DEAR DR. DONOHUE: My mother had macular degeneration, which made her last days very unpleasant. I live in fear that I might get it too. Is there anything I can do to prevent it? How can I tell when or if it starts? – B.C.

ANSWER: The following applies to dry macular degeneration, the more common kind, the kind that accounts for more than 90 percent of all cases.

Age-related macular degeneration – AMD – runs in families, but having had a parent with it doesn’t automatically doom you to coming down with it. Its genetics are not precisely known.

Your doctor is the one who is best able to detect it early. Using a lighted scope, the doctor examines the retina and sees drusen in people who are at risk of developing AMD. Drusen are white deposits in the retina, and they are harbingers of macular degeneration.

If you want to test yourself for early changes, then get an Amsler grid. It’s a little piece of white cardboard with intersecting vertical and horizontal lines. You look at it one eye at a time. If the lines appear wavy, that’s a sign of AMD. If you can’t find such a card, you can make your own.

Doctors in the Netherlands have found that vitamins E and C, along with zinc and beta carotene, might arrest the progression of macular degeneration. This isn’t new information, but what is new is the finding that this combination of vitamins and minerals could be effective in its early stages. These doctors recommend getting the nutrients from foods: vitamin E from whole grains, vegetable oils, eggs and nuts; zinc from meat, poultry, fish, whole grains and dairy products; beta carotene from carrots, kale and spinach; and vitamin C from citrus fruits and juices, green peppers, broccoli and potatoes.

The booklet on macular degeneration gives a full description of this common eye illness. Readers can obtain 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: My granddaughter just presented us with a beautiful little girl. Doctors discovered she has a heart murmur and a hole in her heart. What does this mean? How serious is it? We are very concerned. – M.K.

ANSWER: Your great-granddaughter most likely has a hole in the partition between the right and left sides of her heart. Such holes create murmurs.

A hole in the wall between the upper heart chambers is an atrial septal defect. Small holes there can be left alone. Larger holes that permit a leakage of blood are patched over. Sometimes this is done surgically, and sometimes it can be done with a catheter, a soft tube inserted into a blood vessel and snaked to the heart.

A hole between the lower heart chambers is a ventricular septal defect. These holes also produce murmurs. Again, the call for treatment depends on the size of the hole and the volume of leaked blood. Small holes without significant leakage don’t need repair; large ones do.

The long-term prognosis for septal defects is quite good.

DEAR DR. DONOHUE: We have only one grandchild, a wonderful 11½-year-old girl who is undergoing a traumatic time during her parents’ divorce. She spends time with both parents. Her mother is a drug representative and is on friendly terms with many doctors. She talked a doctor into prescribing Lexapro for the girl because she says the girl has obsessive-compulsive tendencies. When the girl is with her father (my son), she sleeps 14 to 16 hours on the weekend and is not her old self. We are concerned about the heavy dose of Lexapro she takes. Her father’s visit to the prescribing doctor resulted in a “how dare you question me” confrontation. What is your opinion? – M.B.

ANSWER: Something is not right here. The manufacturer doesn’t even list pediatric doses for that medicine, an antidepressant. The drug can cause sleepiness and lethargy. Your son should take the child to a child psychiatrist and get an official opinion – quickly.

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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