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Saturday, March 27, 2010 – Daily News – 5A FEATURES Behcet’s uncommon and troublesome DEAR DR. GOTT: My sister is a 50-year-old widow with four children who has been diagnosed with Behcet’s dis- ease. Her symp- toms began last spring with some arthritis. She then developed horrible sores on her body and a terrible one in her throat. Then her eyes became involved. She has had to quit work and is in almost constant pain. Some nights she has to go to the hospital because she cannot stand the pain. She has seen a number of specialists, but this is tiring for her and usually involves travel. We live in a small Canadian province without much diversity, so it was only by chance that the ophthalmologist she saw recognized the symp- toms because he was from another country. Dr. Peter Gott sion and other conditions can develop. The GI tract can be involved from the mouth to the anus. Inflammatory bowel disorders such as Crohn’s disease share simi- lar side effects that may be difficult to differentiate from Behcet’s. Diagnosis of Behcet’s She has been getting injections in her eye and having both eyes checked frequently. Her throat is getting worse. Should she stop eating and drinking and have IVs until her throat heals? When she does see a physician she hasn’t seen before, they question whether she has lupus, Lyme or Crohn’s disease. She’s very dis- couraged. Could you tell us what you think the treatment should be and if there are any centers in Canada or the United States that have expertise dealing with this? DEAR READER: I must agree that your sister was extremely lucky to have had an ophthalmolo- gist who recognized her symptoms and could put a name to her condition. My guess is he may be Asian, since Behcet’s is most common in the Far East and Mediterranean areas. The disease is rare in the United States and Canada, but cases do surface. It is named after a Turkish der- matologist, Hulusi Behcet, who documented aphthous oral ulcers, recurrent eye inflammation and genital lesions in the 1930s. Epi- demiology of the disease is not well understood. The syndrome is an idiopathic disorder classi- fied as a form of vasculitis (blood-vessel inflamma- tion). Because of the diversity of the blood ves- sels affected, it can occur throughout the body but is most common in the eyes, mouth, lungs, joints, geni- tals, brain, GI tract and on the skin. When the eyes are affected, inflammation can appear in the front or back, or sometimes in both areas at the same time. When the mouth, lips, tongue and inside of the cheeks are affected, the lesions are often painful, large and numerous. Aneurysms in the lungs can rupture and lead to massive hemorrhaging. Painful ulcers can develop on the vulva or scrotum. Involvement of the central nervous system is a dan- gerous manifestation. When the disease involves the white matter of the brain and brainstem, stroke, headache, confu- can be extremely difficult to clarify. More than any- thing, symptoms such as oral or genital ulcers and evidence of vasculitis through biopsy of an involved organ are what lead a physician to make the call. Diagnostic guide- lines involve two of the following: eye lesions and/or skin lesions a mini- mum of three times a year; recurrent genital ulcera- tions; and/or pathergy test- ing, which is a simple nee- dle prick on the arm. A small red pustule occur- ring at the site of the nee- dle insertion within two days is classified as posi- tive. Pathergy is not proof positive of the disease, because many people from the Mediterranean will test positive and may not have Behcet’s. For lesions confined to the mouth, genitals and skin, topical steroids and some oral drugs may be effective. When symptoms become particularly trou- blesome, corticosteroids may be beneficial. Some people may be placed on low-dose prednisone for control. When eye or cen- tral-nervous-system involvement occurs, high doses of prednisone and another form of immuno- suppressive treatment are often necessary for control. Thalidomide, a drug banned in the United States because of a connection with birth defects, has been found to be effective in severe mucocutaneous cases of Behcet’s, even though there is a connec- tion with the development of peripheral neuropathy in patients who take it for extended periods of time. I do not believe that fasting is an answer