DEAR DR. DONOHUE: My son lives three states away from his father and me. He is 27 and has been on his own since graduating from college four years ago. He called us to tell us he might have SBE. He is very tight-lipped and did not go into details other than to say it is a heart infection. What is it? How serious is it? – R.V.

ANSWER: “SBE” stands for subacute bacterial endocarditis, an infection of one of the four heart valves. Most often, the involved valve is one that has been deformed by some prior condition, like rheumatic fever.

Bacteria constantly gets into the blood. The body disposes of them easily. However, when bacteria see a deformed heart valve, they home in on it and begin to multiply. They have found a safe haven. Soon, they further damage an already-damaged valve, and that can lead to heart failure.

SBE is a condition that requires hospital treatment. Antibiotics must be given through a vein to attain high blood levels rapidly in order to stop the bacterial proliferation on the valve. It can take a month or more of treatment to eradicate the infection.

Your son’s doctor will not be wasting any time in confirming the diagnosis. Your son’s blood will be checked for any bacteria that might be in it – one important sign of this infection. Echocardiograms – sound wave pictures of the heart and its valves – can disclose a deformed valve and the bacteria that are growing on it.

Most of the time, treatment for SBE turns out well. In spite of antibiotic treatment, your son could face repair of the damaged heart valve.

For completeness’ sake, I had better mention acute bacterial endocarditis. It too is a heart valve infection, but the infection takes place on a normal valve. Acute bacterial endocarditis is a greater health menace than is the subacute variety.

DEAR DR. DONOHUE: My friend was just in the hospital because her electrolytes were out of order. I have never heard of electrolytes. I had her spell it for me and told her I was going to write you about it. She thought that was a grand idea. What are they? – F.T.

ANSWER: “Electrolytes” is a term used in chemistry. They are atoms that have either a positive or a negative charge. That’s the end of the chemistry lesson.

For all practical purposes, in medicine, “electrolytes” refers to sodium, potassium, chloride and bicarbonate. They are involved in endless body processes. They help keep the heart beating. They keep nerves firing. They balance the amount of acid in the body.

Diuretics, vomiting, diarrhea and uncontrolled diabetes are a few of the conditions that throw electrolytes out of balance. A marked derangement calls for immediate action, or dire consequences result – consequences such as death.

Your friend’s doctors had their hands full in finding a cause for her imbalance. They also had their hands full in restoring the proper concentrations of those important body chemicals.

Ask your friend for me if they found a cause for the electrolyte disturbance.

The electrolyte story is told in the pamphlet on sodium, potassium and other minerals. It provides information that should interest all those taking water pills. Readers can order a copy by writing to: Dr. Donohue – No. 202, 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: Is it possible to become addicted to caffeine? I drink 10 cups of coffee every day. I have tried to stop, but when I do, I become sluggish and get a headache. Is that a sign of addiction? – W.W.

ANSWER: Caffeine can be slightly habit-forming. Abruptly stopping heavy use can bring on headaches and lethargy. They can be avoided by gradually tapering the amount of caffeine drunk.

Start. Ten cups is too much. You must be very tightly wired.

DEAR DR. DONOHUE: What is rickets, and how come we don’t hear about it now? The question came up in my seventh-grade science class. The teacher didn’t know, and she assigned me to write to you. Please answer. My grade depends on you. – D.T.

ANSWER: Rickets is soft bones due to a lack of calcium fortification. The calcium lack, in turn, comes from a shortage of vitamin D. It’s the vitamin that smoothes the path for calcium absorption in the intestine.

Without calcium, the bones become so soft that they are malformed. Rickets can be one cause of bowlegs and knock-knees.

Soft bones break easily. Childhood rickets, uncorrected, stunts growth.

You don’t see much of it anymore because vitamin D is put into many foods, dairy products being the prime example.

DEAR DR. DONOHUE: I have worked in a nursing home for 12 years. My supervisor let me see my employment record. It says that I am susceptible to hepatitis B. What are the implications of that? – K.R.

ANSWER: Everyone is susceptible to infection with the hepatitis B virus. Only people who have gotten the hepatitis B vaccine or who have successfully recovered from a hepatitis B infection are no longer susceptible to the virus.

The note in your record probably reflects the fact that you have not had the vaccination. All health care workers who come in contact with patients are encouraged to take the vaccine. Ask if your employer provides it to its employees. If it doesn’t, get it on your own from your family doctor.

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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