DEAR DR. DONOHUE: I am a 79-year-old woman. This month I was diagnosed with an acoustic neuroma. I had never been dizzy until this came on me. In addition, my balance is off and I stagger. The tumor is small. Is there any treatment I can have beside surgery? – E.J.

ANSWER:
An acoustic neuroma is benign in the sense it isn’t cancer, but it’s not benign in the symptoms it produces. It’s a tumor of the insulating material that wraps around the eighth cranial nerve. Cranial nerves are 12 nerves coming directly from the brain. The eighth one transmits sound signals to the brain for hearing perception, and it also transfers signals that keep us balanced. A mix-up of those second signals leads to dizziness and imbalance. Symptoms of an acoustic neuroma are one-sided hearing loss, dizziness and ear noises – one or all of them.

Acoustic neuromas are usually small growths that cause big problems. If a person has symptoms, regardless of tumor size, treatment is recommended. In older people, small tumors that create no symptoms can be watched, since they are slow-growing.

Two procedures that get rid of these tumors without surgery are the Gamma knife and Cyber knife. No knives are involved, even though the word appears in their names. In these treatments, radiation is directed at the tumor to kill it. Fractionated Stereotactic Radiosurgery also employs radiation that’s accomplished with fewer treatments and entirely as an outpatient. If you’re interested in this method, a very good one, you can contact Dr. Gil Lederman at his e-mail address: [email protected] He practices in New York City and has many years experience in this technique. It’s less likely to produce hearing loss.

Two organizations provide people with up-to-date information on acoustic neuromas and their treatment. One is the Acoustic Neuroma Association (1-877-200-8211; www.anausa.org) and the other is the Acoustic Neuroma Association of Canada (800-561-2622; www.anac.ca).

DEAR DR. DONOHUE: I beg to differ with you that 48 is too young for Alzheimer’s disease. Four of my dad’s siblings had it at a young age, as do my brother and a cousin. – R.C.

ANSWER:
The common variety of Alzheimer’s disease appears after age 65. Age is the greatest factor in acquiring it. The less-common kind of the illness, early onset Alzheimer’s disease, can come on between the ages of 30 and 60. Genetics influences both, but it has a much greater influence on the early onset variety.

Both have similar features: loss of memory, inability to perform the routine tasks of life like dressing and eating, poor judgment and disorientation.

The booklet on Alzheimer’s disease discusses its symptoms and how to cope with them. Readers can obtain a copy by writing: Dr. Donohue – No. 903, 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: Exactly what is dementia? How does dementia differ from Alzheimer’s disease? What are the symptoms of dementia? – L.W.

ANSWER:
Dementia and Alzheimer’s disease don’t differ. Dementia is a word that denotes all illnesses featuring memory loss, poor judgment, the inability to carry out simple mental functions like balancing a checkbook, disorientation and the failure to recognize close relatives and once-familiar faces.

Alzheimer’s disease accounts for more than 50 percent of all dementia cases.

Other dementia illnesses include multiple small strokes, Lewy body disease, Pick’s disease, Creutzfeldt-Jakob disease and frontotemporal dementia. These illnesses differ in some respects, like in the age of onset, the rate of progression and some symptoms unique to each of these illnesses.

DEAR DR. DONOHUE: My daughter is 36. Two years ago, she fractured her hip. While recovering from that, she fractured a bone in her foot. Ever since, she has had a lot of swelling in her body, especially her face and stomach. She has a fatty hump on the back of her neck. Doctors have checked her for many things. The tests for Cushing’s disease have come back positive. She takes a water pill. Her blood pressure is a little high. Please explain this. – B.S.

ANSWER:
Thin, fragile skin, a rise in blood pressure, a moon face, an increase in abdominal fat, muscle weakness and facial hair in women are some of the signs of Cushing’s disease. A mound of fat below the back of the neck is another sign, and it’s called a buffalo hump. Osteoporosis – fragile bones that break easily – is another Cushing’s consequence. The swelling of your daughter’s face and stomach might actually be fat, and, as I mentioned, it’s a typical Cushing’s sign. All of these signs and symptoms result from an overproduction of cortisone, something many people think is found only in medicine form. Our adrenal glands make it, and it’s necessary for life. Too much of it, however, causes all sorts of mischief.

If her doctors say she has Cushing’s disease, their next job is finding its source. It could be her pituitary gland, a small gland at the base of the brain. It makes the hormone ACTH, which stimulates the adrenal glands’ production of cortisone. Tumors of the pituitary gland release too much ACTH, with the result being too much cortisone. Or, in fewer instances, the adrenal glands themselves might, on their own, be the overproducers of cortisone, with the same resulting signs and symptoms.

Surgical removal of the tumor – pituitary or adrenal – is the cure in most instances. Your daughter must undergo more tests to locate the source of the trouble: the pituitary or the adrenal. Scans and ultrasound pictures can pinpoint the correct site.

TO READERS: The booklet on peripheral vascular disease answers the common questions asked about this prevalent problem. To order a copy, write: Dr. Donohue – No. 109, 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.

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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