DEAR DR. DONOHUE: I fell on concrete last month and broke one arm and bruised the other. Now the arm that wasn’t broken has a big water blister on the elbow. It feels like it’s filled with liquid. Every now and then, it hurts. Do you think it’s serious? — C.A.
If my diagnosis is correct, you have a fluid-filled bursa. The body has hundreds of bursas. They’re strategically placed near joints to cut down friction when the joint moves. Here, behind the elbow, they protect the skin when the elbow bends and straightens. You irritated the elbow when you hit the ground. It’s inflamed, and inflammation brings an infusion of fluid into the bursa. Ever hear of housemaid’s knee? It’s swelling of the knee that housemaids get from scrubbing floors. You have the elbow equivalent.
Trauma isn’t the only cause of bursitis, as this condition is called. The medical term is olecranon (oh-LEK-ruh-nun) bursitis, elbow bursitis. Rheumatoid arthritis and gout cause it, too. People who rest their elbows on a desk for long periods also come down with it.
Early treatment is rest, ice and wrapping the elbow with an elastic bandage.
At this point, your doctor can drain fluid out of the bursa and inject it with cortisone to ease inflammation.
Is it serious? If it hurts most of the time or if it’s hot and red, it’s serious.
DEAR DR. DONOHUE: I am a 78-year-old male, 6 feet tall and weighing 173 pounds. My 18-year-old granddaughter is 5 feet tall and weighs 113 pounds. Both of us take an occasional over-the-counter allergy-relief capsule — in the same dose.
My wife is 78, 5 feet 4 inches tall and weighs 128 pounds. A neighbor lady is 73, 5 feet 7 inches tall and weighs 249 pounds. Both take the same physician-prescribed medication for hypertension and COPD — at the same dose.
Are larger people undermedicated and smaller people overmedicated? — G.H.
Body size and age are two factors that do influence the level of medication a person absorbs and circulates. For this reason, most medicines have a wide degree of latitude when it comes to over- and underdosage. A person’s metabolism and intestinal absorption also influence the dosage of drug a person gets.
For medicines that do not have such wide latitude of safety, more precise calculation of doses is mandatory. That’s what’s done with chemotherapy drugs, for example.
To complicate matters further, the ability of the liver to metabolize drugs and of the kidneys to excrete them are other important considerations when it comes to medicines with a small leeway of safety.
It all works out usually quite well, hard to believe as that might be.
DEAR DR. DONOHUE: I have high cholesterol and three lipomas. Is there any connection between them? What causes lipomas? Is there a vitamin or herb that would prevent them from forming? — L.K.
Lipomas are noncancerous growth of fat cells. They form a somewhat-soft lump whose size greatly varies. They can be compressed with a minimum of pressure. Almost never are they painful.
If they are painful or interfere with movement or are cosmetically unacceptable, they can be removed. Liposuction is one way. No vitamin or herb treats or prevents them.
Their cause isn’t known.
DR. PAUL DONOHUE is a syndicated columnist with North America Syndicate Inc., P.O. Box 536475, Orlando, FL 32853-6475.