Tuesday, September 11, 2007; HE02

Immigrants and Mental Health

Thank you for the article on some of the challenges health care providers face in delivering mental health services to members of immigrant communities ["Explaining Away Mental Illness," Sept. 4]. It is a very fine line that we in the medical community walk -- to be culturally sensitive and provide needed care. After all, if a patient or the family feels you are disrespecting their views on an illness's cause, then they are less likely to follow through on a recommended treatment. With our area's large and growing immigrant populations, it is increasingly important for providers to recognize this. Otherwise we will find ourselves with a large number of people in poor health, which in turn leads to higher health care costs overall.

Judith Levine, BSN, RN

Gaithersburg

As we mark the one-year anniversary of the killing of local psychiatrist Wayne Fenton by a patient, it is so important that we are mindful of the obstacles to treatment for the mentally ill. I appreciate that the article pointed out that immigrant populations do not necessarily have higher instances of mental illness but are less likely to seek treatment.

NAMI Montgomery County offers assistance to individuals and families facing the challenges of mental illness; we hold a Latino Support Group on the third Wednesday of each month in Wheaton. For more information on this service and others in Montgomery County, visit http://www.namimc.org/index.asp.

Terri Evans

Outreach Coordinator

NAMI Montgomery County

Silver Spring

I can empathize with Deborah Kaplan and her experience with sulfa drugs ["Chickenpox? No, Worse," Sept. 4]. In the mid-1940s, sulfa drugs were considered a lifesaver for many wounded in World War II. They were in short supply, so when I contracted strep throat during this time, I considered myself fortunate to take them. My strep throat disappeared, but within a few days I was covered with bumps from head to toe. This may have been an allergic reaction. With the vast array of other treatments available now, sulfa drugs shouldn't be used, since about 10 percent of the population can have an adverse reaction to them.

Nelson Marans

Silver Spring

I had an allergic reaction to Bactrim in February 1993 when I was in my late 20s. After finishing a round of medicine, I had a high fever and looked like I had a really bad sunburn all over. Plus, the lymph nodes behind my ears blew up like Ping-Pong balls.

I went to a Dupont Circle walk-in clinic, and luckily they immediately recognized my symptoms as an allergic reaction. The clinic gave me Benadryl and prednisone, and sent me home with strict instructions to go to the hospital immediately if my fever got worse or I developed lesions. I was scared, had a bad couple of hours at home, but slowly started getting better. My entire body peeled a week later.

Katie Rapp

Gaithersburg

My elderly mother suffered congestive heart failure and was administered Lasix, among other medications, at the hospital. After a couple of days, she developed an itchy rash all over. After I asked her about her known allergies, she said she was allergic to sulfa. I then checked her medication list and found out that Lasix is sulfa-based, as were a couple of her other drugs. I then insisted that her doctors look into this. They immediately gave her prednisone and changed her medications. After her recovery, I made sure that on subsequent hospitalizations her doctors were aware of this severe reaction.

I am a firm believer that a patient always needs a strong advocate, especially when being treated by multiple specialists.

Carol Stutts

Rehoboth Beach, Del.

I, too, experienced side effects from taking Lipitor for my cholesterol: Both of my knees hurt, especially after standing for a long time ["Is Your Doctor in Denial?" Aug. 28].

So I then switched to Zocor for three months and noticed my knees only hurt when a weather front came through. I then changed back to Lipitor, waiting for a generic Zocor, and the pain returned once again.

When I finally received my prescription for generic Zocor, all my knee pain disappeared. I told my doctor about my experiences, but he didn't quite believe me.

John Riegler

Locust Dale, Va.

From comments readers posted online:"I am a registered nurse, working in critical care. . . . Having a patient's family call for help ["Teaming Up to Prevent 'Crashes', Sept. 4] is insane on most fronts because most of the calls will NOT be for crisis reasons. Our patients and their families call for ginger ale, bath linen, coffee, condiments, telephones, angst, you name it. And nurses have to drop everything they are doing to answer these bogus calls."