QUESTION: I have been diagnosed as having CREST syndrome, a variant of scleroderma. Would you have information on this? The doctor who diagnosed it has moved. I believe the letters stand for symptoms - the R for rhinitis and the T for tinnitus, etc. I would be grateful for any additional information. - M.H.
ANSWER: Hold it, M.H. You're off the track. True enough, the five letters do stand for individual symptoms, but not for the ones you say.In the CREST acronym, the C is for calcinosis (deposits of calcium under the skin); the R for Raynaud's (sensitivity of fingers to coldness); the E for esophagus trouble (in swallowing); the S for sclerodactyly (hardening of the fingertips), and the T for telangiectasia (a peculiar dilatation of skin vessels). Some feel that CREST syndrome is, indeed, a variant of scleroderma, the illness where skin and internal organs are affected by scarlike tissue.
Since CREST symptoms often stabilize for long periods, you just treat the patient's symptoms when and if they occur, those of swallowing or the cold sensitivity, for examples.
QUESTION: I am 37, female, in good health. I have what is called a lipoma, whose size and location (on the waist) embarrasses me. It also hurts when it gets trapped in the thigh when I have to bend at a filing cabinet. I understand surgery to remove it would be considered cosmetic, and I'd have to pay for it. Is there a non-surgical way to get rid of it? Will it recur? - Mrs. S.M.H.
ANSWER: Lipomas are localized fat deposits. Most are removed for cosmetic purposes, but yours is different. It is hindering your work, your bending, for example. You are seeking removal, not for cosmetics, but for pain relief. That's not cosmetic surgery.
Brace yourself for a go-around with your insurance company, which you should win. I'm in your corner. No, there is no non-surgical answer to a lipoma. They don't usually recur when removed.
QUESTION: I have thyroid and blood pressure problems. I take several pills. Is it OK for me to put the various pills I take next to each other in a pill box? It would help me keep account of what I have taken or not taken that day. - Mrs. J.S.
ANSWER: Sure, go ahead. The pills will get along together fine. None will be affected by the others, if that's what you mean. I'm sending on the thyroid report for your perusal. Others may order by writing: Dr. Donohue/No.32, Box 830, Gibbstown, NJ 08027-9909, enclosing a long, double-stamped, self-addressed envelope and $2.
QUESTION: What are complex carbohydrates? - Mrs.T.L.
ANSWER: Sugars are carbohydrates. So are starches. The difference is in the arrangement of their carbon and hydrogen atoms. Sugars are simple, starches more complex.
Simple carbohydrates are table sugar, syrups, molasses, honey and fruit sugars. Starches include grains, breads, pancakes, pastas, cereals, bran, rice, potatoes, peas, corn, beans - in short all vegetables, fruits and cereal grains. Fruits do have some simple carbohydrates (the fruit sugars), but they also have lots of complex carbohydrates in their skins and pulp.
Complex carbohydrates help replenish the body carbohydrate stores, unlike the simple kind. Their more complex fiber helps keep blood sugar down because it is not broken down so quickly, thus avoiding sharp highs and lows of blood sugar.
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.