DEAR DR. DONOHUE: You were asked about a right bundle branch block and you said: “Electric current still makes its way to the right ventricle. This doesn’t mean you are on the verge of dying.” A few years ago I had an EKG and was told I had a left bundle branch block. The heart doctor told me that in all other respects my heart was working fine and it was not a major problem. He didn’t tell me it was going to get worse and could be life-threatening. Two years later, I passed out. Another doctor put me on a heart monitor, and I was told I needed a pacemaker immediately. The blockage had become complete. Without a pacemaker, I would not be writing this letter to you. I suggest you reconsider your advice to the writer. – E.C.

ANSWER: The heart has two cables, the right and left bundles, that transmit electric current to the bottom heart chambers, the ventricles, the pumping chambers. A block in one of the bundles is like a short circuit in an electrical system. The current must take an alternate route to reach the ventricle.

A right (please note, E.C.) bundle branch block is not a major risk for serious heart disease if there is no associated problems like high blood cholesterol, high blood pressure or diabetes. A left bundle branch block is a different story. It can be considered a risk factor for future heart disease. People can do nothing to unblock a bundle branch block, but people with a left bundle branch block must do everything to minimize other contributors to heart disease — blood pressure, obesity, diabetes, cholesterol and inactivity.

Your experience is not the ordinary experience of people with left bundle branch block. Most with the condition do not progress to the point of needing a pacemaker, but they can develop other heart problems.

DEAR DR. DONOHUE: Your article on chronic fatigue syndrome brought to mind an experience I had. I had periods of total fatigue and dizziness. I believed I had chronic fatigue syndrome. I was hospitalized and had many tests with no other diagnosis.

Three weeks ago, a doctor put me on a Holter monitor, one of those devices that record the heartbeat for 24 hours. It showed that my heart rate would drop to the low 40s. A pacemaker was installed, and now I feel great. – D.B.

ANSWER: Before making a diagnosis of chronic fatigue syndrome, doctors must conscientiously search for all illnesses that sap energy. Often those illnesses are quite devious and difficult to discover. Your heart condition is an example. So are hidden infections like tuberculosis.

Shake your doctor’s hand. He looked for some of the occult causes of fatigue and found one that was fixable.

The booklet on chronic fatigue syndrome gives a detailed account of this disorder. Readers can obtain a copy by writing: Dr. Donohue – No. 304, 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 a large stone stuck in the neck of my gallbladder. Does this affect my whole body? How long will I live if I don’t have it removed? Will it get bigger? I have no pain from it. I am 49 years old. – I.W.

ANSWER: The gallbladder, situated below the liver, is shaped like a pear and is 4 inches long and 1 inch wide. It holds about 1 ounce of bile. When a person eats, the gallbladder contracts to send a jet of bile into the intestine to aid in the digestion of fat.

For most, a silent gallstone – one that causes no symptoms – can be left alone. It doesn’t affect the whole body. It doesn’t shorten life.

Your stone is in a place where it could obstruct the flow of bile. It most likely will grow larger. Am I wrong in believing a doctor has suggested surgery to you? Get a second opinion. The location of your stone might be a good reason for having the gallbladder removed, even though you have no symptoms.

DEAR DR. DONOHUE: Why is there so much talk about men’s impotence but so little about women who have lost their sex drive? What can women take to restore their desire? – L.L.

ANSWER: There’s lots of talk about women’s loss of sexual interest; it’s a big problem. Close to half of all women who have gone through menopause report a decrease in their sexual drive.

It’s partly due to a drop in female hormone production. It’s partly due to physical changes that make intercourse less pleasurable, like the drying of vaginal tissues. And it’s partly a loss of the allure of sexual fantasies. Some of these problems have an answer.

Testosterone, the male hormone, has brought back many women’s sexual appetite. It comes in many forms, like patches or creams. It has not been approved for this use, but it can legally be prescribed for it all the same.

You should discuss this problem with your family doctor. He or she can offer suggestions for the physical and psychological aspects of a loss of libido.

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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