DEAR DR. DONOHUE: About one month ago, I had a spell where my left arm got weak and I had trouble speaking. I sat down, and everything got better in about half an hour. My wife insists that I see a doctor. I feel fine and wonder why I should see a doctor. What do you think happened to me? – T.Z.

ANSWER: I think you had a TIA, a transient ischemic attack. It’s an episode of interrupted blood flow to a part of the brain. The signs of such an interruption usually last less than an hour and never more than 24 hours. The “transient” of the name comes from the limited amount of time that symptoms persist. “Ischemic” is a much-used medical word that indicates a deficiency of blood.

Symptoms of a TIA include weakness of an arm or leg, difficulty speaking, vision disturbance, double vision and dizziness. The symptoms depend on which area of the brain has suffered the blood deficit.

TIAs are warnings that a stroke could be in the offing. Within a month of a TIA, the chance of having a stroke is 5 percent. Within five years, the chance is 33 percent.

Many times a stroke can be prevented by medical intervention.

The first step a doctor takes is to prove that a person has had a true TIA. Listening to the arteries in the neck, doctors can detect noises – bruits (BREW-ease) – that indicate obstruction in the neck arteries that serve the brain. Ultrasound pictures of those arteries furnish proof of such obstructions.

If there is a neck artery obstruction, then surgical removal of the obstruction is one way of eliminating the problem. Sometimes a balloon dilation of the neck artery is possible. It works just like a balloon dilation of a blocked heart artery.

Medicines can be the chosen therapy. Aspirin and Plavix can retard further buildup in the artery. For some, the blood thinner Coumadin is the medicine of choice.

Forget all talk about medicines. See your doctor for a documentation of what happened to you.

The pamphlet on strokes details aspects of strokes and TIAs, both of which fall under the label of cerebrovascular disease. Readers can obtain a copy by writing: Dr. Donohue – No. 902, P.O. 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.

DEAR DR. DONOHUE: I suffer from migraine headaches, and Imitrex has been a godsend for me. The only trouble I have is that I frequently throw up at the onset of the headache, so it is often difficult for me to keep the medicine down. How do I get around this? – B.C.

ANSWER: The triptans are seven relatively new drugs that have been a major breakthrough in the treatment of migraine headaches. They are called triptans because the end of their generic name is “-triptan.”

Your medicine Imitrex is sumatriptan. It was the first triptan drug marketed. Did you know that it comes as a nasal spray? That ought to get around the problem of losing the medicine through vomiting.

Incidentally, zolmitriptan (Zomig) also comes as a nasal spray.

DEAR DR. DONOHUE: I need some information fast. How soon after sex can a woman take the emergency birth control pill and still prevent pregnancy? Would you also tell me how this pill works? – F.H.

ANSWER: To prevent pregnancy, a woman should take the emergency contraceptive (birth control) pills as soon as possible after having sexual relations. Taking them within 12 hours provides the best results. However, the pills can be started within 72 hours of having sexual relations and still have a good probability of preventing pregnancy.

How the pills work is a matter of debate. They might delay ovulation; they might interfere with the passage of sperm or egg within the fallopian tube; they might prevent the egg from implanting in the uterus; or there might be an unknown mechanism at work.

DEAR DR. DONOHUE: I have an embarrassing question. I am a 35-year-old female. With some bowel movements I bleed from the rectum. The blood is bright red. I am not too worried about it because I think it’s just external bleeding. Is this something I should get checked out? – J.T.

ANSWER: Are you kidding? Of course you should get this checked out. You might be right. It could be nothing of great importance, but, all the same, this is something that cries for an explanation.

DEAR DR. DONOHUE: I have a 17-year-old son who wears a baseball hat all the time – indoors as well as outside. He’s a good kid, and I don’t want to badger him about this, but I will be most happy if you agree that constant hat-wearing causes baldness. It does, doesn’t it? – M.F.

ANSWER: I wish I could come to your aid, but I can’t. Hat-wearing doesn’t cause baldness. Why not ignore the issue? A teenager has it in his power to cause much more serious grief.

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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