YOUR HEALTH
Anemia medicine can serious complications
DR. DONOHUE

DEAR DR. DONOHUE: I have been told that the kidneys are the seat of emotions. Is this true?

I have chronic kidney disease and have to take shots of Procrit. I heard that this miracle drug has side effects, like blood clots and heart attacks. How dangerous is it for me to continue with this drug? -- E.H.

ANSWER: The kidneys are not the seat of emotions. They make a hormone called erythropoietin, which stimulates the bone marrow to make red blood cells. When the number of red blood cells dips, erythropoietin increases their number. Without it, anemia results. Many of those with chronic kidney disease develop an anemia because their kidneys aren't making enough erythropoietin.

Procrit is a manufactured replica of erythropoietin that does the same job the natural substance does. It has spared chronic kidney patients the need for blood transfusions. However, it does have serious side effects that must be guarded against. It increases the risk of heart attacks, strokes, blood clots and heart failure. When Procrit is given to raise the blood count to the point where transfusions are not necessary and where people feel more energetic, but not to the point where the blood count is perfectly normal, then the drug's dangers are greatly lessened.

Procrit is also used for people who are anemic from cancer and from cancer therapy. They, too, have to exercise caution in its use. For some cancers, it appears to cause a recurrence, and it should not be used in those instances.

DEAR DR. DONOHUE: I wonder if you would settle an argument for us. My husband was raised with the advice that "when children have a fever, bundle them up to raise their temperature higher to break the fever." He survived his childhood.

I was raised with this advice: "When children have a fever, uncover them to lower their temperature."

Which school of thought is correct? We want our children to survive their childhoods too. -- R.K.

ANSWER: Your husband went to the wrong school of thought. Don't raise a child's temperature when he has a fever.

Your school of thought comes closer to the accepted teaching. Children between the ages of 3 months and 3 years with a fever of less than 102.2 F (39 C) can be made comfortable by giving them fluids.

At temperatures higher than 102.2, lowering the temperature is good practice. A sponge bath with tepid water will bring it down. A children's dose of Tylenol is also acceptable. Let the doctor know what's going on. The doctor might want to see the child for an exact diagnosis of the fever's cause.

Don't use aspirin to lower a child's temperature. It can cause Reye's syndrome in children whose temperature has risen due to chickenpox or influenza. Reye's syndrome is a serious illness that affects the liver and can cause seizures, lethargy, coma and possibly death.

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