DEAR DR. DONOHUE: I was recently diagnosed with and treated for trichomonas infection. I have not had any sexual contact with anyone other than my boyfriend for the past 10 years. Was he unfaithful without a doubt, or is there any other way to contract this disease? How long could I have been infected before I finally developed symptoms? I gave birth to a child two years ago. Could it have been present that far back and gone undetected? – M.W.

ANSWER:
You have to allow some uncertainty in the answers of your questions, because there are aspects of trichomonas infection that are obscure.

Trichomonas (TRICK-oh-MOAN-us) infection is one of the most common vaginal infections. Estimates of the number of people infected yearly in North America run between 1 million and 8 million.

It is chiefly a sexually transmitted infection. However, trichomonas can survive for several hours in a moist environment, such as moist clothes, so there is a remote, theoretical possibility that infection can occur by way of damp towels, for example. I cannot find that such transmission has ever been substantiated.

A noteworthy aspect of trichomonas infection is that men rarely have symptoms, so they are unwitting transmitters of it. That could explain how your friend passed the infection to you. For how long a man can harbor the trichomonas organism is not known.

Women can also be infected without having symptoms, and the length of time that such silent infections persist is another unknown.

Female symptoms, when they occur, consist of a frothy, yellow, malodorous vaginal discharge and itching.

One large dose of metronidazole or smaller doses taken for a week can generally eradicate the infection. Male partners of infected women should be treated simultaneously with the women.

The pamphlet on vaginal infections tells the trichomonas story as well as the stories of other causes of such infections. Readers can obtain a copy by writing: Dr. Donohue — No. 1203, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: It’s impossible for me to go to any sporting event because I cannot use public restrooms. This has been a lifelong problem. I was turned down for a job because I couldn’t provide a urine specimen under observation. Can I ever get over this? – B.J.

ANSWER:
What you have goes by the name of “bashful kidney” or “bashful bladder.” Believe me, you are not the only one suffering from it. It’s a form of stage fright, the same reaction so many people get when they must speak in public. The restroom atmosphere creates the same kind of stress for you. When you try to use one, there is an outpouring of stress chemicals that makes emptying the bladder impossible.

Ask your doctor if it’s OK for you to take an anti-anxiety medicine on the occasions when you know you will have to use public facilities. If the problem disrupts your life, ask your doctor for the name of a therapist who can help you overcome the buried anxieties that engender this psychological stress in you.

DEAR DR. DONOHUE: I had a soft, golf-ball-sized lump on my elbow. My doctor stuck it with a needle and drained lots of fluid from it. It didn’t hurt. What was this? Can it come back? – R.F.

ANSWER:
It was a bursa that filled with fluid. Have you ever seen the swelling of what is called housemaid’s knee? Your swelling was the elbow’s equivalent of it.

Bursae are flat discs that reduce friction when tendons glide across bones. Elbow overuse or injury can cause the elbow bursa to fill with fluid.

Resting your arm and perhaps taking anti-inflammatory medicines like Aleve can lessen the chances that this will return. If it does, the doctor can drain it again and inject a cortisone drug that dependably frees the bursa from inflammation.

DEAR DR. DONOHUE: I am writing this to you while I am hooked up to an oxygen tank. It’s set at 2. Is 2 a good setting? Is oxygen doing anything for my collapsed air sacs? Just what is its purpose? – Anon.

ANSWER:
You must have chronic obstructive pulmonary disease – COPD. There are two varieties: emphysema and chronic bronchitis. Most of the time, a person has a mix of both.

With emphysema, there is widespread destruction of the more than 300 million air sacs in the lungs. Through those sacs, oxygen passes into the blood, and carbon dioxide, a waste product, passes out of the blood. With emphysema, it is a constant struggle to get enough air.

Chronic bronchitis is airway inflammation. The airways – bronchi – are tubes that bring fresh air into the lungs and empty used air out of the lungs. Its hallmark symptom is constant cough with production of thick, yellow phlegm.

If readers would like to know how it feels to have COPD, grab a straw. Breathe in slowly. Then exhale through the straw – no cheating. Before you finish exhaling, you’ll feel the need to breathe again. You cannot empty your lungs of used air. That’s why people with emphysema take shallow breaths and never really empty or fill their lungs with air. It is impossible to do so.

Oxygen cannot repair damaged lungs. It can deliver more oxygen gas with each breath than would be obtained from breathing room air. It’s oxygen that the body needs to carry on basic functions, so supplemental oxygen makes life much more bearable for those with COPD.

Supplemental oxygen stops the overproduction of red blood cells consequent to COPD. Too many red blood cells thicken blood and slow its circulation, another consequence of COPD.

The “2” stands for 2 liters (quarts) of oxygen delivered each minute. It’s a common setting for someone with COPD.

Readers who would like more information on emphysema and bronchitis can order the COPD pamphlet by writing to: Dr. Donohue – No. 601, 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.

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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