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Ask Dr. Gott 9/4
Elephantiasis requires immediate attention
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    DEAR DR. GOTT: I would like to know if you have any information on elephantiasis. I was diagnosed with this affliction in May 2007.
    DEAR READER: I had my work cut out for me when I decided to answer your question.
    Elephantiasis is a hardening and thickening of the skin caused by bacterial infections of the skin and lymph system. It is the result of several lymph-system disorders. The most common cause is filariasis, or lymphatic filariasis, which is a parasitic infection caused by microscopic worms and affects more than 120 million people in the tropics and subtropics of Asia, the Western Pacific, Africa and parts of South America and the Caribbean. According to the Centers for Disease Control, you can't get infected within the United States.
    It can also be caused by repeated contact with volcanic ash. This cause primarily affects people living in the central mountains of Africa.
    A final cause is lymphedema, or hereditary lymphedema, which is caused by a blockage or inefficiency of the lymph system. It causes fluid to collect (often in the lower extremities but can also affect the arms, genitals or breasts) with resulting swelling.
    Anyone who has seen or has lymphedema can tell you how severe and potentially dangerous it can be. It is not uncommon for the affected limb to quadruple in size. There have been reported cases of lymphedema leading to a leg that weighs 250 pounds or more. Without proper treatment, lymphedema can lead to infection, amputation or even death.
    If the cause of your elephantiasis is parasitic, you need to be on medication to eradicate the infection.
    You should be under the care of a physician who can provide you with up-to-date treatment options. At this point, you need to keep your skin clean and dry and have the underlying cause treated. See your physician for a referral to an appropriate specialist.

    DEAR DR. GOTT: I hope you can help me with an issue that has been bothering me.
    To the best of my knowledge, there is no test for Alzheimer's disease. It can be diagnosed only after death, so how is it that people and doctors can say that someone's symptoms are caused by it? How is it that a doctor can say that someone has early Alzheimer's if there is no test for diagnosis? Is he or she simply guessing or assuming? I also would like to know about NPH, which also has no test or diagnosis until after death.
    DEAR READER: You are mistaken. While you are correct that Alzheimer's has no medical test, it can be diagnosed based on symptoms. Certain criteria must be met to make the diagnosis; however, it does not have to be a mystery illness diagnosed only after death.
    As for normal pressure hydrocephalus, tests, primarily MRIs, are available to confirm a diagnosis.
    Dementia has many causes, including simple vitamin deficiency, Alzheimer's, NPH or even alcoholism. It is important that the affected person be examined by a neurologist.
    To give you related information, I am sending you a copy of my Health Report "Alzheimer's Disease."
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