Q: My mom thinks she needs laser treatment for her diabetic retinopathy. I've told her that there's new stuff out there and that she should find out more about the latest treatments before she makes any decision. What do you think?-Doris G., Bayside, New York
A: You're a good daughter, Doris. There is something pretty new that's approved for the treatment of diabetic eye disease. For a long time, laser treatment, or panretinal photocoagulation (PRP), was the best eye docs could do to treat diabetic retinopathy. And in some cases, it still is. However, anti-VEGF treatment ("VEGF" stands for "vascular endothelial growth factors") has been improving, and sometimes actually can reverse retinopathy and improve vision. One anti-VEGF, ranibizumab injections (Lucentis), recently was approved for all forms of retinopathy. It was found to stop disease progression for up to two years! Previously it was approved for treating wet age-related macular degeneration. Anti-VEGF therapy generally comes with fewer risks than laser surgery, which can cause a slight loss of peripheral, color and night vision.
Diabetic nonproliferative retinopathy, the first stage of the diabetic eye disease, happens when chronically high glucose levels damage blood vessels in the retina, making them leak. This can lead to macular edema-a swelling in the retina's macula-the area responsible for your sharpest vision. Proliferative retinopathy is a more advanced stage in which the damaged retina releases VEGF (hence the anti-VEGF treatment). That causes tiny, fragile blood vessels to grow. They rupture, and more grow in their place. Scar tissue builds up, and the retina may become detached. Vision can be severely compromised, or lost entirely.
So tell your mom to explore all of her options with her ophthalmologist (make sure the doc specializes in diabetic eye disease). Her treatment might be a combo of anti-VEGF and laser, or laser and then anti-VEGF. Whatever it is, good control of her diabetes-and not smoking-is essential if she wants to keep her vision sharp.
Q: My 14-year-old daughter is shy and gets picked on at school. That's why I was so shocked when she asked if she could get a nose job and cheek implants! At first I was inclined to say "No way!" but if it makes her feel better about herself What's your opinion?-Katlin B., New York
A: We're glad you asked. Being bullied has a long-lasting impact on a child. The potential repercussions include depression, headaches, problems adjusting to school and long-term damage to self-esteem. So, if you haven't talked to your daughter about how it's not her fault that she's bullied, start that conversation tonight. You also need to discuss how to get support from school and her peers-and help her do that. Check out www.stopbullying.gov to launch an initiative.
The Centers for Disease Control and Prevention indicates that about 20 percent of U.S. students in grades nine-12 experienced bullying on school property within the past year; around 7 percent experienced cyberbullying.
As for plastic surgery a new study shows that over 11 percent of kids age 11 to 16 who are bullied want plastic surgery to improve their appearance or boost their self-esteem. Only about 1 percent of kids who are not bullied are interested. Around 226,000 teens have minimally invasive and cosmetic surgery procedures annually.
We'd recommend caution for now. Your first job is to help your daughter feel more beautiful on the inside-stronger, more confident-by helping her find activities she can excel in and make friends through. And then you should consider cognitive therapy. The teen years are a fragile time, and having a safe, neutral haven where she can express and sort out feelings can allow your daughter to cope and thrive. When she's on her own, she can make the decision whether to have cosmetic surgery. But give her a chance to be comfortable in her own skin.
Mehmet Oz, M.D. is host of "The Dr. Oz Show," and Mike Roizen, M.D. is Chief Wellness Officer and Chair of Wellness Institute at Cleveland Clinic. Email your health and wellness questions to Dr. Oz and Dr. Roizen at [email protected].
(c) 2017 Michael Roizen, M.D. and Mehmet Oz, M.D.