DEAR DR. DONOHUE: I am 47. Six months ago I was diagnosed with prostate cancer. My doctor was quite surprised because of my age, and so was I. Four months ago I had my prostate gland removed. The doctor said he got all the cancer, and I am happy about that. I am not happy that I have lost control of my bladder. What can be done for that? – R.M.

ANSWER:
The urinary bladder and the nerves that serve it lie in close proximity to the prostate gland. In removing the gland, it is next to impossible not to injure nerves or the muscles that keep the bladder closed. Those muscles are called sphincters (SFINK-turs), and there are two of them for the bladder. One lies at the bladder outlet, and the other wraps around the urethra – the tube that drains urine from the bladder to the outside. It’s the second sphincter that is frequently impaired after gland surgery.

Quite often, men regain control over the bladder in six months to a year after the operation. It might be only a matter of time until your problem goes away on its own.

If it doesn’t, there are ways to improve the situation. One example is the artificial urinary sphincter. It works like a blood pressure cuff. At all times, the tiny cuff, encircling the urethra, is inflated and keeps urine in the bladder. When the man feels that his bladder is full and wants to empty it, he activates a small pump, which is placed in the scrotum. The cuff deflates and urine passes out of the bladder. The cuff is programmed to inflate on its own after the bladder has emptied. The device works well, but it might need periodic revisions.

The booklet on enlarged prostate glands and prostate cancer provides more information on these two common conditions. Readers can order a copy by writing: Dr. Donohue – No. 1001, 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: Please write something about a high platelet count as opposed to a low one. Five years ago, my platelet count was recorded at 700,000 – quite high. My father and grandfather died of strokes at relatively young ages. I am concerned about this. I am on anagrelide (Agrylin), and my count has come down to 416,000. What causes a high count? – C.W.

ANSWER:
Platelets are the blood cells essential to clot formation. Another name for platelets is thrombocytes. The condition of too many platelets is thrombocythemia or thrombocytosis. A normal count lies between 150,000 and 350,000.

In thrombocythemia, the bone marrow – the factory for all blood cells – speeds up platelet production, and nobody knows why it does so. One would think that too many platelets would clog arteries with clots and lead to heart attacks and strokes. It can, but thrombocythemia can also result in bleeding, something that sounds odd. The reason for bleeding is that many of these rapidly produced platelets don’t function well. They don’t make clots.

You’re like most. Your thrombocythemia was discovered by a routine blood count. You had no signs or symptoms of it. Many who have high platelet counts, even in the millions, have no symptoms, and they’re often observed without resorting to treatment.

People who are at high risk for complications of thrombocythemia or who have symptoms from it are treated with your drug – anagrelide – or interferon or hydroxyurea. Having had a previous episode of an unwanted clot puts a person at high risk of having another if the platelet count is high. You are doing well on the medicine.

There’s another kind of thrombocythemia – reactive thrombocythemia. It’s seen with blood loss, cancer, some infections and some kidney illnesses. You do not have this kind of the illness.

DEAR DR. DONOHUE: My son eats three raw eggs every morning to build muscles. Is this healthy? – R.W.

ANSWER:
It’s unhealthy. Raw eggs can carry Salmonella, a germ that brings on a most unpleasant illness.

Raw eggs do not build muscles. That’s an idea whose time has long passed.

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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