DEAR DR. DONOHUE: I am the 45-year-old mother of five children. About a year ago, I started itching. The itch moved around, but most of the time the palms of my hands were the worst. I saw a number of doctors and was given a number of medicines, but none worked. More recently, I noticed the whites of my eyes had a yellow tinge, and I went to my family doctor, who sent me to a gastroenterologist. After many tests, he discovered I have primary biliary cirrhosis. Could this have been caught sooner? Everyone who knows I have cirrhosis thinks I am an alcoholic; I am not. – C.M.

ANSWER:
Cirrhosis is a scarred and poorly functioning liver. Alcohol excess is the leading cause of cirrhosis, but it’s not the only one. Your illness isn’t well-known. Alcoholism is. That’s why people with cirrhosis are unjustly convicted in many people’s minds as being alcoholics. Your illness could have been caught sooner, but a delay in its diagnosis is not unexpected. Early symptoms are misleading.

In this condition, ducts that drain bile from the liver have closed down. Bilirubin, a pigment coming from worn-out red blood cells, is processed by the liver. When the liver no longer functions well, bilirubin blood levels rise. The whites of the eyes turn yellow. Lightly pigmented people’s skin turns yellow. Itching can be fierce, and the palms and soles often itch the most. Fats aren’t digested, and that results in diarrhea and an inability to absorb fat-soluble vitamins, like vitamin D. You have to make sure you’re getting enough of that vitamin.

What causes all this trouble? Like so many other illnesses, it comes from an immune system’s misplaced attack on a body organ – in this case, the liver.

Actigall can often lessen the intensity of some symptoms, especially the itching.

If circumstances dictate, a liver transplantation is the ultimate treatment for this illness.

DEAR DR. DONOHUE: Would you write something about trichomonas? How does a person catch it? How is it gotten rid of?

I have a vaginal discharge that has a pretty bad smell. I have used douches for a week, and it hasn’t gotten any better. I have a boyfriend, and I have been faithful to him. He says he has no trouble at all. I
guess I didn’t catch it from him, so I wonder how I got it. – L.M.

ANSWER: You realize you have a vaginal infection. Why did you happen to pick on trichomonas (TRICK-oh-MOAN-us)? There are many other potential candidates.

Trichomonas causes a vaginal infection with a yellow or green discharge that has a foul odor. Women frequently complain of a burning sensation when they empty their bladders. Intercourse can be painful.

This is just about always caught through sexual relations. Frequently, men are infected without having any symptoms. You could have caught it from your boyfriend.

Before considering treatment, you’ve got to find out the nature of your discharge. Doctors can diagnose trichomonas by finding the organism with a microscopic examination of the discharge.

Metronidazole and a newer drug, tinidazole, are used for treatment. If it turns out that you have trichomonas, your boyfriend needs treatment too.

The more common vaginal infections, including trichomonas, are discussed at length in the booklet on that topic. Readers can order a copy by writing: Dr. Donohue – No. 1203, 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: What is aphasia? I know two people who have it. Is it a rare illness? – F.W.

ANSWER:
Aphasia isn’t an illness. It results from an illness. Aphasia means “can’t talk.” Any injury to the brain can cause aphasia. It often follows a stroke. Brain trauma is another cause. So are brain tumors.

Treatment, of course, depends on the cause. Finding the cause and devising a rehabilitation program is the field of neurologists and speech therapists.

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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