Blood clots often missed

Q. My 60-year-old girlfriend had sudden severe lower-back pain and leg pain and swelling. She was diagnosed with sciatica by a doctor in the emergency room and sent home with Valium and Percocet.

One week later, the pain and swelling were so intense that she could not get out of bed. I called the ambulance to take her to the emergency room. She was diagnosed with blood clots in both legs and immediately had an emergency thrombolysis, in which the clot buster tPA is injected into the clot through a catheter.

Doctors sometimes make a potentially fatal misdiagnosis.

A. Blood clots in veins are indeed potentially lethal and frequently misdiagnosed. Hundreds of thousands of Americans are affected by this condition each year (American Journal of Preventive Medicine supplement, April 2010).

Tissue plasminogen activator (tPA) can help break up a blood clot but must be used carefully since it can cause uncontrolled bleeding.

Q. After having increasingly itchy and swollen eyelids for more than a year, I tried the dandruff shampoo solution mentioned in your column. It worked, and I have had no problems at all in more than two months. No more blepharitis.

A. Blepharitis is the technical term for eyelid inflammation. There are many potential causes of symptoms such as redness, itching and swelling of the eyelid, so it requires diagnosis by an eye-care specialist.

Some doctors recommend applying dandruff shampoo (T/Gel) to the eyelids while showering. Such shampoos knock out yeast that lives on the skin and causes seborrheic dermatitis. Be very careful to keep shampoo out of eyes!

If eyelid inflammation is due to bacterial overgrowth, a commercial eyelid cleanser such as SteriLid might be helpful. We have heard that mineral oil applied carefully to the edge of the lower eyelid also may aid in controlling blepharitis.

Q. I’ve been on simvastatin for about six months, and I have developed excruciating hip and upper-leg pain. I also get very tired in the middle of the afternoon.

I also am troubled with constipation, then the runs. Could simvastatin be causing this trouble?

A. Statins such as atorvastatin (Lipitor), lovastatin, pravastatin, rosuvastatin (Crestor) and simvastatin may cause fatigue, digestive distress and muscle or joint pain. The discomfort can affect almost any part of the body.

Muscle weakness also may affect the eyes.

We are sending you our Guide to Cholesterol Control and Heart Health, with pros and cons of statins and many alternatives for lowering blood lipids. Anyone who would like a copy, please send $3 in check or money order with a long (No. 10), stamped (61 cents), self-addressed envelope to: Graedons’ People’s Pharmacy, No. C-8, P.O. Box 52027, Durham, NC 27717-2027. It also can be downloaded for $2 from our website: www.peoplespharmacy.com.

2011 King Features Syndicate, Inc.