DEAR DR. DONOHUE: Daily headaches were making my life difficult. I’m a 34-year-old woman and had no other medical problems. I am not overweight. (I’m sure you would think I am.) I had these headaches for more than six months. I saw many doctors, none of whom could help me. Finally I saw a neurologist, who diagnosed pseudotumor cerebri. The medicine he prescribed is working. I have looked on the Internet for more information and found many citations saying that blindness is a complication of this. Is it? My neurologist didn’t make an issue of this. — H.O.

ANSWER: The literal meaning of “pseudotumor cerebri” is “false tumor of the brain.” The basic problem in this condition is a rise of cerebrospinal fluid pressure in the brain. Brain tumors are the most common cause of such a rise. In this disorder, fluid pressure is high, but there is no brain tumor. A better name for it is idiopathic (cause unknown) intracranial hypertension (high brain fluid pressure).

No solid evidence exists for a cause of this syndrome. It’s something that happens to men, children and the elderly, but the largest group affected is women of childbearing age who are on the heavy side. No one has figured out why this is so. You don’t fit the picture, as you aren’t overweight.

Headache and visual symptoms are its two prominent signs. The headaches can be severe, not severe, daily or intermittent, and usually are not so distinctive that this diagnosis is promptly singled out. Blindness is a complication. However, treatment eliminates that threat, and you are getting treatment.

Acetazolamide (Diamox), a water pill, often is the first choice for treatment. It is used for several other medical conditions. Fortunately, it lowers brain fluid pressure. It’s not the only medicine that works. Some doctors bring down the pressure with a series of lumbar punctures. If medicines or other techniques are not lowering the pressure, then diverting the cerebrospinal fluid though a slender, plastic tube out of the brain and into the abdominal cavity is a safe and effective procedure.

The headache booklet describes the more common kinds of headaches and their treatments. Readers can obtain a copy by writing: Dr. Donohue — No. 901, 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: Is it possible to shrink the stomach by eating only small meals? I wonder if this would be the same effect as stomach surgery for weight reduction. — T.R.

ANSWER: The stomach shrinks when it’s empty and expands after a meal. It can hold as much as 1 to 1.5 liters (about 1 to 1.5 quarts). Constantly underfilling the stomach shrinks it, but it expands as soon as you increase the amount of food. You’re not likely to obtain a perpetually smaller stomach by eating smaller amounts. The stomach retains its potential to stretch. And you’re not likely ever to attain the small size of a stomach that’s been surgically altered.

DEAR DR. DONOHUE: I attended a lecture on lowering cholesterol through proper eating. The speaker said that shrimp is safe to eat. It doesn’t raise cholesterol.

I was sure that shrimp has a fairly high cholesterol count, and I looked it up. It does. Three ounces of shrimp, about 15 pieces, have 166 mg of cholesterol. Was the speaker wrong? — L.B.

ANSWER: Shrimp has very little to no saturated fat. Even though its cholesterol count is on the high side, shrimp has little effect on blood cholesterol due to its low content of saturated fat. Saturated fat primes the liver to produce cholesterol. You don’t get that effect with shrimp.

The speaker was right.

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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