DEAR DR. DONOHUE: I am the mother of an only child. She is 31 and has been married for one year. My daughter is afraid to become pregnant because she believes she’ll have difficulty carrying a child due to her spinal curvature.

She’s also afraid that carrying a baby will make her scoliosis worse. An orthopedic doctor followed her in her teens and didn’t suggest treatment since her scoliosis was “borderline.” I know she wants to be a mom, and I want to be a grandmom. What do you say? – A.A.

Scoliosis is a curving of the spine to one side. The curve can be in the upper back, the lower back or in both upper and lower back. The degree of curvature correlates with the severity of symptoms and with the limits of physical activity. The degree is assessed through X-rays.

Your daughter had mild scoliosis as a teenager. Her curvature didn’t require a brace. It’s not too likely that the curvature increased so much since then that she can’t have children. Rarely, if ever, does scoliosis prevent a woman from having children, and pregnancy doesn’t aggravate scoliosis. Your daughter isn’t complaining of back pain, is she? She does everything she wants to do, doesn’t she? Then there’s no indication of severe scoliosis.

Have your daughter talk to a family doctor or to an orthopedic doctor. I believe she will be surprised to learn that her scoliosis isn’t a contraindication to her having a family.

The back booklet doesn’t handle scoliosis, but it handles the more-common back complaints. Readers can order a copy by writing: Dr. Donohue – No. 303, 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: For nearly two years I had attacks of severe abdominal pain and had seen several doctors.

I was treated for irritable bowel syndrome and for ulcers and was called a “doctor shopper.” Finally, I found a surgeon who performed surgery and found I had a carcinoid tumor. A large portion of my small intestine was removed. I wonder why this condition is so hard to recognize or diagnose. Is it so rare or unusual that doctors don’t know about it? – H.B.

Carcinoid tumors aren’t exactly common, but they aren’t extremely rare either. In a city of a million people, there will be seven to 13 carcinoid tumors diagnosed every year. Doctors can’t get through medical school without hearing about carcinoid tumors, but relatively rare conditions are often seldom thought of – a great misfortune to those with such conditions. It often takes two to 20 years from the onset of symptoms before a patient is diagnosed as having a carcinoid. In the meantime, patients are given a variety of diagnoses until a doctor finally thinks of carcinoid or until the florid symptoms of a carcinoid make the diagnosis inescapable.

Carcinoid tumors spring up mostly in the intestinal tract and in the lungs’ airways. They manufacture products that have a variety of hormone-like actions. These tumors can spread to distant places, so they are malignancies – cancers.

The most common symptom is periodic abdominal pain. A large tumor can block the intestinal tract. Some carcinoids cause intestinal bleeding.

When the products of a carcinoid tumor are produced in sufficient quantities, they bring about flushing and diarrhea, and sometimes asthma. When those symptoms appear, the diagnosis is evident.

I hope your story speeds the diagnosis of carcinoid for others.

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