Question: My son, who is 2, has a lump on the right side of his neck. It has been present for six months. His pediatrician says it is a lymph node and nothing to worry about. I am worried about Hodgkin's disease, but someone said they have to perform a biopsy for that. My son acts fine, so I don't want to put him through unnecessary pain. Can you please help me determine the best course of action? He has had blood work done. All was normal.
- A.L.Answer: It is true that persisting lymph node enlargement can be a sign of Hodgkin's disease, but that cancer rarely occurs in one quite so young. Hodgkin's disease shows up occasionally in children, but it occurs most often between the ages of 15 and 35 or after age 50.
Your concern, though, is understandable. Reasonable parental awareness of lumps is healthy.
An enlarged node in one so young almost always reflects an infection, especially if the node stays the same size, is soft to the touch and can be pushed around with the fingers.
I am sure your doctor has considered such factors. Tell him about your continued concern. Blood tests can tell part of the story, but to ease nagging doubts, the node tissue could be removed and examined microscopically. Such a biopsy is not particularly painful.
I think your implied question involves getting a second opinion. That is reasonable in the face of such concern. If two doctors assure you that all is well, then you can let the matter rest.
Question: I just heard some startling news - that condoms have tiny holes about five microns wide, and that the AIDS virus is only one-tenth of a micron wide. Therefore, it seems condoms are virtually useless in prevention of AIDS. Please comment on this life-threatening problem.
- R.F.
Answer: Experiment after experiment has proved the inherent structural effectiveness of condoms as barriers to the AIDS virus.
No, the problem with condoms has nothing to do with such factors as porousness or sizes of viruses. Rather, human frailty poses the danger. Accidents can and do happen. Condoms can break. Petroleum-based lubricants can make them fragile. Old condoms tend to fissure. Condoms fall off. They can be put on or removed improperly.
It is for just such reasons that pregnancy can occur even with condom protection.
So what's the lesson here? It is that you should not view condoms as either 100 percent "safe" or entirely useless. They are neither. If you do decide to put yourself in harm's way, condoms are better than no protection, and with proper use, they can be excellent protection. But if you want 100 percent protection, you get that through abstinence, especially if you are unsure of your sexual partner's disease status and are unwilling to risk a chance pregnancy.
Question: My doctor prescribed a diuretic for high blood pressure. I have a small bladder and am constantly running to the bathroom. What on earth is the connection between high blood pressure and diuretics?
- N.D.
Answer: Diuretics remove fluid from the body. The result is less blood volume. Pressure in vessels drops. Diuretics also remove sodium from the body, which discourages retention of fluid, again reducing pressure.
You are experiencing what is called diuresis. If the frequency of urination bothers you, tell your doctor. There are other approaches to blood pressure lowering that have nothing to do with fluid removal.
For more details, read my blood pressure report, which readers can order by writing: Dr. Donohue - No. 4. Box 5539, Riverton, NJ 08077. Enclose a long, self-addressed, stamped (52 cents) envelope and $3.
Question: I read a lot about mammograms in your column. How are they done?
- J.H.
Answer: The idea of the mammogram is to get a good picture of each breast. The breast is positioned on a small platform and compressed from above and the sides. That permits separate views.
It is the compression that some women find uncomfortable. It takes but a few seconds, however. Some women might be more sensitive prior to their menstrual period. They might want to schedule the mammogram for after menstruation.
Question: How much radiation is involved in getting a mammogram?
Answer: About the same amount as you get from a dental X-ray.
In response to reader requests, Dr. Donohue has a complete listing of his pamphlets on various medical problems. Readers who want one should send their request to Dr. Donohue - List, Box 5539, Riverton, NJ 08077. Enclose a self-addressed, stamped envelope.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him at P.O. Box 5539, Riverton, NJ 08077.
1993 North America Syndicate Inc.