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PROSTATE EXAMINATION SHOULD BE PAINLESS

SHARE PROSTATE EXAMINATION SHOULD BE PAINLESS

DEAR DR. DONOHUE: You used to make me nervous by repeatedly advising men to get a prostate examination. "No news is good news" was my thought. I moved recently and changed doctors. That was the first thing he wanted to do, and before I knew it, I was there, having it done. Not so bad. A little swelling was found. I had ultrasound, and it turned out to be benign enlargement. Thanks belatedly, even though I never took your advice earlier. I hope other men did and do. - T.L.B.

ANSWER: How could I have made my point any better? The examination is not traumatic. Let's review it.You need no special preparation unless the doctor gives specific advice. The doctor takes normal sanitary precautions, then instructs you on positioning your body. Some doctors have the patient stand, others prefer a lying down position, legs bent, etc.

With lubricated gloved hand, his examination proceeds quickly and painlessly. The doctor probes gently just beyond the anal opening for telltale symptoms of this very accessible structure. He feels for consistency, normally that of a fat pad on the palm of the hand. He checks gland size, feeling for edges. If he can feel those, he knows the gland is of appropriate size. It's all over in a few minutes. The doctor then tells you whether he is completely satisfied, or would feel more comfortable with verifying ultrasound. A nodule suggests a cancer growth.

As in your case, not all enlargement needs treatment, much less surgery. Benign prostate hypertrophy is quite common. Now you can rest easier and read my future references to prostate examinations with equanimity and wisdom. Men 40 and older need this checkup.

DEAR DR. DONOHUE: What does mastocytis amount to? What medication can be used for it? I am a 40-year-old woman with the problem, and have skin itch from hives. It is driving me to the ceiling. - Mrs. V.L.

ANSWER: Mastocytosis, which is the correct name, is a problem involving mast cells, and in your case, presumably mast cells of the skin. I presume you have hives, which can be terribly itchy.

The problem concerns certain body cells, those mast cells, which contain histamine. The skin has accumulated an abnormally high number of these cells. A great outpouring of this histamine brings not only an itch, but often a redness along with the hives themselves.

I presume you are following up this diagnosis. There may be a blood pressure drop with this, and some individuals encounter diarrhea. This may sound strange. However, the explanation is that the same mast cell accumulation can occur in internal organs. Mastocytosis confined to skin cells is called urticaria pigmentosa.

Some patients find they have an intolerance to certain substances, such as alcohol. Drugs like antihistamines help by countering the histamine release. Others respond well to some of the asthmatic drugs. I will leave that up to your own doctor. Many patients weather the hives and find the only relief is time itself.

DEAR DR. DONOHUE: Tell me yes or no, can a mosquito bite transmit AIDS? - Y.N.B.

ANSWER: No.

FOR MRS. V.L. - Check with your former doctor. I am sure he will supply all the test results you got without having to go through them all again. The doctor may want tests anyway, if only to see if a suspicious earlier reading has changed for better or worse. There's no reason you should not ask about this.

DEAR DR. DONOHUE: I would like information on Wolff-Parkinson-White syndrome. Is it hereditary? And is there a method of treating it? - L.A.M.

ANSWER: Wolff-Parkinson-White syndrome results from a miswiring of the heart's natural electrical system. People who are "WPW wired" may get attacks of rapid heart rhythm.

The severity varies, some individuals having many racing episodes and others only a few. For most, drugs are available for control. If they don't help or if symptoms become worse with time, the heart surgeon can correct the wiring. The extra electric circuit that causes the fast beat episodes can be removed. That stops attacks. Surgery is seldom required though.

Most people with WPW have no family history of it.