DEAR DR. DONOHUE: I am 72 and have had urination problems for the past year. I get up during the night, and during the day I have to go to the bathroom every hour or so. The doctor says it’s because I have a big prostate gland. He suggests an operation, which I am not keen to have. What else is there? – P.R.

ANSWER: The normal prostate gland is not much larger than a peach pit. By age 40, 25 percent of men have some prostate enlargement; by age 80, 85 percent do. It can get to the size of a golf ball or larger. The prostate gland wraps around the urethra, the bladder’s drainage tube.

An enlarged gland chokes the urethra and makes it impossible to empty the bladder completely. That’s why frequent bathroom trips are necessary. Furthermore, the gland contains muscle fibers. They, too, can grow and add to the compression of the urethra.

Medicines that counter the effect of testosterone are another alternative. Testosterone fosters gland growth. Even though its production diminishes with age, a lifetime of exposure to the hormone enlarges the gland, and the small amount still around at older ages continues to promote gland growth.

The prostate pamphlet explores all the aspects of this gland. Readers can order a copy 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.

DEAR DR. DONOHUE: Would you tell me about the pill Zetia, which my doctor prescribed for me to take for high cholesterol? It brought my cholesterol down within two months.

How safe is it compared with the statin pills? – A.G.

ANSWER: The most prescribed cholesterol-lowering medicines and the ones that get the most attention are the statin medicines – Lipitor, Zocor, Pravachol, Mevacor, Lescol and Crestor. Statin drugs arrest the liver’s production of cholesterol.

Zetia is a relatively new drug that works in a different way. It blocks cholesterol absorption. It is a safe drug with few and usually minor side effects.

You didn’t ask, but many others do. Which cholesterol-lowering drug is the best? The best drug for an individual is the one that brings down cholesterol to a low level for the least cost and with the fewest side effects. Sometimes arriving at that happy state takes a few tries.

DEAR DR. DONOHUE: I have written before asking about research and information on Friedreich’s ataxia. Our granddaughter has it. – G.H.

ANSWER: Your question gives me a chance to bring attention to NORD, the National Organization for Rare Disorders.

Having a rare illness such as Friedreich’s ataxia presents two problems to a patient: one, the illness itself; and two, believing that he or she is the only person in the world who has it. NORD comes to the rescue, providing information to people with unusual illnesses and guiding them to groups founded to support a particular illness.

NORD does not diagnose illnesses. You can reach NORD at: 1-203-744-0100; P.O. Box 1968, Danbury, CT 06813; and www.rarediseases.org.

Friedreich’s ataxia is a genetic illness whose onset usually appears between the ages of 4 and 17. With this condition, its initial sign often is trouble walking. Subsequently, jerky movement of the arms can arise. The ataxia can also involve speaking muscles, and that leaves a person with thick, slurred speech.

Thanks to NORD, I can provide you with information on how to contact the Friedreich’s Ataxia Research Alliance. The phone number is 1-703-413-4468; the address is 2001 Jefferson Davis Hwy., Suite 209, Arlington, VA 22202; and the Web site is www.frda.org.



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.