DEAR DR. DONOHUE: I am 97. I do not drink, smoke or eat too much. I have a bad right knee. I have been to my doctor for 40 years and have spent much money on it, but nothing works for it.

I also have redness of the nose and pimples on my face and nose. What can be done for this? – T.M.

ANSWER: I take it you have osteoarthritis of your knee. It’s the most common variety of arthritis, the kind that comes with aging. Cartilage that lines the knee joint frays and fragments, and this exposes the ends of the two bones that form the knee, allowing them to rub against each other. The result is pain, swelling and stiffness.

Since you’ve been dealing with it for 40 years, I’m sure you’ve tried all the arthritis medicines there are, so I won’t mention them. Have you ever seen a physical therapist? The therapist can devise a program for you that limbers the knee and strengthens leg muscles. Ninety-seven is not too old for such a program. Stronger leg muscles protect the knee and reduce pain.

Have you every had your knee injected? Hyalgan and Synvisc work like high-grade oils for smooth joint motion. Cortisone shots also bring relief.

Try hot packs on your knee. Put them on for 15 minutes four times a day. If they don’t work, use cold packs.

Your facial condition is rosacea – skin redness of the tip of the nose and often the cheeks along with an outbreak of pimplelike bumps and visible, weblike blood vessels. Antibiotic creams, lotions and gels often control it. MetroGel and erythromycin are two examples. The oral antibiotic doxycycline is another good medicine. Oracea is the newest rosacea medicine.

You can help matters by protecting your skin from the sun, avoiding hot foods and beverages, going easy with spices and using alcohol in moderation, if at all. I forgot. You don’t drink. Good.

DEAR DR. DONOHUE: I have some pregnancy questions. I had a chest X-ray when I was pregnant but before I knew I was pregnant. I am now in the 32nd week and am really worried that the X-ray might have harmed the fetus. Also, is there danger to the fetus from solar and lunar eclipses? I was outside when they occurred. Please put some light on this. – Anon.

ANSWER: Conducting X-rays on women who are pregnant but don’t know it happens more often than you’d think. The X-ray is usually a chest X-ray. The developing embryo and fetus are most susceptible to radiation in the first eight to 15 weeks after conception, but the amount of radiation from a chest X-ray doesn’t come close to a dangerous dose, even in those early weeks. Put this worry to rest.

Solar and lunar eclipses have no bearing on a pregnancy.

DEAR DR. DONOHUE: I have a 50-year-old son who had a recent echocardiogram. It was ordered by a physician’s assistant because a kidney specialist had told me that my son had a heart murmur. The physician’s assistant wanted it because my son is to have extensive dental work done. No results ever came except the bill, so I called for the report. Someone in the office told me everything was “normal.” Can you clarify what normal means? Does my son need antibiotics before the dental work? – J.L.

ANSWER: Heart murmurs are noises heard between the lub-dub of the heartbeat. They can arise from deformed, leaky or narrowed heart valves or from holes in the wall that separates the right and left sides of the heart. Heart murmurs can also arise from innocent disruptions of the blood flow.

Your son had a very good test for finding heart-murmur causes – an echocardiogram, a soundwave picture of the heart and its valves. Nothing bad was discovered on the picture. His heart is healthy. He doesn’t need antibiotics, but I would have him take this up with the family doctor or dentist to be sure.

The report on valvular heart disease discusses murmurs in detail. To obtain a copy, write: Dr. Donohue – No. 105, 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 a bunion and it hurts, but I am not keen on having surgery for it. More than one person has told me horror stories about such surgery, and some say it grows back after the surgery. What are your thoughts on this? – R.D.

ANSWER: A big toe that turns inward toward the other toes often develops a painful lump at the side where it joins the foot. Misaligned toe bones, heredity, arthritis and too-tight shoes lead to bunions. If you wear shoes with lots of room for the toes, you can pad the bunion, and that takes the pain away.

Surgery is almost always successful, and it’s not a horror. I’d favor it if the bunion hurts and nothing else relieves the pain. It won’t grow back if the surgery is done correctly.

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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