DEAR DR. DONOHUE: My daughter, who is 29, wrote to tell me she has lupus. She lives more than 1,000 miles away from me. She says she is working and is not feeling bad, but I wonder. I have heard terrible things about this illness. Does it always kill? Please give me details. – B.R.

ANSWER: Lupus is an illness that strikes mostly women, and it usually does so in the second to the fourth decade of life. Its cause has not been discovered, but circumstantial evidence indicates that hormones (the female predominance), the immune system (antibodies found in the blood) and unidentified environmental factors all impact a person who has inherited a propensity to come down with this malady.

Few body organs and tissues are spared. High on the list are joints. Lupus is a form of arthritis, and joints hurt and swell in lupus as they do in other types of arthritis. One aspect of joint involvement unique to lupus is that morning stiffness is often briefer than it is in other forms of arthritis. Skin ranks high among targeted tissues. A butterfly rash — a redness of the cheeks and bridge of the nose – is a hallmark lupus sign. In addition, most lupus patients’ skin is quite sensitive to sunlight. The lungs, heart and nervous system are other potential objects of a lupus attack. Many lupus patients become anemic and develop a deficiency of white blood cells (infection-fighting cells) and blood platelets (clot-forming blood cells).

All of the above make lupus appear dire, and, in some people, it is a dire illness. Fifty years ago, the five-year survival rate for lupus patients was only 50 percent. That’s what gives older people a chill when they hear the diagnosis of lupus. Today, however, the 10-year survival rate for lupus patients is more than 90 percent. Much of that turnabout is due to the stockpile of medicines now available for treatment.

Your daughter’s comments about her health are believable. The odds are in her favor that she will live a very healthy life in spite of having lupus.

Lupus and other forms of arthritis are discussed in the pamphlet of that name. Readers can obtain a copy by writing: Dr. Donohue – No. 301, 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: Two months ago I had a baby. Everything was going well until about 10 days ago, when I developed a painful left wrist. It’s almost impossible for me to pick up my baby. Is this related to the delivery? – T.D.

ANSWER: I have to guess at what you have, but I believe it is de Quervain’s syndrome, something that often happens after childbirth. It also happens to people who overuse the wrist. Right-handed golfers, for example, are a group vulnerable to getting it. It’s an inflammation of the tendons that control thumb motion. Pain is felt on the thumb side of the wrist when a person goes to use the hand and wrist.

In addition to pain, some people hear a snapping sound when they move the wrist.

Wrap your left-hand fingers around your left thumb so you bury it in a clenched fist. Bend the wrist to the little-finger side of the hand. If that maneuver incites pain, then the likelihood of de Quervain’s increases.

Your doctor has to confirm the diagnosis. If you do have it, an occupational therapist can fashion a splint for you that rests the wrist. You can find an occupational therapist in the rehabilitation department of your local hospital. Anti-inflammatory drugs – ibuprofen, for example – help. Sometimes a cortisone shot into the painful area can calm the inflammation.

DEAR DR. DONOHUE: I take Lipitor to lower my cholesterol. It has done a fantastic job. I have gone from 260 to 160. How does it work? – M.I.

ANSWER: Lipitor, as do all statin drugs (Zocor, Mevacor, Pravachol, Lescol and Crestor), stops liver production of cholesterol. Most blood cholesterol comes from our liver’s making it and not from food.

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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