DEAR DR. DONOHUE: I have been diagnosed with a disease of the heart called amyloidosis. What can you tell me about it and its treatment? I had never heard of it. — R.S.
ANSWER: Amyloidosis isn’t one disease; it’s a group of related illnesses that have in common the infiltration of tissues and organs with a peculiar protein called amyloid. Amyloid is produced by cells called plasma cells, found in the marrow. A line of these cells starts to proliferate and produce amyloid. What stimulates it to do so is not known. Amyloid seeps into many tissues and many organs, leading to their malfunction. The kidneys often are the target, and amyloid might make them fail. The heart is another potential target. Liver, bone marrow, nerves and skin also can become permeated with amyloid.
General symptoms such as fatigue, weight loss and swelling are common to many amyloid variations. Specific symptoms depend on the organs attacked by amyloid.
Amyloidosis is a rare disease. Unfortunately, it is rarely diagnosed. Your doctor deserves congratulations for discovering the cause of your symptoms. Sometimes the diagnosis is made only through taking a biopsy of an involved organ and submitting it for microscopic inspection. A sample of abdominal fat also offers a reliable source of material for microscopic examination.
What medicines are available for you? The same medicines used for heart failure will help your heart to beat more strongly if that stage is ever reached. Mephalan, with or without prednisone (one of the cortisone drugs), often is used for control of amyloid production. In some, adult stem cells can be obtained and used in treating this condition.
You’ll be well-served by becoming acquainted with the Amyloidosis Foundation, whose toll-free number is 877-AMYLOID and whose website can be found at www.amyloidosis.org. The foundation will keep you abreast of the latest developments in treatment.
TO READERS: Heart attacks remain the No. 1 cause of death. The booklet on that topic explains them and their treatment. To obtain a copy, write: Dr. Donohue — No. 102, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: Please explain why my urine stream stops and starts. It has come on in the past six months. I am a 44-year-old male. — M.A.
ANSWER: A urine stream that starts, stops and restarts often indicates that the urethra is blocked. The urethra is the tube that drains the urinary bladder. An enlarged prostate gland is a frequent cause of urethral blockage.
Prostate enlargement isn’t common at age 44. I can make other guesses, but you need a doctor’s direct examination and questioning. This is a sign that should not be ignored.
DEAR DR. DONOHUE: I am 71 years old and have some memory loss. My daughter and my doctor suggested I take Aricept. I have always been able to take care of my own needs and never forget my 11 grandchildren’s birthdays. I pay our bills when due and so on. I stopped the Aricept and don’t see any change. While I was taking it, I had night sweats and never fell asleep until 2 or 3 a.m. I am sort of nervous to tell my doctor that I stopped. — J.D.
ANSWER: It’s impossible to judge a person’s competence by a short letter. However, unless I am deluding myself, you seem to have as keen a mind as anyone I know. If you believe Aricept wasn’t helping you but was causing side effects, you are more than justified in stopping it.
I firmly believe we are an overmedicated society.
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.