DEAR DR. DONOHUE: I am 84 years of age and have been in excellent health. I recently was diagnosed with pericarditis. My cardiologist put me on ibuprofen. Tell me if this ailment is treatable and how dangerous it is. — A.L.

ANSWER: The pericardium is a big baggie that holds the heart in place and protects it. Actually, it’s a double baggie, one bag inside another. Pericarditis is an inflammation of the two touching surfaces of those bags.

Causes of the inflammation include viruses, bacteria, heart surgery, heart attack and an assault on the pericardium by the immune system. And, as always, there’s the category of pericarditis called idiopathic — doctors cannot find a cause for it.

The symptoms of pericarditis are sudden onset of chest pain, which worsens when people take a deep breath in and lessens when they sit up and lean forward. Doctors, listening to the heart with a stethoscope, hear a grating noise as the two opposing surfaces of the pericardium rub against each other with every heartbeat.

Pericarditis is serious and can be dangerous. For most, however, it is treatable and curable. The medicine you’re taking, ibuprofen, often is the first choice of doctors. Other anti-inflammatory drugs also can be used. Indocin is an example. Some doctors prefer their patients take aspirin. In some instances, they add colchicine to the regimen. Colchicine’s main purpose lies in the treatment of gout.

Serious cases of pericarditis have to be treated in the hospital. You’re not hospitalized, so the implication is that yours is a mild case, one that should respond well to treatment.

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Sometimes pericarditis interferes with heart pumping, but not in your case. And sometimes it recurs. I have a friend who suffered from recurrent bouts. He is now actively practicing medicine, so even difficult cases usually have a happy ending.

DEAR DR. DONOHUE: Our 2-1/2-year-old granddaughter has urinary reflux. She has been on antibiotics much of the time.

Can this continuous use of antibiotics be a concern?

What is the best age for surgical correction? Which hospitals are best known for successful surgery? — R.G.

ANSWER: In this condition, “reflux” indicates that urine in the urinary bladder is spurting upward into the ureters and then into the kidneys. The right and left ureters are tubes that drain urine from the kidneys into the bladder.

Ureteral reflux happens to about 1 percent of infants. It leads to kidney infections and kidney scarring. The daily use of antibiotics, at reduced doses, greatly lessens the complications of reflux. It isn’t such a threat to the kidneys or the child’s health. Since the dose of antibiotics is relatively low, treatment is not a source of great concern. Reflux tends to improve with age. By age 6, most children have outgrown it. If reflux continues after age 6 or if the reflux is causing kidney damage at younger ages, then surgical correction is the answer.

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Your granddaughter lives in a city with more than one greatly respected hospital center.

DEAR DR. DONOHUE: My question is about napping. I am 68 and in good health. I am retired now, but for years I worked from my home. Four to five days of the week, I take a nap at midday and have been doing so for 10 years. It lasts about an hour and 20 minutes. I am not tired. I just enjoy the nap. The naps don’t interfere with sleep. Is there a downside to this? — L.S.

ANSWER: So long as your naps aren’t making it hard for you to fall asleep at night, I see no downside. In fact, I envy you.

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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