DEAR DR. DONOHUE: Please read the enclosed article. I would like to hear your opinion on it. How could something like this happen? I was under the impression that medication is supposed to help people, not harm them. Do you think people should take the drug heparin? Please note: I do not know this lady, and she does not know me. I admire her courage. – D.R.

ANSWER:
The article describes what happened to a woman who was in the hospital and was put on heparin. The drug was responsible for the amputation of her lower legs and her arms. It’s a story of how a wonderful, life-saving drug can have tragic consequences. Penicillin, the first antibiotic and a medicine that has saved millions of lives, has also led to the deaths of people. No drug has an unblemished record.

Heparin is a blood thinner. It is given in many situations. People with clots in their leg vessels are put on heparin to prevent the clot from traveling to the lungs and potentially causing death. People who have had heart attacks are often put on heparin to keep blood flowing through heart arteries. It’s a medicine that has been used for a very long time.

Heparin can trigger a cascade of events called HIT, heparin-induced thrombocytopenia. Some people given the drug make antibodies that cause the formation of a clot involving both platelets (thrombocytes) and heparin. The platelet number falls – thrombocytopenia. Arteries in which clots form cannot conduct blood to the places they supply. Often those places are the arms and legs. If the clots that form cannot be dissolved and blood supply re-established, gangrene sets in and amputation becomes a must. This story sickens everyone who reads it. The woman has my deepest sympathy. Her indomitable spirit is the one bright spot of the story.

I believe heparin should stay on the market. It has saved too many lives that would have been lost without it.

DEAR DR. DONOHUE: Can you catch shingles from someone? Can they appear anywhere on the body? Do they go away and come back one month later? Does stress cause them? – M.M.

ANSWER:
Shingles comes from the chickenpox virus, which lives on in nerve cells from the day it infects a person, usually during childhood.

Later in life when there is a temporary lapse in the immune system’s defenses, the virus leaves nerve cells, travels down the nerve and lands at the skin, where it causes the typical rash and pain of shingles.

You cannot catch shingles from someone who has it. People, including children, who never have had chickenpox can come down with chickenpox if they come in contact with the shingles blister fluid. That’s an exceedingly rare occurrence. Most adults have had previous encounters with the chickenpox virus, so they are not going to catch chickenpox again.

Nowadays, most children have been vaccinated against chickenpox and are not going to become sick when exposed to the virus. Shingles can appear anywhere on the body. It most often appears on the face, the back, the chest and the abdomen. It follows the course of the nerve down which the virus traveled. It’s almost always only on one side of the body. A typical outbreak appears as a band of red skin patches on which there are tiny blisters. The band takes a slightly downward course from the back to the front of the chest, for example. Shingles recurs only rarely. It doesn’t usually recur in one month, however. Stress is something that can lower the body’s immune defenses. It, therefore, is considered a possible contributing cause of shingles. The shingles booklet describes the illness and how it’s treated. Readers can obtain a copy by writing: Dr. Donohue – No. 1201, 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: Can you explain to me why menopausal women have trouble losing weight? In fact, they often gain weight. The hot flashes of menopause cause copious amounts of sweat.

Doesn’t this equal calorie and fat burning? If not, where is this energy coming from? They make me feel like I am a furnace. – B.U.

ANSWER:
The drop in estrogen production that comes with menopause throws a monkey wrench in the brain’s control of body temperature. The brain mistakenly believes body heat must be dissipated, so skin blood vessels dilate and bring more warm blood to the body surface. That’s the hot flash. There aren’t many calories involved in doing this. The heat has already been produced. It’s simply brought to the surface. The average hot flash lasts about four minutes and is often accompanied by sweating.

Two tricks for controlling hot flashes don’t involve taking any medicines. One is to breathe slowly and deeply when a flash strikes. Cut the rate of breathing down to six or eight times a minute. The other trick is to sip ice water at the first inkling of a flash. That means you have to have a thermos on hand with ice water in it. Weight gain is mentioned on some lists as one of the symptoms of menopause.

I don’t have an explanation for it. Perhaps women during menopause subconsciously cut back on their physical activities. Hold on a minute. That’s a stupid reason. I should have erased it. I let it stand in hopes that someone more knowledgeable than I am can give a better explanation.

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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