QUESTION: My doctor wants me to try niacin treatment to lower my cholesterol. What about the terrible flushes some say can occur with this treatment? Is niacin safe to use? - Mrs. S.S.
ANSWER: Yes, this treatment is safe and is sometimes preferred over the other cholesterol-lowering drugs. The well-known flushing effect from the niacin is typical of that substance, which tends to dilate skin blood vessels.Doctors have been experimenting with various dosages and dosage schedules to minimize the problem. Some use lower starting doses and build up to higher ones gradually. This can reduce the side effects or make them less troublesome. Sustained-release niacin preparations are also available. They have been tried to reduce side effects.
More on flushing:
QUESTION: Are hot flushes of menopause ever treated or are they considered perfectly normal and something to live with? - P.I.
ANSWER: Hot flushes are, as you say, merely a part of the general menopause picture, so much a part that they can be considered normal in menopausal patients. Flushing is an overresponse to nerve mechanisms that dilate skin vessels. However, some women are so incapacitated by these flushes that they are treated with hormones to relieve them. For your other questions, see the menopause reading matter. Write Dr. Donohue, No.21, Box 19660, Irvine, CA 92713-0660, enclosing a long, stamped, self-addressed envelope and $2.
QUESTION: I have a friend who has been told he has amyotrophic lateral sclerosis. Could you please tell me about this condition? It is most important for me. - F.E.P.
ANSWER: As you know, many famous people have been stricken with this illness, notably the baseball player Lou Gehrig, from whom it takes its more common name, Lou Gehrig disease.
ALS most often affects men and usually after age 40. The first signs usually are muscle twitches and cramping. Weakness ensues, with hand muscles most often the first ones affected. This, of course, forced Gehrig to abandon his career. In time, arms, legs, chest and swallowing muscles deteriorate.
We don't know the cause of ALS, and we have no cure. However, therapists today have devised ingenious ways to permit a patient with ALS to retain as much independence as possible. This depends on how profound the muscle weakness has become. The ALS association can be of help. Their address: 21021 Ventura Blvd., Suite 231, Woodland Hills, CA 91364. They will have much more information on the topic.
QUESTION: I have been seeing floaters in my right eye, especially at night. I am told this is common. Please advise. - D.M.
ANSWER: Floaters are specks of the gel-like vitreous fluid that fills the eye's back chamber. Sometimes, pieces of pigment from the light-sensitive retina shed, causing the effect. Or floaters may be red blood cells from vessels at the rear of the eye or flecks of protein that form with age.
For the most part, floaters are harmless, but they should be reported. Sudden showers of floaters or an increase in numbers are alarms. This may mean the retina is pulling away from its anchorage. If you've been examined and checked for such possibilities, you can ignore them. I have floaters.
C) 1990 North America Syndicate Inc.