June 24, 2016 — Gwinnett Daily Post by Gwinnett Daily Post

4A • Friday, June 24, 2016 To Your Good Health

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Keith Roach

Rare disease prognosis depends on its extent DEAR DR. ROACH: I have a friend who is the primary caregiver to her son, diagnosed with Langerhans cell histiocytosis. I am unfamiliar with this condition and would like to better understand the challenges and prognosis. Can you help? — O.C. ANSWER: Langerhans cell histiocytosis is a rare disease that is difficult to understand. Expert opinion is mixed on whether it is, strictly speaking, a cancer. It acts like cancer in many ways and probably is caused by immune system dysfunction. The predominant issue is that a type of cell, called a histiocyte, is usually present in bone lesions and can infiltrate other organs, especially the skin, lymph nodes and lungs. The histiocyte seems to be a cell that is derived from bone marrow and not the Langerhans skin cell it resembles. LCH is a rare disease but one that probably is underreported due to misdiagnosis. It most commonly occurs in children ages 1-3. Treatment depends on how extensive the disease is, so a careful and thorough evaluation is mandatory. In disease limited to the bone or a single lymph node, surgical treatment may be possible. However, in people with disease in multiple organs or in places not amenable to surgery, treatment is usually with combination chemotherapy. Those with a particular gene mutation may benefit from a medicine used for treatment of melanoma. Prognosis depends greatly on the extent of the disease. For those with limited disease, the prognosis is very good, with greater than 95 percent survival at five years. For those with higher-risk disease, especially with disease in the liver, spleen or bone marrow, the five-year survival rate was 84 percent in a recent trial. Your friend is taking care of a child with a complex, difficult-to-treat disease as dangerous as many childhood cancers, which few have heard of and fewer still understand. DEAR DR. ROACH: I am a 60-year-old woman in excellent health, no diabetes. At a recent annual physical, my urine test indicated some mild inflammation (positive urine nitrite and esterace, WBC 6-10,), for which I am asymptomatic. I was given a prescription for Cipro, as I am allergic to other antibiotics. I do not want to take Cipro, so I have been drinking lots of water and tea, and eating lots of fresh (frozen) cranberries. Since I am asymptomatic, I don’t know if this is working. Should I request a retest? — L.B. ANSWER: First off, I don’t think you should worry about being labeled “uncooperative.” It’s your body, and you get to make the choices. Wanting to avoid antibiotics is commendable, so it’s OK to ask for alternatives, including self-care and no treatment. In your particular case, I wouldn’t have recommended treatment. What you have is termed “asymptomatic bacteriuria,” and most experts recommend against treating it, except in pregnant women, people about to have urologic surgery and kidneytransplant recipients.

HOroscopes

weather watch

solunar tables

The solunar tables for lakes are based on studies that show fish and game are more active at certain times during the lunar period. Major

The Gwinnett Daily Post (UPSP 921-980, ISSN 10860096) is published Wednesday through Friday and Sunday by SCNI, 725 Old Norcross Road, Lawrenceville, GA 30045. Periodical postage paid at Lawrenceville, GA 30044. POSTMASTER: Send address changes to Gwinnett Daily Post, P.O. Box 603, Lawrenceville, GA 30046-0603.

Lake

lake levels

Full Yesterday

Lake

Allatoona (840.0) .........840.11

Full Yesterday

Lanier

(1071.0) ....... 1067.88

Blackshear (237.0) ......... 237.05

Nottely

(1779.0) ....... 1774.58

4:52-6:52 a.m..............5:17-7:17 p.m.

Blue Ridge (1690.0) .......1684.64

Oconee

(435.0) ........ 434.83

10:29-11:29 a.m................................ ..................... 11:58 p.m.-12:58 a.m.

