DEAR DR. DONOHUE: In the past year, my husband complained of dizziness and feeling weak. On more than one occasion, I thought he was going to pass out. After many doctors and equally as many tests, he was diagnosed with hypoglycemia and is scheduled for removal of a tumor in his pancreas. I have heard of hypoglycemia before, but I never heard of it in relation to a pancreas tumor. Is such a tumor common? – R.K.

ANSWER:
Many people who have hypoglycemia (low blood sugar) have so-called reactive hypoglycemia. These people are exuberant producers of insulin, the hormone made in the pancreas and responsible for lowering blood sugar. When they eat, especially when they eat carbohydrates (sugars and starches), they release an excessive amount of insulin, and blood sugar drops. Smaller and more frequent meals can often control this kind of hypoglycemia. It was frequently diagnosed in the past and often overdiagnosed.

Special cells in the pancreas make insulin. In your husband, those cells have become a tumor called an insulinoma. A normal blood sugar is around 70 mg/dL (3.9 mmol/L). When the blood sugar drops below that level, a normal pancreas stops making insulin. Your husband’s tumor, however, pays no attention to the blood sugar level and keeps pouring out insulin. His blood sugar can dip to 50 (2.7) or lower.

The symptoms of low blood sugar include a racing heart, sweating, tremors, mental fog and blurred or double vision. People with such sugar levels feel they are about to pass out. Eating or drinking something sweet quickly reverses the symptoms.

CT scans or ultrasound pictures disclose these tumors.

In a sense, your husband is lucky. Once his tumor has been removed, he will stop having attacks of hypoglycemia.

DEAR DR. DONOHUE: I find that the middle finger on my left hand often locks in the bent position. When I forcefully straighten it, it makes a snapping noise and hurts. What is going on here? – V.R.

ANSWER:
Your finger has all the hallmarks of trigger finger.

With trigger finger, the protective sheath that surrounds the tendon to the involved finger becomes inflamed. The inflamed sheath causes the tendon to freeze, and the finger becomes temporarily locked when it bends. I don’t know what causes it.

Sometimes a splint of the finger can diminish the inflammation of the tendon sheath. It’s a forced rest that gives a chance for the inflamed tendon sheath to cool down.

Most people need a shot of cortisone into the area of inflammation. If the finger is still locking three weeks after the cortisone injection, a second injection can be given. More than 60 percent of people respond to injections.

If people obtain no improvement with cortisone, and if the snapping finger is a major interference in carrying out normal, daily tasks, then a surgeon can release the tendon from the sticky sheath.

One note is worth mentioning. People who have diabetes, rheumatoid arthritis, a sluggish thyroid gland or gout are more apt to have trigger fingers than is the rest of the population.

DEAR DR. DONOHUE: I am 85. My children are now in their 50s and 60s, and they all wear glasses. There are nine of them. When all my children were born, the doctor told me to flush their eyes with boric acid for one month. I did as instructed. I wonder if that is the reason why they need glasses. I don’t. – P.M.

ANSWER:
You are the second person to write about the boric acid treatment. I had never heard of it. It used to be a popular treatment for eye infections, but with the advent of antibiotics it fell out of favor.

I have no idea why the doctor(s) made the recommendation.

I can tell you with assurance that the boric acid flushes are not responsible for your children’s need for glasses.

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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