DEAR DR. DONOHUE: I am writing to ask if you would give me information on interstitial cystitis. I was told I had this after I had a polyp removed from my bladder. I know it has to do with the lining of the bladder wall. What causes it? What’s the treatment? Does it get worse? – J.M.

ANSWER:
Interstitial cystitis is also known as painful bladder syndrome. It’s a fairly common condition that is commonly misdiagnosed. It affects more women than men. It occurs at any age, but typically, the onset is around age 40.

Frequently, a woman has symptoms for years and years and is told she has repeated bladder infections. Antibiotics, however, provide no relief. Trips to the bathroom are numerous, and nighttime urination disrupts sleep. Bladder pain can be severe. Urination often relieves the pain temporarily. Intercourse also can be painful.

One explanation says the protective covering of the bladder lining has thinned or has disappeared, and urine irritants come in contact with the sensitive bladder lining to produce pain. How this comes about is something that isn’t known with certainty.

Symptoms can get worse, but treatments exist. One is the oral medicine Elmiron. Amitriptyline and gabapentin are also used for pain control.

If you find that a particular food causes increased pain, stay away from it. Spicy foods, citrus fruits and juices, tomatoes, chocolate, coffee, tea, carbonated drinks and alcohol are some things on the list of irritants for many with this problem.

If you feel lost about the diagnosis and its treatment, contact the Interstitial Cystitis Association (800-435-7422; www.ichelp.org) for information on treatment and support for this mystifying ailment that can completely throw life into turmoil.

DEAR DR. DONOHUE: My doctor prescribed niacin to lower my cholesterol. After a month and a half, I developed shingles. Could niacin have caused this? – J.

ANSWER:
I can assure you, without equivocation, that niacin did not cause your shingles.

Shingles comes from the chickenpox virus that stays in the body from the time of its entrance in the body until the time of that person’s death. Mostly at older ages, the virus leaves the nerve cell it found a home in, travels down the nerve root to the skin and produces the typical shingles rash and pain.

Older people should consider getting the shingles vaccine.

Shingles is a painful experience, and the pain can last long after the rash has gone. The shingles booklet explains this common problem and how it’s treated. To obtain a copy, write: Dr. Donohue – No. 1201, 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: I read in your column about Vaniqa cream to stop the growth of facial hair and used a tube of it. Then I asked my doctor for a repeat prescription. He said the cream was no longer being made. Apparently production costs exceeded revenue. A check of local pharmacies confirmed this. I just wanted to update you on it. – P.W.

ANSWER:
Thanks so much for writing. However, I just finished speaking to the company that makes this cream, and they tell me they are still in business and are still producing the product. If you want to check, the Website is www.skinmedica.com.

It’s not a wonder cream, but it is pretty effective in controlling facial hair growth in women.

DEAR DR. DONOHUE: I am a 60-year-old male, and I have a yearly physical exam. This year’s blood tests showed I have a high calcium level. My doctor thinks my parathyroid glands are responsible and has me scheduled to see an endocrinologist. I haven’t seen him yet. I am healthy, have no symptoms and play on a senior hockey team. My doctor tells me this is going to involve an operation. Will you discuss this situation? – L.F.

ANSWER: When you wrap your hands arou
nd your lower neck, you’re wrapping them around your thyroid gland. Behind the thyroid gland are four small glands, the parathyroid glands. Their job is to keep blood calcium in the normal range. When one of these four glands pours out too much parathyroid hormone, blood calcium rises, and the consequences can be many.

The specialist will undoubtedly recheck your calcium. If it’s high again, then he will want to have your blood parathyroid hormone level measured. A high reading for that pretty well clinches the diagnosis of hyperparathyroidism – an overproducing parathyroid gland.

What comes next depends on a person’s age, symptoms and how greatly elevated the calcium reading is. About half the patients with hyperparathyroidism have no symptoms. If they are older and their blood calcium isn’t too high, many of these people can be monitored by periodic checks of their calcium. Symptoms of an overactive gland include bone breaks due to osteoporosis, kidney stones and stomach pain – bones, stones and groans. Some patients lose their appetite, suffer from constipation, are constantly thirsty and, because of that, are constantly drinking water, so they urinate frequently.

Only if you have some signs that your body is suffering from the too-high blood calcium would surgery be done soon. If, as you say, you are healthy, your bones are not affected and you have no other symptoms, then the doctor might decide to put off surgical treatment. If you have osteoporosis, he will probably prescribe one of the common osteoporosis medicines like Fosamax or Actonel.

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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