DEAR DR. ROACH: How does one differentiate between reclusiveness and agoraphobia? I realize both are medical terms/diagnoses. — T.H.
ANSWER: Of the two, only agoraphobia is a medical diagnosis. Reclusiveness is a personality trait with a broad definition, meaning someone who is withdrawn from society.
In agoraphobia, this tendency is associated with intense fear or anxiety in at least two of the following situations: using public transportation; being in open spaces; being in enclosed places; standing in line or being in a crowd; and being outside alone. The diagnosis of agoraphobia is very specific in terms of the amount of fear, anxiety and incapacity caused by these situations. It requires experience to make this diagnosis, so I think it’s reasonable to seek out an expert (usually a psychiatrist or psychologist) to make the diagnosis and discuss treatment.
I often hear people use medical terms to describe a person’s symptoms, but people can have tendencies toward a particular disease or condition without meeting strict criteria for a diagnosis. This is often because the degree of severity to make the diagnosis is so high.
For example, I hear people described as narcissistic, but the diagnosis of a narcissistic personality disorder requires multiple criteria. Everyone should be careful of using medical diagnoses lightly, but particularly medical professionals who are in the media.
DEAR DR. ROACH: My daughter refuses to immunize my grandchildren, ages 3 and 5. All I am asking is that they get the tetanus shot. She said that if I can find a solo shot with just tetanus, she would agree to it. Does such a thing exist? If so, how can I get her doctor to order it? — C.G.
ANSWER: Although there is a vaccine that includes only tetanus toxoid, it is indicated only for those over 7 as a booster against tetanus. For your grandchildren’s ages, the DTaP vaccine is recommended.
I don’t understand why your daughter would be willing to protect her children against tetanus but not willing to protect her children from pertussis, a serious disease lasting for weeks, whose complications include seizures and encephalopathy.
Similarly, diphtheria is very rare in the U.S., but it still exists worldwide. Without vigilance, it could return. Diphtheria killed many thousands of children per year in the United States before the vaccine was introduced. In December, there were multiple cases of diphtheria reported in Australia.
I understand that you want to protect your grandchildren as much as possible, but the safest way to protect them against tetanus also protects them against pertussis and diphtheria.
DEAR DR. ROACH: I just found out that I was exposed to Agent Orange when I was in Thailand. Can Agent Orange cause peripheral neuropathy?— J.H.
ANSWER: According to the Department of Veterans Affairs, peripheral neuropathy that occurred within one year of exposure to Agent Orange is presumed to be due to Agent Orange and therefore is eligible for disability compensation and health care. The agency made this determination following an Institute of Medicine report showing some evidence of a link, although it wasn’t definite.
