Not wearing flip-flops in my dorm’s shower caught up with me—now I have yellowed, scaly, flaking, gross toenails on one foot. I asked my doctor about medication, but she said that Lamisil could damage my liver. The over-the-counter stuff she gave me didn’t really help, and now I can’t wear sandals or go to the beach without being self-conscious. What can I do?!
Monty de Leon Denver, CO
You are not alone. More than 11 percent of Americans have this problem, which can be caused by trauma to the toenail, low pH of the skin or poor hygiene. Fungi are living organisms that survive in the damp environment under the nail. Prevention is the best cure: You should start by wearing 100-percent wool or cotton socks and shoes that allow plenty of air and moisture exchange. (You can also add an antibacterial powder.) Terfinabine (Lamisil) is one of a few anti-fungal prescription medications available, with side effects including upset stomach and headaches. There are some alternatives. You can use Vicks VapoRub on the affected toenail or soak your feet in your own urine twice a day. (This can easily be done while showering.) An herb called tea tree oil can also be successful when applied to the affected nail. In my practice, I use a product called Fungal Free Nails, available through Longevity Nutritionals (212.688.5536). Applying this herbal mixture allows the nail to grow in a relatively short period of time. Most important, change your diet. Sugar can aggravate this condition. —PF
I just had my first HIV test and go back in a week to get the results. I’m pretty sure I don’t have anything to worry about, but I’m still a little scared. (Okay, a lot scared!) I’ve never been through this. If it turns out that my test results are positive, what happens?
Lionel via Internet
First, find an HIV specialist by calling The National AIDS Hotline (800.232.4636, available 24/7). Their specialists can explain what’s next. HIV guidelines recommend when to start treatment and with what medicines. Your next blood test determines viral load and CD4 count. Viral load measures the virus in your blood. CD4 cells fight infection. Other potential infections complicating HIV treatment may also be assessed. If your CD4 count is less than 350 and/or your viral load is above 100,000, your doctor may suggest starting treatment. If you have an “AIDS-defining illness” like Kaposi’s sarcoma or other complications, you may be asked to consider treatment regardless of your CD4 count. If it’s time for treatment, your doctor will recommend a combination from more than 20 HIV medicines in six classes (types) of drugs. Each class of drugs fights the virus in a unique way and works best in combination with others to control the virus, thus the term “combination therapy.” Even if you don’t immediately need treatment, it’s imperative that you get a blood test every three months—or at least every six—so you can make the most of lifesaving HIV medicines when you do need them. —FP
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I just moved across the country and started a really demanding job. I’m lonely and stressed out all the time and I worry about getting an ulcer or having a panic attack. What are some natural remedies I could use to calm down, focus and heal, inside and out?
Derrick White New York, NY
A fast-paced lifestyle can be difficult, trust me. A geographic change and a new job don’t make it easier. It is not uncommon to find yourself overwhelmed. There is plenty to do to support a healthy ability to relax and slow down. Eat lots of fresh fruit, vegetables and whole grains to keep your mind producing its own natural “feel good” chemicals. Try practicing some relaxation techniques, such as meditation and a daily walk. There are natural remedies to support the nervous system and keep the nerves settled—passionflower, Melissa, valerian and St. John’s wort have been used for thousands of years. (Yes, there are many published clinical studies demonstrating the efficacy of herbs.) I use lemon balm (Melissa officinalis) in my practice. Rubbing the lemon balm plant between your fingers releases a tart, sweet smell that calms the nerves. A general nerve tonic, passionflower (Passiflora incarnata) is commonly used in combination with lavender and valerian. In addition to the herbs, make sure you get plenty of fresh air, water and sunshine. —PF
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