YOUR HEALTH
Arthritis follows some infections
DR. DONOHUE

DEAR DR. DONOHUE: My son, 25, contracted a foodborne bacterial infection this summer in Egypt. As a result, he came down with reactive arthritis. It also has affected his eyes. Tests revealed that he has a gene from his German heritage that caused this arthritis. Will he heal from this? We've heard only 30 percent do. -- C.W.

ANSWER: Reactive arthritis is a curious kind of arthritis that's triggered by an infection not in the joints. The infection is either an intestinal infection from germs with names such as Salmonella or Shigella, or a genitourinary tract infection from the Chlamydia germ. Joints "react" to the infection one to three weeks later. The eyes and skin also can be involved.

Most often, one or a few joints swell and become painful, and those joints usually are the knees, hips, ankles and feet. Sometimes patients have low-back pain or heel pain at the point where the Achilles tendon inserts.

The course of the illness is unpredictable, but the majority are better in six months.

Anti-inflammatory medicines like naproxen or indomethacin usually quiet the inflamed joints, and, if need be, cortisone drugs are prescribed.

The "gene" you mention isn't one limited to people of German ancestry. It's one of many genes that imprint identification tags on all body cells. In your son's case, the tag is HLA B27. People who have this ID tag are more prone to develop reactive arthritis, but the illness in them is no more severe, nor does it last any longer than it does in other people.

DEAR DR. DONOHUE: I am 77 and in good health. I take medicine for high blood pressure.

My problem is my heartbeat. It is very slow. When I get up in the morning or when I sit for too long, it goes down to the 30s. If I get up, it rises to 60. Is this something to be concerned about? I have taken a treadmill test, and the doctor said I did well. What do you think? -- C.W.

ANSWER: I think 30 beats a minute is way too slow a heart rate. Aren't you dizzy or tired, or don't you feel faint when the rate drops so low. With such a slow beat, it's difficult to supply the brain with sufficient blood. You need to wear a heart monitor, one that records every heartbeat for one to three days. I'd go back to the doctor for more tests.

What is your blood pressure medicine? It might be the cause.

The booklet on heartbeat irregularities covers this subject in depth. Readers can order a copy by writing: Dr. Donohue -- No. 107, Box 536475, Orlando, FL32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient's printed name and address. Please allow four weeks for delivery.

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 or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL32853-6475. Readers may also order health newsletters from www.rbmamall.com. 2006 North America Syndicate Inc. All Rights Reserved