DEAR DR. DONOHUE: I have really bad emphysema. I used to be a heavy cigarette smoker. Now I’m on oxygen around the clock, and I couldn’t light a cigarette even if I wanted one. On TV, I saw that there is a medicine you take by mouth, and it cures emphysema. Are you aware of this medicine? My doctor isn’t. – B.F.

ANSWER: With emphysema, the lungs’ air sacs are destroyed. Oxygen from breathed-in air can’t reach the blood, and carbon dioxide, a body waste product, can’t get out of the body. Emphysema’s main symptom is a feeling of suffocation when physically active. Not enough oxygen gets into the blood to support even the slightest exertion.

Your emphysema is the kind brought on by smoking cigarettes. There is no medicine to cure that kind of emphysema. What’s been damaged stays damaged. That’s not to say there aren’t many things that can make life with emphysema more livable.

What you saw on TV must have been a much less common kind of emphysema called alpha-1 antitrypsin deficiency. It’s an inherited problem, and here’s how the story goes: White blood cells are constantly cleaning the lungs’ air sacs. One of the cleaning detergents they use is alpha 1-trypsin – strong stuff. It’s an enzyme. When the job is through, the alpha 1-trypsin is neutralized by alpha 1-antitrypsin. Without the antitrypsin material, the trypsin detergent keeps working, and the air sac is destroyed.

When the antitrypsin deficit is great, then the substance can be given to patients. It’s not exactly a cure, but it’s a step forward. It’s definitely not a cure for the common kind of emphysema, your kind.

DEAR DR. DONOHUE: Here’s a question for you. I feel quite healthy and am quite active. I’m a 67-year-old woman. My doctor told me I have a slightly “tight” aortic valve due to calcium deposits. He said he heard a soft murmur caused by it. He also said it doesn’t need any treatment.

My question is: What’s a “tight” heart valve? I take calcium and vitamin D to prevent osteoporosis. Is the calcium I take affecting this valve? – V.T.

ANSWER: I believe your doctor means you have a narrow aortic valve. If the valve hasn’t narrowed so much that it impedes the flow of blood out of your heart, then you don’t need to do anything now, and you might never have to do anything.

Did the doctor say anything about taking antibiotics before dental procedures that cause bleeding or before some other procedures that have the potential to release bacteria into the blood? If he didn’t, ask him if antibiotics are necessary for you. Bacteria that get into the blood home in on heart valves that are narrow or leaky and cause a very serious infection called endocarditis.

The calcifications on your valve didn’t come from the calcium you take as a supplement. Your body took calcium from its calcium stores and plastered it on the valve in an attempt to correct any deformity. Keep on taking your calcium.

Heart valve problems are common. The booklet on these problems describes them in detail. Readers can obtain a copy by writing: Dr. Donohue – No. 105, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I had a very itchy elbow. One doctor prescribed cortisone cream for it. That didn’t work. I saw a second doctor, who biopsied it and thinks I have dermatitis herpetiformis. The biopsy isn’t back yet. I want to know if this is a herpes infection. – J.A.

ANSWER: In spite of the name, it has nothing to do with herpes. It’s an outbreak of small blisters on red skin, and it’s unspeakably itchy. The medicine dapsone can usually control it.

This skin condition is closely associated with celiac disease, a digestive problem. Even if people don’t have stomach symptoms, adopting the celiac diet often controls dermatitis herpetiformis.

DEAR DR. DONOHUE: I have trouble falling asleep at night, so I take one Tylenol PM every night and have been doing so for the past year. Is this harmful? I have tried to go without it, but I simply cannot fall asleep. I believe getting a good night’s sleep is essential to good health. True? – M.A.

ANSWER: In the best of all worlds, it’s safest to limit all medicines. Have you tried any simple ways to induce sleep? Taking a warm bath before bedtime often does so. When you get out of the tub, body temperature drops, and the brain sends a message to the body to fall asleep.

However, taking one Tylenol PM at bedtime isn’t likely to get you into any trouble. Tylenol PM has the usual Tylenol ingredient acetaminophen and the antihistamine diphenhydramine (Benadryl). The amount of both is in the safe ranges.

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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