DEAR DR. DONOHUE: I am a 90-year-old lady recuperating from a heart attack. I don’t understand how this happened to me at my age. I don’t drink or smoke, and never have. Now I have to take heart medicines. I was taking an iron pill for thalassemia, but my heart doctor took it away. How can someone have a heart attack at my age? – M.T.

ANSWER: Age is one of the risk factors for having a heart attack. More heart attacks occur at older ages simply because arteries are more apt to become plugged with cholesterol and other stuff the longer one lives. Age is one of those things over which we have no control. It’s called a “nonmodifiable” risk factor. Also in this category are genetics and gender.

If a person has a close relative – father, brother, mother or sister – who died at a young age from a heart attack, that person is more apt to have a heart attack because of the family genes. Men have heart attacks 10 years earlier than women, the gender factor.

You are wondering why you had a heart attack if you never smoked or drank to excess. Those kinds of risk factors are called “modifiable” risk factors. People can do something about them. High blood cholesterol, uncontrolled high blood pressure, a life of inactivity, obesity and diabetes are things that people can control, to some extent. People who are careful about what they eat, about getting exercise, about watching their cholesterol, blood sugar and blood pressure can still have a heart attack. That doesn’t seem fair, but that’s life. If these factors were not controlled, those people could have had a more serious heart attack or had one at a much younger age. That’s the way you should think of your attack.

Thalassemia is an inherited anemia that shares many similarities with iron deficiency anemia. It’s an inherited anemia and iron does nothing for it. People with thalassemia who take iron for long periods of time can get into trouble from an iron overdose. That’s why the doctor took your iron pills away.

The heart attack booklet discusses all aspects of this very common illness. Readers can obtain a copy by writing: Dr. Donohue – No. 102, 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: Until recently, I have been able to walk about a mile a day. Now when I walk, I have a problem with painful calf cramps. Could the cramp problem be the result of having had my leg veins harvested for several heart bypasses? Could it be dietary? – Anon.

ANSWER: The veins that were taken as grafts for your plugged heart arteries were veins that lie just below the skin surface. Those veins have no major influence on circulation, and losing them is not a likely cause of leg cramps.

Dietary? I don’t think so. Some blame cramps on deficits of potassium, but, unless you are taking a water pill that takes potassium out of the body, a potassium deficit is not likely, and few people eating a normal diet develop one.

If you get pain without muscle cramps, then the cause could be due to an obstruction in the leg arteries. Your doctor can check for such an obstruction by feeling the pulses in your feet.

Do you stretch before you walk? That might help prevent cramps. Before walking, stand with the front part of your feet on a step. Rise up on your toes and then lower yourself until your heels are below the step. Repeat 10 times if you can. Have someone with you; you can lose your balance while doing this exercise.

DEAR DR. DONOHUE: I broke out with painful red bumps on my shins. The doctor calls it erythema nodosum. How did I get it? – A.W.

ANSWER: Drugs such as the birth-control pill and sulfa can bring it on. Strep infections, like a strep throat, are another cause. Fungi can trigger the outbreak. Allergies might be involved.

But for many, the cause is never found. It’s something that just happens.

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

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