DEAR DR. DONOHUE: My great-grandnephew has lupus. Is this disease incurable? Please give us some hope. – J.R.

ANSWER: Lupus is an autoimmune disease, one of the many illnesses where the immune system turns on its own body for reasons that, at the present, are inscrutable.

Your great-grandnephew differs from the typical lupus patient in a number of respects. Lupus usually attacks young women between the ages of 15 and 45. Men are not immune, but they are a minority of patients. I don’t know his race, but more blacks get it than whites. None of these facts has a good explanation.

Many organs and tissues are its targets, so its signs and symptoms are equally many. Joints are almost always involved, and the wrists, hands, elbows and knees are the ones most frequently affected. Quite often, the same joint on both the right and left side comes under attack. The joints swell and hurt as they do in rheumatoid arthritis.

Kidneys can be inflamed and spill protein into the urine. Blood pressure may rise because of kidney involvement. Lupus can strike the heart, its coverings and the coverings of the lungs. It might affect nerves and alter their ability to function. Muscle weakness can ensue. If lupus attacks the brain, it can lead to seizures. People with lupus often have a low white-blood-cell count, which makes them vulnerable to infections.

What I describe is a bleak picture, and formerly, lupus was a bleak diagnosis. It is a formidable illness, but today’s treatments bring great hope for all lupus patients. They are living longer and longer and have fulfilling, active lives. Such was not the case only a few decades ago. Your great-grandnephew can expect to lead a long, productive life.

DEAR DR. DONOHUE: My uncle is 90, appears to be in very good health and has a great attitude. He takes 30-minute walks and does his own grocery shopping. Lately he has complained of a sometimes-painful chest sensation. His cardiologist wants him to have a nuclear stress test. How can a man of this age endure a test that takes hours and hours? I don’t want to subject him to such a strenuous test. If he does have heart-artery blockage, what could be done for a 90-year-old, surgically or otherwise? – N.K.

ANSWER: A “nuclear” stress test is an exercise test with an added feature. At the end of the test, a radioactive material is injected, and pictures are then taken of the heart. If there is a partially blocked heart artery, the radioactive material doesn’t light up the area of the heart served by the blocked artery. Hours later, when the patient has rested comfortably, another set of pictures is taken. The radioactive material still circulates. At rest, blood resumes flow through the partially blocked artery, and the second set of pictures shows the entire heart light up with the radioactive tracer. That’s added proof of an obstruction. Most of the test time is spent waiting to take the second set of pictures.

If your uncle is unable to exercise on a treadmill, the same effect can be achieved with drugs. That’s a pharmacologic stress test, and taking it requires no effort.

Age doesn’t disqualify a person from having bypass surgery or angioplasty or taking medicines for blocked arteries. General poor health can be an obstacle to surgery, but your uncle sounds as though he has the health of a much younger man.

DEAR DR. DONOHUE: I recently had a colonoscopy. The report said “very tortuous colon.” No polyps were found. All biopsies came back normal. The doctor said I will need another scope exam down the road. Is it because of the tortuous colon? Will a tortuous colon cause problems later? Please discuss this. I am a 67-year-old woman. – T.H.

ANSWER: The colon is a tube of between 4 and 5 feet in length. Such a long tube often has bends and twists. That’s the meaning of a “tortuous colon,” and lots of people have one. Yours hasn’t bothered you for 67 years. It’s not likely ever to do so. Repeat colonoscopies are the norm for everyone.

DEAR DR. DONOHUE: Some time ago, I met a man who told me he had been rejuvenated by taking intramuscular injections of procaine. He said he felt like he was turning back the clock. His aches and pains had disappeared, and his hair, which had been half-black and half-gray, was turning back to all black. Does this treatment really have the effect this man reported? – E.C.

ANSWER: It’s safe to say that if it did, we would all be taking the shots. Procaine is a numbing agent used to deaden the skin when it has to be stitched. It first appeared in 1905 and has largely been supplanted by better agents. Procainamide – procaine with a slight chemical alteration – is used to regulate an abnormally beating heart. It is not in frequent use today, either. I wouldn’t use either for rejuvenation.

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. Readers may also order health newsletters from www.rbmamall.com.