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`SED RATE' IMPORTANT IN DIAGNOSING, MONITORING ILLNESSES

QUESTION: I was diagnosed as having polymyalgia rheumatica. My sed rate was high. I was crippled for about eight months, but am doing quite well now. My sed rate has gradually come down. How important is the sed rate, and how can it be controlled? - E.Z.

ANSWER: Sed rate testing is important in diagnosing and monitoring progress of several ailments, polymyalgia rheumatica among them.PM is an illness of the elderly, the average age of patients being about 70. Its symptoms are muscle ache and stiffness, usually most pronounced in the morning and most often in shoulder, hips and neck areas. Along with this comes great fatigue.

The sed rate, as in your case, is the key to diagnosis and a fair indication of how serious things are. When sed rates rise after having been normal, that means the PM is back and the patient needs a boost in control medicine. Most often, that medicine is cortisone.

You need patience to weather the ups and downs of PM. During its two years duration (average), dosages have to be adjusted several times up or down, dictated by the sed rate. You are doing fine. Don't be discouraged.

QUESTION: I would like to know if a person can get shingles on the inside. I am 68 and have shingles pain, a burning on the back and front. I can't touch there, and can't wear a bra. But there is no rash. - F.B.

ANSWER: It is possible to have shingles pain without the characteristic rash. It is called "zoster sine herpete." I suppose this is what readers mean when they write me about "inside" herpes. Your other questions on this are discussed in the report on shingles. It is available by writing: Dr. Donohue/No.28, Box 5539, Riverton, NJ 08077, enclosing a long, stamped (52 cents), self-addressed envelope and $2.

QUESTION: Don't you need a certain amount of fat in your diet? How many grams of it do you need if your diet is 1,000 calories daily? - Mrs. P.C.

ANSWER: We all need some fat for energy, for maintaining cell membranes and for absorption of vitamins A, D, E, K and so on. You limit fat in order to avoid artery clogging.

No more than 30 percent of total calories should be fat. You figure out amounts by allowing 9 calories per gram of fat. In a 1,000-calorie diet, that would allow for 33 grams of fat. An ounce of fat equals 28 grams. Thus, in reality, your aim is to keep daily fat intake to just a bit over that ounce.

Incidentally, with a diet as stringent as yours, you may need vitamin supplements to make up for what you are missing.

QUESTION: As far as gaining weight is concerned, is fat, carbohydrate or protein intake most important? - L.A.

ANSWER: We have only begun to understand such things. We know now that not all calories are equal when it comes to gaining weight. Food fat becomes body fat more readily than do carbohydrates or protein. We used to think differently, that any calorie, be it fat, carbohydrate or protein, had about equal effect when it came to obesity.

Dr. Donohue regrets that he is unable to answer individual letters, but will incorporate them in his column whenever possible. Readers may write him at P.O. Box 5539, Riverton, NJ 08077