DEAR DR. DONOHUE: I recently was tentatively diagnosed with CMT disease. Having never heard of it, I did some research myself but can you give me advice as to what I can expect? I am 53 years old and am awaiting more bloodwork results to make sure it is CMT. — C.S.
ANSWER: CMT — Charcot (shar-COE)-Marie-Tooth disease — is a common, inherited nerve disorder that has a multiplicity of signs and symptoms, because a multiplicity of different genes are involved. CMT type 1, the most common variety, shows itself with numbness, tingling and/or burning sensations of the lower legs. This is evidence that “sensory” nerves are involved, the ones that bring sensations to the brain. Lower leg muscles are also involved, indicating motor nerves also are affected. Motor nerves are the ones that tell muscles to move. Signs of motor nerve involvement are trouble walking, frequent stumbling and tripping, and shrinkage of the lower leg muscles. The legs look like upside-down champagne bottles. In some people, the hands and arms are part of the process.
The blood tests you are waiting for must be gene studies.
The progression and involvement of CMT is highly variable. Some are so slightly affected that they scarcely know they have an illness. Others are more severely incapacitated. Life span is not shortened.
Your symptoms have appeared late in life, so you’re not likely to face serious disabilities.
You’ll find the Charcot-Marie-Tooth Association a source of valuable information. You can reach it on the Internet at www.charcot-marie-tooth.org.
DEAR DR. DONOHUE: Will you write about memantine (brand name Namenda)? Who manufactures it? What are its uses? Are there any don’t-take issues?
I’d also like to know if there are any other medicines that can be used instead of it. — L.W.
ANSWER: Namenda is manufactured by Forest Pharmaceuticals of St. Louis. It’s a drug for Alzheimer’s disease. It blocks the action of glutamate, a brain chemical that activates brain cells that contribute to the symptoms of Alzheimer’s. It has to be used with care in those with poor kidney function. It might bring on heart failure, transient ischemic attacks and anemia, but those effects are few and far between.
Often, Namenda is used in combination with one of three other Alzheimer’s drugs: Aricept, Exelon or Razadyne. They have a different mode of action.
DEAR DR. DONOHUE: Please list the dangers of cigar smoking. — S.M.
ANSWER: Cigars can encourage the development of lung cancer, but, if a smoker doesn’t inhale, the danger doesn’t approach the danger that comes from cigarette smoking. Cigars also promote cancer of the mouth, larynx (voice box) and esophagus.
Even if cigar smokers don’t inhale, they have a higher incidence of chronic obstructive pulmonary disease than do nonsmokers. Chronic obstructive pulmonary disease includes emphysema and chronic bronchitis.
Cigar tobacco contains more nicotine that does cigarette tobacco. Nicotine has a multitude of unhealthy consequences, and it is absorbed into the blood through the lining of the mouth.
Cigar smokers have a high level of carbon monoxide in their blood.
DEAR DR. DONOHUE: My son had an EKG where the upgoing line was normal but the downgoing line went very low. He was checked with other tests and was told everything was OK. Have you heard of anything like this? It concerns me. — L.S.
ANSWER: You needn’t be concerned. Often EKG patterns suggestive of possible heart trouble are overruled by other, more sensitive tests. What you describe was nothing more than a normal variation on his EKG.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.