DEAR DR. DONOHUE: I am 75 and had a heart attack five years ago. My doctor discovered something suspicious in my stomach and sent me for an ultrasound. It turns out I have an aortic aneurysm. I was then referred to a vascular surgeon who examined me and reviewed the ultrasound pictures. He says we’ll “watch” it. Just what does that mean? I just as soon do something about it than sit and watch it. Is he putting me off surgery because I have had a heart attack? – W.S.

ANSWER: An aneurysm is a bulge of an artery wall, and it represents a potential weak spot, one that can break and lead to a hemorrhage. Aneurysms can pop up on any artery, but they are most common on the aorta, the body’s largest artery, which courses downward from the heart to the bottom of the abdomen.

The usual place for an aortic aneurysm is the section of the aorta in the abdominal cavity. Most people have no symptoms from it. Your doctor must have felt something pulsating when he examined you, and that pulsation turned out to be an aneurysm.

It’s the size of the aneurysm that determines treatment. Aneurysms less than 5.5 cm (2.16 inches) in diameter can safely be watched with serial ultrasounds. Aneurysms larger than that are usually operated on right away, because they are the ones likely to burst.

Your past heart attack didn’t influence your doctor’s decision about whether your heart is healthy enough to withstand surgery, and it should be. If it isn’t that healthy, treatment can still be given to someone in your shoes if you need treatment. A graft-stent – a sleevelike device inserted through the skin into a groin artery and from there into the aorta – can shore up the aneurysm bulge. It isn’t as taxing a procedure as surgical repair. Apparently you don’t need that procedure now either.

DEAR DR. DONOHUE: I have a bald spot on the right and left sides of my head. I am a male, 29 years old. Could this be ringworm? My girlfriend thinks so, and she’s afraid she’ll catch it. What do I do? – N.Y.

ANSWER: It could be ringworm but the odds are against it. Ringworm happens mostly to children. It’s a fungal infection.

Probably, the two bald spots represent alopecia (AL-uh-PEA-she-uh) areata (air-ee-AH-tuh). It’s an immune attack on hair follicles that leaves bare, oval patches on the scalp. The patches have a diameter usually between 1 and 2 inches in diameter. Some people have only one or two patches. Others have many, which gives the head a moth-eaten appearance.

This condition happens to men and women who are usually younger than 30. Eighty percent see regrowth of their hair in a year, even without treatment.

For a faster return of hair, doctors can inject the bald patches with a cortisone drug. There are other remedies too.

A dermatologist should confirm this for you. Simple tests can tell if this really is alopecia areata.

DEAR DR. DONOHUE: Does calcium cause prostate cancer? If it does, I’ll stop drinking milk. – J.K.

ANSWER: Some studies have suggested a link between calcium intake and prostate cancer, but the link isn’t so strong that you need to reduce the recommended daily consumption of calcium – 1,200 mg/day for those 51 and older.

The booklet on prostate cancer and prostate enlargement outlines the facts on both these conditions and their treatments. Readers can order a copy by writing: Dr. Donohue – No. 1001, 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.

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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