for your sister, even with her troublesome throat lesion. In terms of finding a physician to provide care, while the condition is uncommon in the United States and Canada, it has been studied and docu- mented extensively. In fact, a 1998 article by David Hellmann, pub- lished and copyrighted by the American College of Physicians in the Medical Knowledge Self-Assess- ment Program, edition 11, Rheumatology Section, covered Behcet’s. Further- more, your sister could check with the Johns Hop- kins Vasculitis Center to determine whether any tri- als she can participate in are under way. Good luck. Dr. Peter Gott is a retired physician and the author of the book “Dr. Gott’s No Flour, No Sugar Diet,” available at most chain and independent bookstores, and the recently published “Dr. Gott’s No Flour, No Sugar Cookbook.” PUMPKINLAND Chocolate Company Complete line of Sweets & Holiday Candy made by the Chocolatier Call for availability of you pick .89¢ lb Asparagus /we pick $ 139lb 12000 Hwy. 99E (6 miles South of Red Bluff) 530 527-3026 Open daily 10am-6pm Closed Easter Sunday Readers offer solutions for feminine issue Dear Annie: ‘‘Frustrat- ed in N.J.’’ wrote to say that his 65-year-old wife no longer wants to have sex with him because of vagi- nal dryness. In your response, in which you rec- ommended counseling (which may indeed be needed), you missed an opportunity to educate your readers about what can be done about this problem. I’m 67 years old and still hair, then the gym. I began to feel alive again in the libido area, and now, with another man, intimacy is better than ever. Annie’s Mailbox by Kathy Mitchell and Marcy Sugar enjoy sex with my hus- band. When I talked to my doctor about the discomfort of vaginal dry- ness a few years ago, she recom- mended a vaginal ring that emits a very low amount of estrogen. It isn’t cheap, but otherwise it’s a godsend. — Still Frisky in My Late 60s Dear Still Frisky: We are grate- ful to all the readers (male and female) who wrote in response to that letter and offered suggestions and hope: From California: I am a 60- year-old woman who had a hys- terectomy when I was 50. I wanted to stay away from artificial hor- mones, but I was suffering. I even- tually went to a compounding phar- macy for a natural hormone mixture prescribed by a doctor. I felt much better — but still had no interest in sex. There is a sort of mourning period when the ability to have chil- dren, or when your definition of who you are, is turned upside down. My decision to separate from my husband started with a pedicure, then doing something with my gray Louisiana: I am a retired nurse. Couples can find the act of touching, imagining and cuddling as satisfactory as the physical act. It is vital in our aging process to explore new and different methods to achieve the desired results. Chicago: One can have a simple blood test to check for hypogonadism (low levels of cer- tain hormones that contribute to the sex drive), and in some cases, it can be treated with a specially prepared testosterone cream applied external- ly. It amazes me that while Viagra and Cialis have become household words, women are advised to take a bubble bath. My family doctor referred me to an endocrinologist at my earliest complaint, so my multi- ple orgasms have continued well into the fourth decade of my mar- riage. Louisville, Ky.: I am 65 and struggled with the same situation until five years ago. Finally, a female gynecologist prescribed a combination of estrogen and testos- terone. That, along with a lubricant, did the trick. Sex will never be what it was years ago, but it sure brought sufficient desire to satisfy my hubby and me. Boston: I am 56 and have found that life without hormones is quite a shock. But I discovered bioidentical hormones and, with them, the amazing return of life as I once knew it. Our balanced hormones can begin to decline in our 30s, and bioidentical hormones help us remain much healthier. It is impor- tant to find a qualified physician who understands bioidentical hor- mones, measures and monitors your hormone levels on a regular basis, and gives you those hormones in a way that closely mimics how our bodies naturally deliver hormones. Aurora, Ohio: If she and her husband had a good sex life before menopause, it is very possible that the problem is related to a dry vagi- na, which probably causes pain. I am 71 and had