Q: The rims of my ears both get so sore I can’t even sleep on them. What can I do? – W.W.

A: There are many causes for pain in the cartilage of the ear, including trauma and infection. However, when both ears are involved, it raises the concern for a rare but serious disease called relapsing polychondritis. This is an inflammatory and degenerative disease of unknown cause. It is most common in people of European ancestry and is often diagnosed between ages 40 and 60, but it can occur at any age. As the “relapsing” in its name suggests, symptoms can come and go.

The ears are the most affected site in RPC, but anyplace there is cartilage, there can be inflammation. This includes the nose, eyes and joints. The disease may also affect the heart and kidneys, which is why it’s so important to get a diagnosis. The severity can range from so mild as to escape diagnosis to life-threatening.

There are other causes — one is a skin condition called chondrodermatitis helicis nodularis — but your next step should be to see your regular doctor for an examination and possible referral.

Q: Is it true that eating raw clams or oysters with alcohol can cause acute gastritis? I thought I read this somewhere. – M.A.

A: Alcohol can cause acute gastritis (“gastrum” is the Greek word for “stomach,” and “-itis” always means “inflammation”) all by itself, especially when imbibed in large amounts, and almost exclusively in people drinking distilled spirits (as opposed to wine or beer).

Raw shellfish, such as clams or oysters, do not usually cause inflammation of the stomach unless they are contaminated with bacteria. Several species of bacteria are common, but the most worrisome are in the Vibrio genus. Vibrio parahaemolyticus causes nausea and cramping, often with diarrhea, sometimes with bloody diarrhea and fever. Vibrio vulnificus can cause sepsis, especially in people with liver disease, including alcoholic liver disease, which predisposes to very severe disease with high mortality. People with any kind of chronic liver disease should not consume raw or undercooked shellfish of any kind.

Q: My local hospital told me that I can’t donate blood because I have a pacemaker and had me sign a form acknowledging that I’ve been told that. My cardiologist said he never heard of this. What is your opinion? – C.K.W.

A: I’m with your cardiologist.

A bit of research shows that although some people with pacemakers have been turned down from donating blood, there is no need to do so unless the person has another reason not to donate. This includes some medications used to decrease blood clotting. The American Red Cross specifically allows people with pacemakers to donate blood, so long as their pulse is normal. The maker of one brand of pacemakers noted that the pacemaker is shielded from any machines used during blood donation — meaning it’s safe for YOU to donate blood.

Some blood banks want people to wait for a period of time after the pacemaker is placed, perhaps because of the very unlikely event of a blood infection. Each blood bank has its own rules to protect the safety of the blood supply and the donors. Most blood banks allow healthy people with pacemakers to donate.

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