DEAR DR. DONOHUE: In your discussion of hepatitis C, you did not mention blood transfusions given before 1992 as a source of infection. Please call attention to this fact. – R.A.

DEAR DR. DONOHUE: You failed to tell your readers that hepatitis C could be contracted from blood transfused before 1992. Please give more details on this infection. – C.Q.

It is estimated that more than 4 million North Americans are infected with the hepatitis C virus. Many do not know they are infected, because it can take 20 to 40 years before signs and symptoms of the disease appear.

Nearly 70 percent of those infected will remain infected for life. Of that 70 percent, 20 percent will suffer such liver damage that they develop liver cirrhosis (a scarred and nonfunctioning liver). A smaller percentage – between 0.4 percent and 2.5 percent – develop liver cancer.

The virus is passed by (1) contaminated needles; (2) a small number of infected, pregnant mothers to their infants; and (3) blood transfusions given before 1992. That was the year that the test for hepatitis C was first used to screen all donated blood. For as many as 50 percent of patients, the mode of transmission is never known.

New treatments for this illness give patients great hope. Treatment might have some unpleasant side effects, and full treatment can take up to 48 weeks. There are three distinct strains of the hepatitis C virus. Successful treatment depends on which strain has infected a patient and on how many hepatitis C viruses there are in the blood.

C.Q. made a valid point in her edited letter that needs emphasis. The single most important thing an infected person must do is to abstain completely from alcohol.

The hepatitis pamphlet describes in detail infections from hepatitis A, B and C. Readers can obtain a copy by writing: Dr. Donohue – No. 503, 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: My husband has clogged arteries in both legs. While doing the stress test, his cardiologist informed him that he has a slightly damaged heart valve but not to worry about it. This doesn’t sound right to me, but I would like to know what your opinion is. – S.R.

There are four heart valves. They keep blood flowing in the right direction through the four heart chambers. They also stop blood from returning to the chamber it has just left.

Valve problems come in two varieties. A narrowed valve makes it hard for blood to pass from one chamber into the next. Narrowing of heart valves is called stenosis. The other valve problem is a leaky valve, one that doesn’t stop blood from returning to the chamber it has just left. Leaky valves are called incompetent.

Doctors detect damaged valves by listening to the heart with a stethoscope. Damaged valves produce murmurs. Often the pitch, loudness and location of the murmur reflect the seriousness of valve damage.

Murmurs can also be discovered by sound wave pictures of the heart – echocardiograms. Such pictures are of great value in assessing the degree of valve damage.

Millions walk around with slightly damaged valves and have not a single symptom. The damage is so slight that it does not compromise the heart’s one function – pumping oxygen-enriched blood to the entire body. Trust the doctor. Your husband must fall into this category.

DEAR DR. DONOHUE: Our 35-year-old son was diagnosed with Crohn’s disease at 13. He is now on the Remicade infusion program, and it has done wonders for him. Some natural-medicine friends say he should be on the SCD diet. Our doctor says diet has little to do with Crohn’s. What light can you shine on this? – S.G.H.

In spite of diligent searches, no food has been implicated as a cause of Crohn’s. The diarrhea and abdominal pain it causes are more likely due to an immune attack on the digestive tract. Remicade calms an overly excited immune system. The Specific Carbohydrate Diet – SCD – has not won enthusiastic approval. Stay with Remicade.

DEAR DR. DONOHUE: On occasion I get very severe headaches. They occur in the middle of the night and waken me. The only relief I get is to stand up. No pain pill touches them. All I can do is let them run their course, and in one or two hours they are gone. Can you shed some light on this? – S.B.

Your description of the headaches fits the picture of cluster headaches. They are intense, throbbing, one-sided headaches that often waken people from sleep. The person gets out of bed and paces in pain until the headache leaves. That takes from 15 minutes to three hours.

The eye on the side of the headache frequently tears, and the nostril on the same side frequently drips.

Cluster headaches occur for days or weeks, and they often occur more than once in any given day. Then they disappear, and the patient forgets them until they return.

A number of medicines can effectively block a cluster headache. Breathing pure oxygen from an oxygen tank can put an end to one. Before I prescribe medicines for you, get a confirmation of this diagnosis from your family doctor.

DEAR DR. DONOHUE: I have been told that the mouth should not be acidic. The person who told me this gave me strips that change color when they are touched to anything that is acid. The same person says if the mouth is acid, the whole body is acid, and that people ought to take calcium to neutralize the acid. Is this true? – B.K.

Everyone knows what an acid is. Everyone does not know what a base (alkali) is. It is the opposite of an acid. When an acid and base are mixed, they neutralize one another.

The acidity or alkalinity of a substance is measured in pH units. Numbers less than 7 indicate acids; numbers greater than 7, alkalis. The number 7 itself designates neutrality.

Saliva works to keep the mouth in or near a neutral state. On wakening, the mouth is slightly acid. Before eating, it comes close to neutrality. After eating, it usually is alkaline.

Blood, on the other hand, maintains a pH of 7.4. In other words, we are slightly on the alkaline side.

Calcium carbonate neutralizes acid. It’s the ingredient in many antacid tablets. I don’t know any doctors who tell their patients to check their mouth’s acidity.

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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