DEAR DR. DONOHUE: my wife has a problem. About a year ago, she saw a doctor about her legs. The doctor couldn’t find a pulse in her legs. She is not active. She sits on the couch or in bed all day. When she walks, she has a lot of pain. She has to stop and rest. She is a heavy smoker. She is only 53. What’s the story? H.S.

ANSWER:
The story is a potential tragedy unless your wife makes some big changes.

The cause of her pulseless legs and her leg pain when walking is most likely blockage of her leg arteries with cholesterol and fat. That’s atherosclerosis – artery hardening – and she is quite young to have it.

If her leg arteries are clogged, the chances are great that her heart and brain arteries are clogged also.

She’s inviting a heart attack or a stroke if she lets matters ride. She needs a careful examination of her arteries. Determining the blood pressure at her ankles and comparing it with the blood pressure in her arms provides evidence of artery blockage.

The two pressures should be about equal. If the leg pressure is lower than the arm pressure, there’s an obstruction in leg arteries. An ultrasound of the arteries is also most helpful.

She has to stop smoking. Smoking is a major cause of artery obstruction. She must become more active. Physical activity keeps arteries free of buildup. She should lose weight if that applies to her.

She should be checked for diabetes and high blood pressure.I don’t mean to scare your wife, but she must understand that if she doesn’t make significant changes, she is in danger of losing her leg or legs to gangrene.

She might also need some psychological counseling. Her inactivity could be due to depression.

The booklet on peripheral vascular disease, as artery hardening is called, explains this widespread illness and its treatment more thoroughly. Readers can obtain a copy by writing: Dr. Donohue – No. 109, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order 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 had a normal potassium level until I had CT scans that involved injecting a dye for diagnosis of an abdominal aneurysm. A kidney doctor saw me and made that call. He put me on a diet that excludes foods high in potassium. My spouse is concerned with my foods, but we cannot find a source listing the potassium content of foods. Can you direct me to one? J.C.

ANSWER: Go to your library and see if there’s a nutrition book that lists the potassium content of foods.

If there isn’t, ask the librarian to obtain for you (on a loan): “Food Values of Portions Commonly Used” by Jean A.T. Pennington and Judith Spungen Douglass. The publisher is Lippincott, Williams and Wilkins. It lists the potassium content of every food known to man. There are other books that do the same.

People who can process potassium normally are told to get 4,700 mg a day. Among high-potassium foods are a baked potato with skin, avocado, spinach, orange, cantaloupe and banana.

Ask your doctor how much potassium you are supposed to take in one day, and then add up the potassium in what you eat.

DEAR DR. DONOHUE: I have a much-loved son-in-law who is very depressed and has been for many years.

Doctors and mental health professionals cannot find anything to help him.

He has been given many medicines, but nothing works. He is scared of shock therapy because he’s been told it will erase all his memory.

A suggestion has come up about an operation that entails putting a wire through his head to suppress feelings. Please tell me more about this. – R.D.

ANSWER:
For depression that doesn’t respond to medicine and talk treatment, shock therapy often succeeds.

It’s not done as it’s often portrayed in movies. The patient is sedated and muscles are relaxed, so there is no violent thrashing during the treatment. The whole procedure is over in less than a minute.

If you were to observe it, you would hardly realize it had taken place. Close to 87 percent of people who undergo this treatment have a remarkable improvement in their mood. One’s entire memory isn’t erased.

If memory loss occurs – and it doesn’t always happen – it’s a selective loss of memory, and it almost always returns in time.

The technique you mention is deep brain stimulation. Electrodes – tiny metal filaments – are placed in a particular brain location that regulates feelings. Wires run under the skin to a battery-powered generator implanted beneath the skin of the chest. The trickle of current that comes from the electrodes suppresses activity of nerve cells producing depression.

Deep brain stimulation has been used for other conditions, like Parkinson’s disease and unremitting pain. The brain areas stimulated in those conditions are different from the ones stimulated for depression.

It’s a new technique. If the doctors treating your son-in-law are experienced in it and approved to use it, and if the hospital is prepared to handle the procedure, it’s worth his consideration. He has been depressed for years, and he’s not getting better with standard treatment. He needs to get on with his life.

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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