DEAR DOCTOR K: Can you tell me what happens when someone having a heart attack gets to the hospital?
DEAR READER: You're going about your day when you suddenly start to sweat and become short of breath. You feel a crushing pressure in your chest. You think: "This is it. I'm having a heart attack." A heart attack occurs when one of the coronary arteries, blood vessels that supply the heart, becomes fully or partially blocked.
DEAR DOCTOR K: In a recent column on antibiotics, you didn't mention their use in meat and poultry as a cause of antibiotic resistance. Hasn't this contributed to the problem?
DEAR READER: You're correct. In the United States, food-producing animals such as cattle and poultry are regularly treated with antibiotics. This has contributed to antibiotic resistance: bacteria that are no longer susceptible to antibiotics. How do bacteria become resistant? Let's say you take penicillin to treat a bacterial infection.
DEAR DOCTOR K: Recently, my blood pressure has been low. I feel tired and dizzy. What could be causing this and what can I do?
DEAR READER: Low blood pressure is not considered a problem unless, as in your case, it causes symptoms. In fact, if it is not causing symptoms, low blood pressure can be a good thing. The typical symptoms caused by low blood pressure include weakness and dizziness, which can increase your risk of fainting and falling. If a person who did not previously have low blood pressure develops it, and has weakness and dizziness, he or she could be developing a heart problem.
DEAR DOCTOR K: I've already had shingles. Do I still need to get a shingles vaccine?
DEAR READER: Shingles is caused by the same virus that causes chickenpox. Once you have had chickenpox, the skin changes of chickenpox go away, but the virus that caused it remains alive inside your nerves. It is inactive, but it can be reactivated later in life. This causes shingles.
DEAR DOCTOR K: What caused my gout? Will avoiding certain foods prevent flare-ups?
DEAR READER: Gout is a painful joint condition. I know, because I've suffered from it. I spoke to my Harvard Medical School colleague, rheumatologist Dr. Robert Shmerling, to get the latest information. Gout attacks come on suddenly, with sharp pain, often in a single joint. The big toe is a common target.
DEAR DOCTOR K: I am pregnant, and my doctor says that I'm gaining too much weight. I trust the doctor, but I've heard that it's normal to gain weight during pregnancy. How much weight should a woman gain?
DEAR READER: It's natural for a woman's appetite to increase during pregnancy. This is nature's way of making sure that she eats enough for herself and her growing baby. All women should gain weight during pregnancy, while eating healthfully and sensibly. But too much weight gain isn't good for a woman or her baby.
DEAR DOCTOR K: Does eating several smaller meals throughout the day rather than three larger meals help with weight loss?
DEAR READER:We know that eating fewer calories is important to losing weight, but there is less agreement on the specifics. Are three meals a day best for weight loss? Or is it better to eat more -- or less -- frequently? We can rule out eating fewer than three times a day. You'll feel hungry, making it more likely that you will overeat and choose less healthy foods when you do eat.
DEAR DOCTOR K: As I've gotten older, my fingernails have become very brittle. They chip, break and split easily. I've also noticed ridges. What can I do?
DEAR READER: Many of my patients notice that their fingernails become thinner, more brittle and fragile with age. Nails may split lengthwise, or separate in thin layers at the tips. The nails may look different as well. They may become yellowed or dull, and many develop thin, vertical ridges.
DEAR DOCTOR K: My doctor thinks I could benefit from an antidepressant. But I've heard that antidepressants cause weight gain and I'm already overweight. Do any antidepressants cause less weight gain than others?
DEAR READER: Many of my patients have asked me that question. Like you, they were hesitating to take antidepressants because of the possibility they would gain weight. And they're right: Many antidepressants do cause weight gain in some people. The question has been how much weight gain they cause.
DEAR DOCTOR K: I'm in my 80s. I recently stopped driving, and now I can get around independently only by walking. Can you tell me how to improve, or at least maintain, my mobility?
DEAR READER: Mobility is one of those things most of us take for granted until we begin to lose it. That's when we realize that even a simple, relatively uneventful day requires a great deal of physical stamina, strength, balance, coordination and range of motion. The single most important thing you can do to remain mobile and independent is to engage in regular physical activity. I can't emphasize this enough: You need to be active to stay active.
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Dr. Anthony Komaroff is a practicing physician, Professor of Medicine at Harvard Medical School, and Editor in Chief of the Harvard Health Letter. Learn more »
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