DEAR DR. DONOHUE: I am an 86-year-old female amputee. I drive my car, shop for groceries, play bingo and keep as active as possible. I have lost about 95 percent of my taste. My doctor says, “The golden years, my dear.” He’s probably right, because he usually is. However, I thought I’d get a second opinion. I love to eat, and this is very frustrating. — G.H.

ANSWER: Taste and smell go hand in hand. The tongue recognizes only sweet, sour, salty and bitter tastes. The nose makes a huge contribution in detecting food flavor through its aroma. The texture of foods and their temperature also contribute to their palatability. A search for taste loss has to include the mouth, tongue, nose and sinuses.

Head injuries, smoking, allergies and nasal polyps interfere with the appreciation of food. And your doctor is right; aging makes a contribution, too. Viral infections like the simple cold diminish or eliminate taste, usually for a limited time, but sometimes forever. Finding where the problem lies — nose or mouth — entails checking the tongue for taste perceptions and the nose for smell perceptions through a battery of taste and smell tests.

Medicines that disrupt smell appreciation include amlodipine, diltiazem, doxycycline, lovastatin, methotrexate and nifedipine. Capoten and enalapril can alter taste perception. So do a number of illnesses, like Crohn’s disease, cirrhosis, diabetes, multiple sclerosis, Parkinson’s and Sjogren’s syndrome. A chronically dry mouth also can diminish taste. Thrush, a mouth infection with the yeast candida, is another condition that leaves the tongue without taste.

Some tricks can restore savor to food. Vary mouthfuls of food. After a bite of meat, take some vegetables or a piece of bread or a forkful of salad. The same goes for food textures — something crunchy after something smooth. Marinate meats in things like bouillon. Use flavor enhancers such as vinegar, cayenne pepper, lemon, vanilla and monosodium glutamate.

DEAR DR. DONOHUE: I am concerned because I hear this year’s flu vaccine will contain both the flu strains and H1N1. Do we have a choice? I would like only the normal flu shot and not one with the live H1N1 virus. — C.S.

ANSWER: This year’s vaccine contains materials that protect against two of the A influenza strains, H3N2 and H1N1 (swine flu) and one B strain influenza, B/Brisbane. Those strains were selected on the basis of information that these would be the most prevalent flu strains for the 2010-2011 flu season.

Vaccines given by a shot are inactivated. They contain no living virus. The H1N1 component is dead as a doornail. (I don’t know what that expression means.) So are the other two components.

You won’t be able to find a flu vaccine without H1N1, but you should have no fear of it.

DEAR DR. DONOHUE: I am a 53-year-old female diagnosed with ovarian cancer. I thought that a yearly Pap smear would detect it. I was naive. In March, I discussed my irregular periods with my gynecologist. I thought they were a sign of menopause, and my doctor agreed. He ordered a transvaginal ultrasound, and something suspicious was found. My CA-125 test was very high, and I was scheduled for immediate surgery. My cancer was a stage 2 cancer. I ask your help in making women more aware of this cancer that “doesn’t make much noise.” — C.S.

ANSWER: Around 22,000 cases of ovarian cancer occur yearly in the United States, and 75 percent of those cancers are in late stages, where cure is difficult. Ovarian cancer doesn’t produce early signs. However, women should pay attention to these possible warnings: bloating or distention of the abdomen; pelvic pressure or pain; feeling full quickly or losing the desire to eat; and a need to urinate often. The trouble with these signs is they are so nonspecific that they apply to many other conditions. CA-125, a blood test, isn’t reliable for screening all women. It’s useful for women with other signs of cancer, like an abnormal ultrasound of the ovary or women with a family history of this cancer. Readers and I appreciate your telling your story.

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.

Copy the Story Link