DEAR DR. DONOHUE: I really don’t know where to begin. I am an 88-year-old woman and I have a problem in my head. Music plays there all the time. When the house is quiet, I hear it even louder. It’s worse at night, when it’s really loud and gives me a headache. I have gone to the doctor, but he couldn’t come up with an answer. I hope you have an answer for me. – W.A.

ANSWER:
Everyone, from time to time, hears a song playing in the head, and it often plays for quite a while before eventually stopping. It’s a sound that, sometime in the past, was imprinted in our brain; all of a sudden, it intrudes into consciousness for a while. Your head music doesn’t go away. That condition is called musical hallucination, and it happens mostly to older people.

One explanation goes like this. When something sparks music to play in the brain, people with normal hearing are flooded with outside sounds that turn off the music in a reasonable amount of time. Those sound signals don’t penetrate the brains of people with poor hearing, and the music goes on and on. This is one but not the only explanation.

If hearing loss contributes to the nonstop music playing, a hearing aid might be a solution for you. Or try turning on the radio to a volume that’s loud enough for you to hear it clearly. The doctor you want to see is an ear, nose and throat doctor.

In an admittedly few instances, brain tumors, seizures, the aftermath of a stroke and medicines are other possible causes. The Mayo Clinic has reported on how an aneurysm a bulge of one of the brain arteries caused musical hallucinations in a man who obtained a cure when the bulge was removed.

A reader, G.B., made me aware of this condition and sent me an article from The New York Times that dealt with this problem. I welcome anyone who has more information about it. It intrigues me.

DEAR DR. DONOHUE: Recently I obtained my medical records for my new primary care physician. I noticed on a chest X-ray report the following: “mild prominence of the left ventricle and arteriosclerosis of the aorta.” This was back in 2003. I am a woman, 53 years old, with no family history of heart disease. Should I be concerned? – L.M.

ANSWER:
You could find those words on the chest X-ray report of most 50-year-olds.

A prominent left ventricle indicates a slightly bigger-than-normal heart, one that isn’t enlarged but isn’t exactly the size a perfectly normal heart is. It’s something that’s a fairly routine report in the middle-aged.

An arteriosclerotic aorta means that that artery, and probably others, are becoming hardened. That’s another all-but-universal finding in people 50 and older. There is something you can do about arteriosclerosis. It’s the advice that’s preached daily: Maintain normal blood pressure, lower blood cholesterol by watching the amount of fat you eat, don’t smoke, exercise and lose weight if indicated.

DEAR DR. DONOHUE: A marriage is possibly hanging on your answer to this question. Does a man have control over escaping gas? Doesn’t he have a sphincter muscle to control this, as a woman has? I know this isn’t a usual question, but maybe other folks would like to know the answer. – T.E.

ANSWER:
Men have the same sphincter that women have. Both can often stop gas expulsion until they can get to a place where release won’t offend others. However, a sudden distraction or a sudden physical straining, like a change in position, can bring about loss of control. Such things happen.

Some people are prodigious gas producers, and they cannot be expected to hold it in all day and all night and in all situations. These people should see their doctors to find out why they’re making so much gas. Appropriate steps can sometimes be taken to reduce its production.

DEAR DR. DONOHUE: I know what lupus is, but I don’t know what discoid lupus is. I have it. I had a couple of red, round circles on my chest. I saw a dermatologist, who biopsied one of them. It turned out to be discoid lupus. I put a cream on the spots and take a medicine, and they seem to be going away. Will this turn into real lupus? – G.M.

ANSWER:
Systemic lupus, what you call “real” lupus, affects the body as a whole. That means it can attack many tissues and organs: joints, skin, heart, kidneys, nerves and brain.

Your kind of lupus, discoid lupus, is confined to the skin. It appears as circles on the skin, and the circles’ borders are raised and red. The surface of the circle is scaly. Discoid lupus is treated with cortisone creams and often with hydroxycholorquine, a medicine originally used for malaria treatment.

Lupus patients, systemic or discoid, should avoid sunlight.

Discoid lupus goes on to become systemic lupus in only 5 percent to 10 percent of patients.

The arthritis booklet has a section on systemic lupus, but not discoid lupus. Readers who would like a copy can write to: Dr. Donohue – No. 301, 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.

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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