DEAR DR. DONOHUE: What causes a normal youth to develop schizophrenia when he reaches the early 20s? How can this condition be corrected? — S.B.
ANSWER: Schizophrenia happens at any age, but the late teens and early 20s are years when it frequently develops. The makings of it have been there from birth, with faulty brain wiring and faulty connections between brain cells. This young man had nothing to do with its onset. It’s usually a chronic illness, like diabetes and arthritis. Control with medicine and counseling is quite possible.
This illness is a great burden for the patient and the patient’s family. The schizophrenic gradually loses touch with the real world. Patients see things not present and hear things not spoken. They develop a set of delusions, false beliefs that become rooted in their minds — things like the belief that people are plotting against them. These things are real to patients and are a source of pain and anxiety. Their thinking loses organization, and they jump from one thought to the next. They withdraw from social interactions and live entirely in world known only to them. Holding a job is impossible.
Medicines can clear hallucinations and delusions, and talk therapy can expose to patients the falsity of their unreal world.
The outlook for a patient these days is so much brighter than it was in the past. The odds are in your acquaintance’s favor that he will be able to get the better of his illness and have a productive life in which he can contribute to society. Don’t anticipate a smooth road of success after success. Often, setbacks occur, but the general direction should be one of progress and hope.
This illness is as hard on patients as any illness known to humankind. Your friend or relative needs your love and encouragement.
DEAR DR. DONOHUE: Cellulitis is my problem. I am 78. First I got cellulitis in my right arm and was in the hospital for two weeks. Three years later, I got it in my left arm, and the doctor put me on antibiotics. This past year, I had to go on antibiotics again. What causes it? What is your advice? — A.K.
ANSWER: Cellulitis is a rapidly spreading infection of skin cells (hence, “cellulitis”) and the tissues beneath the skin. The Staph or Strep germs are the ones that are usually responsible for it. They enter skin cells through a cut, abrasion, boil or nick so minor that you never realized you had it.
Once the infection starts, it expands quickly. The skin turns red, becomes hot, is tender and people develop a fever and shaking chills. Antibiotics, along with elevation of the affected limb, usually can eradicate the infection.
Repeated bouts of cellulitis often happen to those with a swollen arm or leg. If this applies to you, the swelling has to be treated, and treatment hinges on its cause.
If swelling isn’t part of your picture, you might need treatment for a longer time than in the past. Or, sometimes prophylactic treatment is the correct route to take. That involves taking a monthly shot of penicillin or a daily antibiotic in a low dose for a prolonged period of time.
DEAR DR. DONOHUE: I had my annual exam, and my lab tests showed a low total iron-binding capacity, TIBC. The doctor tells me everything else is normal. What causes a low TIBC? — V.B.
ANSWER: A low value for a lab test indicates a deficiency. That isn’t the case with TIBC, which measures all the blood proteins that can hold on to iron. A low value here means that you have a higher amount of iron in the blood than normal. Sometimes it results from a liver problem, a low level of proteins or an illness called hemochromatosis. If you had one of those problems, other lab tests would be out of range, and you wouldn’t feel well. You can believe your doctor. Since everything else is OK, you’re OK.
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.