Dear Dr. Gott: I am deeply concerned that my 65-year-old niece, who is a petite 100 pounds, takes 20 pills a day. She has been taking these since she had surgery for a clogged artery on the right side of her neck. The doctor tells her she has to take all of them to live. She has high blood pressure but made it through the surgery. However, when she left the recovery room and went back into her hospital room, they lost her twice. She has only one kidney and only about 60 percent of it is functional. She is a real estate salesperson and is working, but the pills make her nauseated, and her hands shake, which I feel is largely due to overmedication. From what I have written, can you determine whether she is overmedicated? Should she get a second opinion?

Dear Reader: There is a definite possibility that your niece is overmedicated. Her doctor is, I think, exaggerating her needs. I urge your niece to obtain a second opinion.

This can be done appropriately without giving the impression that the family distrusts her present physician. Your niece should call the doctor (or schedule an office visit) to review her concerns, describe her symptoms and ask for a referral to a specialist because she fears that she is reacting adversely to one (or more) of her current medications. I am particularly concerned about her remaining kidney, which might be unable to excrete the medicines, thereby increasing the possibility of toxicity. Perhaps her kidney specialist would be a satisfactory person to solve this issue.

Dear Dr. Gott: I am a 69-year-old male in good health. Every time I have routine blood work done, I am told that I have high bilirubin. All other blood tests are normal. My doctor tells me this is nothing to worry about. Should I?

Dear Reader: Bilirubin is a byproduct of liver metabolism. Although your elevated levels may simply reflect a genetic tendency, they may indicate liver damage or malfunction. I assume that you have had appropriate blood tests for common liver diseases, but before reassuring you not to worry, I want to avoid missing an undiagnosed condition. I encourage you to request a consultation with a liver specialist. You need a diagnosis.

Doctor Gott is a retired physician and the author of the new book "Dr. Gott's No Flour, No Sugar Diet", available at most chain and independent bookstores. If readers would like to contact Dr. Gott, they may write to Dr. Gott c/o United Media, 200 Madison Ave., 4th floor, New York, NY 10016 USA.