DEAR DR. DONOHUE: My wife has shocked me. She and I are 74. She has just told me that she had syphilis before she married me. She says she was treated and was told she would not pass it on to anyone else. Not only am I shocked, but I wonder if I could be infected. – W.R.

ANSWER:
A brief rundown of the syphilis saga can put your fears to rest.

About three weeks after exposure to syphilis, the formerly uninfected partner develops a sore on the genitals if that person caught the syphilis germ. The sore is called a chancre (SHANK-ur), and it usually is painless. The chancre, even without any treatment, heals in three to 12 weeks.

About two months after the chancre’s appearance, a red rash often covers the newly infected person’s body. Simultaneously, lymph nodes enlarge. These manifestations also disappear without treatment. The germ, however, remains in the body.

Twenty years after the infection took place, the germ can pop back to life and can injure the brain or heart.

Untreated syphilis patients usually transmit the infection in the first year of their infection. After four years, an untreated person is not likely to transfer the germ.

Adequately treated people, such as your wife, present no danger of passing the germ. Furthermore, your wife had no symptoms of the later stages of syphilis. If she had, she would have seen a doctor. They are not symptoms a person ignores.

If you want to put the matter to rest, ask your doctor to order a syphilis blood test. I am almost as sure it will be negative as I am that the sun will rise in the east tomorrow.

DEAR DR. DONOHUE: I was a dedicated smoker, but I broke the habit 10 years ago. A fellow worker tells me that my chances of having a heart attack are the same as they would be if I had continued to smoke. He also tells me I am still at risk for lung cancer.

Are these the real facts? – G.M.

ANSWER:
Your source of information is not the best.

Everyone benefits almost immediately upon stopping cigarette smoking. Cigarette smoke contains carbon monoxide, and carbon monoxide sticks to red blood cells so tightly that the red blood cells cannot carry oxygen from the lungs to the rest of the body. Within one day of abstinence, the carbon monoxide blood levels fall, and the body gets its fair share of oxygen.

People who smoke have a 70 percent increased risk for a heart attack. After one year of not smoking, the risk is cut in half. By 15 years, the risk of heart attack is the same as it is for a person who never smoked.

Smokers have a seven to 20 times greater chance of coming down with lung cancer than do nonsmokers. After 10 years of cigarette abstinence, the risk drops to half of what it was. After 15 years of abstinence, the former smoker has a lung cancer risk about four times that of a lifelong nonsmoker.

These numbers are nothing more than rough estimates. The risk of cigarette-caused illness depends on the age when people started smoking, the number of cigarettes they smoked daily and the number of years they were smokers.

DEAR DR. DONOHUE: When I was 17, I had mumps. I wonder if they caused an arrest of sexual development. Are there any statistics on that? – J.K.

ANSWER:
I am not clear on what you mean by “sexual development.”

Having mumps before puberty practically never interferes with a man’s ability to father children, nor does it retard a boy’s sexual maturation.

It used to be taught that mumps after puberty frequently led to sterility. That is not so. Even having mumps later in life does not usually make a man infertile. Nor, at that age, does it have a bearing on sexual development.

Women’s fertility is unaffected by the mumps virus.

DEAR DR. DONOHUE: My delivery date is next month. A friend tells me to have a C-section to avoid the pain of labor. Is that an acceptable reason? After a C-section, must all subsequent pregnancies also be C-sections? – R.H.

ANSWER:
A Caesarean section – C-section – is a delivery where the doctor makes an incision in the uterus to take the baby. The guidelines for this kind of delivery are strict. It is a major operation, and it is not a procedure that is free of pain. I can’t think of any surgery that is.

Nature has devised a process for delivering a baby that is best for mother and infant. Natural labor is painful, but there are so many ways to deaden labor pains that pain avoidance is not a valid reason to choose a C-section.

If the infant is so large that its passage through the birth canal would harm the infant or the mother, then a C-section is preferable. If the fetus is situated in the uterus so its buttocks (or legs) are the first body parts to enter the birth canal a C-section is justified. If, for some reason, the baby’s or the mother’s life is in danger unless the baby is rapidly born, that is another valid reason for a C-section.

What are your doctor’s thoughts on this idea? I’ll bet they are not encouraging.

The answer to your question about future pregnancies requiring C-section delivery generates heated discussions. Vaginal deliveries are possible after a woman has had a C-section. However, there are many considerations that influence such a decision. If the C-section was performed with a horizontal, lower-abdomen incision, then the prospects for a vaginal delivery are more favorable. That is only one of many factors that must be considered when a woman who has had a C-section chooses to deliver vaginally.

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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