DEAR DR. DONOHUE: My mother had her first child, a boy, in 1914. I was born in 1918. My youngest brother was born in 1928, and my mother died when he was born. My youngest brother’s children are all Rh negative. Where did the Rh negative come from? Did my mother’s death have anything to do with it? It was said that she had many miscarriages. – B.H.

ANSWER: I can explain the Rh negative question, but I can’t explain your mother’s death and I can’t implicate being Rh negative in her death — if she was Rh negative.

All red blood cells have identification tags. The most important tags are the AB blood tags, which determine if a person has type A, type B, type AB or type O blood. AB typing permits safe blood transfusion.

Rh is another red blood cell tag. Most people – about 85 percent – are Rh positive. Their red blood cells have the Rh tag. Rh negative people don’t have this identity tag. If an Rh negative woman marries an Rh positive man, there’s a strong chance that their children will be Rh positive. Blood from an Rh positive fetus might enter the mother’s circulation and cause her to make antibodies against Rh positive cells. This isn’t a problem with the first pregnancy, but in subsequent pregnancies those antibodies can cross over into the fetus and destroy its red blood cells. That can cause serious problems for the fetus and even death. Miscarriages are common in such situations.

The Rh factor is not such a problem these days. RhoGAM is a shot given to Rh negative mothers who have an Rh positive baby to prevent them from making antibodies that could harm future children.

Your brother’s children are Rh negative, because they didn’t inherit the Rh positive gene. Being Rh negative doesn’t affect health except for fetal health in the situation I described.

DEAR DR. DONOHUE: I read your column every day in our local paper. A while back, there was a letter about an 80-year-old, in good health, who had been experiencing fatigue and shortness of breath.

I am 74 and in good health, but I have some problems. I am an active rancher. My chest hurts when I walk, and I need to stop and rest. This problem showed up in the past two weeks. I don’t have a doctor and have never been sick. – D.K.

ANSWER: I hope you haven’t waited for an answer from me before finding a doctor. If you haven’t found one, find one today or go to the emergency department of your local hospital.

You describe angina pectoris, chest pain that comes with activity and goes with rest. It’s a sign that your heart isn’t getting enough blood when you’re moving around. Angina is a sign that a heart attack might not be far off. You must see about this quickly.

The booklet on heart attacks explains what happens when the heart is deprived of blood. 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: Basically I am a healthy 74-year-old woman. I have been told I have a condition called factor V Leiden and have been put on Coumadin. What causes this, and is it inherited? Is this a lifetime condition? – I.R.

ANSWER: The “factor” spoken of is a clotting factor, a blood protein that works in conjunction with blood platelets to from a clot when a blood vessel breaks. Clotting factors are numbered with Roman numerals, so you are talking about clotting factor 5. “Leiden” comes from a city in the Netherlands where this factor was discovered.

We are in a state of equilibrium between things in the body that make clots and things that prevent them. People with factor V Leiden have a mutation in that factor that makes them prone to form blood clots. It is inherited, and it is lifelong.

If a person has two genes for factor V Leiden, that person has 80 times the risk of a normal person to develop a serious blood clot. If a person has one gene, the risk of a blood clot is four to eight times greater than is the risk of a person without the gene.

DEAR DR. DONOHUE: Two weeks ago, I went to the hospital for an operation. The tech tried four times to find a vein in my left hand for an IV. She finally had to use my right hand. Not long after, my left hand turned black and was painful. Now it’s turning yellow and purple. Could this cause a blood clot and be dangerous? – W.H.

ANSWER: The color change comes from blood that leaked into the tissues of your hand. It’s similar to a bruise. The change from black to purple to yellow indicates that the blood is being absorbed. This isn’t a danger. It won’t cause a blood clot. Warm, moist compresses can speed the process of blood absorption.

CORRECTION: Some time ago, I wrote that Lantus insulin could be mixed with other insulins. That’s an error. It should not be mixed with any other insulin.



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