DEAR DR. DONOHUE: I am a 34-year-old man who has just been released from the hospital after undergoing treatment for meningitis. I have some questions I would like you to answer. No one has been able to tell me how I got this. There has been no outbreak where I work, and I didn’t come in contact with anyone who had it. Please fill me in on the illness and how it is caught. – H.H.

ANSWER:
The meninges are three coverings draped over the brain and spinal cord. They protect those structures and make it possible for spinal fluid to flow over the brain and the cord.

In most instances, meningitis is an infection of those coverings, and many times the infecting organism is a bacterium. As you imply, meningitis often happens in the setting of an epidemic spread — Army recruits or incoming college freshmen, for example. Large numbers of people from all over the country congregate in close living quarters. One of the newcomers carries a meningitis germ. That person has immunity to it and does not get sick. The people who are not immune and to whom the carrier passes the germ do get sick. That is the usual story.

It is not, however, the only story of how meningitis arises. It can happen to an individual who has not been exposed to a carrier. A person might have a sinus infection, for example. The germ that causes the sinus infection can be transported to the meninges and be the cause for meningeal infection. That might be the way you became infected. The source of infection doesn’t have to be a sinus infection. It could a minor infection anyplace in the body.

Meningitis is a true emergency. Fluid swells the brain. Temperature rises. Patients have terrible headaches and stiff necks. If treatment is not begun quickly, permanent brain impairment or death can be the outcome.

The miracle drugs for meningitis are antibiotics. Even the old standby penicillin is still used for some cases of meningitis, and it still can effect a cure.

DEAR DR. DONOHUE: I am on a low-salt diet for blood pressure. We have a water softener. The source of our water is a well. A neighbor tells me that I should not drink softened water if I am on a low-salt diet. Is this right? I have been drinking it for five years, and my pressure has been OK. – W.M.

ANSWER:
Calcium and magnesium are the minerals that make hard water “hard.” The water softener pulls those two minerals out of the water and replaces them with sodium — the sodium of sodium chloride, salt.

The answer to your question depends on how restricted your low-salt diet is. Routinely, such a diet allows 2,400 mg of sodium a day.

Many water softeners add about 300 milligrams of sodium to every quart (about one liter) of water. You would, therefore, have to drink eight quarts of water to exceed your limit. I am misleading you. Far less than eight quarts of water will take you over the brim when you add up the other sources of sodium in your diet. And you should know how much sodium your water softener adds to the water.

Most people on a low-salt diet can drink softened water.

If your diet demands strict adherence and you are at a loss to find out the sodium content of your water, you can hook up your well water to the cold tap and let the softened water run only in the hot tap.

DEAR DR. DONOHUE: Why do so many medicines have caffeine in them? I did my own survey in a drugstore, and I was surprised to find caffeine listed on the ingredient labels of many drugs. – A.C.

ANSWER:
Caffeine can be found in many over-the-counter pain medicines because it enhances the painkilling effect of the main medicine in the pill or tablet.

Aspirin and acetaminophen (Tylenol) are two medicines often combined in the same pill with caffeine.

I don’t know how effective the combination is over the single-ingredient pill. I don’t even know if there is a difference in price between the two.

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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