DEAR DR. DONOHUE: I have a 4.5-cm aortic aneurysm. Should I be taking precautions, like not lifting, driving or working? My doctor told me not to worry. I didn’t ask why because I am scared. – L.T.

ANSWER: The aorta, the body’s largest artery, runs from the heart to the bottom of the abdomen, where it divides into two arteries, one for each leg. Along its entire route, it sends out branches that supply blood to all parts of the body.

An aneurysm is a bulge that juts through a weak spot in an artery wall. In the aorta, the common site for aneurysms is the abdominal portion of that artery. The danger of an aneurysm is the chance that it might burst and result in a lethal internal hemorrhage.

A normal abdominal aorta has a width of 3 cm (1.2 inches). When an aneurysm increases the aorta’s width to 5.5 cm (about 2.25 inches), the possibility of rupture is great, and surgery is recommended. Aneurysms with widths of less than 5 cm (2 inches) are not likely to burst, and they can be safely watched by taking ultrasound pictures on a scheduled basis. What to do for those between 5 and 5.5 cm is a gray area, and other factors determine the optimum time for surgical correction.

Your aneurysm is not at a danger point. You don’t have to limit your activities. You do have to do things that keep aneurysms from enlarging. One of the most important is keeping blood pressure normal. You must not even think about smoking. Your diet should be a low-fat, low-cholesterol one. Unless your doctor has placed specific restrictions on your activities, you don’t need to limit them.

As an aside to readers, some experts are now recommending that men between the ages of 65 and 75 who are or have been smokers get an ultrasound picture of their abdominal aorta, since smoking is such a risk factor for causing aneurysms. Whether this applies to women of the same age is something that has not yet been determined.

DEAR DR. DONOHUE: I would like to know if there is help for someone with Paget’s bone disease. My 54-year-old daughter has it in her forearm. Is there a support group? – R.T.

ANSWER: In Paget’s bone disease, the daily bone-remodeling process has gotten out of whack. Bone cells called osteoclasts chew up parts of bone for restoration by the construction bone cells – osteoblasts. With Paget’s, the demolition cells outpace the construction crew. In order to compensate, the construction crew throws down bone that is not of the best quality, is often misshapen and is subject to breaking.

For many Paget’s patients, like your daughter, the process occurs in a limited section of bone. For others, it is more widespread.

There are medicines for Paget’s disease. Among them are Fosamax, Actonel and Miacalcin. You might recognize the names. They’re also used for the more common bone disease osteoporosis.

Yes, there is a foundation for Paget’s disease, the Paget Foundation. Your daughter should contact the foundation for information and for the knowledge that she is not alone in fighting this illness. She and other Paget’s patients can reach the foundation at 1-800-237-2438 or www.paget.org.

DEAR DR. DONOHUE: If a person thinks he has hemorrhoids, when should he see a doctor? – A.R.

ANSWER: One sign of hemorrhoids is blood in or on the stool. However, hemorrhoids are not the only things that cause blood in the stool. More serious conditions – yes, cancer – can do the same. Blood in the stool should prompt a visit to the family doctor to find its source.

Hemorrhoids can also be painful. If there is a clot in one of the hemorrhoid veins, the pain is severe, and such pain almost always brings a person to the doctor quickly to obtain relief.

A third hemorrhoidal sign is protrusion of the hemorrhoid through the rectum. Although not always painful, it usually alarms a person. Not knowing for sure what this is, most people call the doctor’s office promptly for confirmation.

The answer to your question is, see the doctor soon. Not because all hemorrhoids need immediate treatment, but because the diagnosis of hemorrhoids needs to be made reliably.

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.