DEAR DR. DONOHUE: In May my wife and I ate in a local restaurant. She contracted an infection with E. coli O157:H7. The infection produced colitis requiring surgical removal of half her colon. It also shut down her kidneys, and they have never recovered. She continues on dialysis. I would appreciate any information you have. – J.D.

ANSWER:
E. coli is a large family of bacteria. Some live harmlessly in the colon, but others cause terrible and complicated infections. The numbers coming after “E. coli” identify the various family members, much like addresses on houses. The O157:H7 is a formidable foe.

This is the germ responsible for some outbreaks of food poisoning, often from eating undercooked, contaminated beef. It has been called the burger bug. For some people, the infection is hardly noticeable. For others, it’s a combination of severe stomach cramps and diarrhea that often becomes bloody. For a minority, it leads to the complications your wife has endured, and for a smaller minority it can be deadly.

Her infection triggered what is known as the hemolytic-uremic syndrome – HUS. “Hemolytic” refers to the breakdown of red blood cells within arteries and veins. “Uremic” refers to kidney shutdown. Another part of the picture can be a destruction of blood platelets, the blood cells that are responsible for clot formation. Bleeding, therefore, is sometimes another complication of this infection.

Twelve percent of those who have HUS die, and 25 percent face long-term kidney damage. There is no wonder drug that can restore your wife’s kidneys. She might have to endure dialysis for the rest of her life, or she might qualify for a kidney transplant. I wish I could give you more comforting information.

DEAR DR. DONOHUE: My neighbor’s daughter is in the hospital with an illness no one, including the family, has heard of – polymyositis. The girl is a college graduate and had a promising career in the computer industry.

Her mother has no idea of what will come of this girl’s life. What is this illness, and what are its outcomes? – G.M.

ANSWER:
Polymyositis is an inflammation of muscles that results in profound muscle weakness. The first muscles usually affected are the muscles of the hips and shoulders. Rising from a chair, climbing stairs or combing the hair requires herculean effort.

In time, the inflammation spreads to other muscles and can even affect swallowing and breathing muscles. Should that happen, patients require artificial ventilation.

The cause has yet to be identified. Some feel it is the aftermath of a viral infection. Whatever the trigger might be, it causes the immune system to turn on the body’s muscles as if they were foreign to their own body.

Prednisone, one of the cortisone drugs, can usually control the muscle inflammation. If it doesn’t resolve the inflammation, drugs that quiet the immune system can. Two examples are azathioprine and methotrexate.

About half of all patients will be off medicine within five years. For 20 percent, polymyositis can be fatal.

I took care of a young woman who was approximately the same age as the one you write about. This young lady had a terrible bout with polymyositis and had to be put on a ventilator. Now she is up and about and has returned to her demanding job as a buyer for a large department store chain.

DEAR DR. DONOHUE: This might sound like a curious question to you, but I wonder about it. I have a sluggish thyroid gland and have been taking thyroid hormone replacement for three weeks. I feel like a new person. Is this possible, or am I experiencing a placebo effect? – K.K.

ANSWER:
The placebo effect is a diminution of symptoms when taking a sugar pill. The act of taking a pill has such strong psychological ramifications that people can be fooled into feeling better.

You are not experiencing a placebo effect. It takes some people a full six weeks before they obtain a response to thyroid medicine, but there is no law that some cannot feel better sooner. You are one of those people.

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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