DEAR DR. DONOHUE: You had an article on urine loss. Will you give a better explanation of the Kegel exercises? There must be more details than you gave. — Anon.

ANSWER: You mean you want me to complicate the exercises for you? One of the exercises’ main attractions is their simplicity.

The target of these exercises is the pelvic muscles, muscles that support the bladder, the uterus and the rectum. Tightening these muscles prevents urine loss and keeps those three organs from falling downward. You have to learn which muscles to contract. You do so by stopping the flow of urine in midstream. You stop the flow only to learn how to contract the pelvic muscles; it’s not part of the exercises themselves. You get the same effect by contracting the muscles you would use to stop the expulsion of gas. Don’t contract the abdominal muscles.

Perform 10 pelvic-muscle contractions in a row. Hold each contraction for three seconds, and then rest three seconds. You can be lying, sitting or standing when doing the exercises. It’s good to vary your position. In the morning, before getting out of bed, is a good time to do the exercises in the lying position. At noon, do them standing. In the evening, while watching TV, do them sitting. And perform another set of exercises before going to bed. Work to the point where you hold the contractions for 10 seconds with a 10-second pause after each contraction.

Don’t expect a miracle soon. It takes four to six weeks of exercise before you see results.

DEAR DR. DONOHUE: In 1951 my firstborn child died of what is now called SIDS, sudden infant death syndrome. When he was 3 months old, he had a slight cold and had a routine health check. It was the end of May. I put him outside in his buggy for a nap since the day was warm and sunny. When I went to wake him, he was dead.

I have just learned that my baby’s father, now in his second marriage, sired another SIDS baby. Has research uncovered a genetic component for SIDS? Is there a connection between adult sleep apnea cases and SIDS? — A.R.

ANSWER: The pain of a SIDS death lasts for life. I’m sorry you had to experience it.

No single gene has been found that can be blamed for SIDS. However, a combination of many genes might be responsible for some SIDS deaths. Those genes are somehow involved in maturing the brain center that regulates breathing. That’s as close to a gene influence as is possible to prove right now.

Sleep apnea and SIDS have nothing in common.

The number of SIDS deaths has decreased since the campaign on alerting parents not to put their babies to sleep on their stomach or sides became well-known. Putting the infant on his or her back is the recommendation made to all parents.

DEAR DR. DONOHUE: My wife, 64 years old, had been active and strong. Now, because of rheumatoid arthritis, she has lost strength, stamina and interest in things she used to do. As a child, she suffered from rheumatic fever and took penicillin daily for more than 50 years. Two years ago, our family doctor took her off penicillin abruptly. Six months later, she developed rheumatoid arthritis. I asked the doctor if the abrupt stopping of penicillin caused her rheumatoid arthritis. He said no. He referred her to a rheumatologist, who put her on different medicines. Do you think, as I do, that penicillin would work better for her? — E.K.

ANSWER: I understand your consternation. Your wife was fine when she took penicillin. Six months after stopping it, she’s not so fine. She took the penicillin to prevent a second attack of rheumatic fever. At this point in her life, she no longer needs that kind of protection. I have no way of being absolutely certain, but I don’t believe that stopping penicillin, even stopping it abruptly, was instrumental in her developing rheumatoid arthritis.

Your point of view has some justification. If you and your wife want to experiment, she could go back on penicillin for a short time to satisfy your curiosity. Her doctor would have to agree. I’m not sure this is the right thing to do. Needless taking of antibiotics leads to the emergence of supergerms.

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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