DEAR DR. DONOHUE: I have been diagnosed with scleroderma. Can you tell me more about this disease? I am 52. I choke on food, and I have lost 25 pounds. – C.S.
ANSWER: The name “scleroderma” (SKLAIR-uh-DUR-muh), from two Greek words meaning “hard skin,” puts the focus on the salient feature of this illness – taut, thickened skin, so much so that it can be difficult to bend fingers or to smile. For unclear reasons, the body overproduces collagen, a protein that supports skin and organs. The overabundance of collagen hardens skin.
Internal organs are not spared. The digestive tract is frequently involved. The esophagus – the swallowing tube – can become rock-hard and make it difficult to get food down to the stomach. The entire digestive tract can be infiltrated with collagen and impair food absorption – a cause of weight loss. Diarrhea is another consequence of digestive tract involvement.
When collagen infiltrates the lungs, breathing becomes difficult, and the infiltration often brings on a cough. Kidney involvement hampers the cleansing of toxic material from the blood, and it leads to a rise in blood pressure.
Up to 95 percent of scleroderma patients suffer from Raynaud’s phenomenon. Arteries of the hands (and sometimes feet) go into an intense spasm when exposed to cold. The hands turn white, blue and then red, and they become painful when this occurs. (Although most scleroderma patients have Raynaud’s, most Raynaud’s patients do not have scleroderma.)
New treatments have lengthened the life of scleroderma patients. There is no medicine that cures it, but many medicines can control damage done to individual organs. For example, ACE inhibitors, such as captopril and enalapril, preserve kidney function and bring down elevated blood pressure. Nifedipine is a control medicine for Raynaud’s.
You should see a rheumatologist, a specialist in this illness. You also need a dietitian to help you with supplements that can overcome the malabsorption your scleroderma has caused.
There is something good to be said about scleroderma. It’s the Scleroderma Foundation, a source of information and help. Contact the foundation at 1-800-722-HOPE or online at www.scleroderma.org.
DEAR DR. DONOHUE: My teenager has asthma. It’s been suggested that he take shots for it. I am not sure if this is the right thing to do. I don’t approve of injecting the body with foreign materials. What are your thoughts? – C.G.
ANSWER: When there is an allergic trigger to a person’s asthma and when that allergy can be identified, then taking “shots” that blunt the allergy trigger’s effect makes a great deal of sense. The “foreign material” is a dilute solution of the allergy-provoking substance. If your son has allergies, he is breathing those foreign materials into his body anyway. The injections induce the formation of antibodies that blunt the reaction caused by those allergic triggers.
Inhaled allergens cause certain body cells to release histamine, and histamine narrows airways – an asthma attack. This is not the basis for all people’s asthma attacks, but it is for some.
My opinion is that your son would benefit from allergy desensitization if it has been shown that his asthma has an allergic basis.
People who would like to learn more about asthma and its treatment can order the asthma pamphlet by writing: Dr. Donohue – No. 602, P.O. Box 53647, 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: What would you say to a woman who allows her children to play in a sandbox that is used as her cat’s litter box? – K.C.
ANSWER: I would tell the woman she has abandoned common sense. She should not allow such a thing. It’s a health hazard to her children.
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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