Burton

(1865.0) .......1865.13

Seminole (77.50)............76.77

Carters

(1072.0) ....... 1072.74

Sinclair

Chatuge

(1927.0) .......1924.35

Thurmond (330.0) ........ 328.22

Minor

pollen counts Trees: None Weeds: High Grass: None

(339.8) ........ 338.62

Harding

(521.0) ........ 520.80

Tugalo

Hartwell

(660.0) ........ 658.55

Walter F. George (190)....... 187.81

(891.5) ........ 889.51

Jackson

(530.0) ........ 528.52

West Point (635.0) ......... 631.40

today in history

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TODAY’S HISTORY: In 1901, the first major exhibition of Pablo Picasso’s work opened in Paris. In 1948, President Harry S. Truman signed the Selective Service Act, requiring all men between the ages of 18 and 25 to register for military service. In 1957, the U.S. Supreme Court ruled in Roth v. United States that the First Amendment does not protect obscenity. In 2011, New York Gov. Andrew Cuomo signed a bill into law that legalized same-sex marriage. TODAY’S BIRTHDAYS: John Ross (1777-1856), Arctic explorer; Henry Ward Beecher (1813-1887), clergyman/ abolitionist; Ambrose Bierce (18421914), writer/satirist; Gerrit Rietveld (1888-1964), architect; Jack Dempsey (1895-1983), boxer; Mick Fleetwood (1947- ), musician; Peter Weller (1947-

), actor; Sherry Stringfield (1967- ), actress; Mindy Kaling (1979- ), actress/ producer; Minka Kelly (1980- ), actress; Lionel Messi (1987- ), soccer player. TODAY’S FACT: Pablo Picasso was honored on his 90th birthday with an exhibition at the Louvre in Paris in 1971. It was the first time the Louvre had exhibited the work of a living artist. TODAY’S SPORTS: In 1995, the South Africa Springboks defeated the New Zealand All Blacks in the finals of the Rugby World Cup as Nelson Mandela looked on. The event was dramatized in the 2009 film “Invictus.” TODAY’S QUOTE: “The palmist looks at the wrinkles made by closing the hand and says they signify character. The philosopher reads character by what the hand most loves to close upon.” — Ambrose Bierce, “A Cynic Looks at Life”

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Jilted lover wants to out co-worker to HR Dear Amy: Recently, I ended an on-and-off relationship with a coworker. What makes this situation even messier than it already should be is the fact that I ended it because I caught him sleeping with our boss. While our personal relationship was allowed (although secret), other co-workers and I are all aware that his ongoing relationship with our boss would likely lead to both of them being terminated. Our boss is aware of the past he and I share, but the two of them have continued their relationship. Worse even, they continue to be rude to me in the workplace and make me very uncomfortable. Even passing these people in the hallway has become intolerable, but I am otherwise happy with my job and do not wish to leave. How can I (or should I), bring this up to human resources (or a higher level) without seeming like a scorned lover who wants revenge? — Wondering Dear Wondering: But you are a scorned lover seeking revenge. I assume that jilted lovers are the primary vehicles for HR learning about workplace problems. By sleeping around at the office, your co-worker risks facing the exact scenario you are describing. His relationship with you was “allowed,” presum-

Ask Amy

Amy Dickinson ably because you either don’t report to each other or are of equal professional status. His relationship with your boss is not allowed because his boss is in a position to damage his (or your) status at work. Although I don’t think rudeness in the hallway or your discomfort about this is necessarily actionable, this seems to have created the classic “toxic” environment at work, at least for you. HR can counsel you and/or reprimand both other parties. Dear Amy: I am lucky enough to have access to a small beach home, and I love going to the beach. Unfortunately, there is a little clutch of people who live nearby who enjoy getting together at the beach. They seem to think it is their right to make fun of people or to talk about those who are missing from their little group that day. They are the neighborhood gossips who know everything about everyone. They like to persuade people to sit with them. Anybody who sits with them witnesses their

