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DEAR DR. ROACH: Is it possible to be allergic to the cold weather and temperature changes? My son is 23 years old, and when he goes out in the cold, he breaks out in hives. What can he do? – K.R.
ANSWER: This sounds exactly like cold urticaria, which isn’t an allergy, but is similar in some ways. Doctors may test this by placing an ice cube (in a plastic bag with water) on the skin (usually the forearm) for five minutes, then watch the skin as it rewarms. If a hive develops (with raised skin and redness), that confirms the diagnosis. Cold urticaria can be associated with some infections (Lyme disease, hepatitis and HIV, among others) and with celiac disease.
People with cold urticaria need to worry about systemic reactions. Avoiding cold (especially swimming in cold water) is critical, but even cold beverages can cause a serious systemic reaction, including swelling of the mouth and throat. Even anaphylaxis, a life-threatening collapse of the circulatory system, can develop. Many people with severe cold urticaria carry an epinephrine auto-injector in case of emergency.
Antihistamines, such as loratadine (Claritin) and cetirizine (Zyrtec), are the best pharmacologic treatment. Experts in cold urticaria include allergists and dermatologists.
DEAR DR. ROACH: Whenever someone is ill with most diseases, they are usually prescribed a drug or a medicine, or a pharmaceutical product. Why is it that cancer patients are treated with “chemo,” or “chemotherapy,” rather than one of the above? Is there a difference, or is it just semantics? Nobody I’ve asked seems to have an answer. – D.G.
ANSWER: To be honest, I was confused too, until medical school, where I learned that “chemotherapy” is just another word for a drug or medicine intended to treat a condition. We just normally reserve the term for drugs used to treat cancer. Although we tend to think of the side effects of chemotherapy as horrific, and some certainly are the most toxic substances we ever use, they vary widely in how well they are tolerated.
DEAR DR. ROACH: In August I had open repair of my right rotator cuff. I was told it was a severe tear with bone and tendon involvement. I am 67, and the recovery has been a long one. If you can believe it, even with physical therapy and pain management, I am still uncomfortable at times. I have a stupid question that I hope you can answer. Ever since surgery, I have had to sleep on my unaffected side. Is it OK for me to finally try sleeping on my right side? I don’t have another appointment at the orthopedic office. I am embarrassed, as it is one question I haven’t asked. – C.V.
ANSWER: It’s not a stupid question at all. I don’t think you will damage the surgery repair by sleeping on the shoulder now, and you certainly can try it to see if it feels uncomfortable. I also would recommend you continue the exercises your physical therapists gave you.
Dr. Roach regrets he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu. To view and order health pamphlets, visit www.rbmamall.com, or write to Good Health, 628 Virginia Drive, Orlando, FL 32803.
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