DEAR DR. DONOHUE: Please give me information on Paget’s disease. I am 85 and have been told I have it. — N.D.

ANSWER: Paget’s bone disease comes about when normal bone remodeling becomes abnormal. From the first moment of life to the last moment before death, bones are breaking down and immediately being rebuilt. Bone-making cells cooperate with bone-demolishing cells to renew our bones. In Paget’s disease, this process is out of whack. The bone-demolishing cells speed up their destruction and leave in their wake weakened and deformed bones. The bone-making cells compete but produce poorly made, disorganized and misshapen bones. This process occurs at older ages and usually progresses slowly.

Paget’s might affect only one small area of bone, or it may take place in larger areas of many bones. When limited areas of one or a few bones are involved, patients have no symptoms, and no treatment is needed. If it’s more widespread and causes trouble, then treatment begins. Enlargement of the skull can bring on headaches. When the hearing nerve is entrapped in new bone, deafness in one ear results. Paget’s bone is subject to fractures. If the process occurs near joints, arthritis can result.

No one knows for sure what causes Paget’s. Some believe it might be a virus.

Drugs used in the treatment of osteoporosis also are used for Paget’s disease, often quite effectively.

If you are unaware of the Paget Foundation, let me introduce you to it. It will be your best friend. The foundation can provide you with the latest information on treatment and enlighten you in depth about what’s happening in your bones. Its website is www.paget.org, and its phone number is 800-23-PAGET.

DEAR DR. DONOHUE: I am 52 years old, and found out that my mother has been diagnosed with dementia. She is 75.

I have been going over things that have happened to her in her life. She has a weak bladder, irritable bowel syndrome, is overweight and short-tempered, and has fought depression. She now has much forgetfulness. Is dementia hereditary? What can I do to prevent it? I want to be around my family and not be a burden or have them ashamed of me. — Anon.

ANSWER: Dementia is a decline in mental functioning — a loss of the ability to think clearly, to express oneself meaningfully, to remember recent events and to make judgments on appropriate behavior. Many different illnesses cause dementia. Alzheimer’s disease is the leading cause, so I’ll direct my remarks to it.

Family history is a factor in coming down with Alzheimer’s disease. That’s not to say that a parent’s illness dooms his or her child to have it. If a mother, father, sister or brother has or had Alzheimer’s disease, a person has twice the risk of developing it than do those without such a family history.

Many other factors are involved. Aging is one. The incidence of Alzheimer’s doubles for every five years lived after age 65. By age 85, one in three people will have a touch of this illness.

Prevention is something everyone is looking for. A diet that is based on fruits, vegetables and whole grains is said to afford some protection. So is remaining as physically and mentally active as possible.

Dementia should not be a matter of shame to the involved person or to that person’s family. It’s an illness.

DEAR DR. DONOHUE: I have been diagnosed with an underactive thyroid. Will you tell me about it? Is medication taken for life? — C.D.

ANSWER: An underactive thyroid gland, hypothyroidism, is a common disorder. Thyroid hormone keeps all body cells, tissues, organs and chemistry working at optimum speed. Without it, everything slows down. Muscles weaken, people lose their pep, and weight is gained without increasing the amount of food eaten. People also complain of feeling cold when others around them are comfortably warm. Constipation is a frequent complaint. Treatment is supplying the hormone in pill form, usually for life.

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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