DEAR DR. DONOHUE: I would like you to settle a discussion my father and I have had some disagreement over. If a person is found unconscious without a heartbeat, would you perform CPR before attaching an AED machine, or would the first response be to attach the AED machine and give a shock? How many minutes can a person survive without heart function before brain damage occurs? – F.L.

ANSWER: Over 300,000 people die yearly in the United States and Canada from cardiac arrest, and most of those deaths occur outside the hospital. If people would take the time to learn CPR (cardiopulmonary resuscitation) and how to operate an AED (automatic external defibrillator), the number of those deaths would decline. Most cardiac arrests involve ventricular fibrillation, a rapid quivering of the heart’s pumping muscles that renders them useless for pumping blood. An electric shock from the AED can often restore a normal heartbeat. The American Heart Association sponsors local classes in how to perform CPR and how to operate an AED machine (it’s very simple). The number to call for information is 1-800-242-8721.

The first thing to do in an emergency like you depict is to call 911. Then give the victim two breaths through his or her mouth while pinching his or her nostrils. The breaths should be strong enough to make the chest rise. Without wasting any time, begin chest compressions and make the compressions hard and fast. The hands are on the breastbone, and the chest is depressed 1.5 to 2 inches. The pace of compressions should be 100 per minute. After every 30 compressions, give two more breaths, but do so quickly.

Then, as soon as possible, apply the AED pads to the person’s chest and deliver the shock according to the voice or screen directions on the AED machine. The shock should be given within five minutes. It is important to get blood circulating to the brain within that time limit to preserve brain function.

Chest compression is the key part of resuscitation. Some are promoting chest compression alone without delivering any mouth breaths.

DEAR DR. DONOHUE: I need help for my irritable bowel problem. I have pain most mornings, and it can wake me from sleep. The pain is so severe that I almost pass out. The pain doesn’t go away until I go to the bathroom. What can help me? – C.C.

ANSWER: Stomach pain is the hallmark of irritable bowel syndrome, and people usually say the pain is crampy, sharp or stabbing. Often the pain is relieved by a bowel movement, and many have diarrhea or constipation. They also notice a change in the consistency and appearance of their stools.

No one knows for sure what causes the pain. It might be that an individual’s intestinal tract is extremely sensitive to the contractions of intestinal muscles, or those contractions might become uncoordinated and counterproductive.

Avoid dairy products, fatty foods, alcohol and large amounts of meat, and see if that helps. Sorbitol, a sweetener in many gums, candies and commercial baked goods, can give people with irritable bowel syndrome tract trouble.

Dicyclomine (Bentyl is one brand name) and hyoscyamine (Levsin) can sometimes calm intestinal-tract muscles. The antidepressant amitriptyline can bring pain relief. It’s not used in this instance for its antidepressant actions.

Your pain is extreme. I am sure you have had many tests and nothing was found. That’s true of irritable bowel syndrome. But at this point, and with this degree of pain, it would be worth your while to get the opinion of another gastroenterologist.

DEAR DR. DONOHUE: My grandson, 12, who lives in another state, wants to spend the summer with me. He is bipolar and on medicine for it. Do you have any information that would help me deal with this illness? – R.M.

ANSWER: Bipolar disorder is a condition where people alternate between the lows of depression and the exuberant highs of unrealistic and frantic energy. Something has gone wrong with the production of brain-messenger chemicals. Medicines can often correct the condition.

You don’t have to treat your grandson differently from how you would any boy his age. Now that he is on medicine, things should go smoothly for him. Just act like a grandmother, and he and you will have a great summer.

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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