DEAR DR. DONOHUE: I mistakenly ate raw pork. Several weeks of diarrhea and sweating followed and then stopped. I lost 15 pounds. Now vague muscle aches and fatigue persist. I wonder about trichinosis. What tests help diagnose it? – N.S.

DEAR DR. DONOHUE: Your pork tapeworm article in response to brain worms is not correct. The correct answer is trichinosis. – R.L.

ANSWER: So readers don’t think pork is a food laden with terrible health risks, it is not. It is a very safe food. The parasite questions I have answered about pork afflict so few that they really aren’t worth so much discussion. All improperly cooked meats have the potential to cause trouble, not just pork. Pork parasites have all but disappeared since a law was passed that prohibited feeding raw garbage to pigs.

The trichinosis (TRICK-in-OH-siss) story goes like this. Eating improperly cooked pork that has the larval form of the Trichinella worm in it causes this illness. Bear meat and other game meat can also be infected with Trichinella. In the stomach, larvae are released and develop into mature adults in 48 hours. The female worms are fertilized, and within five to six days they lay new larvae in the intestine. Those larvae penetrate the intestinal wall and are carried in the circulation to many places, but chiefly to muscles. There they burrow in and form cysts.

The infection takes place in three stages. Stage one is the intestinal phase, where larvae are active in the tract; stomach pain, nausea and diarrhea mark this stage, which lasts one or two weeks. Stage two is the stage where larvae deposit in muscles and other sites; this happens one to six weeks after eating contaminated meat. During this stage, there is fever, muscle pain, facial swelling and often a skin rash. Stage three is the convalescent stage that begins five to six weeks after infection. During this stage, symptoms subside.

Definitive tests for trichinosis include muscle biopsy, blood levels of muscle enzymes during the second stage and a blood antibody test. I would put my money on food poisoning as being your illness, N.S.

R.L., the previous question was definitely about pork tapeworm, not trichinosis, which can also infect the brain and its coverings.

DEAR DR. DONOHUE: I have been a strict vegetarian for 10 years. My weight is normal, and I feel great. My cholesterol is 130 (3.4). Is this too low? I see the normal value is 200 (5.2). – K.W.

ANSWER: A few illnesses cause low cholesterol readings. Severe liver disease, an overactive thyroid gland, sometimes cancer, starvation and malabsorption syndromes lower cholesterol. You feel fine. Your weight is good. You should have only joy over your reading. It’s probably a reflection of your diet.

The cholesterol booklet provides the details on this popular subject. Readers can obtain a copy by writing: Dr. Donohue – No. 201, 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 been taking Ultram, or its generic equivalent tramadol, for at least nine years for rheumatoid arthritis. I have been under the impression this entire time that it falls within the NSAID (nonsteroidal anti-inflammatory) category, like ibuprofen. Now my pharmacist informs me that it is an opiate and can be addicting. What? Was I wrong in my original assumption? If I was not mistaken, how can they change the categorization? I mean, the chemical makeup didn’t change. If it did, it would be a different drug. Didn’t they know from the beginning it was an opiate? What’s going on? – M.D.

ANSWER: Right from the start, tramadol (Ultram) was classified as an opiod, a compound chemically related to opium. It is on a par with codeine. Tramadol is made in the laboratory. It can be addictive, but that shouldn’t throw you. If it’s necessary to get off it, long-term users gradually taper their dose.

Opiods throw everyone into a tizzy. Most don’t make you a slave of the drug. Most are effective pain relievers. And most can be taken sensibly under a doctor’s watchful eye. Tramadol won’t turn your brain to mush.

DEAR DR. DONOHUE: Although I couldn’t see any blood in my urine, my doctor found it with his microscope. To make a long story short, I saw a urologist, who scoped my bladder and removed a small cancer. He also bathed my bladder with BCG weekly for six weeks. Why? What is BCG? – K.A.

ANSWER: BCG is bacillus Calmette-Guerin, the germ that causes cow tuberculosis. The germ has been weakened so it cannot cause infections. It gears up the bladder’s immunity so recurrences of bladder cancer are suppressed. Bladder cancer has a habit of returning.

In some places in the world, BCG is used as a vaccine to prevent one kind of tuberculosis: TB of the brain coverings – tuberculous meningitis, a serious illness that often causes infant death.

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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