DEAR DR. DONOHUE: I have been an insulin-using diabetic for three years now. My husband and I want to have a family. We are scared. We have heard of birth defects in children of diabetic mothers. Can you ease our minds? - Mrs. E.F.
ANSWER: I think I can put your mind at ease. The essential fact to keep in mind is that mothers with any controllable illness have to work extra hard at controlling it when pregnant. Diabetes is one of those illnesses. If you have been able to keep your blood sugar under control in the past, your only concern should be with keeping it under control during the pregnancy.The earliest months of pregnancy are the ones in which such defects are most likely to occur, so your doctor will watch you very carefully during that time. Under control, you are just as likely to have a healthy baby as are non-diabetic mothers. You'll be interested to learn that even non-diabetic mothers are routinely checked for changes in their blood sugar levels.
DEAR DR. DONOHUE: I'm a fan. You've written about gallstones. How about some advice on calcified gallbladder? Should it be removed if you've had no symptoms? - Mrs. L.S.J.
ANSWER: When a gallbladder is inflamed, it can buildup calcium in its wall. We call that a "porcelain" gallbladder. Now, even though a person may not have symptoms from this, removal is often advised, since the threat of cancer exists from it. Granted, it is a rare cancer. I discuss such concerns in the gallbladder report, which I would have sent had you given your address. Others may order by writing: Dr. Donohue/No. 40, Box 830, Gibbstown, NJ 08027-9909, enclosing a long, stamped (52 cents), self-addressed envelope and $2.
DEAR DR. DONOHUE: For some time now my eyes have been yellowish. Can this have to do with anemia? - Mrs. M.M.
ANSWER: Whites of the eyes yellow when bilirubin levels rise in the blood. Bilirubin is the pigment from red blood cells. It is normally controlled by the liver. Thus, when bilirubin starts piling up, you can count on there being either a liver problem or defective red blood cells in the background.
One thinks of rare kinds of anemia, like the kind where a great many red cells disintegrate before their normal lifespan, releasing their bilirubin into the blood at a fast clip. (Ordinarily, red cells live 120 days.) The eyes yellow from this excess pigment substance.
Many liver ailments cause yellowing (jaundice) when it cannot get rid of the dying blood cells efficiently enough. Again, the pigment piles up in the blood. Are you doing anything about this eye yellowing? You should. Early treatment of such problems as I've listed can bring control. Your body has given you a serious warning. Heed it.
DEAR DR. DONOHUE: My husband, who is in the military, is retiring. He is 42. What would constitute a complete physical for him before retirement? - Mrs. O.C.
ANSWER: Your husband should have his blood pressure, pulse, vision, hearing, eye pressure, heart, lungs and other body organs checked in any thorough physical. He should have a rectal exam to check his prostate status. Some doctors include, a chest X-ray, EKG and a colon exam.
Basic lab tests should include those for blood sugar and cholesterol. His stool should be checked for microscopic evidence of blood cells. His immunization should be updated. His responses to medical history questions will dictate other specific testing.
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.