DEAR DR. DONOHUE: I have gone from being a very active person to one who stays home all the time. My left foot and leg feel like they are on fire. When I walk, I have trouble raising that foot off the ground. My doctor says it might be a nerve problem but has not prescribed any medicine. Where can I turn? – K.R.

ANSWER:
With only slight reservations I would definitely say you have peripheral neuropathy. The peripheral nervous system is the network of nerves that carry messages from the brain and spinal cord (the central nervous system) to muscles and organs. They’re the power lines that tell muscles to contract and that bring information – heat, cold, pain – to the brain.

Two consequences can happen with peripheral neuropathy. Muscles can weaken because they are getting no input from the brain. In your case, you describe a foot drop – the inability to raise the foot when walking. The second consequence is that disagreeable sensations, such as your painful, burning feeling, are transmitted to the brain. Either consequence or both can arise.

There are more than 100 causes of peripheral neuropathy. Diabetes, deficiencies of vitamins B-1, B-6 and B-12, and inherited conditions can be reasons why peripheral nerves go on the blink. A search must be made for those causes because treatment will be directed at them. Unfortunately, however, for the majority of patients no cause can be found, so treatment consists of using devices that overcome the muscle disability and choosing drugs that relieve pain. In your case of foot drop, for example, a lightweight plastic shoe insert with straps that are attached to the calf raises the foot when it’s lifted from the ground. Many medicines are available to attack the pain of peripheral neuropathy.

Turn to a neurologist now. And at the same time, turn to The Neuropathy Association, a powerful ally that will provide you with the latest information on this problem. The number is 1-800-247-6968. Canadians who cannot make a connection can turn to the association’s Web site, www.neuropathy.org.

DEAR DR. DONOHUE: I had terrible stomach pains, and it was discovered I had an ulcer. I went on antibiotic treatment to get rid of the helicobacter germ. I am free of both the ulcer and the germ. I have a disquieting thought in the back of my head that cancer might result from the germ. Is that possible? – B.J.

ANSWER:
Most of the world now knows that the bacterium helicobacter has a hand in causing ulcers, so ulcer treatment almost always employs antibiotics in its drug regimen.

You realize, don’t you, that the number of people who have or have had ulcers is enormous and the number of people with stomach cancer is small? That’s proof that there is not a one-to-one relationship between helicobacter and stomach cancer. With a duodenal ulcer – which is more common than a stomach ulcer – the relationship is all but nonexistent. The duodenum is the first part of the small intestine, the first place partially digested food from the stomach reaches. If you had a stomach ulcer, there is a slightly greater risk that stomach cancer might develop. The risk is small. Don’t waste your time fretting about this.

DEAR DR. DONOHUE: My husband is, in my eyes, an alcoholic. He consumes two to three beers followed by at least four whiskey and sodas every evening. He works every day and runs three days a week. He insists he’s fine to drive and that I am making a big deal of this. What’s your opinion? – M.H.

ANSWER:
In my eyes and in the eyes of every reasonable person, your husband is an alcoholic. A man should limited his alcohol to two drinks a day, and a woman to one. A drink is 12 ounces of beer, 5 ounces of wine or 1.5 ounces of hard liquor.

Even though his work record is perfect, that does not have a significant bearing on defining alcoholism.

Your husband is not fit to drive, and he’s teetering on the brink of a tragedy. He is also teetering on the brink of liver cirrhosis. He needs the help of Alcoholics Anonymous badly.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column when 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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