YOUR HEALTH
Nerve damage can cause arthritis
DR. DONOHUE

DEAR DR. DONOHUE: I need help. I am a diabetic on pills only. I have what's called a Charcot joint. Can I get a drug to help me? Sometimes I can barely walk. -- J.C.

ANSWER: When people sit or stand for a long time, they unconsciously move slightly all the time. Their brains know that a perfectly still joint suffers damage if it doesn't move. The movement need not be huge, just a slight change in the joint position. Without those all-but-undetectable movements, joint cartilage begins to crumble. With the passage of time, a severe, destructive arthritis results. The joint becomes unstable, and the joint is often dislocated. That's a Charcot joint.

It happens because something has gone wrong with the nerves that signal the brain to move the joint. That condition is a special kind of neuropathy -- nerve disease. It often happens to diabetics, but it can happen to others with different causes for nerve malfunction.

Other than keeping your blood sugar as close to normal as possible all the time, there isn't anything you can do to restore the joint. But maintaining normal blood sugar stops the process from happening to other joints. There is no medicine for this.

However, braces and splints can stabilize the joint and make it more functional, helping you move around. Fusing the joint surgically is another way to make it less wobbly and more dependable.

DEAR DR. DONOHUE: I had an EKG in preparation for surgery. The doctor said it was abnormal. I was sent for a stress test. I could not do the physical stress test, so I had a chemical one. I was told that the results were OK.

No one told me why the EKG was abnormal. I am very concerned. Is it OK just to go on living as I have been, or do I need to do something?

I have searched the Internet for information but can find none. -- M.D.

ANSWER: A resting EKG is a good test, but it's not the ultimate heart test. Things can look strange on a resting EKG. In order to find out if those strange-looking things are significant, the next step is to do a more sophisticated heart test, one that is more sensitive in detecting true changes and more specific in eliminating EKG changes that look odd but don't truly represent heart disease.

That's where a stress test comes in. During a stress test, the person exercises, usually on a treadmill. All during the test, an EKG runs. It shows changes if the stressed heart isn't getting enough blood when it has to pump harder. You didn't have the treadmill variety of a stress test; you had one where a drug stressed your heart. The end result is the same.

Your stress test must have removed the suspicion of heart disease that arose from the resting EKG. Do you play cards? Your stress test trumped your resting EKG.

t's OK for you to go on living just as you have been. If something was wrong, the doctor would be obliged to tell you so.

Stress tests are done to detect coronary artery disease, the illness that brings on heart attacks. The booklet on that subject explains what coronary artery disease is, how it's detected and how it's treated. Readers can obtain a copy by writing: Dr. Donohue -- No. 101, 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