DEAR DR. DONOHUE: I was first diagnosed with psoriasis in July 1972, at the age of 23. I am now 63. I begin my 40th year of suffering from this dreadful disease. I have tried virtually every form of treatment. I have studied the new biological treatments now available, and it is with a certain amount of trepidation that I am considering trying Humira, recommended by my wife’s ob-gyn, who also has the disease and took this treatment.

Could you shed some light on this subject? I am leaning toward giving it a try. — T.D.

ANSWER: No effective drug is devoid of serious side effects for at least a few users. The new “biological” drugs are quite efficacious in combating an immune system that has gone haywire and attacked its own body organs or tissues. Psoriasis is an example of one of these autoimmune illnesses.

Normally, skin cells from the bottommost layer of skin take a full month to reach the topmost layer of skin. By that time, they have fully matured and are able to handle the job of protecting the body. In psoriasis, the bottom layer of skin cells rushes to the top in a matter of days. They’re immature and show the typical changes of psoriasis: red patches covered with a silvery scale. This is the result of an immune attack on skin cells.

Biologicals rein in an immune system gone amok. Humira is one example. Enbrel, Remicade and Amevive are others. On the plus side, their moderating of the immune system produces gratifying results in psoriasis control. On the negative side, the toned-down immune system can bring to life a latent TB germ in those people harboring it. It also can make people susceptible to many other serious infections. Doctors using these medicines are aware of their side effects and stop treatment should any untoward symptoms occur.

I can tell you honestly that I would not be afraid to take these drugs if I had psoriasis that was not responding well to standard remedies.

DEAR DR. DONOHUE: My grandson was diagnosed with a seizure disorder at age 3 and had been on medication since. Last week, he was found dead in bed at age 34. The cause of death was listed as grand mal seizure. I have researched this and did not find any reports of grand mal seizures being fatal. What are your thoughts on grand mal seizures causing death? — C.L.

ANSWER: Grand mal seizures are now called generalized seizures of the tonic-clonic variety. Such seizures often start with the person making a grunting noise. The individual falls to the ground with initially quite stiff muscles — tonic. Then the arms and legs thrash about, contracting and relaxing — clonic. Most people with this disorder do not die from it. If a person happens to develop a seizure that lasts for hours and hours or longer, a condition called status epilepticus, death results in 20 percent to 30 percent of these people. Another cause of death in generalized seizures is SUDEP, sudden unexpected death in epilepsy patients. It, too, is rare and mostly happens to young people with hard-to-control seizures. It frequently occurs during sleep. The cause isn’t known.

If you have any more details of your grandson’s death, write, and I’ll try to make the answer more specific. You and your family have my sympathy on the death of this young man.

DEAR DR. DONOHUE: Please repeat your recipe of a natural aid for constipation. You mentioned it several years ago. — W.M.

ANSWER: It’s not my recipe. Readers have ascribed it to many different people.

Mix 2 cups of bran (found in health-food stores) with 2 cups of applesauce and 1 cup of prune juice, sweetened or unsweetened. Refrigerate the mixture. Take 1 tablespoon twice daily. If you’re not getting results, increase the dose to 2 tablespoons.

The booklet on constipation describes its treatments in detail. To obtain a copy, write: Dr. Donohue — No. 504, 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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