DEAR DR. DONOHUE: I’m a relatively young woman at 43 years old. Until six months ago, I was the picture of health. I have three young children, had a part-time job and exercised daily. Then I had to put on the brakes. I had little energy to do anything. My hands started hurting. My husband thought it might be psychological. I went to the family doctor, expecting him to say it was all in my head. He didn’t. He took tests and told me I have lupus. How can I be sure his diagnosis is right? Is this a death sentence? — A.C.

ANSWER: Lupus results from an immune system that has gone rogue. It makes antibodies that are destructive to many tissues and organs. Why it does so is an unanswered question. The majority of victims are young women between the ages of 15 and 40. For every man that comes down with it, six to 10 women contract it.

The diagnosis is made by finding four of the following signs: 1. Skin rash that appears on the cheeks and bridge of the nose in a pattern suggesting a butterfly; 2. Other skin rashes of red, raised patches; 3. Sensitivity to sunlight; 4. Sores in the mouth; 5. Two or more swollen, painful joints; 6. Inflammation of the lung covering (pleuritis), the heart covering (pericarditis) or both; 7. Kidney malfunction with protein in the urine; 8. Seizures; 9. A decreased number of red blood cells (anemia) and white blood cells; 10. Peculiar antibodies in the blood; 11. Antibodies directed against the nucleus of body cells — antinuclear antibodies.

Antibodies come from the immune system, and they’re part of our defense against infections. Here, they’re directed at body tissues and organs. Antinuclear antibodies target the body cells’ command center, their nucleus.

I’m not going to bore you with the long list of medicines for lupus. Let me assure you that lupus is not a death sentence. Sixty years ago, the average survival of a lupus patient was five years. Now, 90 percent of lupus patients are living 10 or more years and are active throughout most of their lives. This is primarily due to the impact modern medicines have had on this illness.

DEAR DR. DONOHUE: Help! My doctor put me on a beta blocker medicine for high blood pressure. I have asked him three or four times to switch the medicine, but he refuses. For one thing, my prescription insurance will not pay for it, and also the side effects are too much.

He says I have to trust him because he is the doctor. Now I am in a worse position than I would be had I never taken the medicine because of the increased risk of a heart attack or stroke if I go off it. I wish I had never agreed to medicine if I’m going to live 24/7 afraid of it.

I’m ready to quit it even though my neighbor died of a heart attack after suddenly quitting his. How do I solve this problem? — E.R.

ANSWER: Things are not as bad as they seem. First, take care of the doctor. Say to him: “Look, buster, this medicine you prescribed is tearing me up. It’s worse than the illness. You have to trust me. I am the patient.” If the impasse remains, rise from your chair, wave your hand goodbye and find another doctor.

Beta blockers — medicines with names like Lopressor, Corgard, Tenormin and Visken — are prescribed for many illnesses, including high blood pressure. They’re not the only blood pressure medicines. Doctors have access to many, many blood pressure medicines that are in no way related to beta blockers.

You’re not going to die from stopping a beta blocker. You can’t stop them abruptly. All you do is follow a program of gradual reduction in the number of tablets taken and in the dose taken. It takes a couple of weeks to do this. While you’re tapering the dose, don’t engage in heavy exercise.

DEAR DR. DONOHUE: You say older women need 1,000 to 1,200 mg of calcium a day. My pharmacist says our body cannot absorb more than 500 mg. — S.B.

ANSWER: The body absorbs only 500 mg at one time. Take calcium in the morning, again in the afternoon and again in the evening, if need be, to reach the daily goal.

All of it will be absorbed.

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.

Copy the Story Link