DEAR DR. DONOHUE: When my husband goes to sleep, in a very short time he gets the “jerks.” His legs or arms actually jerk. This goes on for quite a while and sometimes throughout the night. What’s your idea on this? – Anon.

ANSWER: Those jerks are probably periodic limb movements of sleep – PLMS. The arm or leg jerking can last for a few minutes, or it can persist throughout the night. The jerker might never realize what’s happening. The bed partner feels like he or she is a soccer ball.

In many instances, PLMS coexists with restless leg syndrome, a feeling that something is creeping or crawling in the legs. There is an overpowering urge to get out of bed and move around. Walking ends the unpleasant sensations.

Sometimes, PLMS is secondary to another illness, such as sleep apnea or a nerve disorder. Sleep apnea is marked by loud snoring that suddenly becomes silent because the snorer stops breathing. Narcolepsy is another associated illness. That’s a condition that causes a person to fall asleep during the day in inappropriate places and situations.

Have your husband give up caffeine in all forms. No coffee, tea, cola or chocolate. If he smokes, he must stop, for his sake and yours. You might find that this lessens or abolishes the jerking. There are medicines for it. Sinemet, a Parkinson’s medicine; Neurontin, a seizure-control medicine; and Ambien, a sedative, have all been used for PLMS with some degree of success. Ambien must be used with some restraint, since it can become a habit. Your husband has two reasons for seeing the doctor: one, to rule out any associated illness, and two, to see if medicine is appropriate for him.

PLMS is not covered in the pamphlet on restless leg syndrome. But that more common condition is discussed at length. Anyone who would like a copy can obtain one by writing: Dr. Donohue – No. 306, 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: As a rehabilitation counselor for the blind, I wonder why you and other physicians, when discussing macular degeneration or other eye diseases, never mention the benefits of state rehabilitation services. In our work as counselors, we find that very few doctors ever mention our services. We need to work together to give patients all the options available to them. – J.S.

ANSWER: You made the case far better than I could have. I hope people take advantage of the opportunity you and your fellow workers provide.

DEAR DR. DONOHUE: My chest is growing like female breasts do. This is embarrassing. Please help me. – S.E.

ANSWER: I am basing my answer on the assumption that you are an adult male.

What you describe is gynecomastia, something that happens to just about every boy during puberty and to most men later in life. It’s a growth of breast tissue due to an imbalance between male and female hormones. Men do make female hormones, and women make male hormones. During puberty, the normal ratio of male-to-female hormones is upset transiently. About 70 percent of 14-year-old boys have gynecomastia. It generally resolves in a matter of time. Older men have a similar imbalance, and they experience growth of breasts. Their hormone imbalance, while not indicative of any problem, does not right itself.

For other adult males, a search for a cause must be made. Medicines can be responsible. Marijuana can enlarge male breasts. Bodybuilders who take large quantities of male hormones develop breast tissue, because some of the excess hormone is converted into female hormone. Liver disease can cause it. Tumors of the brain and testicles are other possibilities. Your doctor can look for those and other causes. If none is found, then a surgeon can remove the breast tissue without a great deal of fuss.

DEAR DR. DONOHUE: My husband contends that drinking carbonated drinks reduces the amount of oxygen in your blood. I say that is ludicrous. Your help in defusing this squabble is appreciated. – L.E.

ANSWER: I say it is ludicrous, too.

DEAR DR. DONOHUE: I have an enlarged prostate and, as a result, cannot empty my bladder completely. The doctor says I have to have surgery. I read somewhere about saw palmetto being taken for prostate enlargement. Before I accede to surgery, I would like to try saw palmetto. I would like your opinion on it. – E.G.

ANSWER: You are free to give saw palmetto a try. Don’t expect a miracle. There is some evidence that it works, but the results are not the sort that call for a ticker-tape parade.

There are also medicines you might want to try. Uroxatral, Flomax and Cardura relax the muscles that control urine flow out of the bladder and the muscles in the prostate that constrict the urethra. The urethra is a tube that drains urine from the bladder to the outside. It runs through the prostate gland.

There are other medicines that shrink the gland. Proscar and Avodart are two such drugs. It can take up to six months before their effect on the gland takes hold. The combination of these two drug families is another way to correct the prostate gland’s obstruction of the urethra.

Readers wanting more information on all aspects of the prostate gland can obtain a copy of the prostate pamphlet by writing: Dr. Donohue – No. 1001, 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.

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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