DEAR DR. DONOHUE: Do medical doctors sometimes misdiagnose a patient? Here’s the reason I ask: After seeing the same doctor three times, he examined a sample of my spinal fluid and concluded that I probably had multiple sclerosis. That has been on my medical records for 35 years. Now when any doctor sees that, I am treated as though I have it. I have never had an exacerbation in all that time. I have not gone downhill. I am 87. Do I have MS? My arms and legs work well. I speak clearly. I am still driving a car with no accidents. – R.H.

ANSWER: Do rocket scientists ever miscalculate? Do juries ever render a wrong verdict? Did Einstein ever make a mistake? Sure, doctors misdiagnose. They’re human.

The criteria that establish a diagnosis of multiple sclerosis are clear. A single episode of a neurological disturbance is not proof of MS. A “neurological disturbance” is something like a temporary loss of vision in one eye, double vision, peculiar sensations running down the back when the neck is bent, weakness of an arm or leg, or difficulty walking. Typically, the original symptom or symptoms go away, only to be replaced by new symptoms. That’s relapsing-remitting MS, the most common variety. As time passes, symptoms generally become permanent.

You had a spinal fluid test, which is only one test for MS, and it can’t make the diagnosis alone. A person must have symptoms, as I described above. Today, MRI scans are invaluable in establishing the diagnosis. They show the multiple scars (sclerosis) scattered throughout the brain and spinal cord – the fingerprints of MS.

I don’t believe you have MS. You have no symptoms. You had only one test that might have been a bit suspicious for but is not diagnostic of MS. If you want to be sure that the diagnosis was an error, check with a neurologist.

DEAR DR. DONOHUE: My husband, 42, had two days of bright-red blood in an otherwise normal stool. This happened two weeks ago. He had no pain and no cramps then or since. Could this be early colon cancer? He rides a bike for 30 minutes a day and has done so for 17 years. Could the riding have caused bleeding? If colon cancer is caught early, what is the survival rate? – C.C.

ANSWER: Two days of blood in the stool are not are not highly suggestive of colon cancer. Hemorrhoids are a better bet. Or fissures – tears of the rectal skin – also bleed. Diverticula – pouches budding from the colon wall – are another source of blood. I can’t implicate biking as a cause.

Colon cancer, as a rule, begins after age 50. It’s mostly silent in its early stages. It can cause bleeding. Bright-red bleeding from a cancer would mean it’s located at the end of the colon. Colon cancer bleeding can be so slight that the eye cannot see it. Your husband doesn’t fit the picture of cancer. However, no bleeding should be dismissed out of hand. The family doctor is the one who can reassure your husband and you.

When colon cancer is discovered before it has penetrated the colon wall and before it has spread to any lymph nodes, it has a five-year survival rate greater than 90 percent.

DEAR DR. DONOHUE: If I don’t take Metamucil every day, I become quite constipated. I know it’s not good to take a daily laxative; many people tell me so. They have me worried about too-frequent use of it. The box says it’s a bulk laxative. Does that mean it’s a laxative that could get me in trouble? – J.R.

ANSWER: Metamucil contains psyllium, a substance like bran. It’s a laxative only in the broadest sense of the word. It doesn’t irritate the colon like some other laxatives do. You can safely use it every day.

The laxative report explains constipation and its treatment in detail. To obtain a copy, write: Dr. Donohue – No 504, 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: I have a problem that I can’t discuss with my doctor. My wife and I have had an active sex life. About four months ago, I noticed my penis bending to one side. It has become difficult to have sexual relations, and it is painful to do so. I haven’t talked to my wife about this, but I think sex will be over for me in a matter of time if this doesn’t get better. What is this? – B.P.

ANSWER: It’s Peyronie’s (puh-row-KNEES) disease. You have to discuss it with your doctor. It’s nothing that he or she is unfamiliar with. It’s not such an uncommon condition.

Scar tissue has formed in the penis. The scar tissue draws it to one side, or upward or downward. You might be able to feel the scar tissue as a hard nodule.

The bend makes intercourse difficult, and, if the bend becomes great, it can make intercourse impossible. Intercourse is painful.

For many men, pain subsides in time. Some have a lessening of the bend in 12 to 24 months. That doesn’t happen to all. I don’t want to raise false hope.

Vitamin E, a medicine called Potaba and the gout medicine colchicine have been prescribed, but their success is limited. Injecting the scar tissue with a variety of drugs has also been tried and has also met with limited success.

Surgical procedures can often straighten the bend. Surgery is usually postponed to see if things get better on their own.

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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