Dr. Roach: Diuretics usually safe for the long term
DEAR DR. ROACH: Does a diuretic like Lasix (furosemide) have any negative effect on kidney function after being taken over a period of 16 years in connection with congestive heart failure? – E.T.
ANSWER: Furosemide (Lasix) is a powerful drug. It prevents the kidney from being able to reabsorb water and salt, which are then excreted by the kidney. This drug is used for many different medical conditions, but especially to reduce the symptoms of fluid overload in people with heart, liver or kidney failure from some underlying condition. The effect of furosemide on the kidney is very powerful, but it diminishes somewhat over time as the kidney makes changes to compensate, to a degree, for the effects of the drug.
Over time, most people with congestive heart failure on chronic furosemide therapy do have some loss of kidney function. However, most authorities feel that this progressive loss is due more to the underlying disease than it is to the medicine. For example, in heart failure, the kidney often does not get all the blood it needs, which in itself can lead to kidney damage.
Furosemide needs to be used judiciously, but with proper care it is a safe medication for the right indications.
DEAR DR. ROACH: I have a history of squamous cell cancer of the tongue. About six weeks ago, a PET scan highlighted activity on my tongue for the second time in 28 months. The biopsy pathology came back as type 16 positive, associated with the HPV virus. I am scheduled to have surgery to robotically extract the tumor. My question is about HPV. Is this the same virus that causes canker sores? I have had two large canker sores on the back-right side of my tongue, and later two more on the front-right side. Now the sores have cleared up, but my tongue is still numb on the right side. – J.K.
ANSWER: Human papilloma virus is becoming a leading risk factor for development of cancer of the mouth and pharynx. Type 16 is the most common to cause cancer -- in the head and neck for both men and women, as well as cervical cancer in women.
HPV most commonly appears as a wart, but it can have multiple appearances. However, they are an outgrowth from the skin, whereas a canker sore is an ulcer, a hole in the lining of the mouth or tongue. Canker sores (properly called “aphthous ulcers”) are not thought to be related to viral infections, but are thought to be more autoimmune related. They can be related to irritants, such as sodium lauryl sulfate, a component of many toothpastes.
DEAR DR. ROACH: I donated a pint of blood last week through the American Red Cross Organization. Afterward, the nurse drew an additional five vials, and when I questioned her as to the reason, she said they would be “sent for testing.” I have donated blood for years but have previously never had these additional samples drawn. Can you help explain why? – T.C.
ANSWER: Although I can’t be sure, I know that the Red Cross, like other blood organizations, is taking steps to comply with the new Food and Drug Administration requirement to test for Zika virus. Depending on what state you live in, it may be that they were screening you for Zika virus in order to keep the blood supply safe. Zika virus is known to cause birth defects when a pregnant woman becomes infected.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters at 628 Virginia Dr., Orlando, FL 32803. Health newsletters may be ordered from www.rbmamall.com.
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