health

Donating Kidney Does Not Affect Life Expectancy

Ask the Doctors by by Eve Glazier, M.D. and Elizabeth Ko, M.D
by Eve Glazier, M.D. and Elizabeth Ko, M.D
Ask the Doctors | March 22nd, 2023

Dear Doctors: I was surprised to find out that a co-worker gave his nephew a kidney several years ago. He never mentions it and I don’t want to invade his privacy, but I would like to know more about the process. What does it take for someone to donate a kidney? Is it safe for them to do it?

Dear Reader: Your co-worker is what is known as a living donor. It’s just as it sounds -- the donation of an organ by someone who is still alive.

The kidney is the most frequently transplanted organ from a living donor. While less common, it is also possible to donate a lobe of the liver, all or part of a lung, a portion of the pancreas or part of the intestines. The majority of the 6,000 organs provided by living donors each year come from relatives, loved ones or close friends. A small number come from a donor who has chosen to help someone they don’t know but who is in great need. Whatever the circumstances, becoming a living donor is a weighty decision that requires serious thought.

Depending on the transplant center, the prospective donor must be at least 18 or 21 years old. They must also be mentally competent to make the decision to donate and be in good health. Conditions that can interfere with becoming a living organ donor include diabetes, cancer, uncontrolled high blood pressure, hepatitis, HIV or an active infection. All of this is ascertained during the evaluation that is required of all potential donors. This begins with blood tests and tissue typing to see if a potential donor is a good match. If so, the person undergoes additional testing, including heart and lung exams, a colonoscopy, and liver and kidney function tests.

Not surprisingly, given the enormity of such a decision, a mental health assessment is an important part of the screening process. The transplant center also makes sure the donor has the financial, medical and personal support required when someone undergoes major surgery.

The transplant itself is done under general anesthesia and takes three to four hours. Most kidney transplants are now done laparoscopically, which means small incisions and a faster recovery time. The timing of a return to work and a regular routine varies, but typically takes three to six weeks.

Short-term risks to the donor include those involved in any surgery. These include infection, pain, blood clots and an adverse reaction to anesthesia. Long-term risks include the natural decline in kidney function that accompanies aging and developing a disease that itself impedes kidney function. This includes Type 2 diabetes, high blood pressure and obesity. A donor loses 25% to 35% of their kidney function. To compensate, the remaining kidney increases in size.

The data show that donating a kidney does not affect the donor’s life expectancy. People on the kidney transplant list wait an average of three to five years for an organ. Tragically, some don’t survive the wait. In donating a kidney to his nephew, your co-worker has made a courageous and generous choice.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

health

Exposure to Rabies Comes From Contact With Saliva

Ask the Doctors by by Eve Glazier, M.D. and Elizabeth Ko, M.D
by Eve Glazier, M.D. and Elizabeth Ko, M.D
Ask the Doctors | March 20th, 2023

Hello again, dear readers, and welcome back to the monthly letters column. You’ve filled our mailboxes to the brim, so we’ll dive right in.

-- We recently discussed the series of shots required when someone is exposed to rabies. This prompted a letter from a reader in Virginia whose husband found a baby bat. ”He touched the bat with his foot (while wearing socks and shoes), and it flew off,” she wrote. “Then he got worried about rabies. Is there a test that can reassure someone they don’t have rabies?”

There is no single test for rabies in humans. Instead, several tests on samples of saliva, blood serum and spinal fluid are performed. The results show if infection has occurred. Rabies is nearly always transmitted through a bite. It is possible to get infected through surface contact with infected saliva, but it’s rare. In the scenario you describe, your husband did not come into direct contact with the bat.

-- In response to a column about gastroesophageal reflux disease, or GERD, a reader from Louisiana shared their approach to managing the condition. “A behavioral change that works for me to prevent GERD is the elimination of sugar from one’s diet,” they wrote. “Give it a try, and if it works, you have a solution. If not, no harm done.” The reader’s experience is backed by recent research. A study published last year in the American Journal of Gastroenterology found that people with GERD who reduced sugar improved the pH level in their esophagus and experienced fewer reflux episodes.

