DEAR DR. DONOHUE: I pray that you can help me. I am 91 and don’t have much more time. My elbow has a soft sac on it, as though it is full of water. Can you tell me what it is, and how to get rid of it? – L.K.

ANSWER:
You’ve heard of housemaid’s knee? It’s a soft bulge beneath the kneecap. It’s a knee bursa that’s filled with fluid. Since people who are on their knees a lot get it and since many housemaids spend time on their knees scrubbing floors, that’s how it got its name.

The elbow has a similar condition. Behind the elbow is a bursa, a flat disk that prevents friction when tendons rub on bones. That bursa can fill with fluid too, and it can come from even a slight, unnoticed injury. People who rest their elbows on a table or desk often develop a swollen elbow bursa.

Elbow pads protect your elbow and prevent further elbow bursa irritation. An elastic bandage, like an ACE wrap, compresses the swelling and can flatten it. Don’t put this on tightly – snugly, yes. If it’s safe for you to take anti- inflammatory medicine, Advil and similar drugs might make the swelling go down faster. Your doctor can drain the bursa with a needle and syringe, and instill cortisone medicine to prevent the swelling from coming back.

If the skin is red, hot or painful, get to the family doctor quickly. Those signs indicate infection, and antibiotic treatment is needed.

L.K., none of us has much more time.

DEAR DR. DONOHUE: I have never seen anything about carbuncles in your column. I got info on the Internet that it’s a virus like a cold sore. It comes and goes by itself.

How can I avoid it? What can I do for it? – C.B.

ANSWER:
Carbuncles don’t come from viruses. They’re not like cold sores. They’re infections with the staph bacterium. They’re giant boils. They are frequently seen on the back of the neck.

You treat a carbuncle much like you treat a boil. Warm compresses bring it to a head so that it drains. Drainage of pus makes it go away. There are times when a doctor has to lance it to force drainage. Quite frequently, antibiotics are also needed.

If one or more carbuncles keep recurring, then you have to search for the place on your body where staph germs have found a refuge. Often, that place is the nose. Applying a light coat of Bactroban nasal ointment (a prescription item) to the lower inside of both nostrils can generally evict staph from there.

You also have to become a compulsive hand-washer during this period of staph elimination.

DEAR DR. DONOHUE: I am a 56-year-old female, and my heels have been sore for six weeks. I am an avid exerciser and use a treadmill and an elliptical machine to exercise on. A month ago, I was taking Altace for blood pressure, but the doctor took me off it because of elevated lab tests. The pain and fatigue in my legs dissipated after stopping the drug. I wonder if there is a connection between my heel pain and Altace, or could I have heel spurs? – M.T.

ANSWER:
I can’t find that Altace brings on leg or heel pain. I’m glad the leg pain has gone. I find it hard to believe that Altace is connected with your current heel pain.

Heel spurs are not usually a source of pain. They’re evidence that the band of tissue on the bottom of the foot is inflamed. The band is the plantar fascia, and it helps hold up the foot’s arch. Inflammation of that tissue is plantar fasciitis, a common problem for those who walk, jog or run. A heel spur is the body’s attempt to fight the inflammation by laying down calcium.

Stop exercising for a week or two. Wear heel cushions. Splinting the foot at night so the toes point to the ceiling while you’re on your back takes tension off the plantar fascia; you can make your own splint. Anti-inflammatory medicines like Advil can both relieve heel pain and douse the inflammation of plantar fasciitis.

DEAR DR. DONOHUE: My granddaughter is 41 and has had diabetes since age 16. She pays no attention to what she eats. She is overweight. I notice her favoring her left leg. Could this be due to diabetes? – C.N.

ANSWER:
It could be due to diabetes that hasn’t been kept controlled. She might have neuropathy-damaged nerves, which makes her unable able to lift her foot when she takes a step.

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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