Dear Dr. Donohue: I have a niece who participated in one of those "touch the car continuously the longest" contests, where you win a car. She won after almost three days. About a year later, she was diagnosed with Graves' disease. She was treated for it.
Could this gruelling contest have precipitated the onset of Graves' disease? No one on either side of her family has had Graves'.
S.D.
I'm not familiar with the kind of contest your niece was in. It sounds strange to me.
Graves' disease is an overactive thyroid gland, one that produces and secretes an abundance of thyroid hormone. It's another one of the autoimmune illnesses, those diseases in which the immune system turns on its own body. In this case, the target is the thyroid gland.
Unique antibodies produced by the immune system overstimulate the thyroid gland.
The effects are much what you'd expect from too much thyroid hormone. Weight loss occurs in the face of a hearty appetite. The heart at rest beats quickly. Blood pressure often rises. Affected people are intolerant of heat and feel warm when those around are cool. Tremors of the hand are common. Bulging of the eyes is another sign.
In addition to the above symptoms, most with Graves' disease have an enlarged gland, a goiter.
You want to know what made your niece's immune system suddenly produce antibodies that threw her thyroid gland into high gear. Gender is one of those influences. For every male affected by Graves' disease, seven females have it. Cigarette smoking is another stimulus. Infections that somehow influence the immune system's production of the stimulating antibodies are another possibility.
Stress is cited as a potential cause. But the stress has to be in closer time proximity to the development of an overstimulated gland than was it to your niece's onset of Graves.
Dear Dr. Donohue: My husband and I used to read your column regularly. I lost him in November of 2011. He died of a massive heart attack at work.
He was 57. He apparently had ventricular fibrillation.
The only thing we knew he had was mitral valve prolapse, with some regurgitation (leaking). He was told he could live with that. He had had an echocardiogram in 2004. I'd like some closure.
Should we have noticed that something was wrong?
EH.
You have my sincerest condolences.
You husband had no warning signs that he was on the brink of a heart attack - no chest pain when he was physically active, no shortness of breath. Mitral valve prolapse, a ballooning upward of that heart valve when the heart contracts, is not usually the cause of life-threatening heart disease.
Many cases of sudden death happen to people who have a heart attack without ever having symptoms of heart disease. It's an unfortunate fact.
There is nothing you or his doctor could have done that would have prevented this tragedy.
Dear Dr. Donohue: I am 93 and had been constipated most of my life. For the past four months I have been on a regimen that works for me. I take Miralax in the morning and three capsules of Phillips Stool Softener in the afternoon. I found that fibre doesn't work for everyone. I hope this works for others.
J.L.
Your regimen sounds like a winner to me. You're right. Fibre doesn't work for everyone. When you say Phillips Stool Softener, do you mean Phillips LiquiGels?
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 536475, Orlando, FL 32853-6475