childlike behavior. If you don’t sit with them, they say you are a snob. My response is, “I just need some peace and quiet — alone.” That is really not true, Amy. I like talking to some people at the beach, but I don’t like to destroy people who don’t happen to be in the group. These people are loudmouths, and one especially can be crude (to say the least), but I think people are afraid not to be with them for fear that they will become the center of talk. The worst thing is that this makes me want to avoid the beach. But why should we have to avoid the beach? Do you have a response to end this petty nonsense? Beach season is here, and I want to enjoy it. — Surf-and-Sand Lover Dear Surf Lover: There is no question that regular cliques form on the beach, with groups of people gathering together to claim their usual spots, but please — don’t turn the beach into the middleschool cafeteria. You don’t seem to want to join this clique of beach-meanies, so don’t. Wave and say hello and head to another spot. You don’t need to declare your intention to be alone. Be cordial and friendly, but don’t join them. It is your precious vacation, and you should spend it exactly the way you want to. If you do join them, the way to avoid being

the topic of mean gossips is to starve them of the oxygen that turns their sparks into a flame. You do this by being polite and asking them a couple of innocuous questions so they can talk about themselves. If they make unkind and uncalled for remarks about others in your presence, you should be brave enough to say, “Whoa. That’s not fair.” If you are branded a snob because you are kind and considerate, then own it with pride. Dear Amy: “Homeowner” was concerned about unkind remarks family members might make during a housewarming party because of their slightly run-down neighborhood (which Homeowner likes). Inviting neighbors to this housewarming party would allow both sides to take the measure of the other. It would be inclusive and might also prevent these unkind assumptions before they take hold. — Been There Dear Been There: Of course! Great advice. Thank you. You can contact Amy Dickinson via email: askamy@tribpub.com. You can also follow her on Twitter @askingamy or “like” her on Facebook. Amy Dickinson’s memoir, “The Mighty Queens of Freeville: A Mother, a Daughter and the Town that Raised Them” (Hyperion), is available in bookstores.

Don’t let anger get the better of you. If something is upsetting you or causing you distress, make whatever change is necessary to bring tranquility and peace of mind to your life. Don’t lose sight of your goals or give in to the demands of selfish, thoughtless individuals. CANCER (June 21July 22) — It’s OK to do things differently. Add a little spice to your life and sign up for something that will be fun for the whole family or just you and a loved one. LEO (July 23-Aug. 22) — Emotional spending is never a good thing. Do your best to use common sense with regard to money matters. Consider making a change that will offer greater mental stimulation. VIRGO (Aug. 23-Sept. 22) — Make plans, but be prepared to change course if a different path entices you. You can improve your personal life by setting up romantic plans or trying something new. LIBRA (Sept. 23Oct. 23) — Don’t wait for people to come to you. Speak up and air your opinions in order to attract people who share your concerns and ideas. A passionate plea will bring good results. SCORPIO (Oct. 24Nov. 22) — A different approach to a moneymaking idea or investment will lead to financial gains, as long as you don’t let a personal confrontation get in the way. SAGITTARIUS (Nov. 23-Dec. 21) — Read the instructions before you take on a challenge that requires precision and accuracy. Make personal changes before someone makes them for you. Don’t make assumptions — get the facts. CAPRICORN (Dec. 22-Jan. 19) — You have more options than you realize. Refuse to let someone’s complaints or criticism cause you to miss out. Don’t fear being different or using your imagination. Romance is highlighted. AQUARIUS (Jan. 20-Feb. 19) — Your ideas are good, and you should follow through with your plans regardless of what others do or say. The changes you make personally will allow you to reach your goals. PISCES (Feb. 20-March 20) — Check out ways to make your domestic environment better. Include those you love in your plans and offer incentives that will encourage everyone to take part. Romance is on the rise. ARIES (March 21-April 19) — Nurture your health and well-being. Use common sense when traveling or dealing with your finances. Getting together with someone from your past will lead to a new opportunity. TAURUS (April 20May 20) — Look for something or someone unique to occupy your time. Travel to unfamiliar destinations that will offer insight into future trends or possibilities. Romance is featured. GEMINI (May 21June 20) — Easy does it. Put caution first. It’s much easier to control a situation if you don’t let someone else call the shots. You’ll be misled if you believe everything you hear.