DEAR DR. DONOHUE: I am 83 and have longevity on both sides of my family. Recently I had atrial fibrillation. I keep being advised to go on Coumadin. I am doing much research on it, and everything I find makes me decide against it and stick with one aspirin a day. Please advise your opinion of Coumadin. A 92-year-old cousin had it prescribed, took it in the evening and bled to death the next morning. Taking it would stress me out. I would worry about bleeding all the time. – W.L.

ANSWER: Where are you doing the research? It’s not giving you the right answer.

In atrial fibrillation, the atria, the upper heart chambers, are not contracting; they’re squirming – fibrillating. Blood pools in fibrillating atria. Pooled blood forms clots. Pieces of those clots can break loose and be carried in the circulation to brain arteries. They block blood flow in brain arteries, and that’s a stroke. You don’t want to have a stroke.

Coumadin prevents clots from forming – that’s its “blood-thinning” action. It truly lessens the risk of stroke. Aspirin is not as effective as Coumadin in preventing clots and strokes in people with atrial fibrillation.

Coumadin can cause serious bleeding. However, people on the medicine have their blood checked frequently to make sure they are not getting too much or too little medicine.

Your cousin’s story doesn’t ring true. It takes days for Coumadin’s blood-thinning effects to take hold.

The booklet on heartbeat irregularities deals with atrial fibrillation and other heart rhythm disturbances. People can order a copy by writing: Dr. Donohue – No. 107, 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: My granddaughter has a serious problem with whiteheads. Can you tell me what she can do to eradicate them? – R.J.

ANSWER: A whitehead is a skin pore clogged with oil and sloughed-off skin cells. If the top of the pore is sealed, no air gets to the clog and its color stays white. If the top of the pore is open and air can reach the clog, then the color turns black and you have a blackhead.

Whiteheads and blackheads are preludes to pimples. All that is missing to produce a pimple is inflammation, which almost inevitably occurs in time.

Your granddaughter should treat whiteheads the same way she would treat pimples. She should wash her face twice a day with a mild soap. Tell her not to scrub her face raw. That does no good and makes things worse.

She must suppress the urge to squeeze the whitehead to express the material out of the pore. Gratifying as such an act is, squeezing pushes the oily material into the surrounding skin, where it irritates and inflames.

She can buy acne medicines from the drugstore to apply to her face to prevent whitehead formation and unblock pores. Have her read the label of ingredients to see if it contains benzoyl peroxide. That’s the kind of medicine she wants.

DEAR DR. DONOHUE: What can you tell me about hemangiomas in infants? We are told they eventually disappear. What do you think of laser treatment for them? – N.M.

ANSWER: Hemangiomas are benign tumors due to the rapid growth of cells that line blood vessels. Don’t let “tumor” throw you. They are not cancers, and they don’t become cancers.

Usually hemangiomas arise shortly after birth and might continue to grow through the first year. Then they start to shrink. By age 5, close to 60 percent have shrunk so much that they are hardly noticeable. By age 9, 90 percent have reached that stage. They spring up anywhere, but most are found on the face, scalp, chest and back. They’re bright-red with clear-cut margins, and they protrude from the skin’s surface like a strawberry. If, by school age, they show no signs of regression, then a laser can shrink them. That is rarely necessary.

DEAR DR. DONOHUE: Our son-in-law was operated on for a hernia. After the operation, the doctor said it wasn’t a hernia but a tumor. Then the pathology report came back and said it was fatty tissue that had wrapped around his sperm duct. He and his wife are trying to become pregnant. Could this make him sterile? – D.S.

ANSWER: If the fatty tissue compressed the sperm duct, it might have reduced his sperm count a bit, but being on one side, it was unlikely to have made him sterile. If he is infertile now, it’s not because of this. A sperm count can settle the issue.

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.


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