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DEAR DR. ROACH: I heard that there is a sudden surge in people coming down with severe meat allergies. Is there any information as to why, after years of eating red meat, you suddenly can become extremely allergic? – E.V.
ANSWER: Meat allergies are uncommon; however, there has been a recent surge of meat allergies due to tick bites. I have read that over 5,000 cases of meat allergy have been estimated in the United States, mostly in the Southeast. The allergy is most often caused by a bite of the Lone Star tick, which carries the carbohydrate alpha-gal. If introduced into the bloodstream, it can cause a reaction from eating meat, especially beef, pork and lamb. Interestingly, it is much more likely in people with blood types A and O.
It isn't yet clear if the allergy will be temporary or long-lasting, but it can be very severe, and people who develop this allergy should avoid meat and carry an epinephrine device in case of exposure.
DEAR DR. ROACH: A few days ago, I heard a report on breast cancer recurrence. I had cancer in my left breast in 1995, and on my right side in 2003. What are your thoughts on the subject? There is no history of breast cancer in my family. – P.M.
ANSWER: Breast cancer sometimes runs in families, but 70 percent to 80 percent of women with breast cancer have no family history. Once a woman has had breast cancer, she is at higher risk for developing a second breast cancer. Survivors of breast cancer should get regular physical exams and mammograms.
A team of researchers from Johns Hopkins University recently published a study promising that in the near future, a new type of blood test may be able to identify DNA from breast cancer cells and find recurrence much earlier than current methods. If confirmed, this would be a big relief to the many women (and a few men) with breast cancer at risk for recurrence.
DEAR DR. ROACH: Would you please address stem-cell treatment for a torn rotator cuff? My son is facing his second surgery for this problem and is considering stem-cell treatment instead. He had such terrible pain from surgery the first time. – L.P.
ANSWER: A torn rotator cuff is a common sports injury in athletes. Complete tears usually are repaired surgically. A new surgical technique is to inject the body's own stem cells (obtained from the bone marrow) to help promote healing. It is too new of a technique for me to be able to compare it with standard surgical therapy, but the preliminary studies are very promising.
I often have said that only an individual's surgeon can decide the right surgical procedure, based on far more information than we could include in this column. It's really true that you never trust anyone quite the way you trust your surgeon. There are surgeons who are using the stem-cell technique, and it would be reasonable to get a consultation with one of them.
DEAR DR. ROACH: Can a person who has AIDS cook for his or her family and loved ones without fear of getting them sick? How long does it take to die once you are diagnosed with AIDS? How does someone with AIDS die? – D.R.
ANSWER: HIV, the human immunodeficiency virus, is acquired usually through sexual contact, exposure to contaminated blood or passed from mother to child. There has never been a reported case where a person was infected through casual contact, such as sharing eating utensils or using the same bathroom. HIV has never been reported as being transmitted through saliva, tears or sweat. It isn't transmitted by insects, either. However, it's not recommended to share razors or toothbrushes, since these can be contaminated by blood.
The progression of disease caused by HIV is highly variable. There often is a fever and flulike symptoms at the time of first infection. Most people will test positive by the usual blood test within a few months of becoming infected. People with HIV often remain without symptoms for years; however, the virus continues to replicate and destroy CD4 cells, a key regulator of the immune system, during this time.
The term "AIDS" is reserved for advanced HIV infection with a specific, defining illness, such as Pneumocystis pneumonia; or a CD4 count below 200 (normal is around 1,000).
As far as prognosis goes, the most important single factor is whether a person with HIV infection is prescribed (and properly takes!) appropriate treatment. There certainly are many people who have had HIV for over 20 years without getting AIDS.
With very advanced HIV infection, the immune system is unable to fight off infections, but also, the body cannot fight off cancer. Since people with HIV can live so long, heart disease and any other cause is possible. Very often, people die with, not from, their HIV.
For people living with HIV and who haven't told their family, I recommend doing so. I know it's complex, and it may not be right for everybody, but it will help relieve stress for most.
DEAR DR. ROACH: My husband has Meniere's disease. We cannot find anyone who can help him. Is there any medication for this? – L.M.
ANSWER: Meniere's disease causes episodes of vertigo, tinnitus and eventually hearing loss. It is caused by swelling in the organ of balance in the inner ear, but the reason for the swelling isn't clear.
Before being seen by a doctor, your husband can try to identify triggers for the attacks. Common triggers include a high-salt diet, tobacco, alcohol and stress. A low-salt diet can dramatically reduce episodes.
ENT doctors are usually expert in treating Meniere's disease. A diuretic such as hydrochlorothiazide often is used if diet alone doesn't help.
The booklet on vertigo explains this disruptive condition in detail and outlines its treatment. Readers can order a copy by writing: Dr. Roach – No. 801W, 628 Virginia Drive, Orlando, FL 32803. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient's printed name and address. Please allow four weeks for delivery.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [email protected]. To view and order health pamphlets, visit www.rbmamall.com, or write to Good Health, 628 Virginia Drive, Orlando, FL 32803. (c) 2016 North America Synd. Inc. All Rights Reserved.