DEAR DR. DONOHUE: I read your column about liver cirrhosis and wish you would expound on hemochromatosis, which you mentioned. Both my children have it. My son is bled once weekly. He had a liver biopsy, and his liver has been greatly damaged. My daughter has a positive test for it. Neither their father nor I have any problems. We informed our doctor, who had blood tests done, and we show no lab evidence of it. Should our siblings be tested? My husband had a bypass at 48. Could that be caused by hemochromatosis? – H.E.

ANSWER:
Hemochromatosis (HE-moe-CROW-muh-TOE-siss) is another example of an illness with an impossible name that makes it sound like a rarity. Actually, it is one of the most common genetic illnesses. People with two genes for hemochromatosis, one from the father and one from the mother, lose the ability to limit iron absorption. They absorb too much. The excess iron accumulates in the liver to cause cirrhosis, in the pancreas to cause diabetes, in the heart to lead to heart failure and in the skin to change its color to slate-gray or bronze. Since women menstruate monthly, they lose blood and, with it iron, so they usually are less affected than men. The signs of the illness don’t usually appear until the 40s in men and slightly later in women.

When discovered early on, all the complications of hemochromatosis can be avoided by removing blood, the body’s storage place for iron.

Your husband’s bypass wasn’t necessitated by hemochromatosis. It affects heart muscle, not heart arteries.

All first-degree relatives of a patient should be screened for the illness. First-degree relatives are parents and all their children. Now there is a genetic test available. Your siblings should tell their doctors about your son and daughter so they can be at least checked for how much iron is in their bodies.

DEAR DR. DONOHUE: I am a 72-year-old male in generally acceptable health. I developed atrial fibrillation attributed to high blood pressure. I have an irregular heart rate about every three weeks that lasts four to 10 hours. Every time I eat hot, spicy foods, I get it. There are other times when it comes on out of the blue. My cardiologist shakes his head when I tell him this. Any comments? – J.T.

ANSWER:
Atrial fibrillation is one of the most common heartbeat disturbances. It’s a completely chaotic and rapid beat. The atria – the upper heart chambers – are not beating. They’re furiously squirming. That throws off the beating of the blood-pumping heart chambers – the ventricles. It also lays the groundwork for clot formation in the atria, with transfer of those clots to distant places like the brain.

Atrial fibrillation can be persistent – there all the time – or it can be intermittent, so-called paroxysmal atrial fibrillation. (A paroxysm is a sudden outburst.) Many things can trigger a paroxysm: too much alcohol or the generation of extra beats in the atria. I believe you when you say spicy foods set off an attack. I can’t explain why, but I am sure you’re right. “Idiopathic” is a favorite medical word. It means “cause unknown.” Quite often, paroxysms of atrial fibrillation are in the idiopathic category.

Irregular heartbeats are common disorders. The booklet on heartbeat irregularities covers these topics in depth. Readers can obtain a copy by writing Dr. Donohue – No. 107, 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: If children should get 10 hours of sleep, how much sleep should adults get? – M.R.

ANSWER:
That’s an often-asked question for which there is no definite answer. Most say that adults need seven to eight hours of sleep.

However, some people get by with less, while others need more.

People need enough sleep to keep themselves alert throughout the day. That’s something people have to determine for themselves.

DEAR DR. DONOHUE: For the past few days, I’ve had a breathing problem. According to my doctor, my chest X-ray shows I have a hiatal hernia and my stomach is pushing my lung. He said I need an operation. What are your thoughts? – F.M.

ANSWER:
The stomach can push through a small gap in the diaphragm muscle and encircle the esophagus, the swallowing tube. That’s a hiatal hernia. If the hernia is large, it might compress the adjacent lung tissue. If you have a problem breathing, then you might need an operation. However, hiatal hernias don’t usually cause a sudden onset of symptoms. Before you agree to an operation, get a second opinion.

TO READERS: The booklet on endometriosis explains this common female trouble and its treatment. To obtain a copy, write to: Dr. Donohue – No. 1105, 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.

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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