DEAR DR. DONOHUE: Five years ago my right breast was removed because of cancer. Now my right arm is swollen, and I have a hard time using it. My sister has swollen legs, and she was given a water pill that brought her swelling down. My doctor won’t give me a water pill. He says it will not work for me. Why? What will work for me? – G.S.

ANSWER:
All body cells, tissues and organs are bathed with fluid that provides nutrition and sweeps away wastes and germs – lymph fluid. Lymphatic vessels – structures that look a bit like blood vessels – vacuum this fluid to return it to the circulation.

In surgeries where lymphatics are unavoidably disturbed, the lymph fluid is not drained. It remains and causes swelling in the body area that has defective lymphatics. Close to 15 percent of women who have had extensive breast surgery or who have had radiation develop swollen arms. That situation is lymphedema. Water pills do nothing for lymphedema because it arises from faulty drainage of body fluid and not from an excessive amount of body fluid.

Lymphedema is not without treatment. Trained therapists can massage the swollen arm to mobilize the lymph fluid and to help it drain to regions where healthy lymph vessels can vacuum it and return it to the circulation. Pneumatic pumps are also used for the same purpose. A local chapter of the American Cancer Society can provide you with the location of professionals who treat this complication of surgery.

Your sister’s swollen legs are a different matter. Her body retains too much fluid. Heart disease, kidney problems and liver malfunction are some of the conditions responsible for such fluid retention. Water pills help this kind of swelling, which is called edema.

The recently printed pamphlet on edema and lymphedema provides an explanation of these two conditions and an outline of their treatment. Readers can obtain a copy by writing: Dr. Donohue – No. 106, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.50 U.S./$6.50 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: Last January the tips of my index and middle fingers were frostbitten. They told me that I was in danger of losing those fingers. Everything turned out well, but I now have a numbness there. Will I ever regain feeling? – M.F.

ANSWER:
Frostbite can leave a person with permanent aftermaths. Some have chronic pain in the frostbitten skin. A few sweat profusely from that site. If a joint was involved, arthritis can result.

Numbness is another sequel. There’s not a whole lot that can be done for it. I don’t mean to minimize your problem, but you are quite lucky that your fingers were saved.

DEAR DR. DONOHUE: I have noticed white patches of skin on my husband’s back. He says they don’t hurt or itch. Could this be eczema? What can he do for it? – S.S.

ANSWER:
That’s not eczema. Eczema itches with a ferocious intensity.

If your husband works outdoors and if he works without a shirt, those white patches of skin could be tinea versicolor. It’s a fungal infection that causes depigmentation of the infected skin.

The white patches stand out when adjacent skin is tan. Many people call this sun poisoning. It’s not.

Seldom do the patches itch or become painful. They sit there, more or less inert.

The appearance of the skin makes a person believe that this must be something horrible. It is not a serious problem, but it can spread, so treatment is usually given.

Selenium sulfide lotion is one usually effective remedy. The treatment is long, and sometimes the fungus comes back, so prepare your husband for a lengthy battle. The tinea versicolor fungus is hard to banish.

Readers may write Dr. Donohue or request an order form of available newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible.


Only subscribers are eligible to post comments. Please subscribe or to participate in the conversation. Here’s why.

Use the form below to reset your password. When you've submitted your account email, we will send an email with a reset code.