DEAR DR. DONOHUE: I’ll make a long story short. About five weeks ago, my right hand went numb and I couldn’t talk. My husband believed I was having a stroke and called an ambulance. By the time I got to the hospital I was back to normal. The doctor said I had a ministroke and told me I should see my own doctor. I did. He examined me and didn’t find anything wrong. Should I be on some sort of medicine? – W.K.

ANSWER:
What you describe was a transient ischemic attack, a TIA. Some call it a ministroke. Ischemic means a cutoff of blood supply. Transient denotes short duration. In the case of a TIA, symptoms last less than 24 hours, but most last five to 10 minutes. Even though the episode is short-lived, some brain cells die, but not enough to cause permanent loss of function.

The great danger is that between 4 percent and 20 percent of people who have had a TIA will have a full-blown stroke within the next three months.

Symptoms of a TIA are the same symptoms as those of a stroke: numbness, weakness, dizziness, an inability to speak, trouble walking, loss of balance or a vision defect. They disappear when blood flow is re-established.

You definitely need to do something to prevent suffering a stroke. The problem is an obstruction in a brain artery. Either the obstruction is a buildup of cholesterol on an artery wall or it’s a piece of clot (an embolus) that has traveled to a brain artery from a distant site like the heart. Determining the exact problem dictates what the therapy should be.

It might be squashing an artery buildup with a balloon-tipped catheter or surgically removing it. Or it could be taking medicines that prevent platelets from clinging to cholesterol buildup and completely occluding the artery. Aspirin, aspirin plus extended-release dipyridamole or Plavix are such medicines. Or it might be going on the anticoagulant Coumadin. See another doctor. A neurologist would be a good choice.

The stroke booklet explains this common condition, third on the list of causes of death. Readers can obtain a copy by writing: Dr. Donohue – No. 902, 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: I’m a 27-year-old female and have suffered from lichen planus since I was 19. It first appeared when my brother passed away. My mother got it at the same time. Hers has disappeared. I have purple patches all over my legs, arms and back. They keep me from enjoying the beach. Is there a cure? – A.B.

ANSWER:
Lichen planus is a skin eruption of solid, slightly elevated, many-sided purple bumps that range from pinhead size to four-tenths of an inch (1 cm) in diameter. The surface of the bumps looks like it is draped in white lace. The eruption is itchy.

Close to two-thirds of lichen planus patients are over it in two years.

Cortisone family creams and ointments are the medicines most often prescribed. Potent acne medicines have also been used, but they can cause birth defects, so they have to be used with utmost care in women of childbearing ages. Resistant cases sometimes respond to cyclosporine, a drug used to rein in the immune system, which is considered the cause of this condition.

DEAR DR. DONOHUE: My daughter’s boyfriend has focal segmental glomerulosclerosis. What is done for it? They were planning to marry. Is that still possible? – K.D.

ANSWER:
The young man has kidneys in which some of the filters are scarred. It’s an autoimmune illness. Prednisone, one of the cortisone drugs, is the medicine usually given for it. Seventy percent of people achieve a remission from it.

Your daughter and her boyfriend can continue to discuss their marriage plans.

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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