DEAR DR. DONOHUE: A year-old baby in our family has just been diagnosed with cystic fibrosis. No one in either of the parents’ families has had this disease, although it is supposed to be hereditary. How come? We wonder about the baby’s future. Is there anything that can offer a hopeful outlook? – S.B.

ANSWER: Cystic fibrosis is an inherited, genetic disease, but, in most cases, other family members with the illness cannot be found. That’s because two genes, one from the father and one from the mother, must pair to produce a baby with cystic fibrosis. Having one gene makes a person a carrier – someone without any symptoms. Two carriers must mate for an infant to be afflicted. And even when two carriers mate, there’s only a 1-in-4 chance that their baby will have the disease.

The cystic fibrosis gene upsets the transport of salt and water into and out of cells. That disruption is responsible for filling the airways with thick mucus that provokes coughing, interferes with breathing and encourages lung infections. It’s also responsible for the salty taste detected when kissing a cystic fibrosis baby.

The pancreas, the organ that produces enzymes vital to digestion, is similarly filled with sticky, viscous secretions that obstruct the passage of digestive enzymes into the digestive tract. The result is malnutrition and slow growth.

The missing pancreatic enzymes can be given as an oral medicine. A spray with Pulmozyme can thin the thick airway mucus. Gentle drumming on the back with cupped hands helps rid airways of obstructing mucus.

It is impossible to make predictions about a youngster’s future. Everything depends on the extent of lung involvement. I happen to know a young man in his 30s who has cystic fibrosis, had extensive lung involvement, and recently underwent lung transplant. He is now back at work.

DEAR DR. DONOHUE: My husband is 78 and has Parkinson’s disease. I was surprised to learn just last week that there is a special diet for people with this illness. No one ever told us about it. Would you please devote some space to discussing it and to explaining why we were left in ignorance about it? – B.J.

ANSWER: You probably weren’t told about it because your husband responds to his medicines. Not all Parkinson’s patients need to go on the diet, nor do all benefit from it.

The diet is not a secret. It involves eating a low-protein breakfast and lunch.

The brain of a Parkinson’s patient has a shortage of dopamine, a brain chemical needed to perform steady, fluid movement. Treatment, therefore, often consists in supplying the brain with more dopamine by giving patients the medicine called L-dopa.

Proteins interfere with the passage of L-dopa from the blood into the brain. The low-protein diet facilitates transport of the medicine into the brain.

This is not a revolutionary discovery. It is not something that every patient with Parkinson’s must adopt. It is beneficial for some Parkinson’s patients who are not responding to the L-dopa medicine. Don’t feel put-out by not being told about it.

DEAR DR. DONOHUE: I have six toes. No kidding. When I was a kid, my mother was freaked out by it and must have taken me to a dozen doctors. Every one of them told her to forget it. I would like to know if I would be accepted by the “Guinness Book of World Records.” – J.M.

ANSWER: The condition is polydactyly, “many digits.” It happens in about one in every 500 births, so it is not exactly a rarity, and I don’t think you’ll make it into the Guinness Book.

Often it’s the little-finger side of the hand or little-toe side of the foot where the extra digit is located. Sometimes it’s only a small stump. At other times, it is a fully formed finger or toe.

A few times, an extra digit is associated with a serious illness. Since a dozen doctors examined you, I doubt that you have one of those unusual conditions.

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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