DEAR DR. DONOHUE: I suffer from uterine fibroids. They cause heavy, prolonged bleeding and pain. I have decided to go for the procedure called uterine fibroid embolization. Are there any side effects regarding the pellets that are used to block off blood supply to the fibroids? Do you know of any long-term side effects? — C.I.

ANSWER: I know of no medical procedure or medicine that is without side effects. Uterine artery or uterine fibroid embolization is a safe procedure that has no more complications than surgical treatment of fibroids. Long-term complications from the particles used in this treatment are few and far between. I can’t find any specific reference that cites them. Driving to the hospital for the procedure poses greater danger than the procedure does.

Fibroids are growths of the uterine muscle projecting into the uterine cavity. For many women, they’re completely quiet and produce no symptoms. For others, they cause heavy menstrual bleeding, painful periods, pelvic pain, pain with intercourse and infertility.

An embolus is a clot. Embolization involves introducing a flexible tube into a surface artery in the groin and advancing the tube to the uterine artery serving the fibroid. When the doctor has it positioned there, he or she releases small particles about the size of grains of sand. Those particles are inert, sterile materials. They promote formation of a blood clot. Cut off from a blood supply, the fibroid shrinks.

This isn’t a new technique. In the 1980s, doctors began using embolization to stop uterine bleeding. In the 1990s, they adapted it for treatment of fibroids. It’s a method that has two to three decades of experience with a complication rate that is very low. Anytime the body is breached, infection is possible. A few cases of lung blood clotting have been reported because the blood, following the procedure, is believed to have an increased tendency to clot. Those instances have been extremely rare.

The booklet on fibroids discusses this topic and its treatments at length. Readers can obtain a copy by writing: Dr. Donohue — No. 1106, 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.

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DEAR DR. DONOHUE: My question concerns vitamin D. I am a 68-year-old woman who takes calcium supplements daily. Almost all calcium supplements today contain vitamin D. Since I spend two to four hours every day in the sun, I am concerned that I might be getting too much of the vitamin. Do I need to find a calcium supplement that does not contain vitamin D? — B.W.

ANSWER: According to your letter, you live in the Sunshine State, so you get sun exposure year-round. Sunlight transforms a vitamin D precursor found in the skin into the vitamin. The liver and kidney tweak the skin-produced vitamin into other forms that are the active material.

People your age produce 75 percent less vitamin D from the sun’s transformation of the skin precursor than do younger people. This isn’t a matter of lack of sun exposure, which is a factor in vitamin D deficiency for people in Northern climates during the winter. It’s a matter of age-related decreased production. One of the world’s most respected investigators of vitamin D has said, “There has never been a case of vitamin D intoxication from sun exposure.”

Add all the vitamin D contained in your calcium supplements. If it comes to less than 1,000 IU a day, you have no worries. The upper limit for vitamin D intake is 2,000 IU.

DEAR DR. DONOHUE: I am a woman who loves tropical fruits. Instead of a salad for supper, I eat low-fat cottage cheese and tropical fruit. The fruits include pineapple, red papaya, guava and bananas. Am I doing something wrong? — S.L.

ANSWER: Not if you’re getting other food groups, like proteins and unsaturated fats in your other meals. You need some grains, vegetables and protein sources such as lean meat and beans. You also need the vitamins and minerals those foods contain.

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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