July 4, 2008
Nipple Discharge Often Has No Significance
DEAR DR. DONOHUE: I am a 38-year-old woman. Since my early 20s, my breasts have leaked milk. If I apply pressure to my breasts, a few drops of milk appear. It is still going on, and I gave birth to my last child seven years ago. Is this normal? I have been to a number of doctors, none of whom have given me a definite reason for this. Can you shed some light on my problem? - G.R.
ANSWER: Nipple discharge, whether bloody, milky or watery, turns a woman's thoughts to cancer. Cancer isn't high on the list of causes of such discharges, but the cancer question must always be answered. Suspicion of cancer is heightened if the discharge is only from one breast, if it occurs spontaneously, without any breast manipulation, and if it persists. A breast lump really raises the suspicion of cancer. You do not have a lump.You have had a persistent discharge for around 18 years. If it were due to cancer, you would have known it by now. High on the list of a discharge like yours is physical contact of the breast. Women runners often develop a discharge because their top garment rubs against the breast while running. The pressure you apply to your breast is most likely the reason why you have a discharge. Stop it, and the discharge should stop.
Serious causes of inappropriate milk production include a pituitary gland tumor that produces prolactin, the hormone responsible for milk production. Reasoning once again from the length of time you have had this leakage, I find it most difficult to believe you could have had a pituitary tumor for such a long time without having other symptoms.
Another cause of nipple discharge is intraductal papillomas, noncancerous growths in the milk duct. Fibrocystic breast disease is another consideration, but you do not have breasts filled with lumpy cysts. Birth control pills can sometimes stimulate nipple discharge.
You can mention this to your doctor one more time, but first stop applying pressure to your breasts. I believe that will convince you that your discharge is harmless. It will stop.
DEAR DR. DONOHUE: After two years of antibiotics, I was told that my urinary tract infection, due to Enterococcus, is incurable. What will happen? Kidney failure? - M.H.
ANSWER: Do you have any symptoms of urinary tract infection, like pain on urinating, increased number of urinations, fever or flank pain? If the answer is no, you have asymptomatic (no symptoms) bacteriuria (bacteria in the urine). At older ages, asymptomatic bacteriuria often requires no treatment. No kidney damage occurs.
If the answer is yes, you do have symptoms, then it is time to see a specialist in infectious diseases. The Enterococcus bacterium can be difficult to treat and often develops resistance to antibiotics, especially if a person has taken them for a prolonged time. The specialist might suggest less frequently used antibiotics or a combination of antibiotics.
I think you have what I mentioned in the first paragraph.
The subject of urinary tract infections is discussed at length in the booklet on that topic. Readers can obtain a copy by writing: Dr. Donohue - No. 1204, Box 536475, Orlando, FL 32853-6475. 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.
DEAR DR. DONOHUE: My elderly aunts told me that in the old days, their father used to drink a teaspoon of cream of tartar in a glass of water to clean out his bladder. What truth is there to this? Is it harmful? - J.P.
ANSWER: No truth that I know of. I don't believe it's harmful. Cream of tartar is used in many foods. It can stabilize egg whites that have been whipped into froth. It's also found in baking powder. That ends my knowledge of cream of tartar.
DEAR DR. DONOHUE: I would like to request that you do our country a favor. Publish the medical fact that exposure to loud noise from boomboxes, cars without mufflers and motorcycles, over time, destroys one's hearing. - D.K.
ANSWER: Repeated exposure to loud noise is responsible for one- third of deafness cases.
The loudness of sound is measured in decibels. Whispering is 30 decibels; conversational speech, 60; a garbage disposal, 80. Sound above 85 decibels damages delicate hearing cells in the inner ear, and those cells do not regenerate. Many young musicians playing in rock bands that blast music at the 120-decibel level face diminished hearing down the road.
Leaf blowers are my pet peeve. Why can't they be quieted with a muffler?
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, FL 32853- 6475. Readers may also order health newsletters from www .rbmamall.com
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