DEAR DR. DONOHUE: I plan to volunteer to be a kidney donor for my young niece, who suffers from kidney failure. She’s on dialysis now, but a new kidney would make her life much more enjoyable.

What complications might I encounter? What kinds of tests will I be put through? – K.S.

ANSWER:
Your willingness to donate a kidney is most generous and is a great credit to you. More than 60,000 people are on the waiting list for a kidney. Living donors account for a sizable number of transplanted kidneys. Nature has been bountiful to us in giving us two kidneys. A person can live quite well with only one. The only way to shorten the kidney waiting list is for other people to consider imitating your altruism.

Anything can go wrong with any surgery, but the complications from kidney donation are quite few in number. Infection is possible, as is an untoward reaction to anesthesia, but neither constitutes a big risk to you. The life span of a kidney donor is the same as the life span of a nondonor.

Your kidneys will be checked for their health with a battery of regular lab tests, both blood and urine. Your and your niece’s blood group will be determined for compatibility. You might be typed for other tissue compatibility too, but with today’s powerful anti-rejection medicines, more leeway between donor and recipient tissues is possible.

Most donors get back to work in two to three weeks following the operation. You’ll find that the surgery isn’t a great strain on you or your body.

DEAR DR. DONOHUE: After having problems for 12 years, my 34-year-old son has been told he has thoracic outlet syndrome. He has pain and numbness of his hand, chest and neck. How is this usually treated? – W.M.

ANSWER:
The chest cage is dome-shaped. At the top, as in some domes, is an oval opening – the thoracic outlet. It permits nerves and blood vessels coming from the chest to make their way to the head, neck and arms. Compression of those nerves, blood vessels or both gives rise to thoracic outlet syndrome.

The compression can come from an extra rib, arthritic spurs on the neck vertebrae, peculiar anatomy of the upper chest muscles, fibrous bands that have formed over the years or poor posture.

Nerve compression leads to weakness of the arm, hand or finger, or pain in any of those places. Compression of blood vessels brings on swelling, coldness or pain.

Your son would benefit from an exercise and stretching program, supervised by a physical therapist. The changes that contribute to thoracic outlet syndrome don’t happen overnight, so he can’t expect overnight results.

If therapy doesn’t straighten matters out and there is something physical pressing on nerves or blood vessels, surgical correction can be considered.

TO READERS: Chronic fatigue syndrome is an illness where overwhelming fatigue makes a person unable to function. The booklet on this common problem explains it and its treatments. Readers can obtain a copy by writing: Dr. Donohue – No. 304, 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: Does the grade of an egg indicate the amount of cholesterol in the egg? I mean does an AA egg have more cholesterol than a B egg? – R.T.

ANSWER:
Grading has nothing to do with an egg’s cholesterol content; it has to do with the size of the air pocket all eggs have. A small air pocket indicates a fresher egg. An AA rating indicates an air pocket of 1/8 inch or less, the smallest pocket.

Eggs have the same amount of cholesterol, around 212 mg.

DEAR DR. DONOHUE: I suffer from ITP. I have spent much time in the hospital getting blood transfusions or platelet transfusions. Prednisone is not the answer. I took it for 14 months. I have been on CellCept and danazol, and I am 85 percent better. Let America know. – G.S.

ANSWER:
ITP – immune (or idiopathic) thrombocytopenic purpura – happens to children and adults, but it follows a different course in children. I’m confining this discussion to adults.

“Immune” implies that the immune system is at fault. It coats platelets – the clot-forming cells – with antibodies, and thereby causes their death. “Thrombocyte” is another name for “platelet.” “Penic” means “deficiency.” Purpura are bruises, the result of having too few platelets. Why the immune system turns on platelets is something yet to be explained. Platelets form clots; without them, hemorrhages can occur.

In adults, ITP tends to be a chronic illness where the platelet count dips and rises. Sometimes it’s the consequence of hepatitis C infection, HIV infection or the illness lupus. More often, it has no associated illness. It just appears out of the blue.

Treatments are many. Prednisone – a cortisone medicine – is a popular treatment and works for many. Immune globulin is another effective treatment. When medicines fail, removal of the spleen often raises the platelet count, for it’s the spleen that gobbles up antibody-coated platelets. Newer treatments include the drug rituximab, originally a treatment for some cancers. It has been used for ITP, since it has an effect on immune destruction of platelets. Your danazol is a synthetic male hormone that also has been used in ITP.

I am not familiar with the use of CellCept. It’s a medicine that prevents rejection of transplanted tissues. I can see how it might fit in for ITP, but I don’t know how extensively it’s used for it. I am glad it has worked for you.

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.


Only subscribers are eligible to post comments. Please subscribe or to participate in the conversation. Here’s why.

Use the form below to reset your password. When you've submitted your account email, we will send an email with a reset code.