DEAR DR. DONOHUE: I have a problem with bladder infections. I have been getting one every month for the past three years. I am a 49-year-old female. My doctor gives me Cipro and the infection goes away, but it returns in a month. I have tried some other antibiotics with the same result. A doctor examined my bladder with a scope and found nothing wrong. Do you have any ideas on what I could do? – L.H.

ANSWER: Recurring bladder infections plague many women. They have to do with female anatomy. The female urethra – the tube that drains the bladder – is much shorter than the male urethra, and it opens to the outside world in a place where there is luxuriant bacterial growth. Bacteria can ascend up the urethra to the bladder with ease. Sexual relations contribute to the problem because contact massages bacteria into the urethra.

Some steps should be taken. One is a culture of your urine to see if this is the same recurring bacterium and to determine its sensitivity to antibiotics. You might have a resistant germ, one that no longer completely responds to Cipro or the other medicines you have taken.

One way of handling this problem is to stay on a small dose of antibiotic daily or three times a week for a protracted period of time so that eradication of the bacterium takes place. Bactrim (sulfamethoxazole with trimethoprim) and nitrofurantoin are two antibiotics often chosen.

Or your doctor can give you a prescription for antibiotics to have on hand. You start them immediately when symptoms arise. Early treatment increases the chance of completely getting rid of the germ.

A third option is to take an antibiotic after intercourse.

Cranberry juice (not cranberry cocktail) has helped many to stave off repeat bladder infections. The dose is 8 ounces a day (one glass).

The booklet on urinary tract infections explains this common disorder in detail. Readers can obtain a copy by writing: Dr. Donohue – No. 1204, 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: My son-in-law was raised on a farm, and he says he drank milk straight from the cow. He insists that his children drink unpasteurized milk. He claims it is more nutritious and tastes better. Is this harmful for the children? – L.B.

ANSWER: Pasteurization greatly reduces the number of disease-causing bacteria that can make their way into milk. All that’s involved is heating the milk to a certain temperature for a few seconds. Individual states can allow the sale of unpasteurized milk, but such milk cannot be sold between states.

I can supply your son-in-law with the names of the illnesses that are potentially transmitted by raw milk if he wants them.

The nutritional value of pasteurized milk is the same as that of unpasteurized milk. It has the same mineral and vitamin content. There is a slight reduction, anywhere from 1 percent to 10 percent, in the amount of vitamin C, but that’s not enough to quibble about.

I can’t vouch for the taste of unpasteurized milk. I have never tasted it and have no intention of doing so.

DEAR DR. DONOHUE: In the morning, my heart rate is 100 to 120 beats a minute. In about an hour it goes back to 60 to 80 beats a minute. Throughout the day, for short periods of time, I think I am going to lose consciousness. I take a deep breath, pray and walk around, and the feeling goes. It’s worse when I am alone or about to do something unhealthy, like eat takeout food or drink a few beers. What is wrong? – T.S.

ANSWER: I think those are anxiety attacks, and the morning fast heartbeat could result from such an attack. To be on the safe side, tell your doctor. The doctor might want you to wear a heart monitor so the nature of the fast beat can be better studied.

The doctor also might be able to discover the psychological process that’s giving rise to these feelings. If he can’t, he can recommend someone who can.

DEAR DR. DONOHUE: I am very worried about my 68-year-old boyfriend. He has type 2 diabetes. He eats sugar without control – cakes, ice cream, regular soda pop. Most of the time, his sugar is over 300, sometimes over 480. He takes medicine for his diabetes, so he thinks he can eat whatever he wants. What can happen? – G.A.

ANSWER: You have justification to be worried. So does your boyfriend. Uncontrolled diabetes leads to artery hardening, strokes, heart attacks, nerve damage, kidney failure and blindness. Medicine is only a part of the treatment. Diet is the other part. He must limit his total daily carbohydrates, not just sugar. Carbohydrates are starches and sugars. The only way he’ll come to grips with this is to talk to a dietitian or a certified diabetes counselor. He should do so quickly.

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.