Question: I was enthused when my doctor declared that I could lower my mild high blood pressure by cutting down on salt. No drugs. But after several weeks, my numbers stayed put. I guess low-salt diets don't work for all of us. Is it time to try something else? My doctor says many of his patients lower their pressure without drugs.
- Mrs. M.A.
Answer: A low-salt diet works for 40 percent of patients, not an insignificant success rate. For you, it is time to go back to the drawing board. And there are many other non-drug alternatives.
Increasing potassium intake can help. You can do that by eating more potassium-rich foods, including potatoes, kidney beans, lima beans, peas, spinach, bananas, oranges and dried fruits. Commercial seasoning substitutes contain potassium. In fact, it is what provides the salt flavor.
You can add a weight-loss regimen to most pressure-lowering programs. If you have at least 10 pounds you can lose safely, losing that should have a definite effect on your hypertension numbers. Incidentally, reducing fat intake has benefit beyond weight loss alone. The same goes for a regular exercise program.
Some patients need drugs no matter how much they try to control things with alternative measures. You might be one of those. But I agree with your doctor: If you can do the job without drugs, you are better off.
I am sending you my report on blood pressure. It might put things into focus for you. Others can order it by writing: Dr. Donohue - No. 4, Box 5539, Riverton, NJ 08077. Enclose a long, self-addressed, stamped (52 cents) envelope and $3.
Question: I am a 21-year-old woman. For the past month, I have had sharp chest pains occasionally. It hurt so bad once that I went to the emergency room. The doctor there said it might be a hiatal hernia. He gave me some Tylenol with codeine. But I still get the sharp pains, which can bring tears to my eyes. Should I see another doctor or wait until it passes?
Answer: Emergency rooms are just that, places where patients are seen with acute problems. The atmosphere does not always lend itself to definitive diagnosis. The importance of your going in was to rule out any emergent cause for your chest pains. So for starters, you should seek attention in a more-relaxed environment, especially given the fact that your pain continues.
Hiatal hernia is sometimes a companion to heartburn, where stomach acid irritates the lower esophagus. The pain you describe does not seem to fit the heartburn kind of pain, though. And, at 21, heart disease is an unlikely answer. The apparent briefness of your pain suggests a host of possible causes.
The chest has a bewildering array of muscles, nerves, ribs and cartilage in a cavity that contains the lungs, the heart and the esophagus itself. Even non-chest structures can cause chest pain, e.g., the stomach and gallbladder.
Question: In a recent column, you wrote about antibiotics in otitis media. You cited a study on the treatment of 250 juvenile patients. I would appreciate it if you'd print where I can read more about the study, since it is a question I am asked frequently in my work with parents. Thanks.
Answer: The report is in the Lancet, July 13, 1991, Page 96.
In response to reader requests, Dr. Donohue has a complete listing of his pamphlets on various medical problems. Readers who want one should send their request to Dr. Donohue - List, Box 5539, Riverton, NJ 08077. Enclose a self-addressed, stamped envelope.
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 at P.O. Box 5539, Riverton, NJ 08077.
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