DEAR DR. DONOHUE: Two years ago, my 17-year-old daughter needed a TB skin test for a job. She tested positive. After she had a clear chest X-ray, we were told she had been exposed to TB but she did not have an active case. She was put on medicine. The rest of the family had TB tests, and all were negative. The following year, my 14-year-old daughter needed a TB skin test, and she tested positive. We repeated the same procedures. My husband and I are still negative. There are no confirmed cases of TB in our town. Any thoughts on this? – J.S.

ANSWER: A positive TB skin test with a negative chest X-ray and no signs of illness indicates that a person has a living TB germ somewhere in the body. The germ is walled off in a coffin of calcium. The positive person does not have TB and does not spread TB, but can, later in life, come down with TB. For that reason, such a person takes medicines to kill the germ.

Reading a TB skin test correctly takes experience. After injection of the testing material, usually on the forearm, a positive reaction consists of a raised elevation, much like a hive. The test is read in 48 to 72 hours. The largest diameter of the hive is measured, and standards have been set to determine a positive test. It takes some skill to interpret it correctly. The measurement has to be accurate, and only the swelling, not skin redness, counts.

Your second daughter’s experience raises suspicion that there is an active case of TB in their environment. They had to get the germ somewhere. Does the family doctor know this story? He or she ought to be told. The local public-health department also should be informed. An investigation might be started.

A new blood test for TB is now available, and it most likely will supplant the skin test, in time.

DEAR DR. DONOHUE: I had two ministrokes, one in 2006 and the other in 2007. I have not been well since. I miss out on so much because I never know when I will hit bottom again. I start feeling weak, as if life has left me.

It takes a week to be myself again. Many close relatives have recently died. Now I am like an old person. I get tired over nothing. I am not able to keep a clean house and not able to cook much. Do ministrokes leave a person like this? I am 63. – B.

ANSWER: Most people use the term “ministroke” when they’re speaking of a transient ischemic attack, a TIA. A TIA is a neurologic deficit – an inability to talk, weakness of an arm or leg, numbness of a body part, a vision deficit, the onset of incoordination, walking difficulty – that lasts for minutes to two hours, but never longer than 24 hours. People fully recover. TIAs are warnings that a stroke is around the corner if measures are not taken to prevent it. Measures include such things as lowering cholesterol, maintaining normal blood pressure, discovering a blockage in an artery serving the brain or finding a clot at a distant site, as in a fibrillating heart. They also can include taking a blood thinner like aspirin on a regular basis.

Your symptoms indicate depression to me. I can’t be certain. Your personal doctor is the one who is best able to judge this. If depression is the source of your problems, medicines and talk therapy are the ways to get over them.

The booklet on strokes explains what happens to the brain when a stroke occurs and what can be done for recovery. Readers can order 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 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: For years I was told I had irritable bowel syndrome. Then a doctor thought I had celiac disease. Last summer, my cousin told me about a doctor who relieved all her symptoms of celiac disease. I saw that doctor. After a short treatment of holding a vial of something and then having an electrical clip put on my earlobe, the treatment was done. I now eat everything. This has been a lot less stressful and proves that other cultures have knowledge that we do not. – J.L.

ANSWER: I am gratified that your intestinal woes have come to an end. The treatment you describe strikes me as somewhat unusual and leaves me speechless.

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