DEAR DR. DONOHUE: I coughed every night for three straight weeks. My husband insisted I see our doctor. After much fussing around, the doctor said I had asthma. I am 68 and have never had a serious health problem. Do people my age get asthma? Am I stuck with medicines forever? – A.G.

ANSWER:
Half of all asthma begins in childhood. However, it happens to adults, too, and at any age – even 68.

Asthma is a sudden narrowing of the breathing tubes, the bronchi. The constricted airways make it difficult to get air into and out of the lungs. In addition, airway irritation causes them to secrete gobs of thick mucus, which adds to the difficulty of smooth air passage.

Cough is a cardinal asthma symptom, and it might be the only symptom, especially a persistent cough. High-pitched wheezing is another symptom. Struggling for a breath of air is the third tip-off that asthma is the cause of the trouble.

Often, an irritation from the outside sets off an asthma attack. That irritation can come from an allergy to things like pollen, molds, fungi and dust. If allergy is the trigger, then allergy shots are a way of controlling attacks. For others, no allergy is found. They might be susceptible to cold air or to pollutants or to things that can’t be identified. If attacks are infrequent, then people don’t take asthma medicine daily. On the other hand, if they are frequent, daily medicines calm the sensitive airways and stop the production of mucus. Some asthmatics must take these medicines for life. You should be happy that the cause of your cough was discovered and that there are medicines that can keep asthma in check.

The asthma booklet describes the details of asthma and its treatment. Readers can obtain a copy of it by writing: Dr. Donohue – No. 602, 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 four for delivery.

DEAR DR. DONOHUE: In order to obtain an insurance policy, I had to see a doctor and obtain a number of blood tests. My liver results were high, and the insurance company turned down my request. They wrote me a letter and said they would reconsider my application if a doctor sent them an explanatory letter. My doctor had me take a liver scan, which was normal. The insurance company won’t accept that as proof that my liver is OK. Why not? – J.G.

ANSWER:
Ultrasounds and scans of the liver disclose many liver abnormalities, but not all of them. A night of alcohol overindulgence, hepatitis and hemochromatosis (an inherited condition that damages the liver) are a few examples of the many things that can raise blood liver tests and not show up on a scan or ultrasound.

The insurance company wants a statement that all liver diseases were considered and that there is proof that you have none of them. Regardless of getting an insurance policy, you want the same kind of statement for yourself.

DEAR DR. DONOHUE: My 40-year-old daughter has diabetes, the kind you take oral medicines for. She weighs more than 350 pounds. She has been on all sorts of diets, but she cannot lose weight. At one time, I moved in with her and her family and took charge of all the cooking. She didn’t lose a pound while I was there.

Do you know of any diet that might work for her? I am worried about her health. Besides, she has trouble keeping her blood sugar controlled. – M.A.

ANSWER:
If your daughter has conscientiously dieted and exercised but cannot lose weight, she should talk with her doctor about having surgery for weight loss. She is morbidly obese, and she is at risk of many serious complications from it. She’ll never control her blood sugar unless she loses weight.

Bariatric surgery, as this kind of surgery is called, is nothing to be taken lightly. Obesity that doesn’t yield to dieting is nothing to be taken lightly, either. Surgery is justified for someone like your daughter.

DEAR DR. DONOHUE: My question is about a condition called Mediterranean anemia. My father was Greek, and he had that condition. I was diagnosed with it many years ago. However, none of the doctors I have consulted are able to tell me what, if anything, I can do to relieve the fatigue I feel on a daily basis and which I have ascribed to this anemia.

Is there anything you can recommend? Would any vitamin or medical product give me a bit more energy? – H.R.

ANSWER:
A more common name for Mediterranean anemia is thalassemia. There are two Greek words in that name – “thallos” for “sea” and “emia” for “blood.” The sea referred to is the Mediterranean Sea. The largest number of people affected with this anemia come from countries that border the Mediterranean Sea. It’s also found in people with roots in the Middle East, India and Southeast Asia. It is an inherited condition.

There are a number of varieties of thalassemia. Thalassemia major is a most serious condition. It makes itself known in childhood and must often be treated with repeated blood transfusions. You don’t have this kind of anemia, nor did your father.

Thalassemia minor, as the name implies, is an anemia of mild degree. The red blood cell count is just a little below normal and hardly ever produces any symptoms. There is no treatment for it, but no treatment is needed. I believe you’re barking up the wrong tree in ascribing your fatigue to this inherited anemia.

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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