DEAR DR. DONOHUE: I read your column daily and usually enjoy it. However, a few times I have had a problem with your comments. One was what you said about genital herpes. I don’t remember your exact words, but you said it can be spread even if there isn’t a visible outbreak. I disagree. I have had herpes since 1985. I have been married since 1988 and have never used a condom. I have not passed herpes to my wife. I don’t have sex when there is an outbreak. Saying herpes can be spread when there are no sores is, in my opinion, a disservice to your readers. – Anon.
ANSWER: It’s a free country, and you have every right to your opinion, but it is wrong – completely wrong. Arguing from evidence obtained from one’s personal experience is dangerous.
One in five adult Americans is infected with the genital herpes virus. Nearly 80 percent of the infected don’t know they’re infected because they have never had any signs or symptoms of the infection or because they have mistaken the signs and symptoms of infection for something else.
Transmission of the virus takes place mostly by people who don’t know they are infected or by infected people who don’t realize that the virus can be passed when there are no visible signs of viral activity.
Let me quote from a respected medical journal: “In a study of couples discordant (one having the infection, the other not infected) for HSV-2 (the genital herpes virus) infection, 70 percent of transmission events occurred when the source partner (the infected person) was asymptomatic (had no signs or symptoms).” And that’s only one of many such studies.
Condoms reduce the risk of transmission but don’t eliminate it entirely. The chance of passing the virus when sores are present is at its highest, but the virus can be passed when no sores are there.
The herpes booklet describes what happens with this infection and how it is treated. Readers can obtain a copy by writing to: Dr. Donohue – No. 1202, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: I read recently that taking calcium tablets is of no value. A person should drink milk instead. What do you say? Please answer this. I am sure that many other people would be interested. – M.D.
ANSWER: Milk sugar – lactose – and the vitamin D added to milk enhance calcium absorption. However, the calcium in calcium tablets does get into the body. All the calcium studies have been done with calcium tablets. You don’t have to worry that you’ve been wasting your time and money. If you like milk, you can get your calcium by drinking it. An 8-ounce glass has 300 mg. You need four to five glasses a day to reach your calcium requirement if milk is your only calcium source. Drink the low-fat variety.
DEAR DR. DONOHUE: I have been taking my medication pills with either milk or orange juice. My wife claims that I should take them all with plain water. Any merits to her argument? – R.B.
ANSWER: There is wisdom in her argument. Taking medicine with water removes all questions of food-drug interference and makes life easier for me.
On the lists of food-drug interferences that I have, I cannot find orange juice listed. I do find two references of not eating Seville oranges with statin medicine (the cholesterol-lowering medicines) or with calcium channel blockers (blood pressure and heart medicines). Seville oranges are a sour kind of orange used for marmalade. Milk has calcium, and calcium interferes with the absorption of the tetracycline antibiotics.
Why not make life simple? Take your wife’s advice.
DEAR DR. DONOHUE: Is there a truly diagnosable condition known as chronic fatigue syndrome? I recall hearing of it some years ago. Now my granddaughter might have it. – H.L.
ANSWER: Most doctors subscribe to the existence of chronic fatigue syndrome. It’s a complicated illness without a known cause, without any diagnostic test and without a medicine that works for all patients.
We all understand acute fatigue – the weariness that comes from hard physical or mental work and that responds to a night’s rest. Chronic fatigue, on the other hand, is fatigue that lasts at least six months. Sleep doesn’t relieve it. People wake up as tired as they were when they went to bed. Often, they have a hard time concentrating, and their memory doesn’t work as well as it used to. Some complain of a sore throat that lingers, others of tender muscles, and still others of frequent headaches or swollen lymph nodes.
In approaching patients suspected of having chronic fatigue syndrome, doctors must look for medical and psychiatric conditions where fatigue is prominent. They have to consider such things as multiple sclerosis, a misfiring thyroid gland, anemia, diabetes, depression, infections like TB and even cancers. Only when fatigue-causing illnesses have been checked and not found can the diagnosis stand on firm ground.
What to do for the syndrome is as perplexing as the syndrome itself. Staying as active as possible allows patients to avoid a breakdown in muscle conditioning. And a modest exercise program generates body chemicals that fight fatigue. Ten minutes of walking, or even less if 10 minutes is too exhausting, is a good starting point. People should increase the walking sessions to two and then three times a day, and then lengthen the amount of time they walk. Amitriptyline, an antidepressant, is often prescribed for its ability to restore normal sleep. Cognitive behavioral therapy helps patients regain control of their lives. Your granddaughter should seek help from her family doctor.
The booklet on chronic fatigue syndrome explains this condition in greater detail. To order a copy, write to: Dr. Donohue – No. 304, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.
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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