DEAR DR. DONOHUE: I took my blood pressure in a supermarket. It was 150 over 85. I know that’s high. I don’t want to see a doctor because he’ll put me on medicine. I would like to try to get it down without drugs. How can I? – D.J.

ANSWER: You should have your blood pressure reading confirmed by a doctor. You could have been dashing around right before you took your pressure, and the reading might not be reliable. If you do have high pressure, you will want a doctor to follow you and your response to treatment, which isn’t always medicine.

One of the best ways to lower pressure is to lose weight if you are overweight. Weight loss reliably brings pressure down. Cut way back on salt, and that means avoiding salty foods, like most commercial soups and luncheon meats.

Adopt the DASH (Dietary Approaches to Stop Hypertension) diet. I’ve mentioned it many times. It works. In short, it’s a diet that stresses whole grains, fruits and vegetables. The diet requires that people eat four or five servings of both fruits and vegetables every day. That sounds a bit much, but it really isn’t. A fruit serving is an apple or a pear or a quarter-cup of dried fruit. A vegetable serving is a half-cup of cooked vegetables or a cup of leafy vegetables.

The diet also calls for seven grain servings a day. Examples of one grain serving are a slice of whole-grain bread, a half-cup of rice or a half-cup of dry cereal.

Keep meat and poultry to a minimum – only two servings a day. A serving is 3 ounces, about the size of a deck of cards.

Finally, and this you’ll like, eat a third cup of nuts four or five times a week.

DEAR DR. DONOHUE: This past summer, my daughter was very sick. She had a high temperature and a skin rash. Our family doctor wasn’t sure what she had, and he sent us to the university hospital not far from where we live. The doctors there diagnosed Rocky Mountain spotted fever. We were dumbfounded. We don’t live anywhere near the Rocky Mountains, and we have never traveled anyplace near them. How could she have caught this? – A.P.

ANSWER: Rocky Mountain spotted fever is more prevalent in the southeastern United States than it is in the Rocky Mountains. The infection is spread by tick bites.

The illness, which is probably not familiar to readers, gives rise to a high fever and a rash that frequently breaks out first at the wrist. The rash spreads to most of the body and often involves the palms and soles, places where most rashes are never found.

Sometimes there is no rash, and that complicates the diagnosis.

In the days before antibiotics, the death rate from RMSF approached 25 percent. Even now, when there’s a long delay in making a diagnosis and instituting treatment, the death rate can be high.

DEAR DR. DONOHUE: Is Cushing’s disease curable? My sister has it. We live on opposite coasts, and I am quite worried about her. – W.R.

ANSWER: Cushing’s disease comes about from an overproduction of cortisone and other adrenal gland hormones. The problem lies either in the pituitary gland, at the base of the brain, or in the adrenal glands. There is an adrenal gland on top of each kidney.

Regardless of the site, Cushing’s disease can be cured. If there is a tumor in either the pituitary or the adrenal gland, as there usually is, it can be removed.

DEAR DR. DONOHUE: Please clear up a matter of confusion: Whole grain – what is it? – J.D.

ANSWER: Grain is the seed of wheat, barley, oats and rye – the things that grow at their tips. Grains have three structures: bran, the outer coat; endosperm, the greatest volume of the inside and the material that makes flour; and the germ, the tiny inner structure that produces a new plant when the seed is put in the ground. Refining removes the bran and the germ. They contain vitamins, and bran is an excellent source of fiber. A whole grain is flour with all three components.

DEAR DR. DONOHUE: The doctor who interpreted my mammograms wrote that I needed a breast biopsy. Naturally, this shook me up. I went through hell while I waited for the biopsy and the biopsy report. The biopsy came back normal. I wonder if it was really necessary or just a way to generate money for doctors. Please tell me the truth. – R.D.

ANSWER: The doctors who read mammograms are radiologists. They don’t receive any money for suggesting a biopsy.

The doctors who perform the biopsy are surgeons. They don’t pass any money back to the radiologists.

There are few definite tests in medicine. Most are provisional. A mammogram can often look suspicious but doesn’t provide definite evidence to say there is or there is not cancer.

When radiologists inspect mammograms that are borderline, they have an obligation to the patient to suggest a biopsy, which can yield a conclusive result.

I don’t know what can be done for patients’ anxiety during the period when a diagnosis is up in the air.

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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