Pain Source Hard To Trace

GOOD HEALTH Dr. Paul Donohue

March 1, 1994|Dr. Paul Donohue

Dear Dr. Donohue: I am a woman in my late 20s who has been diagnosed with fibrocystic breast disease. Five years ago, I began having pain radiating from my back to the breast, on the left side. Because X-rays showed arthritis in the spine, I had always blamed my breast pain on that. My present doctor says the cysts seem noncancerous. Yet the pain is terrible. - R.L.H.

Dear R.L.H.: The usual complaint in fibrocystic disease of the breast is of breast lumps that become painful and tender before the menstrual period. Since as many as half of all women report breast cysts, many physicians question whether all this is enough to constitute a real disease.

It's important to make sure the lumps aren't cancerous. Apparently, your doctor is satisfied that yours are benign, but if doubt exists, lump fluid can be drained with a needle and examined for cancer cells.

Simple pain relievers will tide most women over the most trying days. It might help to avoid caffeine and salt, especially before menstruation.

Your diagnosis seems to be further complicated by the X-ray signs of arthritis. That can be a part of any back pain. Why not have a second doctor take a crack at it? Two heads are more likely to come up with a more certain diagnosis.

Dear Dr. Donohue: I was recently prescribed erythromycin to treat a respiratory infection. The drug made my stomach hurt, and soon after I finished the medicine, the infection returned. The doctor then prescribed clarithromycin. It didn't hurt my stomach, and after three weeks the infection is still gone. Why didn't the doctor prescribe the clarithromycin in the first place? - J.F.

Dear J.F.: Did you notice the price difference? Clarithromycin is many times more expensive than erythromycin, which often works as well. Most doctors try the less expensive drug first.


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