QUESTION: I have been diagnosed with Sjogren's syndrome, and I have the dry mouth with it. Is there a specific way to handle that? The mouth dryness seems to be affecting my teeth. - Mrs. L.B.B.
ANSWER: Sjogren's (for other readers) involves a disordered immune system. For reasons that are unclear, that system has turned on the body's own tissue. In Sjogren's (pronounce it SHOW-gren's) the tissue involved is that of the salivary and tear glands. Thus, chief symptoms are dry mouth and eyes.Although we usually cannot pinpoint any triggering event for this immune system assault, Sjogren's often is found to be part of a larger problem - rheumatoid arthritis, lupus, scleroderma, for examples. If such associated illnesses are found, they are treated separately.
For the dry eyes of Sjogren's, the only practical answer lies in special lubricants, either by prescription or over-the-counter. Given the susceptibility of dry eyes to infection, keeping them moistened is important. The same applies to dry mouth, with special attention to the teeth, which can deteriorate rapidly in a dry environment. Some Sjogren's patients learn to keep at hand a small water-filled plastic squeeze bottle for moistening purposes. The dentist can offer fluoride application protection, particularly important for those with the salivary gland problems.
QUESTION: Tests show high levels of uric acid in the blood. But I have no gout symptoms, no pain, etc. I am confused by the runaround I am getting. I am a woman, 64. Should I or should I not be on medicine? - Mrs. J.L.
ANSWER: Not necessarily. An elevated blood uric acid level does not have to cause the pain of gout or indicate that you will ever have that. Just having elevated levels is not uncommon.
On the other hand, the blood level should be a warning. For example, you should make efforts to stay well-hydrated, while following through on future tests to keep track of the blood situation. If levels become markedly high, then medicines to lower them can be brought into the picture. Apparently, your test results are such that you have the option of avoiding drugs, which can have unpleasant side effects. For a fuller discussion, see the gout report, which I am sending on. Other readers may order by writing: Dr. Donohue/No.13, Box 830, Gibbstown, NJ 08027-9909, enclosing a long, double-stamped, self-addressed envelope and $2.
QUESTION: I have another answer to the complaint about petrolatum for dry skin. To counter the greasiness, I mix it with cocoa butter cream. This mixture goes on smoothly and stops itching, leaving a pleasant scent as well. - C.L.J.
ANSWER: Thanks. C.J. also notes that the mixture is approximately half and half.
QUESTION: Chest pain of the non-cardiac variety is frequently associated with panic disorder or major depression. Recent studies have shown this. Your previous letter writer (complaining of this) might benefit from . . . appropriate medical/psychological treatment. - K.F., Ph. D.
ANSWER: I'm pleased to pass on your thoughts, and it is something the letter writer might investigate.
DEAR DR. DONOHUE: Many patients with floaters will have no problems, but about one time in 20, floaters actually will indicate a peripheral retinal tear, often leading to retinal detachment. Or floaters can indicate . . . vessel problems. . . . Patients should be told to see an ophthalmologist for an examination within no more than a week of the onset of floaters. Old floaters that come and go are benign as you say, but not new ones. - L.H.B., MD
ANSWER: Thanks for this reminder concerning the bothersome, and usually benign, eye floater phenomenon. First onset should be examined.
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.