DEAR DR. DONOHUE: During my last physical, the doctor spent an awfully long time listening to my heart. She had me sit up, lie down, and then turn on my side while she kept the stethoscope on my chest. Then she said I needed an EKG. At the conclusion of all this, all I got from her was a statement that I had an arrhythmia. She said nothing about taking medicine or limiting what I can do. Will you enlighten me on arrhythmia? I am a man, 38, and thought I was in good health. – M.J.

ANSWER:
“Arrhythmia” is a useless word. It includes so many different kinds of heartbeats that it has little meaning. It’s a name given to innocent kinds of heartbeats, like premature contractions, and to very lethal kinds of heartbeats, like ventricular fibrillation (not the same as atrial fibrillation).

From your doctor’s lack of comment, I have to deduce that your arrhythmia is not a serious kind of heartbeat disturbance.

I bet you have premature heartbeats. They are extra heartbeats sandwiched between two normal heartbeats. They come before the next expected normal beat, and that’s why they’re called “premature.” Atrial premature beats originate in the heart’s upper chambers, the atria. Most people don’t know they have them. They’re innocent and don’t indicate any heart problem. Smoking, coffee and alcohol sometimes can trigger them. Ventricular premature beats arise in the lower heart chambers, the ventricles. People often feel them as a thud in the chest. When a continuous, 24-hour EKG is recorded in healthy people, 80 percent will have had some ventricular premature beats in that time span. People with normal hearts need do nothing about premature ventricular beats. If they are associated with any known heart disease, they take on a different significance. At age 38, you are unlikely to have significant heart disease.

Why don’t you give your doctor a call and ask her if premature beats were your arrhythmia? You can put the matter to rest once and for all. She’s paid to answer such questions.

DEAR DR. DONOHUE: I used to weigh 280 pounds. I am only 5 feet 5 inches tall. I have been overweight all my life. I tried everything to get the weight off. You name the diet and I tried it. I have exercised till I was blue in the face with no results. I even tried a starvation diet and lost a grand total of three pounds.

Finally I got the nerve to have intestinal bypass surgery. My current weight is 140 pounds. I am so happy I could cry.

However, my abdominal skin hangs down like a blanket, and the skin on the back of my arms hangs down too. Will any kind of exercise make the skin shrink? – R.P.

ANSWER:
I hate to tell you, but no exercise will shrink your skin. Your skin was stretched past its elastic limits, and it’s now in a permanently stretched state.

Surgery can remove the redundant skin. It’s the only way I know of to correct the problem.

DEAR DR. DONOHUE: Is pulse rate related to blood pressure in any way? When I am sitting and resting, my pulse is 64. My blood pressure sometimes is 140 over 88, and sometimes 125 over 70. At both times, my pulse is still 64. Shouldn’t they both rise? – N.R.

ANSWER: The pulse is a pressure wave that comes from the heart ejecting blood into the body’s arteries. The force of ejected blood can be felt in any surface artery – at the neck, at the wrist, behind the knee or on top of the foot. Pulse rate and heartbeat are one and the same.

The pulse doesn’t increase when blood pressure rises. The two are mostly independent of each other.

A big drop in blood pressure, however, does make the heart beat faster.

DEAR DR. DONOHUE: I am 73 and very active. I have been taking thyroid medicine for about 10 years. While changing doctors, I stayed off the medicine for about two months and saw no change in my routine. What are the consequences of not taking it? – J.T.

ANSWER:
Without enough thyroid hormone, body metabolism slows. Metabolism includes all the chemical reactions that take place in every body cell every second of every day. It also refers to the way the body processes proteins, fats and carbohydrates. Metabolism includes all the body mechanisms responsible for maintaining body heat. Metabolism participates in the growth and repair of body tissues and organs. Pretty nearly all body functions are related in some way to metabolism. That gives you an idea of the importance of thyroid hormone for health.

Without a sufficient supply of thyroid hormone, the heart beats slowly. Skin coarsens and dries, as does hair. People with too little of the hormone feel like they are freezing when they’re in a room where everyone else is comfortably warm. They gain weight in spite of eating little. The intestinal tract slows, and that leads to constipation. Thinking becomes difficult.

You might not notice a sudden change in how you feel or how your body performs after stopping thyroid hormone. It takes months of low hormone levels before the full-blown picture of an underactive thyroid gland develops. In addition to the signs and symptoms that come with hypothyroidism, as too little thyroid hormone is called, bad things happen to arteries. They become stiff and fill with plaque, the buildup of cholesterol and fat. That, in turn, leads to heart attacks and strokes.

Let your new doctor know what you have done. The doctor can order a few blood tests that can provide evidence of your need or lack of need for thyroid medicine.

The thyroid gland, both over- and underactive, is discussed in the booklet with that name. Readers can order a copy by writing: Dr. Donohue – No. 401, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.50 U.S./$6.50 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

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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