Small navel hernia not usually troublesome
DEAR DR. DONOHUE: I am 65 and in good health. Recently during a physical, my doctor pointed to my belly button and said, “You have a hernia.” I had noticed a year ago that my belly button went from an innie to an outie, but didn’t give the matter much thought. The doctor said that unless it causes problems, I don’t need to do anything about it. Now I am very aware of the whole area and feel some tightness in the abdomen there. I am trying to figure out if the hernia is causing actual physical problems or if it’s just a psychosomatic thing, since I’m prone to anxiety. Does a person definitely know when the time comes for surgery? Are there any dire consequences from doing nothing? — R.F.
ANSWER: All hernias are protrusions of an internal organ or tissues through a weak spot in the muscular wall that keeps those structures in place. The navel (belly button, umbilicus) is a scar left over from where the umbilical cord attaches during fetal life. Many umbilical hernias develop early in life — at birth or shortly after — because of imperfect closure of the umbilical cord attachment. They usually heal on their own. If they don’t by age 5, surgery is done.
In adults, such a hernia comes about from a weakening of the scar tissue that closed over the umbilical cord defect. A small umbilical hernia that causes no symptoms can be ignored. Yours is in that category. There are no dire consequences from doing nothing.
How do you know when the time for surgery arrives? Believe me, it’s hard not to know. The hernia becomes progressively larger, the bulge cannot be pushed back into the abdominal cavity or you have pain severe enough to alert you that prompt attention is needed.
Stop thinking about this hernia. You’re not sitting on a time bomb. It’s not going to explode or kill you.
DEAR DR. DONOHUE: A rare disease recently took my husband — pulmonary fibrosis. At first he was diagnosed with scarring on the chest, but we never got an explanation of what it was or what caused it. He quit smoking at a young age. When he got sick, we thought it was pneumonia, but he was gone in six months. Explain this terrible disease so others will be aware of it. — A.H.
ANSWER: You have my condolences on the loss of your husband.
Your husband didn’t have scarring ON his chest, but IN his chest, in his lungs. For reasons that are unknown, strands of collagen crisscrossed his lungs and impaired the passage of oxygen into his blood. Those strands are the “fibrosis” of pulmonary fibrosis, and they’re the same stuff that forms scars. As a result, a pulmonary fibrosis patient is very short of breath on the slightest physical exertion and often at rest, and frequently has a dry cough.
No cure medicine has yet been found for this disease. Many medicines have been tried. Prednisone is one. It doesn’t halt the process, but it might make some patients a bit more comfortable. Oxygen makes life more livable for patients. The ultimate treatment is lung transplant. However, with the shortage of lungs and the relatively short course taken by pulmonary fibrosis, this option is rarely feasible.
DEAR DR. DONOHUE: My marriage is almost at its end. My wife has a routine of sleeping in our 4-1/2-year-old daughter’s bed, and has done so for three years. When my wife attempted (once or twice) to have the child sleep alone, the little girl went into a terrible tantrum. My wife refuses to believe this arrangement is a problem. She says, “She’s my daughter, and I’ll sleep with her because she is only little for a short time.” — Anon.
ANSWER: Your wife should wean your daughter from this arrangement not only to save your marriage, but to promote a mentally healthy and independent child. Your wife is fostering behavior that is not geared toward teaching the child to become a self-reliant child and eventually a self-reliant adult. That’s as much a parental responsibility as is providing food for her.
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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