DEAR DR. DONOHUE: I am 75 and in good health except for recurrent urinary tract infections. I had my first bladder suspension operation in 1973. It worked well for 12 years. I had repairs on it in 1992 and 1996. Neither worked. I have gotten these infections ever since. They’re very upsetting. Can you suggest anything? – J.S.

ANSWER:
By urinary tract infection, I take you to mean bladder infections. Women get them more often than men, because the tube that drains the bladder – the urethra – is much shorter in women and its opening to the outside is in an area that teems with bacteria. The bacteria have easy access to the bladder.

If your infections are related to sexual relations, urinating shortly after intercourse can clear the urethra of any bacteria that are massaged into it. Taking a single dose of an antibiotic after sex can prevent recurrent infections in this situation too.

For recurrences not related to sex, you can stay on a continuous low dose of an antibiotic. In a low dose, the antibiotic is enough to prevent infection without upsetting the normal bacteria in your body and without engendering the emergence of resistant germs.

A third alternative is to have on hand a prescription for a full course of antibiotics. You take them at the first sign that a recurrence is occurring. That cuts off the infection immediately.

Cranberry juice and cranberry extract tablets have helped some women win the battle of recurring bladder infections. A substance in cranberries interferes with the bacteria’s ability to cling to the bladder wall. They are flushed out upon urinating.

If your bladder has fallen, you’re vulnerable to repeated infections. You can’t completely empty a fallen bladder, and stagnant urine promotes infections. I don’t know if you face another surgical repair. A pessary might be able to push the pelvic organs back into place and keep the bladder propped up and drainable.

The booklet on urinary tract infections delves into this topic in depth. Readers can obtain a copy by writing: Dr. Donohue – No. 1204, 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 7-year-old granddaughter who has a swollen belly. She has had this condition for a few years. It makes her look obese. Her parents took her to a pediatrician, and he prescribed a stool softener, since she is very constipated. She took it for two days and then refused to take it anymore. She had normal bowel movements for those two days. Now she is constipated again. We’re asking for your help. – S.K.

ANSWER:
What did your granddaughter look like when she took the stool softeners? Was her belly flat? If it was, then the answer to the problem is keeping her regular. Perhaps a diet of more vegetables and fruits will prevent her from becoming constipated. If not, her mother can try the stool softeners again. If your granddaughter refuses the capsules or tablets, her mother can try giving her the liquid variety.

There are serious problems that cause stomach bloating. An abdomen filled with fluid is one of them. Enlargement of one of the abdominal organs – the liver, spleen or kidney – can also make the abdomen stick out. I am all but positive that your granddaughter doesn’t have a serious condition. She would have had other symptoms by now, symptoms so dramatic that they could not be ignored.

DEAR DR. DONOHUE: I am 22 and have a patch of skin that the doctor says is morphea. He hasn’t given me any medicine for it. It doesn’t hurt or itch. Do I need medicine? – M.J.

ANSWER:
Morphea starts out as a purple skin patch whose center, in a matter of weeks, lightens and thickens. Morphea often regresses on its own without any treatment. Cortisone creams and salves can sometimes be effective, and injected cortisone can frequently control it. But if it’s not causing you any trouble, you might be better off waiting things out until it goes away on its own.

DEAR DR. DONOHUE: Hello. I am a 27-year-old woman who adopted a healthier lifestyle at the start of this year. Along with a lower-calorie diet and exercise, I started drinking plenty of water. I heard that water can help you lose weight. I also drink it ice-cold because I read that the body has to heat it to body temperature, and that burns many calories. I drink a half-gallon to a gallon of water every day. Someone told me that people who are obsessed with water-drinking can overhydrate themselves. I have seen nothing but good results from drinking water. I started out at 202 pounds (I am 5 feet 2 inches tall), and I now weigh 185 pounds and my skin has become supple. Can you drink too much water? – L.T.

ANSWER:
I have heard the water weight-loss theory for many years, but I haven’t seen any proof that it works, despite of the many reasons given for why it should work. My niece, however, is a believer. It’s a free country, and people can believe whatever they want.

The ice-water calorie-burning idea is another flameout. I owe thanks to Dr. T.E. of Bloomfield, N.Y., who educated me about this. To raise a glass of ice water to body temperature takes 8.8 calories. That’s the amount of calories in 1 gram of fat. One gram is one-thirtieth of an ounce. The volume of ice water you’d have to drink to lose 1 pound of fat is prodigious and impractical. It would take you months and months and months to do so.

Will all your water-drinking hurt you? Probably not. People who engage in endurance events in hot weather often become dehydrated. If they gulp large amounts of water with no salt in it, they risk lowering their blood sodium levels, and in extreme situations, that can be dangerous. That’s not likely to happen to you.

You have successfully lost 17 pounds. Congratulations. Keep doing what you’re doing. I think it’s your calorie reduction and exercise that have done this for you.

But if you like water, go for it. I’m not arguing with success.

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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