DEAR DR. DONOHUE: Will you please discuss phantom limb pain? I am a World War II veteran and had to have a below-knee amputation due to injury. As I age, the phantom pain has become very severe. The medication I take no longer eases the pain.

As many combat veterans have had amputations, I am hoping that there have been new treatments for phantom pain that could help me. – N.H.

ANSWER: A very large number of amputees suffer from phantom sensations or phantom pain. Phantom sensations are the feeling that the missing limb is still there. Phantom pain is experiencing actual pain in the missing limb. It’s the brain where pain is appreciated. Even though we feel pain in a stubbed toe, the pain perception takes place in the brain, not in the toe. With phantom pain, areas of the brain that react to pain are stimulated just as they would be if the limb were still present.

The military has the greatest experience in and knowledge of treating this malady of any institution in the world. If you’re being treated at a Veterans Affairs hospital, I don’t think I can add anything to your care. If you are not, I can make a few suggestions.

Anti-seizure medicines like Tegretol and Neurontin might bring some relief. Nerve blocks and spinal-cord stimulation are two other techniques that could help.

A method employing a large mirror to rewire brain circuits is another approach. The mirror is positioned in such a way that the patient sees he or she has two complete limbs again. The brain becomes conscious of a healthy limb where the amputated limb was, and it suppresses the pain signals it had been generating.

You deserve the best treatment available. You made sacrifices for the rest of us. We should see that you are getting maximum care.

DEAR DR. DONOHUE: Communication between myself and my oldest daughter leaves much to be desired. She is 43. She recently told me that her kidneys are working at only 44 percent of capacity. She says it’s because of extreme stress resulting from an ugly divorce. What factors could have precipitated her declining kidney function? Should she be on a bland diet? – M.T.

ANSWER: Diabetes, uncontrolled high blood pressure, hardening of kidney arteries, an immune attack on the kidneys and narrowing of kidney arteries are some of the causes of kidney failure. Stress isn’t listed.

Your daughter’s doctor will tell her when and if dietary changes are necessary. Often the change consists of curtailing salt and protein.

DEAR DR. DONOHUE: About a month ago, I drove to the store, got my groceries and drove home. I stopped the car in the driveway and that’s the last thing I can remember.

Evidently I got out of the car, opened the garage door and drove the car in. I cannot recall any of this.

My doctor suggested I have my brain and neck arteries checked, and I did. All is clear. When I returned to the doctor, she said she knew of no reasons for my symptoms other than blocked blood flow. Any hints? – E.T.

ANSWER: It could be that you had an episode of transient global amnesia. It’s something that happens to older people, and the event lasts for six to 12 hours. It’s a sudden onset of disorientation where the person doesn’t know where he or she is or what he or she is doing. The affected individual cannot remember any events that occurred during the episode. It’s a blank page.

The basis for this disorder isn’t known. However, it is not an indication that a stroke is about to happen or that any serious health consequences will follow.

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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