Dear Dr. Roach: I am an 83-year-old man in reasonably good health. About six months ago, I started hearing a cracking noise when I turned my head sideways or up and down. Sometimes it would happen every 15 seconds. No one can hear it but me, which is why I haven’t gone to my family doctor. I also have had some light headaches.
The cracking noise could be coming from one of the joints in your neck. Most people at age 83 have some degree of arthritis in the neck, and I think that’s the most likely cause.
Sometimes there can be a snapping noise or sensation as tendons move over a bony prominence.
Other times, there can be a cracking noise, such as cracking knuckles, for the same reason, with nitrogen bubbles forming in the joint with pressure changes. But a crunching or cracking noise most often comes from the joint itself, and often represents some degree of arthritis.
If it’s not bothering you, nothing need be done. A set of X-rays could confirm and determine the severity of arthritis.
The headaches may have nothing to do with the sound, but there are headaches that can be triggered from neck arthritis.
Dear Dr. Roach: If a person has lower than optimally functioning kidneys, and protein is hard for kidneys to process, is it easier for kidneys to process plant protein or animal protein?
Plant protein definitely is better for the kidneys. Switching from a meat-based diet to a plant-based diet has been shown to slow the progression of kidney disease from many different causes. A plant-based diet has probable benefits in terms of heart disease as well, compared with a diet high in animal protein, especially red meat.
Reducing animal protein is only part of what needs to be done for kidney disease. Depending on how advanced the kidney disease is, some people need to reduce the amount of potassium they take in. It also may be appropriate to look carefully at medication doses, which often need adjusting in people with kidney disease.
Dear Dr. Roach: I am an 85-year-old man who has been bothered with trigger finger for a number of years. My doctor says I’m in good health for my age. Several years ago, a doctor said he could give a cortisone injection but would not guarantee it to work over a long period. I had three, and they did not work. What are my options now?
A trigger finger is a condition where a finger (or the thumb, which is considered a finger) gets stuck in the bent position, requiring it to be pulled back into place again. It is caused by one of the tendons getting caught in a pulley system inside the finger. Treatment usually includes modification of activity, short-term splinting and anti-inflammatory drugs, or cortisone injection if that doesn’t work. Only people who have failed to get relief from injections should be considered for surgery. That’s the choice you have to make now. The surgery is very effective (about 94 per cent success rate), and most people are back to near-normal activities in a week or two.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu.