DEAR DR. DONOHUE: I am 84 and have had no major illnesses. I’ve seen a doctor only once. Now I have a problem. The thumb and index finger of my right hand are numb. Sometimes they hurt. It can get so bad at night that it wakens me. I shake my hand. That helps. Please tell me what to do. I don’t want to see a doctor. – R.L.

Your symptoms blink like a neon light saying “carpal tunnel syndrome.” Its first symptom is numbness of the thumb, index and middle fingers, usually of one hand. Pain follows or accompanies the numb stage. Finally, fingers can become weak, and holding a pencil or a glass is a challenge. Carpal tunnel syndrome is famous for the worsening of symptoms at night. Shaking the affected hand can bring a measure of relief.

All symptoms can be traced to pressure on one of the main hand nerves. It enters the hand through a tunnel of tissue in the wrist. “Carpal” is the Latin word for wrist. Inflammation of the tunnel compresses the nerve and leads to the above symptoms. Overuse of the wrist and hand is often the cause of the trouble, but not always. Sometimes the syndrome is associated with another disease, such as rheumatoid arthritis or diabetes.

If you are dead-set against seeing a doctor, get a wrist splint from the local drugstore. Wear it at night. It helps rest the wrist and diminishes inflammation. Anti-inflammatory medicines such as Aleve or Advil can also reduce pain and inflammation. Anti-inflammatory medicines can also cause stomach bleeding. Advanced age makes stomach bleeding more likely to occur. If you notice your stomach burning or if your stools turn black, stop the anti-inflammatory medicines and get to a doctor.

If neither the splint nor the medicines are bringing relief, then you really must see a doctor. They’re not all that bad. I know one or two good ones. The doctor can inject cortisone into the tissues surrounding the carpal tunnel, and that almost invariably helps.

DEAR DR. DONOHUE: I am a 74-year-old diabetic. I control it with diet only. I told my doctor that my blood tests averaged 140 mg/dL (7.7 mmol/L). He had me do a three-month test. It was 6.2. What is the correct three-month number? Is 6.2 OK? – W.S.

A fasting blood sugar is the way to diagnosis diabetes and often the way doctors follow diabetes control. A normal fasting blood sugar is less than 110 mg/dL (6.1 mmol/L), and the goal for a diabetic is to have a fasting blood sugar not much more than 120 (6.7).

The “three-month blood test” goes by various names: hemoglobin A1c, glycated hemoglobin or glycohemoglobin. It gives a picture of how well blood sugar was controlled in the previous three months. It is expressed as a percentage, and a value less than 6.5 indicates good control.

Are those sugar readings you get fasting, or are they random? If they’re random blood sugars, taken without regard to when food was eaten, they’re good. If they’re fasting levels, they are not so good.

Diabetes has assumed epidemic proportions. Readers who would like to learn more about it can order the diabetes pamphlet by writing: Dr. Donohue – No. 402, 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 trying to eat foods with a supply of omega-3 fatty acids. I know they prevent heart attacks, and I have a family history of many heart attacks. Fish has a generous amount of this substance. I don’t like fish, but I can eat tuna. Does canned tuna have as much omega-3 fatty acid as fresh tuna? – R.C.

Omega-3s are the fats that reduce the chances of having heart attacks and strokes. Furthermore, they protect the heart from developing seriously abnormal heart rhythms. Fish is a good source, and canned tuna has as much as fresh tuna.

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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