QUESTION: Every so often, you make mention of the "heart muscle" and the lack of blood supply to it in connection with angina and heart attacks. Please, I feel silly asking this, but how does this work in reality? I find it hard to think of the heart as a muscle. - J.J.
ANSWER: You are not alone in this confusion. And we might just as well clear up this important bit of anatomy as we enter a new year.Blood, as you know, leaves the heart via the aorta, a huge vessel. It gets pumped further along through large, but somewhat smaller branching vessels. Certain of those vessels (coronary arteries) soon make a sharp detour, doubling back toward the heart's exterior walls.
That detour is vital, for the heart is, indeed, a muscular organ, constantly contracting and expanding in order to pump blood to the body. This backtracking coronary artery blood supply nourishes it and supports its immense and perpetual work.
When a section of heart muscle tissue lacks sufficient blood supply because of blockage in one or more of those arteries serving it, it complains as does any muscle in the body, either with pain (angina) or heart attack. I hope this clears things up for you.
QUESTION: I write in reference to an article you had on migraines. You suggested the girl talk to her doctor about taking naproxen. I have migraines with my period. I spoke to my doctor, and he prescribed Naprosyn, which he said is the same. My concern is, how do you take them, during the period or all month, or just when you get a migraine? I take them when I start my period. I still get headaches. - M.E.S.
ANSWER: Naprosyn is the commercial name for naproxen (the generic drug).
I wonder if your headaches are true migraine in nature or merely ones associated with the menstrual cycles. Sometimes, migraine can be triggered by menstruation and the hormonal fluctuations that occur with the period. In one sense this question is moot here, since Naprosyn can be used for either.
Assuming for the moment that you have migraine brought on by menstruation, the medicine is best taken two to three tablets daily, beginning about seven days before you expect the period and continuing until it ends.
However, I really think you should try to pin down the kind of headache you are having. There are other drugs to treat migraine, menstruation-related or not. If you have questions on that, write again. The booklet, "PMS and Menstruation Pain," might be worth glancing through. Other readers can order by writing to Dr. Donohue/No.36, P.O. Box 19660, Irvine, CA 92713-0660, enclosing $2 and a long, stamped, self-addressed envelope.
QUESTION: I work with a lady who always complains of her "palpitations," but her doctor doesn't seem to think they are serious. Could she have serious heart disease? - Mrs. V.F.
ANSWER: A palpitation is a sudden change in the heart's beating pattern. Some describe it as a flutter or a skip. Serious? Depends on things such as the number of skips or flutters. A few extra beats is not serious. Too much coffee can cause that, for example. More serious rhythm disturbances, such as extended runs of flutters or too frequent occurrence of such episodes, paint a different picture, which demands greater respect and a more specific name than "palpitations."
C) 1989 North America Syndicate Inc.