Be Still, My Racing Heart

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DEAR DR. DONOHUE: During the night and mostly early in the morning hours, my heart speeds up to 200 beats a minute. There is no pain, but it wakes me up and seems to happen if I am lying facedown. I sit up and take my pulse, which is about 70 to 72. I feel my heart slowly return to normal in two to three minutes. I have worn a Holter monitor for 24 hours.

My doctor says not to worry about it. Do you think I have anything to worry about? — S.

ANSWER: For readers: A Holter monitor is a device worn externally that records all heartbeats in a given time period. They can be worn for three or more days. The doctor sees on the recording what kind of abnormal heartbeats occurred.

I have to clear something up with you, S. Is your pulse 72 beats a minute when you feel your heart beating fast? The heartbeat and the pulse are one and the same. How are you counting your heartbeat?

If the episodes occurred while you were being monitored and did not last long, then the doctor can dismiss it as not being worrisome. He should name the rhythm; ask what it is.

If the fast heartbeats occurred at times you weren’t wearing the monitor, you need to wear it longer so that the rhythm can be identified for what it is.

The booklet on heartbeat irregularities describes the more common kinds of these beats and how they are treated. Readers can order a copy by writing: Dr. Donohue — No. 107W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: None of my 21 grandchildren has had their tonsils out. All of my seven children did. Is this no longer done? I wish doctors would make up their minds about these things. — B.B.

ANSWER: When your children were young, it was almost standard practice to remove tonsils as a way to protect against strep throat. We now know this isn’t necessary, and we now have antibiotics to treat strep throat.

Children who have repeated strep throat infections still have their tonsils removed, but the operation is no longer done for prevention.

DEAR DR. DONOHUE: My husband and I take Lipitor. We take it before dinner in the evening. We eat half a grapefruit after breakfast. Is that OK? — M.L.

ANSWER: You can take Lipitor any time of the day, and you can take it with or without food. It’s one of the statin drugs — the drugs that are such effective cholesterol-lowerers.

Grapefruit and Lipitor are not a good combination. Grapefruit can increase the blood concentration of this drug. It does the same with a few other medicines. This effect of grapefruit lasts for 24 hours, so even letting 12 hours pass before taking the drug after eating grapefruit doesn’t lessen the chance of this interaction occurring.

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.

© 2009 North America Synd., Inc. All Rights Reserved

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