DEAR DR. DONOHUE: Our neighbor’s cat had a litter of kittens about three months ago. She has given away all but two of the kittens. My daughter, 10 years old, spends much time with these cats and would like to have one. I have some reservations.
Two weeks ago, she showed me a bump under her arm. She had a red, raised bump that was tender to the touch. I told her we’d watch it for a few more days. It got larger, so I took her to our doctor, who said she has cat-scratch disease. She isn’t getting any treatment. Should she? — T.M.
ANSWER: You wouldn’t call cat-scratch disease common, but it’s not exceptionally rare, either. It happens to about 25,000 people annually in the United States. For a small number, it’s a serious infection that can damage internal organs like the liver and the brain, but more than 90 percent of cases are local infections that heal on their own.
Kittens and wild cats are the ones most likely to carry the germ. They don’t look sick, and they are not sick. A scratch or a bite from an infected cat transmits the germ to people. Shortly after, a small red lump appears at the scratch site. It can be so insignificant that it’s ignored. From one to seven weeks later, one or more lymph nodes swell. Since the scratch usually is on the hand or arm, a node in the armpit is the one that most frequently becomes enlarged. It turns red and is very tender to the touch. Headache, low-grade fever and muscle pains are other symptoms that might appear.
Standard practice is to not treat an uncomplicated case of cat-scratch disease. Signs of it, including the swollen lymph node, are gone in two to four months. In the exception to this rule, when the illness is serious, antibiotics are given. Azithromycin is one that’s frequently chosen.
DEAR DR. DONOHUE: I am getting married for the second time. I have three children with my first wife and had a vasectomy after the third child.
My wife-to-be wants to start our own family. She has never been married. How successful are vasectomy reversals? — L.C.
ANSWER: Men should consider vasectomies as being permanent before they make the decision to have one.
However, using a microscope, doctors can rejoin the cut end of the vas deferens, the tube that carries sperm from the testicles and into the seminal fluid. The kinds of vasectomy are many, and vasectomy type affects the success of establishing a functioning vas. The time that’s elapsed since the vasectomy is another important consideration.
If the reversal is done within three years of the vasectomy, pregnancy rates of 75 percent have been obtained. If 15 or more years have passed since the vasectomy, pregnancy rates can drop to as low as 30 percent.
DEAR DR. DONOHUE: My wife and I have been married for 40 years. For at least 30 of those 40 years, I have had a soft lump on my back that has never given me a day of grief. It’s just there.
My wife has suddenly decided that it could be a cancer, and she insists I see a doctor. Do you think this is necessary? — M.K.
ANSWER: A soft lump that has been present for 30 years without changing and without causing any symptoms is not likely to be cancer. It could be a lipoma. A lipoma is an encapsulated ball of fatty tissue. Lipomas that hurt, interfere with movement or are cosmetically displeasing can be removed.
Another possibility is a sebaceous cyst. Such a cyst consists of oily material encircled by tough body-packaging tissue. It, too, can be left alone.
In all those 30 years, haven’t you seen a single doctor? The next time you do, ask about this lump.
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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