DEAR DR. ROACH: I am a very healthy 74-year-old male. I am not on any medications and enjoy normal blood pressure and great stats from my regular bloodwork. I weigh 140 pounds and have been exercising every day faithfully for decades.

A couple of years ago, I started getting cramps in both legs throughout the night. My toes would curl down and my entire leg would get stiff; the pain was horrible. I had a terrible time “walking it off,” and very often when I finally got it to pass, as soon as I got back in bed the whole thing would start all over again. Sometimes I would go a few nights without having a problem, but there was always the fear that I would have another episode.

I read online advice to get the weight of the sheet and covers off the feet. I took a strong cardboard box and sleep with my feet in the open end of the box. The first time I got in bed with this rigged up, it felt very strange not having anything on my bare feet, but eventually I got used to it. The remarkable news is that I have not had a single episode since fabricating the box over six months ago. — G.K.

ANSWER: I appreciate your writing in. I have had many patients use a box during sleep for acute gout, where even a sheet on top of the affected toe can be exquisitely painful, but I had not heard this used for nocturnal leg cramps. Some patients have noticed that the symptoms do seem to be started or exacerbated by the weight of blankets.

Before resorting to that, I recommend regular exercise, even a few minutes of riding a stationary bicycle before bed can help. Couple that with regular stretching of the calf and hamstring muscles and adequate hydration. Although many readers ask about it, I do not recommend quinine for most people, and it’s quite rare for the cause to be disturbances of sodium, potassium, calcium or other electrolytes. B complex vitamins and magnesium are helpful in some people, but I restrict iron to people with proven iron deficiency.

If all else fails, prescription medications such as verapamil may be helpful.

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DEAR DR. ROACH: I’m getting low grade tumors in my bladder. I just had my second operation after the Bacillus Calmette-Guerin treatment didn’t work. I read that tumors can’t grow in an alkaline environment. Should I eat vegetables, like broccoli and sprouts? Also, would vitamin E and selenium be helpful? — R.G.

ANSWER: It is true that having an acid urine pH is a risk factor for bladder cancer. Many fruits and vegetables make urine pH more alkaline, whereas meat and dairy make the urine more acid. Smoking also makes the urine more acid.

Eating more fruits and vegetables (and abstaining from smoking) will help reduce recurrence of bladder cancer, though I’m not sure it’s through urine acidity. Please don’t stop your doctor’s recommendations, though, as diet alone is not adequate therapy for bladder cancer.

A 2012 study found no benefit in selenium and vitamin E on prevention of bladder cancer. It’s unlikely to be significantly effective in treatment.

Dr. Roach regrets that he is unable to answer individual questions, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu.

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