Anytime you notice blood suddenly appear in a place where you don’t expect it, it can be startling. If it appears during urination, most of us would immediately call the doctor.

The fact is that when the blood appears in the urine stream can tell you what kind of problem you have. If you see blood when you first start to urinate, it’s often a sign of a sore or infection in the penis, possibly caused by a sexually transmitted disease. If the blood shows up in the middle of urination, you may have a prostate problem. Or, if blood shows up as you’re completing urination, it may mean that the problem is due to a bladder infection. Blood in the urine might be a sign of a bladder tumor or a symptom of an underlying urinary tract infection.

However, the most common cause of blood in the urine, no matter where it appears in the stream, is a kidney stone. The stone causes irritation in the urinary tract, which, in turn, causes bleeding. The amount of blood can be undetectable, or it may be obvious. Another sign of a kidney stone is a pain in the back that radiates into the groin and penis.

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If your doctor suspects that you have gallbladder disease, based on a physical exam and your health history, he’ll do a sonogram to check for the location and size of the gallstone. If, you ate under 50 and have the symptoms of gallbladder colic but not cholecystitis, you’ll need to eat a low-fat diet for the time being. That should keep your symptoms in check.

In time, however, you may need to have a laparoscopic cholecystectomy performed. In this procedure, a small incision is made in the abdominal wall and a special camera-directed instrument cuts the gallbladder and removes it through the incision. This procedure will probably entail a hospital stay of no more than two days.

If your doctot determines that you have cholecystitis, you will probably need to have a laparoscopic cholecystectomy right away.

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Your risk of having breast cancer increases if you fall into one or more of the following categories:

• You have a close female relative who has had breast cancer.

• You’ve already had breast cancer in one breast.

• You have not given birth, or else had your first child after the age of 35.

• Your first period came before the age of 12; menopause came after the age of 55.

• You’ve been exposed to excessive amounts of radiation.

Unfortunately, these risk factors are etched in stone; there’s nothing you can do to change the fact that your chances of getting breast cancer are increased if you answer yes to one or more of the above statements.

Whether or not you are at risk, however, there are some things you can actively do to cut your chances of developing breast cancer. Being overweight, drinking more than a moderate amount of alcohol—more than three drinks a week—and using estrogen replacement therapy for hormonal problems during and after menopause can all increase your risk slightly. However, I feel that the benefits the hormone provides to the cardiovascular system and in treating osteoporosis outweigh this slightly increased risk. Contrary to popular belief, however, breast-feeding does not lower the risk of contracting breast cancer.

In recent years, there has been a question of whether or not the presence of fibrocystic disease in your 20s and 30s will increase your risk of breast cancer later on. The conclusion has been that the disease itself does not significantly increase your risk; however, if some of the cells involved in the disease turn out to be abnormal upon testing, your risk does increase slightly.

In very rare cases, where a woman’s chances of getting breast cancer are almost certain, she may choose to prevent any tumors from ever forming by undergoing a bilateral mastectomy—the removal of both breasts—before a tumor has a chance to grow.

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You may scoff at weekend athletes, those people who sit in the office all day from Monday to Friday and then act as though they’re the star quarterback for their high school football team all weekend. “Come Monday morning, their backs are going to make them very sorry,” you think before going back to your more sedate activities such as walking and gardening.

Don’t laugh! Though Monday mornings may be difficult for the midlife adult who likes being a weekend athlete, any activity—from gardening to turning your head to reaching for a spoon—can cause the muscles in your back to spasm suddenly.

A muscle spasm can be caused by a number of conditions, both preexisting and current:

• You may have strained a ligament or muscle in your back.

• You may have pulled a muscle.

• You may have made a sudden movement, such as a sneeze, that jarred your back or spine, or you may have injured your back previously.

• You may have fractured one of the vertebrae of the spine.

• You may be able to move your back easily, even though it hurts, or your back muscles may have stiffened up to the point where it’s difficult to move at all.

The cause of a sharp pain in your back may be difficult to determine, though it is usually due to overuse of the muscles in the back in some way.

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To treat a pulled muscle in your neck, you should first try to massage the area gently with your fingers, kneading the sore muscle and stretching your neck at the same time.

In addition, try taking an over-the-counter pain medication such as Advil four times a day, as well as applying a moist heating pad three times daily to relieve your discomfort.

If these methods don’t bring relief after a few days, see your doctor He may prescribe a muscle relaxant such as Valium to ease the pain or a stronger nonsteroidal medication such as Naprosyn, Lodine, or Toradol.

And if these don’t help, your doctor will suggest that you see a physical therapist several times a week for additional treatment, which may include hot packs or electrical stimulation. But it’s rare that a pulled neck muscle will bring you to this point, since torticollis usually lasts only about a week.

Tips and Precautions

To prevent a pulled neck muscle in the future, try stretching more before you exercise. It’s also a good idea to spread your exercise out over the whole week and not just restrict it to Saturday and Sunday. This will also help to cut down on your overall injury rate.

You might also try eliminating your pillow at night. Especially if you have been unable to trace the cause of the muscle pull, this may be a simple—and the only—solution.

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