DEAR DR. DONOHUE: Every year I get bad postnasal drip, but this year it is very bad. It makes me cough out solid, green phlegm. My cough irritates my throat. Please help. – A.B.

ANSWER: Postnasal drip is like water torture, only what’s trickling down is thick mucus. It does irritate the throat and can trigger coughing. That’s especially true when lying in bed.

Most often, the thick mucus comes from infected sinuses. The basic problem is that the normal drainage channel for the sinuses has become partially plugged. The plugged sinus is a haven for germs. They invade, and a viscous, pus-filled fluid is generated. If the sinus opening is enlarged, free drainage is established and the chance for getting rid of the infection greatly increases. An ear, nose and throat doctor can do this kind of procedure.

You can help yourself by draping a hot, wet towel over your face. The heat helps the sinus empty. Cleaning the nasal passages with saltwater dilutes the drainage and stops it from dripping down the throat. You make a saltwater solution by adding half a teaspoon of salt to 1 cup of hot water. With a sprayer or a bulb syringe – available in drugstores – irrigate both nostrils a couple of times during the day and again at night. Let the water cool before you do this.

Your doctor might prescribe antibiotics to help you get rid of infecting germs.

DEAR DR. DONOHUE: Recently you commented on uterine fibroids. In my experience, women with fibroids should have ultrasounds every few months. My fibroid became the size of a football because my doctor wasn’t concerned enough to order ultrasounds. Finally, he sent me to a gynecologist. I was told that something had to be done very soon. This kind of fibroid can turn into uterine cancer. I opted for a hysterectomy. I am convinced that this woman gynecologist saved my life. – B.B.

ANSWER: Fibroids are noncancerous growths of the muscles of the uterine wall. Close to half of all women over 35 have one or more fibroids. It would be prohibitively expensive for all these women to have an ultrasound every few months.

Fibroids don’t ordinarily become cancerous. However, the rapid enlargement of a fibroid justifies immediate investigation and, in many cases, justifies quick removal of the fibroid or of the uterus. Most of the time, the woman or her doctor can detect such an enlargement.

Even large noncancerous fibroids call for removal if they are causing symptoms like pain, excessive menstrual bleeding or pressure on the colon or bladder.

The booklet on fibroids tells their story in detail. Readers can order a copy by writing: Dr. Donohue – No. 1106, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: Recently I had an episode that I thought was a heart attack. I was taken to the hospital. After the doctor’s examination, he said it was not a heart attack and called it a bundle branch block.

I’ve never heard of this before. Will you explain what it means? Will it happen again? – M.E.

ANSWER: The heart’s bundles are two large cables (right and left) that run from the top of the heart to its bottom pumping chambers. They carry an electric signal generated by the heart’s own natural pacemaker. When that signal reaches the bottom chambers, the heart contracts and pumps out blood.

A bundle branch block means there’s a glitch in one of the bundles. The electric signal still reaches the bottom pumping chambers, but it has to take a detour.

Bundle branch block can indicate that the heart isn’t perfectly well, but, in itself, it doesn’t require treatment. Other heart conditions have to be searched for when there’s a bundle branch block.

It won’t happen again. Most of the time, a bundle branch block is a permanent thing.

Did the doctor tell you what caused your chest pain? Bundle branch blocks are almost always silent. They don’t usually cause any pain. They’re detected on an EKG.

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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