DEAR DR. DONOHUE: Since many have read of the tragic death of John Travolta’s son, we would like to know the cause of Kawasaki’s disease. Does something go haywire in the body? I understand this disease taxes the heart. Is Kawasaki’s disease found in other countries? – S.P.

ANSWER:
In 1968, Dr. T. Kawasaki, a Japanese physician, was the first to describe the illness that bears his name. It occurs throughout the world and mostly strikes children between the ages of 3 months and 5 years. The peak incidence is at 2 years. Adults, rarely if ever, contract the acute illness.

Signs of Kawasaki’s disease are dramatic. A fever of 104 F is not uncommon. The eyes become bloodshot. The mouth and throat are red, and the tongue looks like a strawberry. The hands and feet often swell. A red rash pops out on the skin and is most prominent in the groin. Neck lymph nodes are large.

The cause hasn’t been discovered. Many presume it’s an infection, but the infectious cause hasn’t been found.

Without treatment, the illness lasts about 12 days.

The complications of Kawasaki’s disease can be more dangerous than the original illness. That makes it somewhat like a strep throat, whose complication – rheumatic fever – is far worse than the sore throat. Treatment shortens the febrile illness and prevents the dangerous consequences that sometimes occur. The heart can become inflamed, and aneurysms can develop in heart arteries. (Aneurysms are artery wall weak spots that bulge outward like tiny balloons and can burst.) The illness can also inflame the pancreas, the kidneys and the respiratory tract.

Treatment consists of intravenous immunoglobulin (gamma globulin) and aspirin. It shortens the illness and prevents permanent heart and artery damage.

I don’t know the cause of John Travolta’s son’s death. I have read that he did suffer from Kawasaki disease as an infant. It’s best to leave this a private matter for the grieving Travoltas.

DEAR DR. DONOHUE: Will you repeat the article you wrote on removal of earwax? I failed to clip it out. This time I will. – M.V.

ANSWER:
Don’t attempt to remove earwax on your own if there’s a hole in the eardrum, if you have an ear infection or if you have any ear pain.

Warm some baby oil. Hot is not necessary; warm is fine. Put one or two drops in the ear and let the oil stay there for 10 minutes while you rest with that ear tilted to one side. Then, with a rubber-bulb syringe, found in all drugstores, flush the ear with warm water and let the water drain out by tilting the head toward the shoulder.

DEAR DR. DONOHUE: I am a 75-year-old who had an appendectomy at age 10. It left me with a small scar.

I have had a bulge in that area for several years. I have developed a dull ache there. It began several months ago. It’s not severe, but it is constant.

Please explain the difference between a hernia and adhesions. Is surgery at all beneficial? – L.F.

ANSWER:
Most hernias are in the abdominal area. They are defined as bulges through a weakness in the muscular abdominal wall. What bulges outward is the peritoneum, the lining of the abdominal cavity. With it, parts of the intestine can also poke through. The majority of hernias are found in the groin area of men. There’s a weak spot in that area because the testicles, which start out in the abdominal cavity, pass through a small defect in the muscle wall on their journey to the scrotum.

Surgical hernias are also common. The defect made by the scalpel might not entirely close. It’s a weak spot through which the abdominal lining can balloon out.

Adhesions are scars that form within the abdominal cavity. Prior surgery is often the cause. Strands of scar tissue can wrap around the intestine and obstruct it.

Surgery benefits hernias and adhesions.

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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