Question: What about the phen-fen weight loss plan? I read somewhere of cases of pulmonary hypertension being caused by it. What symptoms do you get with pulmonary hypertension as a warning?
- C.C.
Answer: "Phen-fen" stands for phentermine and fenfluramine, two appetite suppressants that when used in tandem are credited with making adherence to a rigid diet easier.
Pulmonary hypertension has occurred in a few people taking the drug combination.
Pulmonary hypertension, the blood pressure found in lung circulation only, is normally 20 percent of that in the rest of the body. The pulmonary system could not long abide a pressure reading remotely approaching that in the general circulation.
While rare, pulmonary hypertension should not be dismissed. Shortness of breath would be chief among the symptoms. Further, it might cause a general deficiency of oxygen getting into the blood.
Pulmonary hypertension is difficult to control. Drugs used for regular hypertension will not lower it.
For some, the lung pressure reverts to normal when stopping the pill combination. In others, it stays high.
My readers know by now that I am no devotee of weight loss through pills. I favor a more natural approach that includes cutting back on calories, learning proper nutrition and embracing a regular exercise program.
Question: Recently, I was diagnosed with congestive heart failure. My doctor gave me water pills for the fluid retention. Is this all the treatment needed? An echocardiogram showed a slightly damaged heart valve.
- Mrs. V.S.
Answer: Questions about congestive heart failure are common because so many people encounter it. CHF is a backup of blood and fluid from the heart because of a feeble heartbeat.
Hearts weaken for various reasons, such as clogged arteries, malfunctioning heart valves or high blood pressure. I doubt that a slightly damaged valve would cause it.
The water pill is designed to remove excess fluid, a standard treatment for CHF. A low-salt diet is another remedy.
Medicines such as ACE inhibitors also play a major role now. It's a new wrinkle in CHF treatment. The old standby digitalis helps strengthen the heart.
Check in with your doctor soon to get an update on your CHF.
Question: I am interested in vitamin deficiencies and diseases that they can cause. One of them is rickets. Which vitamin deficiency causes it?
- K.M.L.
Answer: Rickets is a bone disease that arises from a deficiency of vitamin D. Without that vitamin, calcium cannot get into the bones. That leads to bone pain, fragile bones and bone deformity.
Thus the classic rickets victim might have bowed legs and a caving inward of the chest bone. It also might cause the so-called rickets rosary, a pattern of little bumps where the ribs join the breastbone.
Today, rickets is unusual in our society, where food enrichment prevails. When the occasional rickets case turns up, the cause is usually a digestive-tract problem or a kidney problem.
My report on vitamins is on the way. Other readers can order a copy by sending $3 and a self-addressed, stamped (55 cents) No. 10 envelope to: Dr. Donohue - No. 35, P.O. Box 5539, Riverton, NJ 08077-5539.