DEAR DR. DONOHUE: I am a 16-year-old boy, and I have large breasts. I refuse to take part in gym classes since I take so much kidding. I don’t know what I can do, and I turn to you for help. Please. – R.A.

ANSWER:
There is little you can do for yourself to correct this disorder, but there are things that can be done for you. You have gynecomastia (GUY-nuh-coe-MASS-tee-uh), enlargement of the male breast.

During puberty, with the surge in hormone production, there is often an imbalance between male and female hormones. (Men also make female hormones, and women make male hormones.) It happens to most boys. Some have a greater imbalance than others, but the condition almost always rights itself with time. Nearly 75 percent of boys with noticeably large breasts will experience a regression of breast size within two years from the start of breast growth. By three years, more than 90 percent will no longer have large breasts.

Breast enlargement also occurs late in life. Once again, it results from an imbalance of male to female hormones. Breast enlargement late in life does not regress.

It also happens to bodybuilders who take enormous quantities of hormones to bulk up their muscles.

In a few instances, breast enlargement is a sign of trouble. Liver, kidney and thyroid gland disorders can cause it. So can cancers of the testicles. Abnormalities of the pituitary gland, the small gland at the base of the brain that oversees the body’s hormone production, are another possibility. Some medications do it. So can marijuana.

The remedy for most teenage boys is patience. In your case, however, your parents should take you to the family doctor to make sure nothing is amiss and to recommend the services of a surgeon who can remove the breast tissue with little or no scarring. This matter is making a deep and painful intrusion into your life. Psychologically it would be in your best interest to have the overgrown breast tissue removed.

DEAR DR. DONOHUE: I have allergy symptoms quite badly and have been advised to take allergy shots for them. I don’t know if I should. I have always considered shots as black magic. Do they really work, and how long does a person have to take them? – S.C.

ANSWER:
Decades and decades of use prove that allergy shots work for 90 percent of allergy patients. They are not black magic.

The allergy or allergies are identified usually through scratch tests. Drops of liquids, each containing an allergy suspect, are placed on the skin of the back. Then the tester makes a light scratch on the skin beneath the drop. If a person is allergic to the material, a red hive appears in about 15 minutes.

All of the substances that caused a hive are listed, and a serum is made containing those materials. A dilute preparation of the serum is used for the first allergy shot. Over time, the dose of serum increases until a maintenance dose is reached. At that point, the frequency of shots is lessened. It takes a month or more for shots to control symptoms.

Immunotherapy, as the therapy is called, is usually continued for three to five years.

If a person has allergy symptoms for four or more months a year, if the symptoms are severe or if medicines fail to moderate symptoms, then most would opt for allergy shots.

DEAR DR. DONOHUE: During a recent physical exam, my blood pressure was up. The doctor quizzed me about my family’s health history. My dad died from a stroke at age 52. Hearing that, the doctor insisted I get a kidney scan because he thought my kidneys might be enlarged. He said that the large kidneys could cause the rise in blood pressure. How? – S.Q.

ANSWER: I
believe your doctor was talking about polycystic kidney disease. It’s an inherited disorder in which the kidneys are enlarged due to many kidney cysts. High blood pressure is part of the polycystic kidney disease picture.

Your father’s stroke could have resulted from high blood pressure brought about by polycystic kidney disease.

DEAR DR. DONOHUE: I would like very much for you to explain what ARDS is and why it happened during surgery. Could it have been due to the anesthesia? It happened to a young, healthy person who was very close to me. He went into a coma and died within two days of the surgery. – C.B.

ANSWER:
ARDS is acute respiratory distress syndrome, and it’s a catastrophe. Some noxious agent, identified or unidentified, attacks the lining of the lungs. The attack results in an outpouring of fluid into the lungs, and the situation is very much like drowning. In this case, however, a person drowns in his own fluids.

Examples of noxious agents are pneumonia, smoke inhalation, chest trauma, overwhelming infections and inflammation of the pancreas. Neither surgery nor anesthesia is a common trigger. Why was your friend having surgery? That, perhaps, is the reason he developed ARDS.

Extreme measures must be taken to salvage people suffering from ARDS, but even with the finest and most intensive care patients often succumb to this dreadful illness.

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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