Issue link: https://www.epageflip.net/i/32756
Tuesday, May 31, 2011 – Daily News 3B FEATURES Atrial fibrillation carries dangers DEAR DR. GOTT: I am a 68- year-old female who has been diagnosed with atrial fibrillation. My family doctor has sent me to three cardiolo- gists, one of whom was an electro- physiology cardi- ologist. I have received three prognoses. The first told me that I am getting old, so I just have to live with it and it wouldn’t cause any dam- age to my heart. The sec- ond did a heart catheteri- zation and told me that my heart was great. He con- firmed the a-fib, told me that it wasn’t dangerous, and gave me 25 mil- ligrams of atenolol to take every day. I do not have high blood pressure or chest pain, for which the medication is normally given, and it makes me listless and drops my pres- sure to 90/44. I was then told that he needed to find out why I was having the fibrillation, but that was some time ago. The third physician, the electro- physiology cardiologist, also confirmed that I had atrial fibrillation and told me to continue taking the atenolol. He said that a-fib could cause a stroke, so I needed the drug even though I have no symp- toms that the medication treats. I have had four episodes in the past year, each one lasting longer than the one before. What do you recommend? How dangerous is it? Should I take a medication that treats symptoms I don’t have? DEAR READER: Atri- al fibrillation is an abnor- mal heart rhythm that causes the heart to race, skip beats and may cause palpitations (feelings of the heart beating and/or skipping beats). There are two types, chronic and paroxysmal. The latter form occurs on occasion and resolves spontaneous- ly. You are likely suffering from paroxysmal a-fib. I don’t know that I would classify a-fib as dangerous, but it definite- ly has some dangers con- nected to it. Because the blood is not pumping through correctly, the abnormal rhythm can cause the formation of blood clots within the heart’s chambers, leading to an increased risk of heart attack, stroke or embolism. Prevention is through the use of drugs, such as certain heart med- ications and anticoagu- lants, which ease the pumping of the heart and make the blood less sticky. This essentially makes it harder for a clot to form. you have The atenolol been Dr. Peter Gott prescribed, a beta- blocker, would be appropriate if you require rate con- trol for your a-fib. There are alterna- tives to beta- blockers for con- trol; however, they tend to lower blood pressure. If, on the other hand, you do not require rate control, you may only need an antico- agulant. I am unclear why your family physician felt it was necessary to refer you to three cardiologists. A- fib is a fairly common condition that he or she can likely monitor and treat himself or herself. I also take issue with some of the comments you received from the special- ists. First, at age 68, you are hardly old, and this is not a condition that you should just learn to live with. Second, both the first and second cardiolo- gists don’t seem to have taken the time to ease your concerns or properly explain the condition and it’s potential conse- quences. Finally, the third specialist should have worked with you to find a medication that would not cause your pressure to drop so low as to cause side effects. Atenolol is not the only medication used for the treatment of a-fib. As for your next step, you have two options, as I see it. First, return to your family physician and dis- cuss your concerns about what to expect, the prob- lem with your medication and what you can do to prevent further attacks. Or you can request a referral to a fourth cardiologist, perhaps one associated with a teaching hospital, and explain your current situation and confusion. In either situation, you should request a medica- tion change because the atenolol doesn’t appear to be helping and is causing your problem. Also, inquire about taking a daily aspirin, whether a full-strength (325 mil- ligrams) tablet or a low- dose (81 milligrams) pill, if you aren’t already tak- ing it or another anticoag- ulant. Dr. Peter H. Gott is a retired physician and the author of several books, including “Live Longer, Live Better,” “Dr. Gott’s No Flour, No Sugar Diet” and “Dr. Gott’s No Flour, No Sugar Cookbook,” which are available at most bookstores or online. His website is www.AskDrGottMD.com Slow food events planned at Lucero Olive Oil in Corning Slow Second Saturday events are scheduled for June 11, July 9 and August 13 at Lucero Olive Oil, located at 2120 Loleta Ave. in Corning. The events will feature music, food, tastings, wine, beer and fun. Belittled bride bemoans brooding beau Dear Annie: I’ve been married to ‘‘Sherwin’’ for two years. We are both in our 50s. He has two grown children, and I have two teenagers who still live with us. Before we married, I thought Sherwin was per- fect for me. We enjoyed everything together, and he made me feel special. Once we said ‘‘I do,’’ however, I saw a different side. He spent most evenings on his computer or watching TV, no longer helped around the house and only wanted to pay one-fourth of the bills since my two children and I also live here. I own my home. Sherwin threat- ened to leave me if I didn’t put his name on the deed. I refused since our marriage had been so rocky. So a month ago, he left, taking our sav- ings and all my