DEAR DR. DONOHUE: I am a 36-year-old woman, and I have a fibroid. My doctor says I should have my uterus removed. My husband and I have two children, but we would like one or two more. Is there some way of treating a fibroid short of having an operation? – M.L.

ANSWER: The uterus is a muscular sack, and a fibroid is a noncancerous growth of the uterine muscle. It ranges from the size of a small marble to that of a large melon. By age 50, somewhere between 30 percent and 75 percent of all women have one or more fibroids. For most of these women, the fibroid or fibroids can be ignored because they cause no symptoms.

When fibroids cause bleeding or pain or interfere with fertility, then they’re treated. If they grow so large that they press on adjacent structures, like the bladder, they need attention. Hysterectomy – removal of the uterus – is only one treatment.

Myomectomy is surgery that removes only the fibroid and leaves the uterus in place, thus making further pregnancies possible. Surgeons can perform the operation by making an abdominal incision and entering the uterus directly. Or they can perform it with a laparoscope, a viewing instrument that’s used in so many of today’s operations. Hysteroscopic removal is another technique. Here a hysteroscope, a modified laparoscope, enters the uterus though the vagina. No incisions are made. Instruments designed to remove fibroids are introduced through the same routes. Which technique is best depends on the size and location of the fibroid.

Uterine fibroid embolization is a procedure that gets rid of a fibroid by cutting off its blood supply. Through a groin artery, the doctor inches a catheter into the uterine artery and eventually into the artery that supplies blood to the fibroid. Then the doctor releases particles that cause a clot to form, and that deprives the fibroid of blood. It shrivels and is sloughed off. Talk to your doctor about one of these alternate procedures.

The fibroid booklet provides a full discussion of this common problem. Readers can obtain a copy by writing: 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: Is decaffeinated coffee a health threat? One of my co-workers saw me drinking it and claims it causes cancer. Does it? – B.N.

ANSWER: I can’t provide you with the exact length of time decaffeinated coffee has been around, but it has been a long time. Does your co-worker believe that a food would be allowed to stay on the market for that length of time if it caused cancer?

At one time panic signals were sounded because some lab animals developed cancer due to methylene chloride. It’s a substance used to remove caffeine from coffee.

The amount of methylene chloride in decaffeinated coffee is too tiny to be a source of concern. Furthermore, most decaffeinated coffee these days has had its caffeine removed by a process that doesn’t employ methylene chloride.

DEAR DR. DONOHUE: I have high blood pressure and have taken many medicines for it through the years. None has worked as well as Norvasc.

My doctor told me that Norvasc is a calcium blocker. That has me wondering if I need to take calcium when I take this drug. Does it block calcium absorption? – W.R.

ANSWER: If the name “calcium blocker” confuses you, it must confuse many others. Calcium channel blockers are a large family and are used by many people.

They block calcium’s entrance into the strands of muscle fibers that wrap themselves around arteries. Constriction of those tiny muscles narrows the arteries and raises blood pressure. That’s where the calcium blocking takes place. It doesn’t take place in the digestive tract.

You don’t need a calcium supplement.

DEAR DR. DONOHUE: There are a couple of yellowish bands on my eyelids. I thought they might be grime, so I tried wiping them off, but they didn’t budge. They are deep in the skin. What are they? How can you get rid of them? – W.C.

ANSWER: They are likely xanthelasmas (ZANN-thul-AS-mahs). They are deposits of fat and cholesterol in the skin, and they are often signs of high total cholesterol, high LDL cholesterol or low HDL cholesterol. Sometimes they are unrelated to cholesterol in any of its forms, and they just appear out of the blue.

They are also seen in liver disease and diabetes.

Next time you are in a crowd, take a survey of people’s eyelids. You’ll find that many are sporting one or more xanthelasmas.

If you have never had your cholesterol checked, do so.

Xanthelasmas can be surgically removed, and it is not radical surgery. New ones, however, can pop up.

The cholesterol pamphlet, while not discussing xanthelasmas, does discuss all of cholesterol’s other aspects and how to control it. Readers can obtain a copy by writing: Dr. Donohue – No. 201, 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 lab report lists total cholesterol, LDL cholesterol and HDL cholesterol. Just for the heck of it I added the LDL and HDL cholesterol, and they do not equal total cholesterol. Why not? – R.H.

ANSWER: LDL cholesterol is bad cholesterol, the kind that sticks to artery walls and blocks blood flow. The higher the number, the worse off a person is. HDL cholesterol is the good kind, the kind that keeps artery walls squeaky clean.

There’s a third kind of cholesterol, VLDL (very low density lipoprotein) cholesterol. It doesn’t get much press. If you add VLDL, HDL and LDL, you’ll get the total cholesterol number.

Let’s not get into it. The cholesterol story is a bit overdone as it is.

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.