DEAR DR. DONOHUE: Much is written about obesity, diabetes, high blood pressure and depression, but little is written about Cushing’s disease, which can cause all of these. It took me 15 years of suffering from these until I was diagnosed. Cushing’s symptoms include weight gain, redistribution of fat to the face (moon face), a deposit of fat below the neck in the back (buffalo hump), high blood pressure, diabetes, osteoporosis, anxiety and depression. I have paid a price for being undiagnosed for so long. Treatment saved my life. Please let people know about this illness. – E.S.

ANSWER: Cushing’s disease is not common, but it can cause many common symptoms (as you mention) without the cause of those symptoms ever being discovered in a timely fashion. It’s due to an overproduction of cortisone by the adrenal glands, glands that sit on top of the kidneys.

Excess cortisone causes all the signs and symptoms you listed, and then some. Striae – purple stretch marks – are another sign of cortisone excess. Menstrual periods are often thrown off kilter by cortisone overload. Women with Cushing’s can develop a moustache.

The trouble lies in the adrenal gland about 30 percent of the time. It lies in the pituitary gland the rest of the time. The pituitary gland is a small gland at the base of the brain that regulates other endocrine glands. A pituitary tumor can produce too much ACTH hormone, a hormone that stimulates the adrenal gland’s cortisone production. Removal of the pituitary tumor or of the adrenal tumor puts an end to all Cushing’s signs and symptoms.

The diagnosis is made by demonstrating the hormone glut.

DEAR DR. DONOHUE: Your comments on the following subjects would be greatly appreciated: congestive heart failure, the heart skipping a beat and pulmonary fibrosis. – S.P.

ANSWER: Congestive heart failure: It’s one of the most common heart conditions. What has happened is that the heart has become such a weak pump that it cannot empty itself of blood. Blood backs up, and the fluid part of blood leaks into the lungs, causing “congestion.” That gives rise to shortness of breath. Fluid from backed-up blood also leaks into the tissues of the legs, causing ankle and foot swelling.

Heart attacks, heart-valve problems, untreated high blood pressure and poor blood supply to the heart are some of the causes of congestive heart failure. Medicines usually can relieve this condition.

Heart skips a beat: That’s due to an extra heartbeat, and people feel a thump in their chest when it happens. The extra beat arises either in the upper heart – the atria – and is called an atrial premature beat, or in the lower heart – the ventricles – and is called a ventricular premature beat. A few skipped beats are not indicative of major heart disease. We all have them.

Pulmonary fibrosis: It’s scar tissue (fibrosis) that forms in the lungs and makes the passage of oxygen from lungs into the blood quite difficult. People don’t get enough oxygen and are, therefore, constantly hungering for more air. Most often, doctors cannot find the cause for it, and then the condition is called idiopathic pulmonary fibrosis. Supplemental oxygen helps patients with this disorder.

The booklet on heart attack gives a clear picture of one of the causes of heart failure. Readers can obtain a copy by writing: Dr. Donohue – No. 102, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: If you don’t get the flu shot in November, can you get it later in the winter? – G.H.

ANSWER: Flu reaches a peak in February. It takes two to four weeks for the body to build up its immunity to it. That still makes December and January reasonable times to get the vaccine.

DEAR DR. DONOHUE: I have had cellulitis, a bacterial infection of the skin, on my left arm more than once. I also have lymphedema of that arm. I had my left breast removed for cancer, and I understand that the lymphedema is related to this. What can I do for both? – Anon.

ANSWER: Lymphedema is swelling of an arm or leg due to a disruption of lymph vessels and lymph nodes. Lymph is fluid that oozes out of the circulation to bathe body cells. Lymph vessels vacuum up that fluid and return it to the circulation. On its way back, the fluid passes through lymph nodes, where germs and foreign material are filtered out.

After extensive breast surgery during which lymph channels and lymph nodes have to be removed, the return of lymph fluid to the general circulation is greatly disturbed, and the arm often becomes congested with fluid – it swells. That makes the skin of the arm susceptible to infection – cellulitis.

If you can get the fluid out of the arm, you’ll solve both the swelling and the cellulitis. Therapists trained in “decongestive” massage can knead the fluid out of the arm. They use light massage strokes to achieve that. Pneumatic pumps can also push fluid out of a swollen arm.

Compression sleeves, which firmly and constantly squeeze the arm, can prevent the fluid from returning.

The same therapists who are skilled in decongestive massage can teach their patients exercises that promote fluid drainage out of the arm.

Your doctor or local hospital can put you in touch with one of these health care workers. Or you can contact the National Lymphedema Network, a foundation that serves people with this condition. The foundation’s toll-free number is 1-800-541-3259, and its Web site is www .lymphnet.org.

The pamphlet on lymphedema and edema (another swelling problem due to fluid retention) offers more information on the causes of and treatments for both disorders. Readers can obtain a copy by writing: Dr. Donohue – No. 106, 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.