jewelry with him. I have not let him back into the house. He has apologized over and over and returned the money and jewelry. I am not mad at him, Annie. I just don’t trust him. He begs me not to give up and promis- es to do better. I have seen a counselor, who reminds me that my job is to take care of my kids and myself and not be swayed because I feel sorry for Sherwin. In my heart, I believe I am better off without him. But every time I tell him it’s over, he falls apart and apologizes. I hate to see him like this. Please advise. — I Am Stuck Dear Stuck: Sherwin is manipu- Annie’s Mailbox by Kathy Mitchell and Marcy Sugar lative. He charmed you into marriage, then intimidated and bullied you to get his way, and finally stole from you and walked out. Now he is playing on your sympathy in order to get back into your life. We wouldn’t trust him, either. In fact, we’d run as far away as possible. You can feel sorry for him from a distance. Dear Annie: My hus- band has always been a heavy drinker. He mostly drinks alone, at home, and can go through two large bottles of vodka a week. He’s 65 and retired and stays active, playing golf and hockey every day, after which there may be lunch and drinks. He appears to be sober all the time, and his drinking does not impact on his responsibili- ties. He rarely seems drunk, although occasionally, I notice some slurred speech and drooping eyes. For the past few years, he’s made sure I don’t see him coming into the house with his liquor purchases, and he sneaks the empties out to his truck. Recently, he’s been drinking first thing in the morning. I believe he knows there’s something wrong, but he’s not ready to admit it. I take care to be tactful and nonconfronta- tional. He takes medications for arthri- tis, blood pressure and stomach pain, and I’m worried. If I talk to his doctor, he would consider it a betrayal. Am I overreacting? Is he an alcoholic? I know about Al- Anon, but I’m not interested in being part of a group. Can you sug- gest any other resources? — Wor- ried Wife Dear Wife: You can look into individual therapy for yourself, and there are many suggestions online for dealing with an alcoholic spouse. Although you aren’t inter- ested in being part of a group, we still recommend you check the Al- Anon website (al-anon.alateen.org) for literature and suggestions. Dear Annie: ‘‘Ex-Professor Out East’’ said he was accepting of his wife’s platonic relationship with another man. He should learn the term ‘‘polyamory.’’ My husband and I are happily married and found polyamory to be a welcome alternative. We both have loving relationships outside the marriage, with the other’s bless- ing. This type of lifestyle can add new dimensions to an otherwise stale relationship. — Happily Poly in Ohio Dear Ohio: Polyamorous rela- tionships can be platonic or sexual, but the important part is, they are not secret. The spouse knows and accepts. As long as both partners agree, we say to each his (or her) own. Annie’s Mailbox is written by Kathy Mitchell and Marcy Sugar, longtime editors of the Ann Landers column. Please e-mail your questions to anniesmailboxcomcast.net, or write to: Annie’s Mailbox, c/o Creators Syndicate, 5777 W. Century Blvd., Ste. 700, Los Angeles, CA 90045. Utility to lower top residential rate in June Pacific Gas and Elec- tric Company (PG&E) announced today that the California Public Utilities Commission (CPUC) has approved the company’s request for a sharp reduc- tion in the top rate that residential customers will pay for electricity starting this summer. “As the heat of summer hits and air conditioners turn on, our customers look to us to help them manage their electricity bills. Today’s decision allows us to answer this call by significantly lower- ing the top rate they pay,” said Helen Burt, PG&E’s senior vice president and chief customer officer. The CPUC decision today will drop the top electric rate by over 15 percent, while the rates for the lowest two tiers will stay the same (see table below). The two existing elec- tric rates for income-qual- ified customers under the California Alternate Rates for Energy (CARE) pro- gram will not change. CARE customers, howev- er, will see a new third tier rate of 12.5 cents per kilo- watt-hour for the highest electricity users, a rate which is a 63 percent dis- count off of the highest rate paid by those residen- tial customers not under the CARE program (see table below). For more information, visit http://luceroo- liveoil.com/index.php/. “These changes will continue to encourage energy conservation with rates that increase the more a customer uses. They will also put our average CARE rate at around the same level it was in 1991 after two Sat. 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Howev- er, the new CARE rate will not go into effect until November 1 with the start of the winter season. For more information on rates, as well as PG&E’s many programs to help with bill payment and ways to lower bills through more efficient use of energy, customers are encouraged to call 1-800- 743-5000 or visit PG&E’s website at www.pge.com. Residential Tiers Old Rate New Rate Non- CARE Tier One 12.2c/kWh 12.2c/kWh Non-CARE Tier Two 13.9c/kWh 13.9c/kWh Non-CARE Tier Three 29.4c/kWh 29.3/kWh Non-CARE Tier Four 40.4c/kWh 33.3/kWh CARE Tier One 8.3c/kWh 8.3c/kWh CARE Tier Two 9.6c/kWh 9.6c/kWh CARE Tier Three NA 12.5c/kWh