DEAR DR. DONOHUE: My 23-year-old daughter is not having and mostly hasn’t had regular periods. Since late high-school age, she started gaining weight and has continued to do so. Until then, she was a thin person. She also seems to have more facial hair.

She’s planning to see a new doctor soon. What kinds of things should they check to find out what her problem is? – C.L.

ANSWER:
I’m going out on a limb by suggesting that your daughter’s diagnosis is polycystic ovarian disease. A doctor will have to examine her and ask for pertinent tests to verify that diagnosis.

It’s not an uncommon condition. Between 7 percent and 9 percent of women in their child-bearing years have it. Your daughter has many of its signs.

Menstrual irregularities are one sign, with missed periods and few periods. The growth of facial hair and the loss of scalp hair at the temples are other frequent signs.

Acne might appear. These signs indicate a lack of estrogen and a magnification of the effects of androgen (male hormone), which all women produce.

Polycystic ovarian women are often overweight. Their ovaries are large and studded with cysts. Infertility is frequent.

Serious metabolic consequences are part of the picture. One of them is insulin insensitivity, with the development of diabetes. The doctor, via an examination coupled with a battery of blood hormone tests, can establish the diagnosis and begin treatment.

Weight loss for overweight patients is therapeutic. Birth-control pills restore normal estrogen levels.

If a woman with polycystic disease desires children, Clomid stimulates the maturation of ovarian follicles with viable ova. Sometimes giving the woman a diabetes medicine straightens out all the disparate signs and symptoms of this syndrome.

DEAR DR. DONOHUE: Enclosed is a copy of the results of my latest blood tests. I am, of course, pleased that they are all marked “normal.”

Here is my problem: My doctor, for whom I have great respect, monitors my health solely with blood tests. He says he can learn as much or more from blood tests than from a physical exam. I can’t remember when I had a full physical. I will be 80 on my next birthday. What is your opinion? – F.O.

ANSWER:
Your doctor and I don’t share the same viewpoint.

You can’t take blood pressure from a lab test. You can’t listen to the heart or lungs from lab tests. You can’t examine the eyes, find cataracts or detect the changes of macular degeneration from blood tests. You can’t diagnose Alzheimer’s disease from lab tests. You can’t detect skin cancers from lab tests. You can’t evaluate the nervous system from lab tests.

People do need physical examinations.

DEAR DR. DONOHUE: Please inform me how to get rid of calluses. I have them on both feet. I have been trying to get rid of them for months and have gotten nowhere. They are very painful. – L.P.

ANSWER:
Your feet are trying to do you a favor by forming calluses. It’s their way of protecting the skin and underlying structures from pressure bearing down on them. Without pressure, calluses don’t form.

You can get rid of them and stop them from coming back if you examine your shoes in the places where the calluses formed on your feet. Pad those sites or get a cushioning insole for your shoes.

For calluses already there, soak the feet in warm, soapy water for 15 minutes and then file the calluses with an emery board or a pumice stone. Both are available in drugstores. It takes more than one session to get rid of them. If you don’t make headway on your own, your doctor or a podiatrist can pare them away with a scalpel.

DEAR DR. DONOHUE: In the past year, I tried the Atkins diet and greatly restricted carbohydrates. I ate as much fat as I wanted –cheese, cream, sausages, everything. I kept it up for two months. Then I began having crushing pains in the center of my chest, probably angina. It happened even when resting. My question is: Do I need to see a cardiologist? Or shouldn’t I lose sleep over it? I am 26 years old and overweight; I exercise and have normal blood pressure. – C.H.

ANSWER: You must suspect that I would recommend that anyone having crushing chest pain see a doctor. However, the evidence for angina is slim.

You’re 26. Clogged heart arteries producing angina are possible at 26, but not likely. Developing such arteries in two months is impossible.

Angina typically arises when a person is active. Strangely enough, the high-fat, low-carbohydrate diet appears not to raise blood cholesterol. I don’t know why.

All the same, see a doctor. The doctor doesn’t have to be a cardiologist. You have to find the cause of this chest pain. I can’t tell you what that is.

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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