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FIBROMYALGIA ISN'T SO GRIM AFTER ALL

QUESTION: I have recently been diagnosed as having fibromyalgia. The doctor did not give me a very bright future. All the articles I have read concur that treatment is mostly guesswork. Yet I understand your view is different, that this condition can be treated successfully. Can you give me a rundown on this? - M.Q.

ANSWER: Well, the future with fibromyalgia is not all that grim; it's non-crippling and is, in fact, treat-able.Fibromyalgia is an achy pain with stiffness, mostly concentrated in the shoulders, hips and back, leading to chronic stiffness. Often, there is a distinct sleep derangement present, and that adds to the general vicious cycle of daytime fatigue and pain.

The sleep factor is interesting, since many patients show marked improvement in physical symptoms once proper sleep is restored. (A small dose of amitriptyline at bedtime has helped many.)

Another seemingly strange factor in treatment is exercise, the aerobic kind. That can be walking, bike riding or joining a formal aerobics class. The regularity of exercise is important.

There is no sure-fire cure, but various drugs can be brought to bear when progress does not occur. I would seek out a doctor familiar with muscle problems, although most family practitioners are familiar with fibromyalgia and its treatment. Good luck.

QUESTION: I am desperately in need of help to correct deep vein insufficiency in the legs. I am not a candidate for surgery, so am looking for anything new in the way of treatment. Your comment, please. - L.P.

ANSWER: There are no dramatic new breakthroughs in deep vein insufficiency, but the old standby methods still work well.

You need elastic stockings, the kind that go all the way up the legs. You need leg elevation, raising the legs above heart level at least three times a day. Keep them elevated for as long as possible each time.

At other times, avoid standing in place for long periods. Keep moving about, or at least flex the leg muscles as a matter of habit when standing or sitting for lengthy periods. Contracting the leg muscles this way actually forces blood out of the sluggish vein networks and back toward the heart. I am sending you the varicose veins report. Other readers may order by writing: Dr. Donohue/No.34, Box 830, Gibbstown, NJ 08027-9909, enclosing a long, stamped (52 cents), self-addressed envelope and $2.

QUESTION: What do you know about hypospadias? Does this condition have any effect on sex life later on? - B.K.

ANSWER: About one in every 500 males is born with hypospadias. It is a malpositioning of the penis' opening on the undersurface instead of at the tip. Most often, surgical correction is advised early on, before a year and a half. Timing will depend on the particular circumstances. The doctor to consult in this matter is a urologist. With surgical correction, hypospadias does not affect sex life.

FOR P.M. - In myelofibrosis, the bone marrow, the site of blood cell formation, is invaded by scar tissue. The spleen takes over some of the production, and in the process it enlarges. It is impossible to predict things. You're 70. I should note that the condition may progress very slowly, for as long as 15 years. In others, the course is more rapid. If the blood count drops too low, transfusions are given. I know of no medicine to correct the bone marrow situation.

1991 North America Syndicate Inc.