DEAR DR. DONOHUE: I have been having nightly sweats that are so bad, I have to get up and dry myself with a towel. I am a few years past menopause, so it isn’t that. Can you suggest anything? – O.S.

ANSWER:
The search for a cause of night sweats starts in the bedroom. If the room is too warm or too humid, night sweats are almost guaranteed. I know this is a banality, but believe it or not, this is where the cause of many night sweats lies.

Medications can promote night sweats. On your list of medications, Zestril and Cardizem are possible troublemakers. However, it’s only a very small number of users of these two medicines who experience night sweats. Ask your doctor if it is safe for you to experiment by cutting down the doses or not taking them for a short time. Don’t do so on your own. You say, in an edited part of your letter, that your thyroid medicine was checked and was normal. Too much thyroid hormone, either natural or in pill form, can provoke sweating.

Aspirin and Tylenol can reset the body’s thermostat in such a way that night sweating results. Cigarette smokers sweat at night from the nicotine in the smoke. As you mention, menopause is often the cause of night sweating in women.

Serious illnesses – such as hidden infections, kidney diseases, an overactive thyroid gland and cancers such as lymphomas – are always found of the list of night-sweat causes. At least a cursory look at them ought to be made.

You can get an approximation of how much fluid you lose in one night by weighing yourself before going to bed and again first thing in the morning. A loss of one pound (0.45 kg) represents a loss of one pint (450 ml) of water.

Even if you think your room is not the problem, humor me by leaving a fan on all night. It doesn’t have to blow directly on you. I want it to circulate air to see if that will stop your sweating.

DEAR DR. DONOHUE: Can you elaborate on bladder cancer? Is there a direct connection to smoking? How do you know if you have it? – Anon.

ANSWER:
Cigarette smoking has a hand in about half of all bladder cancers. Indeed, there is a direct connection between the two.

In the past, people who were employed in the manufacture of certain chemicals had a higher incidence of bladder cancer. Since the connection was made between those chemicals and the cancer, appropriate steps have been taken to eliminate them or to handle them in a safe manner.

The early signs of bladder cancer are few. Blood in the urine is an indication. However, early on, the blood can be seen only when urine is inspected microscopically or checked with a paper that reacts with a color change when blood is present. That’s a test done on almost all urine specimens.

When the suspicion of bladder cancer is high, the diagnosis can be confirmed with scans. A scope examination of the bladder, however, gives proof positive of bladder cancer.

An aside to the bladder cancer story is its possible link to foods. Fruits and vegetables decrease the chance of having it, while fatty meat and fried foods increase the chance.

DEAR DR. DONOHUE: I had idiopathic thrombocytopenic purpura, for which I had to take high doses of prednisone. It left me with a full-moon face. How long does it take for that to go away? Does it go away? – P.N.

ANSWER:
In idiopathic thrombocytopenic purpura, the platelet count bottoms out and bruises (purpura) appear on the skin. Platelets are the corks that plug up any breaks in blood vessels. Small vessels are breaking all the time, but they go unnoticed because of the prompt action of platelets.

Prednisone, which is used for the treatment of this illness, is a cortisone drug. Cortisone drugs draw fat from the arms and legs and deposit it in the face and torso.

I cannot give you a time schedule for your face to return to normal. I can assure you that the odds are stacked highly in your favor that it will.

DEAR DR. DONOHUE: When I turned 40, my wife badgered me into having a physical exam. I had never been to a doctor before.

As part of the exam, the doctor took an ECG. He told me I had Wolff-Parkinson-White syndrome. I wrote it down so I wouldn’t forget it. He asked me if my heart ever beats fast or if I ever feel faint. I said no, and he said to forget it. Now my wife wants me to see a cardiologist. Do I need to? What is this? – R.K.

ANSWER:
No doctor can diagnose WPW – Wolff-Parkinson-White – syndrome by listening to your heart or taking X-rays or sound pictures of it. It is seen only on the electrocardiogram. It produces an odd and distinctive squiggle.

The hearts of WPW patients are wired a bit differently from the normal heart. The normal heart has only one path that the electrical signal generated in the heart’s pacemaker takes to arrive at the lower heart pumping chambers. WPW patients have extra paths. Those redundant paths make some WPW patients have episodes of racing heartbeats. The racing heart often cannot pump enough blood, and that can bring on a woozy feeling.

Patients with symptoms are treated with medicines that keep the heart beating at a normal pace. If medicines fail to do the trick, heart doctors can thread a soft, pliable tube through an arm or groin blood vessel to the part of the heart with the extra paths. Once there, they switch on radio waves from the tube, and good-bye, extra path.

You have had no symptoms in 40 years. You are unlikely to have any in the next 40. You need no more input.

Many people have heartbeat problems that range from the innocent to the very serious. If readers would like more information on irregular heartbeats, they can send for the heartbeat report. Write to: Dr. Donohue — SR 102, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.50 with the recipient’s printed name and mailing address. Please allow 4-6 weeks for delivery.

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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