DEAR DR. DONOHUE: I had an eye problem that is sometimes associated with multiple sclerosis. The doctor ordered an MRI brain scan. The radiologist read the scan as highly suspicious for multiple sclerosis. I am 52 and have no weakness, no dizziness, no falls and no other symptoms of MS. I wonder if the MRI findings for MS are similar to other conditions. Are they? – V.M.

ANSWER: The literal meaning of “sclerosis” is “hardening,” but in MS it refers to scars found in the brain and spinal cord. The scars result from a loss of nerve myelin, the nerves’ insulating material. Without insulation, the transmission of nerve impulses can’t take place, and that accounts for the symptoms of MS.

MS usually strikes between the ages of 20 and 40. Its onset can be gradual or sudden, and its symptoms are quite varied. They depend on which areas of the brain and spinal cord are scarred. Often, a person suddenly and painlessly loses sight in one eye or develops double vision. Arm muscles can weaken, and clumsiness results. Leg involvement makes walking difficult. Fatigue is a universal symptom. Some complain of tingling, prickling or burning sensations in various body parts. You have none of these, with the possible exception of the eye trouble.

In the most common variety of MS – relapsing/remitting – an attack and the appearance of symptoms progress in days to weeks. In the following weeks or months, the symptoms go away, and the person recovers. However, another attack occurs and a new set of symptoms arises. This continues until symptoms become permanent.

MRI scans have been an enormous boon in diagnosing MS.

They show the scars in the brain and spinal cord. Other conditions can produce similar scars – the blockage of small blood vessels and migraine headaches are two examples.

And some people have such scars without ever having a single MS symptom. It takes more than an MRI scan to clinch the diagnosis of MS.

DEAR DR. DONOHUE: I am 75 and have been sexually active until six months ago, when I began to have trouble achieving an erection. I have a large prostate gland. Could that be the cause? – B.A.

ANSWER: An enlarged prostate gland rarely, if ever, causes erectile dysfunction.

What medicines do you take? They’re often the cause. Some blood pressure medicines interfere with sexual performance. Many other medicines can do the same.

Poor circulation is another common cause. If circulation to the penis is impaired, then circulation in general is most likely impaired, and that’s an issue that should be discussed with your doctor.

Diabetes can produce erectile dysfunction, as can nerve problems.

Always cited as a cause but seldom found to be the cause is a low blood level of the male hormone testosterone. It’s true that testosterone production wanes with age, but it usually does not fall to such a degree that achieving an erection is impossible.

You should discuss this with your doctor, since many health issues can be involved. You can also talk with the doctor about taking medicines like Viagra, which have benefited so many men with this condition.

DEAR DR. DONOHUE: I had been on Mevacor for about two years to lower my cholesterol. It did drop, but not enough to please my doctor, so she switched me to Lipitor. I don’t follow the reasoning. Both Mevacor and Lipitor are similar medicines. If one doesn’t work, how will the other? – D.T.

ANSWER: You’re right. Lipitor and Mevacor are members of the “statin” drug family. Lipitor is atorvastatin, and Mevacor is lovastatin. There are four other statin drugs. Statins lower cholesterol by slowing the liver production of it. That’s where most blood cholesterol comes from.

Deciding which one to use is often an experiment. Although all six statin drugs lower cholesterol better than any other class of medicines, each member of the family affects an individual user somewhat differently. What works well for one might not work so well for another.

You’ll know in about four weeks if Lipitor is doing a better job for you.

DEAR DR. DONOHUE: I’m not sure you’re the right person to ask. Do you know the recipe for crickets that consists of boric acid, bacon drippings, onions and sugar? – F.W.

ANSWER: Do you mean the chirping insects? You’re correct. I’m not the right person. My cricket information is nonexistent. Maybe readers will come to the rescue. Personally I find the sound that crickets make soothing.

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.

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