DEAR DR. DONOHUE: Please devote some space to congestive heart failure. In the past year, I had a hard time catching my breath. I thought it was just an age thing – I’m 77. One day I became so short of breath that my husband called an ambulance. They treated me for congestive heart failure. I have many questions about how it happens and what can be done for it. Thank you. – M.P.

ANSWER: The “heart failure” part of congestive heart failure is straightforward. It indicates that the heart fails as a pump for blood.

The “congestive” part throws people for a loop. It means that the lungs and body tissues are congested with fluid. Fluid-filled lungs make breathing impossible. It’s like trying to take a breath under water. Fluid-filled tissues are swollen. The ankles and feet show that swelling. The congestion is due to the failing heart. Because of it, blood backs up into veins and the veins leak the watery part of blood into various body organs and tissues.

What causes hearts to fail? Heart attacks do it. So does a poor blood supply to heart muscle. Uncontrolled high blood pressure is another common cause. Incompetent heart valves also lead to heart failure.

You’re breathing better now because diuretics (water pills) have rid the body of excess fluid, and other medicines have made it possible for the heart to pump with greater vigor. A couple of new twists have been added to the treatment list. One is a special pacemaker that restores the normal sequence of pumping for the right and left sides of the heart. Restoring order to the heart’s contraction invigorates its beat. It’s not needed by every patient, however. The second innovation is still in its experimental stages. Blood flows from a vein to a machine that removes a pound of water from it in an hour. It’s a clever device whose time on stage is about to come.

The heart failure booklet details the mechanisms involved in this condition and the many treatments for it. Readers can order a copy by writing: Dr. Donohue, No. 103, 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: You don’t have to get involved in a family squabble, but I would appreciate what you have to say about this.

My 19-year-old daughter is on her own. She makes her own living and lives in an apartment, so she really doesn’t have to pay any attention to me. She’s been a good daughter who listens to what I have to say, but she won’t listen to me when it comes to ear piercing.

I don’t mind earlobe piercing for earrings, but she has gone over the top. She has earrings on the sides of her ears and wants to get more.

Aside from making her look unbalanced, isn’t this a bit dangerous? What do you have to say about it? – L.M.

ANSWER: I see many young people whose ears have a series of earrings going from the earlobe to the top of the ear. It does look a bit strange, but I am not a fashion expert.

There are potential dangers to piercing the upper parts of the ear. The earlobes are skin and soft tissues, and they have a good blood supply. They can pretty well handle an infection that comes their way. Infections are possible whenever skin is broken.

The rest of the ear is cartilage covered with skin. Cartilage doesn’t have a good blood supply. Infections there can create great destruction and permanent deformity. Your daughter should, at least, be aware of that.

DEAR DR. DONOHUE: Do artificial fingernails do any harm to the natural nails? I have been wearing them for a number of years, and I’d like to continue, if they’re safe. – D.S.

ANSWER: The glue that sticks the artificial nail to the natural nail can thin the natural nail, and it can irritate the surrounding skin. If neither has happened to you after a number of years’ use, then you’re in no danger and can continue your fashion statement.

DEAR DR. DONOHUE: What can happen to a person who takes water pills without a doctor’s prescription? My girlfriend takes Lasix because she says she’s bloated. I don’t see any bloat.

She used to take 20 mg a day. Now she takes 80, and she might be taking even more. She says it drains the water out of her body. She gets the medicine from a vet. She works with horses. – J.M.

ANSWER: She’s right. It does take water from her body. It could be taking so much that she’s on the verge of being dehydrated. Along with water, it also takes potassium, sodium chloride and bicarbonate. She runs the risk having too little of those minerals. Such a deficit can be responsible for abnormal heartbeats, among other things. She’s upsetting the balance between acid and base in her body.

If by “bloat” she means a distended stomach due to gas – the common meaning of bloating – water pills do nothing for that. She must stop this nonsense right away.

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