DEAR DR. DONOHUE: I had a headache for more than a month. I used every headache medicine I could get my hands on, but none worked well for me. I have finally seen my doctor. He thinks I have temporal arteritis and has put me on prednisone. The headache went away in a matter of days. I am to have a biopsy of an artery. Please explain all this. Will taking the prednisone affect the biopsy results? – B.W.
ANSWER: Temporal arteritis, also known as giant cell arteritis, is an inflammation of arteries. One that is often involved is the temporal artery, the artery at the side of the head in the temple area. This disorder strikes older people. The average age when it appears is 67.
Headache is the principal symptom. The temporal artery is tender to touch. Constant fatigue, a low-grade temperature and weight loss without dieting are other possible clues. An affected person can have jaw pain when chewing food.
The sed rate, a simple laboratory test, is usually greatly elevated.
Temporal arteritis is an example of an illness where the body’s immune system turns on its own tissues – in this case, its arteries.
Its most feared complication is blindness. That happens when the artery that supplies the eye with blood is inflamed. Because of that possibility, treatment is begun quickly.
Prednisone is the drug that’s the usual choice. It’s a cortisone drug, and those drugs are the most powerful inflammation-fighters medicine has.
A biopsy of the temporal artery can give solid proof that the diagnosis is temporal arteritis. Beginning prednisone treatment before having the biopsy does not interfere with a correct interpretation of it.
Temporal arteritis often goes hand in hand with polymyalgia rheumatica, a condition that produces painful and weak shoulder and hip muscles. It too responds to prednisone.
DEAR DR. DONOHUE: What causes a person to have frequent nosebleeds? My doctor looked in my nose and said it was fine. All my lab tests came back good. I work as a cake decorator, and I have to go in and out of a freezer many times during the day. Someone suggested that might be the cause, but I don’t think so because I can get them at home. – N.M.
ANSWER: Most nosebleeds result from dryness of the nose’s lining and inadvertent touching of the nose and its lining. You would be surprised at how many times people touch their noses every day. A touch of a nose with dry lining causes the lining to flake off and the nose to bleed.
I would lay odds on your work environment being the reason why you have frequent bleeds. A cold, dry environment is the perfect condition for sucking moisture from the nasal lining. The fact that some of the bleeding occurs at home doesn’t change my opinion. You take the dry nasal lining home from work.
With a cotton-tipped applicator, apply a thin film of petroleum jelly to the inside of your nose just a little ways in from the nostril. Do so twice a day. I bet that within one week your nosebleeds stop.
I have to cover the serious causes of nosebleeds for the sake of completeness. Allergies, nasal tumors, aspirin, clotting problems and inherited conditions such as Osler-Weber-Rendu disease are examples.
High blood pressure doesn’t cause nosebleeds, but it makes them last longer.
DEAR DR. DONOHUE: My granddaughter is 28 and has bulimia. She is still vomiting. I have checked with hospitals, but they want $900 a day for treatment. She has no insurance. How can she be helped? – M.S.
ANSWER: Bulimia is the eating disorder where a person goes on sprees of gargantuan eating followed by purging in order not to gain weight. Purging is getting rid of food by self-induced vomiting, taking laxatives or using water pills. How about asking your family doctor if there is a state or city department that provides help for people with this problem? Money should not be an obstacle to your granddaughter’s health.
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.
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