DEAR DR. DONOHUE: My husband and I are expecting our first child in four months. I am 32. I have had herpes since I was 26. Since the first outbreak, I have perhaps two outbreaks a year, and they last around five days. My husband does not have, nor has he ever had, any signs of herpes. We do not have sex if I have an outbreak.

My doctor knows my history and seems unconcerned. I have been told by others that I should have a C-section to prevent the baby from becoming infected. Is this absolutely necessary? – S.J.

ANSWER: A herpes infection is for life. After the first infection, there are often recurrences that are shorter in duration and less painful than the first outbreak. Of all pregnant women in the United States at any given time, 35 percent have been infected with the herpes-2 virus, the herpes virus most responsible for genital infections. I am sure you realize that 35 percent of all deliveries are not C-sections, so the answer to your question is, “No, you do not absolutely have to have a C-section.” Previously infected pregnant women have a 1 percent chance of shedding herpes virus on any given day, even if there are no signs or symptoms of an outbreak. The risk for such women transmitting the herpes virus to their infant by vaginal delivery is not great.

Authorities on the transmission of herpes virus suggest a C-section only when there are signs of an outbreak visible to the patient or to the doctor. Women who are newly infected with the virus near the time of delivery also need to have a C-section.

Some doctors, in these circumstances – i.e., a previously infected woman with no signs of an outbreak at the time of delivery – treat the woman with the viral medicine acyclovir around the time of labor to eliminate all risk of infection. Talk this over with your doctor.

The herpes booklet goes into great detail on this infection. Readers can order a copy by writing: Dr. Donohue – No. 1202, 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: The ring finger on my right hand is bending down to the palm. It doesn’t hurt, but I can’t get it perfectly straight, even if I put a lot of force on it. What is this, and how is it fixed? – D.K.

ANSWER: First on the list of guesses is Dupuytren’s (dew-pwe-TRAHNS) contracture. For unknown reasons, people with this condition have nodules spring up in the palm of their hand. The nodules sprout strands of scar tissue that lasso the finger’s tendon and draw the finger to the palm. As time goes by, the finger can lie against the palm, fixed in that position.

You should see an orthopedic surgeon, who can release the finger from the scar tissue.

DEAR DR. DONOHUE: Two years ago, I had stomach pain and diarrhea and was losing a good deal of weight. After tests that didn’t provide any answer, a stomach specialist performed a colonoscopy and discovered I had ulcerative colitis. He put me on Asacol. Since I’ve been taking it, I haven’t had any symptoms. Can I stop taking this medicine? – W.H.

ANSWER: Medicines for ulcerative colitis have two purposes. One is to put an end to an acute attack of the illness. The second purpose is to prevent relapses, so ulcerative colitis medicines are usually taken for the long term.

The only one who can give you the go-ahead to stop your medicine is your doctor. If you are willing to take a chance on a flare-up of ulcerative colitis and if your doctor agrees, then you can experiment.

DEAR DR. DONOHUE: Sometimes I wake up with a hand that’s gone numb. What’s causing this? – B.W.

ANSWER: Probably you’re sleeping in a position where your body presses on a nerve. Either sleep on your back or sleep on the side that’s opposite the one you usually sleep on.

DEAR DR. DONOHUE: About two years ago, I woke up feeling a rumble in my chest that I can best describe as a running motor. Now this happens every time I lie down. My doctors tell me they cannot find any problem. One time I took myself to the emergency room, remained there for 13 hours, and was tested for everything. They couldn’t find anything wrong. I am not imagining this. I would appreciate your thoughts. – H.M.

ANSWER: I haven’t a clue. I appeal to both doctor and nondoctor readers for their thoughts. I’ll pass them on to you, H.M.

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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