DEAR DR. DONOHUE: Is there any polio anymore? In the early 1960s, my children and I got the sugar cubes. I wish to know if that vaccine is good for life. – M.S.

Polio vaccines eliminated the polio scourge in the United States. The last polio case naturally arising in the United States occurred in 1979. In 2005, an adult traveler came down with polio upon returning from an overseas trip. In that same year, an infant with a faulty immune system and four other children were infected with polio by a polio virus whose origin was never determined.

At one time, two polio vaccines were in use. One was an orally taken vaccine, and it contained live but weakened polio virus. The other was a vaccine with dead virus, and it was given by a shot. The oral polio vaccine gave rise to a handful of polio cases when the virus found its way to unimmunized children and adults. Now, only the inactivated vaccine is used.

Whether either vaccine provides lifelong immunity is a question that hasn’t been completely answered. Most authorities believe it does. Adults are not told to be revaccinated.

People traveling to the few countries where polio is still found are advised to be immunized if they were never vaccinated or if they didn’t complete a full series of the vaccine.

Travel agents can tell people what those countries are. Many hospitals have a department of travel medicine where people can also get this information and the vaccines needed for travel. The Centers for Disease Control and Prevention has a Web site that furnishes this information too. It is

DEAR DR. DONOHUE: I am a 77-year-old man, feeling fine and having four heart artery stents. Blood tests are fine except for bilirubin, which is 160 mg/dl. My doctor says there are plenty of other blood tests that show I am healthy, so I shouldn’t worry about it. I drink two or three beers in an afternoon, and that has been my practice for 60 years. I hope this is not the problem. What is your response? – D.C.

Bilirubin comes from the daily breakdown of worn-out red blood cells. The liver recycles it. If the liver isn’t working well, the bilirubin blood level rises. If it rises really high, the skin and the whites of the eyes turn yellow – jaundice. It’s an index, therefore, of liver health.

I know your lab bilirubin value isn’t 160. That would be a world record. It’s more likely 1.60. A normal bilirubin is 0.3 to 1.3 mg/dL (5.1 to 22 micromol/L). Your reading is higher than normal, but not very much so. Your doctor is right. There are other blood tests that also show liver malfunction. None of yours is abnormal. This slightly elevated bilirubin is, as your doctor said, not a worry.

DEAR DR. DONOHUE: I check my blood pressure on a home blood pressure monitor on my arm. It reads around 120/70.

They suggest you check your ankle blood pressure as well. When I try to check mine, the cuff comes off. I move it up my leg, and kicks off there, too. What can I do? – J.A.

ANSWER: You need a special instrument to take ankle blood pressure. Perhaps your doctor has that instrument.

Comparing the ankle and arm blood pressure provides useful information. The two readings should be about the same. If the leg blood pressure is much lower than the arm blood pressure, that indicates a blockage in a leg artery – peripheral artery disease.

Keep taking your arm blood pressure. It’s excellent now. Make sure it stays that way. Save the ankle blood pressure for your doctor.

DEAR DR. DONOHUE: I developed a sac on my right elbow, which feels like it contains liquid. This started about five weeks ago, and now my left elbow is starting in the same fashion. It does not hurt or stop me from any functions, including golf. I asked two doctors, and all they say is that if it doesn’t bother me, not to worry about it. I would still like to know more about it. – R.C.

My long-distance diagnosis is olecranon (elbow) bursitis. Bursae are scattered all over the body to prevent friction when tendons move across bones or, in this case, when skin moves over the elbow. You might have seen or heard of housemaid’s knee. It’s a swelling beneath the kneecap. The bursa in that location has filled with fluid. That’s the same process going on behind your elbow. Overuse is the usual cause. Or it can come from putting constant pressure on the elbows, as people do who rest their head in their hands with elbows propped on a desk.

Rest, anti-inflammatory agents and elbow pads make the fluid go away. If it’s not bothering you, the process can be ignored. If it is bothering you, a doctor can drain the fluid and can instill cortisone to prevent it from recurring.

Ask the two doctors if this is what you have. “Olecranon” is pronounced oh-LEK-ruh-nun.

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

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