DEAR DR. DONOHUE: I am a retired person who suffers from dry skin, and I itch terribly all the time. I have tried many medicines, creams and ointments, but nothing has helped. I hope you can help me get some relief. – D.L.

ANSWER:
Uncommon but worthy of mention is itching due to illnesses like kidney failure, liver disease, thyroid problems, some cancers and the blood condition called polycythemia vera. Doctors always think of these ailments when people complain of itching, but they don’t usually find them.

Much more common is itching due to dry skin. In Northern climates in the winter, heated homes dry the skin if the home’s humidity is low, as it usually is. You can buy an inexpensive instrument that records humidity. If it’s not above 40 percent, the house could stand a humidifier.

Aging is another factor that dries skin. Oil glands disappear with age. An imperceptible layer of oil on the skin keeps it moist. Without it, water evaporates from skin.

To stop the itch and hydrate the skin, don’t bathe or shower in hot water. Don’t use strong soaps. Alpha Keri, Neutrogena and Dove are good choices. After washing, pat the skin but don’t rub it dry, and immediately apply a moisturizer such as Lac-Hydrin, Aquaphor or Moisturel. These are only a few examples. Petrolatum (Vaseline) works well and is cheap. It comes in many forms that are less greasy than regular petrolatum. Don’t wear woolen clothes next to your skin.

An antihistamine such as hydroxyzine (prescription needed) or diphenhydramine (Benadryl, prescription not needed) can control the itch. Both make people groggy, so take them only before going to bed at first, to see how well you tolerate them.

DEAR DR. DONOHUE: I was told I need to have both my knees replaced because of arthritis. I do not want to go through that. About four years ago, my doctor told me to take two Tylenol in the morning and again at night. I did this for more than two years. Then I found out that Tylenol is not good for people, and I cut down to one in the morning and one at night. I thought that might be too much, so now I take one every three days. What is your opinion on this? Was I taking too much Tylenol? – E.G.

ANSWER:
Acetaminophen (ah-SEET-ah-MEN-oh-fin) is the generic name for Tylenol, one brand name. There are other brand names, so I’m going to stick with acetaminophen here, even though it’s unpronounceable.

This medicine has been in use for more than 50 years, and millions of people have taken it. It has proven to be a safe drug. It’s a wonderful pain reliever, and it relieves pain without irritating the stomach.

The limit to the daily dose of acetaminophen is 4 grams. Most acetaminophen comes in tablets of 325 mg or 500 mg. You can take 12 325-mg tablets per day or eight 500-mg tablets. Some tablets are 650 mg. Six of those a day is an acceptable dose.

If a person drinks three or more alcoholic drinks a day, he or she should ask the doctor if it’s OK to use this drug. Chronic alcoholics would be better off not using it.

You were way under the daily limits set for Tylenol. You can use it in the amounts suggested by your doctor without any fear.

DEAR DR. DONOHUE: You wrote, “I can’t find a whole lot of scientific studies to support or to condemn massage.” I direct you to the Miami Touch Institute on the Web at: www.miami.edu/touch-research. I am a registered massage therapist in Ontario, Canada, and we are required to complete 2,200 hours of education. Comments like yours are unfair. – D.M.

ANSWER:
You’re not quoting the entire item. I said I am in favor of massage and that it has helped me in the past. I wasn’t aware of the Miami Touch Institute at the University of Miami. Now my readers and I are. We thank you and encourage you to continue in your profession.

DEAR DR. DONOHUE: For years, about every seven weeks I have donated blood. After my last blood test came back, my doctor told me I was anemic. Despite that news, I feel fine. Since I feel so well, what do my lab tests (enclosed) mean? Should I stop giving blood? I am 83. – W.R.

ANSWER:
Your blood tests mean that you are anemic. Your red blood cell count is lower than normal. The definition of anemia is a low red blood cell count. It’s not drastically low, and it’s not so low that it’s causing you to have symptoms like breathlessness and weakness, but it is low. Your other blood tests – the hemoglobin and hematocrit – confirm your anemia. The MCV (mean corpuscular volume) indicates the size of red blood cells. Yours are smaller than they should be.

The size of the red blood cells helps pinpoint the cause of the anemia. Small red blood cells are found in iron-deficiency anemias.

Many such anemias come on from the silent loss of blood in the intestinal tract. Blood is the body’s iron reservoir.

Now it’s up to you and your doctor to discover why you have anemia and if it truly is due to intestinal loss of blood. Armed with that knowledge, the doctor can treat you rationally.

You should not donate any more blood until your blood count returns to normal.

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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