DEAR DR. DONOHUE: My doctor tells me I have congestive heart failure. I don’t feel bad. I do become short of breath when I walk any distance, but I thought that was just my age showing. I am 82. My doctor said he ordered a special test to see if I do have congestive heart failure. The test was positive. What is this test? How is this condition treated? – M.B.

ANSWER: “Congestive” in “congestive heart failure” is a source of confusion to people. It means that the lungs and certain tissues, like those around the ankles, are congested with fluid. You can drop the “congestive” word and just use “heart failure.” Heart failure is the inability of the heart to pump enough blood to supply body organs with oxygen and to stop the body from accumulating excess fluid.

A prominent heart-failure symptom is gasping for air when moving around. Ankle swelling is another sign. Fatigue and weakness are other manifestations. When heart failure is advanced, people often wake during the night panting for breath. Weight gain is a sign that the body is retaining fluid. Many heart-failure patients have a fast heartbeat even when they are sitting and relaxed. You sound as though your heart failure is minimal.

I have to take a stab at the “new” test your doctor ordered. It was probably the blood test called BNP – B natriuretic peptide, a substance whose blood level rises in those with heart failure.

There are a number of ways to treat heart failure. A low-salt diet is one. Medicines play a huge role in its control, and there are many of them. Pacemakers are used for some forms of heart failure. The pacemaker can restore the synchronous beating of the right and left ventricles, the heart’s pumping chambers. When they are out of step, pumping becomes impaired.

The booklet on heart failure has the space to deal with this subject in greater detail. Readers can obtain a copy by writing: Dr. Donohue – No. 103, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I have severe arthritis of the left hip. My doctor wants me to have a hip replacement. I am 74, and I have heard bad reports about this operation. Some say the hip slips out of place, and they then have pain worse than before. Would you please give me your opinion on it? – C.C.

ANSWER: My opinion is that hip-replacement surgery ranks as one of medicine’s greatest achievements. Of course, bad things can happen with any surgery. The joint, in a few instances, can slip out of place, but even that can usually be corrected.

Newer materials used in the artificial joint give it a life span of 20 or more years. I wouldn’t hesitate for a moment to have the surgery if I needed it.

The professional golfer Jack Nicklaus had this surgery, and he continued to play golf very successfully after he had it done.

DEAR DR. DONOHUE: Some time ago, I had an episode of acute liver failure. At the time, the doctors said I had cirrhosis, based on the CT scan. I am enclosing my latest lab tests, all of which are normal. A recent ultrasound and MRI of the liver are normal except for some fat seen in the liver. No cirrhosis. Is it possible to make a complete recovery from all this? My liver failure was due to alcohol. I don’t drink anymore. – S.W.

ANSWER: The liver has a remarkable regenerative capacity. It is possible to recover from liver failure. Perhaps you had alcoholic hepatitis, which can be lethal. It can also resolve itself. Early liver cirrhosis is reversible if its cause is eliminated. Advanced cirrhosis is not reversible.

Apparently you have made a recovery. All your liver tests are normal. The ultrasound and MRI scan are normal, and they would have shown cirrhosis if you had it.

You can trust your gastroenterologist, who said the only thing the matter with your liver is a small amount of fat in it. That could go away if you continue to abstain from alcohol.



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. Readers may also order health newsletters from www.rbmamall.com.