DEAR DR. DONOHUE: I want to get rid of a lot of expired medicines. I have heard that flushing them down the toilet or putting them in the garbage will make them end up in our drinking water. What is the proper solution? — M.S.

ANSWER: Different government agencies have different recommendations for medicine disposal. Congress is trying to resolve those differences.

First, check with your drugstore to see if it has a program to dispose of medicines; many do. Also check with your town, county or state to see if it has “take-back” programs. Many do.

If you can’t find a facility that accepts old medicines, mix them with coffee grounds, sawdust, kitty litter or similar materials (making them less appealing for children or pets to eat), seal them in a plastic bag and put them in your trash.

A few drugs ought to be flushed down the toilet or the sink. These drugs are mostly powerful painkillers, like morphine, fentanyl, oxycodone and Demerol. They pose a danger to children, pets and even adults if accidentally ingested. This advice comes from the Food and Drug Administration. You can find the complete list at www.fda.gov.

DEAR DR. DONOHUE: I am writing to you, hoping you can enlighten me concerning a cancer called mycosis fungoides. I know it is a rare cancer that consists of lots of itching, skin sores and skin discoloration. I would like to know its origin and prognosis.

My oldest daughter, 43, has it. She was being treated for atopic dermatitis. — V.B.

ANSWER: Mycosis fungoides is rare. In a population of a million people, you’d find only about six cases of it. It’s a cancer of T-cells, one kind of white blood cell called lymphocytes. What turns these cells into cancer is something that hasn’t been discovered.

Early on, the skin is scaly, itchy and has red patches. Your daughter’s story is typical. The early stages often are mistaken for atopic dermatitis, also known as eczema. The skin patches become raised above the skin’s surface. They may ulcerate. In time, the process can spread to internal organs, such as lymph nodes, lungs, spleen and liver.

Initial treatment is medicine applied directly to the skin that slows the progression of this illness and relieves symptoms, including itching. At more advanced stages, chemotherapy is prescribed. The outlook depends on how much skin is involved and whether internal organs have been infiltrated by it.

DEAR DR. DONOHUE: I have a suggestion for the person who feared public speaking, and it doesn’t involve any medicine. That suggestion is Toastmasters International. Toastmaster club members support each other and share their fears and anxieties about public speaking. They learn from each other and grow at their own pace. People can contact Toastmasters at www.toastmasters.org or at Toastmasters International, P.O. Box 9052, Mission Viejo, CA 92690.

ANSWER: My suggestion was the medicine called Inderal. I like your suggestion better. It involves no medicine.

TO READERS: Questions about the often-disabling condition called fibromyalgia come with an astonishing regularity. The booklet on that condition answers most of those questions. Fibromyalgia is an ache-all-over, energy-robbing malady.

Readers can obtain a copy by writing: Dr. Donohue — No. 305, 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.

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