DEAR DR. DONOHUE: I am under treatment for angina. I don’t have many attacks of chest pain, but when I do, I usually can get rid of them with nitroglycerin. My neighbor, exactly my age, has the same thing: coronary artery disease with angina attacks. His doctor is treating him with some kind of leg pumps. He says he has had no angina since he started the treatment. Do you know what this is? Would it help me? – K.B.

ANSWER:
The procedure is EECP, enhanced external counterpulsation. It’s not a brand-new technique. It’s been around for the past 10 years.

A series of cuffs, like blood pressure cuffs, is wrapped around the patient’s legs. At a very precise moment in the heart cycle, the cuffs are sequentially inflated, with the lowest cuff inflated first. The pumping maneuver increases blood flow back to the heart and to the heart muscle.

Angina is chest pain that comes on with activity. It indicates that one or more of the heart arteries have a blockage. People with artery blockage get enough blood to the heart muscle when they’re resting, but, when they are active, the blockage prevents an increased flow, which is required for the extra effort that the heart must make. The result is the chest pain called angina.

Some people who have undergone a series of EECP treatments have fewer attacks after the treatment, and some have even discontinued medicine for angina.

EECP has yet to win universal approval. People who judge the effectiveness of medical treatments want more evidence before they recommend it for everyone. Would it work for you? Only a trial with it will tell you.

The booklet on coronary artery disease (the cause of angina) explains this most common malady and its treatments. Readers can order 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 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: There’s a yellow streak on both my eyelids. People remark about it all the time. What is this? I have seen it on other people’s lids too. Does it mean eye trouble? – Z.C.

ANSWER:
Those streaks are xanthelasmas (ZANN-thul-AS-muhs). They’re an aggregation of cells filled with cholesterol. In half of people with them, they indicate high blood cholesterol or high blood triglycerides. If you haven’t had a check of your cholesterol or triglycerides, you should have one.

They are not a sign of eye trouble in the near or distant future. If you find them cosmetically distressing, they can be removed.

DEAR DR. DONOHUE: What’s a “chemical” depression? I’m familiar with depression, but I’m not familiar with chemical depression. I have two relatives who say that’s what they have. – R.T.

ANSWER: Brain cells communicate with each other through chemicals with names like dopamine, serotonin and norepinephrine. One current and popular theory about depression cites an imbalance of one or more of these chemicals as the cause. Antidepressants restore the normal balance.

DEAR DR. DONOHUE: What is your opinion on cigar smoke? My husband, 53, started smoking cigars when he golfs or on weekends. Now he smokes one every day. He says the danger is low because he doesn’t inhale. He comes from a family of smokers and was exposed to secondhand smoke for his first 20 years. – S.B.

ANSWER:
By not inhaling, he is sparing his lungs. The risk of oral cancer, however, does exist. He also absorbs nicotine through the lining of his mouth, and nicotine constricts arteries.

One cigar is not a great danger, but, in the best of all worlds, no danger is better than a little danger.

DEAR DR. DONOHUE: This past winter I lost 50 pounds and am quite proud of myself. Now I have all sorts of ugly stretch marks. I thought I would look stunning on the beach. I probably will look stunning, but not for the reasons I thought I would. Can’t something be done about these things? – C.C.

ANSWER:
Stretch marks are scars. Your former weight stretched the skin beyond its limits, and the skin tore. Scars formed where the tears occurred.

Time is one of the best treatments for them. They lighten up and blend in with the rest of the skin. How long that takes is unpredictable, but it happens.

Retin-A – an acne medicine – has been suggested as a treatment for stretch marks. I can’t tell you if it’s successful all the time or how much of the time.

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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