DEAR DR. DONOHUE: I need help and information. Because I had a cough that lasted for more than a month, my doctor had me get a chest X-ray. My lungs were normal, but my heart was big. The cough went away. The doctor’s receptionist called to tell me that the doctor thinks I have cardiomyopathy and said not to exercise. I have no idea what this is. How is it treated? Why no exercise? I am 27. — C.N.

ANSWER: I am using a narrow definition of cardiomyopathy because the all-inclusive definition covers too much territory. And I am focusing on one kind of cardiomyopathy, hypertrophic, because it’s the kind most likely to affect someone your age. Cardiomyopathy is an illness of heart muscle, not heart arteries, heart valves or high blood pressure related heart disease. Hypertrophic cardiomyopathy is a genetic illness in which the heart muscle fibers have grown so large that they interfere with normal heart pumping. The fibers also are arranged haphazardly, another obstacle to good heart function. Often, the wall between the right and left sides of the heart is overgrown and obstructs blood ejection.

Early on, hypertrophic cardiomyopathy produces few, if any, symptoms. Later, chest pain and shortness of breath are its characteristic signs. A person with cardiomyopathy is told to avoid strenuous exercise because activity can lead to dangerous heartbeats and sudden death.

Treatment is beta blockers, medicines that relax the heart muscle and encourage more normal heart function. If medicines don’t bring the desired result, the obstructions caused by the overgrown heart muscle can be reduced surgically or through other methods.

I don’t want to dwell on hypertrophic cardiomyopathy for you, because it might be generating needless worry. This heart condition isn’t diagnosed with a simple chest X-ray. An echocardiogram — a soundwave picture of the heart — furnishes reliable information on it. Your “big” heart might be nothing more than the heart of a person who is a well-trained athlete. If your doctor doesn’t clear this up shortly, see another.

DEAR DR. DONOHUE: As part of a pre-employment exam, I have to submit a urine specimen for drug testing. About a month ago, I smoked a marijuana cigarette. Will that show up on my urine test? I need this job. I haven’t worked in more than a year. — R.M.

ANSWER: Your urine test will not show traces of marijuana. By two to five days, causal marijuana use doesn’t produce a positive urine test. For heavy use, urine tests detect marijuana for four to five weeks.

DEAR DR. DONOHUE: An itchy rash broke out on my right arm. The doctor prescribed a cream to put on it. He told me to cover the area with plastic wrap when I sleep. It’s working. The itch is going.

What does the plastic wrap do? — H.W.

ANSWER: I bet the cream is a cortisone cream. The wrap facilitates the absorption of the cream into the skin.

Readers, don’t use this treatment on your own. Not all skin medicines are enhanced by plastic wrap.

DEAR DR. DONOHUE: This morning, on looking into the mirror, I got a shock. My right eye has a large, red blotch on the white part. It looks like blood. I don’t have any pain, and my sight is fine. What is this? I can’t remember hitting my eye. Could I have done so during sleep? — B.B.

ANSWER: You describe a subconjunctival hemorrhage. “Hemorrhage” is far too strong a word to use here. It’s actually a small amount of blood that comes from a broken capillary, one of the tiniest and most delicate of blood vessels. Capillaries break for innocent reasons. A cough or sneeze can break one. Most of the time, people have no recollection of anything happening that caused the break. “Subconjunctival” means the leak occurred under the transparent membrane that covers the eye, the conjunctiva.

By the time you read this, the splotch should have vanished.

DEAR DR. DONOHUE: My son, age 2 months, has a coated tongue. It’s white. He doesn’t seem bothered by it. He’s eating well.

My mother says it’s thrush and can be cured with a dye. Apparently I had it as a baby, too. What is the name of the dye? — A.S.

ANSWER: Thrush is an infection by the yeast (fungus) Candida. It’s a pretty common infant infection. Sometimes it makes the tongue and mouth sore, which, in turn, makes the baby reluctant to feed. At other times, it’s just there and doesn’t affect the child. Nowadays, the usual treatment is nystatin, the infant preparation of it.

Gentian violet is the dye used in previous times.

It’s best to have this diagnosis confirmed by the baby’s doctor.

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.

Copy the Story Link