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Dr. Donahue answers health questions

By Paul G. Donohue, M.D.

DEAR DR. DONOHUE: Exactly what is prickly heat? Do adults get it? If they do, I think I have it. M.K.
ANSWER: Adults do get prickly heat. It looks like red dots or tiny blisters on the skin. The rash itches or feels "prickly." Sweat ducts have become plugged.
Prevention comes with dressing as coolly as possible in light cotton clothes. Air-conditioning is the ultimate answer. Second best is having a fan blowing on you. If you have a breakout, cool-water compresses take away the itch or prickliness, as do cortisone creams, which are found in all drugstores.

DEAR DR. DONOHUE: My husband has some kind of sleep disorder. He doesn't believe he has a problem. I know about restless leg syndrome, but he has something beyond that. About four nights a week, his legs kick all over, and he throws his body in every direction. The bed bounces like a trampoline. In one month, he made large holes in two quality flannel sheets. Several times, he has hit me across the face. What is this problem? M.L.
ANSWER: You describe periodic limb movements of sleep, (PLMS) which used to be called nocturnal myoclonus. Most of the time, only the legs are involved. The toes, ankles, knees and hips involuntarily bend and straighten during sleep. The movements happen every 20 to 40 seconds, and each episode lasts from a few minutes to hours.
Restless leg syndrome is a crawling sensation beneath the skin of the legs. The person has to get up and walk around to put an end to the annoying sensations. Sometimes it is associated with iron deficiency, and sometimes restless leg patients also experience periodic limb movements. Pramipexole or ropinirole treat both conditions. Your husband should see a doctor.
The booklet on restless leg syndrome and nighttime leg cramps explains these conditions and their treatments. Readers can obtain a copy by writing: Dr. Donohue, No. 306W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient's printed name and address.


DEAR DR. DONOHUE: I play softball for my company. Last week, while rounding second, I felt like I stubbed my toe. It hurt, and it still does. People tell me it is turf toe. What is that, and how long does it go on? M.L.
ANSWER: Turf toe happens when the big toe is forcefully bent upward. That motion sprains ligaments at the base of the toe.
Every time you take a step, your big toe propels the body forward. Limit your walking to give the toe a rest. Splinting the toe with tape is helpful. Shoes with a sturdy sole also protect the toe.
If the ligaments have only been stretched, your toe ought to feel fine in two weeks. If the ligaments are torn, it will take six weeks.
You and I are going on "people's" diagnosis. If there isn't a major turnabout shortly in how the toe feels, have a doctor confirm the diagnosis.


DEAR DR. DONOHUE: I started treatment for asthma for the first time at age 80. At first I took prednisone and albuterol. Then I had a Pulmicort inhaler. Now I am on Symbicort. The material that comes with this medicine advises that this LABA (long-acting beta agonist) may increase the chance of death from asthma. Exactly what is this telling me? E.S.
ANSWER: With asthma, there is a sudden constriction of the breathing tubes (bronchi), along with the production of thick mucus. Both block the flow of air into the lungs, and both cause asthma symptoms shortness of breath, wheezing and coughing. Asthma changes are reversible.
Asthma medications come in three major categories. One is quick-action medicines, the kind that get to work fast to open the breathing tubes. Many of these medicines are SABAs, short-acting beta agonists. Albuterol is one example. Beta agonists dilate bronchi. Too-frequent use of the short-acting beta agonists indicates poor asthma control. They should be used only for an acute attack, and attacks should be infrequent.
The second category is cortisone drugs, the potent suppressors of inflammation. They calm airways and prevent their constriction. They also decrease mucus production. Taken by mouth, cortisone drugs have unpleasant side effects when used for long periods in high doses. Taken by inhaler, the side effects are few. Pulmicort is a cortisone-inhaler drug.
The third category of drug is long-acting drugs, drugs that keep the airways less twitchy for prolonged periods. Long-acting beta agonists, LABAs, belong in this category. LABA drugs have been noted to increase the risk of serious asthma attacks, which ended in fatalities for a few. That was in the days when they were used alone. Now they have been incorporated into preparations combined with cortisone drugs. Since these dual preparations have come to the market, no drug-related asthma fatalities have been reported. The warning still exists because a LABA is part of the drug. You don't need to worry about your medicine, Symbicort. It's a dual medicine.
The asthma booklet explains in detail this common malady. To order a copy, write to: Dr. Donohue -- No. 602W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient's printed name and address. Please allow four weeks for delivery.


DEAR DR. DONOHUE: A while back, you had information in your column about ear trouble while on a plane. This spring, we went on an airplane for my grandson's graduation. On the flight back, my granddaughter got a terrible earache. I had the same trouble a year previously. She was crying, and we didn't know what to do. What causes this, and what can be done for it? B.L.
ANSWER: The earache comes from an imbalance of pressure on the outside and inside of the eardrum. It happens on ascent and descent, but it's more common on descent. The pressure imbalance pushes the eardrum inward. That is painful.
Hundreds of readers wrote to me about EarPlanes Ear Plugs, found in many drugstores. These earplugs lessen pressure on the eardrum. I'm convinced they work well.
Other tricks to equalize pressure include repeated yawning, gum-chewing and plugging the nose between thumb and index finger while forcing air out of the nose.


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. 2010 North America Synd., Inc. All Rights Reserved


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