DEAR DR. DONOHUE: I had a physical exam about one month ago and had my first ECG. The doctor told me I had a right bundle branch block, and she seemed quite indifferent about it. For my peace of mind, I would like your input. What does this mean? – C.K.

In the upper part of the heart is an island of special cells called the pacemaker. Pacemaker cells transmit an electrical signal that activates the lower heart chambers to contract and pump blood. The signal arrives at the lower chambers by traveling down cables similar to electric cables that bring electricity to your home. There are two such cables, a right and a left.

A bundle branch block is a roadblock, and it can occur in either cable. The heart still beats normally because the signal takes a detour to reach the involved pumping heart chamber.

The significance of a bundle branch block depends on the patient’s age, the presence of any other kind of heart problem, how long the block has existed and what, if any, are the patient’s symptoms.

The recent appearance of a left bundle branch block has to be assessed with some care. It can be a sign of heart disease. For example, an inadequate flow of blood to the heart muscle and to the heart’s bundles can produce a left bundle branch block.

A right bundle branch block used to be accepted as not a big deal. Thinking on that has changed. The recent onset of a right bundle branch block also merits further investigation.

The significance of these blocks can be investigated in a number of ways. For a left bundle branch block, a stress test with a radioactive tracer or one taken with sound waves can demonstrate the heart’s health. A routine stress test can furnish proof of heart health for a right bundle branch block.

Call your doctor and ask if further tests are necessary. The doctor might have already made that determination.

DEAR DR. DONOHUE: Is there any truth to the notion that a reformed alcoholic craves sugar and sweets? My uncle was a heavy drinker but has now stopped. I watch what he eats and drinks. He puts close to an entire bowl of sugar in his coffee. Is this related to withdrawal from alcohol? – L.F.

Some time ago, I made the mistake of saying there was very little evidence of an increased sugar desire in those who stopped drinking. Was I wrong.

Recovering alcoholics, alcoholism specialists and spouses of recovering alcoholics flooded me with evidence to the contrary. Many former alcoholics do have an insatiable hankering for sugar and sweets.

One explanation is that levels of a brain chemical, serotonin, fall when drinking stops. Serotonin is intimately involved in suppressing depression and anxiety. Sugar keeps brain serotonin levels in the normal range.

The answer to your question is “yes.”

DEAR DR. DONOHUE: Please give me an honest opinion on magnets. A friend suggested that I get them for back pain. Do they work? Can they cause trouble? – H.M.

I haven’t seen proof that magnet therapy works for the multitude of illnesses it is alleged to cure. Among those illnesses are arthritis, insomnia, headaches, back pain and on and on.

Incidentally, magnets are not a new idea for the treatment of illness. As far back as the 16th century they were hailed as a cure-all.

If you want to try them, they should not harm you. However, pregnant women and people with implanted pacemakers and defibrillators should not use them.

There is another form of magnetic therapy that does work. It is pulsed magnetic therapy, and it requires special equipment. It has been shown to heal broken bones that were mending too slowly.

Transcranial magnetic stimulation is another application of magnetic treatment. It appears to hold promise in treating depression.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

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