DEAR DR. DONOHUE: I suffered from horrendous leg cramps that prevented me from getting a full night’s sleep. Last year my doctor gave me a prescription for quinine, which works quite well. Now I hear that the dear Food and Drug Administration is going to take it away because of its side effects. What’s worse than the side effect of being awakened, screaming with leg pain several times a night? I exercise, I drink lots of water and I take calcium. I have tried bedtime stretches, which you recommend. Nothing works. The FDA really makes me mad. What can I do? – K.F.

ANSWER:
The FDA is trying to do its job of protecting people. Last December, it told manufacturers to stop marketing quinine for leg cramps. Quinine can have some dangerous complications. It might cause abnormal heartbeats, a drop in blood platelets with resulting hemorrhage, and damage to many internal organs. It’s still available for the treatment of malaria because malaria is an illness that has potential outcomes worse than those side effects of quinine.

No one has given a reasonable explanation of why nighttime leg cramps occur. Some feel it might be a mineral deficiency of magnesium, potassium or calcium, and taking those minerals does work for some sufferers.

Stretching didn’t work for you, but let me describe a slightly different stretching exercise that should be done twice a day, and again before sleep. Stand about 30 inches from a wall. Lean forward so your hands are flat on the wall, supporting your body. Now move the hands upward slowly until you feel a stretch in the calves, and hold there for 30 seconds. Repeat five times. When starting, make sure you have a partner nearby to catch you if you start to wobble.

Try propping your feet on a pillow during sleep. Sleeping on your stomach with your feet projecting over the end of the bed is another cramp-prevention measure. If you have to sleep on your back, loosen the covers over your feet so they don’t pull them down toward the mattress. If you want to try a smaller dose of quinine, drink a glass of tonic water before going to sleep.

DEAR DR. DONOHUE: I am 64. My Lp(a) cholesterol level is high, and my doctor put me on Niaspan. I have read articles that say lowering Lp(a) cholesterol doesn’t reduce the chance of having a heart attack. I would like to stop taking the medicine. What do you think? I am enclosing my other cholesterol readings. – T.M.

ANSWER:
Your doctor is on medicine’s cutting edge. Lp(a) – lipoprotein little a – is a form of cholesterol that carries a risk of having a heart attack, but it has a weaker influence on heart health than does LDL cholesterol (bad cholesterol) or HDL cholesterol (good cholesterol). Not many doctors are routinely checking it.

If a person is at a high risk of having a heart attack (a family history of heart attacks at young ages or a very high LDL cholesterol reading), then more attention is paid to Lp(a). I would love to have the cholesterol readings you have. They’re excellent. Why not talk to your doctor about your reluctance to take medicine for Lp(a)? He might have a compelling reason for you to do so.

Niaspan (niacin) can lower Lp(a).

DEAR DR. DONOHUE: I would like your opinion about an incident with my heart doctor. He came in and asked his usual questions. Then he moved his stethoscope all over my right chest for two minutes. He asked where my pacemaker was. I pointed to my upper left chest. He pulled my T-shirt out from my chest, looked and said it looked good. He didn’t check it with his stethoscope. Does he have X-ray vision? Should I change doctors? – Anon.

ANSWER:
You can’t check a pacemaker with a stethoscope. An EKG shows if it’s working, but a doctor can also get a pretty good idea of what it’s doing by checking your pulse. I don’t know why the doctor listens only on the right side of your chest. That would bother me too.

I’m not in a position to tell you to change doctors. You have to make that decision on your own.

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.


Only subscribers are eligible to post comments. Please subscribe or to participate in the conversation. Here’s why.

Use the form below to reset your password. When you've submitted your account email, we will send an email with a reset code.