DEAR DR. DONOHUE: I face a big problem. When I sleep, I always urinate in the bed. I am 15 years old, and I haven’t gone to a doctor yet. What is your suggestion? – N.U.

ANSWER: By age 15, only about 3 percent of children are wetting the bed. It is a big problem, emotionally and socially.

One reason why this happens is a lag in nerve and brain control over the bladder. Time should take care of that. It hasn’t with you. Another reason is a bladder that is too small to hold all the urine that’s made during the night. That, too, usually resolves as a child grows older. Another problem has to do with a hormone called ADH – antidiuretic hormone, a hormone that slows the production of urine. Without a sufficient supply of ADH, urine production surges, and the bladder is unable to hold it all, so nighttime loss results.

You need to see a doctor. One reason is to find out if you have a problem that can be corrected. The other reason is to enlist the doctor’s help in obtaining devices that can often train your brain and bladder to hold a night’s volume of urine without losing it involuntarily.

One such device is an alarm that sounds at the first drop of moisture. It wakens a youngster from sleep in time to make it to the bathroom. Constant use can lead to successful bladder control during the night.

Another stratagem is to set an alarm clock every three hours during the night to avoid accidents. In the long run, this can give the nervous system a chance to fully mature while keeping the bed dry.

For special occasions, such as sleeping over at another’s house or camping out, antidiuretic hormone can be given. It comes in a nasal spray or as a tablet. It does lessen urine production and keeps accidents from happening. It is a prescription item, another reason for you to see the doctor.

In the past, many readers have written me to say their children’s bed-wetting was tracked to food allergies – another point of discussion for you to have with a doctor.

DEAR DR. DONOHUE: I have been told I have variant angina. Will you tell me what this means and about its treatment? – E.W.

ANSWER: Angina is chest pain that occurs due to a deficient blood supply to heart muscle. Ordinary angina happens when a person is up and about. The added physical effort calls for more blood to the exercising heart. When there is a partial blockage in a heart artery, extra blood cannot get to the heart muscle, and chest pain comes on.

Variant angina (also called atypical angina or Prinzmetal’s angina) is chest pain that occurs at rest. It’s due to a deficient flow of blood to a heart artery, but the reason for the deficiency is artery spasm.

The most dangerous period for a person with variant angina is the first three to six months after symptoms appear. During this time, variant angina can generate dangerous heart rhythms, and, on rare occasions, it can induce a heart attack.

However, the outlook for most people with this malady is good. Episodes of chest pain can be controlled with nitrate drugs or calcium channel blockers, such as verapamil. These are medicines also used for the ordinary kind of angina. When a person with variant angina goes 12 to 18 months without an attack, then an attempt to discontinue medicine can be made.

DEAR DR. DONOHUE: You answered a question about between-beat blood pressure being too high. What is between-beat blood pressure? – J.W.

ANSWER: When the heart beats – contracts – it ejects a stream of blood that is under pressure. That pressure is the systolic blood pressure. It’s the first number of a blood pressure reading – the higher number. When the heart relaxes – is between beats – pressure in arteries falls. That is diastolic blood pressure, the second number of a blood pressure reading.

Both numbers are important when it comes to high blood pressure.

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.

Only subscribers are eligible to post comments. Please subscribe or to participate in the conversation. Here’s why.

Use the form below to reset your password. When you've submitted your account email, we will send an email with a reset code.