DEAR DR. DONOHUE: I am 34 and have two children, and I would like one or two more. My doctor told me that I have a fibroid. I made the mistake of telling that to my mother. She says that if I don’t have my uterus removed, I will lose so much blood during my periods that I will end up sick. What do you say? – K.J.

ANSWER: Your mother harkens back to a period when fibroids were thought to be a danger to health. They aren’t. They are benign growths of uterine muscle. They are common and are hardly ever cancerous. By age 50, 70 percent of white women and 90 percent of black women have at least one. Most of the time, a fibroid can be left untreated.

If, on the other hand, a fibroid makes it impossible to have children, if it presses on the bladder or rectum and makes it difficult to hold urine or to empty the colon, if it is painful, or if it makes a woman have heavy periods, then consideration can be given to getting rid of it.

Hysterectomy – removal of the uterus – is only one way to treat a fibroid. Many times a fibroid can be removed without taking the uterus, and sometimes it can be removed without making any abdominal incision. A laparoscope – the telescopic instrument used to view inner organs – is used with simultaneously passed surgical instruments to remove a fibroid.

Uterine-artery embolization is a more recent technique that eliminates fibroids without surgery. A doctor threads a soft, pliable tube – a catheter – from a surface artery into the artery that supplies the fibroid with blood. When the catheter is in place, the doctor then releases beads into that artery. The beads block blood flow to the fibroid, and, in time, it shrivels up. That’s only one of many new techniques for fibroid removal.

Most important is to remember that few fibroids need to come out.

Readers who would like more information on fibroids and hysterectomies can order the pamphlet on them by writing to: Dr. Donohue – No. 1106, 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: My doctor tells me I have discoid lupus and has prescribed a cream that I put on my skin. He says this will not affect my life. I know of two other ladies who have had lupus. One has died, and the other is no longer able to work. How can the doctor say this will not affect my life? – B.W.

ANSWER: There is more than one form of lupus. The discoid variety affects skin only. It appears as one or more red blotches, most often found on the face, neck or scalp. They might be up to an inch in length. Tiny lines might appear on the surface, and the surface can become scaly. Cortisone creams are often the medicines prescribed. If the involvement is more widespread or if the blotches keep coming back, then oral medicines are added to the program.

Systemic lupus is what struck your acquaintances. Systemic lupus affects not only the skin but also many internal organs – kidneys, nervous system, heart and arteries. Joints are usually involved. This is a more serious malady.

Your chances of developing systemic lupus are small. That’s why the doctor gave you the reassurance that he did.

These days, the outlook for those with systemic lupus is much improved over what it was some years back. Most systemic lupus patients live long, productive lives.

You must protect yourself from sunlight, as must all lupus patients. Don’t go outside without applying sunblock.

DEAR DR. DONOHUE: I am 67 and have osteoporosis. A friend tells me not to drink caffeine. She claims it blocks calcium from getting to bones. Have you heard this? – K.J.

ANSWER: Caffeine has a slight effect on calcium absorption, so slight it does not produce or worsen osteoporosis.

DEAR DR. DONOHUE: My wife, who is 78, has been complaining about cold feet from her toes to her calves for the past six months. The condition is improved somewhat when she walks quickly or exercises. Can you give me some insight as to the cause and how it can be corrected? – D.H.

ANSWER: Your wife’s symptoms have some of the earmarks of a circulation problem. It goes by the name of “peripheral vascular disease.” It is the common condition where mounds of cholesterol and fat cling to artery walls and impede the flow of blood to more distant points.

I was going to give you directions on how to feel for her pulse behind the knees, at the ankles and on the tops of her feet, but even an experienced examiner has difficulty at times feeling those pulses. Better leave this to the doctor. If she has no pulse, then the probability of peripheral vascular disease becomes stronger.

The doctor has more sophisticated tests to detect blood flow in leg arteries. If the family doctor does not have such equipment, he can send her to a doctor who specializes in vascular problems and who assuredly will have the equipment to detect blood flow.

If peripheral vascular disease turns out to be the case, your wife can help herself by doing all those things that are preached from medical pulpits daily on how to lower cholesterol and triglycerides. Diet and medicines are usually the ways to do that. Furthermore, there are medicines that can help blood make its way more easily past artery obstructions. In some instances, the obstructions can be smashed with a balloon that is threaded through the artery to the point of obstruction and then inflated.

Exercise – with her doctor’s approval – is important. She does not complain of pain when she exercises, so exercise will not be a burden. She should try to get in at least half an hour of walking every day. It need not be 30 straight minutes. She can break the sessions into two 15-minute or three 10-minute ones.

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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