Leprosy is now a treatable illness
DEAR DR. DONOHUE: Can you fill me in on lepromatous leprosy? I know that it is highly contagious. Is there a cure? I thought it did not exist anymore. I have a friend in a foreign country who has it. -- V.B.
ANSWER: Leprosy -- more correctly called Hansen's disease -- is still with us but is not as rampant or as hopeless as it once was.
It is not a highly contagious disease. At worst, it is a mildly infectious disease. About 90 percent of the world's population has a natural immunity to it. Close living for protracted periods of time with an untreated patient who can transmit Hansen's disease bacteria in the air appears to be the way it is spread.
The illness has a long incubation. From the time that a person becomes infected to the time that symptoms appear can take as long as 20 years, with the average being two to four years.
The germ seeks out skin and nerves. When it stays localized in those two places, the illness is called tuberculoid leprosy, a less destructive form of infection.
In a few people the germ spreads to many places, including the lymph nodes, liver, spleen, bone marrow and eyes. This is the more serious form, and it goes by the name of lepromatous leprosy.
Modern treatment halts the progression of both kinds promptly, and most people can be treated as outpatients without showing any sign recognizable to the public of being infected. Gone are the days of isolation for Hansen's disease patients. Dapsone, clofazimine and rifampin are three drugs that have completely changed the outlook for people who have this infection. They can cure.
If you want to read about this illness, get Stanley Stein's book, "Alone No Longer," from the library. It is a moving and informative account of the illness and of the social injustices that have been perpetrated on patients even in our own time.
DEAR DR. DONOHUE: I have just returned from the hospital because of an attack of diverticulitis. Does it ever go away? Will I have to be on guard for the rest of my life? -- A.D.
ANSWER: A diverticulum is a bulge of the colon lining through the muscular wall of the colon. It looks like a budding pea on the colon's exterior. Diverticula are common. Two-thirds of people who make it past their 80th birthday have colon diverticula -- diverticulosis. Once formed, they stay for life.
When diverticula become inflamed, the condition is diverticulitis, and that can require hospitalization for treatment.
If you keep your stool soft, the chances for diverticulitis drop, as do the chances for forming new diverticula. You can do that by eating a high-fiber diet, one with plenty of whole grains and raw fruits and vegetables with their skins. Bran, found in all health food stores, is an excellent fiber source. It is only in societies where highly refined diets are the staple that diverticulosis and diverticulitis are rampant. Fiber holds on to water and keeps the stool soft. Forceful contractions of the colon muscles are not needed. Those contractions are the reason why diverticula form. People need 25-35 grams of fiber daily.
The diverticulosis report tells the story in greater detail. Readers can obtain a copy by writing: Dr. Donohue -- No. 502, Box 536475, 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: Two years ago, a doctor gave me glucosamine and chondroitin tablets for a sore knee. She said I had arthritis. Only recently did I decide to take it. The first night, I had a rash from chest to feet. The next night I had welts like hives. Itching was terrible. Do you believe this is safe to take? -- M.W.
ANSWER: Most people can take glucosamine and chondroitin safely and without breaking out. You are an exception. You are having an allergic reaction. Why I cannot say. Some glucosamine is derived from shellfish. If you are allergic to shellfish, that might explain the reaction. But if your glucosamine preparation was made in a laboratory, this of course would not apply.
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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.
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