DEAR DR. DONOHUE: I am 83 years old. When I was 7, I had St. Vitus’ dance. I was treated by a children’s doctor, and after two months I was allowed to go back to school. I am now concerned if I have some heart valve damage. I have had a stress test and was told that everything was normal. How do I find out if I have damage? – D.D.

ANSWER: St. Vitus’ dance, also known as Sydenham’s chorea, is one of the hallmark signs of rheumatic fever. The affected children (usually it is children who have rheumatic fever) look like puppets whose puppet master is pulling their strings with wild abandon. Legs and arms make rapid, purposeless jerks. When the child begins to recover, the jerking stops, and no permanent damage is done.

Rheumatic fever is the consequence of an untreated strep throat. It happens only to about 1 percent of untreated strep infections, but it can leave a child with lasting heart and heart valve damage. The valves either narrow and present an obstacle to the ejection of blood or leak and cause a backup of blood. Either way, the heart is liable to fail, and valve replacement becomes necessary.

How do you find out if you have bad valves? You have had a stress test. The doctor must have listened to your heart before the test. If you have valve damage, heart murmurs are heard. No one mentioned a murmur to you, so it is unlikely you have suffered valve damage. Furthermore, the stress test was normal. It’s unlikely to have a normal stress test with deformed heart valves.

If you want absolute assurance, have your doctor listen to your heart. I am as sure as I can be of anything that the doctor will hear no murmur and will pronounce your heart valves as healthy.

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.

DEAR DR. DONOHUE: My daughter-in-law lost her husband, my son. He was scheduled for a transplant, but his liver went bad before it could be done. Now, my grandson, 12 years old, has Gilbert’s disease. His eyes turned yellow. Doctors say there is nothing they can do. Please tell me all you can. We are worried. – L.T.

ANSWER: Gilbert’s should not be called a disease or a syndrome. It’s a common quirk. About 8 percent of the population has a liver that sometimes takes a nap when it comes to processing bilirubin. Bilirubin is a byproduct of the process that recycles worn-out red blood cells.

From time to time, people with Gilbert’s disease have a blood buildup of bilirubin because their livers slow the recycling process. Bilirubin is a pigment. It turns the whites of the eyes and the skin yellow. This often happens when a person with the Gilbert’s gene goes without food, takes some alcohol or has an illness like a cold. The doctors do nothing for it, for nothing is called for. It does not cause any trouble.

DEAR DR. DONOHUE: I am a man, 73 years old and very active, as is my wonderful wife of 52 years. I have type 2 diabetes, which is under control, as well as high blood pressure, which is also under control. My problem is erectile dysfunction. My wife and I had an active sex life, and we miss it. We love each other. Do you think I can take the new drugs Levitra and Cialis? – S.O.

ANSWER: Viagra, Levitra and Cialis have revolutionized the treatment of erectile dysfunction. Viagra has been around since 1998, so there is more experience with it than with the two new drugs, which are similar in chemical structure to Viagra.

Men who have had a heart attack or a stroke in the past can safely take any one of these three medicines. Men with a recent heart attack or stroke should not take them. Nitrate medicines, used for angina, put these drugs off-limits. Some names are nitroglycerin, Isordil, Sorbitrate and Imdur. A few blood pressure medicines, such as Cardura, Hytrin and Minipress, are contraindications to their use. However, your doctor can give you the approval with a simple phone call. Make it.

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