-- We’ve had several letters in reference to a column that included a discussion about hydration. One reader asked about distilled water. “I prefer the non-taste of distilled water, so that is what I normally drink,” she wrote. “But someone told me it’s bad for my body. Is that true?” It is safe to drink distilled water when accompanied by a balanced diet. That’s important because distilled water has been stripped of electrolytes and minerals, including calcium and magnesium. Although the primary source of minerals essential to human health is the foods we eat, water also plays a role. Some studies have found that relying solely on distilled water may contribute to lower levels of these important minerals.

This brings us to a letter from a reader from Nebraska who regularly drinks spring water and wonders if it contains minerals. The answer is yes. For people who dislike the taste of tap water, spring water can be a good alternative.

-- A column about balance that suggested standing on one foot as a useful strengthening exercise prompted a question from a reader. “Should I balance on one foot with bare feet or with shoes on?” they wrote. “I think there will be a significantly different result.” You’re correct that each scenario elicits a slightly different kinetic response. But since both involve the mechanics of balance, we think both would be useful.

Thank you, as always, for taking the time to write. We love hearing from you. We have had an unusual amount of mail recently and will add several bonus letter columns in the coming weeks.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

health

The Best Way To Fight Pink Eye Is With Hygiene

Ask the Doctors by by Eve Glazier, M.D. and Elizabeth Ko, M.D
by Eve Glazier, M.D. and Elizabeth Ko, M.D
Ask the Doctors | March 17th, 2023

Dear Doctors: Our 7-year-old came home from school with an itchy eye. A few days later, all three of our kids, plus my husband and I, had pink eye. Our family doctor gave us antibiotic eyedrops, and it was gone in a few days. What causes pink eye? What can you do to keep it from spreading?

Dear Reader: Pink eye is the common name for an infection known as conjunctivitis. It’s the most frequent cause of eye inflammation and occurs in an area of the eye known as the conjunctiva. That’s a thin, clear membrane that covers the white of the eye and lines the inner eyelid. The conjunctiva protects the eye from potential irritants and pathogens. It is nourished by a dense network of minute blood vessels, and it is the site of numerous lymphatic vessels, which are involved in immune response. The conjunctiva also plays a role in producing tears and mucus, which keep the exposed surfaces of the eye moist and lubricated.

Viral infection accounts for about 80% of cases of conjunctivitis. The cause is usually an adenovirus. Bacterial conjunctivitis is seen more often in children than in adults. While not as common, fungi and parasites can also cause infectious conjunctivitis.

Once the infection is present, it can spread easily and quickly. If someone touches the contaminated fluid or discharge from an infected person’s eye and then touches their own eye, they can transfer the bacterium or virus. As with a cold or the flu, the microbes can also be spread via respiratory droplets.

Conjunctivitis can also be caused by noninfectious agents, such as irritants to the eye, as well as allergies. In those instances, the condition is not contagious.

Pink eye gets its name from its most prominent symptom. When someone develops this type of infection, that network of tiny blood vessels that we mentioned becomes inflamed. This causes the whites of the eye to turn pink, or even red. The inner eyelid often becomes swollen, the membranes of the eyes begin to itch or burn, and the eyes may begin to tear. When the cause of conjunctivitis is bacterial, a discharge is often present.

Treatment for all types of conjunctivitis begins with managing the symptoms. This includes using a warm compress every few hours to keep the eyelid and lashes clean and moist and artificial tears to ease itching and dryness. People who wear contact lenses should pause their use until the infection has cleared. When the source of the infection is bacterial, as occurred in your family, antibacterial eyedrops may be prescribed. But antibiotics don’t affect viruses. In viral cases of conjunctivitis, the infection must run its course. Conjunctivitis typically clears up in seven to 14 days.

Prevention hinges on hygiene. Wash hands before and after touching your eye. Change pillowcases daily while infection is active. Don’t share personal items, such as washcloths, medications, makeup or eyeglasses. Be sure to throw away eye drops, solutions or eye makeup that were used while the family was infected. If symptoms persist -- or if they are accompanied by pain, sensitivity to light or blurred vision -- it is important to see a doctor.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

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