As I talk with my midlife and older patients about how aging affects their bodies, I find that one of their most common complaints is how they find it increasingly difficult to keep pace with the busy lives they lead. In fact, the medical problems that bring patients into the office more often than any other illness involve limitations of movement and their concern that they’re not able to run around as easily as before. The enormous sums of money that are spent on prescription medications, over-the-counter preparations, physical therapy, and surgery that promise to help us stay mobile attest to the frustration we feel when we can’t move freely.

Many of these mobility problems are due to one of several kinds of arthritis—osteoarthritis and rheumatoid arthritis among them—and the related health problems that stem from these diseases. In fact, as many as 60 percent of the population over 55 reports having a form of arthritis, whether it’s mild or severe.

Arthritis is not the only disorder that affects our ability to stay mobile. Certain skin disorders and diseases of the heart, lungs, kidneys, and vascular system affect us as well, and aging affects the movements of our joints, ligaments, and muscles: the ligaments become less elastic, and the muscles lose some of their strength as a result of the decrease in muscle mass that is inevitable as we age—even in bodybuilders. No matter what, the best way to keep the joints, ligaments, and muscles in top working order, despite the effects of age, is to remain active and get some exercise every day.

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BODY SIGNAL ALERT Call your doctor immediately if you experience any of the following symptoms:

SYMPTOM POSSIBLE MEDICAL CONDITION

You are postmenopausal and have Cancer vaginal bleeding?

You are premenopausal and are Fibroid inflammation, cancer experiencing irregular vaginal bleeding.

You feel pain in your lower pelvis.

Appendicitis, ovarian cyst, on the side pelvic inflammatory disease.

You feel pain when urinating and Urinary tract infection your urine is cloudy or foul-smelling.

You have urinary incontinence.

Urinary tract infection, reaction to medication, fallen uterus.

You have a vaginal discharge and feel Ovarian cancer bloated and fatigued.

You feel an abrasion or lesion on the Sexually transmitted disease lips of your vagina.

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It’s a good idea to perform the self-exam the week after your menstrual period has ended. Your breasts will be less congested at this time, and any new growths will be easy to detect. Some women do their self-exam in the shower, because moist skin makes it easier to massage the breast in a circular motion, which is the best way to detect a lump.

First, stand before a mirror and check the nipples and skin of your breasts for any visible changes. Have the nipples or areola changed color since your exam last month? Does any portion of the skin of the breast appear puckered like an orange peel? Is there any noticeable swelling?

Next, raise your arms above your head. Do you notice any difference in the symmetry or appearance of your breasts?

The next, most important step can be done either in the shower or lying on your back. Start with your right breast. Raise your right arm above your head, and, holding your fingertips closely together, start at the top of the breast, at what would be twelve o’clock. Gently move your fingers in a circular motion while you check for any lumps. Next, move to one o’clock, and so on, until you have checked for lumps at the position of every hour on your breast. Next, follow the same motion for the area of the breast that lies under the nipple. Then, gently squeeze the nipple to check for any abnormal discharge. It’s also important to check the area under your armpit, where lymph nodes are located.

Repeat the procedure for your left breast.

If you discover a lump in your breast, you should see your doctor. A regular monthly self-exam can be helpful because it helps you to become familiar with lumps or masses that appear in your breasts and are noncancerous, and also to be aware of changes in your breasts that might indicate the presence of a malignancy. If you have trouble distinguishing between normal breast tissue, glands, and a lump, ask your gynecologist if she has a breast prosthesis that you can feel so you know what a lump feels like. Normal breast tissue can have masses and stringy tissue, but a lump is usually hard and starts out the size of a small pebble.

If you detect a lump, immediately see your doctor, who will then determine the status of the mass. Most lumps are not cancerous, but any new masses that you may find and that your doctor deems suspicious will require further examination. She may choose a mammogram, ultrasound, or biopsy.

A monthly self-exam can mean the difference between successful treatment and a fatal illness. Get in the habit of checking your breasts every month without fail.

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Most of us know at least one person who has had kidney stones. With few exceptions, he will describe the process of passing the stone as one of the most painful things he has ever experienced. Those of us who haven’t had kidney stones wonder how a tiny grain of crystal can create so much intense pain for such a long period of time.

The truth is, kidney stones are a common condition. Kidney stones fall into several categories, depending on their composition. More than three quarters of all stones are calcium stones, and these are the most likely to recur. One out of every 10 people has a uric acid stone, which is commonly caused by the disease gout. Other stones that occur more rarely are cystine stones and struvite stones, which arise due to a urinary tract infection.

Kidney stones are a common condition, and for the majority of people they pass through the urinary tract unnoticed. When one or more of the tiny crystals that form in the kidney cluster together, the stone becomes larger than the ureter tube it must pass through, and that’s when trouble starts.

As the stone starts to move down the ureter, you may feel the pain first on your side just above your hip and down to your bladder directly above your genitalia. Then both the stone and the pain slowly make their way further south through the ureter. The entire process may take up to three weeks. Along with the acute pain, you might also suffer from a fever and bloody urine, signs that the stone has blocked the ureter, which can prevent urine from escaping. In some cases, these symptoms may be a sign of a severe kidney infection, which is much more common in women than in men.

Once the stone reaches the bladder, the pain stops and the stone is quickly eliminated from the body. Some people may pass several significant stones a year with no more than a backward glance. Others, for whom the pain is too fresh a memory, may embark on a plan of prevention while they’re still passing the first stone.

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Calamine lotion and hydrocortisone creams are the most commonly used over-the-counter preparations for contact dermatitis. If blisters start to form, you might want to cover them with gauze to prevent infection. And certainly you should stay away from whatever caused the red patches in the first place.

If the contact dermatitis does not clear up after two weeks or if the rash becomes sevete, see your doctor, who may advise the use of corticosteroids or other prescription medication to treat the condition.

If you think your rash is caused by anxiety and flare-ups start to become regular events, your physician might suggest biofeedback or another relaxation technique to help you learn how to control your stress. In my practice, I see many adults whose necks turn beet red when I examine them. All they have to do, I tell them, is relax.

Tips and Precautions

For some people, their sensitivity is so acute that even calamine lotion causes an allergic reaction. If this describes you, try applying a mixture of baking soda or Epsom salts and water to the rash. Mix the two together to make a paste, and then spread it over the affected area. If the contact dermatitis doesn’t improve after a week or two, see your doctor.

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