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Saturday, January 14, 2012 – Daily News 5A FEATURES Family favoritism fathers father's fury Dear Annie: How do you deal with ignorant relatives? My wife and I have two teenagers and three children under the age of 12. We live an hour away from family and see them during holi- days, birthdays, cookouts and such. I am close to both of my parents and speak to them daily. I believe they should have a good relation- ship with my kids. We also have nieces and nephews who live an hour away across state lines. Annie's Mailbox by Kathy Mitchell and Marcy Sugar I recently found out that my parents have bought these nieces and nephews cellphones (to keep in touch) and spe- cial notebooks for them to write back and forth, and they also send them lit- tle gifts. Once a month, they are invit- ed to spend the night at my parents' house, while my kids have spent two nights there in four years. When I see my parents, they talk about how they never see my nieces and nephews, but I get to hear all about the stuff they do and their daily email chats. I don't understand how my parents can be so blind. They do nothing with my children. There is no bad blood between us. We are close. All I know is that I am sick of seeing my children hurt and tired of answering questions about why Grandpa and Grandma don't call or let them stay over like they do with their cousins. How do I make this better? — Vermont Dear Vermont: Grandpar- ents sometimes don't realize they are playing favorites, and there are a variety of reasons behind it. Often, they feel they must overcompensate for those kids who need them more. In your parents' case, it's possible that they know you will always keep your children close, but they aren't so sure about the nieces and nephews, so they work harder at it. You need to tell your parents how you feel, and let them know that they are inadvertently damaging their relation- ship with your children. We hope they will recalibrate their energies to be more even-handed. Dear Annie: I am 15 and very overweight. I've been this way since I was little. I've tried losing weight, but can never seem to keep it off for long. What bothers me most is the intol- erance at school. I hear the fat jokes and the whispers. I'd love to have a boyfriend, but the guys in my class only like the skinny girls. This has destroyed what little self-confidence I had. I don't understand why people can't accept all body types. Nowadays you have to be thin to be considered pretty. I want to feel pretty, too, and know that people can like me as I am. Why can't these attitudes be changed? — Confused in Connecticut Dear Confused: That's an excel- lent question. Attitudes like these are culturally entrenched and rein- forced by media images. Fat jokes and nasty whispers are a form of bullying and should be reported to the school authorities. But instead of focusing on romance, simply work on being a good friend. Friends will see you through the rough spots. But we also are worried about you. Extra weight can cause all kinds of physical problems. Please talk to your parents and have them make an appointment for you to see your doc- tor and a nutritionist. Get some exer- cise. Work on being healthy, regard- less of your size. Dear Annie: This is in response to ''Noisy Dog Next Door.'' I don't dis- agree with your suggestions to call the neighborhood association and the humane society, but a quieter solution is available, too. There are battery- operated devices that emit a high- pitched sound that is uncomfortable to the dog. (Humans cannot hear it.) We used this for our neighbor's dog. When he barked, we'd push the button and say, ''No, Fido!'' It worked like a charm. Now we only have to step out the back door for the dog to stop bark- ing. — It's Quiet Again Atrial Fibrillation can be managed Q: My husband has an irregular heartbeat, a con- dition his doctor called "atrial fibrillation." He is 55 years old and in fairly good health, but I am worried that this could become a serious problem. Is this condition some- thing that needs to be treated? If so, what are his options? A: The short answer to your question is yes, atrial fibrillation (AF) is a condi- tion that can, and in many cases should, be treated. The best treatment, however, depends on many factors. Before you can under- stand the treatment options, it will help to know what exactly AF is. AF occurs when the elec- trical signals in the heart, which are responsible for producing a regular heart- beat, go haywire. This causes the heart muscles to contract in an uncoor- dinated way. The result is an arrhythmia — the fancy name for a heart- beat that is