DEAR DR. DONOHUE: I need some gallstone information. I had some minor stomach pain and saw my doctor. He thought it best that I have an ultrasound. Gallstones were found. The doctor doesn’t believe they caused my pain, and I know he’s right because the pain has gone completely. Is it OK to leave stones in the gallbladder? Why do they form? – G.K.

ANSWER: Age is one factor in gallstone formation. Being overweight, not being physically active and having a family history of gallstones also figure into their formation. So does rapid weight loss. Still, you will find people who have gallstones who fit into none of these categories.

Most gallstones are composed of cholesterol. However, it’s not high blood levels of cholesterol that have an impact on their appearance, it’s a high level of cholesterol in bile that leads to their formation. Bile is the digestive juice made in the liver and stored in the gallbladder. When bile is saturated with cholesterol, cholesterol crystals form and eventually enlarge into stones.

Most people with gallstones (70 percent) have silent stones, ones that cause neither pain nor trouble. These people don’t need to have their gallbladder removed.

On the other hand, people who have suffered a true gallbladder attack are best served by gallbladder removal. The pain of a gallbladder attack comes on suddenly and is felt in the upper middle of the abdomen or on its upper right side. Sometimes it radiates to the right shoulder blade or the area between the shoulder blades. The pain worsens when a person inhales, a valuable sign of gallbladder trouble. Nausea and vomiting are common during an attack.

You don’t need an operation, and you probably never will.

DEAR DR. DONOHUE: I think I was born tired. I drag around all day long, and it’s getting worse. My doctor is trying to find out what’s wrong. I don’t have an anemia, but the current question centers on the thyroid gland.

I worry whether I have to take thyroid medicine. I hear it makes people gain weight. I don’t want to trade one bad thing for another. Is weight gain an issue with thyroid medicine? – K.L.

ANSWER: You are speaking of thyroid hormone medicine for people who aren’t making enough of it. That’s called hypothyroidism, and it comes about for many reasons. The treatment is supplying the missing thyroid hormone in pill form.

Thyroid hormone speeds metabolism. People who take it usually lose weight, at least initially. It has been inappropriately prescribed for weight loss in the past. That’s not happening so much these days.

DEAR DR. DONOHUE: My husband is currently hospitalized to repair an aneurysm on his aorta. Today I visited him, and in came the surgeon and a young medical student. The doctor introduced the student to us as Dr. X and said he would be assisting in my husband’s operation. Do medical students usually assist in operations? – N.O.

ANSWER: Medical students often are helpers in operations, but they aren’t given major roles in the procedure. I bet the doctor to whom you were introduced is a resident. Residents have graduated from medical school and are licensed doctors. They learn specialty medical fields by assisting those who have already had such formal training. Hospitals where there are residents are hospitals that provide the best patient care. The resident operates under supervision.

DEAR DR. DONOHUE: I know someone who is a nut for flowers. She always has a vase of cut flowers. She tells me that she adds Viagra to the flowers’ water to extend their lives. Does this make any sense? – W.H.

ANSWER: I have heard that Viagra, the medicine for erectile dysfunction, is used to extend the life of cut flowers. Viagra promotes the production of nitric oxide, and that might be the reason why it lengthens flower life. I don’t know if this is true. I wouldn’t spend any money trying it out.

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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