DEAR DR. DONOHUE: My mother fell last week. Her legs gave out, and she had no feeling in them. Her arms became numb, too. The doctors diagnosed Guillain-Barre syndrome. They said it’s a virus that attacks nerves and causes paralysis. What is this? What is the prognosis? Will she walk again? She just returned from a trip, and she had intestinal problems the last day. This was about two weeks ago. – S.S.

Guillain-Barre (gee-YAWN buh-RAY) syndrome is believed to be an autoimmune illness, one of those diseases in which the immune system turns on its own body – in this case, its nerves. Antibodies against the nerves’ insulating material, myelin, cause it to crumble and the nerves to short-circuit.

Often, the first sign of trouble is numbness or pins-and-needles sensations in the feet. Shortly after that, the legs weaken, and the weakness progresses upward in the body. It can reach the breathing muscles. When that happens, the person has to be placed on a ventilator.

In about two weeks, the paralysis reaches its maximum point and the condition then stabilizes. After that stage, recovery begins. In one year, 80 percent are fully recovered; 10 percent are left with deficits that might disappear in two to five years. About 5 percent die from this illness.

Most often, two weeks before the paralysis, the person had a respiratory infection like a cold or an intestinal infection such as diarrhea. It’s that infection that triggers the immune response.

Treatment is either with intravenous immunoglobulin (gamma globulin) or with plasma exchange, a technique that removes the destructive antibodies from the blood.

My 18-year-old nephew had Guillain-Barre syndrome last summer and recovered from it completely. I wish the same for your mother.

DEAR DR. DONOHUE: Where does the body’s energy come from? All my life, until three years ago, I had so much energy that I could labor 12 to 16 hours without getting tired. Now that’s gone. After spending a few hours in the garden, I have no energy left for the next six days. Does energy come from the heart? Muscles? Lungs? – S.K.

The energy that makes muscles move comes from stored sugar (glycogen) and from fat. They are the fuel for muscle action.

However, there are many body processes involved in combating fatigue. A thyroid gland operating at low levels leaves a person without any pep. Adrenal-gland failure is another cause of energy loss. Anemia makes physical labor difficult. A failing heart is another cause for being burned out. Lungs that can’t provide enough oxygen make work impossible.

Unless your diet has changed radically, you probably have enough stored glycogen and fat to supply your muscles. You really should investigate some of these other causes of stamina loss.

DEAR DR. DONOHUE: Please explain the difference between bright-red and dark-red blood in the stool. Does a colonoscopy help determine where the blood originates? – R.R.

Bright-red blood in the stool indicates the source of bleeding is near the anus – hemorrhoids, fissures or rectal cancer. Dark-red blood indicates the problem is farther up in the colon. The color change occurs because of the time lapse involved in the stool’s passage from a more distant site.

Tarry black stools are a sign that bleeding occurs high in the digestive tract. Examples are a stomach or duodenal ulcer.

A colonoscopy is one of the best ways of find where bleeding comes from.

DEAR DR. DONOHUE: Forty years ago, I was infected with gonorrhea. I was in my 20s. They treated me with penicillin, and the infection cleared quickly.

This past year, I had a prostate gland infection. Could that have been the old gonorrhea germ that stayed with me from my 20s? – R.K.

ANSWER: With adequate antibiotic treatment and with a resolution of signs and symptoms, the gonorrhea germ is eradicated. At the time you were treated, penicillin was effective treatment for all gonorrhea strains. It is not one of those infections that live in the body forever.

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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