DEAR DR. DONOHUE: I have a problem with my neck. The muscles on the left side are contracted and pull my neck down and to the left. I have severe arthritis of my neck, and, since I cannot take anti-inflammatory medicines, I am on my own. One doctor told me to “deal with it.” Any advice is appreciated. – D.B.

Your X-rays might show arthritis, but arthritis is not the likely cause of what you describe. Your description better fits the picture of dystonia. Dystonia is a sustained contraction of muscles that pulls parts of the body into awkward positions and leaves them there.

Your symptoms suggest the form of dystonia called torticollis. In everyday speech, the word used to identify it is “wryneck.” It’s a spasm of neck muscles that draws the neck down toward the shoulder and immobilizes it in that irksome position.

Torticollis is not without treatment. One popular approach is Botox. It’s the diluted toxin of the most serious form of food poisoning, botulism. Botox paralyzes muscles. Diluted, it can be selectively injected into muscles in spasm and free them from the lockhold they have on the involved part of the body.

You must consult a neurologist. An examination can put the diagnosis on firm ground. This long-distance diagnosis by me leaves much to be desired.

If the torticollis diagnosis pans out, then the second item on your agenda is to contact the Dystonia Medical Research Foundation. Not only can it give you the latest on treatment, but it can also put you in touch with doctors knowledgeable in dystonias, as well as with other people who suffer from it. In Canada, the number is 1-800-361-8061, and in the United States, 1-800-377-3978. Its Web site is

DEAR DR. DONOHUE: Can you devote space to the dangers and treatment of rabies? Are all canines potential carriers? Do all animal bites require shots? – S.C.

ANSWER: The list of animals that can carry the rabies virus is long. In the entire world, dogs – all dogs – are the No. 1 conveyor of this dreadful illness. In the United States and Canada, thanks to national pet vaccinations, wild animals are the source of spread. Bats, raccoons, skunks, foxes and coyotes are on the list of potential rabies-carrying animals.

About 90 days (and as long as one year) after the bite of a rabid animal, a person develops fever, headache and a nondescript feeling of being out of sorts. Shortly thereafter, pain or peculiar sensations, such as pins and needles, arise at the bite site. Then delirium interspersed with periods of lucidity sets in. Attempts at drinking any fluid trigger painful throat spasms, and even the sight of water engenders dread (hydrophobia). Death follows. This sequence of events transpires if no treatment has been given.

Immediate treatment of an animal bite is washing it with copious amounts of soap and water and then irrigating it with an antiseptic solution. Povidone-iodine (Betadine) is the one usually recommended.

If the biting animal can be observed for 10 days, rabies shots for the human can be withheld. If, after 10 days, the animal shows no signs of the infection, no treatment is required. If the bite is from an animal that is a known rabies carrier and if the animal cannot be observed, then it is appropriate to begin treatment with rabies vaccine and rabies antibodies (rabies immune globulin).

Shooting a wild animal that bites a human can solve the question of treatment. The animal should not be shot in the head in order to preserve the brain for microscopic examination of the rabies virus.

DEAR DR. DONOHUE: I suffer from allergies and take Claritin regularly without experiencing any side effects. Occasionally I take Claritin-D when my allergies bother me more than usual. When I take it, it is difficult to urinate, and it takes longer for me to do so. Why does this happen? – J.G.

ANSWER: I assume you are an older man with a large prostate gland. Claritin contains the antihistamine loratadine. Claritin-D has an additional ingredient: pseudoephedrine, a decongestant. Pseudoephedrine can cause contractions of prostate gland muscles and bladder outlet muscles that close the bladder’s drainage system.

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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