DEAR DR. DONOHUE: I have some questions about cardiomyopathy. They say mine was caused by a viral infection, but I never had symptoms similar to a heart attack. My heart is now functioning at a low level. I also had a defibrillator put in. Does the heart heal itself after a while, or is this chronic? Do diet and exercise help? My wife and I do outdoor art fairs, and it requires some heavy lifting. Should I continue? – R.B.

ANSWER: Cardiomyopathy is a heart problem where the focus of attention is on heart muscle (“cardio” – heart, “myo” – muscle), not on heart arteries or heart valves, the more common kinds of heart problems. Cardiomyopathies come in different varieties. What I am about to say applies only to viral-caused cardiomyopathy.

Many viruses attack the heart muscle and produce heart-muscle inflammation – myocarditis. For most, it gets better in time, and for some, the initial attack produces no symptoms.

For a few, it persists and negatively affects the heart’s functioning. The end result is cardiomyopathy. The heart isn’t able to pump blood efficiently. Usually, this is a chronic condition.

The result is breathlessness when people are active. They can’t manage to do what they used to do. They’re tired most of the time. They often develop abnormal and dangerous heart rhythms, the reason you have a defibrillator. This is a state of heart failure.

Cardiomyopathy heart failure is treated in much the same way heart failure from other causes is treated. Diuretics are often prescribed to rid the body of excess fluid. ACE inhibitors are used to rest the heart. The only diet is a low-salt diet. Exercise generally is kept to a minimum. However, it’s your doctor who has to decide how much exercise you can do and how much lifting is permitted.

In spite of some of the restrictions people face, they usually can lead a good life with viral cardiomyopathy.

DEAR DR. DONOHUE: My wife manages a healthy food regimen in our house: fish, chicken without skin, beans, no soft drinks and lots of veggies and fruits. In addition, I take half a cup of bran cereal every day. Is there such a thing as too much fiber? The real issue is the gaseous consequence of fiber. Is there anything I can take to counteract it? No pills, please. – R.R.

ANSWER: Fiber does promote gas production. Why not cut back on the amount you’re eating? Then, when the problem ends, you can start adding more fiber into your diet and slowly increase the amount of it. That gives your digestive tract a chance to learn how to cope with the increased fiber load.

Eat very slowly to minimize gas production. Stay away from foods that are notorious for promoting gas – beans, peas, lentils, onions, cabbage and broccoli. They’re all wonderful sources of fiber, but they’re also wonderful gas producers.

Eggs, meat and cauliflower impart an unpleasant odor to flatulence. Cutting back on those foods makes the passage of gas less offensive to those in your vicinity.

Can you get too much fiber? Not really. If taken together with calcium and iron, fiber can lessen their absorption.

DEAR DR. DONOHUE: My wife and I occasionally get nighttime leg cramps. A friend told us to put a bar of soap under the sheets. It seems to work. Is it just a coincidence, our imagination or an old wives’ tale? – B.B.

ANSWER: It might be all three. I have stopped writing about the soap solution to leg cramps because it doesn’t have a shred of scientific proof. All the same, many people say it works. The soap can be any brand; it doesn’t have to be unwrapped; it can be put anywhere between the sheets, but most put it near the legs.

This is one treatment that is guaranteed not to hurt. I can’t say if it will help. It sounds a little quirky to me.

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.