DEAR DR. DONOHUE: Eight months ago, I had open-heart surgery to bypass two heart arteries. The surgery went fine. However, I have an enormous scar that used to hurt but now itches. I have to wear dresses with high necks to hide this disfiguring scar. My surgeon says nothing can be done. I would like your opinion. – P.R.

ANSWER:
You describe a keloid. Keloids are huge, irregularly shaped scars that extend far beyond the borders of the cut skin. They can hurt, itch or have no symptoms other than being an unpleasant sight. The reason why some people form these scars has yet to be explained. Black people are quite susceptible to forming them.

Your doctor is too pessimistic. It is true that keloids can be devilish to remove, but there are ways of going about trying to remove them. You need to speak to a plastic surgeon or a dermatologist.

One treatment is the essence of simplicity. A keloid patient applies a special adhesive strip to the scar. It is called silicone gel sheeting. The patient has to apply a new strip daily for at least eight weeks before a significant change occurs.

Doctors can inject triamcinolone, a cortisone drug, into the keloid every six to eight weeks and keep injecting it until a response occurs.

Surgically removing the keloid coupled with injection of cortisone after its removal is another method. The patient must also wear a pressure dressing after the surgery.

Laser treatments are another avenue to explore.

Granted that not every patient responds to these treatments and granted that keloids can come back, it is still worthwhile to get a second opinion from a doctor experienced in treating these scars.

DEAR DR. DONOHUE: I am 42 and used to be a heavy drinker. From age 30 to 35 I put away much alcohol. I haven’t had a drink in the past seven years. I wonder if my previous drinking damaged my liver. How much alcohol does a person have to drink before getting cirrhosis? – D.D.

ANSWER:
Cirrhosis is a liver filled with scar tissue. Such a liver is unable to perform the hundreds of jobs it’s supposed to, jobs like metabolizing protein, fat and sugar, and detoxifying the blood of the daily buildup of harmful byproducts that come from all body organs and tissues.

It’s nearly impossible to dogmatically say how much alcohol leads to cirrhosis. Roughly five drinks a day for a man and three a day for a woman over a span of 10 years do so. A drink is defined as 12 ounces of beer, 5 ounces of wine or 1.5 ounces of distilled spirits.

If you want to know the current status of your liver, ask your doctor to order a few blood tests that indicate liver health or illness.

DEAR DR. DONOHUE: I never heard of cancer of the uterus. I just had my uterus removed because of it. I am 63, and I had been spotting off and on for the past year. I ignored it. When I told my doctor, he insisted that I have a biopsy immediately. I did, and it came back cancer.

Since there is little information on this kind of cancer, I would appreciate any facts you can supply, like how long a life I will have. – N.J.

ANSWER:
Uterine cancer is not an infrequent occurrence. On this continent, close to 40,000 women will be diagnosed with it this year.

Your story ought to make every woman who is past menopause sit up and take notice. Vaginal spotting after menopause suggests cancer, and an investigation should not be delayed.

Uterine cancer is also called endometrial cancer, so maybe you can find more information if you look for that designation. The endometrium is the lining of the uterus.

In its early stages, endometrial cancer can be cured in 90 percent or more of the women who have it. When the cancer has spread out of the pelvis, the five-year survival rate is only 27 percent. Your doctor will know what stage uterine cancer you have.

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.


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