Dear Dr. Gott: I greatly enjoy your column and have learned much through it. some time ago, you ran an article from a reader who asked if body piercings could affect a person’s health, and you gave a list of medical procedures and appropriate tests. I think you missed an important possibility. in my experience, the young lady who would not go for counseling or testing is most likely addicted to prescription drugs. The symptoms described are common in withdrawal from opiates (which feels like the worst flu you’ve ever had). Kidney stones are often invoked ways of getting pain relievers. The frequency of the “illnesses” probably means she’s running out of medicine before it’s time to refill her prescription. The parents should check this out and may want to arrange an intervention to get her into rehab. her lack of motivation could also be due to amotivational syndrome, not uncommon in longtime marijuana users. I hope this helps.

By the way, I am a reverend doctor who is a certified addictions counselor and certified co-occurring disorders professional.

Dear Reader: You are correct that I failed to mention drug addiction as a potential cause of the young woman’s chronic illness. it is also possible that she does indeed have a medical condition, such as Crohn’s, for which pain medication was prescribed, which led to an addiction. Therefore, I stand by my previous statement urging the young woman and her parents to seek out medical attention and testing. however, to that I will add that addiction is a valid potential cause or worsening factor.

As for amotivational syndrome, this is a controversial condition. According to the World Health Organization, it is a constellation of features said to be associated with substance abuse, primarily cannabis use. These features (apathy, loss of effectiveness, low tolerance for frustration, impaired concentration and more) may be the result of chronic cannabis intoxication or may merely reflect the user’s personality, development stage or attitude.

Dear Dr. Gott: I’ve noticed in the past there have been more letters from females about reoccurring yeast infections. my wife had that problem for several years before her doctor had her A1C checked and found she was type 2 diabetic. once her diabetes was under control, she had no more problems.

Dear Dr. Gott: a while ago, you had a column about a lady with a chronic yeast infection. Many years ago, I had a recurring problem in the same area. For months, my OB/GYN and I tried a variety of pills and ointments, but the irritation always returned. I discovered the cause by accident. when we were traveling in our motor home, I had no problem. But it came back as soon as we returned home. The culprit was the extra-soft toilet paper we used at home. I have been using the simple septic-tank-friendly paper ever since and have no more irritation.

Dear Readers: Diabetes increases the risk of developing skin and yeast infections. Undiagnosed, uncontrolled or poorly controlled diabetes increases the risk. it also increases the chances of nerve and kidney damage, cardiovascular disease, cancer, foot damage, brain problems and more. Diabetes can be diagnosed with a simple blood test.

now to the extra-soft toilet paper. I have never heard of this causing a problem so this is completely new to me. I chose to print your letter because switching toilet-paper brands/types is a simple, inexpensive change that may be extremely beneficial to many people.

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