DEAR DR. DONOHUE: If I walk a block, I get a terrible cramp in my calf. It goes away if I stop and rest. What can I take for a cramp like this? I hear potassium works. I am 79 and am in good health. – R.B.

I don’t think you have a cramp. I think you have something called peripheral vascular disease, a clogging of your leg arteries. In this instance, the legs are the body’s outer boundary – its periphery – and “vascular” refers to arteries filled with a buildup of fat and cholesterol.

People with peripheral vascular disease know the distance they can walk before they experience pain. Most often the pain is in the calf, but it could be in the buttock or thigh. Leg muscles that propel the body in walking are not getting enough blood. They protest with pain.

A few simple tests can establish the diagnosis of peripheral vascular disease. One is nothing more than the doctor feeling for the pulse in the leg – behind the knee, at the ankle and on top of the foot. If the doctor feels no pulse in these spots and if the leg and foot are pale, the evidence for artery blockage is reliable. To secure the diagnosis, blood pressure at the ankle and blood pressure in the arm are compared. They should be roughly equal. If, upon dividing the ankle blood pressure by the arm blood pressure, a number of 0.9 or less is obtained, that is proof that there is an obstruction in blood flow in the leg arteries.

An equally important aspect in this process is the fact that people with significant peripheral vascular disease often have obstructing buildup in the heart arteries.

You must see a doctor. Medicines can be effective in increasing blood flow through the blocked arteries. Aggressive cholesterol-lowering is important. If medicines and exercise do not bring results, then the obstruction can be dealt with as it is in heart arteries – with a balloon dilation of the artery or with surgery.

The pamphlet on peripheral vascular disease discusses this common problem at length. Readers can obtain a copy by writing: Dr. Donohue – No. 109, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.50 U.S./$6.50 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: Nicotine gum got me off cigarettes. I have acquired a new habit – the gum. Can it be dangerous to use it daily for more than a year? – B.B.

The purpose of the gum is to help people break their smoking addiction. It was not intended to become a part of people’s daily lives once they’ve stopped cigarettes.

The gum is much less of a threat to health than cigarettes are. The lungs don’t have to withstand the barrage of cigarette smoke. However, nicotine, in itself, is not a boon to health. Nicotine from the gum gets into the blood, and it constricts arteries. Over time, that can damage them.

You can wean yourself from the gum more easily than weaning yourself from cigarettes. Chew the gum for less time. Cut back to 10 minutes, and keep reducing the amount of chewing time. While doing that, also cut back on the number of times you put the gum in your mouth. Substitute sugarless gum.

DEAR DR. DONOHUE: I have quite a few brown blobs on my chest. I hadn’t noticed them until this past year. I also have two on my face.

Could these be cancers? If not, what are they? How are they treated? – W.R.

They could be seborrheic keratoses. They are oval, slightly raised, light brown to dark brown patches that are no larger than an inch (2 to 3 cm) or so in diameter. They are not cancer, and they don’t become cancer. Why they appear is a mystery.

If you want to have the facial ones removed for cosmetic purposes, a doctor can freeze them and then scrape them off.

Don’t depend on my diagnosis as the last word. Have it confirmed by your own doctor.

DEAR DR. DONOHUE: Five years ago I had a melanoma removed. I asked the doctor if I should avoid being in the sun, but he gave me a noncommittal answer, so I have not made any effort to avoid sunlight. My wife worries about this. I told her I would write you for an answer. – L.H.

Melanomas are the most dangerous kind of skin cancer. Ultraviolet rays from the sun play a role in most melanomas. You should not expose your skin to long periods of sun. When you must go outdoors, put on a sunblocker with a sun-protection factor of 15.

Furthermore, you need regular checkups by the family doctor or by a dermatologist. People who have had one melanoma have a 1 in 20 chance of having a second one. Such exams ought to be done yearly. Some advise twice-a-year checkups.

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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