DEAR DR. DONOHUE: I am a 65-year-old, retired male. I am in decent health and go to a gym a couple of times a week. I am a heavy drinker. Last night I had 7 ounces of scotch and 16 ounces of wine. That’s less than I used to drink in my younger days. I do not get drunk, but I can feel the effect. No doctor ever told me I must cut down, but they have recommended it. My family doctor monitors my liver frequently, and it is fine. I don’t need to be scolded, but do you think my liver will inevitably collapse? I am sure you qualify me as an alcoholic, and you are probably right. I enjoy my cocktail time and would miss it. I appreciate any comments you care to make. — P.K.

ANSWER: You are a very intelligent guy. You express yourself most articulately. And you are painfully honest, a quality I can’t help but admire. You recognize that you are putting away excessive amounts of alcohol. Alcoholism is defined in a number of ways. One is how drinking affects a person’s functioning. Does the drinker fulfill all obligations — getting to work on time, paying bills? Is he or she able to maintain his or her social contacts (interact with a circle of friends)? Is the drinker faced with legal complications as a result of drinking, or does he or she continue to drink in hazardous situations, like driving?

I must admit, from what you have said, none of these criteria applies to you. However, the fact that you aren’t drunk with the amount of alcohol you describe is evidence of tolerance to alcohol, a sign of alcoholism. The amount of alcohol drunk is another criterion of alcoholism. The safe amount of alcohol for a man is two drinks a day and for a woman, one drink a day. One drink is 12 ounces of beer, 5 ounces of wine or 1.5 ounces of 80-proof whisky, vodka or gin. It’s an obvious understatement to say you exceed those guidelines.

Serious health complications occur in most drinkers when they drink 60 to 80 grams of alcohol a day for 10 years. Women can tolerate only half that amount. You drink more than 100 grams. You should be suffering liver complications, heart disease, possible stomach ulcers and potential cancers of the mouth, esophagus and rectum. You have none of these. I can’t explain it. All I can say is that you’re very lucky and should not press your luck.

DEAR DR. DONOHUE: Your advice for treating postnasal drip was most helpful. You recommended flushing the nose with a saltwater solution. Precisely how is this done? — L.S.

ANSWER: Dissolve a quarter to half a teaspoon of salt in a cup of boiled water that is still somewhat warm. Add a pinch of baking soda, sodium bicarb. With a bulb syringe, available in all drugstores, gently flush each nostril while leaning over a sink. Let the water drain out. Repeat twice or three times a day.

DEAR DR. DONOHUE: My boyfriend of two years and I have a healthy sex life. We are in our late 40s. During sex, he sometimes gets a massive headache. We stop, and he lies down, and the headache goes away. What causes this? Should we be concerned? — J.B.

ANSWER: Orgasmic headaches — headaches that occur during sex and usually at climax — are not usually a sign of serious trouble. They sometimes can be prevented by taking Indocin or propranolol before relations. Similar headaches are dangerous. Bleeding from a brain artery produces the same kind of pain. Admittedly, this is unlikely in your boyfriend’s case, since it has happened repeatedly without any lasting signs. All the same, to play it safe, have him see a doctor. There are other examples of this kind of headache. Inflammation of brain arteries or temporary constrictions of those arteries cause a comparable headache.

TO READERS: The booklet on edema (swelling of an arm or leg) explains this common problem and its treatment. To order a copy, write to: Dr. Donohue — No. 106, 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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