too slow, too quick or off rhythm. Many people don't fainting may signal a sub- stantial fall in blood pres- sure due to AF. Dr. K by Anthony L. Komaroff, M.D. In some people, AF is not serious and requires minimal treatment. In others, AF can be danger- ous if not treated. It can put people at risk for heart failure, angina and stroke. Lucki- ly, successful treatments are available to help to prevent these complications. There are three major strategies for treating AF: controlling the even notice that they have AF. Others may notice an irregular or rapid heart- beat or a "fluttering" sen- sation in the chest. People who have heart problems in addition to AF may experience fatigue, short- ness of breath and exer- cise intolerance. Light- headedness, confusion and sometimes even The North State's premier supplier of stoves STOVE JUNCTION The Over 25 years of experience EPA approved stoves are EXEMPT from no burn days! Did you know... Tues-Sat 9am-5pm Closed Sunday & Monday 22825 Antelope Blvd., Red Bluff www.thestovejunction.com 530-528-2221 Fax 530-528-2229 heart rate, restoring a nor- mal heart rhythm, and using a medication called an anticoagulant. A doctor's first choice in treating AF is often to try to control the heart rate. Medication can slow down the racing heartbeat in nearly all people with AF. The most useful drugs are beta blockers (such as propranolol and metoprolol) and calcium- channel blockers (such as diltiazem and verapamil). When rapid treatment is in order, these medica- tions can be injected into a vein, which produces an almost immediate effect. But in most cases, pills are used to maintain long- term heart rate control. Doctors usually adjust the dosage to achieve a rest- ing heart rate of about 60 to 80 beats per minute, or 90 to 115 during moder- ate exercise. Some people with AF may also benefit from 2 Bud's BBQ CHALLENGE! We'll have lunch On your plate Within 15 minutes INCLUDING Drive time from TAKE THE this side of the Hudson River 22825 Antelope Blvd. 528-0799 Downtown Red Bluff The Best BBQ rhythm control. The fastest and most effective way to restore the heart's rhythm is with an electric shock. Though the word "shock" seems scary, the process doctors use to treat AF involves only a small, brief pulse of elec- tric current that is quite safe. And, since patients are given sedatives for this procedure, it is at most mildly uncomfort- able. This treatment, offi- cially called "electrical cardioversion," is most effective when used soon after the onset of AF, but many patients require a period of anticoagulant medication before they undergo cardioversion. Doctors may also pre- scribe drugs to restore and maintain a person's heart rhythm. The choice of medication is tricky and may have severe side effects. Amiodarone is frequently the drug of choice. Other specialized drugs are available, but all of the rhythm-stabiliz- ers can have side effects. That's why cardiologists are usually best suited to manage rhythm control, while primary care physi- cians are able to manage rate control. It is important to note that most people with AF feel fine once their heart rate is controlled. But their well-being is decep- BOOK BARN 619 Oak St., Red Bluff (530) 528-Book 2665 Tues.-Fri. 10am-5pm Sat. 10am-2pm Closed Sun. & Mon. tive, since they are still at risk for stroke. The risk is particularly high in older patients, in patients with a weakened heart muscle, high blood pressure or diabetes, and especially in patients with a previ- ous stroke or mini-stroke (a "transient ischemic attack"). Anticoagulants (blood thinners) can reduce James W. 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But it is also the least effective, reduc- ing the risk of stroke by only about 20 percent. Warfarin (Coumadin) reduces the risk of stroke by about 60 percent. It has been a mainstay of therapy for decades, but it is complicated to manage. Now a new group of anticoagulant drugs is available. The FDA approved dabigatran (Pradaxa) for AF in 2010 and rivaroxaban (Xarelto) this November. They appear to be at least as safe and effective as war- farin and are much easier to use. Unfortunately, they are also much more expensive and are not suitable for all AF patients. If you're thinking that AF is complicated, you're right. But the bot- tom line is straightfor- ward and important. Your husband's doctors should: (1) check for things that might have triggered his AF; (2) get his heart rate under con- trol, and discuss the pros and cons of trying to restore a normal heart rhythm; and (3) take steps to prevent a stroke. Think of these three steps as the ABC of AF. 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