Last updated: Apr 19, 2009
Q: Ive never had knee problems, but since I turned 40, my knees are killing me whenever I walk up the stairs. Do I need surgery?


A: Probably not. As we age, the cumulative wear and tear on our knees can take its toll. The tissue in these joints thins, and old sports injuries can complicate matters.

A rheumatologist or orthopedic surgeon can check for osteo-arthritis, the most common joint disease, which can affect knees even if you dont notice it in other joints.

Anti-inflammatory meds or physical ther­­apy may bring some relief. Your doc will also look for undiagnosed injuries, such as a torn ligament, sprained muscle, or chipped bone. Loss of cartilage is another cul­prit. Treatments vary, and many are successful, but in some cases surgery may be necessary.

A: Trembling hands can be traced to a number of causes, both harmless and serious. Too much caffeine, which triggers the release of adrenaline, can leave you shaky, and so can alco­hol, which affects the central nervous system. Cut back on both to see if the shakes subside. Stress and anxiety can cause trembling, too. Make an effort to relax with meditation or deep-breathing exercises.

As we age, whats known as an “essential tremor” can show up as early as our 40s, and it affects nearly 15 percent of people over 65. You might first notice it when picking up small objects. This tremor isnt linked to any diseases, nor does it signal future problems. If it really bothers you, your doctor might prescribe a beta-blocker, tranquilizer, or anti-seizure medication to reduce it. Your doctor will also want to rule out a neurological disease, such as Parkinsons, and check to see if any new medications might be causing your shakiness.

Q: Ive been gassy lately. How can I avoid any embarrassing emissions in big meetings?

A: Most of us know to skip the bean burrito right before those meetings, but heres another idea: keep a “food diary” to discover what grub troubles you. Eating problem foods in moderation the day before and day of your big meetings may help. Some common offenders that could show up in your notes are …

Sugars. Complex sugars, found in some vegetables (such as cabbage and onions) and almost all fruits, can cause gas, as can artificial sweeteners in gum and candy.

Dairy. Milk contains lactose, a natural sugar thats notorious for causing gas. If you suspect youre lactose intolerant, avoid milk products for a week or two and see if the noise subsides. Over-the-counter supplements like Lactaid or Lactrase can supply your system with the enzyme lactase to help you digest.

Starches. Potatoes, corn, pasta, and wheat are gas producers. One safe starch? Rice.

Fiber. Its good for you, but the tough-to-digest fiber found in beans, peas, apples, oranges, and oat bran is a big culprit.

Carbonated beverages. Skip the sodas and fizzy drinks on important days.

Q: Im in perimenopause and having mood swings—and its getting me in trouble at work. What can I do to stay calm?

A: Remember: This too shall pass. A body adjusting to lower hormone levels is bound to hit a few rocky patches—but it will adjust in time. If you feel anger getting the best of you, try relaxation techniques. For example, sit down, count slowly to 10, and inhale and exhale slowly.

Rest is crucial, so try to get an extra half-hour of sleep each night. Cut back on caffeine, and get some regular physical activity each day (but not right before bed) to avoid tossing and turning.

Know that you dont have to suffer. Your doc can refer you to a therapist, suggest antidepressants, and discuss the risks and benefits of hormone replacement therapy, which may give you some relief.