DEAR DR. DONOHUE: Our son-in-law, age 52, was diagnosed with Lou Gehrig’s disease about four years ago. There are three young children in the family. Is it known if the disease can be passed down to the children? – A.S.
ANSWER: Lou Gehrig’s name has become a synonym for amyotrophic lateral sclerosis — ALS. Because of the baseball player’s battle with the disease, most people know the illness by his name.
This is an illness where nerve cells of the spinal cord and brain begin to die. The involved nerve cells are the ones responsible for movement of muscles. The result of nerve cells’ death is increasing muscle weakness and muscle wasting. ALS at first involves leg and arm muscles, but eventually it spares no body muscles. Chewing and swallowing food become herculean tasks. Speech muscles do not escape, so speech ultimately reaches the point of slurred, hard-to-understand words.
The cause is unknown. However, most cases are not passed from parent to child. Only about 5 percent to 10 percent of ALS patients have the inherited form. If your son-in-law’s family has no other cases, it is not likely that his is the inherited variety, and it is not likely that your grandchildren will be affected.
One drug, Rilutek, is approved for treatment. It can slow progression of the disease a bit. It is not, however, a cure. Physical and occupational therapy do a better job at helping ALS patients cope with their illness.
All ALS patients have powerful friends in the ALS Association of the United States and the ALS Society of Canada. Their respective phone numbers are (800) 782-4727 and (800) 267-4257. Their respective Web sites are www.alsa.org and www.als.ca.
DEAR DR. DONOHUE: I suffer from fibromyalgia. I understand that protein is essential for muscle repair and think my diet provides sufficient protein. But is there a test to determine whether the body has enough of it? – P.G.
ANSWER: Hallmarks of fibromyalgia are widespread muscle pain and stiffness, joint pain, extreme fatigue and nonrefreshing sleep. When the examining doctor presses on tender points, the pressure elicits pain far out of proportion to the pressure applied. The tender points are well-mapped-out, and doctors can easily locate them.
Your logic is sound. Muscles are mostly protein. Muscle problems, therefore, ought to respond to increased amounts of protein. It is the same logic that bodybuilders bank on.
Sadly, the logic doesn’t hold up. The daily protein requirement is 0.8 grams for each kilogram of body weight (0.136 grams for every pound of body weight). Growing children, pregnant women and athletes need a bit more. The average 150-pound (68-kg) adult needs 54 grams, a measly 1.9 ounces. That’s not a lot of protein. Three ounces of meat has 18-24 grams of protein. Most North Americans exceed the protein requirement many times over. Eating more than the recommended amount does not build or repair muscles faster than they do on their own when a person eats the suggested daily allotment.
There is a blood test that confirms protein deficiency. It is a test for albumin.
Albumin and protein are, for our purposes, one and the same. A low blood albumin reading can be an indication of too little dietary protein. You do not need this test. Protein deficiency on this continent is a rarity.
Fibromyalgia is a favorite topic of readers. The newly printed pamphlet on it provides the inside story on how best to cope with it. Readers can obtain a copy by writing: Dr. Donohue — No. 305, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.50 U.S./$6 Can. and the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: What does “hemolysis” mean? It was noted on my lab report. Is it serious? – K.K.
ANSWER: Hemolysis on a lab report means that red blood cells have broken apart either during the drawing of blood into the syringe or during transportation of blood to the lab. Hemolysis can sometimes produce false lab values. Blood potassium, for example, rises when red blood cells hemolyze.
Test-tube-caused hemolysis is not serious. Hemolysis that spontaneously occurs within the body can be.
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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