the good fortune to go to a midwife about 18 years ago who prescribed a vaginal supposito- ry that one uses just prior to inter- course. I have never had a single physician, male or female, offer help with sex at my age. A midwife can discuss sex in a way that is comfortable to this woman. I realize she may never have enjoyed sex, and some counseling could be need- ed, but without taking care of the vaginal dryness, there will always be a problem. Annie’s Mailbox is written by Kathy Mitchell and Marcy Sugar, longtime editors of the Ann Landers column. Please e-mail your questions to anniesmailboxcomcast.net, or write to: Annie’s Mailbox, c/o Creators Syndicate, 5777 W. Century Blvd., Ste. 700, Los Angeles, CA 90045. Ocean salmon season opens next week The salmon season for ocean waters south of Horse Mountain in Humboldt County to the U.S.-Mex- ico border is scheduled to open on April 3. Season dates for ocean waters north of Horse Mountain and in Humboldt Bay will be decided in mid-April by the Pacific Fishery Management Council (PMFC) and the California Fish and Game Com- mission (FGC). A map of each area along with general sport fishing regulations related to each area can be viewed at http://dfg.ca.gov/marine/pdfs/salm onsport10.pdf. All Chinook salmon harvested must meet the size limit for the zone where they are taken. All coho salmon are protected by law and if caught must be released unharmed. Current regulations include the following: Humbug Mountain (OR) to Horse Mountain: Closed The rest of California’s coast: Horse Mountain to U.S.-Mexico Border: Season is scheduled for April 3-30, 2010 Limit is two salmon per day of any species (except coho) Minimum size limit is 20 inches total length Closing dates of all ocean sea- sons and size limits may be changed by the PMFC and FGC at their April meetings. Ocean salmon sport seasons in effect on or after May will also be determined at the April meetings. Sport season options currently being evaluated can be found at www.pcouncil.org. Anglers can review additional requirements of the ocean salmon regulations (section 27.80) in the Ocean Sportfishing Booklet on DFG’s Web site at: www.dfg.ca.gov. April hike planned to center of Sutter Buttes Join an energetic climb to the center of the Sutter Butte volcano on Yuba His- torical Society’s Ridge Walker Delight hike 8 a.m. to 4:30 p.m. Saturday, April 10. While trekking to the 1,750-foot destination, hik- ers will view rock forma- tions looming over the ridge like Easter Island statues. While on top, get an up close perspective of all the peaks in the Buttes as well as the Great Central Valley dominating the horizon. If there is a north wind, hikers will be treated to a glimpse of Mt. Diablo to the south, Mt. Shasta to the north Mt. Saint Helena and Konocti on the western horizon and the Crystal Range sur- rounding Lake Tahoe to the east. The seven-hour excur- sion includes talks on top- ics such as Sutter Butte geology, the mountain's unique biology and stories of the Maidu and Wintun Indians who view the mountain as a sacred land form. Participants will be treated one of the best dis- Courtesy photo Hikers traipsing through a hillside of popcorn flowers on a March 14 hike in the Sutter Buttes. plays of wildflowers in years. Cost is $35 for Yuba His- torical Society members and $45 for non-members, discounts for children 12 and younger. Membership starts at $15. To register, learn more about the hike and get direc- Function Junction Add variety to your workouts, and challenge your body! Is your training routine gotten to be “too routine?” Feel like your at a standstill? Child’s TRX Suspension System Medicine Ball Kettlebell Ideal for building whole body strength, coordination, and conditioning. This class is definitely not what your used to! • Cost: $225 payable to TFFC • Duration: 4 weeks • Dates: April-6th - 29th • Days: Tuesdays and Thursdays • Time: 6:00 - 6:45 am • Where: TFFC Gym • Program Designed and Instructed by Troy Lalaguna Limited to six members per class. (First paid in Full) Tehama Family Fitness Center 2498 South Main St • Red Bluff www.tehamafamilyfitness.com 766 Antelope Blvd. (next to the fairgrounds) 527-0886 Easter Basket Planting Class April 3rd @10:00 AM tions to the meeting site, call Daniel at 846-3024, send an email to daniel@yubahisto- ry.com or visit http://www.yubahistory.co m. Red Bluff Garden Center