DEAR DR. DONOHUE: I am a 45-year-old woman who had a pelvic exam and Pap smear three weeks ago. My doctor said he felt a fibroid in my uterus. He did not give me any idea what the next step should be. What should it be? – L.B.

There might not be a next step.

The wall of the uterus is muscle. Fibroids are noncancerous growths of that muscle, and they often jut into the interior of the uterus. They’re common. The number of women your age who have one is about the same as the number of women of that age who do not have one.

For most women, ignoring a fibroid is the road to take. If, however, fibroids cause pelvic pain, excessive menstrual bleeding or make having children an impossibility, then there is good reason to stage an attack on them.

The number of options is large for women needing treatment for fibroids. How many fibroids there are, their size, a woman’s age and health, and the woman’s desire to have more children dictate which option is the appropriate one. I won’t discuss surgery except to say it is still a reasonable way to handle a problem fibroid. Myomectomy (MY-oh-MECK-toe-me) is a newer procedure in which a viewing scope and a snare are introduced into the uterus through the vagina. If the fibroid has a slender stalk, the doctor can snare the fibroid and remove it, much like the way tonsils are removed. Uterine artery embolization is another new technique. Here, a doctor advances a soft tube, a catheter, through a groin blood vessel to the vessel supplying the fibroid with blood. At that point, the doctor releases acrylic beads to plug that vessel. Deprived of a blood supply, the fibroid shrivels up.

If you have no symptoms, forget the fibroid. Keep in mind that fibroids usually shrink when a woman reaches menopause.

The fibroid pamphlet presents more details on this common condition. Readers can obtain a copy by writing to: Dr. Donohue – No. 1106, 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 am the first-time mom of a 2-year-old who puts into his mouth everything he can get his hands on. What should I do if he swallows something like a coin? I want to be prepared. – G.G.

If you think your 2-year-old has swallowed a foreign object like a coin, then call your doctor and ask if the baby needs to have an X-ray. X-rays are necessary to locate the exact position of the foreign body. If the object has a diameter of 1 inch (2.5 cm) or less, it usually passes through the intestinal tract without creating any disturbance. Larger objects or sharp-pointed objects have to be retrieved with a scope or, in a few cases, through surgery.

Swallowed alkaline button batteries, which are used to power many devices like hearing aids or small radios, can erode the lining of the digestive tract. They have to be removed quickly.

If the child is vomiting, drooling profusely, coughing, wheezing or choking, matters are urgent. Call 911. The next time you visit the doctor, ask how to perform the Heimlich maneuver. It’s a technique that expels a foreign body from its position in the airways.

DEAR DR. DONOHUE: My husband believes that during hot weather it is better to drink hot liquids and take hot showers. He believes that by matching your temp to the outside, you will feel cooler. I feel this raises body temperature. Who is right? – A.F.

Do you want a long-winded answer or one that goes straight to the point? I have chosen the second option. You are right. He is wrong.

DEAR DR. DONOHUE: I am an 82-year-old man and am scheduled to have my first colonoscopy exam. Is there a danger that the scope might puncture an 82-year-old intestinal wall that has become weakened with age? – A.R.

The possibility of puncture exists for all, but it happens infrequently, even to those of 82 years.

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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