Herpes-positive patient needs to share truth

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DEAR DR. DONOHUE: I am a man, 68 years old, and have recently begun a relationship with a woman, 58. Prior to this relationship, neither of us had had sex for a considerable time. We are monogamous and practice unprotected sex. I love this woman and hope to make her my wife.

The problem is that I have a case of herpes, dating back to my youth. I have only yearly flare-ups. My doctor gave me a prescription for Famvir to use as prevention. We are abstinent during an outbreak. I understand that herpes is contagious even when dormant. How contagious is it during dormancy? Are there any preventive measures to take other than using condoms? – F.F.

ANSWER:
It is true that herpes can be transmitted even when an infected person has no signs of infection. However, when the virus is dormant, the chances of transmission are much less than they are when there is a visible herpes outbreak. Having said that, I must also add that herpes is mostly spread by those who don’t know they are infected or whose infection is in a hibernating stage.

One-quarter of the adult population is estimated to be infected with the herpes virus. It is unrealistic to expect that one-quarter of the adult population to abstain from sexual relations. Condoms, while not affording complete protection, provide significant protection. Another possible way to avoid transmission is for the infected partner to take an anti-herpes medicine on a long-term basis. Studies have shown that taking Valtrex, a medicine similar to your Famvir, reduces herpes transmission in situations like yours. However, not many people want to be on lifelong treatment. You have to discuss this with your doctor.

The best approach is to be frank with your partner and let her give her input. You were infected a long time ago. The risk of transmission diminishes, but doesn’t go completely away, the longer a person is from the time he or she first acquired the virus.

DEAR DR. DONOHUE: My hubby wants to know the best way to take blood pressure. Should a person be sitting, standing or lying down? – M.P.

ANSWER:
Prior to having blood pressure taken, a person should not have drunk coffee or smoked a cigarette for 30 minutes. He or she should be sitting quietly in a chair for five minutes before recording blood pressure. Sitting is suggested because most studies on blood pressure were done with people in the seated position. The feet should be on the floor without one leg crossed over the other. The arm around which the blood pressure cuff is wrapped ought to be bent at the elbow and supported. Letting it rest on the arm of a chair is fine. The blood pressure cuff is supposed to be at a level horizontal to the heart. The cuff should be applied to bare skin, not wrapped around a shirt or sweater sleeve.

DEAR DR. DONOHUE: I know you get more serious questions, but I would really appreciate it if you would answer my question.

My son-in-law wears a cap all day. He takes it off when he showers. I keep telling him this is not healthy. Although he has a very healthy head of hair now, I believe he will eventually start to lose his hair. Am I right? He says I am completely wrong. Will you give us your opinion? – R.C.

ANSWER:
I’d like to be in your corner, but I can’t be. Your son-in-law’s habit is strange, but it won’t affect the growth of his hair or cause hair loss.

You wouldn’t believe how frequently this question comes up. A large segment of the population wears a hat or a cap at all times and in all places. I can’t figure out why.

DEAR DR. DONOHUE: My sister, 26, has a supposedly inherited anemia called spherocytosis. It was just discovered. My mom and dad don’t have it, nor do the seven other children in our family. How can this be inherited? How is it going to affect her life? – B.N.

ANSWER:
Spherocytosis is an inherited anemia, and for most patients, only a single gene – either from the mother or father – transmits the condition. However, it can have a different inheritance pattern, one in which the parents are carriers of the gene without having any signs of the anemia. Many of these parents’ children also escape coming down with the illness. Your sister who has spherocytosis most likely got two genes – one from her mother and one from her father, although neither has any signs of the illness.

Another possible explanation is that your sister’s genes underwent a mutation during embryonic life. She has the gene, but no one else in the family has it. She can pass the gene on to her children.

With spherocytosis, red blood cells look like solid spheres, unlike the normal red blood cells, which are round disks with central indentations on both sides. Spherocytes die young. The bone marrow often cannot keep up with their premature death, and anemia results.

Some spherocytosis patients have an anemia that is so minor they aren’t bothered by it. That might apply to your sister, since she was 26 before the anemia was discovered. Others have a more profound anemia and have all the signs and symptoms of anemia: breathlessness on little physical exertion and constant tiredness. Removing the spleen almost always corrects the anemia, for the spleen traps and destroys spherocytic red blood cells.

Another point about spherocytosis bears mentioning: Many people who have it develop gallstones at an early age.

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

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