Some facts on Multiple Sclerosis
DEAR DR. DONOHUE: My 53-year-old son was diagnosed with multiple sclerosis in September 2011. He functions quite well, has a small limp and goes to work in his office regularly. Recently, he had an MRI scan. His doctor told him: "There is one new lesion on your brain MRI. I wouldn't change anything now, but recommend you come back in six months for another scan."
I feel he should have more attention sooner. What would you recommend? -- F.C.
ANSWER: Let me provide you and readers with a few facts on multiple sclerosis before I answer your question.
As many as 350,000 Americans suffer from this illness yearly. Its onset usually begins between the ages of 20 and 50. The basic problem is a stripping away of the insulation material, myelin, from nerves that permit the transmission of information from brain to spinal cord through electric signals. Without myelin, the electric transmission isn't possible: It's short-circuited. That brings on muscle weakness, loss of sensation and the many other signs and symptoms of this disease. Current teaching holds that the body's immune system is responsible for attacking the myelin nerve covering.
I'm taking it that your son suffers from the most common variety of MS, relapsing-remitting. This kind of MS has episodes of worsening (relapsing) and episodes of improvement (remitting). The course is unpredictable, however. Relapses might occur around every two years. It's not unreasonable for your son's doctor to wait six months to see him again.
That doesn't mean, however, that should your son develop new symptoms or worsening of current problems, he should stay silent. He ought to call his doctor immediately so that a change in medicines or a change in the way they're taken can be made. With all the medicines now available, MS isn't the incapacitating illness it once was for so many. It still remains an incapacitating illness for some, however.
DEAR DR. DONOHUE: My husband's back has sprouted a number of dark-brown, oval things that have a pebbly surface. Are they moles? Could they be cancers? What should we do? -- N.N.
ANSWER: Any suspicious and undiagnosed brown or black skin growths call for a doctor's exam. What you describe doesn't, however, sound like moles or cancers. They sound like seborrheic keratoses (SEB-oh-REE-ik CARE-uh-TOE-siss).
They're noncancerous growths, brown or dark brown and have a pebbly surface, as you describe. They look like they've been glued to the skin.
Seborrheic keratoses require no treatment unless the person wants them removed. They do require a professional diagnosis.
The doctor can remove them by freezing them with liquid nitrogen, shaving them or snipping them off.
DEAR DR. DONOHUE: I came down with a case of shingles. They're quite painful. Would it help if I got the shingles vaccine now? Would it speed the healing and take away some of the pain? -- J.K.
ANSWER: The vaccine won't get rid of your current outbreak. It's for prevention, not treatment.
However, once you're over your bout, you can get the vaccine. Shingles recurs more frequently than was once believed. The vaccine is designed to bolster your immune system to keep the shingles virus under house arrest. The exact amount of time to wait for the vaccine after a shingles outbreak isn't known with certainty.
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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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