DEAR DR. DONOHUE: We have just moved into a new house in a heavily wooded area in a state where Lyme disease is common. My neighbors talk about it all the time. I’m not all that familiar with it. How do I recognize it, and what can be done to prevent it? – S.K.

ANSWER: Ticks, carrying the Lyme-disease germ, are responsible for the spread of Lyme disease. The first signs of infection begin from three to 30 days after the bite of an infected tick. The initial symptoms can be mistaken as a flulike illness. Muscles and joints often hurt. The head aches, and body temperature rises. A big tip-off for Lyme disease is a skin rash that starts as a flat, oval, red patch whose edges keep expanding. The patch can reach a diameter of 12 inches (30 cm). Often its center pales so that it takes on a bull’s-eye appearance. Smaller, satellite patches can appear. Unfortunately, the rash isn’t always present. Lyme patients can also develop Bell’s palsy, a paralysis of the muscles on one side of the face. The paralysis makes it impossible to close the eye on the affected side, and the corner of the mouth on the affected side droops. When treated early with antibiotics, Lyme disease is usually curable.

Untreated, the illness can progress and involve many organs. A form of arthritis is one consequence. Nerves can be affected. The heart might come under attack. Even in these later stages, antibiotics can often bring a cure.

Prevention entails avoiding ticks. Always apply an insect repellent when you go outside. Those with DEET are quite effective. On your clothes, you can dab permethrin, which also keeps ticks away; it shouldn’t be put on the skin. Wear long sleeves and long pants with the cuffs tucked into the socks. When you go inside, carefully inspect your body for ticks and remove them with fine tweezers. If a tick doesn’t stay on the body much longer than 24 hours, the chances of infection are slim.

DEAR DR. DONOHUE: I’ve known that I have mitral valve prolapse for 10 years. It has never bothered me, and I have had no restrictions on what I can do. However, in the past few months, my heart has started beating fast for no good reason. The fast rate lasts about 45 minutes. Could this be related to my mitral valve prolapse? What should I do about it? – A.S.

ANSWER: Quite a few people have mitral valve prolapse. The mitral valve regulates blood flow between the upper and lower left heart chambers. A prolapsing valve is one that balloons upward when it closes. Sometimes there’s a leak of blood along with the upward ballooning. Mitral valve prolapse can be associated with a number of abnormal heart rhythms, so yours might be responsible for your episodes of rapid heartbeats.

Let your doctor know what’s happening. The doctor will probably want you to wear a heart monitor for a day or more to record the instances when your heart speeds up. He or she will be able to tell exactly what’s going on during those episodes.

Your problem is that the speedups are unpredictable. The next time your heart begins to race, have someone take you to the nearest hospital, where an EKG can be taken and your doctor can be contacted. Depending on the kind of heart rhythm you’re experiencing and the number of episodes you have, medicine might be needed.

DEAR DR. DONOHUE: My daughter gets into every crazy food fad that comes along. Now she’s into raw milk. She has three children. I told her this could be dangerous for the entire family, but she won’t listen to me. She believes raw milk is healthier because it hasn’t been altered. What would you tell her? – B.C.

ANSWER: I admit that pasteurized milk has been altered — to remove the germs that are often found in raw (unpasteurized) milk. Pasteurization is the simple heat treatment of milk. No chemicals are involved.

Your daughter, I suppose, has the right to do with her body whatever she wants. She doesn’t have the right to endanger her children.

DEAR DR. DONOHUE: Will you say something about ARDS? My brother just died from it. He was 56, and he leaves his wife and five children. He never smoked or drank, and he appeared to be in good health. We don’t understand what happened. – J.L.

ANSWER: ARDS – acute respiratory distress syndrome – strikes suddenly and makes the lungs ineffective in bringing air into the body. They become filled with fluid and are comparable to the lungs of a drowning person.

Sometimes ARDS results from a bout of severe pneumonia or from breathing toxic gases. It can also develop consequent to an overwhelming infection, from burns or from head or chest trauma.

In the first stage of ARDS – the stage when the lungs are filled with fluid – people are treated in intensive-care units and are placed on ventilators. In about one week, the second stage of ARDS sets in. During this phase, the body attempts to repair the ravaged lungs. Repair doesn’t always work. ARDS has a high mortality rate, as high as 65 percent.

I don’t know if your brother’s doctors were able to trace the cause of his ARDS. Many times, the cause remains elusive.

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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