DEAR DR. DONOHUE: I recently saw my doctor for a cough that would not stop. He told me I had walking pneumonia but did not need any antibiotics. Please explain what walking pneumonia means. – V.R.

ANSWER:
Pneumonia has many causes, but germs are its primary cause. Those germs can be bacteria, viruses or mycoplasmas – germs with special features that put them in a class between bacteria and viruses.

Bacterial pneumonias begin abruptly, often with shaking chills followed by spiking fevers. Coughing is common to all pneumonias, but with a bacterial pneumonia the cough usually brings up thick, yellow sputum. People who have this kind of pneumonia feel so bad that they willingly take to their beds. Sometimes hospitalization is essential, and that is especially true with older people. Antibiotics cure bacterial pneumonias.

Viral pneumonias have less-florid symptoms than bacterial pneumonias. People cough and feel bad, but not so bad that they have to stay in bed. With a viral pneumonia, most people can stay up and about. That’s where the “walking pneumonia” tag came from. Drug treatment for viral pneumonia is practically nonexistent. Only a few drugs are available to treat some viral pneumonias.

Mycoplasma pneumonias behave more like bacterial pneumonias.

DEAR DR. DONOHUE: Since I had my prostate reamed out, I do not ejaculate when I have sexual relations. Why? Everything else works just as it did before the operation. Where does the fluid go? – C.M.

ANSWER:
Your operation was a TURP – a transurethral resection of the prostate.

This surgery consists of passing a viewing scope along with cutting instruments into the penis and upward to the region of the prostate gland. When it reaches the prostate area, the urologist pares away tissue to reduce the gland’s size.

After a TURP, it is usual for seminal fluids to flow backward into the urinary bladder and not forward through the urethra in the penis.

Retrograde ejaculation, as this is called, does not diminish sexual sensation.

The prostate gland and all its troubles are the subject of the prostate pamphlet. Male readers have hundreds of questions about this gland and about the ills that commonly happen to it. To obtain a copy, write to: Dr. Donohue – No. 1001, 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: For some time I had hip pain that I thought was arthritis. I took Advil for it, and the Advil lessened the pain but gradually lost its effect. The high point of all this was I fell and broke my hip. It turns out that I did not have arthritis. I have osteomalacia, something new to me and all my friends. I take calcium and vitamin D. Are those the only medicines I need? – G.R.

ANSWER:
Osteomalacia is soft bones. Soft bones are fragile, so your hip fracture is not surprising.

Vitamin D and calcium are the treatments. The illness is a result of vitamin D deficiency.

We get vitamin D from two sources. One is our skin. Sunlight acts on substances present in skin to turn those substances into vitamin D. People who are housebound can suffer a D deficiency because they don’t expose themselves to sunlight. In the winter, people who live in the northern United States and almost all of Canada can develop a vitamin D insufficiency when they rarely venture out of their houses.

There is another source for the vitamin: food. In many countries, dairy products are fortified with the vitamin. That takes care of the problem for people – if they are dairy-product users. Quite a few are not.

Sometimes a definite cause can be found to account for the body’s insufficient supply of vitamin D. Kidney and liver diseases are examples. In those cases, therapy is directed at the underlying liver or kidney problem.

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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