Q:My primary doctor recently did a pelvic exam and said I had a fallen bladder. How serious is this? — Rachel, Livermore, Calif.
A: Did you hear a thud? A fallen or prolapsed bladder is serious only if it disturbs you. It's also fixable, and even better, most are preventable. Childbirth and aging are what usually make the sling of muscles and ligaments supporting your pelvic organs — bladder, uterus, rectum, vagina, intestines — sag downward like a plastic bag stuffed with oranges. Have you had pelvic pressure, discomfort when you bear down, painful intercourse, a frequent urge to pee, leaking when you laugh or felt something bulging into your vagina or protruding from it?
Doing what are called Kegel exercises can strengthen your sagging pelvic muscles and help keep your insides inside. (Doing Kegels throughout your adult life, especially after childbirth, also can prevent problems.) The simplest move is just to imagine you're trying to stop the flow of urine for a count of four, then release. Do 10 reps, 10 times a day. If you're leaking, ask your doc about bladder-training techniques, which can help you go longer between bathroom breaks. Your doctor also can fit you with a vaginal insert. Placed like a contraceptive diaphragm, the insert helps hold up your pelvic organs. If all else fails, muscle-tightening surgery will lift everything back to its proper place so your organs remain — thankfully — internal organs.
Q: These are my latest cholesterol numbers: My good HDL is great, 138; but my bad LDL is bad, 173; and my total cholesterol is also bad, 331. There's heart disease in my family. Could my high cholesterol be hereditary? — Maryann, Spring Hill, Fla.
A: Wow, you've got some high HDL! Anything above 60 is spectacular, assuming it is active HDL (there are inactive types that don't perform, kind of like a hunk without a brain). Your HDL ought to be shooing away your bad LDL like Drano on a lard clog. But since your LDL is in the danger zone (we like to see it under 100), and you've got a family history of heart trouble, we suspect you have inactive or "lazy" HDL.
Normally, healthy HDL cholesterol hustles lousy LDL to the liver for disposal before it can plant itself like barnacles on your arteries. However, people who have very large particles of HDL as well as a lot of it can have an even higher risk of heart disease than people with low HDL. Large particles, like contestants trying out for "The Biggest Loser," may not be as active as petite ones. Testing for particle size and HDL activity is just getting ready for prime time. Write us (YOUDocs@gmail.com) if you want to find out if yours is active; we'll refer you and your doc to a reputable lab.
Since there is heart trouble in your family, be diligent about lowering your risk: Eat a low-fat diet with lots of veggies, walk at least 30 minutes every day and keep your stress down (do deep breathing, meditation, yoga).
Q: I recently had a mammogram that showed calcifications. A follow-up found them to be benign. How did I get calcifications, and can they be reversed? — Anna, via e-mail
A: Occasionally, tiny bits of calcium migrate from your bones to other parts of your body and settle in permanently (no, you can't evict them). In your breasts, calcium tends to accumulate in cells that aren't quite right. So if any white calcium dots appear on a mammogram, radiologists take a closer look. Usually, cells with tiny calcium deposits are benign but having them raises your breast cancer risk, so you and your doctor need to schedule mammograms more often. If a "suspicious" calcification ever occurs, there's a 1-in-4 or 1-in-5 chance it's cancer. The good news is that if it is, the cancer's likely to be in an early, treatable stage.
The odds are with you: There's a 98 percent chance that benign calcifications don't signal cancer. If the tiny risk nags at you, get a second opinion from a radiologist at another center. It's not a bad idea anyway: 30 percent of second opinions change the diagnosis. If yours confirms the calcifications are benign, you'll sleep more soundly.
Dr. Mehmet Oz and Dr. Michael Roizen are authors of "You: On a Diet." Submit questions at realage.com.