Q. I have a hiatal hernia. Can that cause heartburn? Stomachacid keeps bouncing back at me, causing belching, etc. I sleep withmy head elevated and still have backflow of juice. What can be done?My doctor does not recommend surgery.
A. Heartburn, as you say, results from reflux of stomach acid,and you don't have to have a hiatal hernia to have that. The hernia(at the diaphragm level of the esophagus) might not be influencingthings one bit. Your doctor doesn't think so, and he's examined you.
In any event, your job is to rein in this acid, to keep it whereit belongs, in the stomach. First off, you have to know which foods,if any, worsen the situation. Chocolate, citrus juices, mints andcaffeine are most frequently mentioned.
You are elevating your head at night. I hope that means youhave six- or eight-inch blocks propping up the head of the bedstead.It is hard to accomplish this with pillows, etc.
Also, I want you to eliminate any constricting undergarmentsaround the abdomen. Don't lie down too soon after eating. And tryantacids on a regular basis - one and three hours following meals andagain before retiring.
Q. Is surgery for varicose veins painful? Can they do both legsat once? How long is hospitalization?
A. What pain there is is always controllable, and it is possibleto do both legs at the same time. Sometimes surgery is done on anoutpatient basis. An overnight or an extra day of hospitalizationmay be required.
There are alternatives to surgery, such as sclerotherapy, inwhich the veins are injected with a drying solution. It's not forall varicose veins but is an option.
For more information, see the varicose vein report. Order bywriting Dr. Donohue/No.34, Box 830, Gibbstown, NJ 08027-9909,enclosing a long, stamped, self-addressed envelope and $2.
Q. I'm always afraid to give my children aspirin when they haveflu symptoms because of Reye's syndrome. Please explain what it isand if it can be fatal.
Q. Reye's syndrome occurs in a child (rarely in an adult) whoseems to have recovered from chicken pox, flu or some otherrespiratory tract infection. You then notice changes, perhapsirritability or drowsiness, or unexplained vomiting.
Any of these signs is enough evidence to prompt a call to thedoctor. If unattended, Reye's can lead to a coma and even death.
Aspirin used in these illnesses seems to play a role in Reye's,although the part played is not quite clear. Statistics tell us tocaution parents not to use aspirin in those who have flu, chicken poxor similar illnesses.
Exercise caution in using any medicine in a child. If afever-lowering drug is needed and your doctor is not available, youare safer using acetaminophen (Tylenol) according to packageinstructions.
Q. My daughter went to a dermatologist and he told her she had arare skin disease. It's called granuloma faciale. Could you tell usin words we can understand just what this is?
A. Granuloma faciale means that white blood cells have gotteninto the facial skin. This produces flat patches, brown to violet incolor. We don't know why it happens. The patches are not painfuland they don't itch. Dapsone is used in treating this condition, andsometimes the argon laser has been used to remove the patches.
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