DEAR DR. DONOHUE: I am a 73-year-old woman. I have an abdominal aortic aneurysm. I have sonograms regularly. I am in a bowling league. I bowl each week. My bowling ball weighs 10 pounds. Should I bowl? My last ultrasound shows that the aneurysm is 3.8 cm. — F.S.
ANSWER: Your doctor is the only one who can answer your question with authority. He or she knows all the circumstances of your health. However, I can tell you that most people with an aneurysm of your size are encouraged to be active. Lifting heavy weights is discouraged. A 10-pound bowling ball isn’t considered a heavy weight.
The size of an aneurysm determines its risk of breaking apart and bleeding profusely. Aneurysms smaller than 4 cm are not in danger of suddenly rupturing. When an aneurysm reaches 5 to 5.5 cm, then surgical repair is recommended. You are quite a distance away from the danger zone.
For readers: Aneurysms are bulges of an artery wall, and are weak spots.
DEAR DR. DONOHUE: I hope you will discuss lactose intolerance. I am 60 and just developed it. — J.B.
ANSWER: Lactose is milk sugar. In our digestive tracts is an enzyme — lactase — that digests milk sugar. People with too little of the lactase enzyme have trouble when they drink or eat dairy products. Milk sugar doesn’t break down. The undigested sugar leads to gas production, stomach cramps and diarrhea.
Medical tests can confirm the dearth of the lactase enzyme.
Standard treatment of lactose intolerance (also called lactase deficiency) is avoidance of dairy products. Most cheeses have little lactose, so they can be eaten. Yogurt made from live cultures is usually tolerated.
Furthermore, many dairy products can be pretreated with lactase, and people with the intolerance are not bothered by such products. The lactase enzyme comes in pill and liquid forms. It can be added to milk or taken by mouth before eating or drinking dairy products.
DEAR DR. DONOHUE: How do I get a doctor to correct or change his written report? Twice in my 77 years I have pointed out incorrect statements in their records. Each time I was told they could not change anything once it appears in their written report.
There must be a way to correct an error, especially before sending the report to other doctors. Do you have any suggestions? — G.J.
ANSWER: I do have a suggestion.
The doctors are afraid of changing information because such changes can be damaging to them if the records are required in any legal proceedings.
However, they can make a current note in the chart, explaining how previous information in the record was not correct. That’s not going to get them into any trouble. It seems to me that not doing so would get them into trouble.
If the doctors balk at this, ask them to talk to a lawyer. Tell them you are preparing a document that states what the correction should be and that you will send it to any doctor to whom your current doctor sends your records. That should motivate your doctor to act.
DEAR DR. DONOHUE: A recent blood check showed that my potassium was high. I was told to stop eating bananas and drinking orange juice. I also was told to return to the doctor’s office the next week. I did. They took another blood sample. They told me nothing more.
What happens when potassium is high? — F.H.
ANSWER: Potassium has many important jobs. It keeps the body’s electrical charges balanced. It’s involved in transmitting nerve signals. It’s needed to keep the heart beating and muscles contracting. It takes part in keeping the body neither too acid nor too alkaline.
High blood potassium raises blood sugar, weakens muscles, causes nausea and vomiting, and triggers erratic and dangerous heartbeats. When the level is very high, potassium paralysis and death occur. Your potassium must not have been all that high. You had no symptoms.
The causes of a high blood level include kidney illnesses, nonworking adrenal glands, a lack of insulin, sudden death of body cells, overuse of potassium supplements and medicines like beta blockers.
The blood level of potassium can be read erroneously as high when the patient, during blood collection, keeps clenching and unclenching arm muscles. It rises when blood cells break apart in their journey from a patient’s arm to the laboratory. It could be your reading was high because of either of these situations.
It’s hard to come up with an explanation that indicts an illness with raising potassium on one occasion and not keeping it raised for a short while.
The electrolytes — sodium, potassium, bicarbonate and chloride — are not well understood by most people. Yet they are responsible for many body ailments. Readers can read about these minerals in the booklet describing their function. Write to Dr. Donohue — No. 202W, 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: Swallowing became a real problem for me. Food would get stuck on its way to my stomach. I tried all sorts of over-the-counter medicines, but nothing worked. I saw a gastroenterologist, who put a scope down my swallowing tube. He discovered that there was a constricting ring of tissue at the bottom of it. How did I get it? He opened it with a balloon. Can it come back? — C.W.
ANSWER: You’re talking about a Schatzki (SHOT-ski) ring. It is as you say — a fold of tissue encircling the lowermost part of the esophagus, and it does cause food to hang up there.
How did you get it? Some theorize that reflux of stomach acid into the esophagus explains why it developed. Acid reflux is a fancy way of saying heartburn. However, people can have reflux and a Schatzki ring but not have any heartburn symptoms. Meat and large pieces of bread are the foods most likely to get stuck.
Stretching the ring with a balloon or other device usually fixes the problem. However, it can come back, and it often does. Because recurrence is common, many doctors put their patients on medicines that suppress stomach acid production.
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.
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