DEAR DR. DONOHUE: I see much written about fibromyalgia but little about polymyalgia. I have had it. My rheumatologist has taken me off prednisone, and I am not sure if I might still be experiencing the residual effects of this debilitating disease. Could I be? – R.K.

ANSWER: Polymyalgia rheumatica usually happens to older people, and more often to women than to men. It’s quite common. It consists of achy pain and stiffness that is most pronounced in the hips and shoulders and which sometimes affects the back and neck. Joints are hard to move in the morning. Simple chores like hair-combing become herculean tasks. The illness can sap patients of energy and give them a fever. Some lose weight. Its cause has not been discovered.

One lab test, the sed rate, is just about always very high.

Polymyalgia responds quite quickly to prednisone, one of the cortisone medicines. When symptoms come under control and when the sed rate drops, the doctor lowers the prednisone dose and, if all goes well, eventually stops the medicine. That can take months – even years – but most respond more quickly.

I wish you had said what symptoms you are now experiencing. I can’t tell you if they are from polymyalgia or from stopping the medicine. Let your doctor know what’s happening.

There is a companion illness often seen in conjunction with polymyalgia. It’s called giant-cell or temporal arteritis. One of its signs is headache and tenderness of the temporal artery, the artery at the side of the head. Prompt treatment, again with prednisone, is urgent because this illness can cause blindness.

DEAR DR. DONOHUE: How can I get rid of fingernail fungus? I have it in two fingernails. A nurse practitioner prescribed Penlac. I started it about two months ago. I don’t see any improvement. She told me it could take months to see any results. Can you help? – F.F.

ANSWER: Penlac lacquer, a liquid brushed on fungus-infected nails, can take 45 days to 48 weeks before a person sees any difference. If it doesn’t work, there are backup medicines.

Sporanox and Lamisil are two oral medicines that are quite effective in eliminating toe- and fingernail fungus. They are expensive and can have some serious side effects, such as liver damage. Blood tests are taken during treatment to monitor any developing trouble.

Results with these medicines are slow to appear, too. That’s because it takes a full six months for the fingernail to grow out from base to tip, and it takes the toenail two to three times longer. The medicine infiltrates the nail at its base, and you have to wait until the nail completely grows out before the fungus is eliminated.

DEAR DR. DONOHUE: Would you please give your readers information on HHT – hereditary hemorrhagic telangiectasia, or Osler-Weber-Rendu syndrome? A person with anemia, low blood oxygen levels, frequent nosebleeds, blood in the stool or bleeding from the lips or mouth should be investigated for HHT. My husband’s “anemia” was treated with iron tablets only. Lack of diagnosis caused my husband to lose his employment. He was unable to get disability because of the wrong diagnosis. We lost our home. He died at the young age of 54, and his death was unnecessary.

HHT’s symptoms are varied and, many times, overlooked. It should be thought of when there is an anemia whose cause cannot be found. – I.S.

ANSWER: HHT is an inherited disorder. Telangiectasias are the direct joining of small arteries to small veins without an intervening capillary – an even smaller vessel firmly attached to the artery and vein. HHT also produces arterio-venous malformations. They are connections of larger arteries directly to larger veins. Telangiectasias and AV malformations can bleed. They are found in the nasal lining, on the lips, in the mouth, in the brain, in the digestive tract and in the lungs. Anemia results from often-hidden bleeding. Frequent nosebleeds are a big tip-off.

An excellent source of information on this condition can be found at the Hereditary Hemorrhagic Telangiectasia Foundation International’s Web site – www.hht.org.

I am very sorry to hear of your loss.

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.