Question: I experienced intense itching over my entire body during the last few months of my previous two pregnancies. The second time, I was diagnosed as having cholestatic jaundice of pregnancy. I had never seen this is my baby book. I also get a touch of this when I take birth-control pills. It has to do with my liver. How common is this? Does it damage the liver permanently? What about the baby you're carrying?
Answer: In cholestasis patients, the liver is not getting rid of its bile. "Chole" refers to bile and "stasis" to stoppage of flow.
When bile remains behind in the liver, it eventually escapes into the blood, causing the skin itch and jaundice.
When it happens during pregnancy, it is attributed to the natural rise in estrogen that occurs. The same thing might occur as a response to the estrogen in birth-control pills.
I have no statistics before me as I write, but I would say the pregnancy-related oddity happens often enough so that doctors recognize the problem in a woman. When it happens, it usually does so in the last three months. It disappears with delivery.
It is not always a harmless thing. It can contribute to premature birth. Occasionally, it threatens fetal health.
Your doctor should keep you under close surveillance in any future pregnancies, for it can recur. Should the jaundice reach danger levels, delivery can be induced as soon as practicable.
Cholestasis of pregnancy usually does not cause permanent liver damage.
Question: What can a discrepancy in blood pressure taken in one arm vs. that taken in the other mean? Mine measures different one arm to the other.
Answer: You can expect to find as much as a 10-point difference. A greater discrepancy should be investigated to rule out such things as a tumor compressing an artery.
Most often the difference means nothing more than a smaller diameter of one vessel compared with its partner vessel on the opposite side. Such harmless anomalies can be present from birth.
Question: An in-law has high blood pressure but is not taking the medicine for it because of side effects. Please stress the need to take the medicine.
Answer: Uncontrolled blood pressure invites artery hardening, heart attack and stroke.
If your in-law dislikes his medicine's side effects, he should know that there is a nearly encyclopedic list of other medicines that can do the job with no such effects. His doctor should be able to find a drug your in-law can tolerate.
Question: I've always wondered about something. I'll be falling into a sleep when suddenly I will jerk awake with a sensation of falling. I have found other people to whom this same thing happens. What's going on?
Answer: It happens to more people than you might think.
The phenomenon has its own name: "hypnic jerk." I've seen it explained as a temporary nervous system shutdown that occurs just as we drift off to sleep. The shutdown might occur a bit ahead of schedule, resulting in the loss of muscle control. The body shudders, and there might be other strange sensations.
Hypnic jerking, common in all ages, is harmless.
Caffeine, stress, vigorous exercise and deep fatigue are predisposing factors or ones that might make the jerking more intense.
Question: Please repeat a recipe you gave to help constipation. Some of us missed it.
Answer: The reader demand for a repeat of that recipe astounds me. I must confess it did not originate with me. I did not invent it.
It calls for two cups of bran, two cups of applesauce and a cup of unsweetened prune juice. Mix. Refrigerate. Take two or three tablespoons a day.
Many adventurous readers have added their own touches, so I invite you to join us.