DEAR DR. DONOHUE: My husband had blood work for a cholesterol study. It included something called lipoprotein (a), something we never heard of. It was over the normal value. I called my doctor, but he was on vacation, so I left word for the covering doctor. A phone call came from his secretary, who said: “He didn’t say anything, so I guess it’s OK.” I want answers. Will you explain this to me? – F.

ANSWER:
Lipoprotein (a), spoken as “lipoprotein little a,” is another cholesterol fraction that is an independent risk for artery clogging and heart attacks. It’s different from LDL cholesterol (bad cholesterol) and HDL cholesterol (good cholesterol).

Frankly, at the present, doctors find it hard to counsel patients about lipoprotein (a), so most don’t order it.

Now emphasis is placed on lowering LDL cholesterol (your husband’s value is very good) and raising HDL cholesterol (again your husband’s was very good). I will trade places with him if he wishes, and I’ll take his lipoprotein (a) reading to boot.

I can tell you what lowers lipoprotein (a). Niacin does. There is no proof, however, that lowering it lowers the risk of a heart attack. Daily exercise of 30 minutes also brings it down, if the doctor approves of exercise for a person.

As does losing weight if that applies. A low-fat diet high in vegetables, fruits and grains is another way of reducing lipoprotein (a). From his other cholesterol values, I’d say he must be doing some of this anyway. All of this, except for niacin, is the much-preached recipe for heart health regardless of lipoprotein (a).

Until told otherwise, put lipoprotein (a) on a back burner.

DEAR DR. DONOHUE: I read your article on actinic keratoses. Why not mention seborrheic keratoses? I am covered with them. They’re supposed to be harmless.

I got treated for one, and it cost me $20. I can’t afford to get rid of all of them. Wouldn’t it be worthwhile to mention this type? – A.W.

ANSWER:
Seborrheic keratoses are oval, slightly raised, tan to brown to black patches, usually less than an inch (2.54 cm) in diameter and found on the chest, back, scalp, face, neck and sometimes the arms and legs. They might itch, but for most, they’re just there and don’t cause any discomfort. They look like they’ve been pasted onto the skin. They’re extremely common. Look around, and you’ll see them on older people. Because of the age factor, they were called senile keratoses. Since they can pop out on younger people, the “senile” has been dropped. Some people have hundreds of them.

They aren’t cancer, and they don’t become cancer.

Doctors can freeze them off or scrape them off. Twenty dollars for removing one sounds a bit steep to me. Can you work out a deal with the doctor to take care of a batch at one time at a reduced price? You don’t have to have them removed.

Actinic keratoses are sun-caused skin patches that begin their lives as a roughened spot with an adherent, yellow crust.

The spot keeps growing and thickening. It occurs on skin exposed to sunlight. These keratoses have to be removed, because they can turn into skin cancer.

DEAR DR. DONOHUE: I found myself in my car, stopped at a stop sign, just blocks from my home. I was not quite sure where I was, was unaware of how I got there and did not remember where I was headed. Things did return to normal. Since then, my short-term memory has been questionable. Is it too early (age 48) for Alzheimer’s disease? – D.K.

ANSWER:
Forty-eight is too young for the more common Alzheimer’s variety. Your story suggests transient global amnesia, a temporary loss of memory with disorientation. An affected person is befuddled by the locale, why he’s there and what he’s doing. Such an episode isn’t a warning of future problems.

Others things can cause a similar reaction – a tiny stroke, a migraine or even a seizure originating in the temporal lobe of the brain. Play it safe by consulting a neurologist.

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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