July 18, 2009 in Features

Rare muscle disorder makes exercise painful

Peter H. Gott, M.D.
 

DEAR DR. GOTT: I have had a condition since infancy that causes abnormal fatigue in the muscles. It was not diagnosed until June 2007, when I was 75. A muscle chemical biopsy showed that I have McArdle’s disease. The first reported case was in 1951. As far as I can tell, there has been very little research on this disease because it is so rare. There is also no treatment or cure.

I am writing in the hopes that you or someone out there knows something about this condition that may be of use to me. My physical activities have steadily become more limited.

DEAR READER: McArdle’s disease, also known as glycogen-storage disease type V, is a genetic disorder. It is caused when the body does not produce a specific enzyme used to make “fuel” for skeletal muscles.

It commonly begins in young adulthood as exercise intolerance and muscle cramping. Some patients may recall symptoms of muscle weakness, lack of endurance and muscle pain starting in early childhood or adolescence. Overall, it is considered to be a relatively benign disorder in that life expectancy is no different than that of other people.

Symptoms include severe muscle pain and fatigue within the first few minutes of exercise. If continued, muscle spasms or contractures may develop. This causes muscle damage, which can result in myoglobinuria, a dark discoloration of the urine after exercise. This comes and goes, depending on the severity of the damage done during exercise.

There is no treatment or cure, but there is some evidence that drinking a sugary beverage before exercise may reduce or prevent symptoms. Gentle aerobic exercise is important because it can help condition the muscles and improve performance and quality of life. Obesity must be avoided because it will decrease exercise capabilities and lead to worsened symptoms.

Because muscle damage can cause kidney damage or failure, it is important to be under the care of a physician familiar with McArdle’s disease. He or she can monitor the situation and give specific advice regarding diet and exercise.

I also recommend you go online to the Muscular Dystrophy Campaign Web site at www.muscular-dystrophy.org for more information.

DEAR DR. GOTT: I have ringing in my ears. My family doctor gave me steroids that didn’t work and then sent me to a hearing specialist who said she couldn’t find anything wrong other than some minor hearing loss. I then got a second opinion from an ear-nose-and-throat specialist and another round of steroids, which didn’t work. What is this, and what can I do to stop it?

DEAR READER: Ringing in the ears is frequently called tinnitus. It is a common yet annoying condition. There are few treatments, and most do not work consistently.

I believe your best option now lies in masking devices that provide background noise that blocks out or distracts the sufferer from the ringing noise. Return to your specialist to discuss non-drug treatments.

To give you related information, I am sending you a copy of my Health Report “Ear Infections and Disorders.” Other readers who would like a copy should send a self-addressed, stamped No. 10 envelope and a check or money order for $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

Dr. Peter Gott is a retired physician. He writes for United Media and can be contacted at Dr. Gott c/o United Media, 200 Madison Ave., 4th fl., New York, NY 10016.


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