DEAR DR. DONOHUE: My doctor insists I have a “no exercise” nuclear stress test. What is the procedure? Could it harm my heart?

I think I might get halfway through the test and need to have it stopped. Are there less-intrusive tests that would suffice? I am 82. Please give me a second opinion. – D.G.

ANSWER:
Your doctor wants you to have a pharmacologic stress test, a no-sweat stress test.

An ordinary stress test is done with the patient on a treadmill. Every three minutes, the speed of the treadmill and its incline increase.

At first the person walks at an ordinary clip on a flat surface. After some time, that person is walking, then jogging, then running on a surface that becomes steeper and steeper.

The idea is to “stress” the heart. During the test, an EKG is constantly running. If the heart muscle isn’t getting enough blood to support the increased work, changes occur on the EKG and the test is stopped.

Your test will be quite different. You don’t move a muscle. You are given an injection of medicine that stresses your heart in ways completely different from exercise. During the test you don’t do a thing. You scarcely know that anything is happening. You don’t become short of breath, sweaty or tired.

The nuclear part of the test is the taking of pictures of your heart after an injection of a small dose of radioactive material is given. The pictures show if there is any blockage in heart arteries, and if so, where the blockage is.

Pictures are taken at the end of the test and four hours later, when the heart has returned to its resting state.

This test doesn’t put you in danger. If anything bad develops – and it rarely does – the test can be terminated immediately.

There are no less-intrusive tests that can substitute for it. This isn’t considered an invasive procedure. Relax. You’ll do fine.

The coronary (heart) artery disease booklet describes how this condition is diagnosed and treated.

Readers can obtain a copy by writing: Dr. Donohue – No. 101, 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: How much can one take of folic acid? It appears to be in many supplements.

I get 800 micrograms of it in a multivitamin/mineral supplement. I get 400 micrograms in another supplement. My hair supplement has 2,000 micrograms. This brings my daily total close to 3,200 micrograms. That seems pretty high. Is it? – E.O.

ANSWER:
Folic acid is a B vitamin. B vitamins are water-soluble. That means that excesses are generally filtered into the urine – a safety valve for not getting too much.

The recommended dietary allowance for adults is 400 micrograms.

The Institute of Medicine has set the tolerable upper limit of folic acid at 1,000 micrograms.

Too much might cause insomnia, anxiety, difficulty concentrating and nausea, but most people are not affected by it.

If a person has a vitamin B 12 deficiency, too much folic acid can aggravate the nerve damage that occurs in pernicious anemia – the consequence of a B 12 deficit.

Your dose of folic acid exceeds what the Institute of Medicine set as an upper limit.

Even though the consequences are usually insignificant, I would lower the intake into conformity with that upper limit. What is this hair supplement you’re taking? I can’t believe that folic acid improves hair loss, if that’s the reason you’re taking it.

DEAR DR. DONOHUE: I am 63 and have a condition that people call “turkey neck.” The skin under my neck hangs down.

How can I get rid of it without surgery?

It’s not a double chin. I do exercises for it, but they aren’t working. – A.L.

ANSWER:
How can I break this to you gently? I don’t know of any way to get rid of that redundant, drooping skin without resorting to surgery.

DEAR DR. DONOHUE: What’s aortic sclerosis? I am 83 and thought I was in good health until I read this on an X-ray report.

I know it’s a heart valve problem. Will I need heart surgery? – R.C.

ANSWER:
Aortic sclerosis is a thickening and hardening of the aortic valve, the heart valve that closes after blood is pumped out of the heart and into the aorta, the artery that distributes it to the entire body. It’s a condition that comes with age.

After all, the aortic valve opens and closes 60 to 80 times every minute, so, after 65 years of all those openings and closings, about one-third of people have it. By 80, close to one-half have it.

Even though it is so common, it’s not normal. It can lead to narrowing of the valve, and that can be a source of trouble. However, at age 83 and with no signs of valve malfunction, the chance that you would ever need valve surgery is all but nonexistent. It’s not something that should keep you awake at night.

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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