DEAR DR. DONOHUE: I have had fibromyalgia for more than one year. I have tried a number of medicines, but nothing seems to work for me. I could cope with this affliction except for the pain it causes. I ache without any letup. Can you suggest anything that might bring me some relief? – W.B.

ANSWER: Fibromyalgia is a condition that was not known until a few short years ago. It’s an illness that causes its victims to ache all over, and it can produce widespread muscle and joint pain.

In addition, the normal sleep cycle is disrupted, and that leaves fibromyalgia patients with an overwhelming fatigue. Its cause has eluded discovery, but it might be that the pain centers of fibromyalgia patients’ brains are inordinately sensitive to pain signals.

No single test proves the fibromyalgia diagnosis. Doctors have to rely on what patients tell them and what physical examinations can disclose. Tender points (also called trigger points) provide doctors with reliable information on fibromyalgia-caused complaints. These points consist of 18 body sites where pressure from the doctor’s probing finger elicits pain far out of proportion to the pressure applied.

The list of treatments is long, and no one treatment has proven useful for all patients.

Exercise is of paramount importance. Begin at a low level, say 5 minutes of walking a day. Gradually increase the time and tempo of the walk until a 30-minute goal is reached. Pilates (pih-LAH-teez) exercises are excellent for this syndrome. They consist of a series of movements from one position to the next, with the exerciser concentrating on the fluidity of motion and the depth of breathing. Most towns have Pilates instructors. Sometimes the Y sponsors classes.

Amitriptyline can restore normal sleep cycles and provide refreshing sleep for people. A combination of Ultram and Tylenol often relieves pain. Pregabalin is a new medicine currently being studied for its usefulness in this distressing illness.

Readers who would like more information can order the newly written fibromyalgia pamphlet by writing: Dr. Donohue – No. 305, 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: I have had granuloma annulare for two years. No one can tell me how I got or how I can clear it up. Can you help? – B.G.

ANSWER:
Before writing this column, I thought granuloma annulare was a rarity. Since then, I think everyone must have it, so frequent are the questions about it.

It’s an outbreak of red, violet or skin-colored small bumps in a circle. The rash expands, and its center often pales. That makes it look a bit like a ring, and that’s the reason for the “annulare” word.

In young people, the outbreak is usually limited to one site – fingers, hand, elbow, top of feet or ankles. In older people the rash can cover larger areas of the skin and is often found on the neck, chest, upper back or upper arms.

The cause appears to be an inflammation of blood vessels at the involved skin site.

On average, the rash lasts from two to four years and then goes away. However, duration can be as short as four months or as long as 10 or more years.

Injections of cortisone into the involved skin can sometimes clear it up. Most people choose not to treat it but to let it run its own course.

DEAR DR. DONOHUE: I have a corn on my foot. Can you tell me how to remove it? – P.W.

ANSWER:
Carefully. Soak the foot in warm water and then pare the corn with a pumice stone. If you get no results, then have the family doctor or a podiatrist treat it. Salicylic-acid pads and gels are available and they work, but I think it is safer for a person to have a doctor apply such treatment. Inexperienced application can damage adjacent normal skin.

Corns result from pressure on the skin. Corn relief, therefore, depends on pressure relief. Roomier shoes or the judicious placement of padding material can stop corns from enlarging or recurring.

DEAR DR. DONOHUE: How can you convince me that I won’t be alive after being buried? The possibility scares me. I hear that DNA survives for along time after death, and that makes me more scared than ever. – B.V.

ANSWER:
In bygone years, stories often circulated that a person had been buried alive. It would be most improbable that such a thing could happen today. Embalming is prevalent, and no one survives embalming. The same can be said for cremation.

Even if a body is not embalmed or cremated, medicine has advanced so much that the diagnosis of death can be made with certainty.

The fact that DNA can be obtained from a corpse is not a sign that the body is alive. DNA is nothing more than a chemical. Calcium can still be obtained from a dead person’s bones, but that is no proof that life remains.


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