Pericarditis causes pain

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DEAR DR. DONOHUE: My son is 18. He plays football and basketball. Two weeks ago he started having chest pains. I took him to a doctor who thought he had costochondritis. He didn’t get better. I took him to another doctor, who ordered X-rays. Within 30 minutes of the X-ray, we were told his heart looked enlarged. He was admitted to the hospital, and the doctor there had an echocardiogram taken. He had fluid around his heart and pericarditis. He was put on prednisone. A follow-up echo showed the fluid to be drying up. What are his chances of it coming back? Does he have permanent heart disease? He wants to play basketball in college. Will he be able to do that? – C.M.

ANSWER: Your son should be able to return to his athletic life without any restrictions. He does not have permanent heart disease.

Pericarditis is an inflammation of the pericardium. That’s a two-layered sac that encloses the heart. The two layers make it look a little like a woman’s handbag, with an outside coat and an inner lining. The pericardium holds the heart in place. The inflammation can happen at any age, but it most often strikes young adults.

Viruses, bacteria, a sluggish thyroid gland and rheumatic fever are all possible causes, but viruses are the most frequent ones.

Pericarditis causes pain – often severe and most often located on the left side of the chest. It worsens when the person lies down and lessens upon sitting and leaning forward. Sometimes the inflammation also leads to an outpouring of fluid between the two layers of the pericardium. That’s a pericardial effusion.

Aspirin, indomethacin and prednisone can ease the inflammation.

Most patients return to a vigorous life after the inflammation has completely subsided. A few have a relapse, but that, too, can be treated if it happens.

DEAR DR. DONOHUE: I had a colon polyp. It was bleeding. The doctor removed it with a scope. He told me the blood loss had left me anemic, and he prescribed iron for me. How does iron fix this anemia? How long will I have to take it? – B.S.

ANSWER: Anemia is a deficit of red blood cells, and that deficit can come about in many ways. In your case, the bleeding polyp caused you to lose so many red blood cells that your bone marrow – the site of blood cell production – could not keep up with the demand of supplying you with enough of those cells.

Red blood cells contain lots of iron. Without enough iron, the bone marrow cannot produce red blood cells. Your iron deficit has to be corrected so your bone marrow can begin production.

In one or two months, your red blood cell count should be near normal, but you have to continue taking iron for months after that happens. You need to replenish all the body’s iron storehouses.

DEAR DR. DONOHUE: What are crabs? My boyfriend says he has them. Will I get them? How do you catch them? How will I know if I have them? What’s the treatment? – M.M.

ANSWER: Crabs are pubic lice. If you look at one with a strong magnifying glass, it looks like a crab.

Most of the time, they are transmitted by having sex with someone who is infected.

If you have had sex with your boyfriend before he was treated, you’ll know in seven to 10 days if you are infected too. Crabs cause an intolerable itch.

There is treatment. Permethrin is one of the treatment medicines.

DEAR DR. DONOHUE: Is schizophrenia inherited, or does it come from bad parenting?

ANSWER: The cause of schizophrenia isn’t known for certain, but it is known for certain that parents are not responsible for inducing it by anything they do or do not do.

Genetics has a hand. If one parent has the illness, the chances are about 7 percent that one of that parent’s children will come down with it.

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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