DEAR DR. DONOHUE: Six months ago, my wife died in her sleep. She said she just felt shaky and tired out around 6 p.m. When I turned on my light at 4 a.m., I immediately knew she had died. I was told she died of congestive heart failure. She told me she had this two months prior to her death. Was there something we could have done? I carry guilt with me every day. Is congestive heart failure a death sentence? — S.F.
ANSWER: Heart failure indicates that the heart has become a weak pump. “Congestive” often is added to “heart failure” to emphasize that the failing heart causes blood to circulate poorly. Fluid oozes out of vessels and congests body organs, especially the lungs and makes breathing difficult. Congestion also shows in swollen ankles and feet. However, not all people with heart failure show the signs of congestion.
Shortness of breath when lying down, waking from sleep gasping for breath, coughing during the night and the inability to get enough air to accomplish even light physical tasks are signs of heart failure. I can assure you that the world’s most renowned heart doctor would not have expected your wife to die in her sleep because she said she felt tired and shaky. You are entitled to feel sad, but you do not deserve to feel guilty.
Heart failure comes from heart arteries clogged with cholesterol, from heart valve malfunction, from high blood pressure and from heartbeat disturbances like atrial fibrillation. Treatments are available. Water pills draw water from an overfilled circulation, and that eases the burden on the heart. Other medicines increase the strength of the heartbeat. Special pacemakers can restore synchronous beating to the heart’s out-of-sync pumping chambers. Congestive heart failure is not always a death sentence.
My sincerest condolences to you and your family.
The booklet on heart failure describes this common condition in greater detail. Readers can order a copy by writing: Dr. Donohue — No. 103W, 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: While trying to get out of the bathtub, I slipped and hit my chest against the side of the tub. My husband took me to the emergency room. X-rays showed two broken ribs.
The ER doctor seemed to think this was nothing, but it was truly painful. He gave me a prescription for pain medicine, and that was it. Should some kind of splint be applied? How long does it take rib fractures to heal? — M.K.
ANSWER: An uncomplicated rib fracture — one in which the ends of the fracture are in alignment — can be treated with pain relievers alone. Admittedly, even the small movement of breathing in and out worsens the pain, but your medicine ought to take care of that.
Sometimes rib belts are put on patients to keep the fracture ends from moving. Whether they do much good is disputed, and they can be uncomfortable.
You can expect your ribs to heal in six weeks.
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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