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Ask Dr. Gott 1/25
Info on PAH saves lives
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    DEAR DR. GOTT: Recently you had a column regarding a gentleman who described breathlessness, exercise intolerance and faintness. I had these exact symptoms before I was diagnosed with pulmonary arterial hypertension (PAH). In simple terms, this means high blood pressure of the lungs. The vessels in the lungs thicken and constrict to the point that the right side of the heart becomes unable to pump blood into them. Untreated, the right side of the heart "fails," leading to congestive heart failure, such as I had.
    PAH is rare and is, unfortunately, often misdiagnosed as asthma, just being overweight, etc., leaving some patients to struggle for years without treatment, and many die before they get the proper medication. Doctors who do diagnose it correctly often tell the patients to "go home and get your affairs in order."
    An echocardiogram is one way to aid in the diagnosis, but most PAH specialists agree that a right-heart catheterization is the gold standard for diagnosis.
    There is no cure, but there are several promising treatments available for PAH that allow most sufferers to lead reasonably normal lives.
    It would be wonderful if you could let readers suffering with these symptoms know that there is another possible cause and that they should check with a PAH specialist right away. There is a Web site devoted to this condition, and I recommend your interested readers visit it at www.phassociation.org.
    DEAR READER: I welcome your review concerning pulmonary arterial hypertension. You've said it all. The Web site contains in-depth information, up-to-date treatment options, lists of specialists and much more. It is an excellent resource for those newly diagnosed and looking for a specialist, and those looking for a community of people who understand what they are going through. Thank you for writing.
    DEAR DR. GOTT: Two years ago, a gland in my vaginal area starting draining smelly yellow pus. It then stopped but began to swell and cause terrible pain. I went to my gynecologist, who opened the gland. After about two weeks, the swelling and pain stopped. However, now it drains constantly. I have gone back to my doctor twice, yet he finds nothing wrong. I am 60 years old and had a hysterectomy 20 years ago because of a fibroid tumor.
    DEAR READER: You appear to have developed a cyst on one of your Bartholin glands. These glands are responsible for maintaining vaginal moisture. This occurrence is more common in women 20 to 29. All women over 40 who develop these cysts should be tested thoroughly to rule out cancer as a possible cause. Follow-up testing should also include blood work to check for sexually transmitted diseases.
    Since your current gynecologist appears to find no problem with your persistent drainage, I recommend you seek a second opinion from another gynecologist. The perseverance of the discharge you describe is not normal and needs to be diagnosed and treated.
    Two years is far too long to have suffered with this. You need answers, so don't delay in finding another physician.
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