MASSAGE GETS FLUID OUT OF SWOLLEN ARM

DEAR DR. DONOHUE: I have had cellulitis, a bacterial infection of the skin, on my left arm more than once. I also have lymphedema of that arm. I had my left breast removed for cancer, and I understand that the lymphedema is related to this. What can I do for both? -- Anon.

ANSWER: Lymphedema is swelling of an arm or leg due to a disruption of lymph vessels and lymph nodes. Lymph is fluid that oozes out of the circulation to bathe body cells. Lymph vessels vacuum up that fluid and return it to the circulation. On its way back, the fluid passes through lymph nodes, where germs and foreign material are filtered out.

After extensive breast surgery during which lymph channels and lymph nodes have to be removed, the return of lymph fluid to the general circulation is greatly disturbed, and the arm often becomes congested with fluid -- it swells. That makes the skin of the arm susceptible to infection -- cellulitis.

If you can get the fluid out of the arm, you'll solve both the swelling and the cellulitis. Therapists trained in ''decongestive'' massage can knead the fluid out of the arm. They use light massage strokes to achieve that. Pneumatic pumps can also push fluid out of a swollen arm.

Compression sleeves, which firmly and constantly squeeze the arm, can prevent the fluid from returning.

The same therapists who are skilled in decongestive massage can teach their patients exercises that promote fluid drainage out of the arm.

Your doctor or local hospital can put you in touch with one of these health care workers. Or you can contact the National Lymphedema Network, a foundation that serves people with this condition. The foundation's toll-free number is 1-800-541-3259, and its Web site is www .lymphnet.org.

The pamphlet on lymphedema and edema (another swelling problem due to fluid retention) offers more information on the causes of and treatments for both disorders. Readers can obtain a copy by writing: Dr. Donohue -- No. 106, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient's printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: Why is there so much talk about men's impotence but so little about women who have lost their sex drive? What can women take to restore their desire? -- L.L.

ANSWER: There's lots of talk about women's loss of sexual interest; it's a big problem. Close to half of all women who have gone through menopause report a decrease in their sexual drive.

It's partly due to a drop in female hormone production. It's partly due to physical changes that make intercourse less pleasurable, like the drying of vaginal tissues. And it's partly a loss of the allure of sexual fantasies. Some of these problems have an answer.

Testosterone, the male hormone, has brought back many women's sexual appetite. It comes in many forms, like patches or creams. It has not been approved for this use, but it can legally be prescribed for it all the same.

You should discuss this problem with your family doctor. He or she can offer suggestions for the physical and psychological aspects of a loss of libido.

DEAR DR. DONOHUE: I have a question to ask you. I took of lot of chemistry in my schooling days. I know that when you mix two materials or liquids together, you come out with a third product.

With that in mind, what good does it do to take a number of vitamins and minerals all at once? How can each vitamin and mineral do its job effectively when it gets mixed with all the rest? Please explain. -- J.D.

ANSWER: Mixing two or more substances together doesn't always produce a third or cause a chemical reaction between the mixed substances. Vitamins and minerals are a good example of a multitude of substances living together as one big, happy family. They don't fight with each other, and they don't inactivate one another.

In nature, many vitamins and minerals come in a single food. They all get absorbed.

A lot of work goes into proving that vitamin-mineral combinations make their way into the blood.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www .rbmamall.com.

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