DEAR DR. ROACH: My youngest daughter gave birth this past Friday to a baby girl. She was supposed to leave the hospital today, but her blood pressure is very high and they say she has postpartum pre-eclampsia. I’m very worried. They are keeping her in the hospital for another day. The baby is fine, but I’m concerned about my daughter. What do you think about it? — R.H.
ANSWER: Pre-eclampsia is high blood pressure during pregnancy, happening after five months’ gestation. It is associated with swelling and protein in the urine, and occasionally with low platelets and liver damage. A dreaded complication is when it affects the brain, causing headache and visual changes, and possibly seizures (at which point it is “eclampsia”). Treatment involves lowering the high blood pressure with medicines that are safe to use in pregnancy. When pre-eclampsia is severe, definitive treatment is delivery of the baby.
Development of pre-eclampsia after delivery is very rare, but it can occur up to four weeks after delivery. The hard part usually is diagnosing it; since it is rare, non-expert doctors tend to think it can’t happen after delivery. Once diagnosed, treatment is straightforward: lower the blood pressure and prevent seizures, often with magnesium for a day or two while in the hospital. Your daughter should be fine, but probably will have to stay a day or two more in the hospital for treatment.
DEAR DR. ROACH: My dermatologist and doctor both diagnosed me with Schamberg’s disease (leaky blood vessels). Everything I’ve been told and read on the Internet says there is no cure and that it is not dangerous in any way. I suppose I’m an optimist, because I refuse to believe that there is nothing that can be done. The ugly spots on my legs are disheartening. I haven’t read anything about this condition in your column and was wondering if you have any suggestions. — J.D.
ANSWER: Your doctors are quite right. Schamberg’s disease is a benign condition caused by leaky blood vessels. The blood is broken down and causes the rust-colored pigment in the skin. It can cause some itching, usually treated with hydrocortisone. As far as the ugly spots go, I don’t know of any way to treat them once they occur.
DEAR DR. ROACH: About 23 years ago I received interferon for hepatitis C. It worked. Every year or so since then, I have been checked for the virus. Everything was fine until about a month ago, when my doctor informed me that my hepatitis C was back. He did one more test to confirm it. Otherwise, my liver is healthy, and my doctor said he would monitor it. What could I have done or taken for the hepatitis C to come back? — Anon.
ANSWER: Hepatitis C is caused by a virus, usually transmitted through infected blood products. Treatment now is with a combination of medications, and is more effective than the interferon alone that was used in the past. Treatment is important in order to prevent cirrhosis and liver cancer, and people with hepatitis C need to avoid alcohol, be immunized against hepatitis A and B, and be careful in their diet, especially avoiding raw shellfish.
Hepatitis C that was undetectable for 23 years and then comes back is something I have never heard of. I spoke to an expert, who suggested either you were re-exposed or you had a very low level of infection that went undetected, and that either with time or by waning of the immune system, it showed up again.
Only an expert, usually a gastroenterologist, should treat hepatitis C.
The booklet on hepatitis explains the three different kinds. Readers can obtain a copy by writing: Dr. Roach — No. 503, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.