DEAR DR. DONOHUE: My husband has high blood pressure, and he took Toprol for many years with good results. Last year he had gout seven times. The doctor put him on a cortisone, which worked for the gout but made his blood pressure medicine stop working. The doctor put him on Norvasc, which brought the pressure down, but the gout is returning, and his ankles and legs have swelled. So the doctor then prescribed hydrochlorothiazide, which has not made much difference for the swollen legs. Aren’t there blood pressure medicines that don’t make his legs swell and don’t bring on gout attacks? – I.M.

There are more than 40 blood pressure medicines, and, of those 40, the doctor will eventually find one that controls your husband’s pressure and does not incite a gout attack.

Norvasc does not ordinarily cause swollen legs. If your husband and his doctor find that it does for him, then a change has to be made. Hydrochlorothiazide is a water pill, and it should take the swelling out of the legs. It, however, can be responsible for a gout attack.

As far as gout medicines go, ordinarily a person does not remain on cortisone drugs forever. Your husband ought to be tapering his dose and ought to come off it in the near future. Perhaps he could then restart Toprol, or he can take daily anti-gout medicine. Zyloprim is a medicine that controls gout. It is taken on a daily basis. It can interfere with the water pill hydrochlorothiazide, but there are plenty of other water pills. Colchicine, taken on a daily basis, is another gout-control medicine, and it should not have an effect on your husband’s other drugs.

Your husband’s case is not a hopeless one. The right combination of drugs will be found, but that can take time.

Is your husband watching his salt intake? Paying attention to the amount of salt he eats can both lower blood pressure and stop the fluid retention that’s swelling his legs.

The same sort of caution applies to gout. Although most gout patients can rely on medicines to free them from gout attacks, your husband ought to watch his diet for foods that can provoke an attack. Such foods include organ meats (liver, kidneys, sweetbread), herring, mackerel, anchovies, asparagus, beans, cauliflower, spinach, gravies and meat extracts. Put alcohol on the list, too.

DEAR DR. DONOHUE: My wife insisted I buy a water softener for our health. Is soft water healthier than hard water, and if it is, why? – K.R.

Hard water contains high concentrations of calcium and magnesium. Neither mineral is bad for health. However, hard water can stain toilets and washbowls and leave a ring on the bathtub. It also prevents many soaps from producing any lather.

Water is softened by exchanging calcium and magnesium for sodium. Sodium could pose trouble for people with high blood pressure. Sodium raises pressure. A quart of soft water has about 300 mg of sodium. This is not much, but it could affect people who are sensitive to sodium. I’m speaking of it as drinking water in this case.

DEAR DR. DONOHUE: This might seem like a frivolous question, but what causes a burp? It never fails that whenever I eat out, I find myself burping. Is it the food I order? I eat the same foods at home, where I never burp. – M.J.

Burps are the result of air swallowed while eating or drinking. Ask any seventh-grade boy to burp, and I am sure he can do so by swallowing air and then expelling it. Mastering burping is a prerequisite for male seventh-graders.

Chewing food slowly minimizes the amount of air swallowed. Make a conscious effort to do so when you eat out. Gulping liquids is another way to fill the stomach with air.

Don’t drink any carbonated beverages when you are out. Don’t use a straw to drink any beverage. If you are a gum-chewer, stop. Gum-chewing can fill the stomach with air.

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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