DEAR DR. DONOHUE: Please discuss tic douloureux. I have this terrible pain in my cheek. I never know when it will start to hurt. It can hurt so bad that tears fill my eyes. What causes it? Is there medicine to help control it? – B.B.

ANSWER: Tic douloureux (doo-loo-ROO), also known as trigeminal neuralgia, is one of mankind’s most painful conditions. Jolts of unspeakable pain that come on unpredictably cause victims to writhe in agony and scrunch their faces in a grimace. That’s why the French named it tic douloureux, “the painful tic.” Episodes are brief, but the pain is intense, and people are left wondering when the next attack will strike. Attacks occur several to dozens of times a day.

A brush of the hand on the cheek, chewing food, brushing teeth, talking and shaving can spark a paroxysm of pain. Often, it happens without any identifiable cause.

The nerve involved is the one that transmits sensations of touch and pain on the face to the brain. It is the trigeminal nerve, and that’s where the condition gets its other name – trigeminal neuralgia. What has gone wrong with the nerve is a matter of debate. It might be that something compresses the nerve, or it might be that the nerve loses its insulating cover.

A number of medicines can control painful attacks. Tegretol and Neurontin, two seizure-control medicines, are quite useful. So is Lioresal, a muscle relaxant.

Procedures that deaden the nerve are another way of getting rid of this disruptive malady. An electrode inserted into the nerve through the skin can ablate the nerve’s pain fibers and end the problem. Injecting the nerve with glycerol is another way to treat it. Inflating a balloon that has been inched to the site of the nerve can also stop attacks. A surgical procedure called neurovascular decompression involves placing a sponge between the nerve and an artery encircling it. The sponge stops artery pulsations, which can trigger attacks.

Rather than give you a confusing list of treatments, let me introduce you to the Trigeminal Neuralgia Association. Its address is 2801 SW Archer Rd., Suite C, Gainesville, FL 32608, and its phone number is 1-352-376-9955. The association will keep you abreast of the latest and most effective treatments.

DEAR DR. DONOHUE: A blood screening indicated my potassium was 5.7, with normal being 3.5 to 5.1. I feel fine for an 85-year-old man. Should I avoid foods high in potassium, like bananas? – S.R.

ANSWER: Your elevation is not of the magnitude to raise eyebrows. Things don’t start to go bad until the potassium reaches 6.5.

Kidney disease, adrenal gland problems, some water pills, muscle injury and red blood cell breakup raise the potassium level. With these conditions, other blood work is abnormal and people don’t feel well.

An innocent cause of an increased potassium level is simple jarring of red blood cells on the walls of the tube in which the blood was collected.

The most you have to do is check in with your doctor. You don’t need to eliminate potassium-rich foods from your diet.

DEAR DR. DONOHUE: I have been trying to lose weight and have read about the new diets that limit the amount of sugar one uses. I tried it. It affected my ability to sleep. I woke up every one and a half hours all night and was exhausted the next day.

I realized the lack of sugar in my diet might be the cause. I began to put sugar in my orange juice and ate cookies and lots of fruit. I now sleep well and am refreshed in the morning. Do I have sugar diabetes or hypoglycemia? – B.S.

ANSWER: You don’t have diabetes – high blood sugar. Sugar makes diabetics feel worse, and it makes them run nonstop to the bathroom day and night.

I don’t believe you have hypoglycemia – low blood sugar – either. Your symptoms are not the symptoms of hypoglycemia.

I don’t know what the trouble was, but you found the solution to it.

DEAR DR. DONOHUE: I am on my school’s junior-varsity basketball team, and I am a good player. I can do everything well except for jumping. I’ll never make the varsity team if I can’t jump, because I am only about 5 feet 9 inches tall. Is there a way to train for jumping? -B.B.

ANSWER: Yes, there is. One method is plyometrics. Plyometrics can be hard on the knees and hips, so if they start to cause pain, stop. Furthermore, you have to perform the exercises I am going to outline on a soft surface and with shoes that can absorb the shock of landing on your feet from a moderate height.

A jump depends on muscle power. Power and strength are not the same. You need strength to obtain power, but you also need quickness. Power is strength exertion in a small parcel of time – seconds. Squats and leg curls with weights will make the front and back thigh muscles stronger and more powerful.

Drop-jump exercise is an example of a plyometric exercise that can increase jump height. Get yourself a sturdy box that can support your weight. The height of the box should be 10 inches (25.4 cm). Stand behind the box about the length of your normal step. Spring up onto the box and then drop off the box, striking the ground with both feet in a semi-crouch position.

Don’t spend any time on the ground. As fast as you can, after landing, jump as high as you can. Turn around and repeat the routine five to 12 times in a row. There should be only a 15-second pause between jumps. With experience, increase the height of the box so that you eventually are jumping off a 30-inch-tall (76 cm) box. Do a session every other day.

Before beginning these exercises, measure how high you can jump from a standing position and after taking two steps. In two months, see if there isn’t a difference in your jumping height. There should be.

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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