DEAR DR. DONOHUE: I am writing this letter for my neighbor.

She feels lightheaded, and her eyes water all day. She feels pressure in her neck and feels as though she’s drunk. Her doctor has diagnosed it as TMJ. What can be done for it? — F.W.

ANSWER: “TMJ” stands for “temporomandibular joint,” the jaw joint. You can feel it by putting your fingers in front of the ear and opening and closing your mouth. That joint and/or the chewing muscles are responsible for the trouble called TMJ disorder.

Persistent dull aching in the jaw joint or in the cheek area housing the jaw muscles is the major sign of TMJ disorder. The pain worsens with chewing.

A medical or dental doctor usually can make the diagnosis without any special or costly tests. An X-ray of the jaw joint might be helpful.

People who clench their teeth frequently or who grind their teeth often during sleep are the people most likely to come down with TMJ disorder.

Moist heat applied to the joint in the form a washcloth saturated with hot water is one way to ease joint pain. If the woman is a tooth-grinder or a jaw-clencher, a mouth guard greatly helps her to conquer those problems. She should not chew gum. She should avoid hard foods. To ease pain, she can try Tylenol, Advil or Aleve, or one of the many other nonsteroidal anti-inflammatory drugs.

You know what? I don’t think this woman has TMJ disorder. Tearing eyes and lightheadedness are not its signs. She should confer with a dentist or another doctor.

DEAR DR. DONOHUE: Please give me your opinion of the drug Evista. My doctor has recommended it for me to take because of my family history of breast cancer. My mother had it, and two of her sisters had it. My dad’s sister and her daughter had it. I am 57 years old and so far have no sign of cancer. My fear is not if I am going to get breast cancer, but when I am going to get it. What are the pros and cons of being on Evista? How long would I be on this drug? — P.C.

ANSWER: Evista is a SERM, a selective estrogen receptor modulator. That means it has an estrogen-like effect on some tissues and organs, and an estrogen-blocking effect on others. As far as the breasts go, Evista blocks the effect of estrogen on breast tissue. That makes it a protector against breast cancer. On bone, just the opposite takes place. It has an estrogen-like effect on bone, promoting the incorporation of calcium into bones. It is, therefore, a prevention and treatment for osteoporosis.

The duration of prevention for breast cancer is uncertain. Most doctors keep their patients on it for five years.

Not every woman is a candidate for Evista; only those women who are at higher risk of coming down with breast cancer.

The cons of Evista include the possibility of leg clots and pulmonary embolism, the traveling of a clot or part of a clot to the lung’s circulation. These are rare happenings.

DEAR DR. DONOHUE: On my doctor’s advice, I take a take a teaspoon of milk of magnesia every evening. I suffered from constipation. I’ve been taking it for three years, and it has worked beautifully for me. I wonder if I might be getting too much magnesium. Am I? — D.R.

ANSWER: If you have been taking too much magnesium, you have signs of that by now.

One teaspoon of milk of magnesia has 400 mg of magnesium. The recommended daily intake for men is 420 mg, and for women, 320 mg.

You’re slightly over the recommendation, but not enough to cause trouble. Healthy kidneys usually can take care of magnesium excess, unless it’s way over the recommendation.

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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