DEAR DR. DONOHUE: I just brought my boy home from the doctor's after an exam for sports participation. My boy is a long-distance runner and has been one for five years. The doc said he had an enlarged heart, but that it is nothing to cause concern. Well, that's easy for him to say, but I remember when people with enlarged hearts stayed in bed. Is this some new theory, that an enlarged heart is not a matter of concern? - E.F.
ANSWER: Many times, athletic training, especially the kind necessary for long-distance running, can cause the heart to enlarge. The heart is nothing after all but a specialized muscle, and so responds to such training by getting bigger.I am sure this is what his doctor had in mind when telling you it is no cause for concern. This fact was not understood in the past and it caused some confusion. The term "athletic heart" prompted fear of the worst kinds of outcomes. Now, there are some bad reasons for heart enlargement. Uncontrolled blood pressure and heart failure are examples of things that can cause an abnormally enlarged heart. I am pretty sure that if either of those factors was present, the doctor would have been whistling a different tune.
DEAR DR. DONOHUE: As a wrestling coach engaged in getting another championship team together, I am concerned with a new problem, wrestler's herpes, which the pros call herpes gladiatorum. I learned over the off-season that the kind of practice shirts worn can cause it. One fellow coach said his doctor mentioned this. I thought if anyone knew, you would. Please comment. - O.N.
ANSWER: I can't recall the source of this, but I read in one of the medical journals very recently a reference to th
s matter. It was from a college wrestling coach. He reported an increased number of herpes simplex skin infections after his team members switched from a light all-cotton shirt to a thicker one made of a combination cotton-synthetic fiber material. He noted that the increased skin abrasions resulting from the rougher fiber translated into easier transmission of the herpes between wrestlers.
DEAR DR. DONOHUE: I wonder if you have material on infantile glaucoma, just how common it is, and when treatment is started? Is it inherited, or what? Can normal eyesight be preserved? This involves an infant boy. - H.H.
ANSWER: All glaucoma is an abnormal build-up of fluid pressure in the eye. It is, of course, sight threatening, depending on the extent of damage to the optic nerve from that pressure.
Infantile (or congenital) glaucoma occurs in young children, and it occurs in about one in every 10,000 births.
The problem is a disturbance of eye tissue, which results in a blockage of the eye's tiny fluid outlet ducts that normally keep eye pressure within limits. In the primary form (cause unknown) there do seem to be genetic influences. In a few children, glaucoma results from eye injury or some unrelated disease. That is the secondary type.
Many times, the glaucoma is evident at birth, but in some youngsters it may be weeks or months before signs are recognized - pronounced aversion to light, for example, or enlarging eyes, eye twitching, tearing, etc.
You can't predict the future, but earliest possible surgery to control the fluid build-up through correction of the duct blockage offers the best chance of preserving normal pressure and vision. Although not terribly common, infantile glaucoma is another of those myriad things a doctor looks for in examining an infant, especially one with any of the symptoms I mentioned.
DEAR DR. DONOHUE: I have already heard of at least three treatments for genital warts. Which method do you prefer? - N.T.
ANSWER: When you see several treatments for the same problem, selection usually depends on variations of the problem, not on arbitrary choice. That's the case with venereal warts.
Freezing, electrosurgery, laser - all have their uses depending on the shape of the warts and their location, whether of the vagina, cervix, groin, or anus. Flat warts are treated differently than the node-like kind. Even non-surgical treatments, such as chemical application, vary with such factors. In short, you have to see the patient (the warts) before deciding on the appropriate treatment.
-DR. DONOHUE'S material on waistline slimming outlines a five-step program based on the specific muscles involved. For a copy, write Dr. Donohue/No. 38, P.O. Box 19660, Irvine, CA 92713-0660. Enclose a long, stamped, self-addressed envelope and $2.00.
-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.