.
 “If you were only vaccinated once against measles or if you were immunized in the ’60s, when they used the ‘killed’ vaccine, which was not as effective,” Ackerman said, “you should consider getting a booster to ensure that you have good immunity against measles.”
Measles symptoms are similar to those of the flu. In the first couple of days, a person may experience a fever, sore throat or headache. After a couple of days a rash comes out and by that time the sufferer has been contagious for several days.

This question came from a viewer who called about mild cases of varicose veins. She was curious about treatment and health insurance coverage.

I checked in with Dr. Marty Smith, an osteopathic physician at Virginia Skin & Vein in Roanoke, for some perspective on the beginning stages of varicose veins.
He said, “Vein disease is genetic. All of it progresses and the rate and extent of the morbidity is the conundrum. Some vein problems are related to trauma; if so, they may never progress.
With this scenario prophylaxis is unnecessary. If the patient wants treatment, it would be considered cosmetic and not covered by insurance in almost all cases.”
Whether varicose veins will get worse and cause pain in the future can be diagnosed.
 “A physical exam and a ultrasound of their veins may enable us to make a reasonable assessment of whether or not they will progress; this in most cases is covered by insurance. Since we don’t have a crystal ball, trying to forecast the future can be difficult given the multiple environmental and behavioral factors that can aggravate the genetic predisposition to varicose vein disease.  I
f someone has the predisposition, it is progressive and incurable and any treatment should be considered a management technique,” Smith said.
Some people have what are called “spider veins,” which are much smaller veins that don’t protrude as classic varicose veins do.
Most people who have varicose veins also have much smaller spider veins.
Spider veins are not necessarily a sign of underlying vein disease, but Smith said, “ Many do and often we are surprised by the extent of the potential problem. If there is no underlying disease then spider veins can be easily treated, but this is a cosmetic procedure and not covered by insurance.”

Q: What are some good exercises for people with arthritis?

A: Some people are under the impression that if you have arthritis, exercise is off limits. That is definitely not the case according to Dr. Joseph Moskal, who said, “Exercise can improve stamina and help with blood pressure along with many other things.”
Some good exercises for people with arthritis include swimming, water aerobics, walking, stretching, low-impact yoga, and low-impact dancing, and stationary bike riding.
While exercise is important, he said, do not do anything that creates a pounding on the affected joints.
Exercise can not only help with movement but also can lead to weight loss, which can benefit arthritis patients.
Moskal said that even a one-pound loss can make a big difference in the amount of pressure applied to an arthritic joint.
For links to more information about arthritis and ways to treat it log on to www.wsls.com or www.arthritis.org. If you do not have access to a computer you can call the Arthritis Foundation at 1-800-283-7800.