January 15, 2011 in Features Peter H. Gott, M.D., United Media the Spokesman-Review

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DEAR DR. GOTT: I am disabled with extensive nerve damage from liver failure. I have a lot of problems. Just in the past few months, I’ve had spells where I yawn constantly. the problem usually starts shortly after I wake up, but it also happens later in the day. they aren’t wimpy little yawns, either, but those that start in your toes and gather momentum as they head north. by the time they reach my head, my mouth is wide open and I’m stretching my jaw as far as I can. this may go on for hours and simply wears me out, not to mention that it kinda hurts. Any ideas?

DEAR READER: unless performed intentionally, yawning is an involuntary action involving many body parts. the mouth opens, the jaw drops, abdominal muscles flex, lungs expand, the diaphragm is pushed down, heart rate increases, and muscles and joints flex. the process is reversed as we force that air back out of the mouth. People of every age – even an 11-week-old fetus will yawn. And when we see someone do just that, we will likely follow along. To even read about the topic in my column will likely cause a person to yawn.

Excessive yawning can be caused by a vasovagal reaction on the blood vessels and could indicate a cardiac problem, sleep apnea or excessive daytime fatigue. Because of this, you should address the subject with your doctor or cardiologist. Yawning doesn’t reflect boredom, as proven by athletes who will yawn prior to running a race or entering a swim meet. Therefore, I recommend you make that appointment so you can get to the bottom of the problem.

To provide related information, I am sending you a copy of my Health Report “Sleep Wake Disorders.” Other readers who would like a copy should send a self-addressed stamped no. 10 envelope and a $2 check or money order payable to Newsletter and mailed to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. be sure to mention the title.

DEAR DR. GOTT: Is there any cure for scleroderma?

DEAR READER: the localized form of scleroderma affects only the skin, while systemic scleroderma damages the heart, lungs, kidneys and digestive system. Symptoms and treatment vary, depending on the type.

Localized scleroderma can resolve on its own, systemic cannot, but a variety of medications is available to reduce the intensity of pain and help control symptoms. some drugs can dilate blood vessels, possibly reducing the severity of symptoms of conditions such as Raynaud’s disease and kidney and lung abnormalities. Physical therapists can help a patient work toward methods to manage pain, improve mobility, and increase strength. the appearance of skin lesions can be helped through ultraviolet-light exposure or laser surgery.

On the home front, a person should remain active, protect the skin from cold, discontinue smoking, and refrain from eating foods that contribute to heartburn or gas. Walking, yoga or tai chi might be to your liking. should Raynaud’s be present, remember to protect your hands at all times, such as by wearing gloves when placing foods in or taking them out of the freezer, or when hanging clothes on the line to dry.