DEAR DR. DONOHUE: I had two abscesses in my liver. After nine days in the hospital, where I was on high doses of antibiotics, I was released to go home with drainage tubes still in my liver and with a supply of those strong antibiotics. No one knows what caused the abscesses. I don’t have any gallbladder trouble.

My liver is now fully healed, and the drains have been removed. The problem is that I am afraid of any little twitch that occurs in that area. Can you shed any light on why this happened? Can it happen again? – D.S.

ANSWER: An abscess is a walled-off collection of pus and germs. It can be found just about anywhere. A minor function of the liver is filtering the blood of foreign material, including germs. If a particularly aggressive germ or a horde of germs travels to the liver through the blood, the liver’s ability to fight those germs might not be great enough to prevent them from staying in the liver and multiplying. That’s one way that abscesses form in the liver.

Where did the germs come from? A good question. Germs can enter the body through minor nicks that a person isn’t cognizant of. Another way for a liver abscess to form is from an infected gallbladder or bile duct that has become obstructed with a stone. A special kind of liver abscess – an amebic abscess – comes about from an intestinal infection with an ameba that gets into the intestinal tract and from there heads for the liver. Amebic liver abscesses aren’t common in the U.S. or Canada. And for up to 30 percent of liver abscesses, no explanation can be given. Those abscesses are called cryptogenic.

Your reaction to any twitch in the upper-right corner of the abdomen is normal for someone who has gone through what you went through. It’s like suffering from post-traumatic stress disorder. In time, the memory of your liver abscess will dim, and you will not be thinking that you’re on the verge of getting another.

Is it possible for you to have a second liver abscess? Anything is possible, but it’s not probable. People are struck twice with lightening, but that truly happens most rarely; so, too, with a second liver abscess.

DEAR DR. DONOHUE: I have arthritis, and I am now using glucosamine/chondroitin for it. Before I started using that product, I was injected with cortisone, and I am scheduled for more injections. How safe is it to have these injections every four months? I know that too much cortisone in the system is not advisable. – F.B.

ANSWER: The cortisone drugs are potent drugs, the most potent drugs available for fighting inflammation. Strong drugs always have strong side effects. When used in high doses for prolonged periods, cortisone drugs have undesirable consequences. In some situations, they still must be used to save a life, and the side effects have to be tolerated.

Joint injection every four months doesn’t constitute excessive use. You will not get into trouble from getting cortisone on that schedule.

What’s the glucosamine/chondroitin doing for you? If your joints don’t hurt and you can use the pills, you might not need the cortisone shot.

DEAR DR. DONOHUE: My grandson is 13 years old. He is in good health. Once in a while he gets a throat infection and has mucus there.

His body is always hot to the touch. He doesn’t need to wear much clothing when it’s cold. Why is his body always hot to the touch? – A.S.

ANSWER: The fact is, the boy is healthy. The occasional sore throat happens to everyone. Mucus production is normal when the throat is sore.

As for the heat he generates, I’m not sure I can give you a correct answer. I have a nephew who is the same. He wears a T-shirt outside in the depth of winter and is never cold. Heat seems to radiate from him. He, too, is healthy. I believe that he, and perhaps your grandson, has a metabolism that is set on high. Both burn calories at a faster rate than the rest of us.

If you want to assure yourself that all is well, take his temperature. If it’s normal, then his body heat merely reflects a system that gets rid of the warmth coming from the combustion of calories. Nothing bad is happening.

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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