DEAR DR. DONOHUE: My 12-year-old daughter is a very active, athletic girl. She plays on her school’s basketball team. Her right knee began to hurt, so I took her to our family doctor, who took X-rays. The doctor tells us that she has Osgood-Schlatter disease. She also told my daughter to stop all organized sports for the next month, and then she would evaluate her. I don’t know much about this. Should we consult a bone doctor? – M.A.

ANSWER:
Osgood-Schlatter disease is a somewhat-common malady in children in their preteens and early teens. It’s due to the immaturity of children’s bones.

The powerful front thigh muscle has a tendon that engulfs the kneecap and attaches to a small projection at the top of the lower leg bone. That projection acts as a hook to hold the tendon in place.

In children, this projection has not firmly fused to the body of the leg bone. The tug on it from the large thigh muscles can separate it from the main bone. The result is pain.

Rest generally resolves the problem.

Your family doctor is doing a good job in diagnosing and treating your daughter. If the pain does not go away or if the next examination does not reveal satisfactory progress, that would be the time to consult an orthopedic surgeon (a bone doctor).

DEAR DR. DONOHUE: Could you give me a good exercise to build chest muscles? Whenever I take off my shirt, I always hear remarks about my scarecrow chest. It’s starting to bother me. I have a set of barbells and dumbbells, but I don’t know which exercise is best for the chest. Thank you. – C.G.

ANSWER:
The main chest muscles are the pectoral muscles. They are involved in many arm and chest movements, and there are many exercises that can strengthen and enlarge them.

Perhaps the most-used one is the bench press. The person lies on a bench with head, back and buttocks in contact with the bench and with the legs bent at the knees so the feet are touching the floor. Execution of the exercise does not involve any complicated motion. The barbell is lifted upward from the chest until the elbows are completely straight. Then it is brought back down to the chest. The hands grip the bar about shoulder width apart.

Raise the barbell to a count of one-two. Lower it to a count of one-two-three-four.

Changing the grip exercises different parts of the pectoral muscles. When the hands are brought closer to each other, the exercise works the parts of the pectorals that lie closer to the center of the chest. When the grip is widely spaced, it’s the outer parts of the pectorals that get the greater workout.

If the bench is adjustable, and if you raise the back of the bench so you’re sitting at a 45 degree angle, the bench press puts more stress on the upper third of the muscles.

For people who are into bodybuilding, I recommend that they get their hands on a copy of Frederic Delavier’s book “Strength Training Anatomy.” It is published by Human Kinetics. Don’t buy the book until you have read it and feel it will be useful for your workouts. If your local library doesn’t have a copy, it might be able to borrow one from another library. The book has great pictures of what exercises benefit which muscles.

DEAR DR. DONOHUE: I have been told that taking a cold shower after exercising toughens the body. I currently am taking cold showers, but I find myself shivering so much that I wonder what exactly I am doing to my body. What do you say about this? – J.L.

ANSWER:
It makes no sense to me. In what way is it supposed to toughen the body?

I suppose it might make a person psychologically better adapted to accept privation and pain, but the idea strikes me as masochistic.

It probably won’t hurt you, but I can’t imagine it helping you either. I don’t intend to adopt the practice.

DEAR DR. DONOHUE: My husband’s liver enzymes are consistently high due to his alcohol intake. I have heard that milk thistle protects the liver. Can you tell me if this is true? – C.L.

ANSWER:
In some parts of the world, milk thistle is considered to promote liver health and to generate new liver cells. The scientific evidence to support that claim is not great.

If you want your husband to take milk thistle to protect the assault alcohol is making on his liver, you cannot depend on it. The only thing that will stop the destruction of his liver cells is alcohol abstinence.

A rise in liver enzymes indicates liver cells are dying. Better than resorting to milk thistle would be a call to Alcoholics Anonymous.

DEAR DR. DONOHUE: My 6-year-old daughter has her heart set on having a kitten. My mother insists that cats are a health hazard. Their scratches are supposed to cause illness. I need an impartial judge. How dangerous is it to have a cat? I have to tell my daughter and mother something. – W.L.

ANSWER:
Your mother must have cat-scratch disease on her mind. It is not the medical problem your mother has been led to believe.

Do you have any idea how many cat owners there are? More than dog owners. Do you read that there is an epidemic of cat owners stricken with cat-scratch disease? No. It happens, but it happens infrequently.

An infected cat can transmit the cat-scratch germ to a human by scratching him or her. The germ makes it way to the nearest chain of lymph nodes. Since most scratches occur on the hands or arms, the lymph node chain involved in cat-scratch disease is usually the nodes under the arms.

About two weeks after a scratch from an infected cat, those nodes enlarge and are tender. Some infected people develop a headache and a fever. The headache and fever last about a week, but the nodes can stay large for quite some time. The majority of patients do not need any treatment.

In the rare case, the infection is serious, and antibiotics must be given.

Neither you nor your mother should hesitate to get your daughter a cat.

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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