DEAR DR. DONOHUE: For the past month, my voice has been hoarse. I thought it was laryngitis, but my throat never hurt. I don’t have and haven’t had a cold. I’m not a smoker, and drink alcohol only occasionally.

My wife says laryngitis should be gone by now. Is she right? I’ve been whispering for the past two weeks to give my voice a rest. It hasn’t helped. What should my next step be? — J.A.

ANSWER: Your next step should be to see a doctor, preferably an ear, nose and throat doctor. Voice changes that last for more than two weeks without signs of a respiratory tract infection require a doctor’s attention. Voice changes that last for three weeks with signs of respiratory tract infection also need a doctor’s examination.

The most ominous possibility is, of course, cancer of the larynx (LAIR-inks), the voice box. It’s not a common cancer, and it’s often associated with cigarette smoking. It’s the reason why an exam is so necessary.

Less-serious causes of hoarseness are voice abuse, like yelling from the first kickoff of a football game until the last minute of play. This happens to politicians during their campaigns.

Polyps — little growths on the cords — are another cause of voice changes. They often result from voice overuse and abuse.

Spasmodic dysphonia comes from spasms of the vocal-cord muscles. With it, a person’s voice often has long breaks while speaking, along with sudden, unpredictable changes in voice quality.

Acid reflux is another possibility. Gastric juices can erupt all the way up to the top of the esophagus and spill over into the voice box.

Let me give you a pointer about caring for your voice: Stop whispering. It’s harder on your vocal cords than is ordinary speech. You can cut down on speaking, however. And sipping warm tea with honey is soothing.

DEAR DR. DONOHUE: I have what I think are called floaters. They look like tiny insects darting around when I move my eyes. They’re annoying and distracting. What’s the cause, and how can I get rid of them? — V.W.

ANSWER: Those are floaters. They’re black specks or long, threadlike chains of such specks that move with eye movement. The back two-thirds of the eye is filled with a jellylike material called the vitreous. Floaters come about when the vitreous shrinks, pulling stringy material into it, or when proteins in the vitreous clump. They’re most noticeable when you’re looking at a white background, like a blank sheet of paper. Aging and nearsightedness promote their formation. Most often, they’re not an indication of any serious eye trouble.

When a flood of floaters appears, that is a sign of trouble. The retina might be tearing or pulling away from its attachment to the back of the eye.

Routine floaters are best ignored. In extreme cases, eye doctors can replace the vitreous with saline solution, but this is rarely done. It’s done only when vision is greatly affected. A few eye specialists use laser treatment for floaters. This treatment hasn’t won favor with the ophthalmological community.

DEAR DR. DONOHUE: Do you believe aluminum causes Alzheimer’s disease? I have heard from a reliable source that it does.

My mother came down with Alzheimer’s. I don’t want it to happen to me. — B.K.

ANSWER: Some respected people have championed the idea that aluminum, one of the most common elements on Earth, leads to Alzheimer’s disease. I find the evidence unconvincing. These same people advise not using antiperspirants containing aluminum. Most antiperspirants do.

They also warn against using aluminum cookware. I don’t follow that warning, either. I am on the side of the majority that doesn’t feel aluminum presents a danger.

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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