DEAR DR. DONOHUE: My uncle just had an emergency carotid endarterectomy for 99 percent occlusion of his right carotid artery. He is 82 years old and quite fit. He had a carotid Doppler (ultrasound) study every year. Furthermore, there was no bruit in his artery. Doppler studies do not show occlusions greater than 90 percent. Why is this technique used?

He started having transient symptoms, including vision loss and loss of the use of fingers on his left hand. If this had gone untreated, it could have been fatal. — J.G.

ANSWER: Doppler ultrasound is a safe, effective, reliable and relatively inexpensive way to determine the buildup of plaque (mounds of cholesterol) in the carotid arteries, the neck arteries that bring blood to the brain. They show occlusions all the way to 100 percent. Someone has misinformed you.

A bruit is a noise heard in an artery. Normal flow of blood in an artery is silent. Noise indicates an obstruction. Unfortunately, most narrowed carotid arteries don’t generate a bruit. It’s a good sign of trouble when present, though.

Your uncle’s symptoms of transient vision loss and the inability to use the fingers of his left hand were transient ischemic attacks, TIAs. Other TIA signs are numbness on one side, blurred vision, double vision, trouble expressing oneself and dizziness. The signs and symptoms of TIAs are fleeting, never lasting longer than a day but usually lasting only for minutes to less than an hour. These are warnings of great danger. A stroke lies in the near future unless something is done to prevent it. Your uncle’s endarterectomy is a procedure where the surgeon opens the clogged artery and removes the obstructing plaque.

Please give your uncle my best wishes for a speedy recovery.

The booklet on strokes covers the causes, prevention and treatment of these terrible events. Readers can order a copy by writing: Dr. Donohue — No. 902, 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: I am 76 years young. I had a cholesterol check from blood obtained by a finger stick. It was high. I decided to have other tests, and it was good that I did. I found out I have diabetes. Recently the medical center changed doctors. The new doctor ordered a new cholesterol test after fasting for 12 hours. When I questioned the difference in results, the girl told me that blood was blood. The next morning they called to tell me I had high blood pressure. I took the van again. When I arrived, they told me the doctor was out sick. I haven’t heard anything since. This is irritating. Why didn’t someone call me? — Anon.

ANSWER: I can’t help you with the runaround you’re getting at the clinic, but I would call again and ask to talk to the doctor. If you get the brush-off, give them your number and ask that the doctor call you. If you don’t hear within two hours, call back and keep calling back until the doctor talks to you.

The change in lab values is probably due to the fact that this time you fasted for 12 hours. That will give you a different but more accurate blood sugar reading and a better reading for your triglycerides — fats that are a bit like cholesterol.

DEAR DR. DONOHUE: I will turn 65 shortly. My health is just fine. I am out and active. I do odd jobs like construction and hauling. Some friends want me to see a doctor just for a physical because I haven’t been to one in 35 years. Why should I? All is OK with me. Is it true that 80 percent of men don’t go to doctors? — C.F.

ANSWER: You’re getting on in years. Bad things happen with aging. You don’t want to be surprised by a heart attack, a stroke or a cancer that has grown so big that it can’t be treated, do you? Those are some of the reasons you should see a doctor. I like your fighting spirit.

I don’t believe that 80 percent of men never see a doctor.

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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