By Paul G. Donohue, M.D. November 20, 2011 12:00 AM

DEAR DR. DONOHUE: In January of 2007, I was a passenger in a friend’s car when it was involved in an accident. I received two fractured vertebrae and severe bruising across my stomach. In June of 2007, I was diagnosed with Guillain-Barre syndrome. I was paralyzed from my feet to my neck, and stayed in the hospital for 63 days. Could the onset of GBS have been triggered by the stress and trauma of the auto accident? I did have a sore throat right after the accident. can GBS start in the throat? You have stated that GBS occurs one to two months after a respiratory or digestive-tract infection. is the incubation period set in stone?

Guillain (gee-YAWN)-Barre (buh-RAY) syndrome first begins as funny sensations in the feet. A paralysis then sets in, starting in the legs and moving upward in the body. the paralysis results from an antibody attack on nerves by the immune system. Antibodies are proteins that serve as ammunition for the immune attack. In 70 percent of GB patients, the ascending paralysis is preceded by a respiratory or digestive-tract infection by one to three weeks. I’m sure there are different time intervals for this; nothing in medicine is set in stone. the germ causing the digestive-tract illness is most often the bacterium Campylobacter (KAM-puh-low-BACK-tur). one of the viruses causing a preceding respiratory illness is the Epstein-Barr virus — the virus of mononucleosis, which features a sore throat as part of its symptoms. the bacteria and viruses don’t actually cause GB. They cause the immune system to produce antibodies against these germs. Those antibodies also are directed against nerves. It’s the antibodies that are responsible for GB. I cannot find information supporting stress or trauma as causing this illness.

DEAR DR. DONOHUE: my doctor refuses to prescribe prednisone for my problem. my feet, hands and knees are stiff. She says my problem isn’t bad enough. I am in pain. how should I get help?

Joint stiffness is a sign of many illnesses. Osteoarthritis is the leading cause in older people. Rheumatoid arthritis is another illness featuring stiff joints. Shortly after the discovery of cortisone (prednisone is a cortisone drug), it was used for the treatment of rheumatoid arthritis with great success. However, side effects from giving the drug in high doses for prolonged periods of time created more problems than the illness itself. Prednisone isn’t used for the more common osteoarthritis. Tylenol, Advil, Aleve and many other similar drugs are. Hot packs are another useful treatment. If you give me the diagnosis your doctor has made for your stiffness, I can expand on it for you.

DEAR DR. DONOHUE: each year, my cholesterol stays around 205. it might be 215 or 195, but mostly it hovers around 205. my HDL is 95 (2.4 mmol/L), and my LDL is 91 (2.35). do I need to be concerned about a cholesterol of 205?

You don’t need to be concerned about a cholesterol of even 215 mg/dL (5.3 mmol/L). There’s leeway in cholesterol measurement. It’s not exactly the most precise science. Rejoice at your readings, and rejoice even more at your HDL and LDL readings. both are terrific. an HDL (good cholesterol) of greater than 40 (1.04) is good and one greater than 60 (1.5) is excellent. an LDL (bad cholesterol) of 91 is very good. A value less than 100 is optimal. stop obsessing about cholesterol.

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