To Your Good Health

By: Dr. Keith Roach

To Your Good Health

Dr. Roach answers reader questions on disease, public health and sports medicine. 5TW

An informative and educational column on infectious diseases, public health and sports medicine by Dr. Keith Roach, a highly respected physician at Weill Cornell Medical College and New York Presbyterian Hospital.

[dr-keith-roach-with-bkg6-307x360] Dr. Keith Roach graduated from the University of California, Berkeley, with a degree in molecular biology. He earned his M.D. at the University of Chicago, and did his internship and medicine residency training there.

In 2000, Dr. Roach moved to New York, joining the faculty at Weill Cornell Medical College and New York Presbyterian Hospital as an Associate Attending Physician and Associate Professor of Clinical Medicine. He has won every major teaching award offered by that institution. He also served as program director for the primary care internal medicine training program.

The focus of his research is in the prevention of disease with rational use of screening technology and with tools that empower people to make lifestyle choices that improve not only their health but their life expectancy. Dr. Roach also serves as Chief Medical Officer for Enforcer eCoaching, a company dedicated to giving individuals specific daily coaching on improving diet, smoking cessation, weight loss and exercise.

Dr. Roach lives in Larchmont, N.Y. with his wife, Dr. Victoria Muggia, M.D. (a specialist in infectious disease), and their three teenagers, David, Hannah and Jonathan. Dr. Roach is a competitive triathlete.

The email address [email protected] is available directly for readers to leave feedback or ask questions of Dr. Roach.

Pneumonia vaccine can be administered in thigh if necessary

February 23, 2018 - 9:45am

    DEAR DR. ROACH: I have a badly torn rotator cuff on my left shoulder, so that arm is basically a constant problem. In January 2017, my physician suggested that I would benefit from the pneumonia vaccine and that it would take two applications, one year apart, to complete. I agreed to have the vaccine, which was administered into my upper left arm. Ever since then, I have had pain in the muscle area and at times do not have use of that arm. I have talked with the nurse, the physician assistant and also with my orthopedic doctor about this problem.

Observant reader nails description of Cheyne-Stokes breathing

February 22, 2018 - 10:03am

  DEAR DR. ROACH: My wife of 52 years is 71 and has developed what I assume is a problem with her breathing when she sleeps. During some periods of sleep, she starts taking a rhythmic set of breaths. There usually are four deep breaths followed by four shallow breaths. Each set of the four breaths decreases in intensity, and the shallow breaths are barely recognizable. She also has developed tics in her arms and legs. Needless to say, this frightens me. She has peripheral neuropathy and takes Lyrica and two different doses of Cymbalta daily.

What can be done after diagnosis of chronic kidney disease?

February 21, 2018 - 3:07pm

DEAR DR. ROACH: I am a 76-year-old woman. I read your column daily, but I do not remember reading anything about chronic kidney disease. I have just been diagnosed with CKD and have been reading as much as I can get my hands on. This is very frustrating, since much of what I find is contradictory. However, my biggest concern is that the doctor sent me to a nephrologist, who told me that I have CKD, stage 3 -- and then nothing!

Lip inflammation causes unending irritation

February 16, 2018 - 10:13am

DEAR DR. ROACH: For over two years, my wife has been having a problem with her lower lip. From morning on, it swells, irritating her and causing her to lick her lips constantly. She has seen doctors, dentists and specialists, all of whom have no answer and have no one to refer her to. It causes her no end of irritation. Do you have a reason, a cause or a medication that would resolve the problem? She has tried Biotene lip balm and Vaseline, with no help. Each visit results in more bills, but no results. -- R.E.

It's time for a more thorough examination of nipple pain

February 14, 2018 - 10:04am

       DEAR DR. ROACH: I am a healthy 94-year-old woman. Over the past four months, I have had pain in the nipple of my left breast. I went to my doctor and was told to put hydrocortisone on it twice a day. I did and it didn't help, but the doctor told me to continue. I saw a gynecologist, who ordered a mammogram, which was negative. I had an ultrasound in November, which was OK, and the doctor wants me to see a surgeon, with no other explanation. I have no idea what this could be, and am upset at the idea of surgery. -- J.H.

With vitamin D, look to total number, not individual types

February 12, 2018 - 11:23am

       DEAR DR. ROACH: I recently received my blood test results. My overall vitamin D was 40 (within the target range of 30 to 60 listed), but I noticed that it was broken up into vitamin D-3 (also 40) and vitamin D-2 (less than 4, and presumably 0 based on the overall score).  What is vitamin D-2, and should I be taking supplements or eating certain foods to boost its levels? -- P.S.

Explaining the ethical line between patient and physician

February 9, 2018 - 9:34am

       DEAR DR. ROACH: Recently, a physician in my area lost his license for having an intimate relationship with several of his patients. I'm just curious why this is considered so unethical if both parties are adults who are sound of mind. Are physicians not allowed to have relationships with patients outside of their practice? If I want to see my physician for personal reasons and not medical ones, should I find a different provider first? -- N.E.

What can be done to get off insulin injections?

February 8, 2018 - 9:19am

       DEAR DR. ROACH: My doctor placed me on insulin for diabetes because I was not able to bring my glucose below 100. The bloodwork results are now 120 glucose and 6.6 hemoglobin A1C. I have been averaging 6.5 hemoglobin A1C for over two years. I have been taking glucose readings three times a day, with results between 108 and 147 mg/dl. My blood pressure reads 117/61, and my heart rate averages 55. All my bloodwork is within normal limits. I'm 65 years old and was wondering if taking the insulin is needed at this time. I still work, and I'm very active for my age.