DEAR DR. DONOHUE: A relative recently was diagnosed with blepharospasm and was treated with Botox injections with little improvement. He has also developed Meige’s syndrome, which I understand is related to the eye problem. He has lost employment and is unable to drive.

I would appreciate your thoughts on these two conditions. — H.M.

ANSWER: Few readers have ever heard of blepharospasm (BLEF-er-oh-SPAZ-um). It’s one of the dystonias, a group of illnesses in which painful muscle spasms contort the arms, legs, neck or other body parts. In this case, the muscles involved are eyelid muscles. With the passage of time, the muscle spasms can keep the eyes tightly closed so the person is virtually blind, although vision is fine. Meige’s (MEZ-huz) syndrome, often seen in conjunction with blepharospasm, is the contortion of lower facial muscles and the muscles of the jaw and tongue. Speaking and eating become all but impossible.

Botox injections are the primary treatment for dystonias. I am sure his doctor tried other medicines such as Artane, Cogentin or Lioresal. I would tell this relative to consult a medical school in his locale and talk to both the departments of Neurology and Ophthalmology. He should consider a technique that involves cutting some of the spastic muscle fibers to relax the lids and the lower facial muscles. The procedure is called myectomy.

Tell your relative to also contact the Benign Essential Blepharospasm Research Foundation at 409-832-0788, P.O. Box 12468, Beaumont, TX 77726, or www.blepharospasm.org. The foundation can furnish him with the latest literature and the names of specialists who do procedures for patients who have failed with medicines, and can alert him to support groups that can make him feel like he’s not the only one with this problem.

DEAR DR. DONOHUE: I am at the end of a very short rope. I have had diabetes for eight years, controlled with diet and oral medicine. Now, at age 77, my physician tells me I need insulin. The problem is I get ill if I watch a nurse in the lab stick my arm for blood. Now I’m supposed to poke my stomach with a needle every day. Is there an alternative? — D.G.

ANSWER: A few years ago, an inhaled insulin was marketed in the United States. No one wanted to use it, so the manufacturer stopped making it. Other companies are now working on similar products. Currently, however, only injectable insulin is available.

You can be desensitized to injecting yourself. The injection is with a very fine needle, and the injection is given under the skin, not deep into tissues. You’re not injecting into the stomach. You hardly feel it. I suppose your spouse could do it for you. The nurse in your doctor’s office will practice the technique with you, and you’ll quickly lose your fear. It truly is not an intimidating procedure or one that requires great dexterity.

The booklet on diabetes explains this illness, which has become an epidemic in the U.S. and Canada. Readers can obtain a copy by writing: Dr. Donohue —  No. 402, 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: My husband gets very mad at me, because he says he talks to me and I don’t hear him because I have wax in my ear. I don’t want hearing tests, because I’m sure they will want to sell me a hearing aid. What to do? — L.

ANSWER: Start with the family doctor. That doctor can verify if you have wax or not. If you do and if you want to take care of it yourself, buy wax softeners like Debrox or one of the many others. After a few days of use, flush your ears with warm water using a bulb syringe, obtainable at all drug stores. You might have to repeat the procedure two or three times.

If you can’t get the wax out or if your hearing is still bad after you do, consult an ear, nose and throat doctor. That doctor won’t pressure you for a hearing aid.

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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