DEAR DR. DONOHUE: Several years ago I was diagnosed with myelodysplasia. I am a 79-year-old widow. I have seen a hematologist for it every six months. After a knee replacement 18 months ago, I suddenly became very short of breath. My daughter took me back to the hospital, and I had to have blood transfusions since my blood count had dropped so low.

I took shots every week for months until my blood count returned to low normal. I read in our paper that myelodysplasia is a form of preleukemia. What are my chances of developing leukemia? – J.J.

ANSWER: Here “myelo” refers to bone marrow, the site of blood-cell production. “Dysplasia” indicates that a monkey wrench has been thrown into the production of blood cells. Myelodysplasia (MY-uh-low-dis-PLAY-zhe-uh) syndrome is a group of blood disorders with a common thread running through each – a greatly reduced production of red blood cells, white blood cells, platelets or a combination of two or all three. It mostly strikes between the ages of 65 and 70 and is not, in spite of the unfamiliar name, an unfamiliar condition.

When the red blood cell count is low, anemia ensues, with all the familiar anemia signs and symptoms: pervasive exhaustion, breathlessness on slight exertion and skin pallor. A drop in platelets leads to bruises and frequent nosebleeds. A deficit of white blood cells makes people prone to developing infections.

The course of myelodysplasia is difficult to predict. Sometimes it progresses to acute leukemia. You have lived many years without a great progression of the illness, save for that one instance when your red blood count dropped quickly. That’s a good sign. However, the uncertainty of leukemia still exists, and that’s something that is a source of anxiety for all patients.

Vidaza (azacitidine) and Revlimid (lenalidomide) are two newer medicines used for a few myelodysplastic varieties.

In younger people, adult stem cell transplants are the treatment of choice, but such people constitute only 15 percent of patients. The Aplastic Anemia & MDS (myelodysplastic) International Foundation Inc. assists all patients in coping with this disease and can be reached at 800-747-2820 or on the Web at www.aamds.org.

DEAR DR. DONOHUE: I think I have been infected with West Nile fever. I was stung by three mosquitoes, and I bled. The next morning I woke up with my eyes stuck shut with sticky matter. This happened for a week, and I would be dizzy when I got up. I also had scabs on my head. Would blood tests show if I had West Nile? – E.G.

ANSWER: After a bite from a mosquito infected with the West Nile virus, most people (80 percent) have no symptoms and are never ill. Around 19 percent come down with mild symptoms in two days to two weeks – headache, nausea, muscle aches and swollen lymph nodes. These disappear on their own without treatment. Less than 1 percent have grave symptoms: high temperature, drowsiness, severe headache, painful muscles, back pain, and they often lapse into a coma.

Your symptoms are not symptoms of West Nile fever. You can still have a blood test now that would show past infection, but it would be a waste of money.

DEAR DR. DONOHUE: I am a 50-year-old woman with hearing loss and ringing in my right ear. I had an MRI, and I have a small acoustic neuroma. I have not seen a specialist yet. I am confused by the treatments I read about on the Internet. I am interested in your opinion. – E.T.

ANSWER: An acoustic neuroma is a tumor that wraps around the hearing nerve and causes deafness and ear noise in the affected ear. It also can produce dizziness. It isn’t a cancerous tumor. It doesn’t spread. But it causes troublesome symptoms that can become permanent. You need to see a specialist without delay.

You have a small tumor. Tumor size is something that dictates appropriate treatment. For small tumors, radiation (Gamma Knife, CyberKnife) is acceptable treatment. No knives are used. The word creeps in as an imaginary comparison. Fractionated stereotactic radiosurgery consists of focused radiation in a series of sessions to reduce injury possibility to adjacent structures. You qualify for all three and for surgery, if necessary.

DEAR DR. DONOHUE: My son is 2 months old. During pregnancy the doctors said his kidneys were dilated. After he was born, his kidneys were the same size, with mild fluid. Doctors want to do a VCUG. We said no to it. The baby is fine, growing, urinating and never having a fever or signs of infection. I can’t imagine my child going through any procedure without me picking him up and comforting him. What are your feelings? Do you agree with us? – A.D.

ANSWER: The problem must be hydronephrosis – kidney enlargement due to distention from urine because of a defective valve in the ureters. The ureters are the tubes that drain urine from the kidney to the bladder. Defective ureter valves allow urine to back up into the kidneys.

A VCUG is a Voiding CystoUretroGram, an X-ray taken with dye that has been instilled into the bladder through the penis. It’s uncomfortable but not terribly traumatic to the child. If I had been in your shoes, I would have gone along with the procedure. Hydronephrosis can encourage kidney infections and kidney scarring.

You have a right to your opinion, and I can’t fault you for it. The baby is doing fine and has had no signs of kidney infection. Ultrasounds of the kidneys can show if the kidneys are continuing to enlarge. If they are, then I would urge you to reconsider your position and have the VCUG done.

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