Question: I am 59, a woman of average build and fairly good health. My problem is that I wake up at night and my right arm and shoulder feel like a block of ice. When I try to move the arm, it is painful. Recently, I read that this ice-cold feeling might be a heart attack happening. I was just wondering if that was happening to me.
- A.A.Answer: You're asking me to walk out onto some pretty thin ice here, A.A.
I can offer general observations only. One is that most heart pain results from physical activity at the time. Further, such pain tends to subside as the activity stops. That generally describes what is called "angina pectoris" or "chest pain."
Now, it is true that there is a special form of the problem, called "noc-turnal angina." That occurs when the person is still, perhaps in bed sleeping. But nocturnal angina is not that common, so you can't leap to such a conclusion.
Nor is the coldness you report a common feature in a heart attack, no matter what you have read.
The symptoms you experience on awakening and moving your arm are more typical of either nerve or muscle compression. Perhaps it results from your sleeping posture. Do you sleep on the symptom side?
No matter what is going on, I cannot allow you to rely on such fragile guesswork. Remove your doubts by getting a firsthand examination to rule out the more ominous causes.
To learn more about heart attacks, readers can write for a copy of the Health Letter special report on the subject. Send $3 and a self-addressed, stamped (52 cents) No. 10 envelope to Dr. Donohue - SR 79, P.O. Box 5539, Riverton, NJ 08077-5539.
Question: Are sarcoidosis and amyloidosis related? Do they occur together?
Answer: Sarcoidosis is a heaping up of white cells - granuloma - in specific body locations, commonly in lymph nodes, the liver, skin and eyes, but most notably in lungs. In fact, coughing and other respiratory signs predominate.
Sarcoidosis can be quite mild and hardly noticeable, or it can develop into a serious illness that requires use of cortisone drugs. Nevertheless, the outcome for the patient is usually good. About 80 percent of the time, the patient pulls through with no permanent damage.
Amyloidosis is entirely different, from its protein makeup and its gluelike appearance to its generally less pleasant prognosis.
An amyloid, like a sarcoid, is a deposit. Amyloids can form in body organs, joints and the digestive tract, with symptoms matching the area of involvement. But lungs are not usually targets.
You might encounter amyloidosis in patients with chronic illnesses, such as rheumatoid arth-ritis or bone infections.
There is no specific treatment for amyloidosis.
There is, then, no connection between the two ailments, and I am not aware of them occurring together, although I suppose that is possible.
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 08077-5539.