DEAR DR. DONOHUE: Less than six months ago, our 22-year-old, otherwise-healthy son died from an aortic dissecting aneurysm. He had symptoms of chest and lower back pain only 24 hours before he passed away, and he left the doctor’s office less than half an hour before his death. He had been sent home to rest, since they felt he had pulled a muscle.
We can’t find much information about this condition. We know our son did not have Marfan’s syndrome. Our concern is about our 21-year-old daughter and ourselves. Could this be hereditary? – V.L.
ANSWER: You have my sincerest condolences. Few things in life are as tragically devastating as the loss of a child.
Your son’s aorta – the body’s largest artery, which comes directly from the heart – had two problems: an aneurysm and a dissection. An aneurysm is a bulge of an artery’s wall and represents a weak spot. A dissection is a tear in the aorta’s wall, and it can lead to a massive internal bleed. Both conditions often coexist, but not at your son’s age. They more typically happen to older people.
Your mention of Marfan’s syndrome is appropriate. When a young man has an aortic aneurysm and dissection, one thinks of inherited conditions that weaken the aorta. Marfan’s syndrome is one of those conditions. It’s often the cause of sudden death in young athletes who did not know they had it. Other inherited conditions can do the same. Cystic medial necrosis of the aorta features a degeneration of the collagen support in the aorta’s wall. That, in turn, can lead to aneurysms and dissections. It can be inherited.
Was any part of your son’s aorta examined microscopically? If it wasn’t, then I tend to feel as you do. Since it could be due to something hereditary, the family should at least have ultrasounds of their aortas to detect any bulges. Why not talk this over with your family doctor?
DEAR DR. DONOHUE: Our grandson, age 15, has been diagnosed with Asperger’s disorder. We don’t know much about it and are very concerned. Please say something about it. – D.P.
ANSWER: People with Asperger’s disorder have difficulty in relating to others. One manifestation of that difficulty is their failure to maintain eye contact with people they’re talking to. They find making friends difficult. They are often preoccupied with restricted interests and find it difficult to express emotions. They often lack fine motor control and are not usually interested or gifted in sports.
Most, however, have normal or high verbal intelligence, and most are able to function independently and lead productive lives. The last time I wrote about the disorder, I received a letter from a middle-age man who was diagnosed with Asperger’s late in life. He related the social difficulties he’d had in his school days. He managed, however, to obtain degrees in mathematics, physics and computer programming and was leading a fulfilling life.
DEAR DR. DONOHUE: Ever since your article in May 2003, I have inquired about stapedectomy and come up with a big zero. Perhaps doctors know but do not want to push the procedure. Is it a well-kept secret?
Would you write information on this ear problem? – B.H.
ANSWER: 2003? You’re a patient person to wait so long to write.
Stapedectomy is an ear operation. Bridging the middle ear is a chain of three small bones that conducts sound waves to the inner ear. In the inner ear, the sound waves are converted into nerve impulses and transmitted to the brain for hearing.
A stiffening of the middle-ear bones makes them incapable of transmitting sound waves. The name of the illness is otosclerosis. The bone most often involved is the stapes. In a stapedectomy, the frozen stapes is repaired, and hearing returns.
All ear, nose and throat doctors – in fact, all doctors – know about stapedectomy. Perhaps they didn’t go into detail for you because you have no signs of otosclerosis. They might not have wanted to raise false hopes of restoring hearing in a person who would not benefit from the operation.
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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