DEAR DR. DONOHUE: I am a 79-year-old man who had been in good health until a month ago. Then my shoulders began to hurt, and I had trouble lifting my arms over my head. Then my hips started aching. My doctor says I have polymyalgia rheumatica, and he has me on prednisone. What is this, and how long will I have to take medicine? – M.O.

ANSWER: Polymyalgia is a common illness of older people. Almost never does a person younger than 50 get it, and most people who have it are in their 70s. The first sign of trouble is painful shoulders. Then hips, back and thighs can hurt. Pain is worse at night in bed and upon arising in the morning. Although people complain of weakness, their strength, when tested, is usually good. Pain limits the use of the arms, shoulders and hips.

The basic problem appears to be an inflammation of the synovium, the material that lines joints. Bursae – disks lying between tendons and bones – can also be inflamed. The name implies that muscles are affected, but they are not.

This is not a kind of arthritis that destroys joints. In time, it goes away without leaving permanent damage.

One lab test, the sed (sedimentation) rate, is abnormal in those with polymyalgia. The sed rate is a simple test. Blood is put in a calibrated tube, and the distance from the top that red blood cells settle toward the bottom of the tube in one hour is the sed rate. It’s not a high-tech or expensive procedure.

Treatment is prednisone, one of the cortisone drugs. Low doses are used so that the complications of cortisone are kept to a minimum. Results are usually seen in a matter of days. Once symptoms are controlled, the doctor can reduce the dose of prednisone, but many patients have to stay on a very low dose for a number of years.

DEAR DR. DONOHUE: In the past month I have had 10 nosebleeds. They happen at any time and at any place. Many occur when I am just sitting and watching TV. I can stop them by pinching my nose and holding the pinch for a couple of minutes. Is this a sign that I have high blood pressure? – N.K.

ANSWER: High blood pressure doesn’t cause nosebleeds, but it makes the nose bleed more briskly and far longer than it otherwise would.

At the top of the list of causes of nosebleeds is dry air. Indoor heating can make air as dry as desert air. The nose lining dries out and cracks. An inadvertent touch of the nose with the finger gives rise to a bloody gusher. A humidifier can restore moisture to your home and your nose. It’s also worthwhile to coat the lower inside part of the nostrils with petroleum jelly. The jelly prevents the nasal lining from drying and flaking.

Ten nosebleeds in 30 days is an alarming number. You and your nose need an examination. Dry air is only one cause of bleeding noses.

A deficit of clotting factors contributes to nosebleeds. Clotting factors are blood proteins that the body makes to aid clot formation. They keep us from bleeding to death when a blood vessel breaks.

A drop in platelet numbers is another cause of nosebleeds. Platelets are small blood cells that also assist in clot formation when a blood vessel leaks blood.

Osler-Weber-Rendu disease is an inherited condition in which tufts of blood vessels are fragile and are easily broken. Bloody noses are one sign of it.

Nasal tumors are another consideration when it comes to frequent bloody noses.

The short message is to see your doctor. And that’s particularly important if humidification and petroleum jelly don’t put a stop to your nosebleeds promptly.

DEAR DR. DONOHUE: I have a 12-year-old boy who complains that his legs hurt. His dad insists that it’s growing pains. That sounds somewhat old-fashioned to me. Is it a reasonable diagnosis? – A.P.

ANSWER: Leg pains in growing children used to be blamed on growth, but no one has ever proved that such is the case. If the child keeps complaining, bring him to the family doctor. Dr. Dad’s diagnosis needs reinforcement.

DEAR DR. DONOHUE: A friend of mine in England has just had a difficult year with mylonea, or something like that. I can’t read the writing too well. The closest thing we can find in the dictionary is myeloma. Will you explain this to us so we can reply to her letter appropriately? She is about my age, 74. – W.A.

ANSWER: Myeloma (also called multiple myeloma) is a cancer of the bone marrow. In the marrow, a blood cell called a plasma cell begins to proliferate wildly. Plasma cells make antibodies.

More than 15,000 Americans are stricken with it every year, and about 11,000 die from it. The average age of its appearance is 68.

The three most common consequences of myeloma are bone pain, bone breaks and kidney failure. The rapidly multiplying plasma cells in the bone marrow weaken the bone, which then fractures easily. The most often affected bones are the backbones and the ribs.

Because plasma cells make antibodies – which are supposed to disable germs – and the antibodies made by myeloma patients’ plasma cells are ineffective, patients with this disease are subject to frequent bacterial infections, pneumonia being a common one.

Chemotherapy is the treatment for myeloma.

I can’t find any other disease names closer to “mylonea” than myeloma.

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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