Q: I read your column for years in our local newspaper but when cutbacks and staff changes were made, it was dropped. How glad I am to find you on line!

My question is about a pain my mother has. She is 82, healthy and active. She had one minor stroke and has high blood pressure controlled by medications. She also has a family history of both. Several months ago she began being awakened at night with a tightness and pain in her jaw. Sitting upright stopped the sensation. She describes it as feeling as though she has eaten something very sour, or it’s like having the mumps. She did see her physician and had a chemical stress test, on which she did well. His only solution was to increase the amount of nifedipine she takes for circulation because of her Reye’s syndrome. That stopped most of the nightly episodes but now she has begun having episodes during the day. They pass when she sits and rests but they leave her feeling very weak and concerned that they are increasing.

I would appreciate any insight or advice you might be able to offer.

A: The first thing that concerns me is your mother’s jaw pain because it is a classic symptom of heart pain from either angina or a heart attack. Her physician ordered a chemical stress test because of her symptoms. By explanation to other readers, a cardiac stress test requires an individual to walk on a treadmill or ride a stationary bicycle to stress the heart. The test she had literally uses chemical agents injected into the body through a vein to simulate physical exercise. If the chemical test was negative, it was determined she does not have cardiovascular disease and her pain was not a symptom of cardiovascular disease. Nifedipine is prescribed for hypertension and is also used to control angina, chest pain or chest discomfort that occurs if an area of the heart muscle fails to receive sufficient oxygen. It works by relaxing blood vessels which, in turn, increase the supply of oxygenated blood to the heart.

Reye’s syndrome causes swelling in the liver and brain. It is almost always associated with a prior viral infection such as the flu, a cold, or chicken pox. It is not contagious and the cause is unknown. It tends to be more prevalent during the winter months when influenza and other viruses are most common. Symptoms may include mental changes, seizures, confusion, and loss of consciousness or coma. Statistics indicate an excellent chance of recovery if the condition is identified and treated in its earliest stages. Diagnosis of Reye’s may be accomplished through a blood tests, CT or MRI of the head, liver function tests or biopsy, spinal tap, and more. Successful management depends on early diagnosis and is primarily aimed at protecting the brain against irreversible damage by reducing brain swelling and preventing complications in the lungs.

All this makes me lean toward the thought that your mother has an issue that must be further investigated and, which may be linked with her Reye’s diagnosis. I feel she has two very serious conditions that require the assistance of specialists. I urge you to suggest a second opinion with top notch specialists. She should bring her test results for review.

While waiting for her appointment, you may find additional information from the National Reye’s Syndrome Foundation’s website www.reyessyndrome.org.