Ask Dr. Phil Donohue
Last Modified: Wednesday, December 26, 2007 at 12:00 a.m.
Dear Dr. Donohue: Please provide some information on congestive heart failure. My doctor told me I have it, but not much more. What are the symptoms? I take good care of myself. I am 84. — E.K.
Dear E.K. In the United States, congestive heart failure accounts for more than 1 million hospitalizations every year. The heart pumps so weakly that blood backs up into the lungs’ vessels, and the fluid part of blood leaks out into the lungs. It’s much like having someone hold your head under water. The fluid-filled lungs are congested — the “congestive” of “congestive heart failure.” You can drop the “congestive” part. “Heart failure” is all you need in order to be understood. Fluid also leaks into the tissues of the legs and ankles, and swells them. Two signs of heart failure, therefore, are breathlessness and swollen ankles. Overwhelming fatigue and the inability to do accustomed work are two other signs.
Medicines usually can get the heart beating more strongly and relieve the congestion. ACE-inhibitors — Capoten, Vasotec, Monopril, Prinivil and Zestril are a few brand names — are standard heart-failure medicines. Beta blockers, water pills and digitalis also can be part of the program.
Dear Dr. Donohue: My 4-year-old grandson came down with a bright-red flush covering his scrotum and penis. He did not complain at first, but then said it itched. He ran a temperature of 102 F the day before this happened. The temperature responded to Motrin.
My daughter took the child to the emergency room and was told it was idiopathic scrotal edema.
After a week, the skin peeled, and he looked OK. A few days passed, and he came down with a fever again and the symptoms reappeared. I have never heard of this in my 70 years. Can you provide information? — A.D.
Dear A.D. That’s something that doesn’t happen too often. The standard North American pediatric textbook of 3,000 pages gives it only a brief, less-than-one-sentence mention. Boys between the ages of 4 and 6 get it. The scrotum turns red and swells, and the penis also might be involved. The diagnosis is confirmed with a Doppler ultrasound, which shows increased blood flow. It’s often treated with an antihistamine, such as Benadryl. People have speculated that it might be an allergic reaction.
I don’t know if a relapse is common. I would take the boy to a pediatrician this time and get a second opinion.
Dear Dr. Donohue: Having had kidney stones, I was interested in your article on them. I have a few questions.
1. Does drinking milk lessen the chances of stones? 2. What do you mean when you say potassium has the opposite effect of sodium? Are potassium-rich foods good? 3. Should we eat less salt, sugar and meat? — W.
Dear W. The discussion was on calcium oxalate kidney stones, the most common variety.
Calcium foods do not promote calcium stone formation, and they might even prevent it. Drinking milk is perfectly OK and might stop stone recurrence.
Sodium (table salt) encourages calcium loss into the urine and, therefore, the formation of stones. Potassium does the opposite. Potassium-rich foods are a preventive for stones.
Sugar, meat and salt favor stone formation. Yes, eat less of all three.
The most helpful step in stone prevention is drinking lots of fluids, enough so that your urine stays colorless.
Dr. Donohue is unable to answer individual letters, but he will incorporate them into his column whenever possible. Readers may write him at P.O. Box 536475, Orlando, FL 32853-6475. Read more of Dr. Donohue at health section, heraldtribune.com.