Persistant yeast infections are a problem for women

DEAR DR. DONOHUE: I have had a vaginal yeast infection for three years. I was retested, and it is a yeast infection. I tried over-the-counter stuff, and my doctor prescribed one thing after another. I have type 2 diabetes, and I know it makes me prone to yeast infection, but this is ridiculous. What is the best possible cure? I take probiotics and eat yogurt daily. I need help. — B.K.

ANSWER: The yeast most often responsible for vaginal infections is Candida (CAN-duh-duh). It is found in small numbers in many women’s vagina. When something upsets the balance of the normal vaginal inhabitants, the yeast population soars, and troubles begin. Antibiotics given for some other reason often are the reason Candida grows out of hand. Candida infection produces a discharge that is thick, white and curdlike, but it also can be scanty and thin. Swelling of adjacent skin occurs. Itching is often present. Painful urination and painful intercourse can result. Candida infections that persist or recur are called complicated infections. In such instances, a culture should be done to be sure of the true cause; you had that. Testing the yeast for its susceptibility to drugs is advisable, but often impossible. Many labs are not equipped to carry out such testing. You say you have had the entire book when it comes to treatments, so I won’t mention them. However, for persistent or recurring infections, boric acid powder, 600 mg, in a gelatin capsule suitable for vaginal insertion, used daily for two weeks often can turn the corner for someone like you. The capsules have to be compounded by a pharmacist. If you can’t find one equipped to prepare them, then take another route. Creams or ointments of clotrimazole, terconazole or tioconazole applied daily for two weeks usually can end symptoms. This treatment is then followed by oral fluconazole, taken weekly for six months. This six-month regimen of weekly oral fluconazole should follow boric acid treatment also. I hope this works for you. The booklet on vaginal infections covers the most common kinds of infections and their treatments. To order a copy, write: Dr. Donohue — No. 1203, 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: My husband is in the hospital recovering from a stroke. He can’t swallow, so they have a tube passed into his stomach through his nose. Now they want to insert a tube called a PEG tube. Can a man who has just suffered a stroke withstand such surgery? — C.H.

ANSWER: Inserting a PEG tube isn’t physically demanding surgery. The procedure takes maybe 20 minutes. “PEG” is short for “percutaneous endoscopic gastrostomy.” ”Percutaneous” indicates that the tube is inserted into the stomach through a small abdominal skin incision. An endoscope is a viewing tube passed into the stomach through the mouth or nose. It guides the doctor in placement of the tube. Gastrostomy is a small opening into the stomach. Tubes passed through the nose or mouth can be irritating to tissues of the nose, mouth and throat, so they aren’t left in for prolonged periods. A PEG tube can remain in place for as long as six months. It is easily cared for, not irritating and almost undetectable.

DEAR DR. DONOHUE: My present doctor of several years has never examined my prostate. He relies on the PSA blood test. Doesn’t a digital examination of the prostate serve any purpose? — B.R.

ANSWER: Most doctors still perform a finger examination of the prostate gland. For one, it provides an estimate of prostate gland size, something a PSA test doesn’t do. The doctor also can feel any suspicious lumps, an adjunct in the detection of cancer.

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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