DEAR DR. DONOHUE: At age 88, I take drops for glaucoma. My eye pressure is controlled, and I have no symptoms. My eye doctor tells me I am at risk for age-related macular degeneration. He has me taking AREDS vitamin pills. I have 20/20 vision, but the prospect of macular degeneration worries me. Is it inevitable? Will the pills work? – W.W.

ANSWER: The prospect of age-related macular degeneration worries everyone; just about everyone is at risk for getting it. About 25 percent of people older than 75 have some signs of it. It usually progresses slowly, for most people. If, at age 88, you have 20/20 vision, your worries are minimal. Macular degeneration is not inevitable.

The macula is the small, central portion of the retina – the light-sensitive layer of cells at the back of the eye that transmits images to the brain. The macula is responsible for central vision, the kind needed to read a newspaper, sew, drive and see faces. Macular degeneration spares side vision (peripheral vision).

AREDS stands for the “age-related eye disease study,” which showed that high doses of vitamins C, E and A (as beta carotene), along with zinc and copper, can slow the progression of macular degeneration when it has reached the intermediate or advanced stage.

Many brands of the vitamins and minerals in doses used in the AREDS study are now on the market. The doses of both the vitamins and minerals far exceed their recommended daily allotments, but apparently nothing bad has happened to people using the pills. However, this is not a matter that people should take into their own hands. AREDS vitamins should be used only when a physician recommends them. The doctor can monitor whether patients are getting too much of a good thing.

I refer to dry macular degeneration, the more common form. Wet macular degeneration is another story. The booklet on macular degeneration gives the details of this common affliction. Readers can order a copy by writing: Dr. Donohue – No. 701, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I have costochondritis. Kindly give me some information and a prognosis. I have led an active sports life. – R.S.

ANSWER: “Costo” is “rib,” and “chondritis” is “cartilage inflammation,” so costochondritis is an inflammation of the cartilage that holds the rib in place at the breastbone. It can come from a viral infection, from trauma or from unknown causes, and the latter “cause” is the most frequent.

The pain of costochondritis often imitates the pain of a heart attack. However, costochondritis pain worsens when a person twists the chest, takes a deep breath or coughs.

This condition waxes and wanes for anywhere from weeks to several months. In most cases, it’s gone in a year, at most. Aspirin or anti-inflammatory drugs like ibuprofen can generally take the edge off of it. Some find that applying cool compresses to the painful area helps. Others are benefited more by using a heating pad. If pain persists, the doctor can inject the area with cortisone, and that frequently calms the inflammation.

The prognosis is eventual victory for you.

DEAR DR. DONOHUE: Since winter is upon us, I need to settle a heated debate between my 15-year-old son and myself. He insists on showering in the morning before school and then proceeds outside with a soaking-wet head of hair in temperatures below 20 F. I say he’ll catch pneumonia. He says you have to come into contact with a germ to do that. Who’s right? – D.R.

ANSWER: A wet head doesn’t cause pneumonia or a cold. Germs – bacteria and viruses – do. However, your son shows a lack of common sense. Why does he bother to dry his body before going out in the cold? Water freezes, and he can freeze his scalp by running outside in the winter with a wet head. Tell him “duh” for me.

DEAR DR. DONOHUE: My husband was recently diagnosed with MGUS. We know it has something to do with too much protein in his blood. Will you tell us more about it? – W.L.

ANSWER: “MGUS” is the abbreviation for “monoclonal gammopathy of uncertain significance.” The name is unfamiliar and unusual, but the condition is not rare. About 1 percent of people over 50 have it, and after age 75, 10 percent have it. That’s a good number of people.

“Gammopathy” refers to an abnormally great production of gamma globulin. Gamma globulin is a protein. It is the stuff antibodies are made of. The gamma globulin in MGUS, however, serves no useful purpose.

“Monoclonal” signifies that the gamma globulin comes from one single cell, a plasma cell. That single cell keeps dividing and dividing, forming an army of similar cells. Plasma cells function as antibody-making cells, but here the process has gotten way out of hand.

“Uncertain significance” means just what it says. Doctors don’t know why this happens, and they don’t believe it is a dangerous condition. On average, people with MGUS live about two years less than do others of similar age who do not have this quirk.

There is a note of caution about MGUS. A small number of patients eventually develop multiple myeloma, a cancer of bone and bone marrow. Doctors, therefore, keep a close tab on MGUS patients, looking for any sign that multiple myeloma might be evolving.

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

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