DEAR DR. GOTT: My daughter is sick all the time and has been for more than six years. She will be 22 in August, has had several live-in boyfriends and is currently living on her own with a dog in a mobile home. She cannot hold down a job or stay in school. One doctor she has seen seems to think she might have Crohn’s, but nothing shows up in blood tests when seeing other doctors. Is she using this as an excuse? She will catch any flu or cold bug that comes around, and it will knock her out of commission.
She has at least 20 body piercings and multiple tattoos, to boot. So, with all of the body piercings, could her immune system be compromised to the point that there is nothing left to fight off everyday germs? I also wonder if depression could cause any of her symptoms such as diarrhea, vomiting, fatigue, fever and an occasional kidney stone. I have talked with her about this numerous times, and she refuses to go for counseling. She would rather sit home and be sick all the time and let life pass her by because there is nothing that can help her.
DEAR READER: There is a great deal that can be done, but she must be willing. While she may have had testing in the past, she should begin with a clean slate. She should undergo a complete examination, get a baseline EKG, chest X-ray, urine analysis and culture, if necessary, to rule out low-grade infection; lab testing to check for hepatitis, anemia and thyroid disorders; and anything else her physician deems appropriate.
Infection from the piercings and/or tattoos, if present, should be identified or ruled out during the physical examination. To the best of my knowledge, tattoos and piercings do not weaken the immune system.
Kidney stones can be the result of improper diet, illicit or prescription drugs, heredity or insufficient fluid intake. Sometimes they can be prevented by drinking up to three quarts of water every day and by remaining physically active. Not all stones cause symptoms, but when they do, pain, nausea, vomiting, fever, chills, blood in the urine and malaise can occur.
Crohn’s disease (inflammation of the digestive tract) should be investigated and either ruled out or treated. Crohn’s can cause abdominal pain, diarrhea, arthritis, fever and more. Treatment will depend on the location and severity of symptoms. Diagnosis can be made through an upper GI series X-ray, sigmoidoscopy or colonoscopy.
Treatment, if necessary, will likely begin with medication, nutritional supplements and surgery when and if conservative measures fail to provide relief.
Once any obvious medical conditions have been ruled out, you can move on to her depression. This is a consuming condition best treated with therapy and, unfortunately, you may not be the best person to recommend it. Leave that to her doctor, who might have a better chance of getting her the help she needs. She has nothing to lose but the rut she is stuck in and everything to gain in that she is only 22 with a full life ahead of her. She needs to make the initial move if she is ever to feel good about herself. Express your concerns, and ask for her indulgence in seeing a new physician. Then step back and hope for the best.
To provide related information, I am sending you a copy of my Health Report “Kidney Disorders.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www. AskDrGottMD.com.