DEAR DR. DONOHUE: My daughter is 32 and just contracted mono. A few years ago, she had shingles. I know why this is happening. She is not taking care of herself, not eating right and is on the go all the time. It would be helpful if you could explain what conditions might ensue as complications of mono and shingles.

For me, will you answer what can be done for trigger finger? — K.B.

ANSWER: A hectic life weakens the immune system and leaves a person vulnerable to infections. Having shingles in her late 20s and infectious mononucleosis at 32 could be an indication that her resistance to infection is at a low level and lack of rest is one of the reasons why resistance weakens. Complications from either disease, if it was short-lived, aren’t common.

I’d like to say some words about mono for other readers. The culprit is the Epstein-Barr virus, which is passed from an infected person or a carrier to another through saliva. Kissing is one way to pick up the virus, but not the only way. Sharing another’s forks, spoons, cups or pop bottles can pass the virus. Trying to determine where one caught the virus is an exercise in futility. Many people harbor the virus without any signs of illness, but they can spread the disease just as easily as the ones who develop symptoms.

Fever, sore throat and enlarged lymph nodes, particularly neck lymph nodes, are evidence of mono. Fatigue is a prominent symptom. Headaches are common. Muscles ache. The illness generally lasts two or three weeks, but patients can feel wiped out for some time after all signs have gone. Your daughter definitely needs to rest until she regains her usual vigor. Blood tests provide the best evidence for infection with mono.

No medicine exists for treatment. Medicines are given to comfort patients, not to cure them.

Athletes who come down with mono are advised not to play contact sports until their spleens return to normal size. An enlarged and somewhat fragile spleen is part of the mono picture.

For a trigger finger, an injection of cortisone in the area where triggering occurs when the finger bends usually can put an end to the problem.

DEAR DR. DONOHUE: I am 79 years of age. I have always had a slow pulse. Recently, I had spells of lightheadedness and dizziness. I went to my doctor and had an EKG. The results were that my heartbeat was slow at times, and sometimes it was very slow. At one time, there was a long pause before a beat occurred. I have mitral valve prolapse. The doctor wants me to have a pacemaker. Can mitral valve prolapse cause my heart to work in this way? Do I have to hurry for the pacemaker? — D.P.

ANSWER: Mitral valve prolapse, a ballooning of the valve upward when the heart contracts, does not ordinarily cause a slow heartbeat.

How slow was your heart beating? Certainly, if it was much below 50 beats a minute, you need treatment to speed up the heart. You don’t want to have a dizzy spell while driving or even walking when you could fall and injure yourself.

I think there’s more to your story than the slow rate. It sounds like your normal pacemaker, the one your heart had since birth, isn’t working properly. The long pause before a beat occurred could be an indication that the pacemaker isn’t pacing the heart like it should. You shouldn’t delay in having an artificial one connected to your heart.

The booklet on heartbeat abnormalities discusses the more common ones in detail. Readers can order a copy by writing: Dr. Donohue — No. 107, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: What’s the meaning of “creatinine” on my lab tests? — V.D.

ANSWER: Creatinine is a byproduct of muscle metabolism. A certain almost-invariable amount is produced daily. Its blood level serves as a gauge for how well the kidneys are working.

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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