DEAR DR. DONOHUE: You have written about hepatitis B and C, but I haven’t seen anything on hepatitis A. I had it. Will it cause liver problems in the future? – T.S.
ANSWER: Hepatitis A is a worldwide problem. In countries where sanitation is poor, it’s a major public-health menace. Even in industrialized countries with excellent sanitation, it poses a threat. Hepatitis A antibodies are found in 40 percent to 70 percent of the world’s population, with the highest numbers in countries where it is difficult to maintain a sanitary water and food supply.
Antibodies are evidence of previous infection.
The virus is spread from person to person or from food or water contaminated with it. It has a long incubation period – the time between when the virus enters the body and when symptoms first appear. The average is one month. Such a long incubation makes it hard to pinpoint the source of infection.
Fever, vomiting, diarrhea, muscle aches and a loss of appetite are common symptoms.
Some become jaundiced – their skin and the whites of their eyes turn yellow, a sign of liver involvement. Urine color darkens. The illness lasts about three weeks for most patients.
For a minority, hepatitis A can be a harrowing experience, and for a very few it can prove lethal.
Peculiarly, young children often develop few to no symptoms.
On the bright side, hepatitis A does not lead to cirrhosis or liver cancer down the road, as can the other hepatitis viruses.
There is a vaccine for hepatitis A. Household contacts of a hepatitis A patient should receive it, as should people traveling to countries where the hepatitis A infection rate is high.
Male homosexuals are at risk of getting this infection, and the vaccine is also recommended for them.
The hepatitis story – A, B and C – is told in the hepatitis pamphlet. Readers can obtain a copy by writing: Dr. Donohue — No. 503, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.50 U.S./$6.50 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: I am a 30-year-old female who is very active and athletically conditioned. My resting heart rate is between 48 and 56. My problem, however, is my blood pressure, which runs as high as 140/100 at times. Apparently this is due to birth control pills that I take for control of ovarian cysts.
Does the lower heart rate allow for less stress on blood vessels because the high pressure is there only half the time it would be if my heart rate were double what it is? – A.P.
ANSWER: Your slow heart rate (pulse) is a testimonial to your training. Your heart pumps almost as much blood in one beat as an untrained heart pumps with two beats. You have a healthy heart muscle.
The blood pressure story, however, is a cloud in the silver lining. The first number of a blood pressure reading reflects the force that the heart imparts to the blood when it ejects it. The second number is the pressure that stays in the arteries between heartbeats. Both numbers are important, and both contribute to artery hardening, heart attacks and strokes. Even with your slow heartbeat, the between-beat pressure is too high.
Do you take birth control pills for polycystic ovary disease? If that is your diagnosis, ask your doctor if you can take a substitute medicine. There are others.
DEAR DR. DONOHUE: I am a male, 86, functioning well physically and mentally. I had a malignant melanoma on my cheek and need information of what my chances are. – S.Z.
ANSWER: Treatment of and outlook for melanoma depend on how deeply it has infiltrated the skin, which of the four different kinds of melanoma it is, whether it has spread to lymph nodes, and if it has found its way to distant organs such as lungs, liver or brain. If a melanoma is confined to the superficial layers of skin, the outlook is most favorable. If a melanoma has spread to distant organs, the outlook is far less optimistic.
DEAR DR. DONOHUE: This is the third time I have written for information. Could a dropped bladder cause low back pain? – B.B.
ANSWER: I apologize to you and all readers whose letters I have to store for the right opportunity to answer. I like it even less than you do.
Sure, a dropped bladder or dropped uterus can cause back pain. A pessary – a doughnut-shaped device – can prop up a fallen bladder or uterus. If it relieves the pain, you know that the dropped organ was the cause. Then most women choose a surgical solution to prop up a dropped bladder or uterus.
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.
Send questions/comments to the editors.
