QUESTION: My uncle had his kidney stones removed with shock waves. I've got gallstones and would like to avoid surgery. I know gallbladder stones have also been blasted the same way, but I can't find anyone in this burg who knows about it or where it can be done. I'd be willing to travel anywhere to get out of the cutting surgery. What do you think about this stone blasting anyway? - W.R.
ANSWER: There is a lessening of enthusiasm for extracorporeal shock-wave lithotripsy (blasting, if you will) for gallstone removal.First of all, not all gallstones can be gotten rid of this way. Limiting factors include stone size (they must be quite small), their composition, and the likelihood of stones reforming afterward. The reformation problem has been limited by putting the patient on stone-dissolving medicine following the shock-wave treatment. However, this does commit you to long-term drug therapy.
I must put in a few kind words for the surgery to remove the gallbladder itself. It has been refined to the point where removal can be accomplished using a small scope instrument through small incisions. Patients often leave the hospital the same day.
Many surgeons continue to favor more conventional (and equally effective) surgical removal procedures. One thing is certain, gallbladder removal does ends stone problems for good.
QUESTION: Some time back, you had an article about nighttime cramps in the legs. You gave an exercise to help. I have been doing that exercise faithfully and have had no cramps since. Thank you many times over. In case you forgot, you stand three feet from the wall with your palms braced against the wall. Then you lean your body forward, keeping the feet in place. It stretches the leg muscles. It's simple. I do it for 10 minutes. I hope others try it. - Mrs. K.S.
ANSWER: Thanks for your feedback. I've heard from others who report success. But I can't take credit for the exercise. That goes to a Dr. Daniell in California. Another cramp preventive is wedging of a pillow against the soles of the feet at night so arches don't flop down when you are on your back. That can make calf muscles cramp up. Other readers can order the leg cramps report by writing: Dr. Donohue/No. 20, Box 830, Gibbstown, NJ 08027-9909, enclosing a long, stamped, self-addressed envelope and $2.
QUESTION: Would you please write about neurodermatitis? Nothing helps, and clothing is a torture to wear. I can't find help. I am taking Synthroid following thyroid removal. I am a female. - E.S.
ANSWER: Neurodermatitis is a form of eczema where the skin develops tiny blisters that itch. Often the blisters appear as raised coin-shaped patches. The "neuro" part of the name refers to the role things like tension, stress or anxiety may play in aggravating such itching.
Usually, cortisone creams in combination with an anti-itch pill (hydroxyzine) gets things under control.
I can't relate your problem to thyroid removal or to the replacement thyroid medicine you are taking.
QUESTION: You recommend regular Pap tests to avoid cervical cancer. Fine, but my insurance company will not pay for them. I am sure others are in this predicament. Your comment? - Mrs. J.
ANSWER: I don't know why this is so, but this is the situation for many women, unfortunately. Let's hope things will change. Meanwhile, it's worth the cost to you to have this valuable test done at your own expense.
Dr. Donohue welcomes reader mail but regrets that, due to the tremendous volume received daily, he is unable to answer individual letters. Readers' questions are incorporated in his column whenever possible.