Outlook for cystic fibrosis has greatly improved
DEAR DR. DONOHUE: My daughter had her first baby (our first grandchild) three months ago. The baby wasn’t gaining weight, and he coughed at night. The pediatrician diagnosed him as having cystic fibrosis. We don’t understand where this came from. No one on our side of the family has it, and no one in our son-in-law’s family has it. We would appreciate any information on this illness, like life expectancy. Thank you. — R.M.
ANSWER: Cystic fibrosis is a genetic illness. Two genes, one from each parent — neither of whom has any signs of illness — are necessary for the disease to manifest itself. The basic problem is a glitch in the way chloride enters and leaves cells. The defect leads to the production of thick, sticky secretions in the lungs and also in parts of the digestive tract, such as the pancreas and gallbladder. Often a parent detects a salty taste when kissing their cystic fibrosis child and that triggers the diagnosis.
Thick secretions in the breathing tubes (bronchi) are the reason for the baby’s cough. They’re also the reason for repeated respiratory infections. Medicines can dilate the clogged airways and can sometimes thin the sticky secretions. Antibiotics are needed at the first sign of a lung infection. Postural drainage and chest percussion drain the lungs of retained mucus, and newer techniques make the process more effective.
The same problems often affect the pancreas. Its production of digestive enzymes doesn’t reach the intestine because the pancreatic ducts become obstructed. Supplements of those enzymes are available in the form of medicines.
The life expectancy of a child with cystic fibrosis is difficult to predict. Some children are less severely affected than others. I can’t talk about this illness without telling about the young man I know who is in his late 30s and is actively pursuing his career as an accountant. He did have a lung transplant, something that many CF patients need. Now that the cystic fibrosis gene has been discovered, your grandson could expect novel gene treatments in his lifetime.
DEAR DR. DONOHUE: In the past six months, my menstrual periods have become incredibly painful. The pain is in the lower part of my abdomen, and it lasts about one day. I have put off seeing a doctor because the pain is gone before I can get an appointment to see one. What could this be? Is it serious? — M.O.
ANSWER: It could be a number of things. You don’t have to be in pain to see the doctor. Make an appointment and tell the doctor your symptoms. He or she can work from your description.
One possible diagnosis is mittelschmerz (MITT-ul-schmertz). It’s not a disease; it’s pain that arises when an ovum is released from the ovary. It happens in the middle of the cycle, the day of ovulation. The pain lasts anywhere from a few minutes to a few days.
What have you taken for the pain? You might find that Tylenol is all you need.
You realize this is only a guess. You have to have a doctor’s confirmation from a hands-on exam.
DEAR DR. DONOHUE: I am on a low-fat diet that prohibits me from drinking regular milk. I cannot stand skim milk. Does it have as much calcium as whole milk? I’m looking for a way to get out of drinking skim milk. — C.N.
ANSWER: Skim and whole milk have about the same amount of calcium, 300 mg in 8 ounces. Actually, skim milk has 5 mg more than whole milk has — an insignificant difference.
TO READERS: Questions on the common female problem fibroids are answered in the booklet with that name. Readers can obtain a copy by writing: Dr. Donohue — No. 1106, 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.