DEAR DR. ROACH: I was prescribed prednisone 5 mg twice daily, but I had insomnia, itching and hot flashes from it. I stopped after four days but am still suffering from sleeplessness. Has the prednisone had a permanent effect on my body? — J.W.S.L.
ANSWER: Prednisone, a powerful anti-inflammatory and immune system-inhibiting steroid, has many side effects on the body, especially insomnia. Hot flashes and itching are uncommon side effects. Insomnia is more common when prednisone is taken twice daily.
Anytime a person gets insomnia, it can create a situation where they become worried about sleeping, which can lead to a persistent problem, even though the effect of the prednisone is gone. I recommend some routine steps for treating insomnia, such as avoiding bright lights, including any electronic screen, for two hours or so before bed; regular exercise, if the condition for which you took prednisone allows it; and a warm bath before bed. A mild sleep aid, such as melatonin 1 mg or less, may help reset your system, but daily use is not necessary.
DEAR DR. ROACH: My wife had a heart attack. They did what they could for her, but she had a 100% blocked artery. They did clean it out, but a week later she had a fatal heart attack. Five or six months earlier, she called me quite often by a former friend’s name. I am wondering if blood was not getting to her brain or if she was starting to get dementia? — G.M.
ANSWER: I am very sorry about your wife. People who have blockages in the heart often have blockages in other blood vessels, such as those in the leg, but also those going to the brain. Poor blood flow to the brain may cause changes to memory and other specific problems.
A stroke is very much like a heart attack. Most strokes are caused by poor blood flow to a specific area of the brain, and if it is severe enough, long enough, brain tissue will die, causing loss of function. People who have had multiple strokes are more frequently affected by dementia, called vascular dementia or multi-infarct dementia.
I don’t know if this was the case for your wife, but it is certainly plausible. People who notice loved ones having memory lapses should get an evaluation sooner rather than later, as sometimes there are therapies that work better when started earlier.
DEAR DR. ROACH: Does BPH increase the possibility of prostate cancer? — A.L.
ANSWER: Benign prostatic hypertrophy is a common condition in men. About half of men in their 50s have an enlarged prostate, and the proportion gets even higher as men age.
The major symptoms of enlarged prostate are difficulty with urine flow, a sensation of decreased emptying, difficulty initiating urination, and increased frequency of urinating, including at night. As symptoms worsen, incontinence can occur and even kidney damage may result due to the high pressure in the bladder.
The first word in “BPH” is “benign”: It is not a cancerous condition. It does not protect against developing cancer, but there does not appear to be an increased risk either, according to the most recent studies.