DEAR DR. DONOHUE: When my brother was 47, he died of a stroke caused by bleeding in his brain. He was fine one minute, and the next he was in a coma. An autopsy showed he had had an aneurysm that ruptured. I have four other brothers and three sisters. Should we all be checked for an aneurysm? I am now 66. – W.C.

ANSWER:
An aneurysm is a weak spot on an artery wall. It looks like a blister. Aneurysms can develop on any artery, but they are mostly found on the aorta and on brain arteries. Should the aneurysm break, bleeding can be catastrophic.

Ruptured brain aneurysms account for 10 percent of strokes, and frequently they occur in younger people, ones not thought to be at risk of a stroke. The story is much like your brother’s. A person, apparently in good health, complains of having the worst headache ever. Then he or she might lapse into unconsciousness briefly. They might have a seizure. The mortality of a ruptured brain aneurysm is high, more than 50 percent.

First-degree relatives of a person who had a brain aneurysm have an increased risk of also having one, but the risk is relatively small, about 1 percent to 4.7 percent. A first-degree relative is a parent, brother, sister or child. The best way to detect a brain aneurysm is a special kind of scan called magnetic resonance angiography. It’s a magnetic resonance imaging – MRI – scan with dye injected into the arteries to outline any aneurysm. Most authorities don’t recommend screening first-degree relatives, because their risk is small and the procedure carries an equally small danger.

The booklet on stroke explains this common and sometimes crippling condition. Readers can obtain a copy by writing: Dr. Donohue – No. 902, 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: I know what sugar diabetes is. It runs in my family. I don’t know what diabetes insipidus is. I have a dear friend who has it. Is it related to sugar diabetes? – N.B.

ANSWER:
The only thing these two illnesses have in common is the production of large volumes of urine. The word “diabetes” means “a running through” — urination. In sugar diabetes, the high blood sugar draws water into the urine and leads to voluminous amounts of it.

Diabetes insipidus leads to excessive urine because there’s a lack of antidiuretic hormone, also called vasopressin. This hormone stops the production of urine to keep body fluids at the appropriate level. The hormone is produced and released by the pituitary gland and the adjacent brain region called the hypothalamus. Head trauma, brain tumors and a handful of other causes upset the production and release of that hormone. Sometimes the hormone deficit arises without an identifiable cause.

Treatment is treatment of the underlying cause, if one is found. Replacement of the missing hormone stops the excessive urination.

DEAR DR. DONOHUE: My 46-year-old son was a blue baby and had a heart operation when he was a small infant. The operation was a success, and he was a healthy boy and is a healthy adult. He has five children. None of his children had the same heart problem. Did the blood transfusions he had during and after the operation change his genes so he didn’t pass the heart defect to his children? – S.R.

ANSWER:
Blood transfusions don’t change a person’s genetic makeup.

A blue baby is one with a heart defect that prevents oxygen from finding its way into the circulating blood. Something happened during fetal development that resulted in abnormal heart construction. Your son’s operation corrected the defect.

DEAR DR. DONOHUE: I have read that omega-3 is good for joint pain. Is it safe to take if you are on the medicines I’m taking? – S.G.

ANSWER:
On your list of medicines, I find none that interferes with omega-3 fatty acids, or any with which omega-3 fatty acids interfere.

Omega-3 fatty acids are things that make fish and fish oil such healthful foods. Their names are DHA, docosahexaenoic acid, and EPA, eicosapentaenoic acid. The American Heart Association endorses omega-3s for prevention of a second heart attack. Others tout them for prevention of first heart attacks and strokes.

Apparently, they have anti-inflammatory properties that can reduce joint tenderness.

It’s safe for you to try them.

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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