DEAR DR. DONOHUE: This is my third and next-to-last letter. Don’t make me come down there after you. I need your opinion on some lab work. My doctor wants to put me on statins to lower my cholesterol. I feel that with an HDL cholesterol as high as mine, it is not necessary. What do you think? – P.B.

ANSWER: Cholesterol experts say that, for now, the focus of cholesterol treatment lies on bad cholesterol – LDL cholesterol, the artery-clogging kind of cholesterol. The LDL cholesterol is best when it is below 100 mg/dL (2.59 mmol/L). For people who have heart troubles, like a previous heart attack, it should be 70 or lower (1.8). Your LDL cholesterol is 155 (4.0) – too high.

HDL cholesterol is good cholesterol, the kind that prevents heart attacks and strokes. An HDL cholesterol higher than 40 (1.04) is a beautiful thing. Yours is 92 (2.4) – a truly beautiful thing. Does your high good cholesterol trump your high bad cholesterol? The answer is no, at least for the present. Information might develop that supports your position, but we have to toe the line with current information. That information tells us to pay more attention to bad cholesterol, the LDL variety.

If all this cholesterol talk and numbers wearies people, it wearies me too. Cholesterol is only one facet of heart health. People with excellent cholesterol readings have heart attacks, and people with bad numbers don’t. However, cholesterol is something that is in our power to change, so we ought to do so when we can. If that means taking a hard pill to swallow, we still have to swallow it.

P.B.: I have asked the FBI for 24-hour protection. If you plan on stalking me, consider the fact that I am under constant surveillance. The cholesterol story is completely told in the booklet on that topic. 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: What do Bartholin’s glands do? I have an infection in one of them, and it is most painful. I put hot compresses on it, but they don’t seem to be helping. What will? – M.R.

ANSWER: There’s a Bartholin gland on each side of the vaginal opening. Secretions of those glands lubricate the vagina.

Infection of a Bartholin gland can be agonizing. The compresses encourage drainage of the infected gland. If they don’t, your doctor will have to open it so that it can empty itself of pus. That brings quick relief. You might have to take antibiotics.

I can’t tell you why the glands become infected, but such infections are common.

DEAR DR. DONOHUE: For three months, I have had back pain. After many X-rays and scans, it’s been determined that I have spinal stenosis. Just what is that? – R.V.

ANSWER: It’s a narrowing of the spinal canal – the long tunnel that runs through the backbones and in which the spinal cord and spinal-cord nerves are contained. If the narrow canal presses on the cord or its nerves, the back hurts. The pain can also run down the leg or legs. And sometimes, when the compression is not relieved, there can be leg muscle weakness.

If the pain is mild, taking simple pain relievers like Tylenol or the nonsteroidal anti-inflammatory drugs (Aleve, Motrin, Advil, etc.) is the initial treatment. If they don’t work, injecting steroids into the spinal canal might. Surgery is reserved for those who get nowhere with medicines.

Don’t forget physical therapy for your back.

DEAR DR. DONOHUE: Is it bad to take a stool softener daily? Will I become dependent on laxatives? – P.M.

ANSWER: Stool softeners are laxatives only in the broadest sense. They keep undigested food moist and able to easily pass through the digestive tract. They are not habituating and do not hurt the colon. You can take them regularly. Have you tried increasing the amount of fiber in your diet?

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.

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