DEAR DR. DONOHUE: My sister has just been diagnosed with hypertrophic cardiomyopathy. Could you explain what this is, how serious it is and what treatment is available? – J.S.
ANSWER: Hypertrophic cardiomyopathy is a big, muscular heart. Most of the muscle growth occurs in the left ventricle – the major pumping chamber – and in the muscular wall between the right and left ventricles. A big, muscular heart sounds like something desirable. It’s not. The muscles make the heart stiff and cause the pressure within the heart to rise. That, in turn, adds to the difficulty of pumping blood out of the heart. Furthermore, the muscular wall can impede the flow of blood from the heart.
One of the most dangerous consequences of this condition is the tendency for the heart to generate abnormal heartbeats – some so abnormal that they cause death. Hypertrophic cardiomyopathy is a relatively common cause of sudden death in young athletes.
About 50 percent of those with this heart anomaly have other family members who are also afflicted with it, so it is advisable for close relatives to be checked for it. The best way of doing so is to have an echocardiogram – a sound-wave picture of the heart.
A mild case of cardiomyopathy produces few to no symptoms.
With greater involvement, such a heart makes people short of breath when they’re physically active. They often suffer from angina – heart pain. Fainting is a common symptom.
Many medicines are used to assist these hearts in pumping with greater ease – beta blockers, verapamil and diltiazem are examples. Sometimes doctors inject alcohol into the heart to selectively pare away the excess muscle and keep it beating normally. There are surgical procedures designed to do the same thing.
Some patients receive an implantable defibrillator, a device about the size of an ordinary pacemaker. It puts a quick end to life-threatening heartbeats.
DEAR DR. DONOHUE: I am a celiac patient and would like to know for certain about oats. Can a person with celiac disease eat them?
What about wild rice? Can celiac patients eat it? – R.D.
ANSWER: Celiac disease was once considered an exotic illness. Now it’s anything but rare. It’s a major cause of chronic diarrhea and weight loss. Gluten, a protein found in wheat, barley and rye, wreaks havoc on the digestive tract of celiac patients and makes it impossible for them to absorb nutrients. Treatment is avoidance of these gluten-containing grains.
Most celiac patients can tolerate pure oats. However, be forewarned: Oats are often contaminated with gluten, because many grains share the same processing machines. You can see for yourself what effect oats have on you. If diarrhea returns, scratch oats off the list of permitted foods.
Wild rice is permitted.
The Celiac Disease Foundation stands ready to help you and all celiac patients come to grips with this difficult illness. Its Web site is www.celiac.org. The phone number is 1-818-990-2354. It is not a toll-free number. but it’s worth the price of a call.
DEAR DR. DONOHUE: I am 13 and play the clarinet. My hands sweat when I play, and my fingers slip off the keys. What can I do about this? – T.H.
ANSWER: Get an antiperspirant (not a deodorant) with aluminum chloride in it. Spray it on your hands before you have to play.
If products on drugstore shelves don’t dry your hands, then your doctor can prescribe a 20 percent solution of aluminum chloride. You apply it to your hands at night and wash it off six to eight hours later. Use it until sweating is under control, then continue using it once or twice a week.
If this doesn’t work, let me know. There are other solutions for sweaty hands.
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.
Send questions/comments to the editors.
