DEAR DR. DONOHUE: I have a friend, age 56, who is diagnosed with multiple system atrophy. His doctor says he has a life expectancy of four to nine years. My friend thinks he will die in the next six months. His speech is slurred and he needs a walker to get around, but he can eat, chew and swallow. Please explain more about this and his life expectancy. – M.B.

ANSWER:
Atrophy is a wasting away, a shrinking. “Multiple system,” in this instance, refers to multiple brain areas where atrophy takes place and multiple body areas where symptoms arise.

The illness presents with a bewildering number of signs and symptoms. People usually lose bladder control, and they usually have a large drop in blood pressure when they rise from the sitting or lying position. Symptoms common to Parkinson’s disease can be found here, like muscle rigidity, a shuffling walk and an impassive face. MSA can make balance difficult and cause people to fall. Speaking and swallowing can become troublesome. Erectile dysfunction is common. This is only a sample of some of the symptoms that can develop.

The cause is not known. It most frequently strikes in the 50s. The average length of survival is what the doctor told your friend. Some live as long as 15 years.

No medicine cures the illness. There are medicines for many of the various manifestations of the illness, but not for all. Drugs can normalize low blood pressure. Parkinson’s medicines are often employed, but they aren’t as effective in MSA as they are in Parkinson’s disease.

Thinking most often remains clear.

DEAR DR. DONOHUE: I am sometimes advised to breathe through my stomach. How can you breathe through your stomach when your lungs are in your chest? I don’t understand this. – R.G.

ANSWER:
The last time I looked, the lungs are still in the chest.

What belly-breathing means is deep breathing. To achieve deep breathing, you have to use your diaphragm. It’s the most important breathing muscle. It’s a sheet of horizontal muscle that separates the chest and the abdomen. If you take a deep breath in, your stomach should stick out, because the diaphragm descends with a true deep breath. When the diaphragm does go downward, the chest cavity expands so air rushes into the lungs. The downward motion of the diaphragm pushes the stomach and abdominal organs out.

People with emphysema and chronic bronchitis are told to belly-breathe. So are speakers, players of wind instruments and singers. It’s important for athletes. For that matter, it’s a good way for all of us to breathe.

DEAR DR. DONOHUE: Please settle an argument that is raging in my house. I like yogurt. I usually have one every other day. My husband insists that yogurt is not good for a person. Will you please print the pros and cons of yogurt? – H.B.

ANSWER: Yogurt is milk treated with friendly bacteria and then warmed to form a thick, rich ambrosia relished by many. It has a good supply of protein with little to no cholesterol. It has a hefty amount of calcium – 450 mg in one cup. It also contains potassium, magnesium, riboflavin (a B vitamin) and vitamin B-12. It’s good for you. I can’t find any cons. It has 154 calories, but if you’re not on a strict diet, that isn’t so many.

DEAR DR. DONOHUE: Is there such a thing as having too many red blood cells? – N.O.

ANSWER:
There is. It’s called polycythemia.

Sometimes an increased number of red blood cells occurs because of living at high altitudes, where oxygen is low. Sometimes it results from the overproduction of red blood cells by the bone marrow. That requires treatment.

TO THE MANY READERS who have requested a replay of chronic fatigue syndrome: I would do so now, but I have worn out the topic. I have to let it rest a bit. You can order the booklet on the subject by writing: Dr. Donohue – No. 304, 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.

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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