DEAR DR. DONOHUE: I would like to know what to do about restless legs. When I sit for a while, it feels like there is something crawling in them, and at night they drive me crazy. My doctor put me on gabapentin. I asked him why I have this, and he said he didn’t know. Can you tell me why I have this condition? Do I have a shortage of something like vitamins? – M.R.

ANSWER: Somewhere between 10 percent and 20 percent of people older than 60 have restless leg syndrome. Younger people also get it, but in fewer numbers, so age must have something to do with it. Genes have a role, because it runs in families. Sometimes iron deficiency brings it on, and all those with the condition should have their blood iron level tested. Or it might have something to do with a mix-up in the transmission of dopamine, a body chemical important for brain and nerve function. Theories abound. None is proven. A vitamin deficiency is not responsible.

Most people describe it as creepy, crawly sensations in their legs. The sensations arise at rest and intensify in bed. Along with the sensations, there is an irresistible urge to jump up and move around. Walking brings an end to the annoying feeling.

Gabapentin is often prescribed for restless legs. If it doesn’t work, there are other medicines that can be tried. The newest one is Requip. If you turn on the TV for only a few minutes a day, you’ll see at least one advertisement for it.

There’s often a companion syndrome that accompanies restless leg syndrome. It’s periodic limb movements of sleep. During sleep, the legs, and sometimes the arms, flail about forcefully, pummeling the bed partner. Both conditions make people tired the next day, since they prevent a night of restorative sleep.

DEAR DR. DONOHUE: Can you give me some input on ganglions? I have one on my wrist. I’ve never heard of them. The lump is nearly the size of an egg and is not entirely painless. The doctor drained it twice, but it returned each time. I understand there is surgery, but I also understand the ganglion returns after surgery. It seems that I might just as well forget it. – I.S.

ANSWER: Ganglions are pouches that arise from the lining of joints or the lining that covers tendons. A thick, gelatinous material fills the pouches. The favorite place for them to pop out is the back of the wrist. Quite often, they are small and don’t hurt or interfere with motion.

DEAR DR. DONOHUE: I have a rectocele along with a cystocele and a prolapsed uterus. I had a pessary inserted, but it fell out before I arrived home from the doctor’s office. My doctor said my only other choice would be a hysterectomy. He also said, “Believe me, you don’t want to have a hysterectomy.” Sometimes all this drops outside the vagina. Is this dangerous surgery? – M.W.

ANSWER: A fallen bladder is a cystocele; a fallen rectum, a rectocele; and a fallen uterus is a prolapsed uterus. The supporting tissue of all three has given way, and these organs drop down and sometimes emerge through the vagina. A pessary is a doughnut-shaped affair that fits over the cervix to prop up the organs.

I don’t know why your doctor said what he said. Hysterectomy with a shoring up of the rectum and bladder is one of the most common and safest operations in the field of gynecologic surgery. Get a second opinion.



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.