DEAR DR. DONOHUE: I suffer from sinus trouble and sinus headaches. I take an over-the-counter decongestant, but it doesn’t help the headaches. What else is there? What are sinuses anyway? – K.S.

ANSWER: Sinuses are hollow caverns in the skull bones. They lighten the head and make it possible for the neck to support it.

Sinus infections cause a runny nose with a discharge that’s often thick and yellow. There is a constant trickle of mucus into the throat. People can feel pain in the region of the sinuses – the forehead, the cheeks and between and behind the eyes. Often, the pain is called a headache, but true headaches are not common in sinus infections. The first thing you have to establish is the nature of your headaches. Self-diagnosis might be leading you astray.

Acute sinusitis is sinus infection and inflammation that lasts less than four weeks. Quite often the infection is due to a virus, so antibiotics are not usually prescribed. Viral sinus infections typically get better on their own in a week to 10 days. Decongestants are about the only medicines used for them. Saltwater sprays into the nose can thin the discharge and clear the nasal passages. Such sprays are available in all drugstores.

If acute sinusitis lasts longer than 10 days, the assumption is that the infection is bacterial, and antibiotics are prescribed.

Chronic sinusitis has symptoms similar to the above ones, but with less intensity. It’s a sinus infection of two or more months. In these cases, a long course of antibiotics is needed. Antihistamines help dry the sinuses and nose, as do decongestants. Many will have to have an ear, nose and throat doctor create a new drainage outlet for the involved sinus. That can often be done in the doctor’s office with a special scope and special instruments inserted into the nose.

DEAR DR. DONOHUE: When I was 21, during a routine eye exam, the doctor told me I had keratoconus. He said I needed contact lenses and that my eyes should be examined yearly. I have worn contacts ever since – seven years. This past year my vision isn’t as clear as it used to be. What’s the next step after contacts for this condition? – J.A.

ANSWER: Keratoconus is a cone-shaped bulge of the cornea. The cornea is the clear part of the eye through which you see a person’s pupil and the colored iris.

Most often the bulge progresses slowly. It might reach a point where contact lenses can no longer correct the distortion to vision that comes with keratoconus. When that point is reached, then the next step is a corneal transplant.

Corneal transplants are among the safest and most successful of all transplants. These transplants don’t require a person to take anti-rejection drugs.

Have you been keeping your yearly appointments with your eye doctor? Even if you have, you should see the doctor now, since your vision has changed.

DEAR DR. DONOHUE: I can’t hold a pen or a pencil anymore. My hand goes into a painful spasm. My doctor calls it writer’s cramp and says not a whole lot can be done for it. Do you have any suggestions? – P.R.

ANSWER: Writer’s cramp is a form of dystonia. Dystonias constitute a large family of muscle problems in which involuntary and sustained muscle contractions occur. The involved muscles might affect only one part of the body, like the hands. You might be familiar with “wry” neck (torticollis), a dystonia that involves contractions of the neck muscles that pull the head down to the shoulder and often lock it in that position. There are other dystonias that affect many muscles and can immobilize a person.

Trihexyphenidyl and baclofen are two medicines that might alleviate your muscle cramping. Botox, the diluted poison of the botulism germ, can loosen the tight grip that dystonia produces.

You should see a neurologist.

DEAR DR. DONOHUE: I had a colonoscopy. They did not find any polyps, but they found diverticulosis. Please explain what this means and how long I have to live. When did it start? I am 77. – R.V.

ANSWER: Diverticula are pea-sized protrusions of the colon lining through the colon wall. It’s estimated that half of all people over 60 have diverticulosis. It does not shorten life. Diverticulosis usually starts any time after age 50.

One reason why diverticula form is our refined diet. Throwing away bran when refining grains throws away Nature’s own laxative. Bran keeps undigested food moist as it traverses the colon. The colon has to generate tremendous force to propel dry, hard stool through itself. That force is partially responsible for diverticula forming.

In a small percentage of people with diverticulosis, the diverticula become inflamed when rock-hard stool blocks their necks. That’s diverticulitis, and it is painful.

To prevent formation of more diverticula and to prevent diverticulitis, add more fiber to your diet — vegetables, fruits (especially those with skins) and whole grains. Strive for 25 to 30 grams of fiber daily.

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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