donohue 10.12

Dear Dr. Donohue: My doctor requested that I have a DEXA scan. The reading (enclosed) came back at L2-4. What does than mean? Is it good or bad?

I take a 600-mg calcium tablet a day, a multivitamin with 450 mg of calcium and I drink three glasses of milk a day. I do take Evista now. I walk 1 to 2 miles each day.

Am I getting too much calcium? — L.M.

A DEXA (dual-energy X-ray absorptiometry) scan is an excellent test for osteoporosis.

The “L2-4″ indicates that the scan took pictures of lumbar vertebrae 2 to 4 in your lower back.

Your DEXA report gave you a T-score of -3.3. The T-score is obtained by comparing the calcium content of a person’s bones with the optimum calcium content of a person at the age when bones have their peak calcium content and are at their strongest.

A T-score of 0 to -1 is normal; -1 to -2.5 indicates osteopenia, a step on the road to osteoporosis; any reading lower than -2.5 signifies osteoporosis.

You’ve been following the suggestions for osteoporosis prevention. You take calcium, and you exercise. I presume your multivitamin has vitamin D, a requisite for calcium absorption.

I calculate your total calcium intake to be 1,920 mg. (Eight ounces of milk has 290 mg.) An adequate calcium intake for most women after menopause lies between 1,200 and 1,500 mg each day. The upper, safe limit is 2,500 mg. Your calcium is not going to get you in trouble.

Your bones are becoming osteoporotic in spite of your efforts. Now is the time to jump in with medicines. Evista, which you just started, is a good choice. There are others: Fosamax, Actonel, Miacalcin and female hormones. Hang in there. The next DEXA scan might show an improved T-score.

Women or men who want a more complete discussion of osteoporosis can order the osteoporosis report by writing: Dr. Donohue — No. 23, Box 536475, Orlando, FL 32853-6475. Enclose a self-addressed, stamped (55 cents), No. 10 envelope and $3. Please allow six weeks for delivery.

Dear Dr. Donohue: I am seven months pregnant and have a brownish discoloration on my forehead. Is it related to pregnancy? None of my friends ever had it. Will it go away? — E.C.

Some women develop a brown discoloration on the forehead, cheeks, upper lip or chin. It is called melasma, and it is related to hormones. Some women on birth control pills have a similar discoloration.

Most often, the blotch lightens after delivery.

Right now, resolve to stay out of sunlight. When you must go outside, apply a potent sunscreen.

If melasma doesn’t lighten after pregnancy and if you find it cosmetically unacceptable, prescription drugs can bleach the skin. Dermatologists can also remove it with a chemical skin peel.

Dear Dr. Donohue: My son, 15, was just diagnosed with pityriasis rosea. Can you tell me more about it? I was told there is no known cause and that it is common in the spring. When my boy gets sweaty, it flares up, but only when he wears a T-shirt. The rash looks ugly. — M.L.

Pityriasis (PIT-ear-RYE-uh-suss) is a common skin rash whose only worrisome feature is its appearance. People between the ages of 10 and 35 are the ones most likely to come down with it.

The first indication, often never spotted, is a patch of discolored skin whose size varies from an inch (2.54 cm) to 4 inches (10 cm). This is the “herald” patch.

Shortly after the appearance of the herald patch, smaller oval spots dot the skin. In whites, they are salmon-pink. In blacks, the spots are darker than the surrounding skin. A delicate, white border surrounds each blotch.

Sunlight hastens resolution of the rash. Your son appears to be an exception to that rule. I can’t confirm a seasonal increase. It usually clears in one to three months.

If the rash itches, antihistamines and cortisone ointments perform well as anti-itch agents.

Dear Dr. Donohue: My doctor requested that I have a DEXA scan. The reading (enclosed) came back at L2-4. What does than mean? Is it good or bad?

I take a 600-mg calcium tablet a day, a multivitamin with 450 mg of calcium and I drink three glasses of milk a day. I do take Evista now. I walk 1 to 2 miles each day.

Am I getting too much calcium? — L.M.

A DEXA (dual-energy X-ray absorptiometry) scan is an excellent test for osteoporosis.

The “L2-4″ indicates that the scan took pictures of lumbar vertebrae 2 to 4 in your lower back.

Your DEXA report gave you a T-score of -3.3. The T-score is obtained by comparing the calcium content of a person’s bones with the optimum calcium content of a person at the age when bones have their peak calcium content and are at their strongest.

A T-score of 0 to -1 is normal; -1 to -2.5 indicates osteopenia, a step on the road to osteoporosis; any reading lower than -2.5 signifies osteoporosis.

You’ve been following the suggestions for osteoporosis prevention. You take calcium, and you exercise. I presume your multivitamin has vitamin D, a requisite for calcium absorption.

I calculate your total calcium intake to be 1,920 mg. (Eight ounces of milk has 290 mg.) An adequate calcium intake for most women after menopause lies between 1,200 and 1,500 mg each day. The upper, safe limit is 2,500 mg. Your calcium is not going to get you in trouble.

Your bones are becoming osteoporotic in spite of your efforts. Now is the time to jump in with medicines. Evista, which you just started, is a good choice. There are others. Women or men who want a more complete discussion of osteoporosis can order the osteoporosis report by writing: Dr. Donohue — No. 23, Box 536475, Orlando, FL 32853-6475. Enclose a self-addressed, stamped (55 cents), No. 10 envelope and $3. Please allow six weeks for delivery.

Readers may write Donohe at P.O. Box 536475, Orlando, FL 32853-6475.