DEAR DR. DONOHUE: I have suffered with restless leg syndrome for 25 years. What causes it? Is there a cure? I do take Requip. Some say that having your veins in your legs stripped helps. Does it? — C.K.

ANSWER: Stabbing pain, a burning feeling and a creepy-crawly sensation in the legs are some of the ways people describe restless leg syndrome. The sensation mostly comes on in the evening when sitting in a chair or, more often upon going to bed. The night is punctuated with interruptions of sleep, as the sensations wake a person. They drive the person to get up and walk about until these annoying feelings go way. Walking does get rid of them, but the respite is only temporary. The attacks reach peaks at midnight and again around 4 a.m.

For most, a cause cannot be found. Sometimes it’s a family affair, passed by the parent to the children. In a few instances, iron deficiency anemia, renal failure and Parkinson’s disease are associated with it. The anemia connection is worth checking out, since it has a definite cure — iron tablets.

The medicine you mention, Requip (ropinirole) is one often prescribed for this problem. If you’ve been taking it for some time without relief, you ought to try some of the other medicines used for it. Mirapex (pramipexole) and Neurontin (gabapentin) are two others. A new variety of gabapentin called Horizant comes as an extended-release tablet so medication is delivered to the body throughout the night.

A warm bath before going to bed, coupled with a leg massage afterward, often can cut down on the number of attacks and their intensity. Restricting alcohol and caffeine works for some people. Removing leg veins will not help.

The booklet on restless leg syndrome and nighttime leg cramps goes into greater detail on both these subjects. Readers can obtain a copy by writing: Dr. Donohue — No. 306, 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: Nine years ago I had on operation for a pancreatic cyst, which turned out to be cancer. I had surgery, radiation and chemo. I recovered, but it left me a diabetic. That’s a small price to pay for my life.

I also have had an annoying beating in the side of my neck and ear. I never had that before my surgery. I have high blood pressure, but it is controlled with medicine. I have seen many doctors and have asked them about it. None has given me a why or what to do for it. So I am trying you. Do you have an answer? — B.E.

ANSWER: The name of the condition is pulsatile tinnitus, an audible beating heard in synchrony with the heartbeat. Check it out. See if the beating is not timed exactly with the pulse. The noise originates in the arteries of the neck, the arteries near the inner ear or those in vascular anomalies in the brain. I can’t relate it to your surgery.

Your doctor has to find where the sound is originating. If it’s the neck arteries, then a narrowing of those arteries might be the cause. Such a narrowing can compromise blood flow to the brain and might require treatment. Scans show if deep artery-venous malformations are the source of the noise. If a cause is found and if it can be eliminated, the noise goes.

If no cause is found, then listening to a radio playing the kind of music you like will soften the beating noises.

You also should take advantage of the information and help available through the American Tinnitus Association at www.ata.org.

DEAR DR. DONOHUE: While hospitalized in May, I had a heart attack. The doctor wants me to have a heart cath to see if there’s a blockage. I have a problem with my tailbone, and it’s a problem for me to lie on my back for any length of time. Is there another way to check? — P.M.

ANSWER: During a catheterization, the patient is conscious but sedated. That might permit you to lie as long as the procedure takes. If not, arrangements can be made to give you deeper sedation or provide you with pain medicines that permit you to stay on your back as long as necessary.

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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